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tioner in making his own sugar tests rather than trusting them to a third party. He mentions an instance in which a physician treated a patient for months with the diagnosis of diabetes based on the finding of sugar in the urine by a third person. The diabetic diet which had been given during this time reduced the individual to an emaciated condition, when the discovery was finally made that the urine contained no suagr. Quanti tative tests should always be made by the physician if he desires to apply therapeutic measures intelligently.

The Blood in Pulmonary Tuberculosis.-UI.

lom and Craig (Am. Jour. of the Med. Sci., Sept., 1905) deduct the following conclusions from a hematologic study of 39 cases of pulmonary tuberculosis, with special reference to prognosis: 1. In pulmonary tuberculosis without cavity formation. a mild anemia, with a decrease in erythrocytes and relatively greater decrease in hemaglobin, is constant. 2. From the standpoint of prognosis an increase in erythrocytes, in cases without cavity formation, is of favorable significance. 3. In advanced cases a decrease of leucocytes is of unfavorable import. 4. The actual increase of lymphocytes seems to correspond to the increase of resistance on part of the organism to the tuberculous infection, but further study is required to confirm this

deduction. 5. The transitionaal cells seem to follow the same rule as the lymphocytes in this regard. 6. At the begining of the investigation the eosinophiles seemed to increase with the patients improvement, but further study did not support this view.

The Effect of Tea on the Gastric Secretion.- Sosaki's (Berliner klin. Wochenschrift, No. 49, 1905) investigation in this direction consisted in effecting a gastric fistula in an esophagotomized dog according to the Pawlow method and feeding large quantities of strong tea (10 gms. to 400 cc. of water). He noted a uniform reduction in the gastric

secretion. These results are of considerable diagnostic import in deducting inference as to the secretory function of the stomach in giving an Ewald test-meal.

Ankylostomiasis of the Skin.- Dubrenilh (Presse Médicale, No. 30, 1905) dwells at length on the subject of ankylostomiasis and says, among other things, that the experiments of Loos, Kairo and others prove beyond the peradventure of a doubt the fact that the ankylostoma larva enter the body through the skin and by the venous circulation is transported to the pulmonary alveoli, thence to the bronchi, and finally wonders through the esophagus into the stomach and intes

tines, where they develop to their full maturity. Schaudinn has successfully demonstrated the presence of the larva in the circulation of the heart and lungs in monkeys after a cutaneous invasion. The author maintains that alterations of the skin must necessarily be a consequence where invasion through the epidermis has taken place. As a matter of fact, characteristic skin lesions have long been described occurring endemically in certain localities, especially in the tea plantations of Assom under the name of panighav, in the southern portion of the United States, as water itch or water scabies,

etc.

beginning on the soles of the feet and extendThe first symptom is intense itching ing to the dorsal surface.

The skin at the onset is red, and after one or two days vesicles form which increase in size and number terminating in painful ulcerations. The eruptending to the ankles, the remaining surface tion is usually limited to the feet, rarely exof the body is never involved. The condition, if left to its own course, lasts several weeks and may be complicated by gangrene exclusively during the rainy season in perand phagedenic ulcers. Panighav occurs sons working on the plantations with bare feet. Ankylostoma eggs are almost invariably found in the feces of those working on demically. Dubrenilh considers this evidence plantations whenever panighav prevails entoma (duodenale, americanum, caninum) penas sufficient proof that the larva of ankylosetrates the skin, and on reaching the gastrointestinal tract completes its development, and further holds this to be the usual mode of infection where ankylostomiasis occurs endemically. He also points out the importance of observing skin eruptions during such a prevalence of the disease.

Sahli's Desmoid Reaction.-Eichler (Berliner klin. Wochenschrift, No. 48, 1905.)— This reaction, as suggested by Sahli, consists closed in a rubber capsule or sack, which is in swallowing a pill of methylene blue ensealed at the open end by a fine piece of raw be administered shortly after the main meal. catgut ligature. The prepared capsule is to Gastric secretion containing the normal amount of pepsin and hydrochloric acid readily digests the piece of catgut, permitting the escape of methylene blue, which is easily detected in the urine several hours later. Eichler has given this test an unprejudiced trial in thirty patients in whom a previous Ewald test-meal had been given to determine. the gastric secretory function. The author quite agrees with Sahli, who regards the reaction as a convenient and practical method of determining the digestive function of the

organ. A positive reaction in from fifteen to twenty hours after the ingestion of the capsule sufficiently proves, with but few exceptions, that the mucosa of the stomach secretes both pepsin and hydrochloric acid in sufficient quantity to carry on adequate digestion. A negative reaction, however, points to no particular gastric affection, it signifies, in general, a gross disturbance in the secretory function. In order to more accurately determine matters it is necessary to resort to the use of the stomach tube.

