of pills and powders, but as a teacher and trainer of the young in everything that makes a stronger, healthier and more perfect manhood and womanhood. Every Ichild when it enters school should be subjected to the most thorough and searching physical examination by the examining physician, who should be one who, by special training and large experience in this particular field, is fully qualified to detect any and all imperfections in either the structure or function of all parts of the body. He should be provided with all the necessary scientific appliances for making such examinations, and with the apparatus necessary to correct the deficiencies when found.

I boldly assert that there is not a single child who has attended the public schools three years or more who has not some physical defect which could be easily remedied, or some local or general weakness which could be strengthened, and all could be greatly improved in health, strength and activity of body and mind by pursuing such a course as I have faintly outlined. Not only this, but their mental accomplishments in a given time would far transcend what they are at present.

If the Hundred Year Club can succeed in accomplishing this one object, and I believe it can do it in time, it will have proved the warrant of its existence a thousand times over.

CREMATION A DUTY.

ON this important topic Dr. Blackwood thus discourses in the Medical Summary: Probably no subject of vast interest to the community at large is so misunderstood ast that of cremation. Most people imagine that the body is burned to ashes; whereas, the fact is that no flame at any time touches the subject. It is actually dried with more or less rapidity to an impalpable powder, consisting of the lime and other solid constituents of the bones. If a body is buried in the earth, in the course of time it is re

duced through the decay of the tissues to precisely the same matter as is the case in cremation, but the process is free from the terrible conditions seen in the ordinary method of reduction through earth burial. Few persons know about the horrible aspect of a body shortly after it is deposited in the grave under the ordinary surroundings. They do not know that it becomes a slimy mass of awful putrefaction. They are not aware that the coffin contains a mass of liquefying tissue penetrated by moles, worms, snails, rats and other cotenants of the tomb.

I will not soon forget the dreadful agony which a friend of mine experienced when, against my strongest protest, he peered into the coffin of his wife which had been held in a vault for some three weeks until a lot was procured in which to inter the remains. The face was a mass of green mould, the garments were soaking in a slimy putrescence, sickening to the senses; the aspect was that of the most horrible character imaginable, and until his own death he never forgot the sight.

Cremation diverts all these horrors; it produces in an hour or two what takes years to do in the earth; it renders the trade of the dreaded resurrectionist an impossibility, and this in itself is something much more to be thought about than most persons have any appreciation of. The common belief is that medical schools are provided with dissection subjects to any needed extent by almshouses and morgues. This is, of course, nonsense. Any high-grade school in such a city as Philadelphia requires many more. subjects in a single winter than the entire supply can be in its vicinity during the whole year, yet we have half a dozen dissecting rooms here to be attended to, to say nothing about the material demanded for experimental institutions.

It is not the province of a medical journal to "give away" anything about the anatomical business, but in my student days there used to be lots of marble piled about graves wherein I knew that a vacancy existed of the most important part alluded to by proud

1eferences to the defunct one in the way of mortuary eulogy. This is supposed to have been done away with for some years past by the regulations of anatomical boards, but demand for material demands supply, and supply is attended to as a business, and nothing is asked about where the supply comes from.

Cremation abolishes all chance of stealing in this direction. It therefore does for the friends of the dead what cannot be done in any other way, and this alone should make the process one of much greater thought than is yet given to it. Then, again, cremation is a duty to the community at large, because earth burial is a prolific cause of contamination of springs whose water eventually reaches many of our river supplies for city use, not only for washing demands, but for drinking by both well and sick.

Few persons have ever counted up the deluge of rainwater which has reached the Schuylkill River from Laurel Hill Cemetery after percolating the thousands of graves for nearly a hundred years. I know that it is the belief of many writers that the water is purified by its journey before it finally debouches into the stream. They say that the water is perfectly pure and free from any defilement. Well, maybe they believe this, but I don't. Others say that the trend of the underlying rocks is away from the river, but those who know the rudiments of geology understand that the 10ck-strata always incline toward the valleys, and rivers usually run in the valleys and not upon the ridges of the surrounding hills. Water, of course, is cleansed of much

when public safety demands that they be closed to further interments. London furnishes several examples of the truth of this point, for in some of the burial grounds the level of the surface is now far above the city datum. In some instances mounds are ten feet higher than streets.

After showing the process to many patients and to my own family, all of them became earnest advocates of the method, and many of my friends have already thus disposed of the remains of deceased members of their families. The crematory at Walnut Lane in this city shows the beautiful efficacy of cremation as compared with the too-long permitted method, and the gentlemen connected with the buildings and cemetery there are anxious and willing to exhibit to all comers or inquirers the simple yet efficient plan involved in the process.

