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It is said by many of the natives to cause poisonous effects even if the tree is not touched, but by simply being in its neighborhood.

Many persons are alleged to have been injured from being under the tree during a shower, when the drops of water fell upon them from the tree.

Some persons are more sensitive to the effect of this poison than others. In fact, there are a few who are not affected by it at all, just as is the case with our poison-oak or poison-ivy, the chief difference being that the manchineal affects the mucous membranes, above alluded to, more than the skin proper, whereas the poison-ivy affects the skin much more frequently than it does the mucous membranes.

Many persons of experience in the tropics assert that it is unwise to camp near this tree.

If poisoned by the manchineal, and beyond reach of your surgeon's help, the best thing to do is to wash the part affected freely with salt-water.

It is sometimes called by the natives manzanilla (pronounced man-zane-ya.)- Journal Amer. Med. Association.

THE ROENTGEN RAY IN WAR SURGERY.-The English papers of May 21st give considerable space to a lecture delivered on the previous day before the Royal United Service Institution by Surgeon-Major Beevor, of the army medical staff. The object of the lecturer was to give his experience in the working of the X-ray in military surgery, and to show by the results obtained in the recent frontier expedition in India that the apparatus can be carried on a campaign and be of the greatest possible benefit to the wounded. He maintained, in view of his success, that it was the duty of every civilized nation to supply its wounded in war with an X-ray apparatus, among other surgical aids, not only at base hospitals but close at hand wherever there might be fighting. There is no doubt of the desirability. of having this aid in field hospitals nor of the possibility of furnishing it for the field hospital of a particular expeditionary force, but we doubt the ability of any army medical department, with our present experience of the X-ray, to have it available in the field hospitals of a large army during the hours of activity that follow the incoming of the wounded from a great battle. Surgeon-General Sternberg has provided the apparatus for the Philippine expedition, for the hospital ship Relief, and for the general hospitals to which the wounded from the field hospitals will be sent for treatment; and the experience thus gained in its applicability to war surgery may lead hereafter to a further extension of its use on behalf of the wounded in war.-Ibid.

BELGIAN PHYSICIANS AND THE ABUSE OF MEDICAL CHARITY.-Belgian medical men are said by the German medical journals to be at odds over the question that is attracting the attention of the medical profession almost universally, the abuse of medical charities. Owing to a protest on the part of the Belgian Medical Society that the public polyclinics were treating a

nuniber of patients free who could well afford to pay for treatment, or at least could pay a small fee, and so were depriving physicians of their rights, the Belgian Minister for Medical Affairs drafted a law for the regulation of dispensaries, and of the relations of physicians to each other. This was followed by a series of resignations of prominent medical men from their positions in public dispensaries on the pretext that the government was attempting to meddle in a purely private professional matter. The Ministry has continued its effort, however, to introduce legal regulations of these matters, and there the question rests.- The Philadelphia Medical Journal.

THE HISTORY OF THE MASSAGE TREATMENT.-It is often impossible to determine the origin of our methods of treatment, particularly as most of them date back to the dark ages, when accuracy in detail was not a characteristic feature in medical records. Sweden is usually credited with being the place of origin of the scientific system of massage and physical exercises. This is no doubt correct as far as modern Europe is concerned, but the real originators of massage and physical exercises appear to have been the Chinese. An interesting article appeared recently in the Deutsche medicinische Wochenschrift in which reference was made to a book lately published by P'an Wei, Governor of Hupeh. The author, a great authority on massage, was consulted by the late Empress of China. The Chinese legends contain many references to various systems of physical exercises, and these are associated in a curious manner with metaphysical thought. Life, according to the Chinese traditions, is entirely dependent on "air currents," which are designated as the primary aura of the organism. So long as the body is permeated by the "air current" it is proof against dis

