For children and the aged the place is a Paradise, no heat diseases which carry off the little ones so ruthlessly in the Eastern summer, no cholera infantum nor membranous croup, while those advanced in years, sheltered from the cold and cutting winds of winter, with but few calls upon their lessened vitality, live on year after year in happiness and comfort. As for asthma, no one climate suits all cases, nor, I think, even the majority. All I can say is that many have tried this place with success; others unable to live in the town find immunity from the attack at various elevations on the neighboring foothills; some have left us disappointed and unimproved. I must not omit to mention our hot sulphur springs useful in a variety of affections, nor the delightful sea-bathing, pleasant on almost any day in the year, for the rate of temperature of the water never falls below 60 deg., but ranges from that degree to 65 deg., with a yearly mean of 62 deg.

And now in conclusion a few words of caution. In Santa Barbara, as throughout California, the nights are always cool, even in the interior; no matter how sultry the day, the night is never oppressive; one sleeps comfortably under a blanket. This is of immense advantage, and yet it has its drawback. Just before sunset the temperature rapidly falls and the invalid at this time should remain in the house, or, if out of doors and not briskly exercising, should put on an overcoat. Indeed although the climate of Santa Barbara is warm it is not hot; flannels next the skin, with moderately warm clothing, can and should be worn throughout the year. On the other hand, our climate from its pleasant equability approaches the subtropical, and my experience convinces me that the diet of a subtropical climate is suitable to this. Vegetables, fruits, hydrocarbons with comparatively little nitrogenous food or stimulants. Meat once a day is ample. Those of our visitors who bring with them the habits of their former home, eating three hearty meals a day, with perhaps meat at each and more or less wine or liquor, soon pay the penalty in a deranged liver, impaired appetite and weakened digestion.

The Cooper Medical College and the Medical Department of the University of California held their commencements in November. The former graduated eleven and the latter seven.

*STUDIES OF THE DIRECTION OF PUS-CHANNELING IN INFLAMMATION OF THE INGUINAL LYMPHATICS; AND SCABIES AS A FACTOR IN THE MAINTENANCE OF PROLONGED SUPPURATION OF THE INGUINAL GLANDS.

BY D. GRANVILLE MCGOWEN, M.D.,.

Professor of Diseases of the Skin and Genito-Urinary Organs in the Medical College of the University of Southern California.

THE system of lymphatic circulation of the skin is the exact counterpart of its blood vessel system. In both there is a superficial and deep net-work of vessels, connected by straight or anastamosing trunks. In an injected perpendicular section of the skin the superficial net-work of lymph vessels appear directly beneath the superficial blood vessel loops of the papillae.t They also accompany the ramifications of the blood capillaries around the hair-follicles, the sweat glands, the sebaceous follicles, and into the adipose tissue, each fat globule being surrounded as well by a lymph vessel as by a blood capillary.. In their anatomical structure they are simply open spaces, star-shaped on section, in the interlaced connective tissue of the skin, having an elastic coat, and an endothelial lining‡ and converging to form the lymphatic channels..

As they approach the subcutaneous adipose tissue, the section presents a tubular form and the lymphatic commences to form a true vessel furnished with valves. The wall of a lymphatic immediately above the point of attachment of each segment of a valve is expanded into a pouch or sinus which gives to these vessels, when distended, a knotted or beaded appearance. The lymphatic vessels are most abundant where the skin is loose, wrinkled and subjected to extremes of expansion and contraction. On the scrotum, labia majora, prepuce and glands where the skin is richly supplied with papillae, on the fingers, toes, palms of the hands and soles of the feet. These subcutaneous lymphatics are supplied with nutritive blood vessels, but so far no nerves has been traced to them. In

* Read before Los Angeles County Medical Society.

+ Teichman-Das Sangadersystem, 1861.

Reynaud:-Recherches anatomiques sur l'érysipéle et les redémes de la peau. Ar

chives de Physiologie, 1874.

| Grey-Descriptive and Surgical Anatomy, p. 88.

§ Neumann-Zur Renntn, d. Lymphg. d. Haut d. Menchen u. d. Sangethiere-Braumuller, Wien, 1872.

¶ Biesidecki-Untersuchung, an d. Path. Institut in Krakau, 1872.

certain regions, attached to these lymphatic vessels, or formed upon them, are small oval bodies, presenting on one side a depression or hilum through which the blood vessels pass and the afferent vessel leaves the gland. A section of one of these glands presents macroscopically a light cortical and a dark medullary portion; the former being interrupted at the hilum, the medullary portion here reaching the surface, being continuous with the afferent vessel. The afferent vessels empty into the cortical portion on its convex surface.

