of opium, and in one case for selling adulterated citrate of iron and quinine. The analysis of the tincture of opium sold showed the following percentages of morphine: .38, .63, .79, .72, .81, where the Pharmacopoeia standard of 1880 required 1.20. They were all convicted, with one exception, and in that case the adulteration was clearly proved, but the firm prosecuted testified that the tincture was sold by a young man in their employ who had no authority to sell, his duties being not those of a salesman but pertaining to another department. This firm escaped conviction in that way. The first prosecution for selling adulterated tincture of opium was before the Central Municipal Court of Boston, and developed the question which Pharmacopoeia was the standard by which these cases should be governed, whether that of 1870 or that of 1880. The Pharmacopoeia of 1880 was not published and in use in August, 1882, when the Food and Drug Act took effect. It was accordingly contended by the parties prosecuted that the Legislature must have had in view the standard of 1870, and that these cases should be tried and judged by, that standard. On this first prosecution the tincture of opium was, in its morphine strength, below both the standard of 1870 and 1880, and the judge who tried the case found as a fact that the drug was adulterated, but did not rule upon the question which standard was in force. On the next prosecution before the chief justice of that court the question was again raised and presented, and a decisive ruling was made to the effect that the Pharmacopoeial standard by which the drugs sold should be judged was that which was in use at the time when the sale was made, and accordingly ruled that the standard of 1880 must govern existing cases. This ruling has been followed by the other judges of that court. On the prosecution for selling adulterated citrate of iron and quinine it appeared that the article sold varied from the standard percentage of the quinine according to the formula of the Pharmacopoeia of 1880. The parties were convicted. our supreme court, and the ruling of the Somerville court in that respect was clearly and beyond question wrong. I have been very much surprised at the position taken by the press of Boston in reference to these prosecutions. The reporters of three of our newspapers have told me that they have received orders not to report facts in reference to these prosecutions, and that articles that have been written by them for publication have been refused publication. I had sup posed that in a matter of this kind that it was the duty of the press to advocate what seems to me to be the cause of the people. The purity of food and the purity. of drugs should and must be a matter of great moment and importance. The reason of this course pursued by the press of Boston we may not know, but I think we can, each one of us, very clearly draw our inferences what that cause may be. The physician is largely interested in the enforcement of this law. When he writes his prescription it is of the greatest moment to him as well as to his pa tient that it shall be filled out as he has written it, and according to the existing standard. A fixed standard is absolutely necessary, and the physician and the druggist must in unison adopt that standard. At the recent hearing before the Legislative Committee on Public Health it was testified by one who had been a defendant in one of the prosecutions for selling adulterated tincture of opium that he did not believe in the Pharmacopoeia, and he would leave it to the discretion of each druggist to fill out a prescription. Comment upon such a statement is unnecessary. Let, then, the physicians of Boston give their strong moral support and encouragement to the State Board of Health, Lunacy, and Charity in the enforcement of this law, and make it an efficient law, and not a dead letter. (To be concluded.) TION. A prosecution was made against a dealer in vinegar, BOSTON SOCIETY FOR MEDICAL OBSERVAin Somerville, for selling a vinegar as a pure cider vinegar. The statute makes it an offense to sell as cider vinegar a vinegar not the legitimate product of pure apple juice, known as apple cider. The chemist for the government testified that in his opinion the sample sold was a cider vinegar which had been watered. The chemist who was summoned by the defendant before the trial had been given full opportunity to test the sample. Upon the witness stand he testified that he had had a large experience in the manufacture and analysis of cider and cider vinegar, but he had in his experience never seen a cider vinegar with the small amount of acetic acid and residue which this sample contained. He further testified that the sample was to him very suspicious. The judge, contrary to all precedents, ruled that it did not appear that any criminal intent existed or any