meteorological phenomena that they are especially fortified against the invasion of the tubercle bacilli. Our experiments seem to demonstrate clearly that immunity does not proceed from the first of these theories, and that by every logical right it may be attributed to the second proposition.

Let objectors say what they may, the mountains are the "city of refuge" to the victim of tuberculosis. Altitude and dry air fortify the system against tuberculous invasion. The improved surroundings limit the disease in those who are not already too far gone, or fatally susceptible, while strict sanitary regulations can and should keep it from attacking the uninfected.

Notes and Queries.

CERVANTES AS PATIENT AND AS PHYSICIAN.-It is related that Sydenham, being asked by Blackmore (afterward pilloried in the Dunciad for his epics "writ to the rumbling of his chariot wheels") what works he should read to improve his medical knowledge, answered, "Read Don Quixote. It is a good book. I read it still." It is probable that our English Hippocrates merely wished to snub a pert youth; but, rightly understood, the advice might with advantage be followed by physicians more largely than it is, especially in these days, when the absorbing pursuit of the microbe tends to make us forget that there is also a macrobe which deserves attention. The physician has to deal with man as a whole, and the human body, whether it be regarded as a piece of "foolish-compounded clay" or as "the Lord's anointed temple," is something more than a happy hunting ground for bacilli. The great creative works of literature in which human life is depicted by men who, in the words of Matthew Arnold, have seen it steadily and seen it whole, and in which the workings of the complicated machinery of man's nature are made visible, can, if rightly studied, give the physician a knowledge which he will find most useful in his practice, and which can not be got from medical books or learnt in the laboratory or the dead-house. For those who appreciate the value of such knowledge, Don Quixote is indeed "a good book." It is a proof of the broadminded view which the University of Paris takes of the art of healing that the other day it accepted a thesis, entitled "Cervantes, Patient and Physician," from a candidate for the degree of Doctor of Medicine. The author, M. J. Villechauvaix, has not, we are bound to say, made the most of his subject, but his essay is interesting as far as it goes, and he appends a bibliography likely to be useful to any one who may wish to make a deeper study of the creator of Don Quixote in his medical aspects. Cervantes was born on October 9, 1547, and died after a life full of suffering, ill-health, and

evil fortune of all kinds on April 23, 1616. He contracted malaria during a visit to Rome early in life, and on the very morning of the famous battle of Lepanto (September 7, 1571,) he was so ill with ague that the captain of the ship on which he served tried to induce him to remain below. He insisted on fighting, however, and received three arquebuss wounds, two in the chest and one on the left hand, which was permanently disabled. He was six months in hospital at Messina, and his wounds were yet incompletely healed when four years later he was made prisoner by Algerian corsairs on the high seas on September 26, 1575. For five years he was held captive by the Moors, suffering much ill-usage at their hands, but at last forcing them, out of fear of the influence which his indomitable spirit gave him among his fellow-prisoners, to set him free. He died of dropsy, which M. Villechauvaix surmises to have been of cardiac origin, but there is really no evidence on the point. There is a tradition that Cervantes. studied medicine, and there are in his works many passages which show that he had a considerable acquaintance with the art of healing as it was. understood in his day. During his Algerian captivity he ministered to the needs of his fellow-prisoners in sickness with a skill which bespeaks, if not special training, a considerable experience in dealing with disease. How close and accurate an observer he was is shown by the wonderful picture of delusional insanity which he gives in Don Quixote. M. Villechauvaix points out that he anticipated Pinel in the rational treatment of insanity. The books of chivalry which disordered the brain of the Knight of the Sorrowful Countenance are destroyed, and every effort is made to create a new mental environment for him, his very delusions being skillfully taken advantage of to this end. It is somewhat strange M. Villechauvaix should have made no reference to Sancho Panza's famous physician, who in his strict views as to diet may perhaps be looked upon as the scientific forerunner of Sir Andrew Clark. He quotes, however, an apothegm that the "stomach is the laboratory in which health is manufactured," which shows that Cervantes had very sound views as to the important relations of the digestive to other functions of the body.-British Medical Journal.

