reader uncertain as to my interpretation of the same, and as it is only right that the reader should expect from me possible definite conclusions that he should know what are my opinions, it is fitting that I should sum up the conclusions which I regard as safely to be deduced from our present knowledge of this subject. These conclusions are:

"1. Bovine tuberculosis is easily conveyed from cattle to cattle and, whether by inhalation (the most common method), by the milk (in calves), by contamination of stalls and drinking water through the agency of the saliva and nasal discharge, through the genito-urinary passages, or by intrauterine infection (very rare), this transmission from one animal of the bovine species to another is far and away the commonest mode of infection in cattle, so common that for practical purposes all other modes may be neglected.

"2 Human tuberculosis is transmissible to cattle. Pure cultures of these bacilli rarely cause infection. Mixtures of tubercle bacilli with other micro-organisms (as in sputum) appear to be more infectious. The difficulty in inducing artificial tuberculosis favors the idea that natural infection of cattle with human tubercle bacilli must be of singularly rare

occurrence.

"3. Swine appear to be fairly easily infected with both human and bovine tubercle bacilli and when infected with the former these gain an increased virulence for guinea-pigs and rabbits. But while through the use of infected milk these animals become frequently infected from cattle, conditions favoring the reverse process are rare. Thus, while it may occasionally be that swine, or possibly other domestic animals, act as intermediaries in the passage of tuberculosis from human beings to cattle, the conditions favoring such transmission from man to the hog, or from the hog to cattle, so rarely show themselves that again, for practical purposes, this mode of infection may be neglected.

"4. If this be so, it should be possible to eradicate bovine tuberculosis in a region in which human tuberculosis continues to be widespread.

"5. Human tuberculosis in the majority of cases is conveyed from human being to human being by inhalation, more rarely it is conveyed through the alimentary tract, still more rarely through the genital tract, through surface wounds, and, from the mother to the fetus, during intrauterine life.

"7. By sojourn in the human body and passage from man to man the human tubercle bacilli have acquired properties differing from those acquired by bacilli which have passed through cattle: their shape differs, the rate of growth and the appearance of the growths outside of the body are different; their virulence towards the animals of the laboratory is also different.

"8. These differences are not, however, sufficiently marked or constant enough to permit us to conclude that we are dealing with distinct. species. On the contrary, the evidence at our disposal points clearly to the fact, that in the different species of animals we encounter at most races of tubercle bacilli which by growth in the bodies of animals of another species take on the characteristics of the race of bacilli peculiar to that species. "9 Bovine tuberculosis can be transmitted to man and this either through wounds or through the digestive tracts.

"10. By passage through cattle, rabbits and guinea-pigs, but lessened virulence for man and (it would seem also) for carnivorous animals.

"11. Save in the very rare cases of wound infection, there is a significant lack of evidence that bovine tubercle bacilli infect adult human beings.

12. It is infants and those of early age who are liable to be infected by the tubercle bacilli of bovine origin and this through the agency of milk. The statistics bearing upon the continued frequency of tuberculosis. in children and upon the relative frequency of intestinal and abdominal tuberculosis in children must be accepted as conclusive evidence upon this point.

"13. Even with children a consideration of the great frequency of bovine tuberculosis in certain regions and of the absence of any record of tuberculosis affecting those supplied from a given "milk round," leads to the conclusion that the bovine bacilli have not heightened virulence.

"14. The few positive records we possess of direct transmission of tuberculosis from cattle to man through the agency of milk indicated that infection is brought about only by the employment of milk of cattle which are very extensively diseased, more espescially of those suffering from udder disease. In other words, large numbers of bacilli are required in order to infect human beings with bovine tuberculosis. This again is an indication that the bacillus cannot be regarded as having gained a heightened virulence for man, and that infection is not very readily communicated.

"15. Animals showing physical signs of tuberculosis (for mild grades of the disease afford no physical signs) and above all, those exhibiting udder tuberculosis, should therefore be condemned and under no conditions should their milk be used for food.

"16. Where there is tuberculosis in a herd, Bang's method should be employed, the animals reacting to tuberculin being separated from the healthy ones; the milk from the reacting animals for whatever purpose used, should be Pasteurized so as effectively to destroy the tubercle bacilli. (Vide previous report.)

