difficulty came in clothing the denuded anterior surfaces and the palm of the hand with integument. One might say at once, employ a Thiersch graft. But a shaving of the scarf-skin will not do here, where so much friction and motion must constantly be borne. I have recommended that Guermonpriz's procedure be employed here in the presence of so much loss of the integument, viz., the sacrifice of one of the fingers, which, after having all the phalanges and tendons dissected out, may be reflected and utilized to fill in the gap; but the father would not consent to this, hence we must do the best we can. In operating each finger was separately, cautiously lifted out of its bed of adhesion and straightened, where a large uncovered breach in the palm was left. To fill this in, a flap with a broad pedicle attached, was carried up from the anterior surface of the wrist and embedded in the gap, its edges being carefully coaptated with fine silk suture. The most thorough asepsis marked every step of the operation. The doctor said the future would largely depend on the preservation of the graft and its assimilation with the tissues in its new situation.

P. S. Two weeks after operation hiatus in palate was restored, perfect restoration of outline of wrist, and little one's hand gave promise of good result.

THE VALUE OF ALBUMINURIA AS A MEANS OF DIAGNOSIS. In a paper on this subject in the International Monthly Magazine, Dr. F. R. Sturgis, of New York, concludes from a survey of the literature that albumen in the urine does not necessarily signify any renal disease; that it exists temporarily in many diseases unassociated with any organic renal complication; that from the uncertainty of tests and methods of testing it loses a great deal of its value as a diagnostic sign; and that if present in even a small quantity it is a danger-signal, and if persistent indicates some serious organic lesion. Med. and Surg. Reporter.

ORIGINAL COMMUNICATIONS.

ON CERTAIN ANIMAL EXTRACTS-THEIR MODE OF PREPARATION AND PHYSIOLOGICAL AND THERAPEUTICAL EFFECTS.*

BY WILLIAM A. HAMMOND, M. D.,
WASHINGTON, D. C.

I want to tell you of some of the work upon which I have been engaged since I left you, and the story will, I think, interest a body of physicians like yourselves, who come here to learn new facts, and thus to keep abreast with the progress of the age. You remember that about three and a half years ago Dr. BrownSéquard electrified the medical and non-professional world by announcing that the expressed juice of the testicles of the guinea pig was an agent capable, when injected into the blood, of arresting to some extent the inroads of old age and of curing certain diseases to which mankind is subject. I at once entered upon a series of investigations of the matter, some of the results of which are published in the New York Medical Journal for August 13, 1889. I became convinced that we had in the juice of the organs in question a means of acting upon the body in a manner and to an extent different from that of the effects of any other substance previously known to medical science.

But, though surprising in its action, I found that there were certain practical difficulties in the way of the fresh testicular juice ever becoming of general use in actual practice.

In the first place, it had to be used fresh, for if not, there was

A lecture delivered at the New York Post-Graduate Medical School and Hospital, January 16, 1893, by William A. Hammond, M. D., surgeon-general United States army (retired), late professor of diseases of the mind and nervous system in that institution.

great danger of a putrefactive process being set up and blood poisoning produced, and this was the result in several cases in which it was used in this country. In large cities there is almost an impossibility of getting the organs in question immediately on their being removed from the animal.

Secondly, it was extremely difficult to filter the thick juice, even when diluted according to Brown-Séquard's directions. Filtering paper would not do, for the morphological constituents passed through and an abscess was very liable to be produced at the point of injection. A porous stone filter absorbed the juice, and none of it came through, as there was never a sufficient quantity to saturate the stone and to pass through it. A large amount could not properly be made at one time, as it would not keep, so that it was necessary at every séance to prepare a fresh quantity.

