DANGERS OF MALT LIQUORS AS GALACTAGOGUES. In an article on this subject in the Annals of Gyn. and Pad., Dr. J. Wellington Byers reports the following case and comments: Infant, aged ten months, cared for by wet nurse, of German nationality, taken suddenly sick at 8 P. M., July 3. Facies anxious and flushed; temperature 104; nausea and vomiting, and bowels acting every twenty to thirty minutes. At eleven o'clock symptoms began to subside, and by four in the morning the pulse and temperature reached the normal and at noon the next day the child had every indication of being well, and there were no manifestations other than the prostration consequent to the attack. At eight in the evening the same symptoms returned with all their former severity; passed through the same stages as before, and ended about the same time. The case for the next six days was a repetition of the first day, when a denoument was made. A neighbor of the child's parents informed them that he had seen the nurse enter a saloon each day for the past week, when it was discovered she would partake very freely of beer. Upon her return home, in the afternoon, the child would get the usual nursing, and in about three hours the symptoms of acute poisoning from bacterial products would transpire in the child. Up to this time of the half dozen physicians in consultation, no one was able to make a diagnosis, each one having a different opinion. In the light of the evidence, furnished by the neighbor, it was now plain what the disease was; namely, poisoning from stale beer-Germ-poisoning. The wet nurse was at once dismissed, and the child recovered forthwith, and there was no return of the symptoms. Other and similar cases might be given, illustrating the effects of mother's milk when adulterated with beer, upon the nursing child. Whenever a child does not thrive, and no other cause can be discovered to which to attribute its indisposition, we should be careful to ascertain if the mother is using malt liquors to help in the production of her milk. Take care not to advise a woman whose milk supply is reasonably full, to resort to beer or other liquors in order to increase it. Always impress upon them the increased risk to the child incurred by using them. In conclusion, I will add that I am fully convinced of the importance of this section in dietetics, and that we have in its abuse a potent source of danger to the child, I am certain. Pamphlets and Reprints. The effect of diseases of the ear upon the general condition. By William Cheatham, M. D., Professor of diseases of the eye, ear, throat and nose. Louisville Medical College Reprint.-Medical and Surgical Reporter. A contribution to the study of cystic kidney. By Ludvig Hektoen, M. D. Reprinted from the Chicago Medical Recorder. Two cases of conservative surgery. By F. Robert Zeit, M. D. Reprint from the transactions of the Wisconsin State Medical Society. Recent progress in diseases of the brain and nervous system. By F. Robert Zeit, M. D. Reprinted from the transactions of the Wisconsin State Medical Society. The treatment of hypertrophic rhinitis. by electrolysis. By W. Scheppegrell, A. M., M. D. Reprinted from the New Orleans Medical and Surgical Journal. The first permanent molar. Dr. J. H. Woolley. Reprint from the Dental Review. ANNOUNCEMENTS. The World's Congress Auxiliary. The World's Congress Auxiliary of the World's Columbian Exposition of 1893, department of medicine, division of medico-climatology. Subject: The Climates of the World, their Effects upon Health and Disease, Climatology from a Medical Standpoint. Preliminary address of the Committee of the World's Congress Auxiliary on a Medico-Climatological Congress. The year 1893 will be made memorable by the Exposition that the world will hold in Chicago. There will be gathered not only the exponents of the industrial wealth of the world in all the forms of material progress, but the advances made in Art, Science and Civilization will also be set forth. A series of Congresses representing all of the departments of thought and scientific investigation, is a true, even an indispensable part of a World's Exposi tion. In accordance with this idea the World's Congress Auxiliary has been organized in connection with the World's Columbian Exposition, and has been recognized and approved by the Government of the United States. Among the assemblages to be convened, what more fitting than that the Department of Medicine, the great healing art, with its many divisions should be conspicuously presented? What more opportune time could have been selected by the Climatologists of the whole world to meet and compare their observations and views on the different climates of the earth, and their effects upon humanity, and the dis eases to which flesh is heir. With that object in view a Local Committee of Arrangements has been