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Tubal Pregnancy, 127.

155; Urethra Prolapse in, 119.

Livesey, T. N., Patoka, Ill., 13.
Tuberculocidin, 74.
Wood-sage, 85:

Lydston, G. F., Chicago, 34.
Tuberculoid Leprosy and Phosphorus, Wood, Dr. T. F. (Obit), 113.

MACFARLANE, W., Pittsburg, 131.
Tuberculosis and Sterility, 28.


McKee, E. S., Cincinnati, 53.
Tuke Centenary (Ed.), 149.

Madigan, M. J., Brooklyn, 125.

Mallison, Elizabeth, St. Peter, Minn., 52.
Typhoid fever, 37, 170; Ascarides and, ALLENL. B. Humboldt, Neb., 21.

, S.

Manley, T. H., New York, 73.
Renal Abscess and, 58: Scurvy and, 157;

Mann, C. A., Chester, III., 178.
Symptoms from Foreign Bodies, 14BALDY L. M., Philadelphia, 147.

Mann, M. D., Buffalo, N. Y., 64.
Treatment, 116; Uterus Atrophy from, Bigelow H. R., Philadelphia, 12.

Matson, E. G., Pittsburg, 105.

Morrow, P. A., New York, 21.
Rorland E. B., Pittsburg, 65.
"Typho-Malarial" Fever, 37.

Murdock, J. B., Pittsburg, 130.
Bowman A. W., Davenport, 46.

Buchanan J. J., Pittsburg, 100.
ULCERS, Leg: 118; Vagina, 148.

NOBLE, C. P., Philadelphia, 147.
Umbilical Hernia, 73.
Umbilicus, see Funis.

CHEATHAM W., Louisville 175.

Christopher W. S., Chicago, 7, 29. PACKARD, J, H., Philadelphia, 159.
Untoward Effects: Atropine, 153; Co-Church A., Chicago, 39.

caine, 96; Exalgin, 115; Sodine, 72; Comegys C. M., Cincinnati, 37.

Park, S. J., Chicago, 161.
Kola Nut, 142; Male Fern, 145; Pheno- Crawford J. C., Davenport, Ia., 136. Perkins, C. E., Sandusky, O., 103.
coll, 116; Quinine, 143; Salipyrin, 142; Crothers T. D., Hartford, Conn., 149. Pitcher, Zina, Detroit, Mich., 167.
Salol, 47;
Silver Nitrate, 64.

Poole, T. C., Mansfield, Tex., 48.
Urachus, 158.

DANDRIDGE N... Cincinnati, 5. Potter, W. W., Buffalo, N. Y., 92.
Ureteral Implantation Rectal, 38.

Dewey R., Kankakee, Ill.

Pusey, W, B., Louisville, 115.
Urethral Application Argyria.64; Inflam-

Dorsett W. B., St. Louis, 148.
mation, Aristol on, 72; Irrigating, 34; Dowling F., Cincionati, 148.
Prolapse, Female, 11y.

Dulaney W. 1., Louisville, 71.

Reed, C. A. L., Cincinnati, 54.
Uricæmia in Children, 53.

Dulles Ć. W., Philadelphia, 175. Reed, R. H., Mansfield, o , 13.
Urinary Meatus Double, 135.
Duncan J. W., Atlanta, Ga., 6.

Reilly, T. W., Springfield, ill., 98.
Uterus A trophy in Girls, 146 Hæmor- Dunlap F., Danville, Ky., 153.

Richardson, G. T., Georgetown, Ill., 48.
rhage; Gossypium in, 162; in a Scro-
tum, 49; taken for a Lympathic Gland, ELDRIDGE J. A., Wareham, Mass., Riggs, J. E., Pittsburg, 127.

Roberts, J. B., Philadelphia, 70.

Robinson, w. D., Philadelphia, 91.
VACCINATION, 168;in the Insane, 125,
FEARRINGTON J. P., Fairon, N. C., Rohe, G. 'H., Catonsville, Md., 132.

, , 69
Inflammation, Aristol on, 72; of Mas GIHONAL. Washington, DC, 1, Sajous, C. E., Paris, France, 122.

