employed on railways. The effect of fog can be produced by smoke or ground glass in front of the colored panes.

LONDON, December, 1889.

Abstracts and Selections.

THE APPROACHING REVISION OF THE PHARMACOPEIA.—“ Eile mit weile." Progress in pharmacy is progress in medicine, and all physicians should be inspired by a desire to improve in every possible way the Pharmacopeia, which represents the accumulated experience of ages in the science and art of pharmacy, and constitutes the most reliable guide to pharmacists and physicians who would acquaint themselves thoroughly with medicinal principles and their effectual combination in eligible pharmaceutical preparations. The value of any addition to the Pharmacopeia suggested by pharmacists should, therefore, receive the earnest consideration of physicians, and the medical profession should be able to furnish from their clinical experience many important and vital suggestions to the committee who are intrusted with the important duties of revision. This committee, indeed, invites criticism from all wellinformed sources, and has widely distributed a Digest of Criticisms of the present Pharmacopeia for the purpose of the freest and fullest discussion by all concerned. It is in this spirit that the following criticisms are submitted.

As the generally accepted standard of strength and quality for medicinal preparations, the United States Pharmacopeia should be most carefully compiled and removed as far as possible from all mercenary influences. One interest which is liable to influence the publication of the next Pharmacopeia disadvantageously, unless such influence is properly controlled and judiciously acted upon, is the manufacturing pharmaceutical interest.

Owing to its wide-spread circulation, its general acceptance as a standard, the Pharmacopeia must exert a very powerful influence both with physicians and druggists in the direction of inducing a larger consumption of pharmaceutical preparations. Thus, houses who own copy-righted, trade-marked, or patented preparations would be willing to pay large sums to induce the Pharmacopeia to recognize the same. The adoption of a new standard of pharmaceutical preparations to substitute existing standards of the present day could be used to great and profitable advantage by the manufacturers if they controlled by copy-right, or trade-mark, or patent, the name of the line of pharmaceutical preparations, or the line itself.

What a profitable thing for the originator, for instance, would be the recognition by the Pharmacopeia of the line of pharmaceutical preparations known as specific medicines, specific tinctures, or green root tinctures as a substitute for the fluid extracts which have been so long in vogue! Shall antipyrin, antifebrin, sulphonal, chloralamid, and many other specialties of foreign manufacturers, who are flooding the country with remedies protected by patented processes or fancy trade-marked names, so as to secure to their possessors a permanent monopoly at any outrageous, price they may wish to arbitrarily fix, be admitted to the Pharmacopeia? Are such remedies and their literature to usurp a place in scientific literature to the disgrace of the legitimate interests of pharmacy, the aggrandizement of foreign capital, and the destruction of pharmaceutical nomen-. clature?

We do not wish to be misunderstood in this matter. We do not wish to reflect on the therapeutic utility of such preparations, but merely to make thoroughly apparent the caution and care necessary to consider the true character and tendencies of the many products advanced for pharmacopeial indorsement.

It is not necessary to amplify on these points. The tendencies of these defilers of the pharmacopeial temple are too well known to ever receive the recognition they covet.

There are, indeed, many actual and muchneeded improvements required in this temple of pharmacy, if we may continue our simile, which have none of the disadvantages, to say the least, of this rapidly growing progeny of foreign invaders. Let the committee address their attention to these. To what standards of excellence do our average manufacturers of medicine live up to at the present time? Are these standards the highest and best known to pharmaceutical science? Not at all; and we shall take occasion, in further comments on this important subject, to mention some improvements in pharmaceutical processes, the claims of which are eminently more worthy of consideration by the Committee of Revision. It will be readily seen that manufacturers of pharmaceutical preparations generally could well afford to bring to bear great influence upon the projectors and controllers of the Pharmacopeia, if they had the slightest hope of inducing the committee to act upon their suggestions.

It is, therefore, essential that the committee in charge of the Pharmacopeia should be actuated solely by a regard for scientific and humanitarian interests. They should be men not only honest in purpose, but they should also be sufficiently competent by experience to judge

as to the merits of each individual presentation. They should be free from all bias and prejudice. Eile mit weile. To make haste slowly should be their guiding rule.-Med. Age.