appointed by the world's Congress Auxiliary, and an Advisory Council will be selected from those eminent in this department in different parts of the world, to arrange a World's Congress of Medical Climatology, to be held at Chicago during the Exposition Season of 1893. The design is to hold this Congress at a time convenient to those who will attend the Congresses of the other divisions of the Department of Medicine which are assigned to open May 29, 1893. This early date was chosen to accommodate those who will de sire to attend the Medical Congress, to be held in Rome, in November of next year. The movement is, as yet, in a formative stage, and much thought must be given to it before a detailed programme can be formulated. The following topics have been suggested, and others will doubtless be added before the final programme is announced: The leading characteristics of the climates of the various States, countries and sections of the world. Diseases produced by the climatic peculiarities and weather changes in the various countries. Relation of climate to consumption. which consumptives recover, or are materially benefited. Health resorts: Special features. Climates in Relations of climatic changes to epidemics. Changes of climate due to cultivation. The effects of the destruction of forests, and other changes incident to civilized life. The relations of diet and climate. What may be done to improve or modify climates for the promotion of health and comfort? Geography of carcinomatous and sarcomatous dis eases. Geography of Bright's disease. Climatic factors which produce epidemic influ enza. Relation of climate to rheumatism. Relation of climate to catarrhal diseases. Relation of climate to longevity. Waters and climate. Climatic effects upon the eye. Relation of climate to diseases of the ear. The effects of sun spots upon climatic conditions. What more can the weather bureaus do to aid climatologists and disseminate climatological knowledge. Comparison of climatic differences as manifested by similar diseases in the North and South Temperature Zones. Climatic relations to remittent and periodical fevers, and to continued fevers. Climatic relation to malaria. Acclimation. Disorders produced by migration. It is the purpose of the committee, with the advice of the council, to arrange for a report from each State and country of its climatic peculiarities. The health resorts of each State and section will also be properly represented. This congress will afford a most favorable opportunity to compare the climates of the various States, countries, islands and continents of the whole world, from a medical standpoint, by delegated, representatives of the various localities. The changes that occur in climates, and which possibly attend the great epidemics, merit world-wide attention. If the effects of the climates upon the one disease, consumption, can by such comparison, be fairly ascertained and approximately settled, great good will result to afflicted humanity. as those who may take part in the discussions. Proposals for membership of the advisory council are also invited. All communications should be addressed to the chairman of the committee. T. C. DUNCAN, M. D., Chairman, I. N. DANFORth, M. D., Vice-Chairman. J. D. HARTLEY, M. D., J. A. ROBISON, M. D., S. A. MCWILLIAMS, M. D., A. L. CLARK, M. D., Committee of the World's Congress Auxiliary on WORLD'S CONGRESS HEADQUARTERS, CHICAGO, August, 1892. MISCELLANEOUS. THE VIVISECTION GNAT AND THE COMMERCIAL CAMEL. The British Medical Journal, in its issue for August 20th, says: It has before been the subject of caustic remark how readily many of those who strain at the gnat of physiological experimental investigation, swallow the camel of wholesale mutilation where either commerce, the pleasures of the table, sport, or agricultural finance require or suggest mutilation, destruction, or wholesale infliction of agonizing pains upon even the most highly organized creatures; not to speak of the wholesale agonies of rabbit-trapping in the warren for the market, or of the coursing of the hare, the hunting of the deer and the fox, and the mutilation of countless pigeons in matches, and grouse, pheasant, and partridge in battues and drives, of the wholesale poisoning of rats and other vermin by strychnine, phosphorus, and arsenic, or of the universal practice of mutilating without anæsthetics. -horses for draft, boars and sows, bulls and rams for the butcher, the creation of liver disease on a great commercial sale to supply the gourmet with foie gras-we notice one of the most humanitarian of papers speaking with approval of an order just given by the departmental commission, appointed recently to inquire into the plague of field mice in Scotland, for experiments to be made on a considerable scale by an eminent biologist, who has undertaken to