its outer edge. Diplococci and chains of three or four are inclosed in a common capsule, which then has an elongated form. Different micro-chemical tests warrant the conclusion that this capsule consists of mucin or a closely allied substance. The search for analogous capsules in micro-organisms of other origin has been for the most part negative. On the other hand, similar micrococci with capsules have been found in the pleuritic and pericardial exudation occurring in pneumonia, in the serous infiltrated adhesions, and in the simply œdematous parts of hepatized lungs. These were not found in the blood and other organs, and at times in inflamed lungs, where the process had existed longer than six days. The formation of the capsule appears then to be an attribute of the pneumonia coccus when it has reached the height of its development. For purposes of cultivation outside of the body a preparation of gelatine, to which an infusion of meat with peptone and salt had been added, furnished the best nutritive material. A minute amount obtained from a fresh lung, inoculated on such a soil with strict precautions, soon developed at ordinary temperature into a little button-like eminence of a dull white color; this penetrated downwards with a sharp point into the gelatine, giving a peculiar "nail-shaped" culture. Microscopic examination showed this to be composed of elliptical micrococci thickly laid together. Capsules were only found surrounding a few of the single cocci. The gelatine did not become fluid with the older growth. The parasites could be made to grow on blood serum and potato, and their infective properties were proved by the inoculation of animals. A portion of one of the cultures on gelatine was emulsified with water and injected by means of a syringe through the thoracic wall of nine rabbits, thirty-two mice, eleven guinea-pigs, and five dogs. The rabbits were entirely refractory, as were four of the dogs. On the other hand, thirty-one mice died in from eighteen to twenty-eight hours, one mouse in forty hours. At the autopsy in all these cases there was found a typical picture a dirty red slimy fluid in the pleural cavity, the lungs almost entirely without air, with numerous foci of reddish infiltration. Micrococci were found in the pleuritic fluid, as well as in the blood even while circulating, which presented all the characteristics, especially the capsule formation, of the microbia of pneumonia. In the control experiments made with indifferent fluids injected in the same manner either the mice remained unharmed or died from other accidental causes. Six of the eleven guinea-pigs died, three in from twentyfour to forty-eight hours, three after a somewhat longer interval. In these there was found a double purulent pleurisy reddening and oedema of the lungs (three times red, reddish-gray, or gray infiltration). In the lungs, and the foci of infiltration in them, at times only very few or no micrococci were to be met with. On the other hand, these were very numerous in the fluid from the pleural cavity, and could easily be cultivated. The micrococci with capsules were found very sparingly in the blood of two guinea-pigs. The five animals that remained unharmed showed themselves as entirely free from the micro-organism. Experimentation by means of inhalation was made upon mice, and of these some were attacked by a typical pneumonia or pleurisy. In regard to the identity of the pneumonia coccus in the different kinds of animals, the size of many of the parasites in the mice greatly exceeded that from man. The cocci of the guinea-pig are smaller, but marked by an exceedingly broad capsule. In the dog they are hardly larger than in man, the capsule being but little broader than the organism itself. Emmerich has traced the cause of an epidemic of pneumonia which occurred in the prison for males at Amberg to a local infection of the dormitories. He was led to suspect that the refuse building material used to fill between the floors might harbor the parasite. He accordingly sowed minute fragments of this on gelatinized beef extract with peptone, after the method of Koch and Loeffler, spread upon glass slides. After three or four days different kinds of fungi could be distinguished springing up. The gelatine was then rendered fluid by melting, and small quantities (one fourth to two cubic centimetres) were injected through the thoracic walls into various animals (rabbits, guinea-pigs, and mice), also into the blood of the first named. The animals died in from twelve to thirty hours. In the guinea-pigs the lungs were dark red; in the rabbits clear red; the spleen much enlarged. On the gelatine cultures as well as in the blood and organs of the animals there were found, besides various septic bacteria (especially the bacillus of malignant oedema), the peculiar encapsulated micrococci of pneumonia. The cultivation on sterilized slices of potato seemed to this author to give a most characteristic growth. On this they developed in a yellow, slimy layer several millimetres thick, which had the peculiar property of always remaining moist. The capsules were found upon the cocci grown upon gelatine, while they were wanting where blood serum was used. The anatomical appearances of the infected animals were characteristic. All the mice and one half the number of guineapigs (in all about fifteen and twenty-five respectively) died in from twelve to thirty hours after the injection. Within two hours the breathing became deeper, and dyspnoea set in, which increased with the weakness until death. Control experiments were made