After a time, therefore, during which I did my best with the fresh juice, using for this purpose the testicles of the ram and creating several abscesses with febrile disturbance, I gave up this method and turned my attention to preparing extracts not only of the testicles, but of other organs of the body. It would be to some extent instructive to go over my failures, but I have not time for that. I can only on this occasion tell you of my success and the conclusions I have arrived at in regard to the subject. And I shall mainly confine my remarks at present to the consideration of one extract, that of the brain, which for convenience I designate "cerebrine." I will merely say that I have prepared extracts also of the spinal cord, " medulline"; the testicles, "testine"; the ovaries, "ovarine"; the pancreas," pancreatine"; the stomach, "gastrine"; and the heart, " cardine"; and that I am nearly ready to give to the profession the results of my observations with these substances. Of course, the kidneys and the liver being excretory organs, cannot properly be used for the purpose of making extracts to be introduced into the blood. Were we to use them in this manner we should be putting back into the system poisons which it had eliminated, and hence would produce disaster, and perhaps even death.

The process and preparation of the extract of these several

organs, while individually somewhat different, does not materially vary from that used for the brain, which is as follows:

The whole brain of the ox after being thoroughly washed in water acidulated with boric acid, is cut into small pieces in a mincing machine. To one thousand grammes of this substance placed in a wide-mouthed, glass-stoppered bottle, I add three thousand cubic centimeters of a mixture consisting of one thousand cubic centimeters each of a saturated solution of boric acid in distilled water, pure glycerine and absolute alcohol. This is allowed to stand in a cool place for at least six months, being well shaken or stirred two or three times a day. At the end of this time it is thrown upon a porous stone filter, through which it percolates very slowly, requiring about two weeks for entirely passing through. The residue remaining upon the filter is then enclosed in several layers of aseptic gauze, and subjected to a pressure of over a thousand pounds, the exudate being allowed to fall upon the filter, and mixed with a sufficient quantity of the filtrate to cover it. When it is entirely filtered, it is thoroughly mixed with the first filtrate and the process is complete.

During the whole of this manipulation the most rigid antiseptic precautions are taken. The vessels and instruments required are kept in boiling water for several minutes, and are then washed with a saturated solution of boric acid. Bacteria do not form in this mixture under any circumstances, but it is necessary to examine it from time to time microscopically, in order to see that no foreign bodies have accidentally entered. Occasionally, owing to causes which I have not determined, though I think it is due to variations in temperature, the liquid becomes slightly opalescent from the formation of a flocculent precipitate. It sometimes takes place in a portion of the extract kept under apparently identical conditions with other portions that remain perfectly clear. It can be entirely removed by filtration through Swedish filtering paper, previously sterilized, without the filtrate losing any of its physiological or therapeutical

power.

Five minims of this extract diluted at the time of injection

with a similar quantity of distilled water constitute a hypodermic dose.

The most notable effects on the human system of a single dose are as follows, though in very strong, robust and large persons a somewhat larger dose is required, never, however, exceeding ten minims :

1. The pulse is increased in the course of from five to ten minutes, or even less in some cases, by about twenty beats in a minute, and is rendered stronger and fuller. At the same time there is a feeling of distention in the head, the perspiration is largely increased, the face is slightly flushed, and occasionally there is a mild frontal, vertical or occipital headache, or all combined, lasting, however, only a few minutes.

2. A feeling of exhilaration is experienced which endures for several hours. During this period the mind is more than usually active and more capable of effort. This condition is so well marked that if a dose be taken about bedtime wakefulness is the result.

3. The quantity of urine excreted is increased, when other things are equal, by from eight to twelve ounces in the twentyfour hours.

4. The expulsive force of the bladder, and the peristaltic action of the intestines are notably augmented, so much so that in elderly persons in whom the bladder does not readily empty itself without considerable abdominal effort, this action is no longer required, the bladder discharging itself fully and strongly, and any existing tendency to constipation disappears, and this to such an extent that fluid operations are often produced from the rapid emptying of the small intestine.

5. A decided increase in the muscular strength and endurance is noticed at once. Thus, I found in my own case that I could "put up" a dumb-bell weighing forty-five pounds fifteen times with the right arm and thirteen times with the left arm, while after a single dose of the extract I could lift the weight forty-five times with the right arm and thirty-seven times with the left

arm.