This paper is written not for physicians for all educated members of our guild know the truth of what I say-but my object is to enlist the attention of the laity, many of whom read the Summary regularly, to this modern and all-important subject, which involves the health and safety of those who live in the vicinity of large cities, although the matter of cremation is equally important to residents of the country or the farm. The plan of earth burial is horrible as compared with the elegance and efficient method of cremation, and time is only needed to render this sanitary improvement a custom universal in its application.

as well do without the mortuary contamination to begin with. A third point is the growing difficulty in obtaining ground for cemetery purposes at a convenient distance from large cities and at a cost which will permit the sale of lots at a figure low enough to enable persons to buy them for family use. This has come to be a matter of much comment, for near our large cities the cemeteries are crowded already, and it cannot be long before they will be filled to the extent

DISEASE.

J. MÜLLER (Münchener med. Wochenschrift, 1900) has re-examined this subject. Considering the regularity with which the tongue is inspected, it is not a little remarkable that so little positive knowledge is entertained. Müller reminds us that the coating, of variable thickness, on the middle of the dorsum of the tongues of most people in middle life is made up of

the filiform papillæ. It is, therefore, a fur rather than a deposit, as is so often imagined. The longer the papillæ, and the thicker the epithelium, the less does the red color of the tongue show, and the whiter or yellower is the surface. At times the papillæ reach excessive size, the epithelium is horny, and contains dark pigment, hence the name "black hair-tongue." As the epithelium becomes loosened and infiltrated by bacterial growth, the cloudy, yellowishgray appearance is exaggerated, and may be further altered by ingesta, such as berries, chocolate, red wine, etc. Milk causes

a white appearance by reason of the fat globules. The desquamation of cells and the accumulation of food remnants, mucus, leucocytes and bacteria cause a coat that can be removed by brushing or scraping. In health this sort of coat never becomes excessive because it is removed in the taking of food, but in the morning is apparent on account of the resting of the tongue over night. The author recommends for obtaining an idea of the activity of epithelial growth in the mouth the examination of sediment obtained by chewing bits of sponge and squeezing out the fluid (bits of rubber tubing are more convenient). In the morning the sediment may equal onefifth the column of fluid. There is a marked difference in the growth of the papillæ at different periods of life, with great individual differences at all ages. In old age the atrophy of the papillæ gives the tongue a glistening appearance, as if varnished. The author thinks there is a parallel between the development of the papillæ and of other epidermoid tissues, as of the skin. He denies a relation between coated tongue and local diseases of the mouth and throat, except when the former are so severe as to interfere with swallowing. As regards disease, he found a coated tongue by far most frequently in cases of acute disease, whether primarily affecting the digestive tract or not. It is less frequent in chronic digestive diseases, and in chronic gastritis does not occur to so great a degree as in healthy people in middle life. The micro

scopical examination of the coating shows usually a more rich and diverse material than in health, but in general no essential differences exist. The leucocytes appear to be numerous in cancer of the stomach and tuberculosis. The claim of Bernabei, that specific bacteria can be cultivated in certain diseases from the coating on the tongue, the author thinks worth further investigation. The disappearance of a coating of acute origin is a good sign, because it indicates, usually, that food is properly taken. In chronic diseases the disappearances may have another meaning. The best way of keeping down the coating is by chewing hard food, especially bread. For abnormal coating the use of a soft toothbrush is best.

MOSQUITOES AND MALARIA.

B. F. GAMBER, M.D., F.R.M.S., in the St. Louis Medical Era,

WITHIN the last few years we have learned to know a very common ailment to be a blood disease. It is malaria. We now know exactly what causes the disease, and no scientific physician will to-day venture to affirm or deny that a doubtful case presenting the symptoms of malaria is of that nature without a microscopic examination of the blood for the purpose of finding malaria parasites.

We not only know that malaria is due to the parasite in the blood, but we also know how they get there, thanks to the investigations of an English physician named Man

son.

Manson and Ross showed that it was through the bite of the mosquito that malaria is contracted, and that instead of arising from a mysterious miasma it has a very tangible and evident cause in the little pest with which we are all familiar.

However unpleasant each of the two hundred or more different species of mosquito with which we are familiar may be to us, only one form has thus far been found to

be the offender that brings us malaria in its sting. Wherever malaria is found this species has likewise been discovered. The malaria mosquito has a basso voice; whereas the ordinary one sings tenor. As was well put by Dr. Stiles, of the United States Agricultural Department, "the villain of the play has a bass voice."

Ross has found that when the mosquito has bitten an individual in whose blood the germ is present, the latter develops in the body of the insect, giving rise to innumerable minute needle-shaped spores or eggs that pass into its poison sac, to be injected into the unfortunate individual it stings. These spores then develop in the blood to full-fledged plasmodia and the malaria is communicated. The eggs can develop in the body of the mosquito only when the surrounding air has a high temperature, and die when it becomes cold. This is the reason why malaria is never contracted during the winter months.

During the daytime the mosquito remains concealed in crevices and corners, but when the sun sets it merrily wanders forth, armed with its sting and loaded with its malarial poison.

During the last season scientists have conducted a series of self-sacrificing experiments to prove the correctness of this doctrine.

