United States troops which furnished the guards for the lazarettos, performed the work of disinfection of infected buildings and in other ways were constantly exposed to the danger of contracting smallpox. Respectfully,

EDWARD L. MUNSON,

Captain, Assistant Surgeon, U. S. A.

THE DIPHTHERIA ANTITOXIN AND TETANUS OUTBREAK IN ST. LOUIS.

DRS. B. MEADE BOLTON, C. FISCH and E. C. WALDEN, the commission appointed to investigate the cases of tetanus following the administration of diphtheria antitoxin in St. Louis, have reported (St. Louis Medical Review of November 23, 1901) as follows:

"As a result of our investigations we draw the following conclusions: "The diphtheria antitoxin prepared by the Health Department of the City of St. Louis, and dated September 30, and some of the serum dated August 24, was the cause of the recent deaths from tetanus in the cases where this antitoxin was used. This antitoxin was sterile, but contained the toxin of the tetanus bacilius in considerable amount.

"There were two different sera issued under the date of August 24; one portion not containing the tetanus toxin and characterized by other properties, while the other contained the tetanus and was identified with the serum bearing the date of September 30.

"The most important result we have arrived at is the positive demonstration that the toxic serum dated August 24 and that dated September 30 are identical. From this we conclude that the serum of September 30 was issued without having been tested by the proper methods, and that a part of it was filled into bottles bearing the date of August 24, and furnished with labels having previously been stamped with this date. We are justified in drawing this conclusion from two observations. First, that the serum of September 30 was issued before there was time to have performed the simple tests necessary to determine the antitoxic potency of the serum. Second, in the same way, serum dated October 23 came into our possession on November 1. This serum had been issued to physicians by the Health Department, and by them returned to the coroner. It is obvious from this that no animal experiments could have been made with this antitoxin. As this was the case with the serum of October 23, it is the natural inference that the serum of September 30 was issued in the same way.

"We must deny any possibility of latent tetanus having existed in the horse 'Jim' from August 24 to September 30, as no wellauthenticated cases have been reported in which the incubation

period extended over seven days, in experiments directed to test this point. The period of incubation cannot be determined from clinical observation, from the nature of the case. It therefore follows from this that the serum drawn on August 24 was free from tetanus, but that the serum of September 30 was drawn during the period of incubation, and had it been tested upon animals it must necessarily have revealed its toxic properties.

"From the foregoing facts we are forced to conclude that the diphtheria antitoxin prepared by the City Health Department has been issued before it was possible to have obtained results from the absolutely necessary tests. Had these tests been performed, the results upon animals would have been such that the serum would not have been dispensed, and the cases of tetanus forming the basis of this report could not have resulted."

THE EFFICACY OF VACCINATION.

DR. WILLIAM M. WELCH, Physician in Charge of the Municipal Hospital, Philadelphia, read a paper at a recent meeting of the County Medical Society, on the "Efficacy of Vaccination," in which he said, in part:

"Not one thus far who has been vaccinated previous to exposure has contracted smallpox. About fifty individuals, including physicians, nurses and attendants, have been continuously and freely exposed to the disease.

"In addition to the individuals referred to as being exposed, there were some sixty or more workmen, engaged in the construction of a new pavilion, who were in close proximity to the smallpox patients. These were vaccinated with glycerinated lymph, some for the first time, and none up to the present date has contracted the disease. One workman, who, by the way, was the only one to refuse vaccination, has within the past week been brought into the hospital with smallpox. He bears upon his arm a good scar from infancy. An unvaccinated garbage wagon driver and several other unprotected individuals, who were merely exposed upon the grounds, contracted the disease.

"We have, from time to time, received in the hospital persons with well-marked and even fatal smallpox in whom vaccination performed some weeks before had failed.

"Many physicians hesitate about vaccinating individuals who are suffering from some other disease. At the Municipal Hospital recently scores of patients suffering from diphtheria and scarlet. fever were vaccinated as a precautionary measure. The vaccina

tion did not unfavorably influence the original disease, and, on the other hand, the course of the vaccinia was in no case unusual.

Only One in Three Hundred.

"Since the beginning of the present year about 300 cases of smallpox have been treated at the hospital. Of this number not a single patient had been recently successfully vaccinated. The shortest period elapsing between a successful vaccination and the contraction of the disease was five years. In this case, which occurred in a boy 11 years old, the eruption consisted of only a score or so of papules, which scarcely developed into vesicles, but dried up in a few days. It was not found necessary to confine the lad to bed. While the majority of the patients admitted they were unvaccinated, a very large number had been vaccinated in infancy. To our knowledge, none, save the boy mentioned, had been successfully vaccinated within the past ten years.

"The writer believes that it may be laid down as a rule that if a child is successfully vaccinated in infancy, and again at the age of puberty, the protection will be permanent. The exceptions to this rule, however, may be sufficiently frequent to warrant repetition of the vaccination whenever there is exposure to smallpox."

