and cautious in their decisions, the intuitively is not. We stated so in 1859, and we state it

learned class never hesitate to pronounce their judgment on even the most obscure and perplexing cases.

still more emphatically now. I cannot recollect a single instance in which a patient has been brought into any asylum in whose case there were not sufThe medical superintendeut, John P. Gray, ficient grounds for saying that he was a proper M.D., of the Utica Asylum, after a residence of subject for care and treatment; I can hardly 30 years among the insane, in which time more recollect a single instance." Such decisive and than 12,000 patients have passed under his ob- clear language, from a man so eminent as the Earl servance in his own establishment, to say nothing of Shaftesbury, and after fifty years' experience as of the ample opportunities availed of by him in a lunacy commissioner, is surely entitled to very his visitation of a multitude of other insane asy-high consideration. We cannot refrain from anlums in his own country and over a large extent of other quotation which we regard as a very marked Europe, may surely be regarded as a person fairly tribute of respect to the medical profession at qualified to express a well-matured and trustworthy large. His lordship being questioned as to the opinion on the most important questions connected general merits of medical certificates of insanity, with asylum administration and the true interests testified as follows:of the insane; and assuredly his present report affords satisfactory proofs of his competency in these relations.

"It is very remarkable, taking it altogether, that the certificates have been so sound, considering the great number that have been given every Most cheerfully, did our space or the recognized year; of course we must admit that they have sphere of action of a medical journal warrant the been signed by medical men who have no very indulgence, would we lay before our readers some extensive knowledge of lunacy, but it is certainly of the more interesting passages of Dr. Gray's very remarkable that the number of certificates able production; but in truth these are so numer- which have passed through our hands since 1859 ous as to render selection alike puzzling and justly-the date of the last committee-amounts to impracticable. Above twenty pages are devoted | more than 185,000, and yet of all those certificates, to quotations from the evidence given before the I do not think so many as half-a-dozen have been committee of the Imperial Parliament in 1877, found defective.” which was instructed to "inquire into the operation of the lunacy law so far as regards the security afforded by it against violations of personal liberty." When it is stated that the witnesses examined were Mr. Perceval, secretary of the Lunacy Commissioners; James Wilkes, Commissioner of Lunacy; Dr. J. Crichton Brown, Dr. John Bucknill, Sir James Coxe, Dr. Maudsley, Dr. D. Williams, and the Right Hon. the Earl of Shaftesbury, all gentlemen of the highest standing and most thorough experience, the public might rest assured that the opinions expressed were sound and practical, and they all concurred in the belief that the security of the personal liberty of Her Majesty's lieges needed no additional protection, and that the less the existing lunacy law was tinkered with the better. Lord Shaftesbury, in reply to the question, "Do you consider that the facility with which patients are admitted into asylums is not too great at the present time?" gave the following strong reply: "No, certainly not. I think that the whole of our experience confirms us in the opinion that it

We commend the above words of Lord Shaftesbury to the deferential consideration of that class of our Canadian sentimental philanthropists who find pleasure in detraction of the medical profession. From all we have been able to gather from intimate intercourse with the physicians of our asylums, we feel convinced that the general profession are entitled to the very same eulogium as that awarded by Lord Snaftesbury to our brethren in England. Certainly not on the side of loose awards of certificates of insanity is it that errors are most liable to occur, but on the contrary, on that of the withholding of them, in numerous instances in which they would have been not only justifiable, but also essential to the protection of the insane, and the safety of the community.

DISEASES OF THE SKIN, by James Nevins Hyde,

Professor of Skin and Venereal Diseases, Rush
Medical College, Chicago. Philadelphia: H.
C. Lea's Son & Co. Toronto: Willing & Wil-
liamson.

This is a good book of 572 pages, on good paper

and in readable type. It is inscribed to Kaposi, of Vienna, which apprizes the reader of the fact that the author has travelled, and has studied his specialty under a competent instructor, who would appear to have given him very liberal permission to copy his plates. This is not the least of the excellencies of Dr. Hyde's volume. The book is written in good English, a fact which almost leads us to surmise that its author has spent long enough time outside the big pork market, to enable him to avoid almost all those peculiar idioms and words which, unfortunately, blemish too many of the literary productions of our western cousins, who seem every year, in point of both orthography and

syntax, to be becoming more and more a law unto themselves.

When we inform our readers that Dr. H. has bestowed no less than sixty pages on Eczema, alone, they are not to conclude that he has given to it too much space. This is one of those most prevalent cutaneous affections which are sometimes equally puzzling and profitable to the practitioner, and if authors in general were to devote more attention to common every-day diseases, they would better meet the wants of the purchasers of their works, both in a professional and a pecuniary sense. As regards Eczema, it is pretty certain that the class of patients who call in medical attendants, are just those who are most able to pay, and whose purses indeed demand depletion; and this is as much as to say, buy Dr. Hyde's book. Some people may be inclined to find fault with the absence of coloring in the plates, which are 66 in number. We regard this want as no defect, but rather the contrary, for colored plates, in any de partment of medicine or surgery, are often more misleading than instructive. The student is too apt to be exactive on nature, and to demand uniformity of morbid aspects in all cases; whereas nothing is more rare than to meet with any two so closely resembling each other, or any one so closely resembling a captivating colored plate, as to render them readily, in all points, identifiable with any of the described or depicted forms he has studied in illustrated books. We have read a pretty large portion of this book, and we cannot withhold our expression of general satisfaction with the contents; but, dear me ! Shakespeare said something "of all the ills that flesh is heir to"; had he read Dr. Hyde's book, he would not have written flesh, but

