deaths in consequence of bicycle riding. This was the a face and were struck by its characteristics, and we starting point of said animated debate and the alarm attributed this characteristic face to the result of an inwhose echo was reproduced a thousand times in all tense bicycle race. We did not, however become fully parts of the civilized world and wherever the bicycle conscious of our mental impression, until we found in cult had penetrated. literature an allusion made to the "bicycle face." We must admit that we have so far only seen two such faces, one being particularly striking and, we think, would cause in everybody's mind the same association of ideas, which were, almost unconsciously, produced in ours. For the sake of completeness we must add that these two bicyclists had been caught in a profuse rain. storm, having found no place of shelter, as the appearance of their clothes and wheels indicated. ** As is always the case in questions that are not ripe for a final answer, the speakers did not agree and a committee was eventually appointed to investigate the matter scientifically. Since then the Academy has had many debates, some members denouncing, others speak ing in favor of cycling. The committee appointed by the Academy does, so far, not seem to have handed in its report and this ap. pears perfectly natural, for scientific men of which the Academy is supposed to consist, are not apt to give a hasty opinion, but will withhold it until enough evidence, physiologic and pathologic, has been gathered to give weight to their final conclusions. What seems reasonable, however, to predict with present limited experience and judging from the scientific physiologic and pathologic resp. clinical investigations is, that the average individual, male or female, will be benefited as much by bicycle riding as by most other muscular exercises, provided of course, that the exercise be taken with moderation and that bicyclists conform with other well established hygienic laws. Among these may be enumerated: Erect position; the saddle should not press upon the perineum and the weight of the body must rest upon the tubera ischii. The shape of the saddle should be in conformity with hygienic rules and should be modified according to the requirements of both sexes. Of course, this form of exercise, as well as any other, should not be taken shortly after meals. Proper clothing to protect against taking cold. The exercise should be discontinued as soon as a sensation of uneasiness or shortness of breath is experienced by the rider. It is possible to ride a bicycle with the body in an upright position and parents and tutors should insist that their sons, daughters or pupils do maintain an erect position whether they are riding a bicycle or are occupied with any other exercise, work or pastime. ** * It is, however, an undeniable fact, that the very nature of this form of exercise partakes of the same character as so many other sports or amusements as far as its tendency of being carried to extremes is concerned. This tendency is, no doubt, more pronounced in cycling than in any other amusement. In observing the average bicycle rider, who has had enough practice to feel safe upon his wheel, the impres sion is left upon one's mind that, while riding, he tries, like the race-horse, to pass every other bicycle and vehicle on the road, and it is this tendency of the bicyclist, which is most objectionable from an hygienic and psychological point of view. Allusions have been made to the effect of bicycling upon the physiognomy of the rider, to the so-called bicycle face. We have seen such The present, almost universal, method of cycling, with the body leaning forward and head thrown back, is certainly exceedingly unhygienic and, unless this position be corrected and the exercise is indulged in with moderation and adjusted to the strength and pos sible physical abnormalities of each individual rider, with a saddle conforming with the laws of hygiene and adjusted to the anatomy of the individual, the extravagant assertions of some pessimistic critics are more or less justified. But with the modifications pointed out by us cycling will prove to be a blessing like almost everything else that is done intelligently and with moderation. ures. That habitual cycling will sooner or later, like any other occupation, prove to cause certain characteristic more or less pathological conditions, must, of course, be expected; but the same thing may be said of the majority of muscular exercises, occupations or social pleas But, as already stated, the main objection to bicycling is the natural inclination in this form of exercise of trying to pass all objects on the road thereby, often unconsciously, increasing the speed to an injurious extent, and this tendency is probably more characteristic of cycling than of any other occupation or amusement. Hence the reported sudden deaths. There is a peculiar exhilaration produced by most forms of muscular exercise and this exhilaration is also experienced by bicy. clists after riding some distance and the exuberant spirit thereby produced is said to incite to increased velocity and racing, and, as a consequence, the rider overexerts himself. Of course, after the muscles