gone. But the solemn truth remains that we are fighting a most unequal battle with Death, whose sentence of execution upon the victim may be sometimes suspended, but never commuted or set aside.

In the election of Dr. C. H. Hughes, of St. Louis, to the presidency the society pays just tribute to one of its oldest and most eminent Fellows.

Too much can not be said in praise of the work of the energetic and almost ubiquitous chairman of the Committee of Arrangements. To making the Louisville meeting a success, Dr. Bloom devoted without stint his valuable time and the best of those rare qualities which distinguish him as a physician and a man. In the result he has the congratulations and the gratitude of all.

The president, Dr. JM. Mathews, came to the chair from a sick-chamber. Though in a state of physical weakness, that heavily taxed his strength he was at the desk at every session, where he presided with dignity, and good judgment.

Our next issue will contain a report of the proceedings and the full text of some of the papers read.

Among the Fellows we were happy to greet many old friends, classmates, and pupils. There were also among these not a few who now take their place upon our above noted ever open list.

Long live the Mississippi Valley Medical Association. "May its shadow never grow less," and may the sun of science soon cast it this way again!

Notes and Queries.

PATENT AND SECRET NARCOTIC PREPARATIONS. The recent discussion by the Society for the Study of Inebriety of proprietary preparations containing alcohol, opium, and other narcotics seems to have aroused considerable interest throughout the country. In America, according to Dr. Craighill, of Virginia, one chloral preparation has made a large number of chloralo-maniacs. Of twenty loudly vaunted "cures" for opiomania nineteen contained

The

opium in considerable proportion; the twentieth possessed the negative virtue of being innocuous, containing only granulated sugar. extensively advertised "cures" for alcohol addiction were composed largely of alcohol, most of them being stronger in intoxicating properties than many varieties of ordinary alcoholic beverages. The discussion brought out the fact that similar mischief is wrought in England, though not to so great an extent as in the United States. It is difficult to suggest a remedy under the existing state of the law. If people will-and we fear they will in increasing numbers-purchase and consume perilous articles, the composition of which is unknown to them, one thing, as proposed in a resolution of the Society, the legislature might do. We advocate as a remedy an act making it penal to sell any proprietary medical preparation unless the composition is printed on the cover.-British Medical Journal.

SEVERE AFFECTION OF THE VAGUS NERVE THE RESULT OF THE POISON OF INFLUENZA.— The following case, which came under my notice in the month of February last during the severe epidemic of influenza which prevailed here at that time, was related in the Section of Medicine at the late meeting in Birmingham during the discussion on Functional Disorders of the Heart, but owing to my accidental omission to prepare it for the press it was omitted from the account of that discussion in the British Medical Journal of August 16, 1890.

The case appears to illustrate in a very striking manner the effect of atmospheric conditions, especially those of an epidemic character, upon the heart's action, as well as upon the actions of those other organs supplied by the vagus

nerve.

An elderly medical man, previously in good health and entirely free from any heart affection, was seized one day with a peculiar feeling of debility, with oppression of the cardiac region, but without any pain. He went about his work as usual, but it was with difficulty and languor. There was no cough or bronchial affection, and the appetite was as good as usual. On retiring to rest he felt deadly cold, and

then, for the first time, felt the pulse, which was beating in the most irregular and feeble manner, about 20 only in the minute being felt at the wrist. The feeling was entirely that of impending death, but there was no pain at or near the heart, and no sickness. A neighboring medical man first prescribed strophanthus in good doses, hot brandy and water, heat to the body, etc. In six hours the pulse became regular and much as usual. The impression at first was that this was an attack of angina, but angina without pain seemed an anomaly and a contradiction in terms. The next night there came on a violent spasmodic and exceedingly irritative cough, which lasted for several hours without intermission. The second and third

nights were the same. This passing away, there supervened a violent gastric catarrh, which lasted for several days. When the cough appeared the patient began to think that the first attack was not of an anginal nature after all, and when the dyspepsia arrived he felt quite certain of it, for the affection of each of the three divisions of the vagus nerve in turn satisfied him that a poisonous influence of some kind had attacked its center; and what more likely than the poison of influenza?

