preliminary washing of sublimate solution, possibly as strong as 1-1,000. If the burn be extensive, this must be followed by copious douching with sterile water or non-poisonous antiseptic solutions.

During the cleansing of the wound, and indeed during the whole treatment, the greatest care should be exercised to prevent the rupture of unbroken blisters. So long as the epidermal covering of the vesicle remains intact, infection of the surface beneath cannot occur, and that portion of the burn at least may be regarded as a subcutaneous lesion, protected by that very fact from infection, and will go on to heal as such. When on examination we find a blister so large and tense as to interfere with bandaging, or which threatens rupture, we might aspirate a portion of the contents by the subcutaneous method. A sterile needle is introduced through a small fold of skin, pinched up at a little distance from the blister, pushed on into its cavity and sufficient serum allowed to run out to reduce tension; the needle is then quickly withdrawn, and the skin fold allowed to slip back into place, when the opening into the skin and that into the blister will no longer be continuous.

When we proceed to the dressing proper of the wound, we must adjust our treatment to the different degrees of severity which will probably be found; portions simply hyperæmic may be anointed with a five per cent. solution of phenol in sterile olive oil, which will greatly reduce the heat and subsequent itching; all denuded surfaces are to be covered with strips of gutta-percha tissue. This material must be kept in cold carbolic acid watery solution, two per cent., and as it is ruined by placing it in warm water, if before applying it to the wound it is desired to wash off the carbolic acid, cold sterile water should be used. Gutta-percha may also be fitted over unbroken blisters, which it will protect from rupture. Over areas in which slough is impending a moist gauze compress covered with rubber tissue to prevent evaporation forms an antiseptic poultice retaining heat, favoring suppuration and preventing putrefaction. Over all, a large, thick layer of sterile absorbent cotton through which no penetration of germs can occur is applied and the dressing finished with a well-fitting bandage.

It is needless to add that the same faithful and scrupulous attention. to cleanliness of hands, instruments, etc., is as necessary as in an aseptic operation, and that these same precautions must be kept up until the termination of the case.

The dressings should be changed frequently, during at least the first week say once dailylater, once every two or even three days will be sufficient.

It may be noticed that no mention has been made of iodoform, and very little stress laid upon the use of any particular antiseptic, except a caution as to the use of strong solutions of poisonous antiseptic drugs. Personally I do not undervalue the use of iodoform, and when the burned surface has not been extensive have always used it; indeed, under a moist dressing, iodoform finds the field necessary for its best action. It must, however, be borne in mind that in all cases of extensive burns the emunctories, especially the kidneys, will be overtaxed, and I have felt safer in redoubling my efforts at asepsis rather than in risking the use of toxic antiseptics.-Polyclinic.

The Fluoroscope.

The laboratory of Thomas Alva Edison has been the scene of active work during the present period of interest in the Roentgen discovery. Mr. Edison early began his investigations on the subject, feeling that he needed but one or two weeks to determine the controlling factors of success. As guide he had Roentgen's original paper, and his path seemed short and clear. Now, after two months' active work, his goal is reached, and he has succeeded in devising a simple apparatus by means of which the skeleton of the limbs may be observed as in a photograph.

His work has taken two principal directions -one.the perfecting of the Crookes tube; the other the production of an apparatus, the fluoroscope, for enabling the X-ray phenomena to be observed directly without the intermediation of photography. After endless trials with different glasses, shapes and sizes. of Crookes tubes and disposition of electrodes, he has adopted as final shape an ellipsoisdal tube about five inches long. At each end are internal disk electrodes of aluminum slightly inclined to each other. The outside. of the tube ends are coated with metallic caps, forming external electrodes. Of the effect of such a tube, about 60 per cent. is due to the internal electrodes and about 40 per cent. to the external ones. He next found that at a particular point of exhaustion the effect was best. This point is when the band spectrum begins to disappear and the spectrum becomes continuous. Accordingly he has adopted the system of using a tube sealed at the ends and with a short tube entering its side. The latter enables connection to be made with an air pump of the Geissler or Sprengel type. After connection with the pump, about half an hour's exhaustion gives the vacuum best for development of the Xrays, the object being to hold the exhaustion at the point of maximum during the period of observation.

