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a patient at the New York Hospital who developed symptoms of gangrene in both feet, which progressed so rapidly that both legs had to be amputated below the knees. The case was pronounced by Dr. Joseph Collins to be one of advanced Raynaud's disease. The patient's mental condition was one of partial dementia, and he was unable to give his name or age, and no history could be obtained other than that he had been out all night and frozen his hands and feet. It was supposed that the mental stupor was due to vasomotor disturbance of the brain similar to that which in lower extremities produced gangrene.

In this connection the case of Dr. C. E. Riggs is of interest,15 for it is stated that Raynaud's disease represents a neurosis which is not perfectly clear, but has its foundation in the central nervous system. The patient was sixty-four years of age, one hundred and ninety-five pounds in weight, and for two years before the doctor saw her she had suffered from attacks of numbness of her fingers of half an hour's duration at a time. She was apparently well, when going up-stairs she was suddenly seized with numbness of the left hand and forearm, with loss of perception of heat and cold, and also complete paralysis of motion and sensation of the same. The hand was as white as marble. Next morning the finger-tips began to turn dark. Three days later she died. There were cardiac and renal complications. Unfortunately, the state of the pulse was not mentioned. The radial artery of the left arm was not atheromatous, and no thrombosis was discovered. Examination of the median nerve showed a simple parenchymatous degeneration; and of the spinal cord, from the fifth cervical to the sixth dorsal vertebræ, the posterior median columns showed degeneration and numerous capillary hemorrhages.

As to diagnosis, some authors regard Raynaud's disease in a wide sense, and consider as belonging thereto all affections whose essential symptom complex shows vasomotor and trophic disturbance with

out regard to their origin; while others limit the picture of this affection much more sharply, and recognize the above-mentioned symptoms as Raynaud's disease only when they are without doubt caused by nervous disturbance and, in the absence of other causes, especially organic disease of the heart and blood-vessels.

Some writers suppose that erythromelalgia, or red neuralgia, is but the appearance of the second stage of Raynaud's disease without the first. A little reflection might convince one that, if there be any relationship between them, they must be different members of the same family; for erythromelalgia usually occurs in women and does not show its peculiar change of color until the limb hangs down, when the arteries throb and the pain grows worse; it is aggravated by heat and eased by cold; it is asymmetrical, and never becomes gangrenousthe opposite of what usually occurs in Raynaud's disease.

It would be quite as much to the purpose and equally wide of the mark to attempt to prove the identity of migraine and Raynaud's disease. Of two dozen articles which I have consulted on the latter, it seems to me somewhat remarkable that no one has pointed out the similarity between these two maladies, both of which present angioneurotic phenomena much alike in the first two stages-vasomotor constriction followed by dilatation, and often affecting vision apparently in the same way. Rosenthal narrates the case of a hysterical girl in whom the migraine began with a sensation of cold in the fingers and toes of both sides. In a little while the face became pale. After the paroxysm the hands became warm and perspired freely, and the cheeks reddened.

Both Raynaud's disease and migraine are favorably influenced by massage.

Enough has been said about treatment in the preceding pages. It can be speedily summarized. When the local syncope and local asphyxia are slight and transient they require no treatment other than the avoidance of exposure to cold and excessive

fatigue. Appropriate food and internal remedies, with plenty of fresh air for the anæmic and diabetic. Our very utmost endeavors should be used to improve the circulation, so that gangrene may not develop; and for this purpose Dr. Adolf Havas, in his article on this subject already referred to, says that massage and remedial movements often act in most excellent manner, preserving the patient from future danger. Such would certainly seem to have been the result in the first case reported in this chapter.

From the foregoing a few conclusions may be justifiable :

1. That when massage is of benefit in Raynaud's disease it shows its effects very quickly.

2. These effects are improvement of the circulation, warmth, comfort, and supple

ness.

3. The vitality of the tissues cannot only be maintained and improved by means of massage, but even when destruction has begun it may be entirely recovered from.

4. As the beneficial effects of massage in Raynaud's disease are of a permanent character, it must, therefore, act not only upon the vasomotor nerves of the affected parts, but also upon their central connections in the brain and spinal cord.

5. As the symptoms of Raynaud's disease would seem to be capable of affecting suddenly or gradually the vessels of almost every part of the human body, the most varied disturbances might thus find an explanation, whether they be sudden attacks of insanity, loss of consciousness, or asphyxia-hemoglobinuria, colicky pains, or dead fingers, etc.

'Boston Medical and Surgical Journal, January 16, 1879.

"Wien. med. Wochenschrift, No. 5, 1898.

Osler, in Pepper's Text-Book of Theory and Practice, refers to a case of Raynaud's disease that behaved in a similar manner to this.

'International Clinics, vol. iii., 1895.
International Clinics, vol. ii., 1899.
"Zerbes, Wien. med. Wochenschrift, 1898.
'Buffalo Medical Journal, 1898.