PREVENTIVE INOCULATION FOR YELLOW FEVER. The following report was presented to the Academy of Sciences, France, by Dr. Domingos Freire, Professor of Organic Chemistry and Biology in the Faculty of Medicine of Rio de Janeiro, Brazil: "The epidemic of yellow fever that developed in Rio de Janeiro in 1888 and 1889, and which propagated itself in several other places in the interior of Brazil, has been the means of demonstrating for the fourth time the value of inoculations by means of the attenuated microbe of yellow fever. The maximum of the epidemic was between the months of December and March, the first sporadic cases having appeared about the end of the month of May, 1888, and the last in June, 1889. During this period there were inoculated 3,570 people, to wit: 988 strangers and 2,582 Brazilians, divided thus: The city of Rio, 2,138; city of Campinas, 651; town of Vassouras, 199; city of Nicteroy, 166; city of Santos, 133; Desengano, a village of 425 inhabitants, 102; Serraria, a small town, 80; city of Rezende, 54; Catagauzes, a village of 2,000 inhabitants, 50. The disease swept with great intensity in all of these spots, and the vaccinations were made, for the most part, during the height of the epidemic. Of the 2,582 Brazilians, there were 1,740 that should be added to the 988 strangers, as this figure embraces not only individuals coming from the interior and resident in the city of Rio for less than six years—that is to say, non-acclimatedbut also children who, according to our experience, are just as susceptible as the strangers them-elves. The rate per hundred of mortality among the vaccinated was 0.078; at Santos, at Rezende, at Serraria, and at Catagauzes the immunity from the disease was absolute. Here is the rate per cent from each locality: Rio, 0.98; Campinas, 0.46; Vassouras, 0.05; Nicteroy, 0.75; Santos, 000; Desengano, 0.09; Serruria, 0.00; Rezende, 000; Catagauzes, 0.00. The mortality from yellow fever among the non-vaccinated was 4,135, divided thus: City of Rio de Janeiro, 2,407 (this includes the dead from the Marine Hospital); Campinas, 812; Vassouras, 15; Nicteroy, 177; Santos, 650; Desengano, 221; Serraria, 21; Rezende, 11; Catagauzes, 20. Among the 4,135 there were about 2,800 strangers, of whom 1,176 died in Rio (and 750 of these in the Marine Hospital), 63 at Nicteroy,500 (about) at Santos, 300 (about) at Campinas, 7 at Desengano, 3 at Rezende, 3 at Vassouras. Thus one fourth of

the deaths were among Brazilians who were unaccustomed to the poison, inasmuch as they resided in localities where the epidemic appeared for the first time this year. In order to make the efficacy of the inoculations more marked, it suffices to remember the proportion established by M. Jemble in Senegal, to wit, that among the strangers who had been there from one to three years, 75 per 100 were attacked by yellow fever, and 68.06 per 100 died. Applying these facts to the vaccinated strangers, or the provincials who had from a few days to three years' residence in the infected locality, we obtain the following results: At Rio we vaccinated 1,183 people under the above conditions, of whom at least 591 should have succumbed to the disease, but only 18 died. Thus 573 lives were saved. At Campinas, a city that never before had an epidemic of yellow fever, and where the 651 inoculated might be considered as new arrivals, of whom 325 should have died, the unsuccessful inoculations were but 3. At Vassouras, 5 should have died; one only died, who was not a recent arrival. At Nicteroy the 11 strangers, under the conditions cited above, should have furnished 5 deaths; one only was a victim. At Santos, of 57 persons under the same conditions, 28 should have died, but the immunity from disease was absolute. At Desengano, the two unsuccessful inoculations were among strangers who had lived from six to eight years in the country. But in view of the fact that the disease obtained for the first time, all of the 102 persons inoculated were as susceptible as strangers who had just arrived. Among them 51 should have died. At Serraria, according to the main calculation, 39 should have died, whereas the immunity from the disease was absolute. The same reflections apply to Rezende, where the 54 vaccinated should have furnished 27 deaths, and at Catagauzes, where the 50 vaccinated should have furnished 25 deaths, in view of the fact that the epidemic made its first appearance in these two localities; still the immunity was perfect, without exception.-N. Y. Medical Record.

