The paragraph in my treatise on Materia Medica and Therapeutics explains the source of the information, and gives an account of the reasons why the antagonism exists. The source of my information and the first knowledge of the antagonism were obtained by Dr. Post, the eminent surgeon of New York, and I am indebted to him for a verbal communication on the subject of the effects of atropine in removing the disturbances of function caused by a lethal dose of carbolic acid. Soon after, I undertook, in my laboratory at Jefferson College, an elaborate investigation, which confirmed the results obtained empirically by Dr. Post. Yours very truly, ROBERTS BARTHOLOW, M. D. Professor in Jefferson Medical College, etc. BOOK TALK. LITERARY NOTES. Among recent interesting reprints may be mentioned: Diphtheria and Diphtheroid; by C. Lester Hall, M. D., Marshall, Mo.-Enucleation of Tuberculous Glands; by Thomas W. Kay, M. D., Scranton, Penn.— Sanitary Entombment; by Rev. Charles B. Treat, Rector of the Church the Archangel, New York City.-The Decimal System of Writing Prescriptions; by C. U. Merrick, M. D., Seattle, Washington, Professor of Materia Medica and Therapeutics in the Medical Department of the University of Washington. D. Appleton & Co., of New York, have issued a neat little volume on Monthly Nursing, written by A. Worcester, A. M., M. D., Physician to the Waltham Hospital, Waltham, Mass. The book is well written. The author begins with a good sentence: "The perfect nurse must be healthy "(and every physician should insist upon it), and succeeding phrases sustain the favorable impression engendered by it. EDITORIAL. To advertisers the question of circulation is of prime importance. Other things being equal, an advertisement placed in a journal reaching three thousand subscribers will be read by six times that number of of persons as one having a circulation of only one thousand. To subscribers the circulation of a favorite journal is also of interest; it is quite a satisfaction to say: "I am taking the most successful of all western journals." Some time ago the INDEX made the statement that "there is no monthly medical journal published west of Philadelphia having a greater circulation than the KANSAS CITY MEDICAL INDEX (the Medical Brief of St. Louis, alone excepted.") The latest statistics show this declaration to be correct. According to Geo. P. Rowell & Co.'s Newspaper Directory, just received, the INDEX has a greater circulation than the St. Louis Medical and Surgical Journal, Chicago Medical Standard, Detroit American Lancet, Cincinnati Medical News, New Orleans Medical and Surgical Journal, Brooklyn Medical Journal, Buffalo Medical and Surgical Journal, Gaillard's Medical Journal, Archives of Pediatrics, College and Clinical Record, all of the Texas journals, Canadian journals, Ohio journals (except the Lancet-Clinic), Georgia journals, Indiana journals, Maryland journals, Minnesota journals, and in fact those of nearly all the states. It has a circulation equal to that of the Western Medical and Surgical Reporter of Chicago, Southern Clinic of Richmond, Medical and Surgical Reporter of Philadelphia, Medical Monthly of Memphis, and nearly equal to that of the American Journal of Medical Sciences, Annals of Surgery, Medical Age, Lancet-Clinic, and most of the other leading medical publications of America. There are barely a dozen American journals having a larger circulation than the INDEX,—the Medical Brief of St. Louis being credited with more than 25,000, the Medical World of Philadelphia with more than 20,000, the Therapeutic Gazette of Philadelphia with 12,500, the Medical Summary, Medical Bulletin and Annals of Hygiene, all of Philadelphia, each more than 5,000; two others about the same. Of course the weekly journals have a large circulation, but the statistics are a little surprising. The New York Medical Record leads with 12,500, the New York Medical Journal has 5,000, the Boston Medical and Surgical Journal 2,000, the St. Louis Weekly Review 4,000, the Journal of the Americam Medical Association more than 5,coo, Maryland Medical Journal (Baltimore) 1,500, Cincinnati LnncetClinic exceeding 4,000, Philadelphia Medical News 4,000, and the Philadelphia Times and Register 2,000. So the INDEX stands almost at the front in circulation, and justifies the statement