bring about the destruction of these marauding herds by spreading an epidemic among the mice. In this case, however, everything seems to be condoned because the object for which the services of the researcher are engaged is a commercial one and in the agricultural interest, whereas if it were only to prevent suffering among mankind by discovering with accuracy methods of preventing or curing disease or the effects of disease, we might be sure that Miss Frances Power Cobbe, Bishop Barry, or the Bishop of Manchester would be heard bemoaning the wickedness and cruelty which could think it right to purchase whatever boons to mankind at the cost of pain to any member of the defenseless dumb creation. The inconsistency is sufficiently marked, but it would be hardly worth while emphasizing if it were not that it indicates the underlying fallacy of their whole argument. Which is the greater cruelty, to infect a herd of mice, to im-. prison thousands of rabbits for long hours with broken limbs in steel-jawed gins, to geld a herd of horses or of sheep, or to perform a physiological experiment in the laboratory after giving proof that the object is one important to knowledge and likely to benefit mankind? Nay, the pain and suffering inflicted in any one county in this way is probably greater in a day than that inflicted in the whole physiological laboratories of Great Britain in a year. Moreover, in the one case anæsthetics are never administered, in the other they are so in most cases, and if they are not so administered a special declaration and a special license is required. No declaration and no license is required when the mutilation is inflicted or the agony imposed for any commercial or agricultural purpose or even to gratify a fastidious palate or to satisfy a peculiar aversion. As Sir William Jenner aptly put it on the occasion of the famous deputation of medical men to Mr. Cross, introduced by Mr. Ernest Hart at the home office in 1876, any man may catch a rat in the most cruelly devised trap, or hunt it to death with dogs, or poison it with strychnine, or destroy it as he pleases for the mere reason of dislike or fear, but if he wishes to inflict any kind of pain, however slight, with a view of deriving knowledge for the benefit of medical science and the relief of suffering, he is either forbidden altogether or permitted only to do so under a special license, and even then is held up as a malefactor by certain of the fanatical anti-party.-N. Y. Med. Journal. THE ABDUCTOR AND ADDUCTOR FIBERS OF THE RECURRENT LARYNGEAL NERVE.-The results of an experimental investigation into the functions of the recurrent laryngeal nerve were recently communicated to the Royal Society by Dr. Risien Russell. The investigation was undertaken with the view of discovering whether it was possible to separate the adductor fibers from the abductor fibers of this nerve. It has been long recognized that in organic and progressive affections of the nerve the abductor fibers are likely to suffer sooner than the adductor fibers, but the reason of this is not at all clear. It was suggested by Sir Morell Mackenzie that possibly the abductor fibers were more superficially situated than the adductor, and that this would account for their earlier affection in cases of tumor and of pressure generally from outside. Dr. Risien Russell's experiments were carried out on dogs, the individual bundles of which the nerves were composed being separated and stimulated electrically. The tive irritability of the different bundles was also observed and the bundles were traced by dissection to their peripheral distribution. The abductor and adductor muscles were also subjected to direct observation when excited to action after dissection, and experiments and observations were made on the degenerations following the division of different bundles of nerve fibers. The results of these different investigations show that the abductor and adductor fibers in the recurrent laryngeal nerve are collected into several separate bundles, each preserving an independent course throughout the nerve trunk to its termination in the muscle or muscles which it supplies. It was also found that whereas in the adult animal simultaneous excitation of all the nerve fibers in the recurrent laryngeal nerve results in adduction of the vocal cord on the same side, in rela the young animal the opposite effect, viz., abduction, is that produced by an exactly similar procedure. When the abductor and adductor fibers are exposed to the air the abductor nerves are found to lose their power of electrical excitability much sooner than the adductors, and this is true of both young and adult animals, although in the former the abductor fibers retain their excitability longer. It was further found possible to separate the adductor fibers from the abductor through the whole