by using other pathogenic fungi in the same way. Circumscribed infiltrations of the lung were observed, but never well marked lobar pneumonia. These experiments show the identity of the micrococcus of pneumonia and that found in the filling between the floors, where they must have existed in great numbers. The cracks between the boards gave exit to them, and thus they were widely distributed about the room. In ordinary soil a similar coccus is found, but which grows differently on the prepared gelatine. In the space between the floors of houses where there had never been an epidemic of pneumonia the parasites could not be detected. Should future investigations confirm these facts they will go far towards clearing up the etiology of this disease in one of its essential points, namely, its occurrence as a house epidemic. THE IDENTITY OF THE MICROCOCCI OF THE PNEU MONIA OF MAN AND OF THE CONTAGIOUS PLEUROPNEUMONIA OF CATTLE. Poels and Nolen 2 have examined the lungs of animals who have died from the above disease, and found numerous micrococci with the characteristic capsules. 1 Allgemein. med. Central. Zeit., 1884. 2 Centralblatt f. d. med. Wissensch., 1884, No. 9. These presented themselves as mono- or diplococci, or as longer chains composed of several individuals. Culture experiments were started at the same time on blood serum, material from human lungs and from animals being sowed. The result showed that the micrococci which came from these two sources developed into the characteristic "nail-shaped" growth when kept at the same temperature. Further inoculations were made from these pure cultures. Here, also, the results were identical. From these facts the authors believe in the identity of the organism which causes the disease. THE ETIOLOGY OF ASIATIC CHOLERA. During the past year a commission has been appointed by the German government to investigate the causation of cholera, and the results are embodied in letters written by Dr. R. Koch,1 the head of the Commission. The first investigations were made in Egypt, but as the epidemic had almost subsided there the scene of their labors was shortly afterwards transferred to India, where the pest still raged. On account of the great number of bacteria normally present in the intestine, it was very difficult at first to determine whether there was only one which was to be considered as associated exclusively with cholera. In the majority of cases death does not occur at the height of the process, but in the stage of reaction. At this time such marked changes appear in the condition of the intestine and its contents that it is impossible to obtain a clear idea of the lesions of the disease. It was not until a series of uncomplicated cases had been studied at autopsies that the real pathological relations could be determined, and then the greatest care had to be exercised in regard to the causal connections. the As the result of such examinations there has been found in the walls of the intestine of cholera patients a bacillus which can certainly be differentiated from all others by the following characteristics: The rods are never entirely straight, but curved a little like a comma, and can even assume a half-circular form. In culture these curved rods often combined into S-shaped figures, and more or less slightly wavy lines. They possessed independent motion, which was very lively, and could be best seen in a drop of salt solution suspended from a cover glass. In a preparation of this sort the bacteria are to be seen swimming in all directions in the field of the microscope. pure Their relation to nutritive gelatine is also very remarkable. At first they form colorless, transparent colonies, resembling small bits of broken glass. Gradually these liquefy the gelatine, and then spread out to a moderate degree. In this way they can be readily distinguished and isolated from the other bacterian growths. They can also be cultivated in hollowed object glasses, and accumulate on the edge of the drop of nutritive fluid, where they are clearly marked by their comma-like shape and rapid movements. Up to the present time opportunity has been afforded for the examination of twenty-two bodies and seventeen cholera patients. In all of these the peculiar shaped bacilli could be found both in the microscopic preparations from the subject and from the gelatine cultures. This result, taken in connection with that obtained in Egypt, justifies the conclusion that these bacilli regularly occur in the cholera intestine. 1 Allgemein. med. Central. Zeit., March 15, 1884. In order to control this, twenty-eight other bodies were examined, eleven of whith were of patients who had died from dysentery, the discharges from simple diarrhoea as well as from a person who had recovered from cholera, also the intestines of healthy and diseased animals, and finally water rendered foul by putrid masses, stagnant water from swamps, and scum from the surface. In not a single instance could the bacillus of cholera be found. Since poisoning with arsenic gives rise to analogous symptoms a series of experiments on animals were instituted, but with negative results as far as finding the comma-shaped parasite. The question then arises, In what relation do these peculiar organisms stand to the disease? Either these specific bacteria are favored by the cholera process, and are associated in such a remarkable way with its progress, or they are the cause, and the malady can only arise when these specific bacilli have found their way into the human intestine. The following grounds render the first supposition