The St. Louis Graduate Nurses' Association has decided to have central registration.

An investigation of the cause of cancer and itg possible prevention and cure has been begun in the College of Physicians and Surgeons of New York, under the direction of a committee composed of Drs. Samuel W. Lambert, Wm. J. Geis, Philip H. Hiss, Jr., Francis C. Wood, Gary N. Calkins and Eugene H. Pool.

On Dec. 15th, the State Health Authorities placed a quarantine on the Illinois State School for the Deaf at Jacksonville, on account of an epidemic of scarlet fever, 110 cases were said to exist. Quarantine was also said to have been established at the Illinois Eastern Hospital for Insane as result of the discovery of several cases of diphtheria. Several patients and two nurses were said to have been stricken.

Major Percy M. Ashburn, United States Army Surgeon, stationed at Fort Banks, Mass., is expected to arrive at Jefferson Barracks some time in January to investigate the supposed spinal menengitis epidemic which prevails among the men stationed at the barracks. While a repetition of the epidemic of a few years ago is not feared, stiil it was thought best that an investigation be made in order to prevent any such recurrence. Four soldiers have been stricken within the last six weeks two of whom died. Major Ashburn is an authority on Bacteriology.

TO PREVENT BLINDNESS.

Health Commissioner Sees Relief in Old Pennsylvania Law.

State Health Commissioner Dixon hopes to prevent fully one-third the number of cases of blindness occuring in Pennsylvania. He declares this can be done if an old law and the suggestions the State Department of Health have made are carefully carried out. A recent report from the Pennsylvania School for the Blind says in the last eight years more than one-third of the persons admitted to that institution have owed their affliction to ophthalmia neonatorum, that is, an affection of the eyes which occurs at the birth of the infant.

The law provides "that should one or both eyes of an infant become inflamed, swollen or reddened at any time within two weeks after birth it shall be the duty of the nurse or other person having the care of such infant to report in writing, within six hours after the discovery thereof, to the health officer or legally qualified practitioner of the city, town or district in which the mother of the child resides, the fact that such inflammation, swelling or redness exists."

Rat Virus Starts Epidemic in Business House.

Twelve employees in a London establishment became suddenly and severely ill, in a manner that pointed to infection. An investigation by the bacteriologist, Dr. Klein, revealed the fact that they were infected by a virus that had been spread for the destruction of mice. All the victims ate in one dining-room, where, on removing boards, numbers of decomposing mice were found. It is possible that after traveling over the virus these creatures may have infected some of the food afterward eatcn by these people. The virus, which was fatal to the mice, only produced severe illness in the men.

Cause of Heat-Stroke.

Dr. Harvey Sutton, of Oxford, has made some observations on himself confirming the view that the essential cause of heat-stroke is a combination of high temperature and great humidity. When the wet bulb temperature reaches ninety-five degrees, the heat-reguating mechanism fails, and the temperature begins to rise. As evaporation fails, oxidation increases; and once this process has begun, it gradually accelerates, the temperature rising faster and faster. The most important procedure in the treatment of heat-stroke is the reduction of body temperature.

Sensational Charges Made Against Runnels Physician in An Effort to Revoke License. Charged with drunkenness, general immorality and incomptency, Dr. J. W. Kern of Runnells has been cited to appear before the State Board of Health Jan. 20 and show cause why his certificate to practice should not be immediately revoked. The charges are filed by the state medical examiners as a result of complaints made by the Iowa Humane Society and prominent Runnells citizens. In other counties of the state the "doctor" has twice been found guilty of boot-legging.

The Delgado Memorial.

The Delgado Memorial building of the Charity Hospital, New Orleans was formally dedicated Dec. 19th; many distinguished physicians and surgeons taking part.

This magnificent structure is said to be one of

the best arranged, most perfectly equipped and completely furnished hospitals south of the Potomac River.

D:. Ernest S. Lewis, President of Beard of Administrators of the Charity Hospital, presided over the ceremonies and introduced the speakers, in addition to delivering one of the leading and most brilliant addresses of the day. Mayor Behrman paid an eloquent tribute to the munificence of Mr. Delgado. Dr. L. G. Lebeuf delivered an add.ess and Dr. Rudolph Matas read an eulogy on the life of Mr. and Mrs. Delgado, after which he delivered an address in which he commented on the blessings conferred on humanity by the legacy of the rich. At the conclusion of Dr. Matas' address, Dr. Beverley Warner pronounced the benediction.

