CURE OF RUMINATION.-Dr. Alt reports a case at Hitzig's hospital at Halle. The digestion of albumen was extremely rapid, while the digestion of starch was checked, and amylaceous matter had to be returned to the mouth, in order to be properly mixed with saliva. The treatment consisted in large doses of alkaline medicines, washing out the stomach, giving albuminous food, and galvanizing the œsophagus. In a fortnight this condition (which up to the present has been looked upon as incurable) was completely removed.-N. Y. Med. Abs.

QUACKS PREFERRED.-The French medical press gives a curious instance of preference for quacks. A provincial magistrate received complaints that a certain person was practicing medicine illegally. The quack admitted that he practiced, but produced a diploma showing that he was Doctor of Medicine of the Faculty of Paris. He explained that while he was unsuccessful as a legitimate practitioner, as soon as he consealed the fact that he was a graduate, and posed as a quack, his fame began to spread, his income grew, and he saved and invested a considerable sum of money. He begged the magistrate to keep his secret, being sure that if it was known that he was a qualified man he would lose all his practice.-Journal Med. Assoc.

CHRONIC SYPHILITIC SALIVATION.-A. W. Furber, M. D., L. R. C. S. and L. D. S., says :-I have for a long time had a gentleman-patient under my care for the disease of the teeth, and although my operations progressed favorably, I had many difficulties to contend with. The whole of my patient's teeth appeared to have a syphilitic taint, and with increased flow of saliva, amounting to chronic salivation. These were not the only troubles I had to surmount; but that which retarded my work most was the repeated recurrence of syphilitic ulcers of the sulcus and gums generally, which, though not painful to my patient, was still a source of considerable discomfort and militated greatly against the success of my operations. Iodia having come under my notice, I inclined to give it a trial, and with the addition of a small proportion of liq. hydrarg. bi-chlor., taken daily before meals for a time-also used occasionally as a mouth wash--the salivation became normal, the mucous membrane assumed a more healthy state and the teeth generally looked like coming back to their original color.

was

DANGERS ATTENDING A TOILETTE OF THE PERITONEUM. In reporting a case where a thirteen pound tumor of the right ovary was removed, the author called attention to the fact that the wash

was not devoid of danger, and often causes the stoppage of respiration. In two of his cases the respiratory act was re-established with difficulty; in another, death from failure of respiration occurred. He thinks this action is due to the direct effect of the water upon the diaphragm or solar plexus, and that is more apt to occur when the water is hot.

"On with the dance," the village druggist cried,
"No sleep till morn when youth and pleasure meet:
Of stomach ache no mortal ever died,

Hark! did ye hear the rattling in the street?
Let's chase the glowing hours with flying feet.
The doctor's carriage-can old foxy con
The lurking poison in a cream so sweet?
He can, he can, high Heaven, it's tyrotoxicon !"
And then there was a hurrying to and fro,

And gathering tears and symbols of distress,
And cheeks all pale that but an hour ago

Blushed at the tale of their own loveliness, And there were sudden gripings, such as press The very stuffing out of love's young dream, And with a frantic universal guess All shrieked; "It was the cheese-germ in the cream!" -Leonard's Medical Journal.

Communications solicited on all Medical and Scientific subjects, and also Reports of Cases occurring in practice. Address, DR. J. L. DAVISON, 12 Charles St., Toronto. Advertisements inserted on the most liberal terms. All Letters and Remittances to be addressed to DR. C. SHEARD, 320 Jarvis St., Toronto.

AGENTS.-DAWSON BROS., Montreal; J. & A. MCMILLAN, St. John, N.B.; GEO. STREET & Co., 30 Cornhill, London, Eng.; M. H. MAHLER, 23 Rue Richer, Paris.

TORONTO, NOVEMBER, 1888.

The LANCET has the largest circulation of any Medical Journal in Canada.

ALBUMINURIA.

The fact that albumen is frequently found in the urine of persons who have, in the ordinary acceptation of the term, no kidney disease, is gradually becoming accepted by the profession as true. Doctors are very often worried by patients who have had the ill fortune to discover that their urine contains albumen, this being looked upon by the laity as a sure sign of " Bright's disease" and consequent early death. Their forebodings are all poured out to their attending physician, who must be strong indeed in the confidence of his patient if he can let him know that there is albumen in his urine, and yet convince him that he need not fear death from immediate kidney trouble.