"17. The great cause of infantile mortality is inflammation of the stomach and intestines (gastro-enteritis and diarrhea) and this is proved to be mainly brought about by the use of badly kept and fermenting milk. Wholly apart therefore from the question of tuberculosis it is imperatively necessary that greater care should be exercised by all concerned in the distribution of milk, the general measures taken to lessen this, the greatest scourge of childhood (prohibition of use of milk from cattle showing any form of sickness, Pasteurization of milk, etc.), will equally lessen the danger of the transmission of tuberculosis from cattle to man.

"Had this been more fully realized at the agitation (in England more especially) for municipal and governmental supervision of the milk supply and for the distribution of pure milk and based upon what we know concerning contaminated milk in general and its dangers, rather than, as it was, upon the danger arising from the conveyance of tuberculosis, it is safe to say that Koch's address would not nearly have had the same deleterious effect.

"But acknowledging this, Koch is by no means absolved from blame for the manner in which he published his conclusions. It was his duty to have pointed out that those conclusions did not effect in the slightest the legislative and other measures adopted to reduce the danger to cattle and to the agricultural community resulting from the spread of tuberculosis among cattle and the domestic animals. Not doing this he left it to be inferred that legislation against bovine tuberculosis is in excess of what is necessary. And this, it is right to protest, was little less than criminal on his part."

FINDING OF THE TETANUS COURT.-As a result of the investigation to fix the responsibility for the 13 deaths from tetanus following the injection of anti-diphtheric serum in St. Louis, the committee, consisting of the Board of Health and a committee from the city council made the folowing report:

Pursuant to the resolution adopted by the Board of Health on November 25, 1901, in reference to investigating the responsibility of the Health Department as charged in the coroner's verdict in regard to the deaths from the use of diphtheria antitoxin, prepared and distributed gratuitously by the city, the board, after having made, jointly with a committee of the city council, a searching and complete investigation of the matter, does find:

1. That the diphtheria antitoxin heretofore issued by the city was prepared, bottled and distributed by and under the supervision of Dr. Amand Ravold, who was employed by the Health Commissioner, with the approval of the Board of Health, in 1894, as consulting bacteriologist, and to have charge of the preparation and distribution of diphtheria antitoxin, and that he was responsible for the quality of material so prepared and distributed.

2. That a horse kept by the city under the supervision of Dr. Ravold, as a producer of diphtheria antitoxin serum, was bled by him September 29, 1901, and on October 2 was found to have tetanus and was killed.

3. From Dr. Amand Ravold's testimony, the poisonous character of the serum from this bleeding of September 29 was known to him, but he failed to cause the serum to be destroyed.

4. That, owing to this inexcusable negligence, the poisonous serum was, in part, bottled and issued to physicians between October 10 and 23, with the deplorable results which instigated the coroner's investigation.

5. That the bottling of the serum proven to be poisonous was done by Henry Taylor, who was janitor of the City Chemist's office, and assistant, at the time, to Dr. Ravold in the work of preparing the serum for issuance. 6. That it does not appear that Henry Taylor was aware of the poisonous character of the serum at the time, but that his course is reprehensible in that he obscured and retarded the investigation by conflicting statements under oath.

In view of the foregoing finding, the board recommends that Dr. Amand Ravold and Henry Taylor be dismissed from the service of the Health Department. And the board further recommends that the city do not hereafter manufacture diphtheria antitoxin.

2.

OUR MONTHLY QUIZ.

Prizes Open to Fortnightly Subscribers.

TOPIC FOR MARCH.

How do you treat the rheumatic affections, viz.: Rheumatic fever, sub-acute and chronic rheumatism?

TOPIC FOR APRIL.

3. Best arrangement of the sick room in the home.

Answers should reach this office not later than the 15th of the month.
Questions for discussion in this department are announced once a

month.

For the best and most practical answer to any one of these questions we will give a prize of $5.00. To the second best a subscription to the FORTNIGHTLY for the year. The answers must be short, no one answer to contain more than four hundred words. We shall publish the substance of such of the answers as seem most likely to prove interesting to our readers.

