J. H., age 52 years, white, male, married, shipmaster. Patient was brought to the hospital from his vessel in a semi-comatose condition, from which he could be roused with difficulty. His coma gradually increased, and he died in an uraemic condition without convulsions at the expiration of 48 hours.

There was obtained a scant history extending back some months of gradually-increasing ill-health, with headache and general disinclination for exertion, culminating in anasarca, ascites, and shortness of breath. He had been confined to bed for several days prior to the arrival of his vessel. He had contracted a chancre five months previously, had been on treatment, and was a constant and hard drinker of gin.

The liver, pancreas and kidneys showed the greatest changes, the spleen was enlarged with increase of splenic pulp.

The

The liver showed great increase of connective tissue, especially in the portal spaces, the liver lobules are smaller than normal and are invaded by connective tissue bands with proliferation of the bile ducts. Under the high power the nuclei of the liver cells are seen to be obscured by a deposit of granules brownish-yellow in color which on test with hydrochloric acid are proven to be haemosiderin. pancreas shows a connective tissue proliferation but a more normal appearance than the liver, the pancreatic cells are lessened in number but their nuclei are visible, the yellowish granules are everywhere apparent. The kidney shows a well marked chronic diffuse nephritis of the parenchymatous variety, there is not so much deposit of the iron-bearing granules as in the other organs.

AN IMMUNE BODY CAPABLE OF INHIBITING THE
DEVELOPMENT OF CANCER IN MICE.

In the April number of The Johns Hopkins Hospital Bulletin, G H. A. Clowes, Ph. D., gives a preliminary report on some investigations pursued by Dr. Gaylord and himself on this subject, suggested by the fact that while there are many authentic cases of recovery from carcinoma, no attempt has been made to determine the effect of the serum of these spontaneously recovered cases upon those suffering from a similar affection. Mice were used for these experiments, inoculation being made from two supplied by Prof. Jenpen of Copenhagen.

The method pursued was to treat in each case two affected mice at the same time, one with injections of blood derived from mice recovered from the disease, the other with a similar amount of ordinary mouse's blood. Up to the time of making the report, experiments had

been carried out on twenty mice; and, of those treated with repeated doses of the so-called immune serum, one only has failed to show some effect, which may be attributed to the serum and all are alive. Of those treated with normal serum five are already dead and the others have now tumors larger than those for which they served as controls. Tumors weighing more than three or four grains were not appreciably affected by the serum, but the cachexia from which the mice suffer in the last stages was in all cases alleviated. The serum of mice cured of their tumors by the above treatment was found to possess a certain degree of activity, but not to the extent exhibited by that of the spontaneously recovered cases.

It must be borne in mind that these mice tumors are very irregular in their development, both as to time and size, so that one must be cautious in drawing conclusions from any limited number of experi ments but in these cases the tendency to recover was very slight, in only one case did a tumor larger than a buckshot recover spontaneously in the series of second inoculations, which were very virulent. Test tube experiments with this serum make it extremely improbable that it can be classed among the cytolysins; it does not exert any more marked haemolytic effect than the blood from the normal animal, Sections of tumors in cases thus treated show changes comparable to simple atrophy, increase in connection tissue, and reduction in the epithelial elements. On the whole, there seems to be evidence of the exist ence of immune forces antagonistic to the development of cancer.

THE DRINK HABIT.

Dr. C. W. Hidden, of Newburyport, Mass., has for some years urged the curability of the drink habit by a method of treatment for which he claims credit of bringing before the medical profession. Stated in his own words we find it thus given in the Medical Brief.

"The remedy that I employ is a combination of cinchona rubra, strychnia nitras, capsicum annuum, and avena sativa. This destroys the craving for liquor, and starts the patient on the road to health. strength and moral control. Only the once intemperate can appreciate what it means to lose that awful consuming thirst for strong drink. "My discovery removes the appetite for liquor, restores the system to normal or healthy tone. No man in health craves strong drink. bend every energy, utilize every means at command, to restore the drink patient to health, to make him sound in body, brain and mind. When this has been accomplished, the reign of old king alcohol is at an end.

"The primary sensation on taking the medicine is one of delicious

I

warmth, which extends to all parts of the body. Patients frequently say, 'The first dose made me thrill and glow from the crown of my head to the tips of my toes." This is not to be wondered at when we recall the condition of the patient prior to beginning treatment: stomach irritable, nerves out of tune, brain in a jangle, vital powers depressed, a weak, trembling, physical wreck. It is well worth while to reverse all this: To suffuse the body with warmth and power, to find the nerves steadying down, the brain clearing, the stomach able to retain food, an awakening sense of manhood and of growing control over a debased appetite."

BACTERIA ON MONEY.

