where they are assistants of Dr. H. L. Kirkpatrick.

Dr. S. K. Owens, of Montgomery, W. Va., has recently recovered from a long and serious illness, and is now convalescing at the home of his parents in northern Virginia.

Dr. P. B. Pendleton, of Longacre, W. Va., has been quite sick for some time with sciatica.

Kanawha County.

Four of the recent graduate nurses of the Sheltering Arms Hospital have located in Charleston for the practice of their profession. They are Misses Lelia Echols Lulu A. Bonham, Emma L. Grishaber and Maude Cassell Peery.

Dr. F. H. Redewill, a recent graduate of Johns Hopkins Hospital Medical School, who was resident physician at the Sweet Chalybeate Springs, Va., during the summer past, is interne at the Sheltering Arms Hospital, Hansford, W. Va.

Dr. W. W. Hume and Dr. J. E. Cannaday attended the meeting of the Virginia Medical Society at Charlottesville, Va., in October. Dr. Cannaday reported a case of abdominal pregnancy successfully treated by operation.

Dr. R. T. Davis, of Charleston, spent the summer at the Old Sweet Springs, in Monroe county, W. Va., as resident physician.

Dr. E. A. Davis, of Mammoth, spent the month of October in Virginia. He has now gone to New York to take a post-graduate course at the Polyclinic Hospital, and will later locate in Virginia. His successor at Mammoth is Dr. W. Bolling Robertson, late of Saltville, Va. Plans are on foot for the building of a new hospital on the present grounds of the Sheltering Arms Hospital, Hansford, W. Va.

Dr. Eugene Davis, of Charleston, W. Va., has just returned from a visit to Lexington, Va., where his father, a retired Episcopal minister, has been quite ill.

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Dr. S. M. Stone, of Tomsburg, W. Va., has succeeded Dr. F. R. Wheelock to the medical practice of the Paint Creek Collieries Company. Dr. Stone will have entire charge of the medical practice of all the collieries on Paint creek with the exception of two small places. will be assisted by Drs. W. W. Koiner, of Mucklow, and Dr. Earl Musgrave, of Standard. Miss A. Cousins McKay, formerly night superintendent of Randall's Island Hospital, is now superintendent of nurses of the Sheltering Arms Hospital.

The P. O. address of Dr. J. E. Cannaday has been changed from Paint Creek to Hansford. Below are the new members of Kanawha County Medical Society: Dr. Joe R. Arnold, Olcott; Dr. Dorse W. Brown, Charleston; Dr. B. P. Garred, Hernshaw; Dr. Wilbur F. Shirkey, Malden; Dr. Chas. N. Watts, Pond Gap; Dr. J. R. Walker, Marmet; Dr. D. E. Musgrave, Standard; Dr. S. S. Staunton. Villa; Dr. J. W. Aylor, Charleston; Dr. H. Sawyer James, Putney.

Mercer County.

Miss Margaret Bowles, a recent graduate of the Sheltering Arms Hospital, has accepted a

position as superintendent of nurses at St. Luke's Hospital, Bluefield.

Dr. W. C. Slusher, of Bluefield, W. Va., is taking a post-graduate course at the New York Polyclinic.

Dr. W. L. Weadon is at present in Philadei. phia, Pa., taking a special course in diseases of the eye, ear, nose and throat.

Raleigh County.

Dr. W. D. Jefferson, formerly located at Tomsburg, W. Va., is now at Raleigh, where he is the assistant of Dr. McRae C. Banks.

Randolph County.

President Golden appointed the following members delegates to a "conference in New York City, November 15th, to devise ways and means to protect the public health and morals": Drs. C. S. Hoffman of Keyser, A. P. Butt of Albert and J. R. Cook of Fairmont. This is understood to be the beginning of an organized effort to protect the public against the manifold evils of quacks and patent medicines. We hope our delegates were on hand.

Dr. W. S. Robertson, of Coalton, W. Va., has resigned his place there and has gone to Richmond to live.

Tyler County.

Dr. G. B. West, of Sistersville, whose name does not appear on our printed list, is an old member of the State Association. Tyler ought to have a County Society. Doctor, you are the proper leader.

Monongalia County.