One very curious tube experimented had

internal wire electrodes only, and these were sealed into a rod or tube of glass extending from end to end of the tube. This tube gave good X-ray effects, although the electrodes were embedded in glass. In another experiment, a metallic tube half an inch in diameter and two feet long was provided with a metallic shield at one end. The shield end was placed against a plate-holder containing a photographic plate. The other end was pointed at the Crookes tube. It was found that whatever part of the tube the testing apparatus was pointed at, the X-ray produced the image of the aperture through the long steel tube. This showed that they radiated in all directions from an active tube.

Combination tube glass was chosen as material for the Crookes tube, which is blown as thin as possible. The second element of the problem reached was the fluorescent screen apparatus, its construction and fluorescing material.

Mr. Edison was early convinced of the importance of the visual as against the photographic method of observation. Dissatisfied with the barium salt used by Roentgen, he bent all his energies to the development of a new apparatus which should be superior in construction and fluorescent material to any yet suggested. During his researches he examined some eighteen hundred chemicals. To test them he used a pasteboard cylindrical box about two inches in diameter and four inches long, with a sighting hole in its bottom. His assistant started at his laboratory shelves and brought him, one by one, every chemical in the place. Some of the chemicals to be tested were placed in the inverted cover of the box, the inverted box was put in place over it, and Mr. Edison through the eyehole in the bottom looked down toward an excited Crookes tube. For four days and nights the tests went on, many salts were laid aside as fluorescent, but calcium tungstate proved incomparably the best-it is about eight times as powerful as platino-cyanide of barium.

The salt is made by fusing together a mixture of sodium chloride, sodium tungstate, and calcium chloride. The calcium takes up the tungstic acid, sodium chloride being the other product of the double decomposition. Treatment with water dissolves out the sodium chloride and leaves the insoluble crystals of calcium tungstate. These are dried and sifted. Such as go through a No. 30 mesh are the coarsest used. The largest are distributed over a pasteboard screen coated with wet celluloid varnish, then finer ones are added until a smooth, uniform surface results. screen is mounted at the end of a sighting box of pasteboard, with the prepared surface inside. The other end of the box is shaped to fit the contour of the face around the eyes.

On holding the hand over the end of such a box, if X-rays fall upon it, the surface will fluoresce, except where the shadows due to the Roentgen effect are produced, with the same perfect detail that is seen in the best of Roentgen's photographs. One grain of tungstate per square inch of screen is required for the coating.-American Medical Compend.

The Use of Silver Wire.

Halsted, in an article on "Operative Hernia," states that for a year he has sewed all of his hernia wounds with silver wire and has covered them with silver foil. Without exception, the wounds have healed absolutely per priman. Not a single stitch-abscess has been observed either during or subsequent to the healing of the wound. Such absolutely perfect healing of the hernia wounds we have not had heretofore, and he is convinced that the use of silver as a suture material has contributed somewhat to this result. The effect of silver on the growth of the more common pyogenic organisms has been tested. He states that he has two Petri plates which Dr. Bolton has kindly prepared for him. They have both been inoculated with staphylococcus pyogenes aureus. In the center of each plate is a piece of silver foil, such as is used in our wounds. Just outside, and completely surrounding the foil, is a perfectly clear zone several millimeters wide. Except for the clear zone and a slightly intensified zone just outside of this, the agar is quite uniformly clouded. The cloudiness is due to the growth of the micro-organisms with which the agar has been inoculated. Dr. Bolton has studied the effects of various metals on the growth of bacteria, and has recently read a most interesting paper on this subject before the Association of American Physicians. With cadium, zinc and copper Dr. Bolton observed that the inhibitory action was greater than with silver. Prior to his knowledge of Dr. Bolton's experiments, Dr. Halsted tried to use copper and brass foil as a protective and copper and brass wire for sutures, but these metals corroded the tissues so much that he soon stopped using them. We do not hesitate to employ buried sutures of silver wire in sewing tissues on the confines of an infected region. In cases of acute suppurative appendicitis, for example, we close the wound in the abdominal wall with deep, interrupted, buried sutures. These wounds are drained by a few strips of gauze. Two of the sutures are taken very close to this gauze, and sometimes must pass through tissues which are infected. Not even in such cases has a stitch-abscess ever occurred.

