averaged 23 per cent. of the whole

THE

stomach. I have found the fundus Cincinnati Lancet-Clinic:

greater in proportion in the first few months of life than in the adult period. Referring to the possibility of overdistending the fundus with the pump, let me add that no very great force was

A WEEKLY JOURNAL OF

MEDICINE AND SURGERY.

ISSUED EVERY SATURDAY.

Annual Subscription Rates.-In advance, $2.50; within the year, $3.00.

Advertising Rates.-Fifty cents a line of

All letters and communications are

employed. If you cut away the liga- J. C. CULBERTSON, M.D., Editor and Publisher. ment which runs from the cardiac orifice to the diaphragm you will notice, even in the undistended stomach, that the fundus is larger than it appears without section of this so-called ligament. This ten words (brevier type). is especially true in the fetal stomachs. I tried the experiment several times of forcing as much air as possible into adult stomachs, using a bicycle pump tied into the esophagus. The stomach always yielded, not in the fundus, but at a point on the anterior surface near the lesser curvature. We also filled several stomachs with water without

extra pressure. The general propor

tions of the fundus were not different from those in which the stomach had been inflated.

One of the members asks about the

absence of HCl in cases of carcinoma elsewhere in the body. Where the stomach is the seat of carcinoma the

absence of HCI is due to the early atrophy of the glands of the stomach. Malignant disease elsewhere does not interfere with the secretion of HCI until marasmus is so far advanced that general atrophy of all secreting membranes occurs.

The Treatment of Epilepsy by Sulphate

of Duboisine.

In La Riforma Medica, Cividali and Giannelli state that they have found that the sulphate of duboisine diminishes the number and intensity of epileptic attacks. They obtained the most favorable results in those forms of epilepsy which were associated with psychical disorders. The dose they administered was 1/120 grain, which might be increased to as much as 1/60 grain if the first dose did not seem sufficient. They do not find that the drug produces too much local irritation, provided strict antiseptic precautions are taken when it is injected. -Atlantic Med. Weekly.

to be addressed to, and all checks, drafts and money orders made payable to

DR. J. C. CULBERTSON,

317 W. SEVENth St.,

CINCINNATI, O.

CINCINNATI, JANUARY 30, 1897.

Editorial.

MISSIONARIES.

There are missionaries and mission

aries, some of whom are medical and some are medicated, to say nothing of those who go to heathen lands bearing in their hands the gospel of glad tidings and good will toward men. There are home or domestic missionaries, whose functions are widely at variance with those who go abroad to preach the gospel. These home missionaries seem to be a growth of recent years, although it is very probable that there have been a few devotees to the calling for scores and scores of years.

These missionaries have sometimes assumed the peculiar characteristics of commercial drummers, and herded themselves mainly in and around watering places, notably at Hot Springs, Ark. Some years ago that mission band became so active and offensive to public morals as to call for special legislative action, after which there came in consequence a purification of the professional atmosphere in that particular locality.

Some-a very few-wives of physicians are noted as business women. They are at the head and front of all mission movements made on behalf of the pater familias. Such wives are active church workers and in social circles, and become members of all the women and children organizations within their reach, and do not once. hesitate to say to the good sisters that it is a duty owed to themselves to employ Dr. Blank. One doctor's wife heard of not only sought out the peculiar ailments of the women of her church and societies, but drummed them into her husband's office for physical examinations. Nor did she stop and restrict her labors to the church with which she affiliated, but neighbor women were placed under her surveillance, quizzed and coddled into seeking advice from her husband.

Ever and anon there have come to | tion and angrily retires from the case. the writer ominous sounds borne upon The missionary has done her work and the winds and whispering of the direct received her compensation as a good and indirect employment of missionaries and faithful servant. for the purpose of drumming trade for medical men hereabouts. Such persons have little or no conception of a practical application of the Code of Ethics. All they know, and all they want to know, is that some one is sick, and a species of diplomacy is begun in the interest of the creature who has engaged them for tooting purposes. The greatness of the tooted is heralded. He is an authority in the medical profession, perhaps by the grace of God is the occupant of a professor's chair in a medical college, and may be a member of a hospital staff. His professional success is unapproachable; he is so kind, so gentle; there are healing virtues in his hands, honey is always in his mouth, to say nothing of the angel wings he is sprouting; his visits are a guarantee of a cure. Nothing to say against the attending physician, only he has not had the large experience of the great and only tooted. Reprints are numerous and freely distributed by the tooter. He is just the man, and—well, he should be called in consultation. A mistake may have been made in diagnosis, and he would be of such great assistance to the doctor in charge. To show how necessary it is to have Dr. Blank, he must be brought in to see the invalid to reassure in diagnosis, you know. The attending physician need not know of Dr. Blank's visit, and if the attending physician is not mistaken no harm will be done; but if wrong, a change should be made, and that right away before it is forever too late. A result of the rehearsal of the story is the calling in of Dr. Blank at an unseemly hour in the absence of the regular attending physician. The latter discovers the situa