Dr. Allen Bush, of Morgantown, is in New York attending the Post-Graduate School and Hospital. He will be gone till the first of the year.

Dr. E. L. Naret died at his home in Morgantown November 1st.

At a special called meeting of the Monongalia County Medical Society the following was adopted:

This society learns with deep regret of the death of its fellow-member, Dr. Edward L. Naret, at his residence in Morgantown, W. Va., November 1, 1906. Dr. Naret's love for his chosen profession and his well-known zeal and energy gave promise of a very successful professional career. The Monongalia County Medical Society hereby records its loss in his untimely death, and extends its sympathy to his bereaved wife and friends. L. S. Brock, R. H. Edmondson, F. T. Haught, Committee.

College of Medicine. Although the requirements of the College of Medicine have been increased from twenty-four courses to thirty-six courses, an increase equivalent to one year's work-yet the number of students in this department has greatly increased. Up to the present time fifty-five students have been enrolled, which far exceeds any previous record. The students are said to rank high in the Medical Schools where they complete their medical

courses.

The chemical department of the University is so crowded that room can scarcely be found

for their accommodation. The total number is 134, being mostly from the Colleges of Medicine and Engineering, and the departments of English and Education.

Ohio County.

Married-October 31st, at the rectory of St. Matthew's P. E. Church, Wheeling, by Rev. D. W. Howard, Dr. H. Byron Baguley and Miss Florence Hannan. May the river of life, for the newly-married couple, "Flo." as smoothly as "Byron's" poetry.

On November Dr. John McColl was married to Miss D. Pollack, daughter of the late Hon. Augustus Pollack, all of Wheeling. For the present the Doctor and wife will make their home at the Pollack mansion.

The following are new members of Ohio County Medical Society: Drs. A. B. Nicolls, C. M. Ulfert, T. F. Downing and A. J. Quimby, all of Wheeling. Three other applications are pending.

Note. Drs. J. A. Cannaday, T. W. Moore, F. T. Haught, C. A. Wingerter, H. P. Linsz and A. P. Butt have placed us under obligations by sending news and society items.-Editor.

Medical Outlook

Hemoptysis.-Fatal result proceeds, in practically all cases, from a ruptured aneurism in a branch of the pulmonary artery. The walls of pulmonary vessels are quickly attacked in tuberculosis. The endarteritis is usually obliterating, or the vessel walls become thick and immobile. The pulmonary blood pressure may be affected by change in the caliber of the vessels, by increased or lessened flow of blood, by change in the rate of circulation, and by failure of left heart to perform properly its functions. Theoretically, hemoptysis may be controlled by making the blood more coagulable, by slackening its flow, by reducing its volume, by lowering the blood pressure, by contracting the affected vessels. The author says the vessels cannot be contracted; hence ergot, adrenalin, etc., are worse than useless. The nitrites are active in reducing blood pressure, by causing dilation of the peripheral vessels chiefly in the head and neck and in the splanchnic area. Amyl nitrite acts instantly, nitro-glycerine less promptly but longer, sodium nitrite still less promptly but still longer. throl tetranitrate is slower than either, but its effects are more lasting. In hemoptysis, then, give amyl nitrite at once, with a dose of morphia, if patient is nervous. Follow quickly with nitro-glycerine, and. in 20 to 30 minutes with sodium nitrite gr.j. Or, erythrol tetranitrate may be given soon after the sodium nitrite. Test the blood pressure, and repeat latter remedies as indicated. L. Brown in Am. Jour. Med. Sci. J.

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Syphilis as Cause of Tabes and General Paralysis of Insane.-In Quar. Jour. of Clin. Med. Dr. Byron Bramwell claims that 80 to 94 per cent. of cases of tabes can be traced to syphilis. Never ask a patient with either of the above diseases, have you had syphilis, but

rather when did you have syphilis. He insists that these diseases are most apt to follow cases that were very mild, probably because such cases of syphilis are apt to get inefficient treatment. Fournier carefully followed 83 cases of syphilis from the initial chancre up to their final termination in general paralysis of the insane, and he found that in no less than 80 of the 83 cases the syphilis in its early stages was slight. Whereas of 243 cases in which the syphilis in its early stages was severe not a single case terminated in general paralysis of the insane.

