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THE MEDICAL HERALD

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is no ground for denying that bad qualities are likewise transmitted, Heredity is universally admitted as an important factor in the transmissisir of somatic and psychical peculiarities or characteristics. The only doubt, therefore, that can arise in regard to the fact is whether the law holds good in a particular case.

Tubercular consumption, showing itself in the lungs, has long been regarded as an hereditary disease; but at the present time not a few deny the fact, because they believe they find an adequate cause, as well as the real one in a micro-organism. As a consequence of this view, the diseased is removed from the hereditary class and placed among the contagious. Treatment is pursued in accordance with this view, and hence this conception of the nature and cause of the disease is one of practical importance. The two views are very wide apart; so wide, indeed, that there seems to be no middle ground.

In the case of tuberculosis, heredity and diathesis are very closely allied. Their connection may be regarded as that of cause and effect, the diathesis arising from heredity, as the primary potential factor of the disease, as well as of the diathesis. The latter is the more apparent, because it is the potential source or cause of certain structural features of the organism. The diathesis is, therefore, the index of the trend of the vital force during the development of the organism from its inception to its maturity, and beyond structural maturity of the species. Hence, diathesis indicates its presence and the nature of its work a long time before the disease takes on a local manifestation; and so very apparent is this that one can prophesy the result with much certainty. The local manifestations are peculiar features to be observed in the organism. These features are the exponents of the implanted disease; implanted from preceding organisms by transmission of vital trends ending in morbid aotion. There is nothing strange in all this. Similar facts are matters of every day observation. Peculiar trends to morbid action distinguish temperaments, and these arise from corresponding peculiarities of organic structure. In the miscegenous nature of the human race, the greatest varieties and peculiarities of vital trends are to be expected, and among these it is unavoidable that there should be those that mark or characterize a high or low vitality of the entire organism.

Now, let us note what indications the tubercular diathesis gives of itself in certain features of the organism.

A diathesis is implanted in the fetus. As the child grows to maturity, the diathesis displays its trends as respects morbid action to be developed under favorable conditions. It has been observed that those who have

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black hair on head and face and blue eyes will die of tubercular consumption, if not carried off sooner by accident or acute disease. Pneumonia in such bodies generally proves fatal.

And more marked physical condition is seen in the proportions which exist between the trunk and extremities in persons inheriting the tubercular diathesis. When a child is born, the body is much longer than the lower extremities. This proportion grows less as the child grows; and should the proportion extend beyond the normal, the fact shows that such an organism is a feeble one. The diathesis assigns to such a body an abnormal length for the upper extremities with a deeply cleft hand, corresponding, in the proportion between the palm and finger, to the high cleft of the trunk. With these featnres of organism, the shoulders lie in a horizontal line. The foot partakes of a like development. All these points in the organism are tubercular features, potentially associated in the organism, and make their appearonce at maturity. Environment, however, has much to do with the early or late development of the local morbid action, which is the ultimate destination of the diathesis and its corresponding organism. When the local action sets in, it is but the exponent of what has, to that time, lain dormant, and presents abnormal fluids in which the germs of micro-organisms, so abundant in the atmosphere, find a soil suitable for their germination and development. Germs enter our lungs on every inspiration and become imbedded in the mucous that covers that membrane; but they do not, and can not germinate and develop, because that soil does not afford them the proper food. In this, micro-organisms conform to the universal law of the life world, and discharge their true function in the economy of nature-that of reducing organic matter to the inorganic state. In this work, like all living organisms, plant and animal, some of them produce toxic substances, which have the power to destroy the life of other organisms as well as their own, when taken into their body. What, therefore, they may do in the production of disease is done by their toxic excretions, an example of which we have in the toxic substance of the cadaver.

Who can say that the excretory products of the bacillus tuberculosis are absolutely any structure in the lining membrane of the air-cells of the lungs; and who can affirm that, if these products were absorbed and passed into the blood, they would produce tuberculosis? These products have not yet been found in the blood; and if they should be, it is assumption without warrant to say that the toxic substance would light up tubercular disease. Ex uno disce omnes.

The rational conclusion from these premises is that micro-organisms, as germs or matured individuals, have nothing to do with the production of tuberculosis.

THEY MEDICAL HERALD

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OLIVER WENDELL HOLMES. Oliver Wendell Holmes, the physician, teacher, poet and philosopher has gone hence at the ripe age of the body at 85, and the eternal ripeness of the Spirit. “Though dead, he yet speaketh," and will continue to speak, wherever the English language shall be read.

THE DEAD POET.

Sombred, the rare light of this fair October,

One, loved of all, in that he loved all men,
Hath drifted out -toll, bells, in cadence sober-

Hath drifted out beyond our utmost ken.
Poet. ne trod earth's chaffering market places

In singing robes, his strain the lark's note high;
Serene and sweet, a lane of anxious faces

Smoothed out their troubles as his step passed by.
Philosopher, 1 he wisdom of the ages,

Filtered and sparking, he has made his own;
In various moods, his white and gleaming pages

Caught inspiration from the morning's zone.
No shaft of his was tipped with any malice :

No word embittered left that smiling lip;
Alike to struggling souls in cot or palace

His genial wit brought brave good-fellowship.
His sun goes down to-day in cloudless splendor;

'Tis we who linger in the lonesome shade,
Missing henceforth the music gay and tender,

The throbbing blitheness of the tunes he played.
Last of the minstrel throng we hold in honor,

Ay, last and dearest, with hushed hearts we lay
Our votive wreaths, where veiled, a pall upon her,
She sits, his grieving city by the Bay.

-MARGARET E. Sangster, in Harper's Weekly.