improbable: It must first be premised that a man who is ill with cholera must already have this particular form of parasite. But the bacilli are wanting even in intestinal affections like dysentery and diarrhoea, to which cholera is so often added. And it is hardly possible if they are normally present in every body, as the fact of their being found both in Egypt and India would tend to show, that they could have escaped observation up to the present time. Since, then, the growth of these bacteria cannot be produced by cholera, the second hypothesis alone remains, namely, that they are its cause. A number of other facts speak also for this assumption in a way not to be denied. Above all the relation during the progress of the disease. Their occurrence is entirely restricted to the organ which is the seat of the affection, namely, the intestine. In the vomitus they were but twice found, and then this had an alkaline reaction, showing that the intestinal contents, and with this the bacteria, had found their way into the stomach. In the intes tine itself they deport themselves in the following manner: As long as the stools remain fæcal in the early stage of the disease only a few bacilli are to be found. On the other hand, the succeeding watery, odorless evacuations contain the specific bacteria in large numbers, while all the others have entirely disappeared, so that it almost amounts to a pure culture. As soon as the attack decreases and the stools again become fæcal the comma-shaped bacilli disappear gradually, and are not to be found after the restoration to health. The appearances after death correspond entirely with this. In the stomach nothing is found. The condition dif fers in the intestine, according as the patient has died during the proper attack or after it has ended. In the recent cases, in which the intestine is of a light red color, the mucosa free from extravasations, and the canals contain a whitish, odorless fluid, the parasites are found in enormous masses and entirely pure. Their distribution corresponds with the seat of inflammation, being most abundant at the lowest part of the small intestine. When death has taken place at a later period of the disease signs of marked reaction are manifest. The mucosa of the lower part of the gut marked by dark-red extravasations, and often with a slight necrosis of the superficial portions. The contents are more or less colored with blood, and putrid and offensive from the reappearance of the bacteria is of decomposition. The specific bacilli are quite abundant in the tubular glands and the surrounding tissue, but not in the free contents. They are only entirely wanting in cases which have died from other diseases after the attack had passed off. The cholera bacillus deports itself in the same manner as any other pathogenic bacterium. They occur exclusively in the disease to which they belong; their first appearance coincides with the beginning; they increase in number with the progress, and decrease with its decline. Their seat corresponds with the extent of the lesions, and their numbers become so great that the deleterious working on the mucous membrane can be explained by them. It was greatly to be wished that an analogous disease could be artificially produced in animals. This has, however, not succeeded as yet, and to all appearances it is doubtful if it ever does. Yet the proof of the abovementioned facts is not weakened by the failure of the experiments upon animals. In two other diseases, namely, typhoid fever and leprosy, specific bacteria occur which it is impossible to inoculate upon animals. Moreover, the further study of the bacilli has brought out other characteristics which are of importance in this regard. One of the most remarkable is the repeated observation that the cholera bacilli increase in a remarkable manner upon the linen which has been soiled by the dejections of the patients and kept in a moist place for twenty-four hours. And in close connection with this is the clinical fact that persons who have to handle this soiled linen are especially subject to infection. Experiments were instituted by spreading some of the cholera dejections upon damp linen, filter paper, and earth. After twenty-four hours the slimy layer had regularly increased to a thick mass of characteristic bacilli. This organism dies much more quickly upon drying than any other bacteria, three hours being sufficient to deprive it of all vitality. Further, the presence of an alkali is always necessary for their growth. Even a little free acid which did not markedly hinder other bacteria kept these back in their development. In a stomach which acts normally they are killed, and this is further borne out by the fact that neither in the stomach nor intestinal tract of animals which had been fed on cholera dejections could these organisms ever be detected. This last peculiarity, together with the readiness with which they are killed upon drying, gives a clew to the fact that infection so seldom occurs from immediate contact with cholera patients. Especial circumstances must be brought up to enable the parasite to pass the stomach and set up the cholera process in the intestine. Perhaps it could do so if the digestion was disturbed. And it is a well-known fact that men who have digestive disturbances are the most apt to sicken during an epidemic. Perhaps, also, there is a condition of the bacillus analogous to that of the reproductive spores of anthrax, but which up to the present time has not been discovered. י Still further proof of the rôle which the specific bacillus