that it is one of the few journals of this country that pays a handsome income to the editor and. publisher. Turning from one kind of a directory to another, inspection of the Physicians' Directory of the United States, issued this year by R. L. Polk & Co., of Detroit, shows some interesting things. There are, for example, 102 regular medical colleges in the United States, distributed as follows: Alabama 1, Arkansas 2, California 3, Colorado 3, Connecticut 1, District of Columbia 3, Georgia 3, Illinois 5, Indiana 3, Iowa 3, Kansas 1, Kentucky 4, Louisiana 1, Maine 2, Maryland 6, Massachusetts 2,. Michigan 3, Minnesota 2, Missouri 9, Nebraska 1, New Hampshire 2, New Jersey 1, New York 8, North Carolina 1, Ohio 9, Oregon 2, Pennsylvania 5, South Carolina 1 Tennessee 7, Texas 2, Vermont 2, Virginia 2, Washington 2. Canada adds to this number 14: Quebec having 4, Ontario 7, Nova Scotia 2, and Manitoba I. There are 10 Post-Graduate Schools, or "Polyclinics." Of medical journals Alabama has 1, Califor nia 7, Colorado 2, Connecticut 2, Georgia 4, Illinois 14, Indiana 5, Iowa 2, Kansas, Kentucky 3, Louisiana 1, Maryland 4, Massachusetts 8, Michigan 13, Minnesota 3, Missouri 18, Nebraska 1, New Hampshire 1, New York 52, North Carolina 1, Ohio 16, Pennsylvania 22, Tennessee 5, Texas 4 and Virginia 4-total 197. And then the names of the doctors! What an assortment there is One is Luckie, another is Shure, quite a number are Good; several áre Noble, but one is Nott. There is an Ague in Pennsylvania, a region singularly free from malaria. Coffins are numerous (of course), but only two Tombs are to be found, with several Sextons. There necessarily is a Wall, because there is a McGinty; but, strange to say, there is no Sea, though there is a Seaton. One naturally expects to find Cattle, because there are a number of Steers. Some lady has had Tripletts, and two have had Pyles. Money is not to be ignored in the practice of medicine, hence an examination reveals the fact that there are only three that are really Poore, though one has a Shilling, and others Dollars while some are running Newbills. Strange to say, there are only two Boozers in the whole medical profession, although there are only two who can always be said to be Sober, and one is always Beery. There is a Dr. Mass (whose first name is not Blue ), a Pellett, a Seidlitz, and Tarwater. The physicians of this country are not without Cheek, although there are only two Hornblowers, and but few Swindles. There are many Slaughters, probably because of the Cutters and Butchers, and one Mangle may have had to do with it. There is one Newborn, one Shinn, a number of Bones, a Mussel, a Rash, a Pain, a Life, three Ills, a Diet, a Death, a number of Lances, Lights, Livers and Lungs, as well as Bowels, and one who is Nothing. There are Bitters, and Bloods, Kile, Kime, and DeKay, two only who are truly Able. Strangest of all, one can find but one School among the ninety thousand doctors of the United States. EDITORIAL NOTES, DERMOID CYST AND PREGNANCY.-Dr. A. W. Felter, of Fulton, Kansas, reports a case in the Medical Standard for March. It occurred at Blue Mound in the practice of Dr. Babcock. He was called to a confinement case requiring help; Dr. Kirkpatrick was sent for, and on his arrival the patient was placed under chloroform. On examination an abnormal growth, the size of a quart cup, was found presenting. Dr. Kirkpatrick removed this, and it proved to be a dermoid cyst. It contained a matted ball of hair the size of a hen's egg, as well as a hair rope eight inches long, well twisted and very strong. There was also an elongated, ossified mass, heavy at the base, with ears about two and a half inches long on what appeared to be the forehead. The ears were somewhat round and dentated. On the back of the base of the forehead was a tooth. In the cleft below the forehead were other teeth. Olfactory hairs, similar to those of the felidæ, were found on the face. The body was covered with hair three inches long. The whole body was encysted. On its removal, a dead child, which had evidently arrived at term, was expelled. The patient claims to have had symptoms of tumor for several years. NORTH-EASTERN KANSAS DISTRICT MEDICAL SOCIETY.