pleural cavities. The man died while preparations were being made to evacuate the pus by rapid incision. At the autopsy, which was made twelve hours after death, the rigor mortis was extremely slight. There were two quite superficial recent abrasions over the second toe, and one over the right knee. The abdominal cavity was normal, with the exception of a slight recent perihepatitis. The diaphragm was depressed about one space on each side. Each pleural cavity contained about fifteen hundred cubic centimetres of sero-purulent fluid, and the lower and posterior portions of both lungs were covered with very thick layers of purulent fibrin. The layer over the right lung was fully one and a half centimetre in thickness. The lungs were adherent posteriorly, and during life gave rise to numerous râles over the posterior portion of the chest. On cutting open the lungs, the upper half of the upper lobe of the left lung showed a mass of fibrous tissue, with cheesy areas scattered through it, showing the existence of an old tuberculosis. In another portion of the same lung were several small, grayish, shot-like tubercles, evidently of very slow growth. Similar lesions, though of less extent, were found in the apex of the right lung. The vessels were free from thrombi, and there was no oedema. The pericardial sac was greatly distended with thin pus, and both surfaces of the pericardium were covered quite thickly with purulent fibrin. The clinical record showed that the heart-sounds had not been particularly feeble, and that there had been no friction-sounds heard. In the same case there was an acute lepto-meningitis, involving both the brain and spinal cord. The exudate was over the entire surface, but was most abundant over the vertex and median surface. An unusual quantity of sero-purulent fluid escaped on incising the brain. The velum interpositum contained considerable pus, and there was a small amount of purulent fluid in each lateral ventricle. Examination of the fresh blood from the brain and pericardium showed in the former an unusually large number of diplococci with distinct capsules. In the fibrin from the surface of the lung and from the pericardium, a few of these only were found. An unusually large Meckel's diverticulum was present in this case. It was about two feet from the ileocæcal valve, and was 14 ctm. in length and 3 ctm. in diameter. There were a number of small secondary diverticula near the termination. At the hepatic flexure of the colon were four pigmented cicatrices, 1⁄2 to 2 ctm. in diameter, and feeling more or less nodular. Encapsulated Empyema; Ulcerative Endocarditis; Renal Calculus. Dr. Biggs also presented specimens from a second case. This patient was a female, fortyfive years of age, who first complained of sickness about five weeks before she came under observation at the New York Hospital. On admission complained of pain on the right side with dyspnoea, and of cough with mucous expectoration. There was no chill or fever, and she did not take to her bed until about three weeks before death. On entering the hospital her temperature was 100.6° F., respirations 36, and pulse 136. At this time there were signs of fluid in the right chest; the heart was intermittent and very feeble. The right chest was aspirated, and seventeen ounces of purulent serum withdrawn. The temperature then rose to 103.4° F. The chest was accordingly incised and drained. Examination of the urine showed a trace of albumin with granular casts. The temperature still remained between 104° and 105° F. after this drainage of the chest ; she developed slight delirium, and finally died twelve hours after the operation. At the autopsy, a double empyæma was found. The cavity which had been drained was free from fluid, but there was considerable fibrin. On the left side there was an encapsulated empyema over the middle of the lower lobe, containing about six ounces of pus. The heart was slightly dilated. The left ventricular wall was very slightly hypertrophied. The tricuspid, mitral, and aortic valves were perfectly normal. On two of the cusps of the pulmonary valve were large thrombi, with ulceration of the under surface of the valve. The largest thrombus had a diameter of 2 ctm., was very firm, and distinctly laminated. The lungs were congested and œdematous, and there was some hypostatic consolidation of the posterior portions. The spleen was two and onehalf times its normal size, and quite soft. The left kidney was much larger than normal, the capsule was slightly adherent, the surface was finely granular, and the cortex showed many cysts. The right kidney was surrounded by an unusually thick layer of adipose tissue. The kidney appeared outwardly to be about normal, except that its capsule was adherent. The pelvis was considerably dilated, and contained a calculus, 4 by 14 ctm., one end of which fitted into the opening of the ureter. Around the pelvis was a thick deposit of solid adipose tissue between the pelvis and the kidney-tissue proper. The latter formed a ring only about three-quarters of a centimetre thick at the surface. Tumors of the Skin-Mycosis Fungoides.