Psychosis of Morphinism."

T. D. Crothers, Hartford, Conn. (Journal A. M. 4., December 23), summarizes the mental and moral changes in the morphin eater as follows: "The psychosis or psychical symptoms common to morphinism are: first, palsy of the consciousness of right and wrong and inability and indisposition to discriminate the ethical principles or responsibility and obligation; second, a delirious stage of profuse explanation and efforts to conceal and to explain the reasons for his acts and conduct; third, a special exaltation or depression of the language centers, with a change in the manner of expression and in the use of words; fourth, a veritable insanity to deceive, to misrepresent and to take advantage of the credulity of others, not for any purposes of gain, but for the satisfaction of being able to defraud and to mislead, also, to act in different characters and to elude the efforts of persons who would discover the condition." The tendency may be either inherited or acquired. The detailed description of these several types or stages is interestingly given.

Tolerance to Nitroglycerin. According to D. D. Stewart, Philadelphia (Journal A. M. A.. May 27), an excessive tolerance of nitroglycerin can be readily acquired if care is not taken to avoid a too rapid increase of the dose, hence the drug, though intelligently employed, is often of little service. He refers to earlier articles of his on the subject, and especially to a case before mentioned in The Journal A. M. A., in which

50 minims of a 10 per cent. solution were taken daily without any marked effects. The best rule for giving the drugs for its effects on blood pressure, is, in his opinion, to administer it four times a day in dose just sufficient. to produce the slightest feeling of fulness in the head or to slightly quicken the pulse. If more than this is given, an undesirable tolerance is likely to be established. When a rather rapid increase seems needed to keep up a constant effect, it is best to discontinue the drug for two or more days, at intervals, and to resume its use with a smaller initial dose. By so doing the use of very large doses and strong solutions, which are not exactly safe to handle, will be avoided. Nitroglycerin, he thinks, has not met expectations as a remedy in conditions of persistent high tension, and he now uses it in such cases less frequently than formerly, endeavoring at first, at least, to relieve by limiting the nitrogenous intake and maintaining free action of the skin and bowels. Aconite is often substituted for nitroglycerin in these cases, with advantage.

Extract from "The London Lancet."

"The value of the hypophosphites combined with the cod liver oil, especially in wasting diseases and debilitated conditions, is well known. In addition to these constituents. Scott's Emulsion contains also glycerine, which is well recognized as assisting very materially in the absorption of fats and oils. We have examined this preparation with care and find that it fulfils all the requirements (CONTINUED ON PAGE 12.)

Some Observations on the Cause and Prevention of Yellow Fever.*

BY JAMES A. EGAN, M. D.,
Springfield, Ill.

In offering some observations on the cause and prevention of yellow fever it has not been my aim or my intention to present to you anything that is absolutely conclusive. It is essentially impossible to reach definite. conclusions as to the best preventive measures or the ideal preventive measures to be adopted, until we have become entirely satisfied as to the specific cause of the disease and the exact means of transmission. That neither of these two points has been determined to the satisfaction of the medical profession of the nation is made the more apparent the more one mingles with the medical men of the south, the more one discusses the subjects with those who have had the widest experience with the yellow fever epidemics of the past.

During the past summer excellent

*Read at the meeting of the Southern Illinois Medical Association at Mt. Vernon, Ill., Nov. 2, 1905.

opportunity has been afforded those interested in yellow fever to study the rapidly accumulating literature born of the epidemics in the south, but during this time my personal attention has been largely directed to the practical work of protecting infectible territory from the invasion of the distions have been necessarily based ease, and my thoughts and observaupon the study of local conditions. in the infected cities, and upon the problems which have arisen in the sanitary supervision and the quarantine service of the south, and upon the opinions and experiences of those with whom I have come in contactmen who have labored among the yellow fever patients in southern cities. for many years past. Unquestionably from the last named source is derived the most reliable and the most satisfactory, information, and the general conclusion of those who have labored longest and who have had the most extended experience, is that there are more problems concerning yellow fever which are yet unsolved than there are points which are fully understood.