plays has been presented by Koch in an account of a local epidemic of the disease which occurred near Calcutta, and which could be directly associated with the presence of the parasite in a contaminated tank. It is the custom of the country for a number of families to use a common tank (which is merely a little pond or swamp-hole) for all the domestic purposes of 1 Allgemein. med. Central. Zeit., April 5, 1884. washing and drinking water. The edges of the tank are often lined by privies, the contents of which are not prevented from contaminating the basin. A local epidemic was reported to the Commission as having broken out in the neighborhood of one of these places. Samples of the water were immediately collected and sown upon nutritive gelatine; a development of bacilli corresponding in character with the specific organisms was developed, but with the decline of the epidemic such cultures were not to be obtained. Investigation showed that the tank had been used for washing the linen of a cholera patient, and the water had been contaminated in this way. Koch regards this in the light of an accidental experiment upon man, which is to be considered of the greatest value, especially since other animals have been found refractory to the disease. Keports of Societies. PROCEEDINGS OF THE BOSTON SOCIETY FOR MEDICAL IMPROVEMENT. E. M. BUCKINGHAM, M. D., SECRETARY. APRIL 28, 1884. The President, DR. CHARLES D. HOMANS, in the chair. PSEUDO-MEMBRANOUS ENTERITIS. DR. O. W. DOE showed a specimen of membrane which was passed by a patient suffering from pseudomembranous enteritis, one portion being twenty-seven inches in length. This case, which is still under treatment, will be reported at a subsequent meeting of the Society. It appears similar to those reported here by Dr. Goss three years ago. REMOVAL OF FETAL BONES BY RECTUM. DR. DOE also showed a collection of cranial bones of a foetus at about the seventh month, which he had removed through the rectum three days before. The patient was last pregnant ten years ago, and had supposed that she miscarried at that time. The case will be reported in full later. DR. J. P. REYNOLDS inquired if the anus was lacerated in removing these bones. DR. DOE said that it was not. On the contrary it was very dilatable, and, being stretched by the fingers, the bones were worked from side to side with the forceps. DR. S. G. WEBBER read a paper on MULTIPLE NEURITIS, showing microscopic sections. The report of the debate is delayed by request of Dr. Webber. DR. O. W. DOE read a paper 2 on RETAINED PLACENTA. DR. C. ELLERY STEDMAN said that the treatment of retained placenta after abortion had to be left to each physician's judgment. His own experience left him in no doubt that as the placenta had to come away with more or less hæmorrhage, sooner or later, the proper plan was to avoid danger by removing it from the uterus as early as possible. The risks were from septicemia and bleeding. He had seen two deaths after abortion from the former cause, though he did not recollect any fatal cases from loss of blood, yet 2 Vide page 436 of this number of the JOURNAL. and was insensible for thirty-four minutes. During the etherization the ether was administered evidently faster than absorption took place, as her abdomen became sufficiently distended to embarrass respiration; but a little pressure on the abdominal walls caused the gas to issue from both ends of the abdominal tube, and all difficulty ceased. patients were often much reduced, and long in conva-pital. She took an ounce and three quarters of ether, lescing. Books tell us the finger is the best instrument for removal of the placenta, but do not instruct that for this purpose the hand has generally to be introduced into the vagina, which often necessitates ether. Sometimes a stiff wire doubled into a blunt hook was a help. The use of tents after abortion was to be avoided if possible, as it is fraught with danger, and, if for this reason only, he liked to empty the uterus as early as it could be done. DR. FRANCIS MINOT thought the proper treatment of retained placenta after abortion would vary according to circumstances. In recent cases it was sometimes difficult to determine whether the placenta or portions of the ovum were really retained or not because the clots were not preserved for inspection. In case of doubt it is best to wait for a day or two before exploring the interior of the uterus. But in case of continuous hæmorrhage, and especially in that occurring at intervals for weeks or months, no time should be lost in emptying the womb. He had rarely had any difficulty in doing this with the finger if the woman be etherized and placed on her left side, close to the edge of the bed, with the knees drawn upwards. Then the physician, pressing the fundus downward with the left hand over the pubes, and introducing the right hand into the vagina, can make the forefinger or the middle finger of the same band meet the fingers of the left with only the uterine and abdominal walls between. In very fat women we sometimes fail to reach the fundus, and then the only resource is to fish for the placenta with long forceps, a tedious and difficult operation. ETHERIZATION BY THE RECTUM. On recovering this woman vomited perhaps an ounce of thin, yellowish fluid. Within an hour had a natural movement of the bowels, and afterwards two slight loose operations, one of which was tinged with blood. The third case was in every way a most favorable one except in length of time required to produce insensibility. The ether was given more slowly to avoid the distention