skin. Satan must have had a forecast of dermato-
logy when he suggested the temptation of Job by
asking leave to test him in this tissue; and he per-
haps foresaw that his children would some day
make a pile of money out of it; and who better
than he understood the power of cash?
MANUAL OF GYNECOLOGY.-By D. Berry Hart,
M.D., F.R.C.P.E., and A. H. Barbour, M.A.,
B., Sc., M.B. New York: Wm. Wood & Co.
The edition of this work before us forms part of
Wood's Library of Standard Medical Books. It is
a reprint of the Edinburgh edition and is in two
volumes, being the monthly issue for the months
of January and February of the current year.
Beginning with a full account of the anatomy of
the external organs and pelvic contents in the
female, the relations of the several organs are care-
fully and fully dwelt upon. The several methods
of examination of the uterus, manual and instru-
mental, are pointed out, with the various surgical
appliances required in many cases of disease of
that organ and its surroundings. The more com
mon pelvic affections are fully entered upon, while
those more rarely met with come in for a full share
of notice. Affections of the Fallopian tubes, the
ovaries, and the uterus, with the several displace-
ments of the organ, and its many morbid conditions
and growths, are treated of in a comprehensive
manner. Vaginal and vulvar diseases are also
described, although, of course, not at any very
great length. The disturbances of the function of
menstruation, and the various abnormalities of re-
production, are also noticed; and the second vol-

ume closes with a concise account of affections of
the female bladder and rectum. An appendix is
is added to this volume, giving a good deal of in-
formation in regard to syphilis, chlorosis, and other
important matters connected with case-taking.
Altogether the book is a useful addition to any
practitioner's library.

A MANUAL OF CHEMICAL ANALYSIS as applied to the examination of medical chemicals, for the use of pharmacists, physicians, students, etc. Third edition, thoroughly revised and greatly enlarged. By Frederick Hoffman, A.M., Ph.D., and Frederick B. Power, Ph.D. Philadelphia: Henry C. Lea's Son & Co. Toronto: N. Ure & Co.

This work has been very much enlarged and improved in passing through the various editions,

and now contains about 600 pages. The senior Student's GUIDE TO DISEASES OF THE EYE, by

THE CANADA

investigating the microbe of chicken cholera, have been extended since to the microbe of charbon or

LANCE, anthrax in a series of studies in which I had for

A MONTHLY JOURNAL OF

MEDICAL AND SURGICAL SCIENCE,
CRITICISM AND NEWS.

VOL. XV. TORONTO, JULY, 1883.

Original Communications.

my collaborators M. M. Chamberland and Roux. About the temperature of 16°, as also about that of 43° C. (temperatures which are near to those in which the culture of the bacillus is impossible), this bacillus no longer forms spores in the different No. II. broths of culture, fowl broth for example.

Its

exposure to the contact of the air at these temperatures, particularly at that of 42 and 43, attenuates it progressively from day to day until it has

PASTEUR ON THE ATTENUATION OF eradicated from it all virulence and soon causes it

VIRUSES.*

to perish by rendering it unfit for any culture. The certain proof that it is to the oxygen of the

TRANSLATED BY C. W. COVERNTON, M.D., M.R.C.S., air that we must attribute the attenuation of the

TORONTO.

microbe of chicken or fowl cholera has been es

tablished by a very simple method. It suffices to compare the effects of cultures where oxygen is excluded with those of similar cultures exposed to the influence of the air. These perish in a few months, having passed through different phases of attenuation; whilst the cultures protected from exposure to air in sealed tubes show themselves to be for this microbe very virulent after the lapse of several years. The peculiarities of the bacillus anthracis, or microbe of charbon, differ in many respects from those of the microbe of fowl cholera. The differences are that it lends itself much less easily than its congener to observations of the nature of which I have just spoken concerning the action of the oxygen. That is due to this circumstance, that the microbe of charbon under its form of filaments dies quickly in a tube sealed from the action of the air. The difficulty can be interpreted, and place still in evidence the influence of the air on the microbe of charbon, by the following arti

