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receiving aid is 956,779. For the week ending February 11, there were reported 87,729 indigents; with 3, 170 on the sick list, and 199 deaths. 589,491 rations were issued to this mass of suffering humanity, while 8,845 men were working for food.

THE SAMUEL D. GROSS Prize of One THOUSAND DOLLARS.-The announcement is made through the Philadelphia Academy of Surgery by the trustees of this prize fund that they have not received any essay which they deemed worthy of the prize announced for January 1, 1900, and they further announce that the prize will be awarded on October 1, 1901. The essays, which must be written by a single author in the English language, should be sent to the "Trustees of the Samuel B. Gross Prize of the Philadelphia Academy of Surgery, care of the College of Physicians, 219 S. 13th St., Philadelphia," on or before that date. Each essay must be distinguished by a motto, and accompanied by a sealed envelope bearing the same motto and containing the name and address of the writer. No envelope will be opened except that which accompanies the successful essay. For further information address the Committee.

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AMERICAN ACADEMY OF MEDICINE.-The twenty-fifth annual meeting of the American Academy of medicine will be held at The Shelburne," Atlantic City, N. J., on Saturday, June 2nd and Monday, June 4th, 1900, under the Presidency of Dr. G. Hudson Makuen, of Philadelphia. “The Medical Aspects of the Home" will be considered in the following papers: "What are the Essential Conditions for a Habitation to Develop and Maintain a Healthful Family Existence?" by Dr. Rosa Englemann, Chicago; "The Influence of Early Training of Manly and Womanly Qualities to Avoid Degeneracy," by Dr. J. Chester Morris, Philadelphia; "Artificial Lighting of the Home," by Dr. S. D. Risley, Philadelphia; “The Influence of Medical Supervision of Children in their Homes," by Dr. J. Madison Taylor, Philadelphia; "The Physician's Influence in re Vacation Schools," by Dr. Helen C. Putnam, Providence; and "Defectives and Delinquents Inside and Outside the Family Circle," by Dr. James W. Walk, Philadelphia. Other papers of interest on miscellaneous topics will be presented.

BIBLIOGRAPHIA MEDICA (INDEX MEDICUS).-On February 15, 1900, appeared the first number of the Bibliographia Medica, published under the auspices of the "Bureaux de l'Institut de Bibliographie" of Paris. This publication, modeled after the Index Medicus which suspended publication last year, will be a monthly review appearing the fifteenth of each month and will contain in the neighborhood of eighty pages devoted to the International Bibliography of the Medical Sciences. M. Marcel Baudouin, Director of the Institute of Bibliography of Paris, will be editor-in-chief, assisted by Mm. C. Potain, Member of the Institute, and Charles Richet, professors in the "Faculté de Médecine de Paris." This publication will be as complete as the Index Medicus but at the greatly reduced price of sixty francs or $12 to subscribers outside of France. All communications, journals, books, etc., should be addressed to M. le Dr Marcel Baudouin, Rédacteur en chef-gérant, à l'Institut de Bibliographie, 93, Boulevard Saint-Germain, Paris.

MORTALITY OF THE STATE OF NEW YORK FOR THE YEAR 1899.-The number of deaths from all causes reported for the year in the Monthly Bulletin is 121,820; this is 850 more than in 1898, and 4,740 more than in 1897, which was a year of unusually low mortality; it exceeds the average mortality of the ten preceding years by 2,550. Besides these reported deaths there were 1,200 delayed returns, not reported in the Bulletin. The death rate per thousand population is 17.3 which is the average death rate for the past ten years; that of 1898 was 18.0. The decrease in the death rate is chiefly in the Maritime district where the mortality was less by 800 than in 1898. The infant mortality was less than the average by nearly 5,000 and is 1,800 less than that of last year, 29.0 per cent of the deaths occurring under five years of age against the average of 35.0. There were 1,100 fewer infant deaths in the Maritime district than in 1898 and there is decrease in all the district save the Lake Ontario and Western. The zymotic mortality was 12.0 of the total against the average 17.0. Compared with the average of ten years the deaths from diphtheria are but little more than half as many, though the number is 175 greater than in 1898; diarrheal diseases caused 2,000 fewer deaths than the average; whooping-cough, measles, scarlet fever and malarial diseases all have fewer deaths reported from them than the average. The only zymotic disease which caused an increased mortality is cerebro-spinal meningitis, of however no local prevalence. Small pox caused 21 deaths, all occurring in New York city, save 1 each in Rochester, Troy and the adjacent village of Waterford. The outbreak in the western part of the state, beginning in May, 1898, continued till midsummer of 1899, reaching 45 localities, in 14 counties, and about 320 individuals, only one of the number ending fatally. Sporadic cases of separate outside origin subsequently occurred in 13 localities, extensive only in one instance, among negro laborers in brick yards at Coeymans and Athens, and causing two deaths in Troy and vicinity. At the end of the year the state is believed to be free from small pox. Grippe is estimated to have caused 7,000 deaths January to April; an epidemic of moderate severity prevails at the close of the year. The deaths from acute respiratory and other local diseases were excessive on account of it, nearly 18,000 deaths from the respiratory diseases having occurred, or nearly 15 per cent of all deaths.

PERSONAL.-Dr. WENDELL C. PHILLIPS, who served as Chairman of the Business Committee at the recent meeting of the State Medical Society at Albany, has been appointed Surgeon in Otology to the Manhattan Eye and Ear Hospital, and Chairman of the Section in Laryngology of the New York Academy of Medicine.

-Dr. JAMES P. KIMBALL, U. S. A. (A. M. C., '64), has been promoted to be Lieutenant-Colonel and ordered from Governor's Island to Omaha, Neb., as Chief-Surgeon of the Department of the Missouri.