That woman was a financial fortune to her husband. She knew every sick nurse with whom her husband came in contact. She carefully collated professional nurses' cards, invited them to tea; she wanted to be personally kind to them, wanted to help them in getting cases, and as one good turn deserved another the nurse was soon marshalled into her service as tooter for a man she called husband. It is a pleasure to say that some nurses were not beguiled by such doings, but human nature loves cajoling, and that business wife of a doctor was equal to all emergencies within her reach. She kept up her mission band and made it a factor of utility where others would have failed. Her labors made her and her husband obnoxious to all honorable members of the medical profession who knew them.

As the monsters with hideous mien are stalking through those lands, there comes forcibly the thought that in this there is an apt illustration of a survival of the fittest among people and among nations.

These remarks are only typical and | marvel is that the pestilence did not not personal, and are brought out by come sooner. the whispers of the whistling winds. that certain physicians are working or attempting to work the professional nurses, and that this is being done by gifts, presents, teas and liberal promises. A halt is called in the business; it is nefarious, and leads to evil and only evil to those who engage in the practice.

That nurses or one's friends are to be debarred from saying kind and pleasant words of a physician who is admired by them is not to be thought of. This is an unquestioned right and privilege that belongs to every one, but the individual coaching, wheedling and duty appeals when there is no duty in the case is simply-well, the writer hates profanity, but such doings as he has at times been cognizant of has provoked his amiability to the very verge where a well-directed cussing would have greatly relieved an over-burdened sense of propriety.

The half has not been told nor squinted at in these lines, but enough. A medical mission service is born of the devil, and belongs to his kingdom, and there is no righteousness in it.

The black spectre of the plague is shadowed by its twin pestilential monster-famine. Reports are bustling over each other with amazing rapidity, each more ghastly than its predecessor.

There are natural physical causes that are sufficient to explain the existence of the plague and famine horrors. As to the plague it is a virulent infectious disease, originally produced by overcrowding and a consequent generation of poison of peculiar character and intensity, in some respects similar to the typhus or jail fever of past centuries. The famine in India is no doubt due to exportations of cereals in recent years, to partial failure of crops, and to a drainage of resources by the English Government. In view of these factsand they are facts-the great tribunal of justice will hold England responsible for much of the woe and distress that is now existing in India.

So soon as science determined and showed to the world that England was

THE BUBONIC PLAGUE AND ITS GAUNT responsible for migrations of Asiatic

SHADOW-FAMINE.

This horrible disease is assuming alarming phases, and a menacing attitude toward the commercial nations of the earth. The affection is one that is due to filth, malnutrition and horrid environment.

With existing enlightened knowledge of conditions of wholesome life, it is not surprising to scientific sanitarians that the scourges of plague and famine are stalking through the populous India and China countries. In fact, the

cholera, that country took measures to stop the pestilence and to confine its devastations to the people among whom it originates and exists because of their ignorant violation of simple sanitary laws. The plague has a cause, and, although it may be regarded by some. very good people as a mysterious visitation of Divine Providence, which is true, at the same time the visitation is just all the same traceable to a violation of the laws of Providence.

Famine and pestilence from an ab

straction of the products of a land already overburdened with people! A mysterious Providence is not mysterious, but a knowledge of His ways are as wide open to the world as the light of the noonday sun, so that he who runs may read them. The governing nation

over India should rescue her own people;

she has the power, ability and the accountability.

Recent reports are to the effect that

the Caucasian race has not suffered to

an appreciable extent from the pestilences of famine and plague, but with the existing conditions of rapid transit for people and freight, it is quite probable that cases of plague may be found in any of the great centres of population. When discovered, isolation should be practiced in a manner that would end the focus of infection at any cost.

EDITORIAL NOTES.

Correspondence.

NEWSPAPER DOCTORS.