The Delgado Memorial is erected to the memory of Samuel and Virginia Delgado by their nephew Isaac Delgado for the relief of the suffering poor of both sexes. The cost of the building is approximately $150,000, while the furnishings, surgical appliances and outlay is about $50,000.

Max Joseph von Herzog, "world's prophet," etc., who has "read the hands of kings," etc., was fined $200 by Judge Wilson A. Taylor in the Court of Criminal Correction in St. Louis on a charge of practicing medicine without a license, although Von Herzog's attorney emphatically denied he practiced medicine, and declared there are other ways of treating diseases than by the use of medicine.

Von Herzog's only defense to the charge was the introduction of a circular which he used for advertising purposes, in which it is set forth that "Medicine is a business of frauds," and the filing of a demurrer to the State's evidence on the ground that it was not shown he represented himself to be a physician. He did not take the witness stand.

The Second International Leprosy Conference. The Secretary-General, Dr. H. P. Lie, announces from Bergen, Norway, that the Second Leprosy Conference will convene at Bergen on Monday, the 16th of August, 1909, and will continue until Thursday, the 19th. The preliminary program has announced gubjects as follows: The Conside:ation of the Geographic Extension of Leprosy; The Forms and Diagnosis of Leprosy; The Causes and Manner of Propagation of Leprosy; The Pathologic Anatomy of Leprosy and the Treatment of Leprosy.

The conference is to be held under the auspices of the Norwegian Government and His Majesty, Haakon VII, and under the Presidency of Dr. G. Armauer Hansen, Physician-in-Chief for the Disease of Leprosy in Norway. Professor C. Boeck, of the University of Christiana, is the Vice-President of the organization, and the membership includes a distinguished group of Norwegian physicians.

Further announcements with regard to the conference will be made from time to time. All interested are urged to address the Secretary-General, Dr. H. P. Lie, at Bergen, Norway.

City Hospital Alumni Dinner.

The annual dinner of the Medical Society of the City Hospital Alumni was held, January 7th, 1909, at eight o'clock at Faust's Cabin. Talks were made by Dr. W. E. Sauer, the retiring president; Dr. Walter aumgarten, the present incumbent; Dr. L. M. Warfield, who spoke of the Society as viewed by an

outsider; Dr. Francis Rader, who kept the entire audience in a constant uproar by his humorous reminiscences of the hospital corps of twenty-five years ago. The class of 1899 was there in force and made their presence felt by numerous songs in chorus, original and otherwise; Dr. Emmett Kane acted as spokesman. A short address was also delivered by Dr. Albert Taussig of the corps of 1895; and Dr. Coughlin gave an amusing and interesting account of his recent trip abroad. Altogether it was a most delightful affair, and probably the most successful in the history of the society. One hundred and ten members and guests were present.

Registration of Nurses.

Within the past few days another Irish grievance has come into being, the agg.ieved parties being the Irish nurses. For many years past the trained nurses of England, Ireland and Scotland have been agitating for a system of state registration. During the last session of parliament a bill drawn up by the nursing organizations was int oduced into the house of lords, and has passed that house, but with the extraordinary amendment added that Ireland should be excluded from its provisions. The amendment was added at the instance of the government, and the Irish nurses, who are clamoring like their English siste.s for registration, want to know the reason why. No one can tell them, though there are rumors that the religious orders, in whose hands is much of the nursing in Ireland, are opposed to the principle of registration, The net result is that the bill is likely to be wrecked, and many medical men will not be sorry, since they regard a state-registered nurse as a probable rival in practice.

Dr. Knopf Vindicated.

Dr. S. Adolphus Knopf, of New York has compromised his case against The North American, a daily newspaper of Philadelphia. The following is taken from an article in The North American on November 9th., which is self-explanatory:

Dr. Knopf is the man who was so sadly misquoted in a dispatch from Washington to The North American during the meeting of the National Association for the Study and Prevention of Tuberculosis, held in 1907. At the sessions of May 7, the matter of the use of morphine was discussed by eminent physicians on both sides and Dr. Knopf in an able address stated his views with much force and impressiveness.

In the report of his address sent to The North American and published next day. he was erroneously credited with saying that where the patient was dying with tuberculosis, the physicians should administer morphine in large doses, so “that the end would come painlessly and quickly." The reFort added that these remarks led to the meeting breaking up in confusion.