-Dr. Biggs next presented some unusual tumors of the skin. They had been removed from a married woman, thirtyfive years of age, whose family and personal histories. were negative. About four years before coming under observation at the New York Hospital, she had first noticed an eruption on the legs, arms, and back, which was described as consisting of red pimples slightly depressed in their centres. These had grown slowly until some of them had reached the size of a hen's Some had disappeared spontaneously, it was said, leaving a copper-colored stain, while others had ulcerated. The urine had been normal; the temperature 99.2° F., the pulse 80, and the respirations 20. At the time of admission, examination showed an immense number of reddish non-indurated spots on the legs, and a few on the back. There were twenty to thirty' nodules, varying in size from a pea to a hen's egg, and ulcerated on their flattened surfaces. The large ones were found chiefly on the legs, thighs, and hips. They were all very freely movable, and slightly constricted at the base. The glands of the groin and axilla were enlarged. A number of the large tumors were removed from different situations. About two weeks after this, the history stated, two tumors had nearly disappeared spontaneously, and two weeks later, some new tumors had appeared. Three of these large growths were presented to the Society. One had a diameter of 8 ctm., and was elevated about three centimetres above the surrounding skin; another was 51⁄2 etm. in diameter, and the third was 3 ctm. in diameter. In the fresh state they were red over the surface, and appeared to be superficially ulcerated. On incision, they were found to be of firm consistence, grayish in color, moderately vascular, and not degenerated in any portion. Microscopical examination. showed that the epidermis was not involved except where ulceration had occurred, the process having been in the derma and subcutaneous tissue. In structure they consisted mainly of small round cells with a small amount of young connective tissue mixed with them. The blood-vessels had quite thin walls. The appearance was not unlike that of some cases of apparently simple adenitis. It also bore a striking resemblance to a sarcomatous growth, so that it had been a matter of dispute whether these growths could be distinguished from sarcomata. Those who claimed to distinguish between the two, said that the clinical history was different-the condition beginning as an eruption not unlike lichen planus, and the fungoid growths not developing for some time afterward. other distinguishing point was the spontaneous disappearance of some of the tumors, eventually leaving not even a copper-colored staining. If no complication occurred, death resulted in these cases from progressive anæmia or from the development of leukæmia. An A few observers had found the condition associated with a micrococcus, but many other observers had not found them present. Correspondence. OUR LONDON LETTER. (From our Special Correspondent.) DR. JAMESON, C. B., THE SOUTH AFRICAN ADMINISTRATOR DETACHMENT OF 66 RETINA-MALINGERING PARALYSIS OF DIAPHRAGM AFTER DIPHTHERIAINTESTINAL OBSTRUCTION FROM GALLSTONES HEALTH OF LONDON. LONDON, February 2, 1895. DR. JAMESON's distinguished career as a South African Administrator" is naturally a source of congratulation by his professional brethren, especially those who knew him in earlier days. This feeling has led to his being entertained at a dinner got up in his honor by his old teachers and fellow-students of University College, where he obtained no little credit during his curriculum and competed successfully against Mr. Pepper for a residential appointment. Mr. Christopher Heath took the chair at the dinner, where Sir Russell Reynolds and other teachers of Dr. Jameson were present. In returning thanks for the toast of the evening Dr. Jameson was very happy in the way he assured his hosts that whatever political views might be held and whatever public opinion might eventually obtain, he was most anxious that his profession should understand the origin of what took place, how for three years everything possible had been done to avoid a conflict, how he hoped to the last it would still be avoided, and that no one could be more ready than he was to condemn any attempt to bring on a conflict with these unfortunate races. On Monday Dr. Jameson gave an address at the Imperial Institute to a distinguished audience, between two thousand and three thousand in number, presided over by the Prince of Wales. The doctor gave a glowing account of the territories of the chartered company, where whites can live in health and rear their families, and where there is plenty of room for our overflowing population, and prosperity awaits their arrival. Sometimes the course of retinitis in cases of granular kidney is very rapid, though in others dimness of vision may not be complained of. The prognosis, however, of albuminuric retinitis in any form is generally grave. Occasionally detachment of the retina occurs, and Dr. Samuel West related two cases of this lesion at the Clinical Society last Friday. He drew attention to the suddenness of the onset of failing vision; for a patient may become blind in a few days after first perceiving any dimness. It must be admitted that detachment of the retina is very rare compared with hemorrhage, though one of Dr. West's cases was complicated by purpura; thus showing a hemorrhagic tendency. Dr. Semon