Grube E. H., Pittsburg, Pa., 136, Sanger, T. D.. Baltimore, Md., 6.
Masturbation, 70; Ulcers, Alcoholism, 165.

Schmidt, H., Richmond, Minn., 21.
Guttmann P., Berlin, Ger., 93.

Senn, N., Chicago, 120.
Varices, Aristol on, 72; Leg, 118.
Variola, 168 Darkness Treatment of, 144. HA

TAVEN A. C., Lake Forest, Ill., 176.
Vertigo, 39.
Hektoen L., Chicago, 96.

, W, , ,
Virchow (Ed.), 113.
Henning J. A., Garnett, Kas., 116.

Thayer, W. S., Baltimore, Md., 35.
Hersman, C. C., Pittsburg, 27.

Thomas, J. D., Pittsburg, 97.
Visceral Lesions, 136, 137.
"Vis Medicatrix,” 64.
Hughes C. H., St. Louis, 107, 169.

VERITY, W. P., Chicago, 157.
“Vitaline," 16.
Vivisection, 171.

JOHNSTONE J. H., Cincinnati, 137.
Vomiting Stront. Brom. in, 116.

KIERNANJ. G., Chicago, 14, 15, 21, WARRENCE, Boston, 110.
WERLHOFİS Disease, 158.

Wright, T. J., Churchland, Va., 21.
Wilder, Dr., Homicide (Ed.), 82.


ANPHEAR E., Kansas City, Mo., Wyeth, J. A., New York, 15.
Women: Double Meatus in, 135: Evolu- 163.
tion and, 45; Masturbation in, 70, 77, Lemoyne J., Los Angeles, Cal., 82.

ZEIT, F. B., Medford, Wis., 129.
110; Physicians, 14, 19; in Germany; Lewis B., St. Louis, 128.



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The discovery of this or that microbic cause, Among the pleasantest recollections of my or coincident or inevitable consequent of cause, early life are those of my old preceptor, whose of one disease after another, naturally led to the father, himself a favorite pupil of Benjamin deduction of special germicidal agencies for Rush, had conferred the latter's name upon his each, and for a time there was an appalling own son, which doubtless explains my inherited prospect of preventive hypodermic tattooing, admiration for that wonderful man. I recall scarcely less repulsive than the disease, and a how carefully I was indoctrinated with the bebravado resolve to let each particular microscopic lief, which I have not been over-ready to devil do its worst. Multiplying a million a min- abandon, that nosological nomenclature was a ute, it was realized that we could be no match treacherous guide, that diseases were not so for our Lilliputian enemies, whom we could not many entities for which specific antidotes were kill by drugs without at the same time killing to be sought, and that the cardinal points of ourselves. Apace with the bacteriologists' reve- diagnosis to guide the medical pilot were the lations have been the chemists' syntheses, which, grade of action as indicated by the pulse, the however we might be disposed to recommend to state of the secretions and the condition of the our friends and patients, none of us were brave organic fiber. To-day, we go behind these with enough to care to take within our own econo- lens and test-tube to ferret the particular mimies. I confess to no intimate familiarity with crobe, bacterial proteid or chemical toxine, which these latest evolutions of the laboratory, though has disturbed the circulation, obstructed the the names of some I know by sight very well, flow of the secretions, or irritated, inflamed or even if most of them I neither can speak nor disorganized the basis structure of the tissues. can spell. Hence it was a gratifying announce- It would be unpardonable, therefore, if, in an ment that we had within ourselves our address on medicine, however cursory and superdefenders and defenses. “In the blood is the ficial, one should neglect to give due credit to life thereof" began to have greater significance the bacteriological investigators, the scope of through the belief that its living cells devoured whose researches embraces not merely the disthese countless swarms of intruders, and thus covery of disease causation, but the means for prevented their disastrous inroads. It was its prevention and cure. The busy practitioner, enough for us, then, by tonic and alterative, and perhaps, has little time to follow diligently the stimulant and corroborant, to preserve appe

discussion as to whether the bacteria themselves tites of these domestic phagocytes, and see that are the real enemies of health, or only the agents they were always in sufficient force to patrol the for the introduction of their proteid products or avenues of the circulation. So, the homely toxalbumins, ptomaines or other chemical toxphrase of cleansing the blood of its impurities ines, which are the actual pathogeners. He is came back like an old friend in a new dress, chiefly concerned as to the practical results of but already we are called upon to abandon our these investigations. bio-therapeutics, with its war of the microbes