VIRCHOW AS A POLITICIAN.-The London "Spectator" says: "Berlin has been honoring itself by celebrating the eightieth birthday of Professor Virchow, the great pathologist, whose demonstration that the human anatomy was based on cells laid the foundation of modern medicine. He is the son of a little farmer in Pomerania, and his rise from that position to the headship of science in Germany has been marked by a singular peculiarity. Professor Virchow, though devoted to scientific research, has been a weighty politician. He was practically for twenty-five years the leader of the Liberal party, had once the honor of a challenge from Bismarck, and incurred the fiercest anger of the Court, which secured his expulsion from his scientific appointments. He was also a hard worker in the field of local government, having been for forty years a member of the Municipal Council of Berlin, which he induced to undertake and carry through great sanitary reforms. He is now honored by Court and people alike, the Emperor forwarding to him the Grand Gold Medal for Science in a letter which, though without warmth, acknowledges to the full his scientific rank, and the people complaining that the decoration is insufficient. Here rarely or never do our scientific men or even physicians enter politics."

MEETING.

According to its wont, the Medical Society of the County of Kings held its annual memorial meeting at the Society's building, in Brooklyn, December 1, 1901. Dr. Browning, the president, opened the meeting with brief explanatory remarks and introduced Dr. H. N. Hoople, chairman of the historical committee, who gave a brief biography and eulogy of the following members who had died during the year:

GUTHRIE RIDER WARNER, M.D.; JAMES BYERS WARDEN, M.D.; JOHN BARNARD BUSTEED, M.D.; JOHN HENRY HOBART BURGE, M.D., an ex-president; JAMES WILLIAM EDWARD ROBY, M.D.; AUDLEY HASLETT, A.M., M.D.; ADOLPHUS WILLIAM DUNBAR, M.D.; THOMAS ENNIS MCCARTY, M.D.; CHARLES EDWARD DorITY, M.D.; JARVIS SHERMAN WHITE, A.M., M.D., LL.D.; FREDERICK CORNELL DEMUND, A.B., M.D., and STEPHEN CHANDLER GRIGGS, M.D., together with Drs. JOHN CHARLES HARTT, RICHARD CARSON BAKER, GEORGE WILLIAM WELLS, EDWARD F. MORGAN and ORSON HOPKINS SMITH.

Dr. Browning then introduced the Rev. E. W. McCarty, rector of St. Augustine's Roman Catholic Church, as the brother of one physician and the uncle of another, both deceased.

Father McCarty delivered an address which was listened to with close attention and earnestly applauded at its close. He spoke in part as follows:

"Members of the Kings County Medical Society-You have gathered here to-night to recall and to honor the memories of your associates who during the last year have passed away. This annual custom dignifies your large and venerable organization. It reveals your fealty to friendship, your fine sense of justice and your loyalty to your profession. Usually physicians are not credited with a surplus of sentiment; but when you busy men leave your duties that are pressing and important to listen to the roll-call of your recent dead, to write in your records an outline of their lives, and to eulogize their achievements in medical science, you not only give evidence of the sincerity and manliness of your sorrow for the dead, but you hold out to the living a splendid incentive for noble effort in their difficult work. If the lips now turned to clay could give voice to the hearts that beat no longer, I am sure they would tell you that, after the tears of those who are nearest and dearest, they prize most of all on earth your commendation

and the writing of their names in honor here in this temple of medical fame.

"Twelve of your men have fallen since your last memorial meeting. Twelve doctors' signs have come down, and on twelve silver plates their names have been graven and then fastened to coffin lids. On their new signs no office hours are stated. Their office chairs are empty. They have made their last call. Here, in imagination, to-night, we have twelve full-sized caskets, ranged becomingly side by side. From one to the other we reverently go and unscrew the tops and uncover the faces. As we look from one white face to another we find that some of them were old, some were in middle life, and some were young. On every face is stamped the evidence of intellectuality and thought-faces that brought hope to many a sick room and health to many a home. There they lie, fine types of noble manhood. Shower upon them generously your fragrant flowers of remembrance, and join in a fervent song of earnest praise because of the efforts they made and the work they did on behalf of suffering humanity.

"The world does not discriminate well in crowning its heroes. Read the story of the human race and it will tell you that here and there, in every age and in every land, geniuses shed their light on their time and on their country. Some led victorious armies. whose iron tread shook the earth; some with master hand guided the destinies of nations to magnificent success; some revolutionized geography by their discoveries; some rose on the wings of literature until they seemed almost inspired; some scanned the heavens with the eagle eye of science, and told the astonished nations the secrets of the stars. These names were forged in iron, cast in bronze, carved in stone, and written in ink that seemed indelible on the glorious pages of history. This is as it should be. Raise them on their pedestals of polished granite and let them, placed in graceful posture, receive the homage of their fellow-men. But why not give equal reward to greater merit? Why has not your great profession been fittingly recognized? Is it not strange that the heroism of an hour is often recorded and rewarded, while the heroism of a life is passed by unnoticed? You do not sweep the heavens with the telescope and speak to the listening thousands of the music of the spheres, but you search the earth with the microscope and warn mankind of its discords and dangers. You do not soar into eagle flights of literature that fascinate the imagination, but you tell with pen that is learned and graphic the mysteries of the