have become trained and hypertrophied after habitual cycling, even an intense speed may have comparatively little, or no immediate injurious effect. Such exercise, when in. dulged in habitually, would have a similar effect as the habitual muscular exertions of acrobats who, as a rule, break down suddenly when they retire in later life. * The position of the bicyclist, leaning forward, when the exercise becomes habitual or becomes a daily occu pation, will no doubt have a more or less lasting effect upon the individual's carriage and does, more or less, interfere with the physiological function of the respiratory muscles and, consequently, with the expansion of the thorax upon inspiration and, therefore, with the has been viewed from the aesthetic, moral and purely proper oxygenation of the blood. The latter may, of medical standpoint; but, in spite of all adverse criticism, course, be compensated by an increased action of the cycling among the better sex is constantly increasing. heart, which, aided by the effort of cycling, will eventually result in a compensatory hypertrophy of that organ. Like every other muscular exercise, cycling increases the arterial blood pressure. Increased work is under physiological conditions followed by increased growth. A moderate amount of hypertrophy of the heart is not injurious, but cycling carried to excess will cause the same pathological alterations (degeneration) in the walls of the blood vessels and the same forms of heart disease as those observed in athletes, e. g., simple hypertrophy, degeneration of the heart muscle, acute dilatation, valvular disease and so-called functional derangement. From an esthetic aspect there can be no question that other diversions, lawn tennis, rowing, swimming, skating, riding and fencing are of a much more graceful nature and it would be deplorable, if the American girl who has for the last ten or fifteen years been waking up to the advantage of a physical training in the open air, should neglect these recreations in favor of cycling. Educators of girls can not lay too much stress upon the fact that all occupations and recreations, should, if pos sible, tend towards increasing the loveliness and gracefulness of their pupils. To us, cycling appears an ex. ceedingly ungraceful and unbecoming occupation for young ladies, and we believe that our taste in this matter is shared by the vast majority of men and women. As to morals, we do not see how, under ordinary cir cumstances, cycling should affect them. There are people who consider dancing immoral, while others look upon it as an exceedingly useful and wholesome recreation, and the same might be said of a social game of cards or, for that matter, any other innocent recrea. tion. It is hardly necessary to enter into a discussion of the modus operandi of excessive exercise with regard to its injurious effects upon the circulatory system, the pathological changes which take place in the heart and arteries. Suffice it here to say that the immediate effect upon excessive exercise is the inability of the function of the lungs to keep up with the increased heart's ac tion, resulting in an insufficient oxygenation of the From the medical or hygienic standpoint a great deal blood; the lungs and, consequently, the right side of the of theorizing has been indulged in as to the probable heart thereby becoming gradually overfilled with blood and a dilatation of the right ventricle following as a consequences of cycling upon young girls and married natural result, unless the cyclist is forearmed in being not borne out by facts. On the contrary, it seems that It appears, however, that these theories are farewarned by the knowledge that he must stop as soon as he feels an uneasiness in the chest or a difficulty in cycling, when a judicious use is made of the exercise and when it is not indulged in at wrong seasons, is, under ordinary circumstances, of benefit to both, the breathing. women. girl and the married woman. There can be no question that, with the proper hy gienic precautions, the principal ones having been Dr. Charles W. Townsend recently addressed a numpointed out by us, cycling will prove to be an exceed-ber of lady doctors practicing in Boston and Massachuingly beneficial exercise. setts (The Practitioner): Moderate bicycle riding develops most of the muscles. of the body and strengthens the heart-muscle; increases the appetite, and improves digestion and assimilation. It stimulates the action of the skin thereby producing a more rapid elimination of waste products, and relieves insomnia. Other virtues have been justly attributed to the bicycle but, as they are all of a more or less subjective nature, we have preferred to omit them. "Eighteen replies were received, which may be summed up as a chorus of approval-with only one dissentient voice-of the use of the bicycle by average women un. der proper conditions. Nine had seen no instance of harm arising from the exercise. Single cases of injury (in the form of ovarian inflammation, bleeding from the kidney or womb, displacement, and miscarriage) had come under observation. On the other hand, a number of cases were cited in proof of the beneficial effects of bicycling in retroversion, enlargement, and prolapse