he employed the catheter. He removed stone by incising below the scrotum, and cutting inward to the neck of the bladder until there was an escape of urine and calculi. He deserves credit for his endeavors to found pathology upon an anatomical basis.

Aretæus seems to have understood the direction of the blood flow in the veins; if so, he knew more than the physicians of subsequent centuries.

Aretæus had few queer notions. It is true, in conformity with the custom of his age, he was too fond of venesection, but he always warned against excess of blood-letting, claiming it was better to err on the side of chariness. He believed castor was a remedy in all diseases of the nerves, and that white hellebore would vanquish any case of gout. For this we must not blame him severely, for there is scarcely a physician who has not at least a pair of old standbys by which he swears.

WAS A CAREFUL AND NICE OBSERVER.

An idea of the nicety of his observations may be gained from a random passage. In discussing methods for procuring sleep Aretaus writes: "Gentle rubbing of the feet with oil, patting of the head, and particularly stroking of the temples and ears are effectual means; for by the stroking of their ears and temples wild beasts are overcome, so as to cease from their anger and fury. But whatever is familiar to any one is to him a provocative of sleep. Thus, to the sailor, repose in a boat, and being carried about on the sea, the sound of the beach, the murmur of the waves, the boom of the winds, and the scent of the sea and the ship. But to the musician the accustomed notes of his flute in stillness, or playing on the harp or lyre, or the exercise of musical children with song. To a teacher, intercourse with the tattle of children. Different persons are soothed to sleep by different means."

Here is a bit of psychology which every medical man will endorse: "This is a mighty wonder that, in hemorrhage from the lungs, which is particularly dangerous, patients do not despair, even when near their end. The insensibility of the lungs to pain appears to me to be the cause of this; for pain, even when slight, makes one fear death. In most cases pain is more dreadful than pernicious; whereas the absence of it, even in serious illness, is unaccompanied by fear of death and is more dangerous than dreadful."

There is another sentence which I wish to quote, as it will arouse a response from every physician who has been called at the last moment or when there was no hope for recovery: "If you give a medicine at the height of the dyspnea or when death is at hand, you may be blamed for the patient's death by the vulgar." What a world of reserve and dignity is in this simple remark! The shoulders of Aretaus the Cappadocian were broad enough to wear becomingly the mantle of Hippocrates.

Twenty centuries ago Aretæus knew the knack of driving a point home by a good story. Wishing to illustrate that the gout may intermit, he relates that a person subject to gout won the race in the Olympian games, during the interval of the disease. And he closes his chapter on melancholy thus: "A story is told, that a certain person, incurably affected, fell in love with a girl; and when the physician could bring him no relief, love cured him. But I think that he was originally in love, and that he was dejected and spiritless from being unsuccessful with the girl, and appeared to the common people to be melancholic. He then did not know that it was love; but when he imparted the love to the girl, he ceased from his dejection, and dispelled his passion and sorrow; and with joy he awoke from his lowness of spirits, and he became restored to understanding, love being his physician."

Aretaus shows himself a true physician by his concern and sympathy for the patients in small matters and great: "Inunctions are more agreeable and efficacious than fomentations; for an ointment does not run down and stain the bed-clothes-a thing very disagreeable to the patient-but it adheres, and being softened by the heat of the body, is absorbed. Thus its effects are persistent, whereas liquid preparations run off."

Elsewhere occurs this noble phrase, rarely equaled and never bettered: "When he can render no further aid, the physician alone can still mourn as a man with his incurable patient: This is the physician's sad lot."

Some authors call their work "a confession." This is unnecessary, as all writing is autobiographical. Write, and in spite of your best efforts at concealment, your feelings, passions, prejudices, predilections, your good qualities, wisdom, sympathies, will become apparent; where you least expect it, you will give yourself most away; your true self will lurk between the lines, and it will peep from the pages.

I am confident that, from the excerpts here given, the reader has already formed a high opinion of Aretæus. If ever a man cast credit on the art of healing, it was this lofty-souled Cappadocian. He was a disciple who not only followed in the footsteps, but caught the spirit of the immortal Father of medicine. Aretæus should not be a forgotten physician, for no one better than he could repeat with decorum the soul-testing Hippocratic oath:

"With purity and with holiness I will pass my life and practice my art. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females and males, of freemen and slaves. Whatever, in connection with my professional practice, or not in connection with it, I see or hear, I will not divulge, as reckoning that all things should be kept secret. While I continue to keep this oath inviolate, may it be granted to me to enjoy life and the practice of my art, respected by all men at all times. But should I trespass and violate this oath, may the reverse be my lot!" Journal of Clinical Medicine.

