they affect an intermediary host, and may be swallowed in drinking water by the final host. The digestive juices destroy the secondary host, and the young helminth becomes liberated and ultimately matures in some part of the body. The best example of this kind is Filiaria medinensis.

These parasites are fortunately not all found in this country, but they are to be taken into account by American physicians who practice medicine in our Island possessions or by those who handle patients returning from sojourns in such places.

It must not be forgotten that our domestic animals harbor parasites which may gain entrance into human beings through the intermediation of drinking water infected from this source. For example, we know that the hydatid of Tenia echinococcus, the tiny tapeworm of the dog, very frequently enters man through the medium of infected water. In all probability, the oncospheres of Tenia solium and saginata frequently reach their intermediate hosts, the pig and ox, respectively, in the same way. We should therefore try to accustom ourselves to a correct appreciation of the need of drinking uninfected water, not only because of bacterial, but also because of possible entozoon diseases being contracted by our patients in that way.

Comparative Measurements of Blood Pressure by the Palpatory and Auscultatory Methods.

Sterzing compares the common method of sphygmometry with the modification in which instead of feeling the pulse the pulse tone is heard by means of a phonendoscope. By listening below the constricting cuff of the manometer on the reduction of the pressure, a pulse tone is heard when the circulation commences. This represents the point of maximal pressure. The disappearance of the tone again represents the diastolic pressure. The method is much better than the palpatory in cases in which the pulse is small and hard to feel, especially in fat persons, children and with a weak heart. The systolic pressure registers several m.m. higher than by palpation and the diastolic considerably lower. One hundred cases were investigated. The author concludes by stating that the method does not give absolute blood pressure, but does designate accurately any rise or fall therein. The auscultatory method requires no extra apparatus, and is easy to learn. It is recommended for clinical work, especially when the diastolic pressure is desired.-Deutscher Med. Wochenschrift, November, 1909.

Tearing of the Rectum in Fracture of the Pelvis.

Harras reports two cases in which in a fracture of the pelvis the rectum was torn away from the anus. From experiments on the cadaver he finds that tremendous force is required to separate the anus and rectum, if the power is applied to the former, and he, therefore, offers the theory. that this accident is probably the result of a direct pinching of the lower rectum between the two halves of the pelvis at the time of the accident. The organ is seized by the traumatic approximation of the two tuber ischii, and is thus torn away from the anus.-Deutscher Med. Wochenschrift, November, 1909.

NEUROSINE

NEUROSINE

A RELIABLE NEUROTIC, ANODYNE AND HYPNOTIC. The remedy par excellence in Insomnia and Restlessness of Fevers. Almost a specific in Epilepsy. In Female Neurosis, combine with two parts Dioviburnia. Contains no Opium, Morphine, Chloral or other Deleterious Drugs. FREE.-The Perpetual Visiting Book with full size bottle of NEUROSINE, DIOVIBURNIA and GERMILETUM, also complete Formula, only to Physicians paying express charges. Formula and literature by mail.

DIOS CHEMICAL CO., ST. LOUIS, MO.

Physician to Brooklyn and Swedish Hospitals; Pathologist to St. Catherine's Hospital;
Assistant Pathologist to Seney Hospital.

Numerous articles of various temperaments have recently been published upon the general subject with which this paper deals, showing at popular interest in the discussion of the psychic element in disease. entering this field of discussion, it is not my desire to pursue a course of fruitless polemics, nor draw undue attention to the various modes of healing outside the domain of regular medicine. This paper is intended to review certain known physiological facts without claiming to add anything new to the subject. I do not wish to criticise nor theorize upon the metaphysical, but, at a time when there arises in our midst numerous therapeutic iconoclasts who persist in tearing down the idols of our orthodox materia medica, we are justified in looking carefully for the grain of truth that has leavened this whole lump of therapeutic heresy and "theological quackery."

The different sects have taken from our hands legitimate methods. of treatment, generalized upon them, and made them of universal application. The fad, in one form or another, that has become so widespread that if one speaks of faith in the healing of disease, he is likely to be classed as a Christian Scientist, or the advocate of some other one-ideaed school. It is my purpose to call attention to the sphere in which this immaterial remedy, faith, is useful, and was found useful long before Mrs. Eddy ever rose from her bed of hysterical suffering to take upon herself the dispensing of Heavenly blessings, and which will continue to be used by the regular physician when "Science and Health" has taken its place. on the shelves along with other wornout metaphysical teaching and obsolete philosophy. The very nature of my article makes it necessary to allude to some of the modern "faith cures," but let it be incidental and secondary and, perhaps, by contrast, point out the reputable uses of faith more clearly. Also in regard to religion, let it be remembered that I am discussing a subject from a medical, and not from a theological standpoint.

"Now faith is the substance of things hoped for; the evidence of things. not seen," according to St. Paul, and in a term so closely allied to religion. we might be willing to accept the ecclesiastical definition. That, however, is hardly sufficient for our purpose. Faith is something more than belief. It is the conviction of the truth of a thing without being able to prove it true by the usual processes. In this paper faith, whether of supernatural or natural things, shall stand for that quality which enables the mind to accept those things and to assume a state of complete composure-purely a mental condition, but that upon which hangs the individual health and happiness to a very great degree.