Upon the Roman Campagna, in the most deadly malarial region of Italy, a number of investigators have lived for several months in a hut specially constructed with wire netting, so that no mosquito could enter. They have inhaled the same air and have drunk the same water as those around them who have contracted the disease, and yet every one of them has escaped the contagion, merely because he could not be bitten by the mosquitoes. But a stronger proof even than that afforded by the negative evidence thus obtained was given by the son of the celebrated Dr. Manson. A number of mosquitoes were permitted to bite malarial patients in Rome. These malarial-laden

insects were carried to London and there were caused to bite Dr. Manson the younger,

who had never had the disease. In six days chills and fever developed and the plasmodium was found in his blood.

The method of eradicating malaria from any region, then, is a very simple matter. It consists of accomplishing two very easy tasks. First, curing every case with the proper dose of medicine, and, secondly, of exterminating the mosquito by draining the pools and by covering those that cannot be so treated by coal oil and preventing the growth of the wigglers. Surely, when we remember the loss of life and health that is entailed by the plasmodium, the efforts seem well worth the trouble.

The regularity with which this parasite is found by all practiced observers leaves no doubt that they are to be found in every case of malaria.

In certain forms of this disease in which these parasites retire to the internal organs, the most marked evidence of the disease may be found in pigmented débris and the characteristic loss of hemoglobin. Its percentage of loss is sometimes equivalent to one-half of the original amount, in fortyeight hours. The loss is so great that its restitution is an absolute necessity in order that life may continue. To bring about this result we have found nothing better than pepto-mangan ("Gude"), which in a number of cases has served us perfectly. By the administration of this remedy we have prevented the occurrence of the characteristic cachexia which so often develops in persons living in malarial districts. This remedy we have found to be all that is necessary.

MALARIA AND ITS PREVENTION.*

SINCE the work of Laveran (1880) proved malaria to be a fever caused by the invasion of the blood by, minute animal organisms, steady progress has been made in the work of probing and elucidating the etiology and pathology of this dreadful scourge. English, Italian, and German workers have comReproduced from the Scientific American.

peted with each other in their attempts to limit this dread disease, if not exterminate it, and of their work an immense bibliography remains as a monument to-day.

We have already published a considerable number of papers upon malaria and its prevention, and upon the anopheles, but a few brief notes relative to some investigations which have recently been carried on may prove of interest. The prime cause of malaria being known, its method of invasion having been satisfactorily demonstrated, and the official seal of scientific approval of these facts having been obtained in Lord Lister's recent address to the Royal Society, it remains now to apply our knowledge in a practical way so as to evolve some method or methods of prophylaxis and thereby crown a piece of scientific work as farreaching in its power to benefit the whole human race as any of those brilliant discoveries which have made the Victorian age conspicuous above all others. Some of the members of the various expeditions have advocated the wholesale destruction of mosquitoes by surface drainage and by the treatment of their breeding puddles with substances fatal to their development. Others have suggested a careful and more extensive use of mosquito-proof curtains and blinds, while one distinguished authority holds that the continuous administration of quinine is likely to give the best results. The efficiency of surface drainage appears to have been known as far back as 500 B.C., and it is doubtless one of the surest methods of exterminating the mosquito, but in districts unsuitable for any cause, the application of larvicidal substances (petroleum, tar, lime, etc.) has been suggested; but so far as experiments go the effect of such application has proved too transient to be of much value. The general point is to avoid being bitten by infected mosquitoes by night, and also by day, for, notwithstanding statements to the contrary, Mr. R. Fielding-Ould says in Nature that he has repeatedly noticed anopheles gorging themselves in full daylight, though no doubt their habits are chiefly nocturnal. For this purpose the con

stant use of mosquito curtains of a prepared. kind is essential, but only too frequently one finds in the tropics curtains of an utterly useless kind. Either they are torn, or the mesh is too large, or by their arrangement the free ingress of mosquitoes is possible. They are best fixed on four posts on the four corners of the bed, and as the netting descends around the bed, it should be tucked in under the mattress. The inclosed space should be of sufficient size to allow a certain freedom of movement during sleep so that the danger of coming in contact with the netting is impossible. Celli recommends that windows should be protected by wire netting and meshes which measure only from one to one and a half millimeters (onesixteenth inch) square, and that all doors opening exteriorly should be protected by a cage of similar netting, so as to oppose two screens to the ingress of the mosquitoes. He further suggests that to facilitate the capture of any stray mosquitoes, all walls should be bare and painted white, and trees should not be allowed to grow near dwellings, as they afford a retreat in which mosquitoes may hide. Experiments carried out on the Roman Campagna have proved that these and similar devices have been sufficient to protect inhabitants from fever for considerable periods, but it is to be feared that unless unceasing vigilance be exercised all such precautions may prove ineffective, and one mistake may render them entirely abortive.

A MAN was severely injured by being dragged for a considerable distance by a trolley car. On making an examination, the ambulance surgeon of Bellevue Hospital expressed the opinion that because the pupil of the right eye was somewhat more dilated. than that of the left, there was concussion of the brain present. "O, doctor," said the patient, "you needn't mind the appearance of that eye. It's a glass one."

。