of the uterus. The advantage of the bicycle as a means of exercise for women to whom walking is difficult or impossible was dwelt on by several of the witnesses. The question, 'Would you advise the bicycle in any form of uterine diseases?' was answered in the affirmative by all but two. Dr. Townsend is careful to point out that the favorable verdicts were not received from bicycle enthusiasts, only one of the lady doctors to whom the questions were addressed having herself used a bicycle. The greatest source of danger to women in whom bicycling seems to be the saddle, which, as It usually made, is not well adapted to the female anatomy. There are, however, many diseased conditions in which a prudent use of the bicycle like most other well directed and systematic muscular exertions, will be found very beneficial, of these, neurasthenia, anemia, dyspepsia, gout, obesity, constipation will readily sug. gest themselves; but when the bicycle is to be used for diseased conditions, a physician should always be consulted, in order to avoid errors in diagnosis and to point out the necessary hygienic precautions, and regulate carefully the amount of exercise required in each individual case. ** Many comments have been made upon the growing custom of cycling among young girls and women. The construction of a perfect saddle for women is a etc., cycling may be overdone, or improperly done, and problem that still awaits solution." At the meeting of the Societe de Medicine Publique, Mme. Gaches Sarrante read a paper on the utility of the bicycle for women (Gross Medical College Bulletin): "All acute inflammation should forbid the use of the machine, but where the lesions were chronic, moderate exercise might be permitted, and even enjoined; in any case, riding is much less fatiguing than standing or walking. alpingitis or chronic salpingo ovaritis does not constitute a counter-indication, and in cases of chronic peri-uterine inflammation the bicyclette can replace with advantage the Swedish method of massage. Bicycling exercises, consequently, a healthy influence on the physical nature of women; they sleep better, digest better, and their chest expands so as to find it necessary after a short time to enlarge the corsage of their robes. Mme. Sarrante concluded by drawing a vivid picture of the moral role of the bicyclette, the only physical exercise that husband and wife can take together." What has been intimated with regard to the careful adjustment of the exercise of cycling to individual weaknesses or deviations from physiological conditions, is true in a much greater degree of the female sex, because of the anatomy of the pelvic organs. With a greater abundance of clinical material the facts with regard to pathological conditions produced by cycling will more and more accumulate and in a few years doctors will know a great deal more about its injurious effects. It may take a lifetime of clinical observation before it will be possible to study all the abnor mal conditions due to habitual cycling. But there is hardly any occupation in which individuals are habit ually engaged that will not leave a more or less pathological imprint upon some part or organ of the body. We will not dwell long upon the accidents that may accur in cycling. These are too well known to everybody to need pointing out, but the ability of a bicycle and rider in rapid motion to do serious damage in a collision with another machine or with a pedestrian is fully appreciated by few wheelmen. According to the Scientific American, "a man weighing 150 pounds and moving at the rate of ten feet per second (which is only about seven miles per hour) has a momentum of 1,500 pounds, leaving out of the account the weight of the wheel. This is sufficient to upset any pedestrian with terrific force. A collision between two wheels, each with a 150 pound rider, spinning at the moderate speed of seven miles per hour, would result in a smashup with a force of 3,000 pounds. In view of these facts, it is no wonder that bicycle accidents are often very serious." Nevertheless, the bicycle is one of the most useful inventions of the nineteenth century; its trained rider competes in velocity, not with the horse, but with the steam-engine. Like eating, drinking, working, playing, become injurious. It is the abuse of things and not their judicious use that is objectionable. The present outlook is, that the bicycle has come to stay. BOOK REVIEWS Books reviewed in this column may be obtained, post-paid, the quoted price. by addressing the publisher of this journal, and remitting Practical Dietetics, With Special Reference to Diet in Diseases. By W. GILMAN THOMPSON, M.D., Professor of Materia Medica, Therapeutics, and Clinical Medicine in the University of the City of New York; Visiting Physician to the Presbyterian and Bellevue Hospitals, New York. Large octavo, 800 pages, Illustrated. Price, cloth, $5.00; sheep, $6.00. Sold by subscription only. New York: D. Appleton & Co. This work fills a field, heretofore unoccupied. The book will be found of great assistance in the dietetic treatment of diseases that are influenced by proper feeding. Beginning with the elementary composition of foods, the author next classes them, and takes up in succession force production and energy; the force producing value of the different classes; stimulating foods; their economic value; a comparison of the nutritive properties of animal and vegetable foods, and vegetarianism. The classes of foods are next considered, including water, salts, animal and vegetable foods, fats, and oils. In the section on animal foods much attention is given to the subject of milk in all its forms-pure, adulterated, prepared, etc.