2. TUBERCULOSIS. Such recent editions of books concerning Pathology, as those of Cohnheim, Green, Coates, Ziegler, give complete adherence to the doctrine that the bacillus is the essential cause of tubercle. Says Ziegler, "it may, therefore, be accepted, as an established fact, that the bacillus tuberculosis is the cause of all tubercular processes." It is an evidence of the rapid strides of knowledge in researches of this kind, to mention that, in the latest edition of Cornil and Ranviers's Pathological Histology, the last volume of which has lately been issued from the press, the tubercle bacillus is not mentioned. Between the issue of the first volume, in which the subject of tubercle was treated of, and the issue of the second volume, Koch has made, and substantiated, the discovery.

It is to be therefore noticed that in the newer pathology of tuberculosis there is not the same prominence given, as formerly, to the process of caseation as a part and forerunner of infection. It is the bacillus and not the product of caseation which produces the infection. We notice also that infiltrating tubercle, so named by Laennec, as distinguished from the grey and yellow nodules, is again given a place in the discussion of tubercle. The poison, the bacillus, may produce an infiltrating inflammation.

In the Paris Revue de Chirurgie for Feb. 1885, there is mentioned the formation of a permanent commission by the Societe Medicale des Hopitaux de Paris, to study the question of the contagiousness of tuberculosis and its prophylactics. Similar commissions exist in England, in Germany, and in Italy. While the possibility of its transmission by contagion is considered to be now but little contested, it is desired that it should be ascertained in what exceptional circumstances such transmission takes place; whether, for example, by the breath, by dejecta, by milk of tubercular persons or animals, by meat, etc.

3. CLASSIFICATION OF TUBERCLE, SYPHILIS, LUPUS VULGARIS, LEPROSY, GLANDERS AND FARCY, AND ACTINOMYCOSIS. Permit me to call your attention to a method of grouping of certain pathological lesions in recent books on Pathology. The pathological lesions in the diseases mentioned above, namely, tubercle, syphilis, lupus vulgaris, leprosy, glanders and farcy, and actinomycosis, are grouped together in most recent works on pathology,-as those of Cohnheim, Coates, Green, Ziegler, under the title of the infective granulomata. The structural changes met with in them have characters pertaining to chronic inflammation, namely, a granulation tissue which often contains giant cells, multinu

cleated cells. They all have the property of infecting the surrounding tissue, or distant tissues. Such of the group as tubercle, leprosy, actinomycosis, have been proved to be connected with, and caused by, microorganisms. It is presumed that similar causes will be, in time, discovered for the remainder of the croup.

4. TRANSMISSION OF SYPHILIS BY VACCINATION. Dr. Corey of London, England, as quoted from the London Medical Record, by the Journal of the American Medical Association, presents, in his own person, a well authenticated case of syphilitic infection by vaccination with lymph, not containing blood, from a syphilitic child. Dr. Cory having previously, in different years, made upon himself other, but unsucessful, vaccinations, in a fourth experiment, which was made under the observation of appointed known medical gentlemen, became inoculated with syphilis, which was allowed to run a course into characteristic secondary symptoms.

5. PROFESSOR GERMAIN SEE is quoted,-Paris letter in Journal of the American Medical Association for January, 1885 -as contending, in a paper read before the Academy of Sciences of Paris, that acute lobar pneumonia, croupous pneumomia, is always a parasitic disease; that it can be reproduced in animals by the introduction of the parasite, while mere physical and chemical irritants will not produce the disease. He thinks the parasitic evolution occupies about seven days. I think the condition of the medical mind is at present to give consent to the parasitic cause, as well as to causes acting through the nervous and vascular system, such, for example as chilling the surface of the body.

6. ALBUMINURIA. On page 125 of the Journal of the American Association for 1885, there is a resume from the Edinburg Medical Journal, in which the not infrequent presence of albumen in the urine after taking albuminous foods, is affirmed; also, the not infrequent presence of albumen in the urine in the day time, but its absence in urine passed during the night. A note in Bartholow's last edition of text book of practice of medicine, page 557, says: "Albuminuria itself is, according to Gull's statements, as common in young men and boys as spermatorrhea. Maxon confirms this. Young girls from fourteen to seventeen have it." The reviewer of "some recent works on albuminuria and the testing of urine," in the American Journal of Medical Sciences, January 1885, the reviewer being, presumably, Prof. James Tyson, says: "Dr. Johnson properly insists that the smallest amount of albumen detectable, whether accompanied or not by the presence of tube casts, is abnormal."

178635

This corresponds. with the experience of your present reporter of progress. From a record of examinations for Life Insurance for a careful company, the urine being examined in every case of application, out of two hundred and sixty-six consecutive examinations there were only five cases of albuminuria. Of these five cases,, two were temporary, one of them was suffering from carbuncle, and the other had recently had gonorrhea.

7. THE THYROID GLAND. Professor Horsley, in the course of lectures of the Brown Institution of London, presented the recent advance made in our knowledge of the thyroid gland. He concludes that one of its functions is the excretion of mucin. Its ablation or disease leads in the human being, to myxedema and to cretinism. Enlargement of the spleen follows excision of the thyroid in some animals. Nervous symptoms ensue after its removal in dogs. I. From affection of the lower motor centres there are tremors with rigidity and paresis. 2. The higher nerve centres are also affected, causing imbecility. Death come on with

a comatose state.

