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boards one to three, boards of trade one to three, state pharmaceutic associations two and local medical societies from one to three delegates, according to the population of the city. Agricultural and trade organizations are also to be represented.

Dr. Wm. A. Hammond. In the recent death of Dr. Hammond another light has faded from our sky. A fascinating lecturer, a brilliant writer, and a distinguished neurologist, he was a man of great capacity, yet with marked limitations. He was in many respects an idealist, seeking to mould destiny rather than to conform to his environments. As the founder of the New York Medical Journal, the American medical profession is definitely indebted to him. He had his failings, of course, like all of us, but we are confident that American medical practice is broader and better for his having been a physician.

The Thirteenth
International
Medical Congress.

This congress, which convenes in Paris from the 2nd to the 9th of next August, bids fair to outrank all its predecessors in point of attendance and scientific interest. The attractions of the Worid's exposition and of Paris itself, the most beautiful city in the world, are certain to draw great numbers of physicians, who, like other people, often like to combine pleasure with profit. The American national committee, with Osler at its head, is thoroughly representative of progressive American medical science. Any doctor of medicine may become a member by making proper application and paying five dollars to the American secretary, Dr. Henry Barton Jacobs, 3 W. Franklin St., Baltimore, Md., who will return a receipt for the amount. The application and the money are to be forwarded to Paris, and in due time cards of admission will be distributed to all subscribers. Members desiring to present papers (limited to fifteen minutes) should forward the title and a

resume before May 1 to the secretary of the section to which they belong.

New York THE NEURO-MUSCULAR ELEMENTS IN HIP Academy of JOINT DISEASE.-Dr. N. M. Shaffer read a Medicine. paper of which the following is an abstract: If, as was generally conceded, the origin of hip joint disease was in the epiphysis, a great center of growth and development supplied from the central, spinal and great sympathetic nervous centres, it would be readily seen that the presence of a foreign body like the bacillus of tuberculosis in such an osteitic focus would cause serious nerve irritation.

The following neuro-muscular elements had been recognized and described: 1. Involuntary tonic muscular contraction. 2. Muscular atrophy. 3. Reduced faradic reaction. 4. Increased muscular excitability. Together they presented a clinical picture of an irritative peripheral nerve lesion and gave expression to a distinct reflex spinal condition. They were absent from a joint suffering, a simple injury and from primary tuberculous degeneration of synovial membrane, which was comparatively simple in structure and nerve supply.

REFLEX MUSCULAR SPASM.-This sign had been noticed early in his practice by the reader of the paper, who had spoken of it in 1872 as a "reflex muscular spasm," the first time, so far as he was aware, that the term had been applied to the sign. The occurrence and character of the spasm were unmodified by opium or chloral, but it was annulled by ether or chloroform. It produced joint deformity and sometimes simulated anchylosis. Clinically it was of the utmost importance. Its presence was the first sign of the disease and its absence the surest warrant for the suspension of treatment. It was involuntary, tonic, tetanoid.

When passive motion reached a certain point, at which the intra-articular pressure excited nerve irritation, the muscles involved, hitherto quiet, suddenly

contracted and resisted further motion. When that point was reached the alert joint sense almost talked to the observer. When convalescence approached and actual immobilization was no longer required the motion permitted by the apparatus used should be to the inner side of the point indicated by the spasm. Protection, however, should be maintained until the joint was free from reflex muscular spasm, when the patient might safely be restored to a gradually increasing use of the weakened limb freed from its diseased joint. Cases illustrating the ill effects of not heeding this indication were related.

MUSCULAR ATROPHY.-In this sign of joint disease we were dealing with something more than the effect of disuse. It was far from being functional atrophy. Although an early, important and expressive sign, its significance was impaired at a later stage by the incidental effects of mechanical treatment, which included rest and compression. This was to be borne in mind when the patient and his friends were apt to think that the atrophy was entirely the result of maintaining too long the restraints of treatment.

Before applying electricity to the muscles involved, the reader of the paper had surmised that reduced faradic reaction would be found. It seemed to be uniformly present in all of the atrophied muscles which were subjected to electrical test. In 1892 increased muscular excitability was shown by Dr. E. G. Brackett to be a fourth constant neuro-muscular element in hip joint disease, readily demonstrated early in the disease by the exaggerated patellar tendon reflex.-Jan. 19, 1900.