Editor LANCET-CLINIC :

As men in high official position seem to seek publication of their wonderful

operations in the daily press, I think it well to publish in your high-toned journal, Section 3, Article I, of the

Code of Ethics. It is as follows:

the profession to resort to public adver"It is derogatory to the dignity of tisements or private cards or hand-bills inviting the attention of individuals afflicted with particular diseases, publicly offering advice and medicine to the poor gratis, or promising radical cures; or to publish cases and operations in the daily prints, or suffer such publications to be made; to invite laymen to be present at operations, to boast of cures and remedies, to adduce certificates of skill and success, or to perform any other similar acts. These are the ordinary

DR. E. C. BRUSH, of Zanesville, O., reprehensible in a regular physician." practices of an empiric, and are highly

was recently elected President of the Baltimore & Ohio Railway Surgeons' Association, the staff of which numbers more than two hundred physicians.

ACADEMY OF MEDICINE-Monday evening, February 1:

Hyperostosis Cranii (Megalocephalis), with report of the case. Reports of Cases of Hyperostosis of the Orbit and Diseases of the Pneumatic Sinuses of the Cranium and their Surgical Treatment. By Dr. Robert Sattler.

Sunlight and Mental Development. By Dr. T. L. Brown.

All who violate the above section

are empirics, and forfeit the respect and confidence of the profession. The end of all such is an unhappy one. High position and even great ability will

not save them from the scorn of all

worthy men.

It is well for young men not to imitate the newspaper doctor.

X.

The Bubonic Plague at Bombay.

The disastrous effects of this scourge, seem now to be greater than ever. Since the appearance of the disease Bombay has lost more than 300,000 inhabitants, who have fled to the country districts. The absence of all quarantine restraint makes it altogether probable that the infection has thus been spread over a wide area. In conjunction with the famine now afflicting the Indians their numbers will be seriously reduced by the "Black Death."-Med. News.

Selections.

FROM CURRENT MEDICAL
LITERATURE.

Effects of Atropine on Respiration.

difficulty. The objection that smaller doses, of two to four milligrammes, act favorably on the respiratory centres, is theoretical and not proved. The author refers to recorded cases of atropine poisoning in which severe respiratory disturbance has been produced. He concludes that atropine is not a respiratory stimulant, that even in small doses it produces an unfavorable action on the respiratory centres, and that in severe cases of morphine poisoning it is not to be recommended.-British Med. Journal.

Life and Death in the Emotions.

Unverricht (Berliner klin. Woch., June 15 and 22, 1896) draws attention to the harmful effects of atropine upon the respiration. He observes that the results of treatment by antagonists, such as morphine poisoning by atropine, have been only moderate. It is incorrect to assume that the respiration is improved because it becomes more rapid. The author's investigations have shown that there is no antagonism between morphine and atropine as far as the respiration is concerned. Atropine can produce Cheyne Stokes breathing, and an agent which can call forth this phenomenon cannot be looked upon as a respiratory stimulant. Both morphine and atropine can produce in man breathing of the Cheyene-Stokes type. Orlowski has made abundant experiments in the author's laboratory upon the action of atropine on the respiratory centres. Dogs can bear doses of atropine which the human subject cannot. From the experiments it is shown that after the first injection of atropine the volume of the breathing is diminished, and that a further diminution is noted after a second injection. Eventually the volume may be increased just before general convulsions show the exhaustion of the nervous centres. Thus this increase is a manifestation occurring shortly before death. The frequency of the respiration showed generally a striking constancy. When increase in the volume of breath- The writer was once an invalid and ing occurs, this can only be due to expected to die. His physicians said: alteration in the depth of the breathing." We can do nothing to help him be

The author then relates his investigations into three cases of atropine poisoning. All three cases recovered, and the only symptom which caused any anxiety was the severe disturbance of the mechanism of respiration. These cases show how little atropine can be looked upon as a respiratory stimulant. In one case one centigramme of atropine sufficed to produce severe respiratory

Whatever can flush a face or pale it, whatever can bathe the body in hot perspiration or chill it with dampness, whatever can nerve one with strength or prostrate with weakness, whatever can cause rupture of blood vessels by pressure, or faintness from weakening circulation, must certainly have wonderful power and influence upon the standard of physical condition which we call health. Instances are on record where a mother after being very angry has nursed her child, and it immediately went into convulsions and died, so great had been the effect of her emotions upon her milk. It is not uncommon for authors to suffer with extremely cold feet while at literary work. Many speakers, (as well as soldiers) are troubled with diarrhea, or with overactivity of the kidneys, immediately preceding a public effort. Indeed, the variety of manifestations of this principle is almost as great as is the number of people engaged in pursuits in which the emotional nature is taxed or the emotions play an important part.

cause he knows his own condition so well that we can inspire no hope in him. When we sound his lungs he hears the dull thud or the light resonance and he knows what it means as well as we," and there never was an improvement until hope was inspired, and I am confident never could have been.

I have patients in my care to-day whose mournful state of mind over their