The object of physical exercises is to circulate the "air current." The Chinese system is divided into three periods, each period occupying 100 days. The first period should commence at the time of the new moon. The patient must rise at 4 A. M. and walk outside his house, and take seven deep inspirations; immediately after this two youths, who have been specially trained, commence a gentle friction all over the body, starting over the cardiac area. At the time of full moon a further set of inspiratory exercises must be taken. Later on in the second period the various parts of the body are rubbed with wooden planks until the muscles are hardened. It is not until the hardening of the muscles takes place that the real physical exercises commence. Between the fifth and sixth month is the period of greatest activity; the European dumb-bell is replaced by large sacks filled with stones. In the third period the back muscles are chiefly exercised. Great benefit is said to have resulted from this system.- British Medical Journal.

ease.

THE HEROISM OF A MEDICAL OFFICER.-Sir Walter Foster has submitted the following interesting statement for the consideration of the Secretary of State for India, in reference to the campaign on the Indian

Frontier : “ Lieutenant Ford, of the Malakand Field Force, was dangerously wounded in the shoulder, and was bleeding to death from the bullet having cut the main artery, when Surgeon-Lieutenant Hugo came to his aid. The fire was too hot to permit lights to be used to examine the wound, and there was no cover; nevertheless, the surgeon struck a match and examined the wound. The match went out amid a splutter of bullets which kicked up the dust all round, but by its uncertain light he saw the nature of the injury, and seized the bleeding artery, and as no ligature was available, he remained for three hours under fire holding the vessel between his finger and thumb. When, at length, it seemed that the enemy had broken into camp, he picked up the officer, who was unconscious from loss of blood, and bore him into a place of safety without relaxing his hold of the artery.” Sir Walter Foster has pressed on the authorities the expediency of rewarding in a suitable manner this splendid act of devotion.Ibid.

A POCKET-Knife blade embedded in the skull and projecting for 14 inch into the cranial cavity was an unlooked-for discovery at an autopsy in the Pathological Institute of the Charite (Virchow's laboratory) in Berlin not long ago. The blade had wounded the outer, cellular or periosteal layer of the dura, but had pushed the fibrous layer before it. There had been no inflammatory reaction, and no symptoms seem to have occurred. There was no history to account for the presence of the knife-blade. The friends of the patient could recall nothing that might furnish an explanation for what might easily have proved a fatal wound.-- The Phila. Med. Jour.

FORCED ARTIFICIAL RESPIRATION WITH THE USE OF O'DWYER'S INTUBATION TUBE.-Lowy, of Budapest (Deutsche medicinische Wochenschrift, 1898, No. 19; Wiener klinische Rundschau, June 26th), reports six cases in which he has successfully employed the O'Dwyer method of artificial respiration. The larynx is intubated, and air is forced through the tube by means of a bag connected with it.-New York Medical Journal.

AGAINST DISCRIMINATION.—The Senate, on July 2d, passed a resolution preventing discrimination against graduates of legally chartered medical colleges in appointments to the Medical Corps of the Army, Navy, and Marine Hospital Service.

AWARD OF THE JENNER MEDAL.—The first award of the Jenner medal of the Epidemiological Society of London has been made to Mr. William Henry Power, F. R. S., senior assistant medical officer of the Local Government Board.

PROF. H. OPPENHEIM, of Berlin, has been made corresponding member of the Society for Mental and Nervous Diseases of Moscow, Russia.

DR. B. SACHS, of New York, has been elected a foreign member of the Society of Psychiatry and Nervous Diseases of Moscow.

Special Notices.

CHRONIC GOUTY AFFECTIONS.—In cases of chronic gout, a remedy is generally required which is adapted for long-continued administration in order to obtain any lasting improvement. Most of the drugs recommended have the disagreeable feature of disturbing the digestive organs after being taken for some time or of exciting the aversion of the patient. Lycetol is entirely free from these disadvantages. It has an extremely pleasant taste, is always well tolerated, and has proven a most efficient antiarthritic remedy. Its action in cases of gout is not only to render the uric acid circulating in the blood more soluble, but to promote its excretion by way of the kidneys, owing to its marked diuretic effect. It thus fulfills completely the desiderata of a remedy for aiding in the elimination of the materies morbi of gout, and when administered in connection with appropriate dietetic and hygienic regulations, very favorable results from its use may be anticipated.

