subject, and that the thing for her to do | of the symptoms mentioned. The experi- . was to have constitutional treatment and leave her pelvis severely alone. She went on her trip, and, in the teeth of my advice, had this uterus tamponed and fooled with all summer long, and came through here again last fall in a very much worse state than when she went away. In the meantime Dr. Rachford had examined the urine after the headache and found it simply loaded with paraxanthine. By following out his directions the condition has been very much improved, and from what I hear of the patient I think she is now on the high road to recovery. To my gynecologic friends, who will want some short key to these conditions, I will say that the one I have relied on is the family history of gout. I am convinced that most, if not all, of our menstrual headaches are caused in some such way as this, and that a very large proportion of the convulsive attacks are due to the same thing. I also believe that some of our cases of dysmenorrhea are aggravated by this paraxanthine making the involuntary muscle of the uterus more irritable than usual. The beneficial effects afforded by gynecology is in regulation of the circulation of the blood in the abdomen; and, as this is the place where most of the oxidation takes place at any rate, my belief is that many a case has been cured before we knew what was causing the trouble. By this regulation we increase the oxidation and prevent the formation of paraxanthine. But there is a certain proportion of cases in which the habit is so thoroughly fixed that this regulation is not enough, and we will have then to resort to the artificial means, and I am only too glad to say that in these inveterate cases Dr. Rachford's treatment has been of the greatest benefit to all the cases on which we have tried it. DR. DAVID I. WOLFSTEIN: I should like to ask Dr. Rachford if he has examined any of his cases with a view of determining whether any leucocytosis was present. I was privileged to see some of the experiments that the essayist has men tioned, and should like to add my testimony to his with regard to the occurrence | ment performed upon the white mouse was eminently successful, the sequence of symptoms, including respiratory spasm, spasmodic twitching of the jaw muscle, tonic spasm just before death, all occurring in the order detailed in the paper. The demise of the guinea-pig had not taken place when I was obliged to leave, but an injection of about 15 m had already produced some reflex excitability-much less marked, however, than in the mouse-and respiratory spasm, as well as vertical oscillation of the eye-balls. I understood, however, that the other symptoms and the death followed later. The death of the mouse occurred about five minutes after the dose was given, but the guinea-pig must have lingered nearly two hours. I am very glad that the doctor undertook his experiment upon a larger animal like the guinea-pig, and he should utilize still larger animals, I think, for otherwise I should not like to draw too positive conclusions from an animal so small as the white mouse. I feel this hesitancy all the greater as I myself have produced convulsions just as typical in white mice with an injection of a small amount of thyroid gland extract in glycerine for twenty-four hours, the only difference being that death, whilst inevitable, occurred in about thirty minutes. It seems, therefore, that there must be many substances of organic nature capable of causing convulsions in small animals. I asked the essayist about the possible presence of a leucocytosis in his cases, as I should like him to explain whether he thinks there is any relationship between the breaking down of leucocytes and the occurrence of paraxanthine, as Horbascewski has shown so clearly is the case with respect to the other bodies of the alloxuric group. DR. S. P. KRAMER inquired whether the essayist had been able to demonstrate the toxicity of paraxanthine in the carnivora. DR. RACHFORD: No, because the amount of urine that I was able to obtain-about one quart—was not sufficient to isolate enough paraxanthine to kill a dog. Shows the Pelvis as it rests on the ordinary saddle. is aware of the danger in riding the ordinary bicycle saddle. Sensitive CHRISTY ANATOMICAL BICYCLE SADDLE. MAKES CYCLING A PLEASURE. Metal frame, cushions for the pelvis bones, Shows pelvis as it rests on the Christy Saddle. 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FERRETT, Agent, 372 Pearl St., New York. [In corresponding with Advertisers kindly mention LANCET-CLINIC]. DR. KRAMER: A critical examina- | ally leads to dementia; migraine, extion of the results obtained by Dr. Rach- cepting in the class of cases before menford will not, I think, justify the con- tioned, never weakens the intellect. clusion that these cases are due to Epilepsy, in the majority of cases, tends paraxanthine poisoning. The doctor to get worse, and to continue to the has proven undoubtedly that the urine end; migraine generally disappears in of these patients is toxic. But the the course of years. So clinically the degree of toxicity does not appear to me two diseases, fortunately for the mito be very great, nor do I believe that graine patient, are very unlike. the toxic agent has been proven to be paraxanthine. In the case reported 750 c.c. of urine yielded a final fluid of 2 c.c., supposed to contain paraxanthine. Twenty minims of this, or two-thirds of the toxine in half the daily urine, was sufficient to kill a guinea-pig. When we consider that the ratio of the weight of a guinea-pig is to the weight of a man as about 1 to 140, we cannot call this urine an extremely toxic urine. Furthermore, before one could accept the view of the highly toxic character of paraxanthine its toxicity ought to be demonstrated on the carnivora. Chemical compounds very like paraxanthine are found in meat, and perhaps they, too, may be present, and the constant ingestion of this substance may produce an immunity that does not exist in the herbivora. We certainly should require