related a rather curious case of malingering in a lady, thirty-six years of age, who inflicted injuries on her throat, apparently for the sake of exciting sympathy. There seems to be no doubt about the origin of the injury, and the patient had formerly been seen by Mr. Hutchinson for injuries about the breast, which he was convinced were artificially produced. Some other cases of malingering were mentioned by other speakers, after which a paper was read by Dr. Pasteur on respiratory paralysis associated with cardiopulmonary symptoms in diphtheritic paralysis, based on 32 cases in the Northeastern Children's Hospital. In no less than 29 of these cases the diaphragm was paralyzed and 16 of them died. This is certainly a very large proportion, and the author found that the diaphragm might be affected with paralysis coming on insidiously as a part of the peripheral palsy, or it might come on acutely as a part of a bulbar crisis. If such experience is general, the mortality of diphtheritic paralysis is probably higher than commonly supposed, as the fatal symptoms might not be attributed to the primary disease. Certainly, recovery from bulbar crisis must be very rare, and the supervention of respiratory trouble would indicate the gravest prognosis. If paralysis of the diaphragm lasted for two days, Dr. Pasteur found collapse of the lung very likely to occur, giving rise to definite physical signs, the base of the right being more frequently affected than that of the left lung. Many of his cases were verified by autopsy, and all were excluded in which there was any doubt as to the paralysis of the diaphragm. A good deal of surprise was nevertheless expressed at the large proportion of recoveries from a lesion which is generally observed to be fatal, and there is no doubt that it may occur later than is often supposed, coming on quite suddenly, six, eight, or nine weeks after the primary disease. At the last meeting of the Royal Medical and Chirurgical Society Mr. Mayo Robson read a paper on the varieties of intestinal obstruction due to gall-stones, which he classified thus: 1. Dependent on local peritonitis in the region of the gall-bladder leading to paralysis of the bowel. 2. Volvulus due to violence of the colic induced by the passage of a large concretion through the small intestine. 3. Mechanical obstruction by a large concretion. 4. Obstructions by adhe sions or stricture, the result of past attacks, or of healing fistula. Two cases were related of the first kind, then two of the second. While as to impaction, communications from institutions receiving eighty thousand patients gave only four cases in the last twelve months, showing that even this form, though the commonest, is certainly rare; a conclusion which agreed with the statistics of other speakers. Mr. Robson considered recovery from volvulus scarcely possible except by operation, and that statistics earlier than two years ago could not give such results as may now be obtained, still less as we anticipate in future. At the same time he admitted that if all surgeons operated as routine treatment increased, mortality might follow. The President (Mr. Hutchinson) regretted the author had not collated the successes in recent years, and said that up to this time one-half of his cases died after operation, and he was inclined to think that even when death threatened, the chances of recovery were about equal if operation was refused. He hardly thought the third class supported the proposal for operating, and he mentioned another class which had not been alluded to, viz., cases when a gall-stone remained for months in the intestine, giving rise to repeated attacks of obstruction. He spoke of two such cases, both of which eventually passed the stone without assistance, and remarked that he had never seen in the autopsy-room an impacted stone which had caused death. Another speaker had previously remarked that he had only seen one impacted gall-stone in the course of eight hundred autopsies, but I believe there are a few specimens scattered among the pathological museums. The health of London is improved. Last week the mortality from diphtheria fell to twenty-nine, just one under the corrected average for ten years. The British Institute is now supplying antitoxin. The British Pharmacopoeia is apparently as perfect as, and more tangible than, the British Constitution, In a heated discussion before the General Medical Council concerning the need of a revision, one speaker after another declared it to be the best pharmacopoeia ever published, and the general opinion seemed to be that it would be as wicked to revise the pharmacopoeia as to revise the prayer-book. A HYPNOTIZED MURDERER. TO THE EDITOR OF THE MEDICAL REcord. SIR Referring to your editorial in the MEDICAL RECORD of January 12, 1895, entitled "A Hypnotized Murderer," it fell to my lot to be a witness in this case, at the coroner's inquest, the preliminary, and at the final trial in the District Court. I was called to attend the murdered man, Thomas Patton. The subject of hypnotism was not suggested until after the jury in the case of the State against Anderson Gray had rendered their verdict, which was murder in the first degree; but during or after the trial of Macdonald, who was cleared and whose case immediately followed