BULLETS IN THE Brain and THE ROENTGEN RAYS.-Von Bergman (Berl. klin. Woch., May 2, 1898,) refers to thirty-two cases of bullet wounds of the brain which he had observed, and in which the bullet has been left undisturbed. Of these eight were severe cases, and the patients rapidly died. Of the remaining twenty-four, nineteen recovered, and these had remained well. Of the other five, two developed an abscess of the frontal lobe, and both subsequently died, although the abscess was opened; two others died apparently from a suppurative meningitis, and the fifth had not been heard of. The patients who recovered either showed no symptoms or were unconscious for a short time, or had a local paralysis or spasm. It is possible that in the first-named group of cases the bullet did not penetrate the brain substance. Thus it becomes important, as Eulenburg has shown,

to determine the situation of these bullets by the Roentgen rays. The author gives details of two cases examined in this way. Case I occurred in a woman, aged twenty-eight, who shot herself in the head when cleaning a loaded revolver. There was severe pain in the head and vomiting, but no loss of consciousness. The site of entry of the bullet was on the nasal side of the left upper eye-lid. There was no paralysis. The wound was healed in the second week, and the patient subsequently recovered from an exophthalmos and choked discs. The situation of the bullet was found by the Roentgen radiography to be in the white matter of the occipital lobe. Case 2 was that of a man, aged twenty-five years, who was wounded by a revolver shot in the right temporal region three years ago. He was unconscious for three days, and had a left hemiplegia and partial anesthesia. His sight was also impaired and the hearing in the left ear. Very considerable recovery followed. Within the last six months, however, there had been severe attacks of pain in the head, chiefly limited to the right side. Here the situation of the bullet was at the junction of the anterior two thirds and posterior one third of the hinder limb of the internal capsule, and this was confirmed by the Roentgen rays. The patient wished to have the bullet removed. During a stay of three weeks in the hospital there was no return of the pain, and the patient was eventually dissuaded from an almost certainly fatal operation. Von Bergman says that both cases supply evidence in favor of leaving these bullets alone. The treatment should consist in not searching for them, and in a most rigid protection of the wound against infection. When the bullet lies in or near the bone without penetrating the brain, the treatment prescribed may not be suitable, and the Roentgen radiography should determine the situation, and hence the treatment. The author refers to a case in which the bullet had not even penetrated the skull, but lay outside it.-Ibid.

AN EARLY SYMPTOM OF MEASLES.-Slawyk, of Heubner's clinic (Deut. med. Woch., April 28, 1898,) draws attention to the eruption present in the mouth during the early days of measles, first described by Koplik. It consists of shining red spots, in the middle of which there are very minute bluish-white efflorescences. Slawyk says that Koplik's spots have not received the attention which they deserve, and that they represent an absolutely trustworthy and early indication of the disease. During last winter an epidemic of measles broke out in some of the clinics of Berlin Charite. These cases, along with those of Heubner's clinic, numbered fifty-two cases, and in forty-five of these Koplik's spots were observed. In two of the remaining cases the patients were too ill to permit of a satisfactory examination of the mouth. The spots appeared on the mucous membrane of the cheek and sometimes of the lips. They are mostly few in number. A bright light is necessary, as they are not visible in a yellow light. They practically never run together. They are distinguished from thrush by

their color and their rounded contour. They may be picked off with the

forceps without pain or bleeding, and they are then seen under the microscope to consist of large masses of epithelium undergoing fatty changes. They have not been observed in other acute illnesses. In every case where they were seen the measle rash followed, so that whenever they were present the child was at once transferred to the measles ward. Koplik spots appear on the first or second day of the disease, and increase in numbers up to the time of the skin eruption; they usually further remain for three or four days, so that they last from three to six days. They produce no discomfort. In some cases of measles followed by a stomatitis they were absent. No prognostic significance can be attached to them, as they were present both in mild and severe cases. Details of eight illustra

tive cases are given.-Ibid.