-in accordance with the great importance of the article so commonly used. Stimulants and beverages, with their good and ill effects, their comparative values, administration, and varieties, are fully and carefully considered. The various methods of cooking food are given, with the effect of each method on the different classes; also the means used for condensing and preserving food. In the article on foods that are required for special conditions the author takes up food in its relation to age, individual size, body weight, sex, diet and heredity, diet and race, and climate and season. Proper attention is paid to the subject of digestion and the conditions which especially affect it. The author considers the general relations of food to special diseases; those that are caused by dietetic errors and the administration of food for the sick, giving the necessary rules as to method, time, etc. Dietetic treatment in fever in gen eral is followed by instructions for diet in specified diseases, with lists of food suitable for the patient in certain stages of the disease, as in the infectious fevers and other acute affections. ABSTRACTS MEDICINE. The work abounds in analytical tables giving the percentages of ingredients in the various animal and vege. table foods; standards for daily dietaries as influenced by age and occupation; the energy developed by a given quantity of certain foods; diet tables representing a ration as issued in the army and navy under different conditions; and also those used in various prisons and The Etiology of So Called Diabetes Mellireformatory institutions. tus. While the symptomatology of the condition deThe book will prove to be an excellent guide to stu-signated as diabetes mellitus is quite well known, our dents and of most practical value to practitioners and knowledge of the etiology and pathogenesis of this af teachers of medicine. MEDICAL SOCIETIES Mississippi Valley Medical Association The Mississippi Valley Medical Association held its twenty first annual meeting at Detroit, September 3, 4 and 5. At the opening session of the convention Mayor Pingree welcomed the delegates and paid tribute to their profession. Dr. Wm N. Wishard, of Indianapolis, President of the association, responded. The papers read were of much interest. Dr. Willian Pepper, of Philadelphia, delivered the annual medical address. His subject was "Then and Now," the address being largely devoted to the life and work of Dr. Daniel Drake, who died in Cincinnati in 1852. He contrasted medical education and practice of that period with their present stage of advancement, the neglect of athletic sports and other exercises by both sexes and the indifference to what are now common precautions against illness. He spoke of the diminishing of catarrh and malaria in America despite all pessimis tic predictions, and of the general vigor of the youth of to-day compared with forty years ago. fection is still obscure. This much, however, is already Direct heredity was observed in ten cases; collateral heredity in four cases. (By this the author designates the occurrence of diabetes in brothers and sisters, while The following officers were elected for the ensuing at the time no symptoms appeared in the parents.) It is year: President-Dr. H. O. Walker, of Detroit. possible that the children may suffer from diabetes, and even die from it, before either of the parents is attacked. First Vice-President-Dr. Merrill Ricketts, of Cin- In five cases diabetes was seen to follow infectious dis cinnati. eases-once each after cholera and malaria, and three Second Vice President-Dr. F. C. Woodburn, of In times after influenza. These were exclusive of syphilis, dianapolis. Secretary-Dr. H. W. Loeb, of St. Louis. which deserves especial consideration. Diabetes following syphillis was observed twice, once in a woman, once in a man, both between 40 and 50 years. The Judicial Committee-Drs. W. N. Wishard, T. E. Hol- woman was infected by her husband, who subsequently land and A. B. Buchanan. The Convention expressed thanks to the local medical fraternity for the excellent provision for the Convention, and to Dr. Wishard, the retiring President, for his efficiency. St. Paul was selected as the place of meeting in 1896. died of general paralysis. Treatment with iodide of potassium was ineffectual in assuaging the execretion of sugar. The second case was, as has already been said, a man. Here, in addition to glycosuria, inequality of the pupils existed-the right was larger than the left -and violent headache. Energetic treatment with mercury caused the sugar to disappear. The case blankets and permitted to shake, burn and sweat in passed out of the observation of the author. The author succession until the paroxysm wears itself out. Not also observed seven cases of so