A Journal of Medicine and Surgery, published every other Saturday. Price $3.00 a year, postage paid.

This journal is devoted solely to the advancement of medical science and the promotion of the interests of the whole profession. Essays, reports of cases, and correspondence upon subjects of professional interest are solicited. The editors are not responsible for the views of contributors.

Books for review, and all communications relating to the columns of the journal, should be addressed to the EDITORS OF THE AMERICAN PRACTITIONER AND NEWS, Louisville, Ky.

Subscriptions and advertisements received, specimen copies and bound volumes for sale by the undersigned, to whom remittances may be sent by postal money order, bank check, or registered letter. Address

JOHN P. MORTON & CO. 440 to 446 West Main Street, Louisville, Ky.

A NEW CONTRIBUTION TO THE STUDY OF PNEUMONIA.

The microbian origin and nature of acute croupous pneumonia has been religiously believed in by the progressive pathologist since 1882, when Friedlander discovered in pneumonic exudates the coccus which bears his name, and when the etiological and pathological relationship of the microbe to the disease was all but confirmed through subsequent experimentation by himself, Leyden, Gunther, Talamon, Affanassieu, and others. Nevertheless the doctrine was held with misgiving, since certain important links in the chain of evidence were yet to be supplied. Thus the facts that pneumonia is most commonly a sporadic affection, rarely if ever prevailing under epidemic influence, and seldom under circumstances that would allow one case to stand in causal relationship to another, gave force to the arguments of the doubter, while the scarcely questionable influence of cold as a factor in the etiology of the disease confirmed the skepticism of the skeptics. But the coccus continued to be always demonstrable in true pneumonic exudates, while mice, dogs, rabbits, and guineapigs would develop the symptoms of pneumonia when this exudate was injected into the

pulmonary parenchyma, which in the autopsy would always show red hepatization and more microbes, which could be cultivated and be made means for the further propagation of the disease.

Thus the matter has stood with more than a balance in favor of the truth of the microbian doctrine.

Recently, however, some needed light has been thrown upon the question, under which the truth of Friedlander's conclusions seems to stand confirmed.

The Bulletin de Thérapeutique, December 15, 1889, gives the results of the work of Platania, an Italian observer who, in experimentally following the researches of Friedlander, brings forth some pregnant facts in confirmation of the master's position. These experiments are thus described and commented upon in the Boston Medical and Surgical Journal of January 23, 1890:

"Platania has produced pneumonia by inoculating the microbe by the natural passages, at the same time favoring the result by aseptic traumatism of the lung through the thoracic parietes, or by causing the animal to inhale irritant gases, as ammonia, hydrochloric acid, etc. He has found, as a condition of successful experimentation, that some degree of traumatism at the point of inoculation, whereby the vital resistance of the lung is weakened, is necessary; it was not enough that the pneumo-coccus should be simply inhaled, and all such experiments failed to induce pneumonia.

"Platania has endeavored to ascertain whether chilling of the pulmonary texture, formerly regarded as the direct cause of pneumonia, was also a predisposing condition of the production of the disease in animals inoculated with or made to inhale the specific microbe. Animals after inoculation were placed in a frigorific apparatus for a brief time; these invariably succumbed more readily to the disease with a more elevated temperature and more extensive pneumonic lesions than animals similarly inoculated that had not been exposed to the cold. Out of eleven guinea-pigs inoculated by the trachea and exposed for half an hour to intense

cold, in eight the result was positive and in three negative. If,' he says, 'we compare this experiment with that of simple tracheal inoculation, where in ten cases nine were negative, we are obliged to conclude that the influence of chilling does really manifest itself in our experimentation as a condition which predisposes the organism to cultivate in the lung the pneumo-coccus of Friedlander.'

"Platania also varied the experiment, both in subjecting the animals to refrigeration and in making use, as the material of infection, of dust containing the specific disease germs, which the animals were made to inhale with cold air. Out of eight cases, three were positive and five negative.