Dr. James G. Kiernan, Medicine, Detroit, 1898.

"Pester med.-chirurg. Presse, 1898.

"Clinical Journal, London, April 6, 1898.
"Pester med.-chirurg. Presse, 1898.
"Annals of Surgery, July, 1898.

13Journal of the American Medical Association, December 10, 1898.

14Since this article was written I have learned from Dr. Crowell that this patient's urine always contained sugar in about the same quantity whether he was on a diabetic diet or not, and during the last five years of his life albumen also was present.

15Since the above was written, I have learned that he was seen at this time by an oculist, whose report confirmed my suspicions, inasmuch as he found on ophthalmoscopic examination that the arteries in both eyes were diminished in size, the veins congested and tortuous, besides other appearances that he thought were due to diabetic albuminuria. The lenses were clear.

THE SELF-INJURY IN LYING.

AT birth, all of us were liars, more or less. This is because lying is the diplomatic refuge of helplessness. The instant we learn to know punishment, desire to escape from it becomes a prime instinct.

Morality, like knowledge, is not hereditary, but attained. The child must learn that lying is a sin and a self-injury, just as it must learn by being burnt to avoid the fire.

Until this lesson is learned, the child, youth, man will continue to lie. Many never learn it. Perhaps none ever learn it thoroughly.

Lying comes not of aggressive shrewdness, but of cowardice and of a shallow cunning that is often treacherous and tricks. the lie into transparency.

But it is not the danger of being found out by others that is most to be dreaded; far more dreadful is it that the liar must know himself to be a liar.

His self-respect suffers-the leaven in him loses strength and leaves him dead dough.

The cunning that leads to lying is a rot that must permeate the whole character and make a man uncertain of himself.

It distorts his perspective, obscures his vision, and warps his comprehension.

The habit of misrepresentation leads to misconception, the judgment becomes as erratic as the tongue, and there results the man who "couldn't tell the truth if he wanted to."

Nothing so shakes the confidence of one's friends as known lying does; nothing so shatters one's own self-confidence as does lying, whether known to others or not.

The cowardice that fathers lying increases with the lie. Fear of detection joins with self-contempt in making the liar a greater coward than before. One lie calls for another in its defense. The poet said it thus:

"O, what a tangled web we weave when first we practice to deceive."

This tangled web makes it all the harder for the liar to succeed in even an honest undertaking. His lies are a chain and ball upon his foot. They are a beam in his eye and a weight on his heart. He flounders along, most of his energy being required to overcome the impediment, while the truthful man easily outstrips him.

The lying cheat in the Vicar of Wakefield, who was always swindling everybody, died in jail for debt, while his honest neighbor, who was swindled a thousand times, steadily prospered and died rich and respected. Fiction-eh? Well, it is immortal as fiction, simply because it is fact, the world over, all the time.-Cleveland Press.

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The position you hold your body in the most of the time soon becomes its natural position. Continuously folding your arm across the chest will develop a flat chest and a rounded back just as certainly as will clasping the hands behind the head, or folding the arms behind the back and doing much posterior chest weight work develop a flat back and a deep, full rounded chest. You can't think of all these things? Do you think of folding your arms across the chest? No, it is a habit. Make these things habits and you won't need to think of them; you will do them unconsciously.

Here are four other hints which should be habits: Keep the back of the neck close to the back of the collar at all possible times. Always carry the chest farther to the front than any other part of the anterior body. Draw the abdomen in and up a hundred times each day. Take a dozen deep, slow breaths a dozen times each day. To do these exercises properly, dress loosely. You cannot do them properly otherwise. Never wear shoulder braces to keep your shoulders back. They weaken nature's shoulder braces. Develop nature's braces and you will breathe more deeply and have a better form physically.-Men.

THE "odor of sanctity" is likely soon to be a thing of the past in the East, through the introduction of sanitary reform measures. In the Holy Land sanitary reform is the order of the day. Bethlehem has her well-paved streets and even Jerusalem is becoming clean. The tanneries and slaughter houses have been removed without her walls, and a system of sewerage is being put into operation.

QUAINT CATASTROPHES.

BROODING over tombstones does not sound exactly like a cheerful occupation, and one certainly would not think of retiring to the graveyard in search of liveliness. Nevertheless, those who for antiquarian or other reasons spend much time in the deciphering of old inscriptions are occasionally rewarded by "finds" of an unexpectedly entertaining sort. Here is an epitaph recently discovered by a seeker for ancestral tombs in a village churchyard in England. It assuredly ought to be pathetic, but―!

Here lies the Body of Mary Anne Flower
Brief Alas! was her earthly Hour.
Sweet Buds must Fade, and Cankers eat
Blossoms most Delicate and Sweet:
Thus did this Flower in May Time Bloom
Perish untimely to the Tomb
Slain in the Spring Time of her Year
By an Insect Ent'ring at her Ear.