Judging by this experience as to how life might have been and was very nearly cut short by the influence of this poison, it in no way taxes our credulity to believe in the rapidity with which death ensued in the epidemics of the middle ages, or even in the strict truth of the Scriptural account of the destruction of Sennacherib's army in a single night.

Given a little addition to the virulence of atmospheric poison during the epidemic of last winter and spring, that epidemic might easily have counted its victims by thousands and hundreds of thousands.-Dr. William Strange, in British Medical Journal.

CYANIDE GAUZE AS A DRESSING: REMARKS IN A HUNDRED CASES.-(A. S. Barling, House Surgeon.) The cases on which the following observations are made are the first hundred which were dressed with cyanide gauze in this hospital. They occurred in the ordinary course, and have not been picked in any way. This

being the case, some of them are of necessity slight, but the large majority are not. The list includes eight abdominal sections, six compound fractures, and nine hernias, besides the usual run of amputations, osteotomies, excisions of tumors, and incisions of abscesses. The first case was admitted on December 2, 1889.

The great advantage claimed by Lister is that this dressing does not cause irritation of the skin. How does our experience bear on this point? There is no doubt that with the carbolic and sal alem broth gauze, whatever care was used, a certain number of cases suppurated, this suppuration being apparently directly due to the irritation of the dressing. A case occurs to me which bears strongly on this point.

A boy was admitted here with a compound depressed fracture of the skull. The wound was cleaned most scrupulously and dressed antiseptically with sal alembroth gauze. All went well for a week, when on dressing it a large crop of pustules was found covering the whole, of the skin which had been in contact with the sal alembroth. On again dressing it two days afterward the discharge from the deeper parts of the wound, which up to then had been serous, was purulent. There was never any rise of temperature, pointing to the fact that the suppuration was not septic in origin. I may add that this was not accounted for by the gauze being put on too wet, as it was wrung out as dry as possible.

In none of the cases treated by cyanide gauze has this effect been produced, so that our small experience goes to prove that on this point the dressing fulfills all that is claimed for it. Its antiseptic properties, regarded purely from a clinical point of view, seem to be as great as those of the blue gauze, and the cyanide does not dust out to any appreciable extent.

One more point. The powers of absorption of the cyanide gauze are much less than those of the sal alembroth, or perhaps I ought to say are exercised much more slowly. This was shown by the following simple experiment: Two exactly similar pieces of the two dressings were dropped simultaneously into water; the blue gauze sank in two seconds, while the other was left floating at the end of ten minutes.British Medical Journal.

MILK AND ELECTRICITY.--An Italian scientist, Tolomei, has made a study of the souring of milk by thunder storms, and concludes that this rather annoying phenomena of the dairy and household is explicable on the ground of the production of ozone during such storms. It may not act directly upon the milk to sour it, he thinks, for he prefers not to ignore or discard the prevailing opinion that the change is due to the presence of the bacterium ferment and is allied to other fermentations. He assumes that in the presence of ozone, when it comes into contact with the upper surface of the milk-in the form of a layer superimposed on it, without agitation--the bacterium finds its most favorable conditions of propagation. Some experiments made by Tolomei go to show that ozone, when electrically generated without detonation, effects the souring of milk more rapidly than when its liberation is abrupt and accompanied with report.-Journal American Medical Association.

A SUBSTITUTE FOR TOBACCO-Many different vegetable substances used as stimulating beverages in widely distant parts of the world have been shown to contain caffeine as their active principle. Only one substitute for tobacco has, however, as yet been discovered. This is the leaves of the Duboisia Hopwoodii, a shrub growing in Australia, the leaves of which are chewed by the blacks in the same way and for the same purpose as tobacco is chewed. The leaves contain an alkaloid piturine, which is said by certain chemists to be identical with nicotine, but more probably is only closely allied to it. Messrs. Langley and Dickinson have recently shown that the actions of nicotine and piturine are in every respect identical. British Medical Journal.

TREATMENT OF CHOLERA BY THE CHINESE. -Dr. Alexander Jamieson, in his report on the health of Shanghai to the InspectorGeneral of Customs, states that the Chinese have many specifics for cholera, all equally inert. A few years ago all the dead walls in the settlement and suburbs were covered during the autumn with posters recommending a nostrum which on examination turned out to be

essential oil of peppermint. The native internal treatment is stated to be unintentionally evacuant, consisting of warm, bulky infusions and decoctions of nauseous herbs, which the patient rejects as soon as swallowed. Patients brought moribund into the hospital at Shanghai show that external applications also have been tried, such as scraping of the skin of the neck, moxa to the chest and limbs, and acupuncture here and there.-British Medical Journal.