This report did Dr. Knopf great injustice. The alleged confusion following the doctor's remarks had its existence only in the imagination of the repo:ter, and the authorized version of the speech as the same appears in the official report of the proceedings of the Association, shows that he did not advise that morphine should be administered in quantities so large as to hasten death, but only for the purpose of relieving rain, which is the gencral practice of physicians.

The following extract from the authentic report shows what the doctor's position on the subject is, and is the accurate report of his expressed views when he addressed his professional brethren at the Washington meeting:

"When we are in the presence of a dying consumptive, who is suffering, I believe it is our sac.ed duty to give him morphine to relieve his pains and make him comfortable and let him die easy."

Dr. Knopf's standing and the widespread interest of his work is shown by the recent publication of the fifth English edition in book form of his $1000 prize essay. Besides, it has been printed in twentyone other languages, including all the European tongues and A:abic, Chinese and Japanese.

International Medical Congress at Budapest. Arrangements have been perfected for the American party to attend the International Medical Congress at Budapest, next August. The ar: angements for transportation are in the hands of Thomas Cook & Son. Rooms have been reserved at the best hotels in Budapest, but it will be necessary for the committee to know approximately the number who will attend at an early date in order that the reservations may be augmented, if necessary. A very low round trip will be announced, including all expenses. Inquiries in regard to the trip to the Congress, with program and itinerary will be sent to those interested. All communications in regard to membership or scientific program should be addressed to Dr. J. H. Musser, chairman of the Ame.ican Committee, Philadelphia. Communications in regard to transportation and hotel accommodations should be addressed to Dr. Chas. Wood Fassett, St. Joseph, Mo.

Wednesday, Dec. 16. VII-Exophthalmic Goitre (Concluded): Complica tions; varieties; prognosis; diagnosis; treatment. Athyreosis and Hypothyreosis: (Cretinism and myxedema): Historical, endemic; etiology; patholcgy and pathologic anatomy; clinical features; treatment.

Wednesday, Jan. 6.

VIII-Sporadic Cretinism: Etiology; clinical features; prognosis; diagnosis; treatment. Myxedema: Etiology; pathologic anatomy; symp toms; varieties; diagnosis; course and prognosis; treatment.

Wednesday, Jan. 13.

IX-The Pituitary Body: Physiology; pathologic anatomy.

Acromegaly: Historical; etiology; morbid anatomy; clinical featu: es; prognosis, diagnosis; treatment.

Progeria.

Wednesday, Jan. 20.

X-Osteomalacia: Historical; etiology; morbid anatomy; clinical course; diagnosis; prophylaxis; treatment.

Panorama of the

Medical Sciences

SURGERY.

Under the Charge of

W. E. LEIGHTON, M. D.

PANORAMA.

The interest in surgery of the thorax has been stimulated in recent years by the experimental works of Sauerbruch and Brauer.

Successful operations in the pleural cavity would seem to demand the avoidance of pulmonary collapse. To insure this we must keep air out of the pleural space or else artificially inflate the lung: To Sauerbruch we are indebted for the negative pressure apparatus or pneu matic cabinet, which aims to keep air out of the pleural space, or at least to diminish the at mospheric pressure. To Brauer we are indebted for the positive pressure apparatus which aims to overcome the atmospheric pressure by raising the intra-pulmonary pressure and artificially dilating the lung.

While a few operators claim that no apparatus is necessary and fear of pulmonary collapse is overrated in thoracic operations, and that the apparatus is prohibitive on account of expense, still we cannot but feel that some effort should be made to imitate the natural order of things and everything done to prevent collapse. We should welcome any apparatus which will overcome this objection and the following ar ticle will explain a simple method of preventing pulmonary collapse. It offers a field for some interesting experiments.

An Apparatus to Prevent Pulmonary Collapse on Opening the Thorax.

Dr. M. Katzenstein (Centralblatt fur Chirurgie, Nov. 21, 1908).

For the surgeon who can not afford to buy the expensive apparatus for the operation of opening the thorax, he offers the following improvised apparatus which he has tried on the dead and once on the living. The often used physiologic principle of the lung to collapse on account of the elasticity after opening the thorax is employed. It seemed necessary to construct an artificial expansion of the lung for which purpose the bellows is employed for the artificial breathing. The getting of the inspired air into the lung can be accomplished either through a tracheotomy wound or by intubation.

