health. In addition, they must have ability to enable them to detect the exact location of any and all obstructions to the regular movements of this grand machinery of life, and supplement this ability with skill to remove all such obstructions.

From this study in bones I went on to the study of muscles, ligaments, tissues, arteries, veins, lymphatics and nerves.

I began now to feel that I was irresistibly headed for some road; what road I myself knew not. If one thing I was certain: I was getting farther away from the use of medicines in the treatment of ills and ails. I was a physician of the old school in name but not in fact.

I carried on my theories; I practiced them wherever I could find people who would place confidence in me, until the Civil War came on. Then I enlisted and went "to the front."

On resuming my duties as a private citizen after the war I took up again the study and research of my all-absorbing topic: how to cure disease without medicine, and on June 22, 1874, there came into my mind the first clear conception of the practical workings of what is now known as the Science of Osteopathy This day I celebrate as its birthday.

One of the First Cases I Treated. In the autumn of 1874 I was given a chance to try my ideas on a case of flux. I was walking with a friend on the streets of Macon, Mo., in which town I was visiting, when I noticed in advance of us a woman with three children. I called my friend's attention to fresh blood that had dripped along the street for perhaps fifty yards. We caught up with the group and discovered that the woman's little boy, about 4 years old, was sick. He had only a calico dress on, and, to my wonder and surprise, his legs and feet were covered with blood. A glance was enough to show that the mother was poor. We immediately offered our services to help the boy home. I picked him up and placed my hand on the small of his back. I found it hot, while the abdomen was cold. The neck and the back of the head were also very warm and the face and nose very cold. This set me to

reasoning, for up to that time the most I knew of flux was that it was fatal in a great many cases. I had never before asked myself the question: What is flux? I began to reason about the spinal cord receive their power and motion, how but that gave no clew to flux. Beginning at the base of the child's brain, I found rigid and loose places in the muscles and ligaments of the whole spine, while the lumbar portion was very much congested and rigid. The thought came to me, like a flash, that there might be a strain or some partial dislocation of the bones of the spine or ribs, and that by pressure I could push some of the hot to the cold places, and by so doing adjust the bones and set free the nerve and blood supply to the bowels. On this basis of reasoning I treated the child's spine, and told the mother to report the next day. She came the next morning with the news that her child was well.

There were many cases of flux in the town at that time and shortly after, and the mother telling of the cure of the child brought a number of cases to me. I cured them all by my own method and without drugs. These began to stir up comment, and I soon found myself the object of curiosity and criticism. Why I Started the American School of Osteopathy.

Another case which I was asked to see brought upon me still further criticism. A young woman was suffering with nervous prostration. All hope had been given up by the doctors, and the family was told. After a number of medical councils her father came to me and said: "The doctors say my daughter cannot live. Will you step in and look at her?" I found the young woman in bed, and from the twisted manner in which her head lay I suspected a partial dislocation of the neck. On examination I found this to be true-one of the upper bones of her neck was slipped to one side, shutting off, by pressure, the vertebral artery on its way to supply the brain. In four hours after I had carefully adjusted the bones of her neck she was up and out of bed.

I employed the best talent that I could

Own

find to teach them anatomy, physiology and chemistry, teaching them, myself, the principles and practice of my science. After my school had been in running order a short time others became interested and asked permission to join, and the class increased in numbers. At the end of the first year I had some students who were able to help me in a way, and in the course of two years I really had assistance. This was the origin of what is known today as the American School of Osteopathy.

With the origination of the school came, of course, the necessity of a name to designate the science. and I chose "Osteopathy." I reasoned that the bone, "osteon," was the starting point from which I was to ascertain the cause of pathological conditions, and I combined the "osteo" with "pathy."

So "Osteopathy," sketched briefly, was launched upon the world.

Now What, Really, Is Osteopathy? Many people naturally ask: What is Osteopathy?

Osteopathy is simply this: The law of human life is absolute, and I believe that God has placed the remedy for every

disease within the material house in which the spirit of life dwells. I believe that the Maker of man has deposited in some part or throughout the whole system of the human body drugs in abundance to cure all infirmities; that all the remedies necessary to health are compounded within the human body. They can be administered by adjusting the body in such manner that the remedies may naturally associate themselves together. And I have never failed to find all these remedies. At times some seemed to be out of reach, but by a close study I always found them. So I hold that man should study and use only the drugs that are found in his own drug store-that is, in his own body.

Osteopathy is, then, a science built upon this principle; that man is a machine, needing, when diseased, an expert mechanical engineer to adjust its machinery. It stands for the labor, both mental and physical, of the engineer, or Osteopath, who comes to correct the abnormal con

ditions of the human body and restore them to the normal. Of course, "normal" does not simply mean a readjustment of bones to a normal position in order that muscles and ligaments may with freedom play in their allotted places. Beyond all this lies the still greater question to be solved: How and when to apply the touch which sets free the chemicals of life as Nature designs?

An Osteopath is only a human engineer who should understand all the laws governing the human engine and thereby master disease.