THE HEART-BEAT AFTER DEATH.-A few days ago a criminal was executed at Epinal, France. Immediately after the execution, which was effected very rapidly, the corpse was given over to Dr. Gley, Professeur Agrégé at the Paris Medical Faculty. The heart-beats were observed during six minutes after death. Dr. Gley was able to study auricular and ventricular contraction, which he observed to be independent of each other. Dr. Halletté examined the dead body of another criminal executed at Montreuil, and detected the heartbeats a quarter of an hour after death.

CURING CONSUMPTION BY INOCULATION.Whatever may be the results of Dr. Koch's experiments, about to be made, of curing consumption by inoculation, they are sure to lead to considerable disagreement among doctors; and, though success should crown his efforts, it is safe to predict that years will be required to introduce the process. In the meantime we may expect a renewal of the discussions that attend every proposed system of inoculation. for any purpose. The importance of finding a cure for consumption will, however, excite general interest in the experiments to be made. -Times and Register.

DEATH UNDER CHLOROFORM.-On Saturday last Mr. Wynne Baxter held an inquest at the London Hospital concerning the death of a man aged fifty one, who was admitted into the institution suffering from abscess of the thigh and an affection of the spine. On August 23d an operation became necessary, and was quite successful, chloroform having been adminis tered. On the 3d inst. it became necessary to probe the abscess, for which chloroform was

again given; but, according to the report before us, death ensued before the patient was fully anesthetized. Mr. Andrew Smith, the house surgeon, stated that at the necropsy the heart was found healthy, though poorly nourished, while the lungs were not in the least affected.-London Lancet, September 13th.

TRANCE FOLLOWING INFLUENZA.-Dr. H. Appleton writes to the London Lancet: A lad aged sixteen years, who had always been healthy, contracted influenza toward the end of January. He was not then under my treatment, but was nursed in bed for a day or two. Having to attend to his duties as under-groom, he went to his work before the influenza had quite passed off. After a week's illness he was sent home, when he came under my care, suffering from mental derangement with continual delirium by day. He threw an infant on the ground, attacked a child with a poker, and ran about the house half dressed; but at night he rested well without an anodyne. Aperients were administered, and he was carefully watched. In ten days' time his mind and recollection returned, and he went back to his place.

DR. CHARLES B. PENROSE, of Philadelphia, on August 25th, swam fifteen miles in the Delaware River in five hours and five minutes. His competitor, Mr. Robert Ralston, made the

distance in five hours and thirteen minutes.

THE newspapers announced on September 21st that a girl thirteen years old had given birth to triplets in Cincinnati.

JAMES MATTHEWS DUNCAN, M.D., F.R.S.The following is from the London Lancet's tribute to the memory of Matthews Duncan, who died of angina pectoris at Baden-Baden on the 1st of September last:

James Matthews Duncan was born in 1826 in the city of Aberdeen, where his father was engaged in shipping and commerce.

He was

educated in the grammar school under Dr. Melvin, known as a schoolmaster of great repute. When a mere youth he was entered at Marischal College, and in the course of time he took the degree of M. A. He began his med

ical studies in the same college, and we have often heard him dilate on the benefit he derived from the instruction of Professor MacGillivray, the well-known author of the "Natural History of Deeside." The love of observing the habits of animals which he imbibed from that naturalist he never lost, and one of his great pleasures, even to the end of his life, was, during the autumn holidays, to watch the birds, the ants, and other animals in the district where he was staying. The latter part of his student life was spent in Edinburgh and Paris, and then he returned to Aberdeen to take his degree of M. D.