The apparatus consists of a tracheal canula attached to a bellows. At right angle to this tube by means of a T piece connecting with a funnel. Ether or chloroform can be administered. By means of the bellows pulmonary collapse is prevented.

Cancer of the Mouth and Tongue.

Dr. J. Collins Warren (Annals of Surgery, Oct., 1908.)

The conclusion which we may derive from a review of the literature and an analysis of these statistics of cancer of the mouth and tongue are as follows:

1. The relation of the lymphatic system to the primary growth is the most important anatomical consideration in operations for cancer of the mouth and tongue.

2. Chronic inflammatory processes of the mucous membrane which do not yield promptly to local treatment are of importance as predisposing to precancerous conditions, and should be treated gically.

sur

3. Cancer of the mouth and tongue is a local dis ease limited to the tissues immediately surrounding its point of origin, and to the adjacent lymphatic system. Internal metastases are rare.

4. Microscopical examination of the primary growth should be made the crucial test of diagnosis in doubtful cases and should be done preferably at the time of the operation.

5. Antisyphilitic treatment is not a sure guide, and should not cause delay in surgical interference. 6. The ideal operation of the future should contemplate a free exposure of the mouth and anterior cervical triangles, as one continuous area, with a block dissection of its diseased contents.

7. The mortality varies with the extent of the operation.

8. In a series of 112 cases of cancer of the mouth and tongue from the Mass. General Hospital, operation resulted in 16 cases free from recurrence over three years after operation.

9. Of 57 cases of the tongue, 17.5 per cent were cured by operation.

10. Local recurrence of the disease occurred more frequently than recurrence in the lymphatic glands alone. In only one case did recurrence take place after a period of three years after operation.

Surgical Catgut-The Argyrol Method.

Macclure (Annals of Surgery, Nov., 1908.) The catgut is cut into strands eighteen inches long, and then placed in a basin of sterile water to soften and make easy to handle. The gut is then made into coils and wound on glass tubing and placed in a 10 per cent argyrol solution made up with distilled water, for 10 days. At the end of 10

days the argyrol is poured off and the catgut washed with sterile water until all the argyrol has been washed out. The gut is then stored in alcohol. Examination of strands of this gut have been shown to be sterile.

Ethyl Chloride as a General Anaesthetic. W. E. Lee (Annals of Surgery), Nov., 1908.) An agent which may in 15 to 20 seconds produce deep anaesthesia and whose danger signs are 80 easily passed, cannot be used with impunity, and a few of the reported fatalities certainly demonstrate its dangers in inexperienced hands. Another objection to its use is the muscular spasm and rigidity which occurs.

Its advantages on the other hand are very tempting. For the patient there is no irritation of the respiratory tract with its usual coughing, increased secretions, gagging and vomiting. The rapid onset of unconsciousness is not to be overlooked, and most important, the usual amount of ether necessary for the introduction of anaesthesia to the third stage is eliminated; and as this averages four ounces with the open drop method the excretory organs are saved a considerable task. In our experience it certainly lessens the occurrence of post-operative vomiting.

For the anaesthetist the ease and rapidity of induction with complete eleminiation of the preliminary stages of ether and chloroform speaks for itself.

Lumbar Appendectomy.

C. G. Levison, San Francisco (Journal A. M. A., Nov. 28th), reports two cases in which the appendix occupied a retrocolic position and was operated on by the lumbar route. He says the rule to be observed in surgery of the appendix is to make the incision correspond to the localization, and McBur ney's point must sometimes be ignored to a certain extent. When the exudate is situated in the loin, the diagnosis of a retroceal appendix should be made, excluding as far as possible paranephritic abscess and gall-bladder disease. If low down, the differentiation from pelvic disease should be made. Naturally, the classic form should be first thought of. He finds this subject almost completely overlooked in the literature. It is his conviction that in cases in which the appendix can not be found at operation, it is situated in the retrocecal space. This has been his experience in several cases, and he believed that other surgeons must have had the same fortune.

The Peripheral Vessels in Shock.