fraudulent conduct. The counsel for the government suggested that it was not necessary for the prosecution to prove either elements, that the sale itself, under the statute, was a violation of law, and that no criminal intent, or guilty knowledge, or fraudulent conduct need be shown. He replied that that would be unconstitutional. The defendant was discharged. This principle has been decided time and again by CHARLES H. WILLIAMS, M. D., SECRETARY. JANUARY 7, 1884. DR. E. G. CUTLER read a paper on a case of PROTRACTED LETHARGY AFTER THE USE OF BRO- by an individual having the morphia habit.1 DR. BUNDY said that he had a case twelve years ago where the patient took two and a half ounces of bromide of potash with similar result; the patient was unconscious for two weeks, but gradually recovered. The disease was a habit of drinking whiskey and ether, but the bromide did not cure the trouble. There was entire loss of the power of coördination, and at the end of two weeks he was moved into another house without knowing it. DR. CUTLER mentioned one fatal case where the drug was pushed to its limit, in which the patient sank and died in one week. In this case the kidneys did not work well. DR. EDES referred to two cases reported by Dr. Schweig in the New York Medical Record, in which 1 See page 246 of this number of the JOURNAL. 2 Vol. xi., page 841. DR. FOLSOM had seen a case where there was much physical depression, boils, etc. After excessive doses of bromide he gave large quantities of water to help eliminate the drug. After the effect passed off there was much insomnia. For three weeks after the taking of the bromide the patient had no desire for morphia, but it returned later. After this he had an interval of five months during which he gave up the morphia, but his suffering was so great that he began using it again, and says he shall never make another attempt to break up the habit. Dr. Folsom had seen cases where bromide of potash had been given for other purposes where the torpor had lasted as long as this. It seems to vary with different persons. In epileptics the bromides sometimes do good, but sometimes harm, as in the case of a young lady who was taking fifty grains three times a day without effect on the epileptic attacks, but who was suffering from the excess of bromide. When pushed to excess it may cause a mild form of silly mania. DR. CHANNING had seen cases of morphia habit where large doses of bromide of potash had been used, but without good result, and he considered the excessive doses as dangerous. He also thought chloral was not of much service in these cases. After the shock of the bromide of potash passes off there may be a temporary relief, but the desire for opium returns. The treatment must be largely moral, and must depend on the patient. It is best to break off the opium as rapidly as possible, best in one week. Then bromides may be used occasionally for sedative effect. DR. EDES mentioned Laport, Indiana, as quarters for "morphia cures." a head freely. Sinuses persist from the pelvic disease, but the boy's condition is such as to justify the belief in a cessation of the carious process. Dr. Bradford mentioned that there were no less than forty-two methods described for amputation at the hip-joint. The chief anxiety is in regard to hæmorrhage. The method employed was suggested by Dr. C. B. Porter, who himself has employed it. The amputation is performed in two steps, first an amputation of the femur as high up as is practicable, using Esmarch's bandage and tourniquet to control the bleeding. The vessels are then tied, and there is no fear of hæmorrhage while performing the second step, namely, the removal of the head and upper part of the shaft, which is done by a lateral incision and subperiosteally. The difficulty in disarticulation in the case reported was slight. Only a portion of the head remained. Where this is not the case disarticulation, as for excision, can be performed before the amputation is begun. DR. CABOT said the same operation might be applied to the shoulder-joint, for patients are often much benefited by the removal of these diseased parts and the constant drain on the system caused by their suppuration. Recent Literature. Hints on the Drainage and Sewerage of Dwellings. This excellent work of three hundred pages contains much valuable information for all who are interested in the sanitation of dwelling-houses. it Physicians, householders, and plumbers will find in DR. DAVENPORT said that all the so-called morphia cures manufactured there contained opium, often in solu-ing-fixtures, and on the Removal and Disposal of tion in glycerine, and colored with aniline. He spoke of Household Waste are especially full and well illusthe increase in the strength of the tincture from nine in indicated, and modes of remedy suggested. The book trated. The defects of various contrivances