THE STUDY OF REMEDIES.

BY JOHN WILLIAM FYFE, SAUGATUCK, CONN.

The students who are soon to leave our college as young doctors will no doubt find that during the early years of practice their professional duties will not require their entire time, and that they will, therefore, be able to continue their studies more or less regularly. In doing so it would be well to give careful attention to therapeutics. Every physician should, so far as possible, make himself thoroughly acquainted with the indications for his remedies, and thereafter keep them fresh in his memory. The young physician, however, should not attempt to study a great number of drugs at first. It is much better to know a few remedies well than to have an imperfect knowledge of many drugs. Twenty or thirty firmly established remedial agents afford a very good working materia medica, and if carefully studied will enable the practitioner to successfully treat a large number of diseases. When one becomes well grounded in these drugs, additions may be made to the list, and in this way an extensive knowledge of drug action finally acquired.

In making this study the young doctor should begin in a systematic manner. In the first place, he will do well to take his materia medica and make a list of the drugs he knows something about. Now, having this written list of remedies before him, he should proceed to make a classification of his own, and one which he can revise as his knowledge of the remedies increases. Possibly, it may be well, at first, to divide them into those which have a general action and those which have a local action. The action of some of them will be, of course, both general and local, but one or the other will be the most pronounced, and therefore the classification can be made sufficiently accurate for all practical purposes. After the remedies have been sufficiently studied in their relation to this classification, they may with profit be classified as excitants, sedatives and alteratives. This new grouping will add interest to the study and a knowledge of their action sufficient to enable one to make sub-classifications according to their action on the brain, the spinal cord, and the sympathetic nervous system. Still further classifications may be made according to the action of the drugs on the structure of the blood, its circulation and regular distribution. Again, one may divide them according to their action on the lymphatic system of the entire body, as well as regards their influence over the apparatus for the removal of waste.

The study of materia medica conducted in this way soon becomes one of absorbing interest and of great profit to the practitioner of medicine. The Eclectic Review.

ANTERIOR POLIOMYELITIS-INFANTILE PARALYSIS.

BY DR. WADE H. FROST, UNITED STATES HEALTH AND
MARINE HOSPITAL SERVICE.

The rapid increase in the number of cases of infantile paralysis reported to this office, and the difficulty of making an early diagnosis, have caused this number of the Report of the Board of Health to be devoted largely to this subject. The information which follows is taken from Bulletin No. 44, Public Health and Marine Hospital Service, by Passed Assistant Surgeon Wade H. Frost.

"CONTAGIOUSNESS.-It has been experimentally demonstrated that the mucous membrane of the nose of infected monkeys is infec

tious, and in one case the salivary glands; and it has been quite reasonably inferred therefrom that the secretions from the nose and mouth are infectious. It has also been shown that infection may take place through the mucous membrane of the respiratory and digestive tracts.

"These facts indicate very strongly that the disease is transmissible directly from person to person by direct contact.

"SYMPTOMATOLOGY.-As is to be expected from its pathology, the symptoms of acute poliomyelitis are most diverse. Broadly speaking, they are the symptoms which may be expected from"1. An acute general infection.

"2. An acute inflammation affecting the leptomeninges and medullary substance of the brain and cord. The nervous symptoms are first those of irritation, followed in more severe cases by symptoms of depression, and in typical cases by loss of function of certain areas of the central nervous system. The irritative symptoms, arising from inflammatory lesions of comparatively mild degree but wide extent, are usually both sensory and motor; predominantly spinal, but to some extent bulbar and cerebral. The depression and loss of function resulting from more intense inflammatory changes, characteristically localized in the anterior cornua of the cord, are motor.

"Of a disease embracing such a variety of symptoms it is impossible to give a single clear-cut clinical picture. Wickman has differentiated eight clinical types, and as later observations have confirmed his classification, it will be adopted and followed as closely as consistent with the scope and purpose of this paper. Wickman's types of acute poliomyelitis are as follows:

"I. The spinal poliomyelitic type, characterized by onset with fever, gastro-intestinal disturbances or angina, headache, pain, often rigidity of the neck and spine, and pains in the extremities of varying intensity and distribution. From one to six days after the onset of the febrile symptoms there develops a paralysis which has certain distinctive characteristics, viz., it is a flaccid, motor paralysis. It is sudden in its onset, reaching its height within a few days, after which it shows a regression in extent, the final result being usually a permanent paralysis of considerably less extent than in the acute stage, although complete recovery may take place. This is the most common and easily recognized form of acute anterior poliomyelitis.