"As the complement of these researches, he studied the action of chilling alone. He placed a certain number of animals for a time in an elevated temperature (104° F.), then chilled them in various manners, by plunging them directly in ice-cold water, by inclosing them in boxes surrounded by a frigorific mixture, etc. The results were conformable to those already obtained by other experimenters, that is, there was found a state of hyperemia of divers organs, but never the least focus of inflammation or any thing like pneumonia in any of the animals subjected to the experiments of this kind.

"It is not yet definitely settled whether

the encapsulated micrococcus of ordinary saliva, called by Sternberg micrococcus Pas. teuri, be readily identical with Friedlander's pneumono-coccus. It will be remembered that Sternberg induced pneumonia in rabbits by injecting this microbe; and still more recently Chautemesse has shown by numerous experiments that the injection of two or three centimeters of normal saliva into the lung determines in twenty-four hours the death of the animal, after having produced an intense fever and a red hepatization, with at the same time a fibrinous pleurisy and pericarditis in which the encapsulated micrococci exist in great numbers."

If the experiments of Chautemesse be confirmed, it may be truly said that every man

carries in his mouth the elements of his own undoing, since he may set up pneumonia in himself at pleasure by simply "swallowing down his spittle"-the wrong way.

Notes and Queries.

TENTH INTERNATIONAL MEDICAL CONGRESS. In accordance with the decision of the Ninth Congress, at Washington, the Tenth International Medical Congress will be held at Berlin, from August 4th to 9th, 1890.

By the delegates of the German Medical Faculties and the chief Medical Societies of the German Empire, the undersigned have been appointed members of the General Committee of Organization. A Special Committee of Organization has also been appointed for each of the different sections, to arrange the scientific problems to be discussed at the meetings of the respective sections. An International Medical and Scientific Exhibition will also be held by the Congress.

above decisions, and at the same time corWe have the honor to inform you of the dially to invite your attendance at the Congress. We should esteem it a favor if you would kindly extend this invitation to your friends in medical circles, as way may offer.

We beg to accompany our invitation by at copy of the statutes and programme, as also

by the list of the intended sections and their special committees of organization.

All communications must be directed to the General Secretary, Dr. Lassar, Berlin, NW., Karlstrasse 19.

DR. RUDOLF VIRCHOW,

President.

Regulations and Programme: 1. The Tenth International Medical Congress will be opened in Berlin on Monday, August 4, 1890, and will be closed on Saturday, August 9th.

2. The Congress shall consist of legally qualified medical men who have inscribed themselves as members, and have paid for their card of membership. Other men of science who interest themselves in the work of the Congress may be admitted as extraordinary members.

Those who take part in the Congress shall pay a subscription of twenty marks (one pound stg. or $5) on being enrolled as members. For this sum they shall receive a copy of the Transactions as soon as they appear. The enrollment shall take place at the beginning of the Congress. Gentlemen may, however, be enrolled as members by sending the amount of the subscription to the treasurer, with their name, professional status, and residence appended.

3. The object of the Congress is an exclusively scientific one.

4. The work of the Congress will be discharged by eighteen different sections. The members shall declare upon enrollment to which section or sections they intend more particularly to attach themselves.

5. The Committee on Organization shall, at the opening sitting of the Congress, suggest the election of a definite committee, or bureau, which shall consist of a president, three vice-presidents, and a number (as yet undetermined) of honorary presidents and secretaries.

At the first meeting of each section a president and certain number of honorary presidents shall be elected; these latter shall conduct the business of the sections in turn with the presidents.

On account of the different languages employed, a suitable number of secretaries shall be chosen from among the foreign members. The duties of the foreign secretaries shall be confined to the sittings of the Congress.

After the termination of the Congress the editing of the Transactions shall be carried out by a committee specially appointed for this purpose.

6. The Congress will assemble daily,either for a general meeting or for the labors of the different sections.

The general meetings will be held between 11 and 2 o'clock. Three such meetings will take place.