are clearly one hundred to ten in one hundred, but said that the increase was not great enough to produce much effect in contains nearly three hundred illustrations, which are ordinary doses. He mentioned the assays which he had sufficiently shorn of extraneous detail to render them been making for the Board of Health of the strength intelligible to the non-professional reader. of the tincture of opium sold in the shops. Variations had been found all the way from one quarter of the standard strength to fifty per cent. over this standard, but in the latter case a single druggist had made a mistake in compounding. DR. C. H. WILLIAMS read a paper on Intraocular Changes in Cases of Cerebral Tumor. A DR. E. H. BRADFORD reported SUCCESSFUL CASE OF AMPUTATION AT THE JOINT. By E. MICHENER, M. D. Philadelphia: F. A. Davis, Att'y, Handbook of Eclampsia. This sextodecimo book of sixty-eight pages contains notes of forty-four cases of puerperal eclampsia, being "all which have occurred during the present century HIP- within a radius of several miles around Avondale, Chester County, Pennsylvania, so far as can be ascertained." The ostensible object of the book is the advocacy of blood-letting in all cases of puerperal eclampsia without discrimination. The patient was a boy eight years old, whose hipjoint had been excised in July by Dr. A. T. Cabot for caries. The femoral shaft was found so extensively diseased that amputation was advised, but the parents' consent could not be obtained, and the patient's condition became gradually worse from long-continued diarrhoea. This, however, stopped in October, and in November amputation at the hip-joint was performed by Dr. Bradford. No shock followed the operation, and the boy steadily improved, at the present time, three months after the operation, having nearly doubled in weight, and being able to walk about with crutches Deference to the age of the chief author, who was an interne in a Philadelphia dispensary in 1816, and whose views of the pathology and etiology of eclampsia do not conform to those held by modern authorities on this subject, forbids that freedom of criticism which the book should otherwise receive: and we will simply say that while we believe in the efficacy of blood-letting in certain selected cases, we do not believe in its indiscriminate use, especially in the cases of eclampsia nationalities should be felt in such questions, — as by any means conclusive of the correctness or value of the positions assumed. The similarity in the attitudes of the two investigators toward the common subject, cholera, ceases with their both having preconceived views confirmed by their investigations. Hunter asserts that cholera is a non-contagious disease (typhoid fever may also be Medical and Surgical Journal. called non-contagious); hence he disbelieves in the ex REPORTS ON CHOLERA FROM SURGEONGENERAL HUNTER AND DR. ROBERT KOCH. THE fifth cholera report of Dr. Robert Koch to the German government, this one from Calcutta, and the report of Surgeon-General Hunter to the British Foreign Office on cholera in Egypt, the essence of which is contained in a paper read by him before the London Epidemiological Society on January 9th last, have again turned medical attention to the discussion of this disease. Dr. Koch's report, which was first published in the Deutsche Med. Wochschr., February 14th last, and in the Berlin daily papers of the same date, is being republished and commented on by the medical periodicals, and Sir W. G. Hunter's remarks were made the special subject of debate at the adjourned meeting of the Epidemiological Society held February 13th. There is one thing in common between the report of the German and that of the English investigator, each seems pretty well satisfied that he has found what he went out to seek, and the results in each case confirm the investigator in the preconceived views with which he departed on his mission. SurgeonGeneral Hunter is probably but little more certain to-day that cholera is endemic in Egypt than he was when first commissioned by government to ascertain the cause of the outbreak last June; and Dr. Robert Koch, notwithstanding his really scientific cast of mind and methods of work, would probably have been more surprised and disappointed than he was prepared to be had not the Imperial German Commission confirmed and enforced, wherever cholera was actually to be found, the results of the study in the Berlin laboratory on the cholera intestines imported from India. The two reports have at least one other thing in common, namely, that whatever coloring they may lend or appear to lend to the views advocated or expressed by the respective writers, neither the one nor the other can impress the impartial reader, of whatever nationality, and we are sorry the influence of istence of a specific germ, and consequently in the necessity