The insurance companies almost universally reject an applicant who has this symptom, and, perhaps, with our present knowledge of what may be termed extra-renal or false albuminuria, and "physiological albuminuria," they are quite justified in so doing. At any rate, it is probable that a medical man would require to know well the standing of a practitioner who might recommend such an applicant for insurance if he, the first medical man, were personally responsible for the amount of the insurance policy issued.

The careful diagnostician will take into account the various conditions outside the kidney before he concludes that albumen, even in a considerable amount, means structural change in that organ.

The fact that he can truthfully say to his patient, who by some means has discovered that this dread substance is present, that it may not be from his kidneys at all, will be a great comfort to both physician and patient.

In the false albuminuria the proteid found in the urine is not true serum albumen, derived directly from the blood as in true albuminuria, but is the result of some inflammatory or ulcerative process going on in some part of the genito-urinary tract outside the kidneys, as, for instance, pus, which is indeed nearly always the chief factor in producing this spurious kidney disease. Such pathological conditions as urethritis, purulent catarrh of the bladder, pyelitis, and such less important and circumscribed morbid conditions as ulcerations, small glandular abscesses, cancer, tubercle, and various forms of neoplasm may furnish elements such as blood, pus, or debris which, either singly or combined, will give the albuminuric reaction.

The Germans speak of a "physiological albuminuria," which differs from the false species above accounted for; in which there appears to be a congenital deficiency in the power of the glomerular epithelium to resist the passage of albumen through it. The question as to whether, in such cases, there is any tendency to the development of renal disease can not be considered settled, though such authorities as Leube and Fürbringer consider, as does Moxon, perhaps, that a young man who has albumen in the urine, say only occasionally, and in the forenoon, should be a good risk for life insurance. Hilton Fagge states that both Fürbringer and Moxon detected hyaline casts in one instance of this physiological albuminuria, so that, says he, "casts cannot be taken as conclusive evidence of serious mischief in the kidneys."

Dr. Shepherd lately presented to a meeting of the Connecticut Medical Society, an elaborate statistical report on albuminuria (Jour. Am. Med. Assoc.), compiled from examinations made on supposed healthy men. He covers all the ground and gives his conclusions as follows:

"1. Albuminuria is much less frequent in the United States than in England, Stewart giving thirty-one per cent. as the general average, while ours, conducted on a larger scale, show but two per cent. 2. The brain workers, rather than the muscle workers, show the largest percentage of

albuminuria. 3. The urine of perfectly healthy people rarely shows albumen after food, while those who suffer from albuminuria and oxaluria are very liable to show it. 4. Privation, scanty food and clothing, with insanitary surroundings, increase the liability to albuminuria. 5. Cold bathing does increase the liability to albuminuria, though more notably so in the case of dyspeptics. 6. Severe exercise increases this liability in a very moderate degree. 7. In the large majority of cases albuminuria is not associated with kidney disease. 8. In the matter of life insurance, albuminuria should be looked upon as a symptom only, and acceptance or rejection of the risk should depend on the gravity of the cause. 9. The existence of any such condition as physiological albuminuria is extremely improbable."

The doctor will be supported, we think, by the majority of the profession in protesting against "physiological albuminuria." The term is unscientific, and the idea does not accord with what we have been taught to consider physiological processes, notwithstanding the eminent authorities mentioned above.

VACCINATION AGAINST CHOLERA.

Dr. Gamaleia, of Odessa, has been experimenting for a considerable time on the action of the cholera bacillus upon animals. Lately at a meeting of the Paris Académie de Médecine, M. Pasteur read a communication from him (Br. Med. Jour.), in which he states that he has discovered a method of vaccination, which will be to cholera what Jenner's vaccination is to small-pox, namely, preventive of the disease. He found that, contrary to Koch's idea, the cholera germ is inoculable in the lower animals, and that its virulence becomes very greatly intensified by conveying it to pigeons after it has passed through the guinea-pig. "After passing through several pigeons, the microbe acquired such virulence that one or two drops of the blood of an inoculated bird sufficed to kill healthy birds in from eight to twelve hours, whilst an even smaller dose proved fatal to guinea-pigs. If the virus obtained after passing through pigeons is cultivated in nutrient broth and is afterwards exposed to a temperature of 120° C. for twenty minutes, it will be found that there is left in the sterilized culture a toxic substance which produces