Farbenfabriken of Elberfeld Co.

Most of our readers will remember the sensation among druggists a few years ago by the prosecution of smugglers of phenacetin from Canada into this country, where this well known preparation is protected by letters patent. Although the smugglers and satchelpeddlers were heavily punished by fine and imprison

ment, there is no doubt that phenacetin and other preparations of the Elberfeld Co. are still being largely substituted, counterfeited and adulterated. Among these are somatose, guaiacol-carbonate, tannigen, erophen, aristol, piperazine, sulfonal, salophen, heroin, trional and protargol—all definite chemical products used more or less by the great majority of physicians in the United States. Counterfeited drugs are worse than none, and it behooves physicians to inform themselves personally as to the purity and genuineness of the drugs dispensed by their pharmacists.

To Distinguish Between Smegma and Tubercle Bacilli.-Pappenheim (quoted in American Year-Book of Medicine and Surgery) stains with carbol-fuchsin and then with a solution containing 100 parts of absolute alcohol, I part of rosolic acid, and methylene-blue to saturation, to this 20 parts of glycerin being finally added. This solution is applied to the cover-glass and then allowed to run slowly off, which is repeated from three to five times. Tubercle bacilli will be found stained a brilliant red-everything else blue.

Deafness of Middle Ear Sclerosis.-Fischerich (quoted in Laryngoscope) reports satisfactory results in 120 cases treated during the past four years by the intratympanic injection of a 2 per cent. aqueous solution of pilocarpine, introduced by means of a flexible tympanic catheter passed through a metallic Eustachian catheter well up into the tube. The course of treatment comprises thirty to fifty daily injections. The dose at first is 6 to 8 drops, gradually increasing to twice as much.

The Lingual Tonsil.-Among the symptoms caused by hypertrophy of this gland, and mentioned by Derrick T. Vail, (Cincinnati Lancet-Clinic) are: 1. Sensation of a lump in the throat, which the patient vainly endeavors to swallow. 2. Early voice fog in public speakers or singers. 4. The "graveyard" barking cough of puberty. 4. Constant desire to clear the voice by hemming and hawking, with nothing raised. 5. Relief of symptoms during meals. 6. Spasmodic asthma, globus hystericus. 8. Patient fears cancer or consumption of the throat. 9. Vague distress in the throat. 10. Blood-stained sputum in varix.

EDITORIAL ITEMS.

Sycose. This new sweetening agent for diabetic cases is 550 times as sweet as cane sugar.

Change in Name. The Medical Examiner will hereafter be known as the Medical Examiner and General Practitioner.

A Painless Blister.-The Medical Record gives the following formula: 20 grains each of menthol and chloral, 1⁄2 dram cocoa butter and I dram spermaceti.

Editorial Change.-The New York Lancet begins it 21st volume auspiciously under the editorial management of Drs. Walter B. Chase and Carroll Chase.

Lyddite. This high explosive consists chiefly of fused picric acid, which is contained in thin steel cylinders with conical points. It is extremely destructive.

The lodoform Stench.-Dr. Edwin Ricketts writes (Lancet-Clinic) that a teaspoonful of vinegar rubbed on the hands after the use of soap and water will promptly remove the disagreeable odor.

Rebellious Hiccough. The method of tongue traction introduced by M. Laborde is commented on by J. Noir (Le Progress Medical), who has found the plan successful in a large number of cases.

Thyroid Extract in the Treatment of Fractures.-A new use for this product is in the treatment of delayed or ununited fractures, where it is said to have accomplished much good in a number of cases.

Trichotillomania. This is the name applied by Dr. Hallopean (New York Medical Journal) to the intense itching of hairy parts in general paretics, together with the habit of plucking out the hair.

Anti-Typhoid Inoculation. It is stated (Clinical Review) that at least 70 per cent. of the British troops voluntarily submited to antityphoid inoculation previous to embarkation for South African service.

Chronic Parenchymatous Nephritis. In the Monthly Cyclopedia of Practical Medicine we find recommended the following dose combination: Iron and ammonium acetate, 1⁄2 ounce; tincture of cantharides, 2 minims.

Postural Albuminuria.—The treatment of this symptom, according to Geissier, (quoted in Medical Review of Reviews) consists of rest in bed or a chair for two hours after a full meal, with supporting and roborant measures.

Editorial Items continued on Page 495.

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