PUERPERAL MYELITIS.—Brush (Medical News, New York, March 26, 1898,) reports five cases of this complication of the puerperium. In every case the patient had been in good health up to the time the disease in question made its appearance, and the symptoms began with loss of power, numbness or anesthesia, and incontinence or retention of urine; in the five cases the onset dated from "the getting up," and the tenth, seventh, fifth, and third days after labor respectively. The later results were as follows: Case 1, four years later: spastic paraplegia, diminished sensation, slight ataxia of the arms, feebleness and incompleteness of the act of urination. Case 2, five months later: spastic paraplegia, return of sensation, improvement in the incontinence of urine. Case 3, sixteen months later: complete paraplegia with partial loss of all forms of sensation and absence of reflexes, no incontinence of urine, atrophy of the paralyzed limbs. Case 4, eight months later: spastic paresis, return of sensation, improvement in control of bladder and rectum. Case 5, sixteen months later: spastic paresis, return of sensation, retention of urine alternating with incontinence. The author regards it as probable that septicemia was the etiological factor, since in all the cases there was either a history of a febrile movement, not due to any other assigned cause, or of injuries to uterus, cervix, or perineum, through which septic infection might readily have entered.-Ibid.

GALL-STONES IN NEWLY-BORN INFANTS.-John Thomson (Edinburgh Hospital Reports, vol. v,) records the case of a male child who became jaundiced two days after birth, and, getting steadily weaker, died on the twentieth day. The urine was brown; the motions yellow, and later green, but never clay-colored. There was no ordinary meconium, but yellow matter like ocher was passed. At the necropsy no abnormity of the bile ducts was noticed; the liver was normal to the naked eye, but microscopically showed commencing cirrhosis and some fatty infiltration. The gall-bladder contained one calculus weighing 25 mg. which was elongated and constricted in the middle, a smaller one, and several fragments. Their combined weight when dried was 30 mg. Their composition showed billi

verdin and traces of cholesterin. The author has collected six other cases with biliary calculi in which jaundice was present either at or immediately after birth. In all death occurred within one month. In the only two in which a description of the bile ducts is given abnormities were found. Probably in this class of cases the same conditions are present which give rise to congenital obliteration of the bile ducts.-Ibid.

THE twenty-fourth annual meeting of the Mississippi Valley Medical Association will be held at Nashville, Tenn., October 11th-14th, under the presidency of Dr. John Young Brown, of St. Louis, Mo.

This Association is second in size only to the American Medical Association, and has done most excellent scientific work in the past. The annual addresses will be made by Dr. James T. Whittaker, of Cincinnati, on Medicine, and by Dr. George Ben Johnson, of Richmond, Va., on Surgery. The mere mention of the names of these gentlemen establishes the fact that the Association will hear two scholarly and scientific addresses.

Nashville is a most excellent convention city and is well equipped with hotels, and with the record of the meeting in Louisville in 1897 as an example, the local profession, under the leadership of Dr. Duncan Eve as Chairman of the Committee of Arrangements, has prepared to have a better meeting.

Already titles of papers are being received. These should be sent to the Secretary, Dr. Henry E. Tuley, No. 111 West Kentucky Street, Louisville, Ky., as early as possible to insure a good place upon the program. Reduced rates on all railroads will be granted on the certificate plan.

DR. HENRY P. BOWDITCH, of Boston, is to receive the honorary degree of D. Sc. from the University of Cambridge when he is present at the meeting of the International Zoological Conference in that city in August. The other recipients of the honor will be Drs. Camillo Golgi, of Pavia; Willy Kühne, of Heidelberg; Hugo Kronecker, of Berne; and Sir William Turner, President of the British Medical Council.-Medical Record.

HENOCH'S PURPURA.-The disease occurs much more frequently in children, and the principal symptoms are: (1) pain in and near a joint; (2) a purpuric or erythematous eruption; (3) abdominal pain accompanied by vomiting and diarrhea; and (4) hemorrhagic nephritis. In typical cases all these symptoms are present; in other cases one or other of the symptoms may be absent. Relapses are very common.-Dreschfeld, in Medical Record.

COLIC and flatulence, as evidenced by the signs of abdominal pain and also vomiting may often disappear with regulated diet. These symptoms are usually much relieved by bicarbonate of sodium with syrup of ginger or spirits of chloroform. Bismuth too may be given with good effectpeppermint, caraway, or cinnamon water being useful excipients.—Donkin, "Diseases of Children," page 21.