Dr. Sternberg in a recent valuable paper and the final victory of good over evil-minded admi s that until a very late day the bacteriolobacteria, as poetic fancy, and now comes the gist's demonstration of the specific cause in a chemist with potencies, that are marvelously considerable number of infectious diseases had alike in looks, which set sail on their mysterious not resulted in the discovery of a specific treatvoyage in the channels of the blood to neutral- ment for these diseases. Preventive medicine ize the toxic products of each malefic monad. has almost exclusively profited by his researches,

as when the discovery of the bacterial parasite Abstract from Address on General Medicine, Detroit Meeting, A. M. A.

placed tuberculosis among the infectious dis



eases and the destruction of the sputum became bumins not produced by bacteria, but of vegea recognized practical necessity. Of the same table origin, Sewall's showing that immunity order are the precautions of modern aseptic from poisoning by rattlesnake venom may be surgery and obstetrics, and the use of antiseptics produced by injection of small doses of its in traumatic infection and in localized infectious toxic agent, and others strongly support the processes. Sternberg has

described 475

view that all infectious diseases are due to the species of bacteria of which 158 species are action of substances resembling the toxalbumins pathogenic, although all are not differentiated already discovered, and that acquired immunity by morphological characteristics, and the latest from any of them is due to the formation of andiscoveries have established the fact that the titoxines in the blood of the immune animalpathogenic action of those bacteria, which have but while in many infectious diseases the toxalbeen shown to be concerned in the etiology of bumin is produced by a specific micro-organism, specific infectious diseases, is due to the forma- we have no evidence that this is the case in the tion of toxic products during the active develop- strictly contagious eruptive fevers, and none to ment of the bacterial cells, and to isolate these justify a generalization that all infectious distoxines and toxalbumins is now the attempt. eases, as small-pox and scarlet fever, are due to

Recent experimenters, significantly prominent specific micro-organisms. Sternberg suggests among whom were three Japanese biologists, the possibility that in these diseases the toxalhaving demonstrated that the blood of an ani- bumin, which gives them their specific character, mal having a natural immunity against anthrax, is a product of the living cells of the body of if injected into the body of a susceptible animal, the infected individual, and says the inference is protected the latter from anthrax, it was subse- justifiable that the blood and tissue-juices of quently found that the blood of animals having any individual who has recently suffered an an artificial immunity against tetanus or diph- attack of small-pox or scarlet fever, contains an theria injected into susceptible animals, in like antitoxine which would neutralize the active manner, protected them against the effects of poison in the circulation of another person imthe injection of virulent cultures of the bacilli mediately after infection, and he holds the exof tetanus or diphtheria, and finally Dr. Rudoph periment warrantable to ascertain whether a Schwarts, assistant to the surgical clinic at small quantity of blood drawn from the veins of Padua, reported the actual successful treatment the protected person would suffice to arrest or of an advanced case of traumatic tetanus by modify the course of these diseases. The injections of tetanus antitoxine obtained by transfusion of a moderate amount of such blood Dr. Tizzoni from the blood-serum of a dog, might be curative or confer immunity in advance which had been rendered immune against te- of infection, and possibly an antitoxine may be tanus, and three other cases of success with obtained from the blood of vaccinated calves, this same treatment elsewhere have been since which would have a curative action in small-pox. reported.

