asafoetida, etc., or by the salts of sulphurous acid; the saturation of the system with ammonia in the typhoid state, as there is known to be nitrogenous waste with ammoniacal exhalations. And further, what is now more to the point, in elucidating the treatment of the tuberculous state, I allude to the exhalation of sulphuretted hydrogen from the decomposition of the sputum of tuberculous subjects, which probably suggested Bergeon's plan of infusing into the system this very gas, and also to my own treatment by the free use of the salts of sulphurous acid and the sulphides. I do not know whether subsequent experience has established the efficacy of Bergeon's method, but with regard to my own, the results in eight cases, up to this time, have satisfactorily proved its value. I admit that the importance of this subject demands a much more extended investigation than I have been able to give it. My inference as to the sulphurets being required, was derived merely from perceiving the odor of sulphuretted hydrogen from decomposing sputa. That these sulphur salts have a most decided effect upon the hectic paroxysms, any one can determine for himself. In a very marked case which I was able to watch closely, I could readily prevent the return of the hectic chill, fever and colliquative sweating by means of the bisulphite of soda. The eight cases which I could report as either absolutely cured or decidedly improved up to this time, afford a good demonstration of the correct ness of the principle for which I am contending. While the means above alluded to were my reliance for the control of the hectic condition, other means were, of course, used for general nutrition and building up of the system, the relief of dyspnoea, diarrhoea, etc. Cod-liver oil has been but little used in any of my cases, and alcoholic stimulants only at periods of extreme prostration. Besides the constant use of the sulphur salts, the chief means employed were Parrish's syrup of the phosphates, inhalations of vapor of turpentine with carbolic acid and iodine, which latter was found to materially relieve the dyspnoea. This plan of treatment, I contend, effectually arrests the tuberculous process by crippling or destroying the bacillus, without causing the necrosis of the diseased tissue, which is so fatal to the success of Koch's method. I do not pretend to claim that sulphuretted hydrogen is the only exhalation from the bacillus tuberculosis which might furnish an indication for treatment, for it is not only possible, but highly probable, that a minute chemical study might reveal some other product resulting from the lifeprocesses of this organism, which might suggest some other agent which would be still more efficacious in arresting its vitality and checking its predatory attacks upon the system. All I contend for is, that it is upon this principle the treatment should be conducted, and upon this line we should search for the agent most destructive to its life. This also appears to be the conclusion arrived at by Koch and his collaborators, and it is curious to note the similarity of the language employed by them in the year 1890, to that used by me in 1879, at least three years before the bacillus tuberculosis was discovered. A PATHOLOGICAL CONDITION OF THE BY F. PEYRE PORCHER, A.B., M.D., ONE OF THE PHYSICIANS TO THE CITY HOSPITAL, CHARLESTON, S. C. During the course of a very prolonged service in hospitals, I have repeatedly observed a condition of the lungs which is markedly distinct and characteristic, which I have not seen described. A full account of this appeared in the New York Medical Record, October 19, 1889. I will give here a succinct review of the main features and symptoms, in order that we may decide whether it is only a pathological state, or whether it should rank as a distinct disease. Patients presented the following symptoms: Dulness or sub-dulness, generally at the middle, lateral or posterior portions of the chest; there was always imperfect respiration; scarcely any râle present, or if so sparsely disseminated, and generally the subcrepitant; or perhaps there was only rough breathing. The condition was consequent on antecedent morbid states, and was discoverable weeks before death, if a fatal result ensued. There was not necessarily fever or elevation of temperature; there did not exist evidence of any acute inflammation, or any of the well-known diseases of the chest-no phthisis, pneumonia, bronchitis, pleurisy, emphysema, hydrothorax, etc. The positive physical signs of these diseases were all absent-there were no crepitant, or sibilant, or crackling râles; neither were there pain or rubbing sounds. So all the diseases which these signs indicated had to be excluded. To continue the citation of positive and negative symptoms: The respiratory murmur, though not normal, was not absent, for the lung was still pervious to air; the vocal resonance, or what I prefer to call the reverberation of voice, was slightly affected; some complementary respiration might be present, but this was not very decided, because there was no absolute consolidation. Scarcely any dyspnoea may exist, and the cough may be moderate or absent. Hepatization, solidification and asthma had also to be excluded, for there was no absolute dulness, complementary or puerile respiration characterizing the two first, or crepitant râles to indicate the last. The crepitant râle, the fever or the rusty-colored sputa essential to pneumonia were not present. There were no frothy, watery, blood-stained expectoration, blueness of lips, lividity, or cold extremities, as in extreme cases of œdemas; no pure hyperæmia—for in our cases we have blood and serum |