length of the recurrent laryngeal nerve to their termination in the muscles, and also to so accurately separate the two sets of fibers as to be able to produce abduction or adduction, as the case might be, without evoking any contraction in the muscles of opposite function. The complete separation of the two functions was also shown by the degeneration of the muscles related to one function which followed the division of the corresponding nerve fibers, while the muscles subserving the other function remained unaffected. The greater liability of the abductor fibers to degeneration is very curious, and no explanation of the phenomenon is forthcoming. Sir M. Mackenzie's theory does not find any support from the investigation under discussion-in fact, it is held to be disproved. The fact that in the young dog the abductor influence is found to predominate makes an explanation even more difficult, unless Dr. R. Russell's view is accepted that the greater power of adduction in the adult is related to the increased power of phonation while in the young animal phonation is imperfectly developed.-Lancet. Dr. Joseph L. Hancock, in the Practitioner, describes a simple device for holding soft drainage tubes in place. It is a pin, constructed of one piece of nickel-plated steel wire, turned into a circular form once and a half around. A sudden bend is made and the end carried straight across the middle to opposite side where the point rests upon the wire. The other end of the curved wire is turned into a small hook to receive the point, for holding and giving firmness to the springing frame, which is so made as to facilitate the catching and unlocking of the pin. -Medical Age. Mr. President, Members of the Faculty, Ladies and Gentlemen: I have listened for many years in succession, to addresses delivered on occasions of this kind, but until my own turn came, I failed to appreciate the difficulties under which each speaker must have labored. What could be more diverse in tastes than an audience composed of college professors, practitioners of medicine who do not teach, students who are shortly to enter upon their professional careers, new beginners in medical lore, and ladies and gentlemen whose interest in doctors and doctor's doings is more friendly than scientific? No one, perhaps, is capable of fulfilling the indications presented by such an audience, and I certainly shall not be presumptuous enough to try. Having thus at once apologized for what is to come, and demanded your sympathy, I will proceed to address myself chiefly to the nonprofessional elements of my audience, and to those gentlemen who are about to begin their professional careers--either this evening as students, or a few short months hence as graduates in medicine. During my remarks, the members of the faculty are privileged to go to sleep if they wish and before I am done they will doubtless be very glad of the opportunity. The portion of my audience which I have especially selected for my victims, have a certain community of interest, that has given me, if not an inspiration, at least a suggestion, of a theme for discussion. The layman wonders what kind of a doctor he had best employ, the student, if he be honest, often wonders what kind of a doctor he will make. The latter question was long ago settled as regards the members of the faculty; regard for their excessive modesty forbids my saying more. And so, with your kind permission. I will devote myself to a few remarks descriptive of some of the many kinds of doctors in the profession. Like every one who attempts to show up the other fellow, I shall take good care to keep out of the range of the calcium light and devote my attention to manipulating the machinery. It is to be distinctly understood that nothing I may say has any hypercritical bearing upon Chicago doctors. They have been too thoroughly analyzed and too critically classified by the physicians directory to demand any of our valuable time. I may say in passing, however, that the broad line of distinction is, that Chicago doctors are divided into two classesordinary doctors, and doctors in the Venetian Building. The latter are a little, just a very little, lower than the angels, at least this is true of those attic or as our energetic secretary occupies an office in that sacred pile, I am not so sure about the relative position of the angels. For my purpose it will suffice to divide the profession into city and country doctors. City doctors are so diverse in their characteristics that I must be content with a few distinctive types. None of them are bad perhaps, but some are better than others. First, we have the medical pharisee-I say "first" because I am anxious to get him out of the way-I will leave the audience to judge of his numerical strength and to modify the picture as may seem proper, and content myself