-Dr. FREDERICK D. BRANCH (A. M. C., '99), House Surgeon at St. Peter's Hospital, has been appointed Acting Assistant Surgeon, U. S. A., with the rank of first lieutenant, and has been ordered to report to the General Commanding at San Francisco to proceed to the Philippine Islands for

service.

—Dr. W. J. CAVANAUGH, of Worcester, N. Y. (A. M. C., '99), has purchased the practice of Dr. Lemuel Cross, of Cobleskill, N. Y., where he I will locate in the near future.

-Dr. ARTHUR G. ROOT (A. M. C., '90), has been appointed by Governor Roosevelt to fill the vacancy in the board in the Rochester Industrial School.

MARRIED: SALMON-ASHLEY.-At Lansingburgh, N. Y., Thursday, December 21, 1899, Thomas W. Salmon, M. D. (A. M. C., '99), to Helen Potter Ashley. Dr. and Mrs. Salmon will reside at Brewster, N. Y., where Dr. Salmon is established in practice.

Book Reviews

Text Book of Ophthalmology. BY DR. ERNEST FUCHS, Professor of Ophthalmology in the University of Vienna. Authorized Translation by A. DUANE, M.D., Assistant Surgeon, Ophthalmic and Aural Institute. New York: D. Appleton & Company, 1899.

This treatise on the entire subject of Ophthalmology is a royal octavo volume of 860 pages; contains 277 illustrations. It constitutes the second American edition. The work is what would naturally be expected from its author, who is everywhere known, among those informed on the subject, as one of the ablest ophthalmologists. The translator is likewise a man of very superior attainments, whose possessions he has abundantly proved by his literary and clinical work. Neither author nor translator exploits any fads in this book. It is inevitable that diseases and their treatment differ somewhat, according to their geographical location; this naturally results from the variation in environment. Dr. Duane has fully allowed for this fact and has pointed out, in this American edition, the necessary differences between ophthalmology as seen in the Eastern, and the same science and art, as seen in the Western continent. The work is exemplary, as being free from typographical and other errors. Of course it is not absolutely so. The one concluding the first paragraph of page 764 might be bothersome, to one who had not a pretty firmly fixed opinion of the matter, already, but it is not likely to appear in any subsequent edition, as it has already been called to the attention of the publishers by the translator. This work is so nearly a leader in its class, and its class is so advanced, that it seems well nigh presumptuous for a reviewer to recommend it. It is entitled, however, by its merit, to high recommendation.

C. M. C.

ALBANY

MEDICAL ANNALS

Original Communications

FEVERS AND FEVER REMEDIES.*

By A. JACOBI, M. D., LL. D.,

New York.

The etiology of fever may be ever so obscure, or disputable, still there are a number of facts common to all its varieties. There is in every form of fever some degree of hyperthermy; both the heart beats and the pulse are accelerated, blood pressure is mostly low, and the number of respirations is increased. Consumption both of ingesta and of tissues (amongst which the volumes of the heart and of the brain are the last to be influenced either by fever or by inanition) is increased, more in fever however than in mere inanition. For while the absorption of oxygen increases in fever by only twenty per cent., the elimination of carbonic acid grows by from fifty to eighty per cent. Such is the case though it be cold water that depressed the temperature; but much more so in warm surroundings than in cooler ones. That shows how detrimental must have been the method of keeping fever patients warm.

The coloring substance of the urine which originates in the blood is increased twenty fold, the elimination of potassium seven or eight fold, that of sodium however is diminished, so that in pneumonia for instance there is almost none in the urine. Albuminoid disintegration is vastly increased, thus more nitrogen is eliminated. Urea, the daily amount of which in the normal man is thirty grammes, during starvation ten, during copious intro

*Read before the Medical Society of the State of New York, January 30, 1900.

duction of nitrogenous food sixty grammes, is eliminated while the food supply is scanty, in quantities changing from forty to eighty grammes daily, not only during the height of, but before and after the fever. Kreatinin and uric acid also are largely increased. Albumosuria is common both in infectious and in aseptic fevers, and is likely to be a common-perhaps universal-symptom which indicates danger. For albumoses seem to be the final results of albuminoids decomposed in the muscles and the liver by the fever generating substances that circulate in the blood. When they are rapidly eliminated through the kidneys, the danger is not great; when not, they paralyse or poison the nervous system and interfere with the innervation of the blood vessels and the elimination of the body heat.

The vascular ganglia in the blood vessel walls are under the influence of the vascular centres of the spinal cord, these under that of the main vaso-motor centre of the medulla oblongata, and this again is controlled by the temperature centre in the cerebral hemisphere which at the same time regulates the intensity of metabolism. It is here that a puncture, or a trauma, or a tumor, or a local disease may rouse sudden or protracted temperatures. Whether there is, in addition to the centre that makes temperatures rise, another one that inhibits, remains to be seen. The assumption of its existence appears to be unnecessary.

Increased temperatures and increased metabolism are not however identical. For the latter when both production and elimination are equally increased may grow with normal temperature.

And there are surely fevers which result from diminished elimination during normal production of heat. The dangers of such condition depend upon the degree of vitality in the organs or the organism. Toxic fevers for instance while they increase metabolism, injure the power of resistance on the part of the cells.

Most fevers seem to be of microbic origin, but there are many exceptions to this rule.

Specimens of fevers not caused by microbic influences are those which are observed after childbirth when there is no endometritis or parametritis, but only a clot in the uterus; or in the presence of hæmatomata, or during the disintegration and absorption of exudations in protracted pleurisy or pneumonia or in ascites originating in tuberculous peritonitis, or during the absorption of

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