of the bowels that had occurred in the previous case. A little less than two ounces was given, and etherization was complete in fifteen minutes. The stage of excitement was marked by a laugh and a comical remark or two, but no struggle. Insensibility continued nearly thirty minutes, and no unpleasant symptoms occurred during recovery. This patient was operated on for piles, and her rectum was packed with sponges to provide against hæmorrhage. Slight meteorism occurred, but no more than might well follow the closure of the anus. The sponges were removed after a few hours, but no diarrhoea showed itself. So far as it is possible to draw conclusions from present experience, etherization by the rectum differs from inhalation principally by the absence, or rather the diminution, of the stage of excitement. If vomiting occurs during the etherization it does not interrupt the administration of the anesthetic. The unpleasant after effects seem less marked. Vomiting, if it occurs at all, is slight. The secretion of mucus, which so frequently fills the DR. ABNER Post reported three cases at the Boston City Hospital. The Boston Medical and Surgical Jour-mouth and air passages, has not occurred so far. The nal of April 17th had a short account of etherization by the rectum as done at Lyons. Its administration in that manner has been tried at the City Hospital since that publication. The ether has been given from a small bottle with a perforated cork, to which is attached a rubber tube, to the other end of which is fastened a catheter. The bottle of ether is placed in a vessel of warm water, and the catheter passed into the rectum. The ether is seen to boil in the bottle, and its vapor is conveyed through the tube into the bowel. The hot water used was drawn from the hot-water pipes, and was so hot as to be uncomfortable to the hands. The first case was a patient of Dr. Homans, a man with cellulitis of the arm, who had been vomiting before etherization. After the tube was introduced he first complained of the taste of ether in the mouth. It was then noticeable to the by-standers in his breath. His pulse grew rapid, the pupils dilated, he partially stiffened out, put his hand to his mouth, vomited, and anesthesia was complete at the end of thirteen and a half minutes. The ether was discontinued almost as soon as he was insensible, but the anesthesia continued for nearly thirty minutes, probably not so complete as to allow surgical interference without shrinking during all that time, but so complete that he lay without motion. During the afternoon he had two or three loose discharges, mostly gas, for which he received a starch and opium enema, and which soon ceased. The second case was a woman of large size, who had eaten a hearty breakfast before coming to the hos spasm of the glottis which sometimes occurs at the commencement of inhalation, and which is the result apparently of the local effects of ether vapor, is not to be expected by this method. The feeling of suffocation which is so common when ether is given by inhalation, and which is the cause of most or at least a large number of the struggles which patients sometimes indulge in, is wanting. Of course the constitutional effects of ether, however given, are the same. The use of a much smaller quantity is sufficient to induce anesthesia when given by the rectum, where all is absorbed, than when given by inhalation; at the same time the effect is slower in most cases. After complete anæsthesia is reached it is apt to grow more profound after the supply of ether has been removed so that its administration should cease when once the patient is asleep. The effect of ether upon different individuals varies very widely. It cannot be supposed that no patient will ever struggle if etherized by the rectum. Of course the man who makes a row whenever he is drunk will probably show his ugly disposition when ether is the cause of his excitement, but so far the excitement shown has been very small. The disagreeable effects seem to consist in the possibility of blowing up the rectum. Evidently the power of absorption differs in different individuals; probably the rate at which the vapor is poured into the rectum differs, as it ought to do, where the heat applied is indefinite and variable. It is necessary to watch the abdomen somewhat to see that it does not become ballooned. An irritation of the rectum is set up in some cases which, perhaps, corresponds to occasional effects on the air passages when the ether is inhaled, but nothing so far has transpired to cause alarm or anything more than a temporary inconvenience.1 DR. WEBBER quoted the account of rectal etherization at Lyons, given in the New York Medical Journal, as stating that the process was finished by the mouth in some of the cases. He asked the experience of Dr. Post. DR. POST thought the French surgeon must have been impatient. Etherization was profound. DR. CHARLES D. HOMANS said that etherization was slower than in the common way. There was also much less ether used. DR. POST said that there was less excitement as well. DR. H. K. SABINE inquired if this method was used for the first time at Lyons, or had the Swedish surgeon who proposed it there seen it elsewhere. DR. POST said that it was to be inferred from the published account that it had been done at Copenhagen. NEW YORK ACADEMY OF MEDICINE. THE TREATMENT OF MEMBRANOUS CROUP. Ar a meeting of the Obstetric Section of the Academy held Thursday evening, April 24th, DR. A. JACOBI read a paper on the medicinal treatment of membranous croup. Having repeated his