characteristic phenomena in animals. If 4 cubic centimetres of the sterilized broth be injected into a guinea-pig, the animal's temperature gradually falls, and death takes place in from twenty to twenty-four hours. Pigeons die in the same way, but require a larger quantity, namely, 12 cubic centimetres injected in one dose. hand, if the same quantity of the sterilized fluid is injected, but in two or more doses given at intervals of a day or two, they do not die, but are found to have become refractory to cholera to such an extent that even half a cubic centimètre of the most intense virus (the blood of an inoculated pigeon) is not fatal to them. Guinea-pigs are still more easily vaccinated by injecting the sterilized broth in doses of 2 cubic centimetres once or twice repeated. Dr. Gamaleia has fround this chemical vaccine of unfailing efficiency and perfectly inocuous. He admits that he derived the idea of it from a paper of M. Pasteur's on chemical vaccine of rabies, and from Dr. Roux's experiments on septicemia." Dr. Gamaleia shows his full trust in the efficacy of thus preventing the attack of cholera, by offering to test it on himself, and afterwards going to regions where cholera prevails in order to show whether his discovery will be in man, all he thinks it will be. M. Pasteur's laboratory is to be placed at the Dr.'s disposal, for the purpose of carrying on his experiments.

SIR MORELL MACKENZIE AND THE

GERMAN SURGEONS.

It is a pity that so great a man as Sir Morell Mackenzie should have stirred up so unseemly a controversy as the one going on between him and the German surgeons. His fame was surely established on a sufficiently firm basis to enable him to pass over in silence their ungracious, unprofessional and sometimes contemptible remarks. Not only is this generally recognized as true, but it is believed that his hands have been tied by persons of high estate, who, for reasons not entirely understood, have controlled Sir Morell's actions, and have said when he should speak if not indeed what he should say, or rather what he should not say. And knowing all this, as well as that no amount of reasoning could convince the prejudiced Germans that he was right and their own countrymen were wrong, would it not have

been more seemly and more politic to have suffered in silence, secure in the esteem and admiration of his own countrymen, and of the whole world, Germany excepted? How many a professional man of low degree has learned thus "to suffer and be strong" under undeserved blame, obloquy and persecution even, only those who are in the profession know.

The question of damages for the learned German professors seems to be in nubilus, but we have not heard, nor perhaps shall we soon hear the last of this quarrel.

The surreptitious acquisition of the proof sheets by some smart journals is another phase of the affair which does not reflect credit upon their management; and indeed the whole matter, from beginning to end has, we believe, been a mistake, and one which may be far-reaching in its results, and out of which no good can possibly come. The handling of the German physicians was so rough, that they would have been more than human if they had not struck back with all their power and venom even, and it yet remains to be seen which of the parties to the controversy have the best of it, if indeed any decision ever be reached. But perhaps our readers have had a surfeit of the subject. Certain it is that the daily papers have not spared space to place the points of the contest before the public, and no doubt every one in the profession at least, has his own views on the subject. We shall therefore forbear inflicting our readers, further than this notice of a subject which is attracting so much attention at the present time.

THERAPEUTIC NOTES.

For insomnia and restlessness of typhoid at night, Prof. Janeway recommends morphia sulph. gr. given in hot milk at ten o'clock in the evening, and he has found this of more service than any other hypnotic.

septic and prevents sepsis of the bowels, and in his experience, is the best internal antiseptic we can use; it is also claimed that it has a decided empirical effect in checking diarrhoea. A case of violent diarrhoea was recently admitted to the hospital, and the first day the movements numbered 24; salol was then prescribed and the second day the number was reduced to three,and on the third day no movement.

Prof. W. H. Thomson begins the treatment of every case of typhoid with bismuth and pepsin and continues it throughout the whole course of the disease, claiming that as the stomach is the seat of parenchymatous degeneration, gastric digestion needs assistance, which is obtained by the pepsin, and bismuth controls gastric disturbances and irritations. During the course of all fevers, the entire alimentary secretions are checked, and thus the system is deprived of its natural antiseptics and as a result fermentation is set up, which causes the diarrhoea. Here the indication is to give intestinal antiseptics and he prefers bismuth, as having given him the best results. R.-Bismuth subnit., Pepsin,

M. et divide in chart No. xii. Sig. One t. i. d.

Zij

3j

For vomiting of pregnancy, very good results have been obtained from 3ss-3j doses of fld. extract viburnum prunifolium. It has been extensively tried in Bellevue and other city hospitals. In a series of eight cases, in which it was recently given in 3j doses, a uniformly successful result was obtained. It seems to have a direct action on the uterus itself, thus preventing the reflex irritation which results in vomiting. In some of the hospitals all other remedies have been discarded.