of importation, and therefore seeks for, and believes he finds, the cause and origin of epidemic outbreaks in the condition of the country itself, the disease being endemic. Telluric influences foster the disease as an endemic, and favorable climatic or meteorological conditions light up an epidemic. What he learned in Egypt convinced him that cholera had been continuously present there in one form or another at least since the great epidemic of 1865. The following curious extract from Lord Bacon concerning the climatic and telluric peculiarities of Egypt was unearthed for the benefit of Dr. Hunter: - "It is recorded, by competent observers, that if you take earth from the side of the Nile, and protect it from wet or waste, and weigh it every day, you will find that it remains always of the same weight until June 17th, when it begins to increase in weight, and continues to increase in weight during the whole time that the river is rising. This can be due to nothing but the air, and this is the more extraordinary, because it has been observed that just at that date it is the habit of grievous plagues to make their appearance at Cairo." The Surgeon General had previously expressed himself on the point thus: "The frequency with which atmospheric phenomena have been observed in connection with outbreaks of cholera leads to the conclusion that they stand in close relation one to the other. Whether that be as cause and effect is perhaps hard to say. It is probable that it is to a combination of certain conditious of a cosmotelluric character, of air, soil, and water (filth, as in Egypt, being a powerful factor), that the development of an epidemic is due. Given, as in Egypt, endemic centres, the peculiar atmospheric state noticed would probably act as an exciting cause in the immediate production of the epidemic outbreak." The German Commission went out, not to find the cause of any one outbreak of cholera, but to study the disease and to find its ultimate causa causans. Koch evidently regarded the disease à priori as specific — whether contagious in any degree or not exhibiting a specific germ, whose habitat was probably the bowel; this may be fairly presumed from his general attitude toward other epidemic diseases, and from his investigations at the laboratory of the Sanitary Bureau at Berlin. Instead of studying the Egyptian circumfusa, Koch devoted himself to the dejecta and especially, among the internal organs, to the bowel. The limited Egyptian experience (twelve cases of cholera, and ten autopsies) confirmed the observations made at home in regard to the presence of a certain bacillus in the walls of the small intestine without affording satisfactory proof of its specific character. The last and fifth report of Koch, dated Calcutta, January 7th, is based upon a further study of eight cases of cholera, and nine autopsies. The bacillus has continued a constant feature, and has been successfully isolated and cultivated, and its distinguishing characteristics carefully noted. Furthermore this bacillus has not presented itself except in the intestinal contents or walls of cholera victims. The report offers no further evidence as to the relation of this micro-organism to cholera, and, though vague on that point, it is pretty plain that attempts to reproduce the disease by inoculation still remain unsuccessful. It is therefore in order to restrain excessive enthusiasm in regard to the "cholera-bacillus " of the small intestine, no less than it was in regard to the cholera microbion of the blood reported by the French Commission in Egypt, which Koch now with fine irony suggests in his report is probably nothing more nor less than the well-known "blood-plates," figured as far back as 1872 by Lewis and Cunningham in a report on microscopical and physiological researches concerning cholera. It is not probable that the Germans will allow themselves to abdicate their judgment as to the bearing of Koch's observations, and we need not be overhasty to immolate ours in this country; the English are criticising Hunter's position very judicially; but it is pretty safe to predict that both Koch and Hunter will be ruled out of court by French scientists. also to enlarge the clinical description of the disease. Some of these cases ran their course with fever and others without. Zemann concludes from his study of them that the important point in the diagnosis of actinomycosis is the discovery of the pathognomonic fungus. Apart from such identification the disease can neither be diagnosticated from the part affected nor from the course which it runs, since the process may be febrile and acute, or almost without fever and chronic; in which latter case it manifests itself as an induration, as a chronic inflammation of serous membranes, as an inflammation in the bones or periosteum, or as an inflammation attacking the internal