COMPARATIVE PATHOLOGY. The pathological society of London possesses a committee of comparative pathology, which, by the study of pathological conditions in the lower animals, endeavors to obtain further knowledge of the nature of disease in man. One member of this committee, Dr. J. B. Sutton, has been investigating such subjects as the occurrence of cystic disease of the ovary in mares, fatal peritonitis from metritis in the kangaroo, uterine flexions in the monkey and deer. The science of comparative pathology includes pathological developments in plants as well as animals.

9. SUPRA RENAL CAPSULES. Tizzoni, an Italian observer, has experimented in removing the supra-renal capsules. Pigmentation about the mouth and nose occurred, extending in such way as to make bronzed patches of considerable size. (Lancet of Sept. 27, '84.) These researches are in keeping with the conditions found in Addison's disease, which has so long been referred to disease of the suprarenal capsules.

IO. HYDROPHOBIA. The success of Pasteur's researches in the inoculation for rabies is vouched for by good authority. The exact methods of Pasteur have not been, as yet, made public.

II. THE BRAIN. The knowledge of the brain, derived from experimental physiology and pathology, has led the most expert in this knowledge to diagnose, in at least one case, the location of a tumor of the brain, and in consequence, to its removal by operation.

REPORT OF A CASE OF ALBUMINURIC RETINITIS.

BY F. W. SCHWAN, M. D., POPLAR, O.

Mr. D― aged 34, farmer, bilious, sanguine temperament, well nourished, and of good habits, called at my office, complaining of an impairment of vision in both eyes he expressed it as a dimness or haziness, which had come on suddenly, sometime previously, without any premonitory symptoms. The visual defect was gradually becoming more pronounced. Inquiry elicited the fact that he had "not felt quite well" for over a year before. When he consulted me, in addition to the dimness complained of, there was slight headache, some nausea partial loss of appetite, and at times, great thirst, with frequent calls to urinate during the night, and at times difficulty of breathing. A superficial examination revealed nothing abnormal in the appearance of the eyes, excepting an uncertain vacant stare, similar to, yet differing from, that observed in cataract. Feeling satisfied that the main lesion was not in the eyes, I subjected him to a critical examination, and after fully dilating the pupils with sol. atropia sulph. the ophthalmoscope revealed in the right eye an enlarged, and quite hyperemic optic nerve, and near its insertion, and to the left of it, an irregular, dirty, grayish spot about two lines in diameter. In the left eye could be noticed retinal congested vessels, and the optic nerve pale and shrunken, with whitish lines radiating from the macula lutea.

The impulse of the heart's apex could be distinctly felt over the seventh intercostal space, and the heart sounds were muffled, irregular, and unequal. The spleen seemed greatly enlarged. The urine was heavily loaded with albumen, somewhat diminished in quantity and quite pale.

With this train of symptoms before me, I felt quite certain that I had a case of that rather rare manifestation of Bright's disease, known as "Albuminuric retinitis." As there also seemed to be malarial complications, I at once directed free doses of quinia sulph., followed in several days with strychnia and hydrochloric acid, with nourishing diet and restriction of all fluids, as far as possible. This treatment seemed to hold the progress of the disease in check for five or six weeks, and at times there was apparently well marked improvement, and great diminution of albumen in the urine, but this was only temporary. About this time I advised him to consult Dr. Scott of Cleveland, who verified my diagnosis, but made little

further suggestions, and the treatment was continued with such modifications as seemed indicated, but without effect, the patient gradually getting worse, with increasing emaciation, persistent nausea and ejection of all nourishment taken. The thirst was almost intolerable, and as the disease progressed there was edema of the lower extremities. Coma set in toward the last, which could be only partially combated with full doses of fld. ext, jaborandi at short intervals. The patient finally succumbed, having lain in a perfectly comatose state for over sixty hours. He was in all about seven weeks under treatment by myself and my friend Dr. Bland.

Thirty hours after death rigor mortis was well marked, and a postmortem showed a much hypertrophied, friable lardaceous heart with enlarged spleen. The left kidney weighed four ounces and a quarter and the right two and a half ounces, and there was well marked granular degeneration. The other organs were free from any structural change, which leaves litttle doubt that the retinal maculation was the direct result of the cardio-renal lesion; and, although the granular kidney is frequently, and in fact nearly always, present in this form of albuminuria, it is not necessarily so.

This deficiency of vision resulting from retinal complication is very frequently the first symptoms of Bright's disease, and then again it may not supervene until the malady has progressed for some time, but that it is the direct or indirect consequence of tubal or diffuse nephritis or of lardaceous, cardiac change is clearly evident.

The exact pathological condition that calls forth this retinal complication is not clearly understood, "but there is little doubt that it is not necessarily associated with a specific renal condition, but is evidently more or less, the direct issue of the increased arterial tension which a loss of renal function may entail."

THE DIVISIONS OF HOMEOPATHY.-Judging from expressions in the various homeopathic journals, the homeopaths of the country are more or less strictly divided into three sects. One represents uncompromising Hahnemannism, and its special organization is the International Hahnemannian Association; the second is homeopathy tinctured with rational medicine, and is represented by the American Institute of Homeopathy; the third class includes the so-called "liberals," who believe in the value and soundness of certain homeopathic principles and artistic methods, but who repudiate dogmatic medicine, and advocate giving up the title "homeopath.”—Ibid.