THERAPEUTICS.

W. T. HIRSCHI, M. D.

The Significance of Spinal Anagesia for the Diagnosis and Treatment of Rectal and Anal Diseases. (T. Neugebauer, Zent. für Chirurgie, No. 44, 1905.)-The writer observed 560 of spinal anagesia, the majority of which had a complete relaxation of the sphincter ani muscles during the anesthesia, so the lower portion of the rectum could easily be inspected. For this reason he prefers this method of anesthesia for operations in the region of the anus and rectum. He fre

quently observed a spontaneous reduction of incarcerated bernia during spinal anesthesia. The same, however, also occurs with general anesthesia.

Nausea and Vomiting after Narcosis.-(T. D. Luke, Edinburgh Med. Jour., Sept., 1905.) Ether causes nausea and vomiting coming on soon after, being severe, but lasting only a short time. Chloroform causes nausea and vomiting much later and lasting longer. Purging the day previous to anesthesia is injurious, and if it should be necessary this should occur at least two days before operating. Severe fasting is not advisable. Milk diet should be avoided for a day or two following anesthesia, since ether and chloroform produce a temporary hyperacidity. The patient must remain quiet for a few days and receive a rectal enema (onehalf litre of normal saline solution) immediately after narcosis, to hasten the elimination of the anesthetic and reduce the thirst. mouth should be washed repeatedly with a mild astringent. Warm water may be taken soon after an anesthetic. No drugs are of benefit to prevent vomiting.

The

The Treatment of Albuminuria and Eclampsia Occurring in Pregnancy. (Boxall, British Med. Jour., Sept 23, 1905.)-In all cases of pregnancy associated with persistent albuminuria, especially if the urine is diminished in amount and casts are present a strict diet

should be observed. Milk and farinaceous articles must be used freely, while meat is to be restricted. The bowels should move freely, and if necessary mild saline physics, comp licorice powder or comp. jalap powder can safely be used. Large hot normal saline enemata are very useful as they increase diuresis and cause the bowels to move freely. Pregnancy should not be interfered with, unless there is grave danger to the mother and all other useful means have failed. If eclampsia occurs, chloral (30 grains) and potassium bromide (60 grains) combined given per rectum often are useful. Hot water baths, hot air baths, and hot mustard poultices also do good. Chloroform anesthesia in rapidly recurring convulsions, and morphine injections in less frequent attacks are highly recommended. Phlebotomy followed by intravenous normal saline solution injections also does good. If the case does not improve with these methods of treatment labor must be induced. If the convulsions occur at long intervals the cervix may be dilated by introducing bougies and rupturing the membranes. If the convulsions recur often rapid manual dilation is resorted to. At times, forceps delivery, craniotomy, version, or Cesarean section are necessary.

DEPARTMENT OF LEGAL MEDICINE.

R. B. H. GRADWOHL, M. D.

The Influence of the Presence of Organic Coloring Agents in the Determination of the Presence of Blood by Means of the Spectroliche Medizin und of entliches Sanitatsscope. Giese (Viertel jahschrift fuer gerichtwesen, Band XXX, Heft 2, October, 1905) states that Dvornitschenko in 1900 said that every year a new method of identifying blood would be described. This article is on the

subject of the identification of blood by tities of blood are submitted for examination means of the spectroscope where small quanand that, too, in cases where the blood is in wearing apparel of dyed stuff of various kind. The presence of the anilin color or the dye-stuff is a hindrance to the exhibition of the typical spectrum of blood, acIn order to cording to most authorities. definitely determine whether or not blood on dyed material will give the characteristic spectrum, Giese mixed blood with anilin colors and dipped pieces of dyed goods in blood, allowing the pieces to dry in the incubator, and then extracted them in various extraction fluids-10% potassium cyanide solution, weak sodium hydrate solution, acetic acid and carbolic acid. He tried both