Once

a silver stitch and once a silver bone-plate, having been exposed to view and to the air by necrosis of the overlaying tissues, were al

lowed to remain and to become embedded in the granulations of the wound, which healed by suppuration. Neither the stitch nor the plate at any time caused the slightest disturbance in the tissue or inconvenience to the patient. Much has already been observed in the use of silver wire that is worth recording, and enough to satisfy us that it will play a new and more important role in the surgery of the near future.-Boston Medical and Surgical Journal.

Rupture of the Liver.

At a recent meeting of the College of Physicians of Philadelphia, Dr. William J. Taylor presented a specimen which was obtained from a boy sixteen years of age. He was standing holding a horse which was attached to a wagon backed up to the sidewalk at right angles to a trolley track. A car struck the wagon, knocked it over upon the boy, and pinned him to the ground.

When taken to St. Agnes' Hospital there was very great shock, but no external evidence of injury. He had a great deal of difficulty in respiration, which was very rapid, and a very quick pulse. He lived for twenty-two hours after the accident.

When Dr. Taylor saw the boy the night of his admission to the hospital he was in such a profound shock that nothing could be done in a surgical way, and there was evidently some serious internal injury. Other than this no diagnosis was made.

The post mortem showed a very extensive rupture of the anterior surface of the liver. When the chest was opened the right pleural cavity was found filled with clotted blood, and the root of the lower lobe of the right lung was torn through. The other organs were normal; the peritoneal cavity was filled with blood, and the stomach and intestines were enormously distended.

Dr. White said that one would suppose that such a rupture would be followed by immediately fatal hemorrhage. It is hardly to be thought that any surgeon would venture in a healthy liver to make an operative wound of the size and depth of the rupture in the specimen presented and hope to restrain fatal bleeding.

Dr. W. J. Taylor referred to one case in which the liver was intentionally wounded by Dr. Keen when he removed a tumor a few years ago, but Dr. White recalled the fact that in that instance the division of tissue was done by the galvano-cautery.-Annals of Surgery.

God is the restorer of health and the physician puts the fee in his pocket.-Italian.

Miscellany.

The Country Doctor.

The country doctor! Let the bard
Whose lyre is tuned to idle praise-
His locks unshorn, his face unmarred
By sweat and grime, his hands unscarred
By daily toil-in dulcet lays,
In empty word and hollow phrase
Recount the annals of the great;
Let him record and celebrate
Their noble deeds; their pomp and state;
Their wisdom-all, perpetuate.

A humbler theme to you I bring—
The smell of flow'rs, the breath of spring,
The flutter of the bluebird's wing-
And with it all I bring to you
The country doctor, good and true.

The country doctor! Him whose life,
From sun to sun, is daily rife

With bootless toil and ceaseless strife;
Whose sturdy frame is made to feel
The summer's flame, the winter's steel-
I come to sing in praise of him.
His soul is fat; his purse is slim;
His eyesight keen; his foresight dim―
For caring naught for power or pelf,
While there's a crust upon the shelf,
He works for fun and boards himself!

Ah!
ye, who traverse city streets,
On swaying springs and cushioned seats,
The difficulties that he meets—
The bumps and jolts—ye little know,
Through seas of mud, o'er wastes of snow,
Where icy tempests howl and blow,
In pouring rain, where torrents flow
And sheen and shadow come and go,
Astride the sorriest of nags

And armed with spur and saddlebags,
He onward works his weary way;
And be it night or be it day,
He never falters nor looks back
Adown the steep and rugged track,
But sets his teeth and onward plods-
Himself a clod among the clods!