by presenting him as I have often caught him with my kodak. There are two kinds of medical pharisees-the lean, lank, cadaverous misanthrope, who would make an excellent understudy for an undertaker; and the fat, sleek, and unctuous brother, on whom the cloak of religion rests ever so lightly, especially on fast days. As success in a worldly way, comes to the lean and hungry fellow, he frequently evolves into the more rotund type. Whether lean or fat, the soul is cast in the same mould, and would not strain the capacity of a silver thimble. If the materialistic theory that the living sensitive brain is the seat of the soul be correct, then indeed is a thimble large enough to hold that of the medical pharisee. From the very beginning of his professional career, the pharisee works the church for what there is in it very much as the coal barons do the mines-and wears his religion upon his sleeve, that he who runs may read. He is the true Christian scientist, who has been described as one who has no science, and less Christianity. He belongs to several churches or rents pews therein, and manages to occupy them all during the brief intervals of his exacting practice. He has a hired man who, like Yorick, is a fellow "of infinite jest," whose delicate sense of humor impels him to call out the pharisee in the midst of services, to attend an imaginary patient. Did you ever notice the voice of the pharisee's hired man? He is usually a red headed Irishman of recent importation, with a brogue you could spread butter on, and a voice like an Italian bananna man. Sometimes the doctor's supe forgets his lines, and then there's trouble in the church. I once heard of a case of this kind. The doctor drilled his servant very carefully, with the result that the Hibernian poked his head through the church door during the morning service and called out "Docthor Jones! Docthor Jones! Mrs. Johnson's baby do bes afther swallyin his cud, and she sez will yez come quick!" But of course the pharisee is not responsible for the pleasantries of his man Friday. Neither is he responsible for the vagaries of the clergymen, who announces from the pulpit that "through divine aid and skillful ministrations of our dear brother, Dr. Pharisee, Mrs. Fourhundred has recovered from her serious illness." This, by the way, is not an unusual Occurence. I heard a very funny story in this connection, the other day. A certain Chicago clergyman announced from the pulpit that "our dear sister Mrs. X. is suffering from a serious and painful illness. She is being cared for by our dear brother Dr. G. Let us all pray for her safety." Knowing the doctor, a very prominent society doctor, I can safely assert that the preacher knew his business. A caustic critic of medical men once said, "Scratch a doctor's back and you will find an infidel.” This was unfair, but if you scratch the pharisee's back you are sure to find a hypocrite. The medical pharisee is very intolerant of other people's opinions, and, to him, the man who does not. believe with him, is beyond redemption. To be sure, he prays, weeps, smiles, and exhorts only with his mouth, but he has as much faith in the efficacy of noise, in wafting souls to heaven, as does the average Chinaman. The pharisee goeth into the various holy places of a Sunday morning and prays with a mighty voice as of sounding brass and tinkling symbols. And the burden of his prayer is for the "welfare of the dear people of the congregation; " he asks" that the plague may go by on the other side," but qualifies by praying that, "in case the affliction should come, a good and wise physician like himself should be selected to care for the afflicted ones." If you would see the medical pharisee at his best, just drop a joke some where in his vicinity, and see the old fellow jump. The effect of dynamite in the hands of an enthusiastic anarchist is not a circumstance to that joke. "he The medical pharisee is a great stickler for ethics; he prates on this question ad nauseam. Strange to say, however, it is at the hands of this ultra-ethical individual, that the reputation of the young doctor who dares to flaunt his shingle to the breeze in the pharisee's neighborhood, suffers the most. He it is who in consultation makes diagnoses by intuition and damns the young aspirant for medical fame with faint praise or covertly thrusts a blade of uncharitable. criticism under the young doctor's fifth rib. He it is who says, with a scornful intonation, as he feels the pulse of a patient with both lungs solidified clear up to his neck, "this is not a case of pneumonia; the paraphernalia of this man's brain has become obfuscated, with a resultant corpusculation of the diaphragm, and that's what makes him short of breath." And the poor patient turns his face to the wall and dies, in the sublime consciousness that he at last knows