A number of experiments have been carried on by the New York Board of Health, with the following results : The germs of only two diseases have been experimented with-tuberculosis and diphtheriaand both of these may be communicated from one person to another on money. Moderately clean bills obtained from a cheap grocery store held 2,250 living bacteria, and dirty bills held 73,000. Pennies held only 26, and dimes 40. The experiment was made of placing pennies, nickles, and dimes in the mouths of children suffering from diphtheria. The coins showed no trace of diphtheria bacilli twenty-four hours afterward. The report sums up the results reached thus: Pennies at the end of twenty-four hours gave a growth of diphtheria bacilli when fairly dry; at the end of forty-eight hours they gave no growth. Nickles at the end of twenty-four hours gave a growth at times, but not at others; at the end of forty-eight hours they gave no growth. Dimes gave a growth at times, not at others; in forty-eight hours the growth had disappeared. Paper money at the end of forty-eight hours gave a growth and continued to do so at times for a month. The number of bacteria found alive on paper was 170,000, on nickel about 40,000, and on copper none. The data thus obtained ought to convince the authorities what a menace soiled bills are to the public health.

SURGERY.

Under the charge of H. A. BEATTY, M.D., M.R.C.S.. Eng.

Chief Surgeon Canadian Pacific Railway, Ontario Division: Surgeon Toronto Western Hospital. TREATMENT OF THE STUMP IN APPENDISECTOMY.

In a letter of Dec. 12th, 1904, to the editor of the St. Louis Medical Review, Edmund Owen, Consulting Surgeon to St. Mary's Hospital, London, says :

As is well known, a very usual way of dealing with the stump is to turn back a considerable cuff of peritoneum, and then, having tightly

surrounded the naked fibromuscular tube near its base with a fine ligature, to bring forward the peritoneum again, and to stitch it over the raw end of the stump. Probably before the cuff has been drawn forward the mucous membrane lining the end of the stump has been scraped out with a small sharp spoon, and the raw tissue disinfected by a drop of pure carbolic acid. In most cases where this treatment has been carried out, certainly in nearly all in which the operation has been resorted to in the "quiet stage," the result has been good. Nevertheless, one cannot regard it as the most perfect way of operating, for there is always the risk-notwithstanding the presence of the carbolic acid of the tubular piece of the appendix between the ligature and the cut end becoming a small incubation chamber, and of an abscess being formed beneath the cuff of peritoneum, which has been stretched over the end.

I have done the operation in this way many times, and, like my confreres, I suppose, I have now and then been annoyed by the formation of a small, deep seated abscess.

The way in which I now try to deal with the stump is by cutting it as close to the large intestine as possible, turning it into the bowel, and stitching up the opening after bringing together the neighboring parts of the peritoneal coat.

Seemingly, some surgeons do not mind if they leave a rather long stump; my belief is that there ought to be no stump left.

THE TREATMENT OF CONGENITAL TALIPES EQUINOVARUS. Dylion, Arch. de Med. des Enf. says that much has been written upon the subject of club-foot, but the writer believes that the bloodless method of treatment is steadily gaining in favor.

Having completely cured several complicated cases of club-foot by manipulation alone, the author draws the following conclusions : (1) By methodical manipulation congenital talipes equinovarus may be completely corrected.

(2) If the result proves to be unsatisfactory, it is proof that the method was faultily applied, or that it was not continued long enough. (3) The treatment should not be regarded as auxiliary, but as the principal and exclusive method.

(4) By manipulation one restores the normal form as well as the function of the member.

(5) Correction of the position having been obtained, the treatment should be continued for a time in orded to prevent recurrence.

(6) In the intervals of treatment the foot should be supported by a small splint.

(7) It is desirable to begin treatment as soon after birth as possible.

REDUCTION OF STRANGULATED HERNIA.

Fischer, Therapie der Gegenwart, No. 3, 1905, finds that by applying an ether spray to strangled hernia it may be reduced without difficulty or danger. The patient lies on his back with the pelvis raised and knees flexed. The skin surrounding the rupture is smeared with vaselin and covered with cotton. The ether spray is then directed over the rupture and inguinal canal; the intense cold if continued for one to two minutes condenses the tissues, blood-vessels, and the gass in the distended bowel. Taxis is then made, usually with success; if it fails, the procedure is repeated in fifteen minutes.

ENTEROSTOMY.

J. W. Long, American Medicine, April 8, 1905, says that enterostomy is always a life-saving measure, never an operation of choice. Enterostomy is not indicated when a more ideal surgical procedure is feasible.

In the hands of an experienced, carefully trained abdominal surgeon, capable of dealing with.grave emergencies, an enterostomy is rarely resorted to; but the better the surgeon, the more quickly will he adopt any measure that will save his patient.

Every abdominal surgeon, according to the abundance of his material, must find cases in which only an enterostomy can with propriety be done.

When an enterostomy is indicated, to hesitate is to lose your patient; to operate promptly, dexterously, and with celerity means to tide your patient over the imminent peril and spare him for future consideration.

RADIOTHERAPY AND SURGERY, WITH A PLEA FOR PREOPERATIVE RADIATIONS.

William T. Morton Medical Record, March, 1905, draws the following conclusions:

1. Radiation treatment exerts a retarding effect upon the growth of some cancers.

2. It cures some cases-the ratio to operative measures is not here discussed.

3. Preoperative radiation will increase the ratio of cures by opera