Dr. Sternberg has himself demonstrated, by Since Behring's experiments, in Sternberg's recent experiments with the blood of vaccinated opinion, suggest the possibility that the potent calves, that there is something in this blood toxalbumin of the diphtheritic bacillus may be which does neutralize the specific virulence of neutralized in the bodies of infected animals, vaccine virus, both bovine and humanized. and the Klemperers having shown the proba- I can hardly close without a passing reference bility that the blood serum of animals which to the malady which is on every tongue, and is have an artificial immunity against cultures of credited with the virulence of a plague—the inmicrococcus pneumoniæ crouposæ, when in- fluenza-the influence whose mysterious grip jected into other susceptible animals, renders upon the physically strong and robust, as upon them immune, Sternberg indulges the hope that the feeble and frail, leaving all alike mentally croupous pneumonia in man may be arrested by and bodily prostrated, has been attributed to a similar mode of treatment. He further says, some occult cause, acting upon or through the from analogy, based upon experimental evi- nervous system. It too is now known to have dence, the successful treatment of tuberculosis its bacterium, the latest micro-organism to be appears to call for the administration of anti- discovered, unless the verification of the Berliner tuberculin rather than that of the active toxic Hospital experiments shall give that distinction principle elaborated by the tubercle bacillus. to the alleged bacillus of measles. The bacterial

Ehrlich's experiments with pathogenic toxal- proteid of influenza has not yet been isolated,

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and when it is, and its antitoxine shall be demonstrated and successfully administered with curative results, a new era shall indeed have begun in general therapeutics.

gr. xxiv

ARISTOL IN CHAPPED NIPPLES.–Vinay (“St. Louis Med. and Surg. Jour.") recommends a twenty per cent aristol ointment as useful in chapped nipples. After suckling, the base of the nipple is firmly grasped so as to open out the cracks, which are then brushed with the ointment.

Surg. Jour.") the treatment of protracted diarrhæas in children under two years of age by the internal administration of bismuth salicylate after the formula: R Bismuthi salicylici.. Gummi arabici.

3 i Sacchari albi...

3 iss Terendo adde Aquæ destillatæ.

3 viii Fiat lac. Tum adde Aquæ destillatæ....

3 xlviii M. S. Shake well before using. Give from one to two teaspoonfuls from three to six times a day.

Each teaspoonful of the mixture contains about one-half grain of the salicylate, which represents a normal individual dose (repeated three or four times daily) for an infant aged from six to eight months. The bottle should be kept in ice or cold water (to prevent nausea, sometimes produced by the salicylate). In emaciated children the remedy, in largest doses, is apt to induce profuse perspiration, accompanied by general weakness. Hence, as soon as the sweating appears, the dose should be correspondingly diminished. In recent cases (of a few days' standing) the salicylate is useless.

EUROPHEN IN BURNS.-Dr. Siebel has (“Berlin klin. Woch.") had excellent results in the treatment of burns and injuries resulting from corrosives and caustics from the use of the following ointment: Europhen..

3 grams Olive oil.

7 grams Vaselin..

.60 grams Lanolin

..30 grams He obtained the best results from this ointment, and what was especially remarkable was the marked diminution of the secretions. Owing to the latter effect it was found possible to leave the dressings in place for three or four days, and to renew them easily and without pain. Many patients were enabled to continue work under the use of a starch dressing. Severe burns of the third degree healed completely after three or four dressings. The longest period of healing (twenty-two days) was observed in a case of severe injury from hydrochloric acid, extending from the elbow to the wrist, over a breadth of five centimeters. It should also be noted that the europhen ointment relieved the pains from the moment it was applied to the burns. In children europhen can also be employed without risk, since it may be regarded as innocuous, at least in the doses which obtain here.

FRACTURES OF THE HUMERUS.—Dr. J. B. Roberts in a paper read before the American Surgical Association arrives at the following conclusions anent the treatment of uncomplicated fractures of the lower end of the humerus: In the treatment of fractures of the lower end of the humerus, the divergent angle between the axes of the arm and forearm must be preserved; and hence, dressings which interfere with the normal difference in level of the radius and ulna are not permissible. Fractures of the lower end of the humerus of ordinary severity are, as a rule, more successfully treated in the extended than in the flexed position, because the “carrying function” is less liable to be impaired. Passive motion at an early date is harmful, and should be deferred until union has occurred and the dressings have been finally removed. Good results as to anatomical conformation and as to motion are generally to be expected, and can usually be obtained. Recent fractures in which satisfactory coaptation is not obtainable under anæsthesia may with propriety be subjected to exploratory aseptic incisions. Old fractures, in which deformity and impairment of function are marked, may, within certain limitations, be sub jected to refracture or osteotomy for the relief of these conditions.