organs. All of which is demonstrated by the varied points from which the fungus gains access to the body, and by almost innumerable complications attendant on its presence. Zemann's cases certainly tend to show that by no means so simple a picture as that given in Ponfick's monograph will suffice to represent actinomycosis. THE REFLEX EFFECT OF DEALING IN "FU- THERE can be no doubt that the character of the habitual mental occupation exerts a considerable influence upon the physical condition of men. That a sistent with excellent general health and long life is a very high degree of intellectual activity is not inconfact familiar to common observation, and is confirmed by published mortality records, from which it appears that the longevity of the members of the so-called learned professions is hardly exceeded by that of any ACTINOMYCOSIS OF THE PERITONÆUM AND other class in the community. It seems to be also ABDOMINAL ORGANS IN MAN. well established that an alternation of the character of one's studies often is equivalent to a positive rec Thus we have recently met with the statement of an Englishman, eminent at once in the law and in literature, to the effect that after what would be a fair day's work in the former field he turned to his historical writing with a feeling of actual refreshment even greater than that to be obtained from mental inactivity. Thus dividing his time he was able to accomplish, without fatigue, fifteen hours' work per day. FIVE cases of actinomycosis affecting the perito-reation. næum and abdominal organs are reported from Vienna by Dr. Adolf Zemann,1 assistant at the Pathological Institute there. The characteristic fungus colonies were found in all cases both in the purulent contents of the abscesses and in the tissues of the affected parts. The number of previously reported cases is small. Ponfick collected sixteen in all of his own and others, and these were published in his monograph on the subject, which appeared in 1882. These cases Ponfick divided into two groups, those which recovered and those which were fatal. The former group consisted of cases where the malady made its first appearance on the jaws, preferably on the lower jaw, - and spread downward along the neck to the clavicle. The second group of cases comprised those in which the process announced itself by pains in the limbs or, more generally, along the spinal column and neighboring parts of the back, succeeded by pneumonia or pleuro-pneumonia of the left lower lobe. In a few cases these pains precede a prevertebral gathering which becomes a psoas abscess. These five cases now reported seem therefore to be, not only a considerable addition to the existing observations of a but little-known pathological process, but 1 Wien. Med. Jahrbuch., 1883, page 477. The amount of actual labor of which the human mind and body are capable under well adjusted couditions is certainly very great. In all men of affairs of whatever calling, it is of course unavoidable that anxiety (whose exhausting tendencies are generally admitted) should to some extent be present. But it seems to be the fact that so far as the uncertainty has to do with affairs which are controlled by one's own powers it is less wearing than when such affairs are independent of one's own control, and entirely the sport of extraneous chance. Thus while the conductor of a legitimate business project is, perhaps, working under a higher pressure than the student of a pure science, his calling is yet more favorable to longevity than that of the stock operator. And, indeed, it is, perhaps, not unlikely that the great stock manipulators, some of whom have certainly reached a green old age, are more favorably situated in this respect than the smaller speculators, in that the former are really able to a considerable extent to make the market, and that to them Fortune is not altogether a blind goddess, but gives a knowing wink as she turns her wheel. Thus in judging of the effects of these occupations one should remember that even as many physicians are not given to dosing themselves, so some stock brokers do not themselves speculate. To buy and sell for the account of others, even to collect a wide "margin" from one's client, do not involve any personal risk-taking. If business is brisk the pool seller may be equally content whichever horse wins, and we believe that in certain other games of chance, however the cards turn, the "bank" makes its earnings without interruption. There may, then, be a class even of professional gamblers who while sitting in the very vortex of the giddy whirl are quite at rest in their own minds. Not so with those who are fairly in the current. Of the moral effect of gambling, of course in this connection we have nothing to say. Its disastrous influence upon the mental and physical nature of its votaries was emphasized in a recent lecture by Dr. Crichton