Unfortunate Mary Anne! Her death was certainly peculiar, and therefore, according to old-fashioned ideas, impressive. It was long fashionable to record upon gravestones the manner of any death that was unusual. "He fell over a Precipice and Entered ye Heavenly Gate," says one old epitaph; "He made his exit from a World of Sorrow on ye Horns of a Cow," says another, "and found Peace beyond;" while a third, in the Old Hill BuryingGround at Newburyport, records of an esteemed housewife that "she sweetly breathed her life away" after "swallowing a pea at her own table." At Lichdene, England, there is a stone which chronicles doubly the catastrophe by which the deceased perished.

The clinging earth his earthly part did slay

And freed his spirit and it flew away.

So says the memorial verse; while above, a less poetic version gives, with name and date, the grim explanatory statement: "Be

ing fallen therein Head Downwards, he died of Sticking in ye Mud."-Youth's Companion.

A WOMAN NEVER FORGETS

To place her hand across her mouth when yawning.

To avoid contradicting flatly.

That when an apology is offered, courtesy demands that it be accepted.

That she is not privileged to lend a borrowed article without permission from the

owner.

That it is in bad taste to discuss private or domestic affairs in the public car. The vehicle is apt to be stopped suddenly, and her remarks fall upon ears for which they were not intended.

That the clerks in the shops receive salaries to be models of patience and to cater to her whims and fancies.

There is not a moment when some one, upon whom she desires to make a good impression, may not be observing her.

To gaze long into the plate-glass windows she is passing; not, however, at their contents, but at herself.

That it is a matter of course for "mere man" to give her his seat in the car. He does not need to be thanked; an icy bow is sufficient.

THE original civil engineer was the mole. He anticipates danger by making several exits and entrances to his abode.

A striking feature of Havana is the absence of women in the streets.

One smoker contracts diphtheria to three non-smokers.

An ordinary railway engine is equal in strength to 900 horses.

A thousand children are born yearly in London workhouses.

HOW TO SLEEP SOUNDLY.

THE "sure cures" for insomnia are almost innumerable. One of the latest is that of a German, Prof. Fischer (Doctor's Magazine), who claims that it will not only bring about profound and refreshing sleep, but also increased mental strength. The discovery consists essentially in putting the pillow or pillows under the feet instead of the head. The advantages claimed for the innovation are that the venous circulation is favored and the heart needs to work less during sleep, hence the tired feeling on waking is prevented. The professor claims to be in receipt of a great many communications from ladies all over the German Empire who are profuse in their praises of his epochal discovery.

AVOID CONTACT WITH SICK PETS.

Dogs and monkeys are subject to tuberculosis and are said to be capable of communicating the infection to human beings. A large number of the canaries that die in captivity fall victims to the same disease. Parrots suffer from a malady peculiar to themselves. The bacillus that causes it is thought to originate pneumonia in man. Cats have been known to be carriers of diphtheria, and possibly of scarlet fever and other infectious diseases. Great care should be taken during an epidemic to keep pet animals out of the reach of infection, or else away from the children, and at any time a bird or animal that seems ailing should be at once isolated.—Ex.

A NEW MOTIVE POWER.

A Paris scientist has taken out a patent for an invention which he claims will supplant petroleum as a motive power and motor stoppage to take a supply of electricity will hereafter be unnecessary, for the auto

mobile itself is made an automatic generator of electricity. The invention takes up very little space. It measures the electricity as the automobile speeds on its way. A small quantity of water is required for generating the electricity. It can be carried in a bottle. The French government has under consideration the advisability of using this new invention in connection with their submarine boats.

SUGAR FOR ARMY HORSES.

As a result of bad roads and heavy transportation, army horses in Argentina have been overworked during the rainy season, and many of them have been exhausted or have fallen ready victims to disease. To give greater endurance, sugar has been added to the food of the animal. The effects have been quite surprising, and it is reported that not only has fatigue been overcome by two ounces of sugar in the daily food, but that animals that had become quite useless regained strength and capacity for work.

THIS Denver physician's experience is the same as a good many others.

"A child, thirteen months old, teething, had for some time suffered with a very watery, greenish diarrhea, bowels full, hot and gurgling continually, head rolling, eyes. half closed in sleep, hands and feet cold, and frequent straining to vomit. Could retain no food, either mother's or fresh cow's milk, pulse 120, feeble, head bathed in cold perspiration, bowels evacuated twelve to eighteen times in twenty-four hours. I began using Eskay's Albuminized Food in teaspoonful doses hourly; it was retained and amount increased until about second day, when about half meals were given every three hours. I had no more vomiting. The child is now well and in excellent health and flesh."

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