assertion, made in 1868, that there ought to be no contra-indication to the performance of tracheotomy whenever, no matter how young the child or what complication might be present, there was danger of death from suffocation, and having stated that he had himself now performed it more than four hundred times, he said that he could hardly be accused of underrating the value of that operation (which had, indeed, already been discussed at a previous meeting) if he confined himself on this occasion entirely to the medical side of the treatment of croup. He spoke first of the use of pilocarpine, and said that he had not modified the opinion which he had expressed in regard to it at the meeting of the American Medical Association in 1881, when he stated that in severe cases of septic pharyngeal and laryngeal disease he had found that this remedy actually hastened the fatal termination by inducing cardiac failure. He then mentioned two cases which had been under his care at the Mount Sinai Hospital, in which one of the children was a little over, and the other a little under, two years of age. Neither case was very severe, and the treatment consisted of the inhalation of steam with the vapor of turpentine, under a tent, and the use of pilocarpine muriate in one-thirtieth-grain doses after the manner of Guttmann. Under this treatment one of the cases got well, but in the other the pilocarpine had to be withdrawn after two days on account of its depressing effect, notwithstanding the fact that alcohol was freely used to counteract this. The final recovery in this instance was attributed, first, to the macerating effect of the pilocarpine on the mucous membrane, and, secondly, to the timely discontinuance of the drug. Dr. Jacobi also mentioned another case, three years 1 Further experience leads me to modify somewhat the favorable opinion here expressed. Certain feeble individuals have taken an unusually long time to recover, insensibility has been occasionally so profound as to cause anxiety, and bloody discharges have been more frequent than is desirable. A. P. ago, which recovered with a fair amount of strength after taking it for four days, and said that his final opinion in regard to it was that it was a powerful remedy, which was of considerable service in certain cases, but which, on account of its debilitating effect, had to be watched with great care, while at the same time its depressing influence was counteracted as far as possible. In regard to the use of steam inhalations, his views, as expressed in his treatise on diphtheria published in 1880 (page 168), had not changed. In employing them it was not to be forgotten that by this agency the underlying tissues were also softened, and that the poison was thus sometimes enabled to penetrate more deeply. The results were not always satisfactory, and he had seen cases which became distinctly less cyanotic on being taken out of an atmosphere filled with steam. At the same time in many instances the steam was of great service, the benefit depending to a large extent on the special locality affected. Thus wherever there was pavement epithelium beneath the membranes it could not be employed successfully. He therefore again insisted that steam will improve; steam will impair. It was a matter of vital importance where steam inhalations were resorted to that the patient should also have plenty of fresh air. He also repeated his conviction of the utility of the inhalation of turpentine, which he had first employed many years ago in cases of pneumonia where resolution and expectoration had not commenced. He recommended that about a tablespoonful of the rectified spirits or oil should be poured into water that was being heated over an alcohol lamp or stove or the gas every hour or oftener, and mentioned one case at the Mount Sinai Hospital in which a child two years old was kept, with its nurse, under a tent filled with steam charged with turpentine for four successive days and nights. No other treatment was used except the internal administration of chlorate of potassium and tincture of chloride of iron, and he believed that by this means the case was kept from being a severe one. Dr. Jacobi then said he would select one topic for discussion in this connection which was not a new one, but which, in the light of recent developments, had excited renewed interest, and that was the treatment of croup by mercurials. In order that the subject might be discussed intelligently he first gave a very careful and complete review of the opinions of various authorities in regard to it from the time that Dr. Samuel Bard wrote, in 1771, down to the present. In regard to his own opinion concerning the use of mercury, in the treatise on diphtheria before referred to he had expressed himself as more favorably disposed towards it at that time (1880) than he had been in former years, and since then he had still further modified his views in the same direction. At the meeting of the American Medical Association in 1881 he had been particularly impressed by the remarks of Dr. William Pepper, of Philadelphia, in favor of the bichloride of mercury treatment. The latter, in the course of his address in medicine, said that his attention had been called to the matter by a paper read by Dr. G. A. Linn before the Pennsylvania State Medical Society, in which he reported a number of cases of pharyngeal and laryngeal diphtheria treated with eminent success with the bichloride, and that he had first used it himself in a case of diphtheritic croup which he saw in consultation with Dr. Yarrow, of Philadelphia. |