called diabetes in which only is this discomfort unnecessary, but the physician nerous diseases played an important etiological part. by permitting it loses valuable time and makes subseThese were seen in five cases of neurasthenia, and once quent treatment more difficult. Careful, judicious in Basedow's disease, and tabes. It was also seen once treatment of the paroxysmal stage of malarial fevers in a case of melancholia. Traumatism is given as the will relieve much suffering and very materially aid subcause in one case. It was in a man aged 49, who had sequent treatment. received a fall. Finally, the author reports one case following gall stone colic. I propose to outline in detail the treatment of a typi cal case of intermittent fever, and I will preface my Of individual diseases we know that they are fre- description with the statement that I have followed quently associated with the occurrence of sugar in the this treatment in a large number of cases, obtaining urine; e.g., diseases of the pancreas and gout. Other such invariable successful results as to lead me to adopt affectians so sften coexist with diabetes that we are justified in assuming there is some connection between them; e g., arterio-sclerosis, some nervous diseases, etc. The affections belonging here are: 1. Diseases of the pancreas, which produce atrophy and total or partial destruction of this organ. This has been experimentally proved by the researches of Mino wski and v. Mering. 2. Gout. It is a well-known fact that gouty per sons frequently suffer from diabetes. In gouty individ uals, gouty attacks have been seen to alternate with attacks of diabetes. Arterio-sclerosis. The author's statistical tables seem to indicate that the association of diabetes with arterio sclerosis is more than simple acccident. 4. Various nervous diseases, such without anatomi cal alteration, as neurasthenia and Basedow's disease, as well as such with anatomical lesions, e.g., takes, brain tumors, etc. 5. Various infectious diseases, as cholera and influFrerichs also mentions diphtheria, typhoid fever, and scarlatina. enza. 6. Syphilis. The author, in closing, expresses the hope that, if the designation "diabetes mellitus" is, for the time being, to be retained, those using it will in all cases, where possible, indicate the etiological factory by speaking of an arterio-sclerotic, pancreatic, gouty, neurotic, infectious, or traumatic diabetes.-Karl Grube in Zeit. f. klin. Med.; Amer. Med.-Surg. Bull. Ammonol in Malarial Paroxysms.-Many writers have called attention to the unfavorable effects of quinia when administered during the paroxysm of malarial fever. The drug then seems to increase the headache and to have a rather bad effect on the general condition of the patient. It has been effectually demonstrated that the proper time for quinine administration is during the period of intermission or remission, and no one can deny that quinine is sine qua non in the treatment of malaria when thus used. The treatment of the malarial paroxysm, i. e, the algid and febrile stage of the disease, has not received the attention it deserves at the hands of medical men. Usually the patient is packed in heavy it as a regular routine practice in all cases of malarial fever. The treatment is commenced, during the first chill if possible, by administration of from 5 to 15 grains of ammonol, the dose depending on the age of the patient, a child of ten years being given the minimum dose, and one grain being added for each subsequent year for older persons up to the maximum dose of 15 grains. The remedy is given in powder form, dry on the tongue, and washed down with a hot toddy of whiskey, rum or gin, sweetened to the taste, and not very strong. The amount the alcoholic liquor should vary from a tea spoonful to two tablespoonsful in about four or five times the amount of hot water. This quantity should be determined by the age of the patient. The good effect of this dose should be apparent within an hour. The headache disappears as if by magic; in many cases the chill is shortened and the fever and sweat com. pletely aborted. At the expiration of an hour from the time of administration of the first dose, a second dose of the same quantity of ammonol, followed by half the amount of toddy, should be given. Occasionally the second dose may consist of half the quantity of ammo. nol first given; this if the patient seems so completely relieved as not to require medicine. My first action after a cessation of the paroxysmal stage is to exhibit a dose of calomel rubbed up with soda bi-carb., and the following prescription indicates dosage: R Hydrarg chloridi mite., M. Sig. One dose. aa grs.iij to vj. In very young children gray powder in dose of threequarter grains may be best substituted for the calomel. During the stage of intermission I give a dose of six to twelve grains of quinine, preferably in liquid form, i. e., dissolve by aid of sulphuric acid in water as follows: R Quinia sulph., M. Acid sulph., dil., gr.xij. q. 8. ft. sol. 3j. Sig. One dose; to be taken after cessation of fever. In the majority of cases no secondary chill will occur until the seventh or fourteenth day if no further treatment is given, but to clinch the driven mail, it is neces |