that of Gray, some enterprising newspaper correspondent sprung the hypnotism theory; the wide publication of the matter came about in this way; no evidence was introduced during the entire trial tending to show that Macdonald had been hypnotized. Gray was convicted upon the ground that he was an accomplice in the murder, that he influenced Macdonald to do the shooting. I am yours very truly, R. A. MCILHENNY, M.D. CONWAY SPRINGS, KAN., January 31, 1895. THE NATIONAL HEALTH BUREAU. TO THE EDITOr of the MeDICAL RECORD. SIR It is earnestly to be hoped that legislation for the establishing of a national department of health, or a national health bureau of some kind, will not be jeopardized, or entirely defeated, in the present Congress by differences among medical men as to the proper scope and character of the proposed law. The details of the scheme are of minor importance, and it would be well for medical men to waive somewhat of their preferences and endeavor to unite upon that which seems most feasible, rather than divide upon different measures and, by want of unanimity, secure nothing. [The session of the present Congress ends in about four weeks from now, and if no action be taken before March 1st, the question goes over to another Congress, and nothing may be done for two years or more.] The importance of this measure can hardly be overestimated. Nothing is of more importance than the health of the people, and there is every reason why there should be in the general government a department or bureau charged with the duty of investigating the causes of disease, especially of epidemics, the collecting of statistics of disease, health, and mortality, and reporting upon all facts bearing upon the sanitary conditions of the people. And no one who has had occasion to examine the statistical reports of the health boards in different cities and States of the Union need be told how imperfect, confusing, and unsatisfactory they are. One of the first good results of the proposed department would be something like order and reliability in the reports from different parts of the country in the matter of disease and mortality, instead of the present incomplete conglomeration. The President of the United States has, in his late message to Congress, recommended the inauguration of a national board of health, "or similar national instrumentality," and a bill to that end is now before Congress. The scope of this bill is none too broad, nor its powers too great, for the work of collecting and collaborating reliable data as to the sanitary conditions in all parts of the country and presenting them in intelligible form as a basis for the action of local health authorities or of Congress. Out of such a department we might expect to grow an institute similar to that founded at Berlin, under a special act of the German government, for experimental investigations in the line of bacteriology. A large part of the work on the antitoxin treatment of diphtheria has been done in that institute, or in connection with it. New discoveries in this direction are certain to be made, and we should 253 have a national laboratory for such investigations. If a national board of health were to give its endorsement to antitoxin treatment in diphtheria, and stand ready to furnish from its laboratory the immunizing serum, then its use in the treatment and prevention of this disease throughout the country would become general, and the neglect to use it, should epidemics of diphtheria occur, would be almost criminal. Those who have this matter in charge should rouse themselves and push it at once and vigorously in some shape. If we cannot get the ideal measure, let us have what we can get. LEONARD LANDES, M.D. NEW YORK, February 2, 1895. A MAN WITH FOUR TESTES. TO THE EDITOR of the MEDICAL RECOrd. SIR In mentioning the following fact to a physician, he asked me to write of it to you, as a matter of interest to the medical profession. As the recruiting officer of the United States Army at this point, the duty of making medical examinations of applicants devolves on me. In a recent examination of a recruit I found he had, as I supposed, three testicles. Knowing that it would interest a physician, I took the man to one, who found that the fellow was better off yet he had four. Three were on the left side of the scrotum, and one on the right. They were all apparently perfect testicles, and gave the peculiar pain incident to pressure. Three were large and welldeveloped, and one, situated high up in the scrotum, was small. There appeared to be but two spermatic cords, though the two large testicles in the left side seemed connected by a subsidiary spermatic cord, which I suppose would indicate that one was supplied from the other. Yours truly, ALEX. M. DAVIS, 2d Lieutenant, Eighth Cavalry, Recruiting Officer. FORT WAYNE, IND., January 29, 1895. THE SIN OF SUBSTITUTION. TO THE EDITOR OF THE MEDICAL RECORD. SIR Physicians all over the country are complaining of the "sin of substitution" practised by druggists, yet, notwithstanding this universal complaint on the part of physicians, they do not begin to realize the extent to which substituting is indulged in by druggists. It is impossible for physicians practising in large towns or cities to "follow up" their prescriptions as