Browne, of England, on the Gospel of Recreation. Those amusements which depend for their zest upon the element of chance certainly have a strong attraction for the average man, as is shown by the frequency of betting on all sorts of subjects. The sporting papers and the sporting column of the daily press add fuel to this flame, which needs little to keep it alive. Dealings in futures are made easy by the widely published quotations of all sorts, and despite the heavy chastisement which has recently been inflicted on hundreds of small operators by the merciless depreciation of values, yet the public is still ready at every opportunity, whether at a club table, in politics, in athletics, or even over the great staple commodities of life, such as cotton, petroleum, or grain, to bet on events yet to occur. As a producer of intense emotional excitement perhaps no other amusement has the power of gambling, and it requires no demonstration that profound and repeated emotional excitement is a frequent precursor of nervousness, sleeplessness, and insanity, even if we do not go to the extent of Dr. Browne in attributing to this cause" numerous cases of dyspepsia, . . . heart disease, diabetes, paralysis, and apoplexy." Dr. Browne, alluding to the effects of a vice or habit on the faces of those addicted to it, and quoting Mr. Francis Galton to the effect that the sight of a bundle of photographs of criminals will excite from their ugliness a sense of aversion or disgust in a spectator, says: "But the next best place to a prison in which to see the English physiognomy at its coarsest and worst is the platform of a London railway station on the day of a suburban race meeting, when the special trains are just starting. There may be seen a pushing, chaffing crowd of betting men, or bookmakers, and their dupes, with rascality stamped on their features in a way that cannot be matched in any other spontaneous assemblage of their countrymen. In almost every face may be discerned cruelty and greed, in many be recognized a hideous mixture of imbecility with low cunning, and in a few may be caught glimpses of infra-human or mere animal rapacity. There may be seen faces that are congenitally and radically bad, and with them others that bear the faded traces of better things almost blurred out, perhaps by the blotches of dissipation and the hard lines carved by this soul-destroying vice." A glimpse by Bulwer-Lytton, when a young man, in Paris, of his own face in a mirror after a night of successful gambling, was such a revelation to him, in its haggard and sinister lines, of the effect that gaming was exerting on his whole nature that he thenceforward abandoned it completely. There is ground for the physician and hygienist as well as the moralist to discountenance that general devotion to hazard which, in public and private, characterizes so much of the city life of the day. MEDICAL NOTES. -A correspondent of the Medical and Surgical Reporter (March 1st) narrates a case where it seems tolerably certain that scarlet fever was transmitted by means of a letter. At least there is much less room for doubt than in many cases where such a cause is popularly assigned. The outbreak was in a country house half a mile distant from the nearest neighbor, and the family had occupied the house for three years; the children had not been away from the farm for two months, and no one had been in the house who had had the fever or been where it was. In fact, no case of the disease had been known of or heard of by the physician for some months anywhere in the county. It appeared, however, that the mother had received a letter from her brother only a short time before, stating that her brother's family had just lost a child with scarlet fever. This letter contained a photograph. The letter was received only seven days before the first child was taken sick, and the children all handled the letter and picture. -The Faculty of the New York Polyclinic have been obliged by the increasing success of that institution to provide larger room, and have therefore purchased the extensive property heretofore occupied in part by them, which will be remodeled and fitted with amphitheatres for clinical work, well-furnished laboratories for chemical, histological, and pathological studies, and rooms for operative surgery and demonstrations in surgical anatomy. These increased facilities, taken in connection with the hospital appointments of the Faculty, enable the Polyclinic to offer great attractions to those members of the profession who wish to supplement their undergraduate studies while remaining in this country. The Swedish physician, Santesson, relates in Hygiea that he was called to a young man of twentyfive with an abscess in the left iliac region. Examining him M. Santesson found the right side of the scrotum empty, and in the left side a hard, round |