wool and cotton goods dyed with many different stains, acid and basic. As a result of these experiments, Giese concluded that there are certain coloring agents which will interfere with the spectroscope identification of blood that is mixed on these artificially colored goods. He recommends that in order to prevent false conclusions when seeking to identify blood in this way a preliminary effort should be made to get the normal spectrum of the particular dye used on the suspected goods, this being afterwards compared with the spectrum given by the bloodstained fabric. He also believes that the modification of the hematoporphyrin test of Takayama will assist in the identification of blood on dyed fabrics.

A New Method of the Determination of the Presence of Seminal Fluid by Micro-Chemical Means. (Michele Barberio, Nuova reazione microchimica delle sperma e sua applicazione nelle richerche medico-legali. Rendiconto delle R. Acad. delle sc. fisische e mathematiche di Napoli, Fasc, Aprile, 1905).-P. Fraenkel of Berlin in the Viertels-jahrsschrift fur gerichtliche Medizin for October, 1905, discusses this work of Barberio. He says that Barberio's directions for this test are to place upon a glass-slide a drop of semen with about half a drop of saturated solution of picric acid. Within five minutes a precipitated crystallization takes place; opaque yellow crystals, needle-like rhombs, sometimes without corners. The needles lie crosswise. The angles in the crystals are from 10 to 15 degrees. The reaction is present in seminal fluid, even though spermatozoa are not present, and it is demonstrable in dry as well as in fresh fluid. It is present even when the material is heated up to 200 degrees, but not beyond that point. No other body fluid gives this reaction, according to Barberio. presence of blood does not influence the reaction. The nature of these crystals is not explained by Barberio. It is probably a union of the picric acid with the albuminous substance in semen, with a mucin adjuvant. Protamine probably enters into the solution of the problem of explaining this wonderful(!) reaction.

The

Admissibility as Evidence in Criminal Proceedings of Blood-hounds Following Trail (Nebraska Supreme Court).-Geo. W. Bratt was convicted of burglary. The Supreme Court reversed the judgment, as stated in No. 97 of the N. W. Reporter, page 593. The crucial point in this case was the admissiblity of the evidence of the conduct of blood-hounds in following the trail of the burglar from the scene of the crime to the defendant's residence. The court holds that the evidence

was improperly submitted. The court stated that there is a prevalent belief that in the pursuit and discovery of fugitive criminals, the blood-hound is practically infallible; that it is a commonly accepted belief that he will start from a place where a crime has been committed, follow'the track for miles after he has been given the scent, find the culprit, confront him, and mirabile dictu, by accusing "bay and mien" declare "Thou art the the man!" This strange misbelief is in the minds of some people apparently a deeprooted fact, and it is a delusion which abundant actual experience has failed to dissipate. It lives on from generation to generation. It has still the attractiveness of a fresh creation. "Time writes no wrinkle on its brow. The court stated that the path of every individual from the cradle to the grave is strewn with putrescent excretions thrown off from the body and this matter is in a process of rapid decomposition. The blood-hound which has great ability for distinguishing smells follows the odor thus generated, and for a short time a man may be easily trailed in the woods or open country. But in the city, after the lapse of considerable time as in this case-about twelve hours of sun-light, where the trail is crossed by hundreds of others, the work is obviously very difficult, yet the dog does the best he can. Nice and delicate questions are time and again presented to him for decision and as to considerations which move his choice of paths, he cannot be cross-examined and the jury informed. The result of all this is that the conclusions of the dog are too unreliable to be accepted by the jury as evidence.

CORRESPONDENCE

A FEW MORE WORDS ON WHOLESALE POISONING.