Before the therapeutic effect of any remedy can be judged with any accuracy, something of its physiological action must be known. Faith is no exception. Faith has a marked physiological effect upon the vital processes which is best exhibited in a study of its opposite condition, viz.: fear. Remove faith and we have fear, apprehensions, worry. By fear I do not necessarily mean that state of mental excitement produced by the sudden appearance of some menacing object, whether animate or inanimate, which arrests our actions, throws the whole nervous system into a state of confusion, and interrupts the vital functions for the time being. This, like other instinctive emotions, has its place, and often is of service in avoiding impending dangers. This emotion has its origin in the wilder states of life, and is experienced to a much less degree in the protected communities of civilization. But quite common with us is the more subtile expression of fear experienced, such as apprehensions and worry connected! with our associates and business affairs. It is this condition of mental perturbation that I mean here by the term fear. If it were permissible to apply the adjectives of pathology to terms of psychology, I would qualify the former as acute fear and the latter as chronic fear.

Practically all we know of the physiology of certain organs of the body, 2. g., the thyroid gland, has been learned through observation upon living animals from which that organ has been removed. In a similar way, by removing faith and allowing fear its full sway in the mind of man, certain well-defined effects are apparent. A few illustrations will suffice to emphasize that which is so generally understood. I remember seeing a patient at one time who was unable to walk in an open place without falling. If he were near a fence or railing he could walk with ease, even though he did not take hold of it for support. Physical support was not necessary, but mental support, such as the knowledge that something was there to keep him from falling, should he begin to fall, was enough to keep him up. This, of course, is a pathological condition, but how does it differ in any respect except in degree from what the majority of men experience? Place a long, narrow plank on stones six inches from the ground, and one will walk along it with ease and never think of misstepping. Place the same plank six feet above a stream, and it becomes difficult for most people to cross and impossible for some. Here fear interferes with the functions under control of the will. Embarrassment is a form of fear, and affords a good illustration. At a recent examination for internes at one of our hospitals, a man personally known to me, and whose ability was shown by the fact that he eventually secured an enviable position on the house staff, was influenced by his embarrassment to the extent of incoördination. His hand so shook that it was with difficulty he placed the reagents for urinalysis in the test-tube; a thing he has done so often he could almost do it with his eyes shut. That at times he could not express himself as he wished was apparent. Perspiration stood on his forehead, and I have no doubt his pulse and respiration were far from normal. Here fear interferes with functions under control of the will and functions not under control of the will, and it is the latter which are really most important. The important functions of the body are those which are not under control of the will, but go on in spite of the will, under the guidance of the sympathetic system, and anything which influences them, for better or worse, influences the health in the same degree and direction. The alimentary tract is especially involved when the nervous system is upset by fear or worry, the influence being anywhere from a perverted taste to a relaxed

sphincter. Attempt to eat when the mind is occupied with dire apprehensions the appetite is gone, the mouth dry because of lessened secretion. of saliva, and swallowing becomes difficult. Food that is thus swallowed under protest remains undigested because the gastric and other secretions are checked, and peristalsis interfered with. The latter may be increased to the extent of producing a diarrhea. Respirations are quick and shallow, and the heart beats rapidly and with changed quality, which may be hard, thumping, or fluttering; perspiration is often profuse, and large quantities of urine may be voided.

With the digestion, respiration and circulation so markedly and visibly affected by such a condition, it is not contrary to reason that further and less noticeable changes in the organs and tissues follow, both as a direct result of the mental state, and indirectly resulting from the important grosser functions already noted. That there is a perverted cell activity is shown by the abnormal character of the secretions-checked, as the digestive juices, increased, as the perspiration, or altered, as shown by a limpid urine. If the cells that produce pepsin and hydrochloric acid are so influenced, we may easily believe that the hematopoietic centers are similarly affected, and that the blood suffers proportionately, likewise the other cells of the body, including the nerve cells. Let this state continue for some time, even in a small degree, and chronic physical lesions result. There is not the proper assimilation of food and oxygen on the one hand, and on the other there is increased exhaustion. The result is seriously impaired health, due to a broken-down equilibrium in cell metabolism.

Take down a standard work on the practice of medicine and note the number of constitutional diseases of which, in the paragraph on etiology, fright, fear and worry are given as exciting causes. They form a considerable list, and include arthritis deformans, diabetes, enteric disease with chronic diarrhea, and exophthalmic goitre, while acute yellow atrophy of the liver has followed fright or profound emotion (Osler). Besides these, bronchial asthma, cardiac arhythmia and chlorosis are largely due to a neurotic element, and a host of functional disorders have no other The same condition may be the cause of premature hardening of the arteries, with all the various far-reaching effects on the different organs of the body. Add to these such states as have their origin in pathological conditions of the psychic processes, such as obsessions, abulias and imperative conceptions, and we have mapped out a pretty good corner of the field of medicine.

cause.

It may be thought that the point is being stretched to attribute all the above to the single cause of fear, but it must be remembered that the definition given above made it comprehensive of all I have enumerated. The last-mentioned class of cases is different from the others in that the fear is an expression of disease, and not the disease the result of fear necessarily, although it doubtless has its origin in states similar to those described, and I am inclined to look upon the man who is subject to imperative conceptions as an example of an advanced type of the cases I have attempted to describe.

Neurasthenia is generally attributed to improper methods of living, especially associated with American social customs. The irregular habits, improper food and attendance upon social functions at the expense of personal hygiene is undoubtedly the source of nervous breakdown and other ills among those who substitute the pleasant-tasting dishes of the fashionable restaurants and hotels for the plain bill-of-fare of the home