TUBERCULOSIS IN MEAT.-The importance of meat tuberculosis is attracting the attention of sanitary authorities, and is no doubt a very serious problem for butchers and graziers. The decision in the Glasgow case, which is now celebrated, and the recent actions at Sheffield, prove that, so far as the health of her Majesty's subjects is concerned, there is a strong opinion of the infectivity of meat from an animal which has suffered from tuberculosis. Last week the sanitary inspector of Wigan seized part of a carcase of a cow which was dressed

for food, and took Mr. Barnish, medical officer of health, to see it. He examined the meat, and from the appearance of the texture could not say that it was unfit for the food of man ; but seeing the lungs, pleura, and intestines, in which tubercles were present, he had the meat taken before a magistrate and condemned. The butcher was summoned before the magistrates (Mr. Roocroft and Mr. Pendlebury), who, after hearing the evidence of Mr. Barnish and his inspectors, fined the man twenty shillings and costs. At the same time, they considered that the defendant was not aware that the meat was unfit for food. The proceedings were taken under the 116th Section of the Public Health Act, and for the defense Mr. Macloghlin was called and two butchers, all of whom considered the meat fit for consumption. This is the first case of the kind in Wigan, and to the butchers of the town is one of serious importance, because undoubtedly a large number of beasts, especially those stall-fed, are subject to tubercles, and hitherto it has been considered, if the meat was unaffected, that is, no general tuberculosis, it could be sold for food without. any danger to man. Mr. Barnish, in his evidence, alluded to the prevalence of tuberculosis in the town, and thought that consumption of this class of food was a cause of it, whereas Mr. Macloghlin thought the reverse, and the following extract of a letter from a very eminent professor of pathology of the University College, Liverpool, was read: "It has not yet been proved that the flesh of tuberculous animals is tuberculous of necessity. There is no legal decision on the subject in England so far as I know." Now this subject is of so much importance that it should be settled positively whether or not the flesh of an animal which has only turbercle in the lungs and no general infection or glandular infection should be destroyed or not. It is too important a subject to depend on scientific opinions only. In the Glasgow case, for example, men of equal scientific attainments and experience gave entirely opposite opinions, so that a poor butcher or grazier might have a cow or the meat of an animal passed by the meat inspector of Birmingham or Leeds, while if he had the same beast dressed in Glasgow or Edinburgh it would be seized and destroyed. No doubt the subject is one of vital importance to her Majesty's sub jects from a health point of view, but even from an economic point it is of very great moment.-London Lancet.

THE WORK ALREADY DONE IN THE DIRECTION OF STANDARDIZING FLUID PREPARATIONS. The first and most notable advance made in the direction of supplying stan

dardized preparations not open to the dangers of the existing pharamacopeia! processes for fluid extracts, was by Messrs. Parke, Davis & Co., who introduced in 1883 a class of assayed preparations which were entitled normal liquids. The standard decided upon for these fluids was the result of long experience in the collection, purchase, examination, and analysis of crude drugs, with a determination of the amount and character of their active principles. The reliability of normal liquids soon led to their large consumption, and the medical profes sion have evinced their preference for them to such an extent as to make them now an established and popular method of exhibiting the toxic and narcotic drugs.

Normal liquids may be defined to be concentrated tinctures, the methods of manufacture of which serve as models for imitation. They represent more closely than fluid extracts made by the present pharmacopeial methods the average standard strength of crude drugs. The simplest explanation of their nature would probably be to regard them as fluid extracts adjusted by assay to a fixed standard of strength which makes them absolutely uniform in composition and therapeutic action.

The favor with which normal liquids and assayed products generally have been received by representative men of the medical profession has led us to believe that the best interests of pharmacy will not be served unless these or like preparations are officially recognized. For concentrated tinctures of a definite strength, the name "normal liquids" appears to be happily chosen, as it implies a definite standard of strength. The list should embrace preparations of the more potent crude drugs, one ccm. representing one gram of drug of standard strength.

It does not seem to us, from a careful review of all efforts made in this direction, that any have met with equal acceptance or merit as much appreciation. Whatever may prove to be the decision of the committee as to making such assayed preparations official, there can never be any ques tion as to whom the honor of their actual practical introduction is due.