It is regretful to me to note that my article in the MEDICAL FORTNIGHTLY of November 25, 1905, should have caused Dr. Wabrer to say things that come perilously near to invective. It would give me sincere cause for regret to think that anything was written. therein that gave any reasonable excuse for his feeling offended. To me the subject we are discussing is too important to permit of levity, raillery or personal abuse. It is fraught with consequences that are too serious to the community to permit of any other than a conscientious and candid consideration. To know that food is the best kind of culture for disease germs of every kind, that in it they will multiply under favoring circumstances, from enough to kill one man to

enough to kill a million men within a few hours, and to know that the most positive kind of proof exists showing that epidemics have arisen from such multiplication is, or ought to be, enough to make sober men pause and consider. To know that refrigeration and preservatives are the only means at our command to check this multiplication, in fresh foods, and that refrigeration is not always available and preservatives forbidden, is to wonder at the lack of intelligent thought displayed by multitudes. Why will men not put two and two together and discover that the total is four. Why do they refuse to link these facts and discover the consequences? To find North Dakota praised to the sky for forbidding, under severe penalties, the use of preservatives, pushing the execution of this law to its fullest, and its people blindly being led into a ditch of death and destruction which their own official statistics, given by their own board of health, reveals, is, to say the least, depressing. Did the North Dakota Board of Health deliberately falsify its death rates in order to cast discredit on its very popular dairy and food commissioner. They show that since Prof. Ladd has had a full swing, with his new law and new powers, the number of deaths in that state has increased over 66 per cent. To nearly double the number of deaths in a state, in so short a time, is great work for one man and a legislature of farmers to accomplish. To find the Vital Statistics of the United States Government declaring after Wisconsin's brilliant crusade of this same kind its grand division death rate, from diseases of the digestive system-diseases that are food borne-was not only the highest, but by far the highest of any of the other twenty grand divisions of the United States is important. Its rate was nearly double that of the North Pacific Coast region. As Dr. Wahrer lives in Wisconsin*, perhaps he can tell us whether the statisticians of the government have wilfully sought to defame his region and its pure food efforts. To discover that Germany, seeking to favor its farmers as against the farmers of the United States, adopted a law like that of North Dakota and that, soon after its enforcement began, its death rate, in diseases of the digestive system, at once rose 40 to 60 per cent, is to wonder at the uniformity of such results. Many other just as remarkable statistical facts are available and the official records with volume and page can be cited, when called for. It requires something more than a sneer for an explanation of such figures, though all that the foes of preservatives are as yet willing to give, is a sneer.

By a misprint, Dr. Wahrer's residence was given as Wisconsin in a recent issue of this magazine, when it should be Fort Madison, Iowa.-ED.

In my article I asked Dr. Wahrer for bread the bread of facts-and here is what he has given me: "He (referring to this writer) closes with a burst of enthusiasm which leads me to think that he came very near convincing himself of what he was writing." Frankly now, Dr. Wahrer, on your rereading this sentence are you not heartily ashamed of it, and do you not wish you had never written it? I have a good enough opinion of you to believe this to be the case. You certainly must know that such departures from serious reasoning are but frank confessions of inability to meet the positions of your adversary.

The doctor tells me that he read my article through carefully, and adding "more carefully than I think Dr. Eccles read mine." Then he goes on to accuse me of advocating the following: (1) "Vigorous opposition to pure food laws and their enforcement:" (2) "disbelief in adulteration of food sold at standard prices;" (3) "a sweeping defense of the use of preservatives without regard to kind and quantity;" (4) not seeing "any crime in the substitution of an inferior article for a superior one, as long as the inferior is harmless to health;" (5) "the use of fraudulent labels ** * is not only condoned but defended;" (6) stooping to defend practices that play football with not my logic alone, but my "moral sense;" (7) defending dishonesty; (8) classifying those who seek to force upon us pure food as "scoundrels," and (9) being sorry that "thieves are being punished." Now I would be pleased to have the doctor point out a single passage in my article, or for that matter in anything I have ever written, that supports him in any but one of these charges. I hardly think it is even necessary for me to deny them or to characterize the entire batch, with one exception, as the dreamy imaginings of the doctor's own brain. The intelligent readers of the MEDICAL FORTNIGHTLY must remember, if Dr. Wahrer does not, that I distinctly stated that "The present writer, while sincerely opposing adulteration as a crime to be suppressed, regrets being unable to agree with Dr. Wahrer," and again, "It (the Department of Agriculture) should try to discover the exact limits of safety in which preservatives can be used, and then have a law passed giving its representatives the power to condemn all food which transcends these safe limits." On the matter of adulterating I say: "Of course there is adulterating going on. There never was a time in this world when there was not. It is therefore easy enough to find genuine adulteration if we seek it.'