The time for the sittings of the various sections will be fixed by the special committee of each section, it being understood,

* Treasurer's address: Dr. M. Bartels, Berlin, SW., Leipzigerstrasse 75. Please to inclose a visiting-card.

however, that no such sittings are to take place during the hours allotted to the general meetings.

Joint sittings of two or more sections may be held, provided that the Bureau of the Congress can offer suitable rooms for such sittings.

7. The general meetings shall be devoted to (a) Transactions connected with the work and general management of the Congress; (b) speeches and communications of general interest.

8. Addresses in the general sittings, as well as in any extraordinary meetings which may be determined upon, can only be given by those who have been specially requested by the Committee of Organization.

Proposals relative to the future management of the Congress must be announced to the Committee on Organization before July 1, 1890. The committee shall decide whether these proposals are suitable to be introduced for discussion.

9. In the sittings of the sections questions. and problems will be discussed, which have been agreed upon by the special committees of organization. The communications of those appointed by the committee to report on a subject shall form the basis of discussion. As far as time allows other communications or proposals, proceeding from members and sanctioned by the Committee of Organization, may also be introduced for discussion. The bureau of each section decides as to the acceptance of such offered communications, and as to the order in which they shall come before the meeting, always provided that this point has not been already determined in the sitting itself by a decree of the section.

Scientific questions shall not be put to the

vote.

10. Introductory addresses in the sections must as a rule not exceed twenty minutes in length. In the discussions no more than ten minutes are allowed to each speaker.

11. All addresses and papers in the general and sectional meetings must be handed over to the secretaries, in writing, before the end of the sitting. The Editorial Committee

shall decide whether, and to what extent, these written contributions shall be included in the printed Transactions of the Congress. The members who have taken part in the discussions will be requested to hand over to the secretaries before the end of the day, in writing, the substance of their remarks.

12. The official languages of all the sittings shall be German, English, and French. The regulations, the programme, and the Agenda for the day will be printed in all three languages.

It will, however, be allowable to make use of other languages than the above for brief remarks, always provided that one of the members present is ready to translate the gist of such remarks into one of the official languages.

13. The acting president shall conduct the business of each meeting according to the parliamentary rules generally accepted in deliberative assemblies.

14. Medical students, and others persons, ladies and gentlemen who are not physicians but who take a special interest in the work of a particular sitting, may be invited by the president or be allowed to attend the sitting by special permission.

15. Communications or inquiries regarding the business of separate sections must be addressed to the managing members thereof. All other communications and inquiries must be directed to the General Secretary, Dr. Lassar, Berlin, NW., 19 Karlstrasse.

Editors American Practitioner and News:

NEW YORK LETTER.-It is like getting home again for one who has spent the most important part of his educational career in this great medical center, to return after four years and watch the workings of the great hospitals and clinics. At the Manhattan Eye and Ear Hospital, from which five years ago I resigned the house-surgeonship after two years of service, I find the same familiar faces with few exceptions. Dr. Agnew, the founder and for many years one of the main stays of the institution, is dead. Many of the young men who worked side by side with me are now prominent in

the field of practice in different parts of the country; the others, however, are still working away at the same table day after day, furnishing relief to the suffering, and fitting themselves to fill the places of their elders, when they, like Dr. Agnew, shall be called from their labors. Day in and day out hundreds are given relief at this institution. Since the removal of the hospital into its present building the number of patients treated has increased very much, and its clinics are daily crowded by medical men from all parts of the country seeking clinical instruction. The Manhattan seems to be the most popular of all the eye and ear clinics for Southerners. They are cordially treated, and the material of the hospital is at their command if they seek clinical instruction. Many of the prominent members of the staff were formerly Southerners, and most of its House Surgeons, a position eagerly sought for, has been filled by young men from the same part of our country. Its House Surgeons are scattered all through the South, and are among the most promising specialists in their respective cities.