As the time approaches when the revision is to take place (and in the minds of thinking men the standardization of fluid extracts is now an accepted fact) there will no doubt be many competitors for this honor who may claim, by reason of a mushroomlike growth in the field of this new departure, official recognition for scientific work.

It will be necessary on the part of the Committee of Revision, therefore, to carefully investigate the claims in this direction, and when awarding the credit for such work to see that they do not place the laurels upon the wrong brow.

Unsupported and disinterested scientific labor, no matter from what source, should always be welcomed with the indorsement of scientific men, and we sincerely trust that the efforts made in this direction by those deserving it will receive full appreciation at the hands of the compilers of the forthcoming Pharmacopeia.-Medical Age.

EMPYEMA OF THE ANTRUM.-At the last meeting of the Odontological Society Dr. Felix Semon read a paper on Some Points in the Etiology, Diagnosis, and Treatment of Empyema of the Antrum. In the great majority of cases the antrum is affected secondarily, the pathological process starting either from the nose or from the teeth; but in some few cases it is quite possible that it has originated in the antrum itself. Any inflammatory process affecting either the mucous membrane or the bones of the nose or the periosteum of the teeth or alveoli may set up purulent inflammation of the antrum. Authorities differ with regard to the relative frequency of these two main causes, but Dr. Semon thinks that clinical observation shows that an overwhelming majority of cases of antral empyema have their origin in affections of the alveoli of the teeth. Bayer, of Brussels, draws e-pecial attention to the frequency of the combination of nasal polypi with purulent catarrh of the antrum, and as exceptional causes may be quoted its occurrence after section of the infra orbital nerve by Malgaigne's method and from the stump of a tooth being forced into the antrum during an attempt to extract it. The diagnosis of empyema of the antrum may be divided into (1) cases in which there is no discharge into the nasal cavity, and (2) cases where from some cause the opening is not patent. In the great majority of cases in which the nasal opening is not obstructed the disease is characterized by a unilateral periodical discharge from one nostril, the periodicity corresponding to the different positions of the patient's head. From the anatomical position of the ostium maxillare the pus can only find exit when the antrum is nearly full or in certain postures, as when recumbent, especially when lying on the sound side, or leaning forward, as in writing. Frontal headache, depression of spirits, and general derangement of health

are frequent accompaniments. With a good light and a nasal speculum the pus may be seen issuing from the ostium maxillare, the superior meatus being healthy. If this is not clear, the nose should be carefully cleansed and the patient directed to lie down for a few seconds on his abdomen on a sofa, with the head low and inclined to the sound side, when, upon resuming the horizontal position, if there is pus in the antrum, a greater or less quantity of discharge will be seen in the middle meatus. Where there is obstruction of the ostium maxillare there will be, in extreme cases, distension of the inner wall of the cavity, and in almost all cases violent neuralgic pains in the face and teeth of the affected side, and often swelling of the soft parts of the cheek, sometimes of an erysipelatous character. In forming a diagnosis it must not be forgotten that disease of the frontal or ethmoidal cells may coexist. Should an exploratory opening be necessary to clear up the diagnosis, it may be made through the nose, the socket of a tooth, or the alveolus, either of the two latter being preferred by Dr. Semon. Heryng maintains that in obscure cases electric trans-illumination is of great value. The patient is placed in a perfectly dark room and an electric lamp of not less than five volts passed into the mouth, when the maxilla will appear red and translucent on the sound side, but dark on the affected one. With regard to treatment, which is essentially free drainage, Dr. Semon decidedly prefers an opening through the mouth to one through the nose, as it is the most dependent part and most easily accessible to the patient for syringing; but in obstinate cases he advocates a counter-opening in the nose, and, that failing to effect a cure, a large opening through the canine fossa and stuffing the antrum with io loform gauze.— London Lancet.

INTESTINAL SUPERDIGESTION. An article with this title appears in the New York Medical Journal of November 9th, from the pen of Dr. W. S. Christopher, of Cincinnati. The term is used to designate the pathological fermentation of the products of normal intestinal digestion. The author's deductions are based upon well-established chemical laws, and, if true, go far toward the explanation of a train of phenomena concerning which our knowledge has been very incomplete.