I've said "A clod among the clods."
'Twere better-"God among the Gods!"
For sacrificing hours of ease
And striving hard to do and please
And winning but the dregs and lees
Of life's sweet wine, he fights disease
With clenched hands and bated breath-
And knows no conqueror but death.
It shames me not to tell the truth-
An unkempt, muddy god, forsooth!
Besmeared, bespattered, leggings, suit--
From crown of hat to sole of boot,

And ofttimes tumbled in the wave
That seems to yawn a watery grave,
He bobs serenely on the flood
And swims about the sea of mud.
For lo! his pockets are so light
He cannot disappear from sight!

No scientific friend has he

Who ends his name "A. M., M. D."
Or tacks thereto a "Ph. G."-
To help him in perplexity,

And earn them both a handsome fee;
But when he finds a knotty case,
A problem that he dare not face,
He sends his patient off to town
To some physician of renown.
(God save the mark! All, all are great
Who dwell within the city's gate!)
And this great man dilates his eyes

And rubs his hands, looks wondrous wise-
And nimbly gobbles up the prize!
The city doctor counts his gold,
Makes fresh deposits in the banks,
And sends the country doctor, old—
A neatly worded note of thanks!

To church the city doctor goes,
(Ye need not smile and wink at me
And strive his spotless name to smirch;
I'm told on good authority
The city doctor goes to church)
To take an hour's profound repose,
To hear the gilded organ ring.
To say his prayers and nod and doze
And see the sweet soprano sing;
The organ peals; the tenor squeals—
Great Scott! how good that doctor feels.
The selfsame hour, the selfsame date,
The country doctor-sport of fate-
Moves up some gully's rocky course,
Astride his rhubarb-colored horse.
The only anthem that he hears,
The only tune that greets his ears
Is murmured by the evening breeze-
Which moans “Old Hundred" thro' the trees!

The city doctor spends his days

In crowded marts and traveled ways;
At night he sees the latest plays,
And rests his half enchanted gaze

On some new "star" that lights the stage-
A star of most uncertain age,
Of whom the critics rant and rage.
The country doctor, poor, despised-
His purse half-starved and undersized-
Contents himself to stay at home;
The only stars he ever knows

Are those that rest in heaven's dome
And light the waste on winter snows.

The country doctor! Blessed be he Who sets the weary suffr'er free From burning fever, raking pain

And countless ills-and does it, too,
Without a thought or hope of gain;
Without a single cent in view!

I come to sing in praise of him
Whose soul is fat, whose purse is slim;
Whose eyesight keen, whose foresight dim,
For caring naught for fame or pelf,
While there's a crust upon the shelf--
He works for fun and boards himself.

-From the Ohio State Journal.

Iowa State Association of Railway Surgeons.

We are requested to announce that owing to the meeting of the Masonic Grand Chapter, the date of meeting of the Iowa State Association of Railway Surgeons has been changed to October 7 and 8, 1896.

A sporting character, fond of his mare, used to call the animal "his dear Flora." One day his dear Flora threw him and a wag observed of the accident, "that it was a shocking thingMr. S.'s Flora had miscarried."

Physicians, of all men, are most happy. Whatsoever good success they have, the world proclaimeth, and what faults they commit the earth covereth.-Quarles.

An ill wrestler turned physician. "Courage," says Diogenes to him, "thou hast done well, for now thou wilt throw those who have formerly thrown thee."-Montaigne.

FOR SALE.

PRACTICE FOR SALE:-I offer for sale my practice in the county seat of one of the best counties in Iowa. Have been here for twelve years; am surgeon of the leading road entering the town; am medical examiner for six life insurance companies, etc. I simply require that my successor buy my office fixtures, mostly new-worth $700. Purchaser must be reliable physician with few years' practice. Address "Z. V.." care RAILWAY SURGEON, Chicago.

Desiring to remove to the Pacific Coast, I offer my well-established practice of over 20 years to any physician who will purchase my real estate, situated in one of the most beautiful and thriving towns in Southern Michigan, and surrounded by a very rich farming country. The town is intersected by two important railroads. for one of which the subscriber is surgeon. The real estate consists of a fine brick house of eight rooms and two fine offices besides, attached to, and a part of, the residence. A fine well of the purest water, two cisterns, waterworks, etc. Fine garden filled with choice fruit in bearing, peaches, pears and apricots and small fruits, raspberries, currants, etc. Fine barn and other outbuildings, comparatively new and in the very best condition, all offered with the practice and goodwill at a very low figure for cash. Address "MACK. Surgeon," care RAILWAY SURGEON, Monadnock Block Chicago, Ill.