more proof of the toxicity of paraxanthine before we accept this compound as a disease-producing toxine. DR. PHILIP ZENNER: We are all under deep obligations to the essayist for the valuable paper presented this evening. My teacher in neurology, Hughlings Jackson, thought that migraine, as well as epilepsy, were cortical diseases, the one in the posterior, the other in the anterior part of the hemisphere. So far as I know, he was the first to entertain such ideas, a view that has since gained much ground. Nor is migraine always an innocent disease. In not a small number of cases has a special form of it appeared to initiate organic disease, paresis, which it may have antedated several years. But these are the unusual cases. Whatever may be the pathological likeness of migraine and epilepsy, clinically they are very unlike. While the one is a disease of the greatest gravity, the other, apart from the suffering entailed, is not a serious disease. Epilepsy usu As The researches of Dr. Rachford are a large step toward solving the question of the nature of migraine and epilepsy. In a paper of Herter and Smith, quoted by the essayist, on the etiology of epilepsy, the authors surmise that intestinal putrefaction is related to the attacks, some poisons being thus formed which act as irritants to the brain. to Dr. Rachford's investigations, the important matter to determine is to what extent the paraxanthine found was an excitant, to what extent the product of the attacks. To help answer this question I would suggest, if possible, the examination of urine passed just before an attack. For if paraxanthine is the cause, and not result of the nervous explosion, we might expect its presence before the explosion occurred. the In the cases of epilepsy it appears that a series of attacks always occurred just preceding the appearance of paraxanthine in the urine. Is it possible that the poison was the product of the severe and continued convulsive movements? Whatever may be the result of further studies in this direction, there can be no question of the great value of Dr. Rachford's painstaking researches to the science of medicine. DR. RACHFORD: My remarks were not intended to enter into the subject of the formation of the xanthine bodies, which in itself would require considerable time, but it was to call attention to paraxanthine in relation to migraine and certain forms of epilepsy. I am at present working on leucocythemia. In this condition we have a great number of white corpuscles in the blood, but no para- or heteroxanthine present, but others of the alloxuric bodies are found, which brings up the question of nuclein and its destruction as formative of these bodies. A great deal shows that the destruction of nuclein may be a factor THE in their formation; in fact, all alloxuric Cincinnati Lancet-Clinic: bodies are due to the breaking down of nuclein, which can be demonstrated in the laboratory. Paraxanthine and heteroxanthine have the same action, but it requires four times the amount of the 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 ten words (brevier type). latter to produce the same effects as one J. C. CULBERTSON, M.D., Editor and Publisher of the former. They are both very soluble, and it is for this reason they readily enter into the circulation and are brought more readily in contact with the nervous tissue. They have never been found in meat or meaty extracts. The most expert German chemists have not recorded them present, showing most positively that responsibility for their formation is elsewhere. By demonstration I have proven its effects upon smaller animals. I have been afraid to try it upon myself, for it has proven fatal to the animals experimented upon. The method of eliminating paraxanthine from the urine is a long and tedious one, requiring three weeks' work. I had about one quart of urine, and probably lost some of the paraxanthine in the washing and other manipulations that were necessary; besides, we probably get but one-half in the urine, because some is eliminated by the respiration, intestines and sweatglands, and part destroyed in the blood, so that we get but a small quantity, so we hardly expect to obtain enough to kill larger animals. The symptoms produced by paraxanthine are not similar to any other poison. You can take your text-book and find that it corresponds in every instance, except the contraction of the pupil, with the symptoms of grande mal. I came to the conclusion that it was a slander on the brilliant people who suffer with migraine to find it in literature as akin to epilepsy, for a great number of epileptics are degenerates; so that I show there is a form of epilepsy due to a toxine that is related to migraine. I recently saw a case in Dr. Hoppe's service at the Cincinnati Hospital of a woman who had a number of convulsions in twenty-four hours. I got less then a quart of urine, and examination revealed no paraxanthine present. It was a case of focal convulsions. All letters and communications are 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, MARCH 13, 1897. Editorial. DEGENERACY AND RELIGION. Degeneracy is a term largely made use of in application to members of the human family who have mentally, morally and physically deterioratedin other words, who are not up to a given standard. The tests of degeneracy are in many instances such as hold good and at once appeal to the good or scientific sense of those who are qualified to make comparisons. In other cases the tests are at least seemingly without reason. For man is a deinstance, to say that a generate simply because his arms are a trifle longer or shorter than normal gives an appearance of ridicule to the statement, and yet it is upon just such measurements than Lombroso makes his diagnoses. The large or distorted ear of the mental degenerate is familiar to all students of psychology, and yet there are scores and hundreds of people who are mentally strong whose ears who are mentally strong whose ears would class them, according to the Lombroso scale, among the degenerate, while |