In reply to his points let me say; (1) I

have never opposed having an honest pure food law, nor have I opposed the just enforcement of such laws as exist. I have opposed proposed laws that violated human rights and objected to the punishing, by fines and imprisonment, of men who were every whit as honest as either Dr. Wahrer or myself. If the doctor. or his brother, had happened to be victims of such laws I would have opposed them for his sake. (2) I believe and distinctly state that there is some adulteration of food at standard prices, but I object to the wholesale condemnation of merchants because there is an occasional rogue among them. (3) I make no sweeping defense of the use of preservatives without regard to kind or quality. I prepared and presented to the Congressional Committee on Standards what Professor Wiley and Professor Frear pronounced the first attempt they had seen at a classification of preservatives as regards how their use should be regulated. It called for a dose use from which neither salt, sugar, nor smoke could be exceptions. It put all substances used as preservatives on a common and honest footing that showed no favors to any. It is absurd to allow vinegar, salt, sugar and smoke to be used in amounts of greater potency than of any other preservative. Make potency the test and punish the user of vinegar who transcends that test with exactly the same severity as the one who transcends it in benzoic or salicylic acid. (4) I distinctly see a crime, and a most serious one, in the substitution of an inferior article for a superior one. I emphatically declare that adulteration is a crime to be punished. Barmlessness has nothing to do with it. I can see a similar crime in the substitution of exaggeration for honest facts in defending a fad.

(5) I neither condone nor defend the use of fraudulent labels, and am bitterly opposed to State laws that compel merchants to put false labels on their goods in order to prejudice an ignorant public against them. The merchants are not the only ones guilty of such fraud. The pure food advocates make it a crime, in some states, to use an honest, truthful label. They insist upon a label that will prejudice the ignorant against the goods. (6) I think my moral. sense is quite as keen as that of Dr. Wahrer. If I am to be classed as a moral degenerate by him because I fight for honesty, fair play, and truthfulness on every side of the game, and not on my antagonists alone, then I must continue to humbly bear the opprobrium. (7) I have never defended dishonesty. My whole fight is for honesty. want it on both sides. I am heart-sick of the clap-trap of pretended advocates of pure food, and equally heart-sick of the villainous

I

charlatans of commerce. (8) Dr. Wiley, Prof. Frear, Prof. Ladd, and even Dr. Wahrer, surely can be opposed by me without their having the slightest cause for believing me to look upon them as "scoundrels." I know the two first named gentlemen personally, the first I have known for about eighteen years, and I have not the slightest hesitation in declaring that there are not another two more honorable and honest men among all my acquaintances. I do not believe they are right on this subject, and they are quite sure that I am wrong. In the struggle for existence one or other of our opinions will survive. I believe it it will be mine. (9) Unfortunately I must confess to being sorry when even thieves are punished. I never could take pleasure in knowing that any one was being punished. I feel by the punished thief as I do by my suffering patient when I thrust a bistoury or lance into a deep-seated periostitis. It is a weakness of mine. But I suffer agony when I see and learn of the myriad cases of punishment inflicted upon honest merchants for selling goods that, from the standard of true sanitary science, are superior to those being disposed of by their neighbors who escape such punishment. Thousands. are being thus sacrificed today to an ignorant public opinion that future men and women will feel for as I do now. "Oh for the rarity of Christian charity under the sun." there was more charity there would be less suspicion. If there was more charity there would be a greater inclination to learn just why others differ from us in opinion and why business men appear, from our standards, to be doing what they should not do. If there was more charity there would be less such encouragement of those who seek to suppress honest opinion than is manifested in a sentence that reads: "If he had not been capable of writing an apparently clever and convincing argument, it is safe to assume that he would not have had the privilege of writing it at all." Are we to understand from this that the doctor thinks the editor did wrong in letting my side of the subject be heard at all?

If

I hope that Dr. Wahrer and all the readers of this communication, will unite in fighting for a just and honest pure food law. What is wanted is one that will be fair to every industry, fair to the public, fair to progress, and that honestly expresses what it means instead of hiding a subtle and unjust intent in a complex definition which but few readers understand. Let us fight for a truthful label that will tell us exactly what we are buying. Let us fight together for the suppression of any substance that is used of any greater potency than some agreed stand

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