The first clinic I sought on arrival was my old haunts, and through the kindness of the staff on duty, I spent my afternoon most profitably. In the evening, through the courtesy of Dr. D. D. Pomery, I attended the meeting of the Section on Ophthalmology of the New York Academy of Medicine. The paper of the meeting was by Dr. H. Knapp, on Tuberculosis of the Conjunctiva. Dr. Knapp described in a most interesting manner a case recently under his care. In this case the question of diagnosis was for some time in doubt. When Dr. Knapp saw it there were simply two small ulcers on the conjunctiva, and a history of former nose trouble with some slight destruction of tissue about the nose. Dr. Knapp excised the ulcers, and with the assistance of Dr. Weeks, submitted the excised portions to tests for the tubercle bacilli, also the tubercle in the tissue. He also inoculated the anterior chamber of rabbits with portions of the excised tissue, and in course of several weeks tuberculosis of the iris developed. Dr. Knapp

said tuberculosis of the conjunctiva as a secondary manifestation of tuberculosis in other portions of the body was sometimes encountered, but for the disease to arise primarily in the conjunctiva was exceedingly rare. From a careful research of the literature of the subject he found only two perfectly authentic cases of primary tuberculosis of the conjunctiva.

The question was discussed by Dr. Swan M. Burnett, of Washington, who read the report of a case similar in many respects to Dr. Knapp's, occurring in a negro, in which microscopical and bacteriological examination proved the presence of the tubercle cell and the bacilli.

The discussion was further made interesting by remarks from Dr. Lustgarten, recently of Vienna, who had examined the specimens of Dr. Knapp. He thought, from the history of previous nose trouble, that it was a case of lupus of the conjunctiva secondary to lupus of the nose.

Dr. Lustgarten has recently moved to New York from Vienna. He is extensively known from his writings, especially as the discoverer of the syphilis germ. He is a man of probably thirty-six years, wears glasses, speaks English well, considering only a few months' residence in this country; beard cut after the prevailing Boulanger style. He is a syphilographer of world-wide fame, and no doubt will eventually come to the front in the great city full of active, wide-awake, and progressive men.

Another face familiar to me, but nevertheless always interesting, that I observed in the audience at the meeting, was that of a man of two and thirty years, with small mustache, quick, restless moving eyes that project quite prominently from the orbit, who sat nervously pulling his mustache. He was Dr. Karl Koller, who is now a resident of New York.

His name will forever be connected with cocaine, for it was he who first demonstrated that when dropped into the conjunctiva of the healthy eye cocaine produced an anesthesia so complete that all forms of surgical operations could be performed without dis

comfort to the patient. He too has left Vienna to try to seek fortune in the New World. As for fame, both the name of Koller and Lustgarten are to-day known of all students of medicine, and thousands of patients can daily bless the name of Koller for the relief to pain he furnished to suffering humanity by his most wonderful discovery.

The meeting of the Society closed with a demonstration of cases.

The next day, Tuesday, through an invitation from Dr. Leffert, I went through the new buildings of the College of Physicians and Surgeons and the Vanderbilt Clinic, which have been so generously endowed by the Vanderbilt family. In the throat department I saw a large number of cases, and a young and active staff of six men were required to treat the patients in attendance in two hours. Dr. Leffert tells me that the clinic has grown to such proportions that it requires all the time allotted to his staff to perform the work. The work is done most thoroughly. The rooms are fitted up with. all modern improvements in the way of instruments and cautery and motor battery, and now, instead of giving every patient that presents himself with nose or throat trouble an innocent spray of carbolic acid and borax, or a mild astringent, the source of trouble, which is usually found to be obstruction in the nose from turbinated hypertrophies, deviated septum, or post-nasal adenoid, or in the throat from hypertrophied tonsil, faucial and lingual, is attacked by radical surgical methods, with cautery, saws, and drills, and the source of the trouble eradicated. Thus the patient is relieved.

NEW YORK, January 23.

J. M. RAY.

PURE AIR IN CHURCHES.-Probably all church-goers have at one time or another experienced the irresistible tendency to drowsiness or somnolence that begins to be felt about the beginning of the sermon, and is only finally dissipated on quitting the church for the open air. Many people are inclined to assume rather hastily that pulpit oratory is to be held accountable for the creation of the soporific influences of the