Again, amongst persons living in districts where syphilis is rare or unknown, and amongst certain classes of the population (such as ecclesiastics, monks, etc.) in which syphilis is very rare or unknown, tabes and general par alysis of the insane are very rare or unknown; but amongst these persons and classes mental diseases and nervous diseases, which are not the result of syphilis, occur as frequently, or almost so, as amongst the general mass of the community.

The opinion that syphilis is the most important factor in the production of tabes and general paralysis of the insane is corroborated by a great number of facts, some of which are the following:

Rarity of tabes and general paralysis in women, females affected with tabes and general paralysis of the insane have had syphilis or have been exposed to syphilis; juvenile tabes and juvenile general paralysis of the insane always syphilitic; the children and wives of patients affected with tabes and general paralysis of the insane often present symptoms or signs of syphilis; conjugal tabes and conjugal general paralysis of the insane are always syphilitic. Some very remarkable cases have been met with which seem to show that syphilis contracted from the same source is specially apt to produce tabes and general paralysis of the insane; in other words, special varieties, so to speak, of the syphilitic poison seem to predispose to the production of tabes and general paralysis of the insane; or, as Professor Erb puts it, certain forms of syphilis are especially toxic for the nervous system. Dr. Bramwell thinks that these facts show that syphilis is a factor of the very highest etiological importance in tabes and general paralysis of the insane. It is, in fact, the most important factor in the etiology of these diseases. He is rapidly coming to the conclusion that syphilis is probably an essential factor in the production of these diseases; in other words, that without previous syphilis we probably never have true tabes and true general paralysis of the insane. -N. Y. Jour. of Med.

J.

The Bacillus Paralyticans.-Dr. F. W. Langdon reported on some research work in progress at the Clinical Laboratory of the Cincinnati Sanitarium on the Bacillus paralyticans, recently announced by Dr. Ford Robertson, of Edinburgh, as bearing an important causative relation to paresis and to locomotor ataxia. Pure cultures of the bacillus in both rods and filaments, derived from the cerebro-spinal fluid, urine and other secretions,

were exhibited; also photomicrographs. The bacillus belongs to the "diphtheroid" group, but differs from the Klebs-Loeffler bacillus in important particulars: Thus, it is non-pathogenic to guinea-pigs, while fatal to rats in two or three months. Rats fed upon it develop clinical symptoms and histological lesions resembling some of those of paresis.

The organism occurs in rods singly and tending to be grouped in threes; also in a filamentous or "thread" form due to non-separation of the individuals and presumably rapid proliferation. A high temperature (42° C.) during culture, or the presence of fever in the patient, are considered by Robertson as favoring the production of the thread form. The organism, like the Klebs-Loeffler bacillus, appears remarkable for its polymorphism. It occasionally shows barred as well as solid color forms when stained with methyl-blue or carbol-fuchsin. The "barred" forms convey something of the impression of a link of dark-colored sausage, with two or three broad light bands painted around it transversely. The polymorphonuclear leucocytes exert a marked lysogenic action upon the bacillus, and this necessitates the immediate cooling of blood containing them, in order that the lysogenic powers of the leucocytes may be arrested. By this process the bacillus has been found in the blood. According to Robertson, the bacillus paralyticans gains access to the system by way of the respiratory tract and alimentary canal chiefly. Syphilis, alcoholism and the "strenuous life" generally are merely important factors in breaking down the general defenses against the bacterial invasion. The invasion of the blood, lymph and tissues generally by the bacillus gives rise to the production of toxines to which the various trophic, degenerative, convulsive and paralytic phenomena of the disease are due.

The bacillus has been found in the bronchial, alimentary and genito-urinary mucous membranes; in the cerebro-spinal fluid; in the brain; in the walls of the cerebral blood-vessels; the blood; the urine; and other tissues and secretions. To the lysogenic action of the leucocytes and blood-serum of the paretic, is attributed the recession of the bacterial invasions, and consequently the "remissions" so characteristic of paresis.-Cinti. Lancet-Clinic.

Ether Narcosis by Rectum. - Stucky reviews the history of this method of producing anaesthesia, mentioned in Pirogoff's book in 1847. In 1884 mentioned by Mollier, who followed suggestion of Yversen of Copenhagen. Same year Hunter reported six, Weir seven, Wanscher twenty-two and Post three cases. Since then scant reference which seemingly has met with disapproval.