Christopher's aim is to elucidate the pathology of the intestinal fermentations. He objects to the prevalent idea that fermentation is opposed to digestion; or, in other words, that a food may be either digested or undergo fer

mentation, but can not be both digested and fermented. On the contrary, he believes that the action of the digestive ferments is usually, if not always, a prerequisite to the action of the micro-organisms of pathological fermentation. The process is thus brought into analogy with the alcoholic fermentation of cane sugar; for it is a well-known fact that the latter process can not occur until the sugar has been inverted; that is, transformed into the two glucoses, dextrose and levulose, by a soluble ferment accompanying the yeast plant and probably produced by it. Superdigestion is always induced by micro-organisms, and varies in its results according to the food upon which these develop.

We have, therefore, superdigestion of proteids, of fats, and of carbohydrates; and each of these forms is discussed in the paper.

Concerning the superdigestion of proteids, the author tells us that it may also occur in the stomach, but is there less frequent than in the intestine. In the products of tryptic digestion it is exceedingly common. This differ ence he believes is due less to any doubtful antiseptic action on the part of the gastric juice than to the difference in extent of the digestion or decomposition of the albuminoid molecule produced by the two juices. "The most interesting of the decomposition products of proteids, for our present purpose, are the fatty acids, the ptomaines, and the gases, which latter comprise carbonic acid gas, ammonia, nitrogen, hydrogen, marsh gas, and sulphureted hydrogen." The ptomaines, the most important of these products are alkaloids, and produce their effect through through the agency of the central nervous system. A frequent group of symptoms produced by this putrefaction comprises constipation, headache, drowsiness, and listlessness, or even marked depression-the so-called biliousness." The author has also seen a group of symptoms comprising "constipation, coma, contracted pupils, slow and shallow respiration, and a depressed heartaction."

But he considers the superdigestion of the carbohydrates the most important as well as the most frequent form of intestinal fermentation in adults. Normal digestion converts all the carbohydrates, starch, cane sugar, maltose, lactose, into glucoses. Sub-equent fermentation may convert the glucose into alcohol with liberation of carbonic acid gas; or into one of several fatty acids, which in turn breaking up give rise to carbonic acid gas, and hydrogen or marsh gas. The clinical features and the treatment of this form of fermentation were presented in the report of two cases in which the trouble had been diagnosticated and suc

cessfully treated. The most prominent symptoms were constipation, tympanites, and abdominal pain. The chief feature of the treatment was the withholding of those articles of diet (carbohydrates) in the products of whose digestion the abnormal fermentation was believed to have occurred. However, since total abstinence from the carbohydrates for any length of time is next to impossible (and this implies the exclusion of milk on account of its contained sugar), the author recommends the allowance of a small amount of farinaceous food and the administration therewith of an active diastatic ferment by means of which the starch may be digested in the stomach.

The

We doubt not that Dr. Christopher has given us a true explanation of a certain number of cases of intestinal fermentation; in other words, that he has described a possibility. We regret, however, that he has not given us some data in support of his assertion that this is the most frequent form of intestinal fermentation beyond the fact that such is his individual belief. frequency with which we encounter in these cases gross errors in diet with the passage of undigested food, especially in children, is sufficient evidence that fermentation may occur in food that has wholly or in part escaped the action of the digestive juices. And although the paper is expressly limited to intestinal fermentations, it seems that stomachic fermentations should have been discussed so far at least as to point out the means of distinguishing them from processes occurring in the bowels.

We trust that the author will yet more fully elaborate his theory with especial reference to the relative frequency of superdigestion and its differential diagnosis.-Journal American Medical Association.

STRANGULATED INGUINAL AND FEMORAL HERNIA ON THE SAME SIDE.-T. T., aged sixty-four, laborer, in August, 1888, had consulted me suffering from a strangulated inguinal hernia, which had made its appearance the day before, and which with a good deal of difficulty I reduced by taxis. Since that time he has worn an inguinal truss. On September 12, 1889, after working in a hop-field, he suffered great pain in the abdomen, and in the evening noticed a swelling below his truss. He had constant attacks of sickness during the night, the pain still being very severe. In the morning he came to see me, still wearing his truss. At first I supposed that the old rupture must have slipped down under his truss, which was a new one, but on making an examination I discovered a femoral hernia about the size of a walnut protruding below the truss. The inguinal ring could be felt free and unoccupied.