Only subscribers to the FORTNIGHTLY will be recognized as competing (although we shall be pleased to hear from others who have ideas to suggest), and all persons known to be engaged in medical journalism are disqualified. Prizes will not be awarded to the same person more than once each year. Every answer must be accompanied by the writer's full name and address.

ON the evening of March 1st a dinner was given to Drs. Corlett and Brayton, who were in the city as the guests of the St. Louis Medical Society, at the Mercantile Club. Dr. O. F. Ball presided.

THE ST. LOUIS MEDICAL SOCIETY.-A meeting of more than usual interest in the annals of our local society was that held on the evening of March Ist. In view of the great prevalence of smallpox throughout the country, a scourge which is not neglecting St. Louis, it seemed wise to devote an evening to this disease. That the meeting might be one of great advantage the commitee invited Drs. Wm. Thos. Corlett, of Cleveland, and A. W. Brayton, of Indianapolis, to address the Society. Thanks to these two authorities the evening was one of exceptional interest to all present.

DR. SANDER CELEBRATES HIS EIGHTIETH BIRTHDAY.-Dr. Enno Saner, he of Garrod Spa fame, had another birthday on the 26th of February, his eightieth, and he is still a younger man than many are at fifty. To celebrate the event a number of his pharmaceutical friends gave him an elaborate banquet at Faust's. The toasts were: "Our Guest," by Henry M. Whelpley; "The Teacher and Pupil," by Prof. Otto A. Wall, Sr.; "Honor to Whom Honor Is Due," by Prof. Henry T. Rohlfing; "The Pharmacist of Old," Christian F. G. Meyer, Sr.; "Continued Honors," by William H. Lamont; "The Pharmacist of Today," Otto F. Claus; "His Absent Friends," Prof. James M. Good. Albert E. Ebert, president and historian of the Chicago Druggists' Association, was toastmaster.

The Reviewer's Table.

Books, Reprints, and Instruments for this department, should be sent to the Editors, St. Louis.

A TEXT-BOOK OF PHYSIOLOGICAL CHEMISTRY.

For Students and Physicians. By Charles E. Simon, M.D., of Baltimore, Author of Simon's Clinical Diagnosis, etc. One octavo volume of 452 pages. Philadelphia: Lea Brothers & Co. (Cloth, $3.25 net).

Physiological chemistry has made very decided and valuable advances during the past few years. Advances which appeal to the student interested in understanding the wonders of the human body, as well as appealing to the essentially practical knowledge necessary to an understanding of the life processes in health and disease. Simon in this volume gives an exhaustive and classical review of the subject, he discusses origin and chemical nature of foods, the products of their decomposition; the processes of digestion, assimilation; the elementary tissues of the organs of the body; their relationship, etc., to physiological function. The laboratory feature of the subject is especially thorough and in keeping with Simon's well established reputation as a teacher and investigator. The book is a deserving companion work to "Simon's Clinical Diagnosis, "and like it will live to become a standard and recognized text-book for students and a superb guide for the thoughtful student physician who wishes to delve into the intricacies of physiological chemistry. Simon has honored American medicine in his pioneer work in this field-a field indeed, which heretofore, has been occupied by foreign authors. We congratulate Simon, his publishers and American medicine on the publication of this most excellent book. F. P. N.

DOSE-BOOK AND MANUAL OF PRESCRIPTION-WRITING; with a List of the Official Drugs and Preparations, and the more important Newer Remedies. By E. Q. Thornton, M.D., Demonstrator of Therapeutics, Jefferson Medical College, Philadelphia. Second Edition, Revised and Enlarged. Octavo, 362 pages, illustrated. Philadelphia and London: W. B. Saunders & Company, 1901. (Bound in flexible leather, $2.00 net.)

The volume will prove of value to the practitioner of many years' standing, for purposes of reference, as well as a text-book for the student. In the revision additions have been made to the chapters on "PrescriptionWriting" and "Incompatibles," and references have been introduced in the text to the newer curative sera, organic extracts, synthetic compounds, and vegetable drugs. To the Appendix, chapters upon Synonyms and Poisons and their antidotes have been added. As in the former edition this volume will be a valuable work of reference for the practitioner, full of practical suggestions. To the student such a book is indispensable. Prescription writing with such a guide will not become a lost art, but, on the contrary, will become a credit to scientific medicine and applied therapeutics.