The

Osteopathy absolutely differs from massage. The definition of "massage" is maso, to knead; shampooing of the body by special manipulations, such as kneading, tapping, stroking, etc. masseur rubs and kneads the muscles to increase the circulation. The Osteopath never rubs. He takes off any pressure on blood vessels or nerves by the adjustment of any displacement, whether it be of a bone, cartilage, ligament, tendon, muscle, or even of the fascia which enfolds all structures; also by relaxing any contracture of muscle or ligament due to displacements, to drafts causing colds, to

overwork or nerve exhaustion. The Osteopath knows the various nerve centers and how to treat them, in order that the vasometer nerves can act upon the blood vessels, bringing about in a physiological manner a normal heart action and freeing up the channels to and from the heart. The Osteopath deals always with causes, has no "rules of action," as such, but applies reason to each case according to the conditions presented, treating no two cases quite alike. He knows from past experiences that the effect seen is produced by a cause with which he must deal in order to give relief.

The Osteopath is a physician. The masseur does not take the responsibility of the full charge of a diseased condition, but works under the direction of a physician, and has to do with effects applying by rote to the body so much rubbing, so much stroking, so much tapping. so much kneading, etc., there being definite rules laid down applicable to general cases.

Publication Office: 532 Altman Building.

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O. L. McKillip, M. D., Managing Editor,

LIMITATIONS OF THE NEWER

TUBERCULIN REACTIONS. The enthusiasm that has greeted the advent of the recent cutaneous and ophthalmic methods for the early diagnosis has reached the stage when it must needs be tempered by the searching criticism of experience. That there has been an urgent need for a simple clinical test for the detection of incipient tuberculosis is amply evidenced by the widespread adoption of the methods of von Pirquet and Calmette. The literature, particularly of Germany and France, is teeming with reports, some favorable, and some unfavorable, upon the real practical utility of these newer diagnostic resources. The comparative value of the various reactions in children has received the attention of F. Reuschel (Munchener medizinische Wochenschrift, Feb. 18, 1908). This observer has found that the original hypodermic method of Koch is not trustworthy in cases of severe phthisis and in acute miliary tuberculosis, and cites the observations of Kohler and Behr that 25 per cent of normal individuals react with fever to the hypodermic injection of tuberculin, this febrile response being attributed to hysteria. Of far greater value than the constitutional symptoms of the subcutaneous injection of tuber

WHOLE NUMBER, 341

culin has been found the local phenomena in the region of the needle puncture. This, the so-called "puncture reaction" ("stichreaction" of Escherich), consists of a sharply circumscribed red area of infiltration, edema, and pain surrounding the site of puncture. Reuschel has found that the puncture reaction was constant in cases of tuberculosis, and that it was present in cases that did not react with fever. He believes that the puncture reaction is particularly available for suspicious cases that are regularly "running a temperature," in which, of course, the febrile response to tuberculin would be entirely masked. On the other hand, a febrile response to tuberculin, in the absence of the puncture reaction, is not to be regarded as an indication of the presence of tuberculosis. As regards the cutaneous reaction of von Pirquet, Reuschel found that it was convenient and adapted for general use in practice: when positive, it indicated. tuberculosis, but its negative occurrence after a single trial gave no decisive answer. In the latter case, the performance of the puncture reaction would clear up the difficulty. Both methods were not to rival the older method of Koch, but all three were to supplement one another. It was still to be investigated whether the local sensitization re

vealed by the newer methods indicated the presence of antibodies of tuberculosis, which this observer doubted or whether it revealed the presence of antibodies to the proteid substances of the bouillon.

Prof. E. Feer (Munchener Medizinische Wochenschrift, Jan. 7, 1908) finds in the von Pirquet reaction a valuable aid in the diagnosis of tuberculosis in children. But the intensity of the reaction is not proportionate to the extent of the lesion, and while the positive reaction indicates the presence of tuberculosis, a negative result does not exclude this disease, for in the presence of cachexia, military tuberculosis and meningitis, there is no cutaneous reaction. In children the vaccination test is considered preferable to the opthalmous reaction, which is absolutely contraindicated in scrofulous children, on account of the frequent occurrence of severe conjunctival irritation and phlyclenlulae following the installation of tuberculin. The value of the cutaneous reaction diminishes as age advances, for in older children and adults, aparently in perfect health, some of whom are possibly carriers of small, inactive tuberculosis foci, in the majority of cases there is a positive reaction to both the cutaneous and conjunctival tesas. Thus, Von Pirquet has found that in individuals from 10 to 14 years of age, 55 per cent, and in adults, 90 per cent, react positively to both tests. Feer found that between the ages of 10 and 15 years, 35 per cent react positively. Thus, at this period of life, the positive reaction is of limited signficance, while to the negative response a greater value must be accorded. The rule is laid down that the nearer one approaches the nursing period, the more the positive reaction is apt to indicate. the presence of tuberculosis.

A careful study of the comparative values of the skin and ophthalmic reactions was made by Carlos Maunini (Munchener medizinische Wochenschrift, December 24, 1907). He found that both reactions occurred with great constancy in all cases of tuberculosis, excepting those that were far advanced.

and that although it was quite probable that the reactions were specific, this had not yet been proved. In individuals in whom there was no reason to suspect tuberculosis, a positive cutaneous reaction occurred six times as frequently as the ophthalmic. Assuming that the reactions were specific, this contradiction was explained on the hypothesis that the ophthalmic reaction revealed an active tuberculosis, while the cutaneous reaction revealed a latent focus.