-This body will meet at Atchison on the first Tuesday in June, with the following programme: "The Best Method of Conducting Non-Operative Midwifery"-Joseph Haigh, M. D., of Grenada. "Progress of Medicine and Surgery during the Past Year"--Dr. G. W. England, of Valley Falls. "How to Treat Diphtheria-Dr. R. B. Taylor, of Circleville. "Sympathetic Ophthalmia"-J. E. Minney, M. D., of Topeka. "Nasal Disease" -Dr. D. P. Paddock, of Netawaka. "How shall we Treat the Diarrhoea of Teething Children?"-Dr. J. L. Love, of Whiting. "Is Specific Treatment a Humbug?"-Dr. Riggs, of Muscotah. "Report of a Case of Abscess of Frontal Sinus "-Dr. Grant Cullimore, of Atchison. CLINICAL TEACHING IN THE UNIVERSITY MEDICAL COLLEGE.The University Medical College of this city is attempting to make its course as purely clinical as possible, and has made the innovation of having a clinic held every day. The schedule for next year will be: Monday-Venereal Diseases, Prof. Geo. W. Davis. Tuesday-General Medicine, Prof. J. Brummell Jones. Wednesday-Diseases of Women, Prof. Chas. W. Adams. With the almost unlimited sources from which to draw clinical material, this ought to attract many students to the city. It is believed there is no school in America having more clinical instruction than above outlined. THE DANGER of MiscarriagE.-The query is often made: Why is a miscarriage more dangerous than a natural labor at term? Prof. Wm. Goodell, in a recent clinical lecture (Practice, Feb. 20, 1890), answers this question as follows: Because the very fact of a miscarriage implies some lesion-something abnormal; because, the placenta not being fully formed, the chorion villi are attached to the whole surface of the womb, and some portions of the membrane are liable to remain behind and cause either hæmorrhage or septicemia. Then again, the cervix is not effaced, and the small canal is liable to close up on the retained fragments. A criminal abortion is still more dangerous, because gestation is abruptly interfered with before any detachment of the membranes has taken place, and their retention is therefore far more likely to happen than in an honest miscarriage. A stung or decayed apple falls from its bough at the slightest breeze; while, to pull off a healthy green one, demands a force which often snaps the bough from which it hangs. This illustrates the difference between a natural miscarriage and a criminal abortion. In the former, the process of detachment is slow and usually complete. In the latter, the detachment is violent, incomplete and traumatic. The result is, retention of the membranes, from which come serious hæmorrhages and still more serious septic infections. Should the patient fortunately escape these, she hardly will escape an arrest of involution, and its resulting discomforts. TUBERCULOSIS CURED BY OPIUM AND WHISKY.-Dr. Thomas A. Pope, of Cameron, Texas, reports ( Medical and Surgical Reporter April 5 ) a case of phthisis where the patient was in bad condition and accidentally acquired the morphine habit, taking from four to seven grains hypodermically. After beginning the use of the morphine he commenced taking whisky--about twelve ounces a day-which he had previously been unable to take. With the establishment of the morphine habit the spread of the disease ceased. He also relates a case of a man supposed to be dying of consumption, to whom opium was given for a chronic diarrhoea; the opium habit was rapidly acquired, and for sixteen years he has had comparatively good health. He naturally asks: What arrested the disease? There is nothing in the physiological action of morphine to lead us to suppose, à priori, that it would arrest tuberculosis; but sometimes clinical experience has shown properties in drugs quite different from those which the laboratory has shown, or experiments have led us to conclude. An interesting investigation would be to ascertain what proportion of morphine habituès die of tuberculosis. TUMOR OF THE PANCREAS.-Prof. Waldo Briggs, M. D. (St. Louis Med. and Surg. Reporier), records a case of successful diagnosis and removal of tumor of the pancreas. The patient, a German woman of fortyfive, had a history of occasional spasms of the stomach, extending back one year; chronic gastritis, with constant vomiting, the food often tinged with blood, increasing emaciation, abdominal enlargement dependent. upon ascites. At this time she came under the surgeon's observation, |