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Whether drunkenness be a disease, a habit, a ing of the patient with such powerful drugs vice or a combination of the three or whether partially paralyzes him, mentally and physically, alcohol be looked upon as the agent to remove and this is important as a means of impressing those not fit to survive, is what the physician him with the idea that some great and remarkcan but have a certain interest in. As superin- able change is taking place in his system. He tendent of the State Insane Hospital at Kanka- naturally believes that he is being reconstructed kee, eight patients have come under my care, from top to toe, and that a great process of who were committed directly after a residence elimination is going on, which, when completed, at Dwight. In the first case insanity had never will make him a new creature in all his appeoccurred until after the Dwight treatment and lites and desires. He is told that his appetite a cure was effected; the second case, one of for liquor will disappear, that he will not care morphine habit, resulted in insanity after the for it any more, and he devoutly believes it. Keeley “home treatment"; not cured of insanity; He is told, perhaps, that he cannot take liquor case three, alcohol habit, sent to Kankakee in- even if he should wish it; that it will disgust him sane hospital after treatment at Dwight; patient and not remain on his stomach. That it will cured of insanity, but still drinks; case four, disgust him is a fact, for liquor is disgusting to alcohol, morphine and cocaine habits, treated at a healthy man. It has been shown that Dwight, relapsed, was wildly insane, recovered Keeley's patients have actually found, as prementally, but still drinks; case five, alcohol and dicted, that they could not swallow whisky, or, morphine, sent to insane asylum from Dwight, if they did, it would be expelled by the stomach. still in asylum; case six, alcohol, morphine and The very fact of the prediction has a great cocaine habits, took Keeley "home treatment,” deal to do with this. It is the same principle sent to Kankakee insane hospital, not insane be- that the mesmerist uses in talking to his subfore going to Dwight, but received insane and jects, the fact that they are in his power; that discharged cured; case seven, alcohol case, in- they must do as he says; that at a certain time sanity developed at Dwight while undergoing they will feel a certain impulse they cannot retreatment, still in insane asylum; case eight, sist to do a certain thing. The hour comes, alcohol case, insanity developed one month after they feel the influence and obey it, providing leaving Dwight, not previously insane, still in they believe what the mesmerist has said. insane asylum.

It is an important question whether there is In each of these cases insanity resulted from any treatment which will remove the appetite the Dwight treatment. There seems to be no for liquor, and it remains to be shown whether doubt that ordinary well-known tonics are com- anything further than the operation of natural bined with some narcotic, and mydriatic drug, causes is required to account for the undisputed probably atropine. As to the presence of gold, fact that a large proportion of Keeley's patients there is great doubt. The moral influences are do lose their appetite for liquor. remarkable, the patients going to Dwight with There is another question about the Keeley an earnest expectation of benefit, which places system to which an answer is required by them in the most favorable attitude for beneficial science and humanity. Dr. Keeley announces results. The powerful influence of an aroused that drunkenness is a disease. He makes no expectation is similar to that resulting from hyp- exception to the statement that it is a disease notization, prestidigitation and mediumistic per- pure and simple. If this be true the question formances and from the apparently miracu- arises why he refuses to treat patients a second lous results of visits to Lourdes or of laying on time. In doing this is he not punishing them, of hands by some people supposed to be en- in his own showing, for their misfortune? What dowed with supernatural powers.

would be thought of any hospital or sanatarium Any person who is powerfully "doped" with which refused to receive a patient with pneustimulating and narcotic drugs, as strychnia or monia or rheumatism because he was guilty of atropine, will, for the time, lose all accustomed having a second attack? It does not answer appetite for other stimulants or narcotics. Ply- this question to say that the effect on others is *A, M. A, Trans. Cond.

bad to take in old cases, though we know the

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