INSTRUCTIVE EXHIBITS.--"One of the chief attractions at the annual gatherings of The American Medical Association is always the exhibition hall, where the principal drug, instrument, and food products of the world, the results of years of experimental research and labor, are placed in view.

Among the many attractive exhibits at this year's Denver meeting, that of Imperial Granum, recognized by many leading physicians as the standard among prepared foods, occupied a prominent space, and the representative in charge was kept busy explaining to the visiting physicians the superiority of this preparation. Handsome sample boxes of the food and copies of The Imperial Granum Co.'s valuable clinical record were presented to each physician in attendance.”From The Journal of the American Medical Association, Chicago.

SANMETTO IN URETHRAL AND BLADDER DISEASES-IN PRE-SENILITY AND ENLARGED PROSTATE.-In nearly thirty years' practice I have never written to the proprietors of any medicine extolling its virtues, but after some years'constant use of Sanmetto I can but say it is my sheet anchor in all urethral and bladder diseases. In pre-senility it has no equal. Have recently used it in two cases of enlarged prostate with marked benefit in both cases. BERKELEY SPRINGS, W. VA.

GEORGE E. GILPIN, M. D.

LABOR SAVING: The American Medical Publishers' Association is prepared to furnish carefully revised lists, set by the Mergenthaler Linotype Machine, as follows:

List No. I contains the name and address of all reputable advertisers in the United States who use medical and pharmaceutical publications, including many new customers just entering the field. In book form, 50 cents.

List No. 2 contains the address of all publications devoted to Medicine, Surgery, Pharmacy, Microscopy, and allied sciences, throughout the United States and Canada, revised and corrected to date. Price, $1.25 per dozen gummed sheets.

List No. 2 is furnished in gummed sheets, for use on your mailer, and will be found a great convenience in sending out reprints and exchanges. If you do not use a mailing machine, these lists can readily be cut apart and applied as quickly as postage stamps, insuring accuracy in delivery and saving your office help valuable time.

These lists are furnished free of charge to members of the Association. Address CHARLES Wood FASSETT, Secretary, cor. Sixth and Charles streets, St. Joseph, Mo.

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Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than any thing else.-RUSKIN.

Original Articles.

BULBAR PARALYSIS, DUCHENNE'S DISEASE, AND OTHER LESIONS

OF THE BULB.*

BY H. A. COTTELL, M. D. Professor of Physiology, Histology, and Clinical Diseases of the Nervous System in the University

of Louisville.

The object of this paper is to present for discussion a report of three cases of bulbar disease. One (perhaps two) is of that form known as Duchenne's disease or glosso-labio-laryngeal paralysis. I will preface the report with a few words upon the pathology and natural history of this disease. Of course I can say nothing new upon the theme.

Duchenne's disease was recognized by Robinson in 1825, but it was first inade a matter of careful clinical study by Duchenne, who made an analysis of thirteen cases in 1861. The lesions were located on theoretical grounds in the medulla oblongata by Baerwinkel, Schultz, and Wachsmuth, and later the correctness of these theories was confirmed by autopsies made by Charcot, Joffroy, Leyden, and many others.

Symptoms. According to Gray and Dana, the symptoms are as follows: Vague pain in the neck and back of the head, slight vertigo, a sense of contraction about the chest and breast, and occasional dyspnea. Loss of reflex excitability in the pharynx, larynx, trachea, and esophagus has been noted. But tactile sensibility was maintained. Paralysis, and atrophy of the tongue, lips, lower part of the face, palate, and finally the larynx and heart are the chief visible signs of the disease. *Read before the Louisville Medico-Chirurgical Society, September 23, 1898. For discussion see p. 309.

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