Four cases reported by Stucky in which Cunningham's method was followed. Cunningham's paper in Boston Med. & Surg. Journal of April 20, 1906, is closely followed in the description.

Advantages. In operating about the head the absence of the ether cone lessens the technical difficulties, minimizes the chances of sepsis, and shortens the time of the operation. Less ether is used and the patient passes rapidly under its effects with no sense of suffoca

tion. The stage of excitement is lessened or absent and the after effects are diminished. The direct irritation of the vapor in the lungs is absent, and this is an obvious advantage in diseases of the lungs. The absence of bronchial secretion and vomiting is marked and patients express a preference for this method.

Preparation of Patient.-Bowels should be thoroughly cleansed forty-eight hours previous to operation by cathartics and enemas. A breakfast of beef tea or milk and toast may be given four to six hours previous to operation.

Apparatus.-A bottle seven and a half inches in height, with five inches for ether and two and a half for vapor space. The afferent tube, which leads to the bottom of the ether column, ends in a bulb with several small perforations so that air ascends in fine bubbles. The bottle is placed in water between 80° and 90° F. Efferent tubes of various lengths have been tried with no difference in results.

Administration.-Patient lying on back with legs slightly flexed, rectal tube inserted from 10 to 14 inches. The rectal gases are driven out around the rectal tube, the fingers aiding in this process. The ether is forced in by a few squeezes of a bulb on the efferent tube. The breath is ether-laden in from one to five minutes after the administration. When operation is completed expel as much as possible of the ether by abdominal massage, with the rectal tube in position. The author says, "I have no hesitancy in predicting that the apparatus will be simplified, the technic of administration better understood, and that this method of narcotizing will become the method par excellence in selected cases."-Am. Jour. of Surgery. Abstract by G. D. L.

Local anesthesia, by the introduction into the tissues of some neutral or physiologically active drug, has been practiced for a score of years or more. It seems, therefore, that we have had ample time to arrive at some definite conclusions as to its uses and abuses. While the use of cocaine for this purpose was first used, other remedies have been equally valuable and much safer. Morphia is claimed to be an antidote to cocaine, so that anyone who prefers the latter drug should give a hypodermic of morphia 15 or 20 minutes prior to the use of cocaine. The addition of adrenalin or epinephrin to the cocaine solution prolongs the anesthetic effect and controls hemorrhage. The following is considered to be an ideal solution for local anaesthesia:

Sol. Epinephrin (1-1000) gtt. x
Beta-eucain

Sodii Chloridi

Aquae

grs. ij

grs. xij 3iijss

This is free from danger, even if the whole is used in one operation. If cocaine is preferred, not more than one-third the above quantity is to be used. Operations for the radical cure of hernia, hemorrhoids, fissures of rectum, appendicitis, exploratory laparotomy, removal of tubes and ovaries and many others, have been done under local anaesthesia.-Edwards in Cal. State Jour. of Med.-J.

The Treatment of Hyperemesis Gravidarum. -In the New York State Journal of Medicine for May, 1906, Stone tells us that the treatment of hyperemesis gravidarum, considered specifically, should consist of: (1) Rest in bed, absolute in most instances, at least for a few days. (2) Exclusion of all visitors, even members of the family in severe cases. (3) A milk or broth diet, or absolute withdrawal of all food by stomach in the severe cases, but a liberal allowance of water. (4) Catharsis at the beginning of treatment with calomel and salines, the salines sometimes to be repeated. (5) Colon irrigations with normal saline solution, or rectal injections of the same. Intravenous infusions in the severest types. (6) Nutrient enemata. (7) Administration of a few doses of opium, well selected as to time, either hypodermically or by rectum. The writer considers the opium a valuable adjunct, and does not think that the beneficial results following its use offer any more argument against the toxic origin of the disease than do the good results of its use in other toxic conditions.

In the treatment of the severe cases, particularly those of the acute or fulminating type, the additional evidence furnished by a complete chemical examination of the urine will give the most accurate knowledge of the gravity of the condition, although as yet the appearance of no single pathological constituent can be said to furnish an infallible guide. The writer believes, however, it will be possible to decide in a larger number of cases than formerly whether the treatment as outlined above shall be continued, or whether pregnancy shall be terminated.