That the ophthalmic reaction is not altogether a harmless procedure is indicated by the experience of Wiens and Gunther (Munchener medizinische Wochenschrift, December 24, 1907). These observers found that the installation of a 1 per cent solution of tuberculin in a number of cases caused severe ocular disturbances, in some lasting for several months. These severe reactions occasionally occurred in patients in whom there was not the slightest evidence of tuberculosis. tuberculosis. It is concluded that the Calmette reaction is by no means as harmless as has been thought, and is to be absolutely excluded in all cases of chronic conjunctivitis, no matter how mild.

test.

In 17 positive cases of tuberculosis in which the diagnosis confirmed the presence of bacilli in the sputum, C. Kleinberger (Munchener medizinische Wochenschrift, December 24, 1907) found that 7 cases did not react at all, and that 2 reacted doubtfully, to the ophthalmic A positive reaction following a second installation into the conjunctival sac was of no clinical value, fo in 46 cases in which tuberculosis was clinically excluded, and in which the first installation was followed by a negative or by a mere trace of a positive reaction, a second installation was followed by a markedly positive reaction in 36 cases, which was 78 per cent of the entire number. This percentage was certainly too large to be explained on the basis of a latent tuberculosis. It simply indicated that the conjunctiva was sensitized by the first instillation. This observation has more recently been confirmed by M. J. Rosenau and J. F. Anderson (Journal

of the American Medical Association, March 21, 1908), who found that in twelve normal individuals in whom the first instillation of tuberculin was negative, the second instillation after an interval of 51 days was followed by a positive result. These experiences prove that no reliance can be placed on the result following a second instillation of tuberculin.

There have been a number of investigations whose results argue against the specific nature of the ophthalmic reaction. Thos. L. Blum (Munchener medizinische Wochenschrift, January 14. 1908, has found a positive reaction in 31 out of 188 cases which were clinically non-tuberculosis, the positive reaction occurring in cases such as emphysema. chronic bronchitis, tabes dorsalis, apoplexy, sciatica, severe anemia, enteritis, pleurisy and diabetes. Similarly, S Cohn (Berliner klinische Wochenschrift. November 25, 1907) found that 8 out 12 typhoid patients presented the specific reaction. F. Levy (Deutsche medizinische Wochenschrift, January 16, 1908) obtained a positive reaction in 2.5 per cent of 235 non-tuberculosis patients, while P. Eisen (Beitrage zur Klinik der Tuberculose, Vol. VIII, No. 4) obtained. a positive reaction in 31 per cent of 17 patients, with various non-tuberculosis affections. G. Serafini (Giornale della R. Accaddemia di Medicina, Turin, November, 1907) found that the ocular reaction was not conclusive in cases of tuberculous processes in the bones and joints. The reaction was positive in certain gonorrheal articular affections, as well asin several cases of senile and other non-tuberculosis bone affections. A. Plehn (Deutsche medizinische Wochenschrift, February 20, 1908) obtained at positive reaction in 2 out of 5 cases of typhoid; in 2 out of 5 patients with scarlet fever; in 6 out of 12 with articular rheumatism; in 3 out of 6 with acute bronchitis, and in 3 of enteritis. In none was there any tuberculosis.

It cannot be denied that the cutaneous tuberculin reaction is a valuable addition to our diagnostic armamentarium, furnishing strong presumtive evidence of

the presence in the body of some tuberculosis focus, either healed or active, but reliable only when considered in connection with other signs of the disease. The positive reaction should be interpreted in the light of the numerous recent investigations of the limitations of and teh possible erroneous conclusions that might be derived from it. In addition to its diagnostic value, this reaction bids fair to throw considerable light upon the problem of immunity in tuberculosis. The ophthalmic reaction, however, is one that should be employed with extreme caution, for the procedure is by no means as harmless as was at first supposed, and many cases are now on record of corneal ulceration and other untoward results of the tuberculin instilations.—Med. Record.

HONOR TO WHOM HONOR IS DUE.

Recognition of the investigations carried on by various members of the Medical Faculty of the University has recently come from several foreign societies. For some years past Dr. Vaughan, his assistents and students have been

engaged in the study of proteid poisons. This work was begun some ten years ago, when he devised a tank in which bacteria can be grown in large amount. Typhoid and other bacilli are planted over large surfaces, are harvested and purified and the poisonous part obtained. It has been found in this work that all proteids, not only those of bacterial origin, but vegetable and animal proteids as well, contain a poisonous group. The medical profession has long suspected that this might be the case, but until this work was done no one had succeeded in isolating the poisonous body.

It is interesting to note that from such bacteria as the typhoid bacillus, after the poisonous group has been removed, the non-poisonous residue can be used in immunizing animals to typhoid fever From egg-white, from the casein of milk, from the gluten of flour, and from various other proteids, poisonous and non-poisonous groups have been obtained. It has been definitely shown