It was, however, his residence in Edinburgh that formed the turning point of his life and decided what branch of the profession he was to follow. He became a member of the class of midwifery in the University, then taught by the late Sir James Y. Simpson, and he obtained such high distinction in it that after his graduation he was appointed one of the private assistants to that eminent physician. Simpson was at that time engaged in his world-renowned inquiries into the action of ether, and in the search for some better anesthetic. Duncan assisted him in his work, and tried experiments. with various substances. From a statement made in the "Life of Sir Robert Christison," we learn that Duncan was the first person to be rendered insensible by chloroform. Simpson also, in a letter published in his "Memoirs," refers to the night on which Duncan, Keith, and himself tried it simultaneously, and were all" under the table" in a minute or two. All the world knows what has been the result of these experiments.

Shortly afterward Duncan began practice in Edinburgh, and he very soon attained the confidence and friendship of Syme, Christison, Miller, and other leaders of the profession in that city. His activity during his Edinburgh life was untiring. He rapidly built up a large private practice. He became one of the physicians to the Royal Infirmary. He was greatly instrumental in founding the Royal Hospital for Sick Children, and for a time he was one of its physicians. He was elected a Fellow of the Royal College of Physicians, was chosen one of its Council, and during a period when medical

politics ran high in Edinburgh his calm and solid judgment was of the greatest value in the administration of its affairs. He was also a member of the Royal Society of Edinburgh, the Medico Chirurgical and the Obstetrical societies, and took a frequent part in their proceedings. In 1853 he began a course of lectures on Midwifery in the Extra-mural School, which were soon recognized by the students as highly practical, but with their practical recommendations based upon a scientific foundation. Duncan's command both of French and German enabled him to keep himself on a level with all that was good in the professional literature in those languages, and his students got the benefit of his reading and thought.

But amid all the distractions of a large midwifery practice, and of the work of the various public institutions to which he was attached, Duncan found time when in Edinburgh to do an amount of literary work which makes him one of the most prolific authors in his branch of the profession. Moreover, the work which he did was of so high an order that his reputation rapidly grew, so that he became a recognized authority over Europe and America in both the science and practice of obstetrics, and patients were attracted to Edinburgh from all parts to consult him.

On the death of Sir James Simpson in 1870 the profession both at home and abroad looked upon Duncan as the natural person to succeed to the chair of Midwifery, and his candidature was supported by an immense mass of evidence of his fitness. He was, however, much to the surprise of the profession and the public, passed over. Duncan was not a man to "wear his heart upon his sleeve" and to show his feelings openly, but there can be no doubt that he felt keenly the slight, for the bestowal of the chair would have been the proper crown to his professional work. When, therefore, the authorities of St. Bartholomew's Hospital a little time afterward invited him to go to London to act as obstetric physician to the hospital and as lecturer on midwifery in the medical school, his mind was open to accept the call, and Edinburgh lost what London gained-a great physician.

the impression which he produced there will now be stated in the words of one who first came under his influence as a pupil, and has since been much associated with him in practice.

When Dr. Matthews Duncan came to London he was in his prime, with a European reputation and the character for honor which was early stamped on him. He at once acquired a large practice, which soon became very large. He was trusted by the profession, who sought his help in consultation at once and in increasing numbers, and by the laity, who from the very highest were sure of all that learning, experience, and integrity could guarantee. He was a sort of referee for matters of difficulty in the profession, and was the center and rallying point of all that was best in his department. Some five years before his death he gave up midwifery, except in consultation, only attending a few old patients. This was in accordance with the plan of his life. "I always said I should give up midwifery at sixty," he said, and added that he had done every thing he had hoped for and at the time he intended. How few could say the same. His life was therefore in a sense complete. He was at his zenith, and neither he nor his friends had the grief of seeing his reputation decline. To have given place by simple years to younger men of the right sort would, we are sure, have been nothing but a pleasure to him; he was quite free from jealousy and meanness, and would have regarded such a succession as that of younger brothers or sons.

As an obstetric physician, it may be safely said that the position held by Dr. Matthews Duncan, both in the science and practice of his profession, was second to none, and this not only in his own, but in all countries. The latter half of the nineteenth century is rich in great names, but it can not be said that any of them stand at a higher elevation than his. He was a worthy successor to William Hunter aud Denman in England, and to Naegeli in Ger many. The amount of his work was immense. There is scarcely a subject in obstetric medicine on which he has not written and left his deep and characteristic mark. As Johnson said of Goldsmith, "Qui nullum fere scribendi genus non