For uræmic dyspnoea, Dr. Roosevelt recommends cobalt nitrite in grain doses, repeated every

R.-Salol, . .

Divide in chart No. xii.

zij.

Sig. One every four hours. This in its passage through the alimentary canal is converted into salicylic and carbolic acids in the intestines, and thus acts as a direct anti

produced, and then discontinued.

For the same affection and for urgent uræmic symptoms of all kinds, Dr. Porter gives grain of pilocarpine hypodermically, and claims to get rapid relief. He believes that the drug acts as a vasomotor stimulant and increases blood pressure, and that the lethal effects of the drug are due to the

usage of too small a quantity, which acts in a directly opposite manner, and paralyzes the vasomotor system and thus causes lowering of blood pressure. Dr. Porter relates several interesting cases, but his views have not been adopted generally.

THE LESLIE FUND.

Hamilton, explains itself:

37 Main St. W., Cor. Park, Hamilton,
20th Oct., 1888.

JAMES WHITE, Esq., M.D.,

8 Cannon St., Hamilton. DEAR DOCTOR,-Allow me to thank for $461, you which has been handed to me by you, for the purpose of contributing towards defraying the legal expenses incurred in defending the persecution lately raised against me. While I regard this practical proof of feeling as given in support of a cause, rather than personal, I am at the same time deeply sensible of the heartfelt sympathy manifested to me by a great many of my professional friends, not only in this city, but elsewhere.

I thank you personally for all your kindness, and thus through you, those who, regardless of their own time and trouble, espoused my cause and assisted me in it with their wise counsel, their sympathy and their moral support.

I am, yours sincerely,

JAMES LESLIE.

THE USE OF CALOMEL IN PNEUMONIA.-Dr. McManus, in the Medical Record, gives the result of the treatment of sixty-two cases of pneumonia by early large does of calomel. His statements are rather startling, especially the dose, which would generally be considered heroic. He says:

My method is to give from thirty to sixty grains of calomel at the first dose; and in every case, unless it be given too late in the disease, it will bring down pulse, temperature and respiration in from six to eighteen hours.

I do not believe it to be of any use to give it after the fourth day of the disease; and I think at or near the crisis it will do harm. I cannot help thinking that if I had been able to give the next to the last case I have described the calomel two days earlier, he would not have run on to fibroid phthisis. And I cannot help believing that I

I have given it, with good effect, in two cases of pneumonia occurring in the puerperal state; and I have given given it in one case of pneumonia in a pregnant woman, and had the pleasure of seeing her recover promptly without aborting. I afterwards delivered her of a healthy male infant, three months after her attack of pneumonia.

DEATH WITHOUT DISEASE.-Stories of death having taken place without injury to the organism, and simply by the effect of the imagination have been long familiar, but have been regarded as more or less apocryphal. That of the negro who was condemned to be bled to death by a sham council, and who without being at all injured was led to believe he was bleeding by warm water being poured over his arm, and by the remarks of the by-standers, he being blind-folded, is perhaps typical of all such cases. It is said that the man actually died. He was told he was dying, and when the beholders lifted the bandage from his eyes they were horror-stricken to find that he was indeed gone.

In this connection the following from the Med. and Sur. Rep. will be of interest :-Boston papers tell of "the singular death, at Danvers, of Miss Emma Felch. She was taken ill some months ago and, from the fact that her mother died of cancer, she became possessed with the idea that her sickness was from the same cause. Her physicians could find no indication of cancer, but she asserted she had one, and located it. She refused food, saying it distressed her. At her desire, after she died, an autopsy was held, and no cancer could be found. It was decided that her disease was purely sympathetic."

This points a moral as to faith cure, the use of infinitesimal doses, etc.

THE CAUSE OF ECLAMPSIA AND ALBUMINURIA :—The etiology of this dread condition of the pregnant woman may be considered as yet, sub judice.