In the presence of urinary changes that denote a serious disturbance of metabolism it is the writer's own opinion that pregnancy should be terminated at a much earlier period than any text-book has so far suggested.-Therapeutic Gazette.

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Treatment of Coryza by Formaldehyde.In the Concours Medical (Practioner, July, 1906) Dr. Lacroix describes a method which, according to him, gives the best results. prescribes formaldehyde [liq. formaldehydi, U. S. P.] iss. in a wide-mouthed bottle. To be used for inhalation.

The patient holds the open bottle below each nostril, as if about to use a smelling bottle, and inspires gently. There is produced in the nasal fossae and generally also in the forehead, cheeks and nape of the neck, showing the penetration of the formic vapors to the frontal, maxillary and sphenoid sinuses, a sense of smarting and tingling, intense enough to cause a slight lachrymation, and a running of mucus from the nose. As soon as this sensation becomes painful, the inhaling is stopped for a few moments, and then renewed two or three times more. This is done every hour, or less often, according to the degree of severity of the coryza.

The advantages of this method of treatment are: first of all, its simplicity; then, its cheapness-with one or two drachms of formalde

hyde a cold in the head can be treated for several years; its innocuousness-for formaldehyde, used in this manner, has no untoward effects; and its efficiency, for these inhalations give excellent clinical results. Some patients preserve with the greatest care their little bottle of formaldehyde and have recourse to it whenever a cold in the head threatens, and for many years they have never been disappointed in its good effects.-Critic and Guide.

Methylene Blue in the Treatment of Inoperable Cancer.--Dr. A. Jacobi of New York says: "When he has to treat an inoperable cancer, particularly of abdominal organs, or in cases where operation has been refused, he gives methylene blue in pill form, a half grain four times daily in the beginning, and increasing up to four, five and six grains a day. From the very beginning, in order to counteract the disagreeable dysuria, he gives an extract of belladonna, three-fourths of a grain a day, divided into three or four doses. It acts very much better than nutmeg which has been recommended for that purpose. Under such treatment the cases have done well, particularly the intra-abdominal cancers. In cases of cancer of the liver, after using this treatment for some time, he has seen autopsies performed, and the tumor found to have been much reduced, the patients having lived for a good many years in tolerable comfort. He has had one case under observation eight years; this patient now has been attending to his business all the time. He would recommend this treatment, too, in cases that have been operated upon, as a routine measure. This plan of treatment he suggests because there are so many of these cases. Frequently he has combined the methylene blue with arsenious acid, a preparation which he considered better than Fowler's solution. It could also be given with strychnine or other remedy. It is important that the pills should be made up by a good apothecary. The dosage of the methylene blue should be gradually increased from two up to six grains daily, and even more, divided in four doses.-N. Y. State Jour. of Med. —J..

Adrenalin in the Opium Habit. Dr. J. Hunter Wells, medical missionary in charge of the Presbyterian hospital at Pyeng Yang, Korea, has the following remarks to make on the use of opium and morphine: "The opium fiends, or morphine users, who began by smoking opium, are a most abject lot and usually from the homes of the well-to-do. They use the hypodermic syringe and inject morphine daily. I took on one case and instituted an original treatment in which adrenalin was the main medicine used, and the habit cut off at once. This was so successful that it created something of a furore among the morphine users, so that in April I had some thirty appli cations for treatment. They were so numerous that I sent some of them to a hospital conducted by one of my former students, and he, with the same remedies I used, is having good success."-Assembly Herald.

Miscellany

Caesarian Section by Heifer.-In a village near Salem, Oregon, late in July, a woman of twenty-three years, who was near her time for delivery, was attacked by a vicious heifer, one of whose horns penetrated her abdomen and tore the uterus. As she fell to the ground the child was delivered on the road. She walked into the house, assisted by her husband who carried the baby. She died of hemorrhage within a half hour, before the arrival of medical aid. The baby survived and is in a healthy condition.-North West Medicine.