closely as those who are located in smaller towns, as the former do not meet their patients in a social or casual way nearly so often as the latter; and, indeed, not more than perhaps fifty per cent. of the patients of the busy city doctor are personally known to him, and not one time in a hundred has he the opportunity of knowing whether his prescription accomplished its purpose or not. It is different with the doctor living in a small town; if the medicine he prescribes does not do its work he hears from his patient "in no uncertain tones," and how often have I investigated under these circumstances and found that the medicine prescribed had not been put up by the druggist, but a substitute instead. Not long ago I had occasion to repeat for a little. patient a prescription of elix. pepsin and bismuth; as the little patient and her mother were about to start for a visit to San Francisco and had not the time to have the prescription filled by the home druggist, it was taken to San Francisco and filled by one of the best known druggists of that city. When the mother went to give a dose of the medicine to the child it was so unlike that which had been previously prescribed that she refused to use it, and on her return home brought the bottle of medicine with her and immediately sent it to my office for examination. I found it to be nothing more than a simple elixir containing a little subnitrate of bismuth and a little powdered pepsin. It might have answered the same purpose as the preparation I prescribed, but it was not what the prescription called for. Again, not long since I had occasion to prescribe for a child suffering from indigestion, with instructions to have the prescription repeated as long as the child needed it. It was properly filled the first and second times; the third time it was filled it seemed not to have the desired effect, the child got quite sick and I was sent for. I asked to see the medicine and on examination found it not to be what the prescription called for. I sent the bottle to the druggist with a message to put up the preparation my prescription called for, and no other. The patient began immediately to improve, and soon recovered from the attack of indigestion. I afterward found that the druggist had substituted his own preparation, a very good imitation so far as color and general appearances were concerned, but utterly worthless as a medicinal preparation. I could give many instances such as these that have come to my knowledge, not only in my own practice but also of other physicians, so I think I am correct in presuming that similar substitutions have often occurred when I had no opportunity of tracing them up. My experience with the average druggist leads me to conclude that his reliability is about on a par with that of the butcher and milkman. Now what is the remedy for this appalling and unfortunate state of affairs? There are two, and I think only two. First. The physician can keep his own drugs and compound his own prescriptions, but this is possible only with the country doctor or those located in small towns. With the physicians living in large towns and cities it is impracticable and not to be considered. Second. For the benefit of the city physicians I propose the following plan: Let the physicians form a joint stock association for the purpose of owning and operating a certain number of drug-stores (according to population) in every large town and city, the stock issued by said association to be owned exclusively by the practising physicians of the town or city in which the drug-stores are located. The association to elect annually a board of managers, say of three or five of its members or stockholders, this board to appoint competent druggists to conduct the business of the several stores, the druggists to have no monetary interests whatever in the business, but to depend entirely upon their salaries-this will relieve them from any temptation to indulge in the art of substituting. These stores may carry a general line of druggists' sundries or do only a prescription business, as the association may elect. I believe this plan will not only solve the vexed question, but will also yield a profit to the stockholders. Of course practical unanimity of action on the part of the physicians of each town or city is necessary for the success of the enterprise. This plan will also put a stop to the universal habit of counter prescribing indulged in on the part of druggists, which is carried on to an extent beyond any idea conceived of by physicians generally. Not one case in fifty of gonorrhoea is now treated by the physician, the druggists having completely captured that branch of the business which legitimately belongs to the physician. The same may be said in regard to many other diseases, and I have even known of their making a habit of treating syphilis. Much more could be said in advocacy of the necessity of physicians associating themselves together for their mutual protection against their archenemy the druggist; but as this article is already longer than I intended, I will leave its further consideration to some other MEDICO. CALIFORNIA, February 1, 1895. ANTISEPTIC TREATMENT OF DIPHTHERIA. SIR Discussion is the forceps for wisdom. So then, in in one instance, I remember, sterilized in the same 266 WEST FORTY-SECOND STREET, NEW YORK. MALARIA A WATER-BORNE DISEASE. TO THE EDITOR OF THE MEDICAL RECORD. SIR: In the interest of getting at all the facts, the following questions ought to be answered in connection with, and as a part of, the report made by Dr. E. Kershner, Medical Inspector, United States Navy, etc., in the MEDICAL RECORD, January 5, 1895, viz.: 1. What were the exact dates during which the flagship New York laid respectively at St. Lucia, Rio de Janeiro, and Bahia? 