The managing committee, aware that I had the intention of passing the holidays in the Jura, a short railway journey from your beautiful city of Geneva, have had the kindness to invite me to read a paper on the "Attenuation of Virus." I have accepted with readiness, happy to find myself, even for a short time, the guest of a people friendly to France in adversity as in prosperity. Besides I entertained the hope of meeting here with the opponents of my labors in recent years. If congresses are a ground fitted for drawing together and conciliation, they are in the same degree a fitting arena for courteous discussion. We are all animated with a high motive-the motive of progress and truth. You are aware, gentlemen, that our knowledge of viruses has been recently enriched by valuable discoveries which had their origin in the researches that I published in 1880 on the microbe of the disease termed chicken cholera. A virus, when it is represented or constituted by a microbe, may without any marked change in its general morpho- fice. Suppose, to fix the idea, that a broth is seeded, logy be attenuated in its virulence, preserve this and that it is distributed in closed tubes subsein culture, produce germs, and under its new state quently placed at a temperature of 42°-43°, and communicate a passing ailment capable of protect- that they are dead in the tubes in six days, which ing from the mortal disease peculiar to the action may be easily proved in seeding every day one of this virus in its natural state. This most valu- of the tubes. There is nothing to prevent your able modification may be produced by a simple making with the culture of the fifth day, on the exposure of the virus to the oxygen of the air. eve of the death of the closed tubes, a new This action of the oxygen is further variable with culture equally protected from the air, which shall the temperature at which it operates and with the be in its turn at 42-43°. If the new culture medium containing the virus and in which it has dies also in six days, a third may be prepared which taken its origin. These facts, first established in shall be distributed also in closed tubes, the seed* Delivered before the Congress at Geneva, Sep. 6th, 1882. | ing of which shall be taken from the culture of the

Im

fifth day, and so on in succession. At the same that I speak. On the 10th of December, 1880, I time that we are proceeding with this series of was requested by Dr. Lannelongue, surgeon of the successive cultures in vacuo, we prepare parallel Hospital St. Eugène, to visit a poor child of five cultures in flasks in contact with the air. We will years seized with hydrophobia. She had been now compare the virulence of the closed tubes bitten on the face a month previously by a mad with the virulence of the cultures of the same dog. Four hours after her death, which happened days which have been exposed to the contact of on the 11th of December, we inoculated two the air. We have established that the viru- rabbits with mucus from the palate diluted with lence of the cultures exposed to the air has be- water. The rabbits died in less than 36 hours. come more and more attenuated and cannot pro- In their blood we recognized a special microbe, duce the death of the cobayes,* whilst those of the cultivable in a state of purity, and from which cultures in closed tubes kill. The action of the successive cultures occasioned death to rabbits, oxygen of the air in the attenuation of the anthrax their blood always having present the same microbe. or charbon microbe is then equally incontestable The cadaveric lesions consisted in a partial dilatawith that on the microbe of fowl cholera. The in- tion of the venous system, in a swelling and wine fluence of oxygen for the attenuation of the mi- lees redness of the ganglions of the groin, of the crobe of charbon may be viewed also by a remark-arm-pit and of the trachea. This is always hæmorable peculiarity. It is known that M. Toussaint rhagic. A little saliva moistens the lips and runs has announced the attenuation of this microbe by from their commissure. The lungs, generally the effect of heat alone, and that we can procure oedematous, are sometimes hepatized. At the by this means vaccinal bacterides; but we have point of inoculation made under the skin of the recognized that these bacterides do not preserve bowels in the cellular tissue, this is slightly oedema. in their cultures their produced attenuation. tous and emphysematous. In a trial, when we mediately the first culture of the blood is heated attempted to discover the moment of the appearit again becomes virulent and deadly. The bac- ance of the virulent organism in the blood, we terides attenuated by oxygen, on the contrary, pre- perceived that nine hours after inoculation the serve their attenuation in the cultures. This dif- seeded blood cultivated the microbe of the disference has a greater importance and it is to it in ease, without this being as yet visible by the part that we must attribute the difficulty of obtain microscope; but that twelve hours after inoculaing charbon vaccinations practically utilizable by the tion it was perceived by the aid of the instrument. method of M. Toussaint. We do not at all hold The fever appeared at the same time that the the opinion recently advanced to the contrary by microbe was shown; death took place thirty-five M. Chauveau in a note read at the Academy of hours after inoculation. The temperature only Sciences. There is at any rate nothing in it the sank to 40° C. two hours before death. The anileast reliable, sure or regular, whatever precaution mal weighed 1.920 kilo. at the time of inoculation, may be taken, in the effect of heat on charbon- 1.730 kilo. at the moment of death, a diminution of ized blood, even when exercised when very thin 190 grammes in thirty-five hours. The saliva of and at a fixed temperature. rabbits dead transmits invariably the disease to other rabbits. Adult guinea-pigs support perfectly inoculation with this microbe, but it kills in two or three days cobayes of some days of age. In pursuing inoculations from cobayes to young cobayes, the virulence is exalted, and we easily arrive at killing cobayes at one, two, three and four months. With the first cobayes the cellular tissue around the point of inoculation shows oedema, bathed with bloody serosity, often thick and gelalatiniform; the subjacent muscles are lardaceous, thickened, and purulent. It is remarkable that in proportion to the raising of the number of the

The principal object of the communication that I have the honor to make to you is to furnish new examples of attenuation by the oxygen of the air, and to demonstrate that we have to do with a general method of attenuation of certain viruses. I commence with a microbe which is shown for the first time under circumstances as interesting as curious. I have again had as collaborators in the studies on which I am about addressing you M.M. Chamberland and Roux, and in addition particularly M. Thullier. It is in their name equally with my own

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Guinea pigs.