The Wanderings of a Leper in Europe.A recent similar occurrence in the United States lends interest to the statement in an Austrian exchange that a man of 48, in the early stage of leprosy, recently arrived at the Austrian frontier on his way to his home in Roumania. Passage through Austria was not allowed, and he was sent back, with a car to himself, the doors locked and sealed. The Bavarian railroad returned the man to the place where he had taken the train, Frankfurt a. M., where he was transferred to the city hospital and isolated. It is proposed to send him back to London, where the disease was first diagnosed and where he started on his journey. Our exchange queries in conclusion: "What country will finally have to keep him?"-Jour. A. M. A.

Labor Obstructed by Unruptured Hymen.The following case, which came under my care some time ago in North London, is worth recording. With an experience of over 3,000 labors during the last twenty-three years, this is the only example of the kind I have had, though similar instances are mentioned in obstetrical works. The patient was a young woman who had been married about a year. When summoned to attend, labor had progressed for many hours, for the fetal head was well down on the perineum. The hymen was firm, rigid, and unyielding. As this condition was obstructing labor, I made several incisions into the hard, fibrous material, after which delivery proceeded naturally! The perineum was slightly lacerated, but this was purposely left unsutured. The presentation was normal; no complications followed, and the mother subsequently did well.-Edwin Chill, in British Med. Jour.

Damage Suits Terminating in Favor of the Surgeons.-Prof. Berger of Paris was recently sued by a couple whose child he had been operating on. He had undertaken a series of plastic operations to restore the face of the child, but for certain medical reasons was obliged to abandon the attempt. The parents sued him for not having completed the task, but the court dismissed the case. Dr. Aubeau of the same place was also recently sued by a woman for $10,000 damages on account of an indispensable gynecologic operation which he had successfully performed. She claimed that the operation had been too complete. He entered a counter suit, claiming 1 franc damages for her

abusive pursuit. The woman's case was dismissed and the physician was awarded the damages he asked. An editorial in the Gaz. Med. Belge says that times are becoming brighter; ten years ago the courts would in all probability have decided differently.-Jour. A. M. A.

An Early "Cut-Rate" Apothecary.-"Whereas, the majority of Apothecaries in Boston have agreed to pull down the prices of Bleeding to sixpence, let this certifie that Mr. Richard Clarke, Apothecary, will bleed anybody at his shop, gratis."-Stamford Mercury, March 28th, 1716. G. D. L.

Beauties of Electricity. A Denver physician, whose window reads, "Nose, Throat and Electricity," was recently called in an emergency to see a gentleman who had been attacked with apoplexy. Not being a neurologist, he had to make the case fit his specialty, so he informed the family that electricity was the best treatment, and has since been applying it to the patient.

The wife, weary and worn with watching, fainted from fatigue, and our accommodating M. D. diagnosed the case "nervous prostration," and advised electricity.

After getting the parents both started on the electric route, the rest became easy. Upon inquiry, he discovered the young lady of the family suffered from dysmenorrhoea, and she, too, was put on the same treatment. Not content with three daily seances in one family, he discovered some acne spots on the young lady's face, and persuaded her to come to his office each day and bask in the effulgence of the miraculous life-giving "rays."

Great is electricity, and great is the specialist who can make grist of every case that comes to his mill.-Colorado Medicine.

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Benjamin Franklin's Views as to the Nature of Colds.-The following passage from President Eliot's address on "Benjamin Franklin, as Printer and Philosopher," at the meeting of the American Philosophical Society, April 20, 1906, to commemorate the two hundredth anniversary of the birth of Franklin, is of decided medical interest: "The sagacity of Franklin's scientific inquiries is well established by his notes on colds and their causes. He maintains that influenzas usually classed as colds do not arise, as a rule, from either cold or dampness. points out that savages and sailors, who are often wet, do not catch cold, and that the disease called a cold is not taken by swimming. He maintained that people who live in the forest, in open barns or with open windows, do not catch cold, and that the disease called a cold is generally caused by impure air, lack of exercise or overeating. He came to the conclusion that influenzas and colds are contagious -a doctrine which, a century and a half later, was proved, through the advance of bacteriologic science, to be sound. The following sentence exhibits remarkable insight, considering the state of medical art at that time: 'I have long been satisfied from observation, that besides the general colds now termed influenzas (which may possibly spread by contagion as well as by a particular quality of air), people