MICROBES IN NORMAL URETHRA OF WOMEN. Dr. N. Garousky records the result of a large number of examinations of the healthy female urethra. Out of sixty-two cases, there were positive results in fifteen, i. e., 24 per cent; streptococcus three times; staphylococ. cus piogenes aurens eight times; st. piogenes albus once; bact. thelocideum Gessner once; bact. coli communis twice. The occurrence of the last is noteworthy, as its existence in cases of cystitis is well known. The author's negative results are also interesting, none being found in some cases of para-and perimetritis, in one case diagnosed as gonorrhea; or in three cases of pregnancy.--Journal of the Royal Microscopical Society, London, Eng.

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Our Book Table.

ESSENTIALS OF THE DISEASES OF THE SKIN; By Henry W. Stelwagon, M.

D. Saunders' Question Compend, No. 1. Pp. 270. Phila. 1894.

The author--this being the third edition-has gone over all his work, carefully revising and making such additions as time made necessary. The text is well illustrated. It has met with a very flattering reception, and can not fail, with the additions made, to maintain professional favor.

Lippincott's Monthly for October presents its readers with a very entertaining story which hold's the reader's attention to the close, under the title of A Question of Courage. An article from the talented Gertrude Atherton gives us some insight into what woman has done when she enjoyed the power, and from which we may inter what she might do in other directions were all her dreams realized. Coals of Fire, by Le Roy Armstrong, will please many readers, while other articles complete a very interesting number. A MANUAL OF THE PRACTICE OF MEDICINE, prepared especially for

Students; By A. A. Stevens, A. M., M. D., of the University of Pennsylvania. Third Edition, Revised, Illustrated. W. B. Saunders, Publisher. Pp. 501. Philadelphia. 1894.

Especially prepared for students, they find it a valuable vade mecum while in attendance on lectures. The practitioner will find it very practical and useful for ready reference. A third edition in so short a time is an evidence of the favor it has received, and of the value which is placed on it. ESSENTIALS OF DISEASES OF THE EAR; By E. B. Gleason, M. D., of the

Medico-Chirurgical College, Phila. No. 24 of Saunders' Quiz Compends.

This volume takes rank with the rest of the Quiz Series published by this house. The whole field of Otology is here epitomized and the subjects are fully illustrated. One can gather a great deal of information from this small volume, and refresh his memory on subjects he has studied in larger works. LESSONS IN QUALITATIVE AND VOLUMETRIC CHEMICAL ANALYSIS; By

Chas. 0. Curtman, M. D., Professor of Chemistry and Director of the Chemical Laboratory in the Missouri Medical College, St. Louis, Mo., including Lessons in Qualitative Chemical Analysis, by Dr. F. Beilstein, Professor of the Imperial Institute of Technology, of St. Petersburg. Fourth Edition. John L. Boland, Book and Stationery Co., St. Louis, Mo. Pp. 295.

If extravagant eulogy were employed in commendation of this work, its merits would not be exaggerated. We cordially commend it for laboratory work.

THE MEDICAL HERALD

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TREATISE ON DIPHTHERIA; By H. Bourges, M. D. Translated by E. P.

Hurd, M, D., Professor of Pathology in the College of Physicians and
Surgeons, Boston, Mass. This volume of the Physicians' Leisure
Library, Published by George S. Davis, Detroit, Mich.

A very great variety of opinion prevails in regard to the treatment of this disease, though its etiology is now generally accepted, assuming as the cause, the Klebs-Leffler bacillus, which produces (1) the local affection and (2) the constitutional or systemic state, arising from infection by the toxic excretion produced by the bacillus. All that is said may be summarized under these two headings, so that one can readily and logically follow the course of treatment advised. LANDMARKS IN GYNECOLOGY; By Byron Robinson, M. D., B. S., Chicago,

III., in Two Volumes. Geo. S. Davis, Detroit, Mich., Publisher of the
Physicians' Leisure Library. 1894.

This busy practitioner and prolific writer, in these volumes, gives his fellow-workers, as well as the profession at large, his experience in this department of medicine and surgery. They contain the outlines of his lectures in the Chicago Post-Graduate Medical School. The work, therefore, which we have here, has been well digested and is well set forth. The “Landmarks in Gynecology” which he considers of prime importance are Anatomy, Menstruation, Labor, Abortion, Gonorrhea, and Tumors. The reader is not disappointed in this outline. Caretul observation and a large experience with a ready pen, he has brought to the labor of these volumes, and we trust that a laudable ambition will be fully pratified by the reception it shall find with the profession.

The North American Review, always interesting and instructive, is more than usually so in the November number. The Fight on the Yalu River, by the Hon. Secretary of the Navy H. A. Herbert, he takes as an occasion to discuss the importance of a Navy for the United States, the equal of England's. The Probabilities of an Anglo-American Union, discussed by Capt. Alfred T. Mahan, U. S. N., and Capt. Lord Charles Beresford, R. N., is a paper that continues the discussion of a question destined to excite the interest and employ the pen of many able writers. It is a leading question for the people of England and the United States, since the English language is destined to be the one language of the civilized and commercial world. The War in the Orient, by Japanese Minister; How Law is Made, by Jno. L. Mitchell; The Evolution of Political Parties, by Bishop S. M. Merrill, and The Business Revival, by the Presidents of the Chambers of Commercial Boston, Cincinnati and New Orleans and The Merchants' Exchange at St. Louis, are all subjects of public interest and well and forcibly written. Max O’Rell has a pungent article on French and AngloSaxon Immorality, Amelia E. Barr has a very readable article on The Modern Novel and Chas. Dickens one on Public Dinners in London,

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