exactly what's the matter. It is the pharisee who gets the weeping crowds and the longest funeral procession when he dies; the only honor which we grant him with any degree of cheerfulness and resignation. Who could be more worthy of respect than the consistent Christian who has the courage of his convictions, yet is broad and catholic in his tolerance of the conscientious opinions of others; and who is more contemptible than the medical pharisee? But, after all, the medical pharisee is not a fair type of the city doctor, he is but a noxious weed in the broad field of city practice. If this weed could only be torn up and destroyed, there would be more of a living chance for the more worthy plants. Unfortunately, however, the pharisee is popular, he lives ostentatiously, and drives a stylish rig, and all this takes with the masses. And the struggling yet talented young doctor must keep up with the procession or go to the wall. Many a doctor's family has gone threadbare and even hungry, in order that its breadwinner might have an even chance with the medical pharisee in the struggle for existence. Only a doctor knows the heartaches and disappointed hopes that often lie just beyond the swell turn-out of the city doctor. Things sometimes look very different when the scenes are rolled away and the bare boards of the doctor's life are revealed. Let those optimistic idiots who say that the doctor makes his money easily, try a hand at general practice for a short time, and they will be a little more liberal with the profession. There is another individual who is an excellent running mate for the pharisee, although they could. hardly be said to be well matched. This fellow is popularly known as "Doc." As we are drawing botanical comparisons, we might call him "dockweed." He also has an exacting practice, but in lieu of the church, he spends the intervals of his arduous labors in working for the cause of prohibition-by surrounding the enemy, so to speak. His capacity for whisky is enormous, and his popularity with ward. politicians correspondingly great. This is the man of whom the laity says, "he's the best doctor in the neighborhood when he's sober." I never could see the logic of this assertion, but you have all heard it, or something similar. As the calcium light of calm reflection glitters on the rich carmine of his proboscis, what do you think of him? Does he deserve a Cook County Hospital position? You all know that this exalted position is never beyond his reach. An astute Cook County Commissioner once remarked, "that the county hospital should no longer be a kitchen for medical colleges." Perish the thought! It is so much better to convert our public institutions into garbage boxes for ward bummers and shady politicians. This good doctor-when he's sober-is a fruitful theme, but it makes me so weary to think about him that I will do no more than to briefly introduce him, feeling sure that you will be surprised to learn that he is an old acquaintance-that you have met him before. This much I will say, however: When anybody tells you that a town drunkard can be a good doctor, believe him, providing he can show a correctly drawn death certificate for the aforesaid doctor. A drunken doctor is a good doctor when he's like Mark Twain's good Indian, very, very dead. And when such a man prates of his greatness, as he often does, for he is often one of those men with genius written upon his brow-written there by himself-and complains because the world at large, and the profession in particular, cannot see it, just be thankful that some people, in some directions, get about what they deserve in this world. And now, that the medical pharisee and the dock have been weeded out, metaphorically, you are perhaps wondering whether there is an ideal. city doctor, and what he may be like, I have an ideal, which has often been realized in the medical profession. Although the particular embodiment of the ideal of which I shall speak has long since passed away, the type is always with us, and each one of my hearers, perhaps, may know such a one. He was of a type which may be familiar to many of you as "our family doctor," even though you may not fully appreciate him. The man who was to me an ideal physician had grown gray in the service, and had seen less deserving classmates push forward to wide reputations and financial rewards, while he remained in the same plodding path that he entered on leaving the hospitals. He was not popular in the early days of his practice in the North, for he was a Virginian, and the people of his colder northern environment were rather slow to forget that he had been a rebel surgeon. He had seen his duty in the care of the suffering soldier in gray. How well he performed that duty the stricken soldiers of the army of the Tennessee could testify. When popularity did come, it was |