By reason of failing health, physician wishes to dispose of real estate and practice. Practice amounts to nearly $4.000 per year. No charges except for real estate. Address WM. D. B. AINEY, Montrose, Pa.

Desiring to remove to a warmer climate, owing to poor health. I offer my well-established practice of 11 years to any physician who will purchase my real estate; situated in one of the most thriving towns in the Platte Valley, in Central Nebraska, on main line of Union Pacific R. R., on which road I am the assistant surgeon.

The real estate consists of 2 lots "on corner." on which there is a fine artistic "modern" frame house. 8 rooms; stable 20x30, wind mill, tower and 30-barrel tank: nice blue grass lawn, trees and fine garden (all new); and all offered with my $5,000 practice and good will, at a very low figure. A part cash, balance on time. A very thickly populated country. Address 'BOVINE," care RAILWAY SURGEON, Monadnock Block, Chicago, Ill

President.....

First Vice-President..

Second Vice President.

.F. J. LUTZ, St. Louis, Mo.

216

216

W. R. HAMILTON, Pittsburgh, Pa.
J. H. LETCHER, Henderson, Ky.
Third Vice-President.. ...JOHN L. EDDY, Olean, N. Y.
Fourth Vice-President. .J. A. HUTCHINSON, Montreal, Canada
Fifth Vice-President.. ..... A. C. WEDGE, Albert Lea, Minn.
Sixth Vice-President.. RHETT GOODE, Mobile, Ala.
Seventh Vice-President... E. W. LEE, Omaha, Neb.

Secretary.....
.C. D. WESCOTT, Chicago, Ill.
Treasurer....
..E. R. LEWIS, Kansas City, Mo.
Executive Committee:-A. I. BOUFFLEUR, Chicago, Ill., Chair-

man:

J.N.JACKSON, Kansas City, Mo.; JAS. A. DUNCAN, Toledo, O.; J. B. MURPHY, Chicago, Ill.; S. S. THORNE, Toledo, O.; W. D. MIDDLETON, Davenport, Ia.; A. J. BARR, McKees Rocks, Pa.

THE RAILWAY EMPLOYES' HOSPITAL ASSOCIATION.*

BY DR. GEO. CHAFFEE, BROOKLYN.

Founder and Ex-President New York State Association Railway Surgeons.

The history of this beneficent association dates back to the year 1869, when the late Mr. A. N. Towne, vice-president of the Central Pacific Railway, organized and put it in operation on that line. The association early became popular with railway men and its field of operation has been extended until the popular wave has reached the Atlantic coast via the Plant System and the C. & O. It has been thoroughly tested by conservative people, has become a fixed branch of the operating department and it is not at all likely that it will ever be abandoned. Prominent among the lines which have organized and are now operating the hospital association may be named the Great Northern, Northern Pacific, Union. Pacific, Central Pacific, Southern Pacific, Denver & Rio Grande, Texas Pacific, Santa Fe, Missouri Pacific, Wabash, Big Four, Plant System and the C. & O. Steps are now being taken to organize this hospital association on the Erie Railway.

I am under obligations to Dr. W. H. Morehouse, chief surgeon of the Wabash Railway, for the accompanying photo of the Wabash hospital at Moberly, Mo., and for a brief description of the same, as follows:

"I send you by to-day's mail a photograph of our Moberly, Mo., hospital, with accommodations for about sixty patients. The diningroom, kitchen and nurses' sleeping rooms are in a building detached from the hospital building proper, but connected by a lighted and heated corridor. We thus have no kitchen odors in the hospital building. This photograph was taken immediately after comple

* Read by title at the ninth annual meeting of the National Association of Railway Surgeons, at St. Louis, Mo., May, 1896.