2. What were the distances and locations from shore, and the geographical conditions of the nearest land? 3. What were the prevailing winds and other meteorological conditions? 4. What were the prevailing symptoms of the cases of malarial fever? 5. What were the means of diagnosis resorted to? 6. Were any specimens of blood inspected for the malarial parasite? 7. Are we to understand, literally, that "no one was permitted to go ashore at either of these places," as meaning that no officer, even of any rank, was permitted to, or did, go ashore at any of these places? 8. What, if any, sales, surreptitious or otherwise, were made to the men (including officers) by bumboats, of such drinks as pulque, or other possible native beverages, or milk, fruits, melon, or other vegetables, specifying them and their character? 9. What, if any, aërated waters were purchased and used there, naming brands, and where made? 135 FIFTH AVENUE, PITTSBurg. W. H. DALY, M.D. CIRCUMCISION. TO THE EDITOR OF THE MEDICAL RECORD. SIR Referring to the controversy taking place in the recent issues of the MEDICAL RECORD, respecting circumcision, I would say that I am in perfect accord with the opinion of Dr. Levien: that the operation itself should be performed by the physician, or at least superintended by him. I have witnessed a number of these operations, and the want of asepsis or even ordinary cleanliness employed is sufficient to strike terror and apprehension to the physician of to-day, who is accustomed to the neatness and cleanliness of our operating-rooms in the hospitals and in private practice at the present time. That accidents and complications, which are preventable, do occur, and not infrequently, too-of that there is no doubt; these accidents being attended to and treated by the physician who is called in later, and thus the reports do not spread any farther, or are prevented from reaching the public ear at all. Only recently I was hastily summoned to attend one of these cases; when I arrived, I found the child almost exsanguinated from the loss of blood. The operation had been performed about two hours ago, during which time the neighborhood was being searched for a doctor; the child bleeding profusely all this time. The underclothing and rags covering the penis were soaked. with blood; the penis itself being covered with bits of rags, brown paper, solution of iron, etc., and presenting a most pitiable spectacle indeed. The hemorrhage was only controlled after passing a ligature around the penis proper, and the child slowly recovered from the severe shock and loss of blood it had sustained. Such and similar cases occur to almost every practitioner ; then, why not have a physician present at the operation who can prevent or intelligently treat such accidents, should they arise, instead of hunting two hours or more for a doctor when they do occur. Certainly our system of the present day should be changed; the religious rite in itself should not be interfered with, but a physician ought to be present at every operation, and if he himself does not perform it, he should see that it is properly performed; that the patient is well cleansed; the genitals scrubbed and washed with bichloride or carbolic solution, the instruments sterilized, and above all the hands of the operator, not forgetting the finger-nails, clean and aseptic. New Instruments. MODIFICATIONS IN THE OPHTHALMOMETER. BY FRANK D. SKEEL, M.D., NEW YORK. I WOULD like to call the attention of users of the ophthalmometer to a few minor improvements which. I have made upon it in a way of increasing its general convenience. FIG. 3.-The Base. When channel in its under side to receive a lever. The short arm of the lever is acted upon by the screw, while its longer arm extends out under the central upright pillar, which is made to pass through the base. the screw is turned downward, the pillar with its telescope is carried upward and vice versa, the pillar always remaining perpendicular. The focus being once found, is not lost while bringing the image of the mires to the centre of the telescopic field. The instrument as here described is made by Mr. E. B. Meyrowitz, of this city. 361 MOTT AVENUE. FIG. 1.-The Eye-Shade. Marion County (0.) Medical Society.-At the annual meeting of the Marion County Medical Society, held in Marion, the following officers were elected for the ensuing year: Dr. Dana O. Webb, President; Dr. D. S. Maddock, Vice-President; Dr. A. M. Crane, Secretary; Dr. H. L. Uhler, Treasurer; Drs. O. W. Weeks, W. C. Denman, and F. W. Thomas, Standing Committee. A new constitution and by-laws were adopted and signed by the members. The Union Médicale. With the beginning of the new year the Union Médicale has enlarged its size and transformed itself into a weekly, and has somewhat widened its scope. |