The considerable time usually necessary for the complete suppuration of a lymphatic gland is explained by its anatomical structure. Each gland is enveloped in a sheath of connective tissue which is reflected on to the blood and lymphatic vessels pertaining to the gland. This capsule sends numerous prolongations into the cortical portion of the gland, thus dividing it into many compartments or spaces, known as alveoli, In the medullary portion of the gland these septæ become thinner and more numerous, forming smaller and closer compartments which freely communicate with the trabecular portion of the gland. In the center the compartments expand once more into larger intercommunicating spaces also termed alveoli. In these spaces lie the gland tissue proper

masses

of lymphoid cells, held together by meshes of connective tissue. processes of the trabeculæ. These cells do not completely fill out the alveoli, but between the trabeculæ and them are channels, which frequently appear in a microscopic section as empty spaces, from the cells having fallen out during the preparation of the specimen, and are known as sinuses or lymph-channels. They are the commencement of the efferent lymph vessels and converge to the hilum.

In inflammation and suppuration of a lymphatic gland I think the explanation of the inflammatory changes which take place and the comparative rarity of general infection from such changes is this: The septic material or ferment entering the gland from a distant center of infection through one of the afferent vessels, it is in the cortical portion that we should look for the most intense primary inflammatory changes. The presSure of the products of inflammation is naturally greatest at its most yielding portion, the region of the hilum, thus: 1st, cutting off the return circulation from the glands by direct pressure upon the veins and the afferent lymphatic vessel; and

2d, probably causing inflammatory changes in the coats of these vessels, with accompanying thrombosis.

In the lower grades of inflammatory changes this lymphatic exudation has time for organization into a low grade of connective tissue thus forming a dam between the seat of suppuration and the general circulation. In these cases we usually find that the medullary portion of the gland has been completely destroyed by the changes of inflammation. The tendency of a confined fluid is always to escape along the path of least resist ance. The pus being prevented from escaping from the hilum along the efferent vessel seeks the most yielding points of the capsule for its points of exit. These points we find at the entrance of the afferent lymphatics, and it is along the track of these vessels that the pus channels to the surface. The course of these sinuses may, to the superficial observer, when viewed from the experience of single cases, seem erratic. But their courses are so constant that in an indolent suppuration of a lymphatic gland we can predict with a positive certainty the direction or directions the pus will take if left to evacuate itself. It is always in the line of the afferent vessels of the gland which is undergoing the process of suppuration. However be it understood that the afferent vessels of one gland may be efferent to another. For instance, directly above the saphenous opening, in the femoral canal, is situated the femoral gland, which is intermediary to the superficial and deep inguinal glands. This gland establishes a comunication between the lymphatics of the lower extremity, walls of the abdomen, superficial inguinal region, and those of the trunk. The lymphatic vessels of communication between it and the deep inguinal glands are efferent to it though afferent to the glands lying next above it. However the rule holds good even here, for it is along this channel that pus burrows to reach the surface in inflammation of the glands of Rosenmuller or the deep inguinal glands. The best instance of this tendency is offered in that most frequent form of glandular lymphatic suppuration caused by the absorbtion of the chancroidal poison by the superficial lymphatics of the penis and its deposition in the nearest lymphatic gland, one of the superficial inguinal glands, usually the first or second. Should the consequent bubo be left to itself, the pus will always form sinuses, and their directions will be constantly along the course of the afferent lymphatics of the gland, usually along those most dependent, but not always so. [TO BE CONTINUED.]

the

CHEMICAL NOMENCLATURE.

[From advance sheets of a Manual of Practical Chemistry.]
BY PROF. J. W. REDWAY.

THE names of the chemical elements are more or less arbitrary, and generally do not conform to fixed rules. A few of the more common ones, such as gold, iron, lead, sulphur, etc., retain their common names. The more recently discovered elements are distinguished by the suffix ine for non-metals and ium for metals. Thus we have chlorine, iodine, etc., and potassium, sodium, alluminium.

Within a few years an excellent but somewhat complex system has been adopted to designate the compounds formed by the union of two or more elements. The following tables, which are intended for reference only, will show the manner in which the names are formed:

In compounds of two elements, or binary compounds, the termination ide is affixed to the non-acid element. Compounds of chlorine are called chlorides; of sulphur, sulphides; of oxygen, oxides; of arsenic, arsenides, etc.

Lead Sulphide,

3

H1 P

or Chloride of Silver.
or Lime.

or Sulphide of Lead.

Hydrogen Phosphide, or Phosphoretted Hydrogen.

Several such compounds have strong acid qualities, and are therefore more commonly called acids, as

H Cl

H Br

Hydrochloric Acid,
Hydrobromic Acic,

In many instances the same portions. Thus we have

or Hydrogen Chloride. or Hydrogen Bromine; etc. elements unite in several pro

or Carbonous Oxide.
or Carbonic Oxide.

or Hyposulphurous Oxide.
or Sulphurous Oxide.
or Sulphuric Oxide.
or Iron Dichloride.
or Iron Tetrachloride.

or Tin Dichloride.

or Tin Tetrachloride.

Unfortunately there is not the uniformity of names desirable to make the chemical nomenclature simple. The names given in the left hand column are the ones usually preferred.