M. G. Seelig and E. P. Lyon, St. Louis (Journal A. M. A.. Jan. 2), after reviewing the various theories of shock, give an account of experiments under taken by themselves to determine whether the peri pheral vessels are contracted or dilated during the time the pressure is low in the larger more centrally located vessels, such as the carotids They studied visually the retinal vessels and measured the cutflow of the temporal vein. They found that the proproportional rate of flow from the vein during shock was more rapid after division of the sciatic; thus showing that the section of the nerve caused vasodilation of the vessels of the leg, just as it does in an unshocked animal. This dilatation, however, is proportionately greater than it is in a normal animal, and the difference must be accounted for assuming that in the shocked animal before division of the sciatic, which contains the chief vasomotor nerves of the leg, the vessels are more contracted than they are in the normal animal. That is to say that the shock,

with the vasomotor impulses unimpaired, the peripheral vessels are more contracted than normally. In the retina, where the uninjured vessels are open to inspection, the indications were the same. The ophthalmic examinations were made from the fundi of the dog's eyes, before and after shock, and to note carefully the size of the vessels. In every instance he reported that the vessel showed a marked degree of contraction after the animal was in shock, contracting down to one-third to one-half their size before shock. The authors do not claim to offer any explanation of the causes of the shock, but simply to demonstrate that the peripheral vessels are contracted, which necessarily implies that the shock can be due to exhaustion of the vasomotor centers. If their results are confirmed, then the doctrine that shock is due to vascmotor exhaustion must be revised.

Symptomatic Abscess of Cancer of the Large Intestine.

M. C. Therenet (Gazette des Hospitaux, Nov., 1908.) We have in view in this study, abscess following the onset of cancer of the large intestine when it is only manifested by vague troubles, nor permits of confirming diagnosis of tumor. He leaves aside general peritonitis due to intestinal perforation since limited inflammatory processes do not convince us. Bernutz, in 1850, in a paper published in the Archives de Medicine, is the first author who reconized the diagnostic value of these abscesses. Wedrychowski (Thesis de Paris, 1857) showed intes. tinal tumors to be a cause of abscess of the abdominal wall. Thiery in 1859 reported to the Anatomical Society two observations of phlegmon of the abdomen following upon a cancer of the intestine. The first complete work upon this question is the thesis of Opin, inspired by Gangolphe. Opin collected eleven observations of cancer of the large intestine followed by abscess. Since these observations, many others have appeared, especially following the article of Tuffiere.

Literary Notes

"Backbone."

"The man with a spine like a banana" says Dr. Geo. F. Butler in the booklet just published called "Backbone," "is invariably pushed aside in the race of life by the man with backbone and a determined will." The little book has many cheerful and encouraging hints written by men well known in the world of thought and action. There are a collection of sentiments which might be a stimulant to any one in these days, including the man with a spine of steel, for even steel has been known to contract.

A Doctor On Christian Science.

A new book by the author of that delightful volume, "Confessio Medici," will receive a warm welcome, particularly when it is known that this most genial and human of physicians is to deal with a subject of very present interest. The title of the new book is "Faith and Works of Christian Science," and the various chapters will deal with such subjects as The Reality of Nature. Disease and Pain, Common Sense and Christian Science, and Authority and Christian Science. A feature of the book will be a critical examination of two hundred cases reported as cured by Christian Scientists.

Ingersoll's Bock Liked in England.

Ernest Ingersoll's excellent book, "The Life of Animals," has received high praise from the English critics, who are usually none too ready to bestow their approval on the works of American authors. The publishers say that among the many long reviews published in En land, not one has been other than laudatory. The distinguished naturalist, J. E. Harting, editor of the natural history department of The Field and of The Zoologist, wrote: "It is satisfactory to know that 'The Life of Animals' has been so well received. I have often turned to it for information, and keep it among my books of refThe bibliography is very useful."

erence.

A Readable History of Canada. Frank Basil Tracy's "History of Canada," which was opportunely published just after the ter-centennial celebration in Quebec, has been long in preparation and is evidently a work of more than passing interest. One of the most distinguished scholars and writers of Canada, a professor in McGill University, writes of it: "It is the only history of Canada I have ever been able to read. I venture the prediction that it will become a standard text-book in the Canadian schools. I think it is nearly flawless."

A Book on School Administration.

In a book entitled "The Administration of Public Education in the United States," just published by the Macmillan Company, the authors, Professors Samuel T. Dutton and David Snedden, have performed a noteworthy service to the cause of educa tion. The evolution of public education in this country has been a significant feature in our national life. While the various movements which have led to the present expenditure for plant and service have been measurably slow, they have also been constant and there is no evidence that progress is likely soon to cease. While the several States have been develoning systems of schools reaching often from the kindergarten to the free university, considerable