with provisions for drainage; but before we could get the patient off the table he was dead.

The moral to be deduced from these cases of ours, and similar cases in other hands with like results, is this: Operate early in cases of appendicitis where the diagnosis is clear. If we wait until general peritonitis sets in, either from extension of the process or perforation of the sac, we are guilty of an act that borders upon criminal negligence, if not of this offense itself, provided the consent of the patient and friends could be obtained. I regard it as our duty to advise every patient suffering from this disease of the possible termination, and be on the alert to advise operation at the right time.

LA GRIPPE—SUGGESTIVE LETTERS FROM EMI

NENT MEN.

BY J. D. BURCH, A. M., M D.

AURORA, TEXAS.

This association has coughed and sneezed, hawked and wheezed, through three consecutive epidemics of la grippe, and the writer has not the slightest idea of asking the members to labor up from a probable epidemic 415 B. C. to this good year 1892, through the chronology of influenza, la grippe, blitz katarrh.

The Italian name, "Influenza," was most familiar to my boyhood days. The Italians believed the disease due to the "influence" of the stars-hence the name "influenza."

If, after our experience of the past winter, our scholarly brethren of Germany would again take up their name for this epidemic catarrhal fever, "blitz katarrh," and recoin it into "donnern und blitzen" (thunder and lightning), I think it would be declared legal tender nomenclature in Texas.

Hurrying through the centuries, from an attack on the Athenian army in Sicily more than four hundred years before Christ, we come more definitely to the epidemics of 1173, 1239 and 1299. Then we will glance at Gluge's chronological table, beginning in the fourteenth century, and by interjecting dates from the highest authorities, make, I believe the most perfect table so given. As Dickens' word painting of love, we behold it "an old, old story."

Fourteenth century-1323 and 1326. Fifteenth-1410, 1411 and 1414. Sixteenth-1510, 1557, 1562, 1574, 1580 and 1593. Seventeenth-1658, 1669, 1675 and 1693. Eighteenth-1708, 1712, 1729, 1732, 1733, 1742, 1743, 1761, 1762 and 1775. Nineteenth-1800, 1803, 1831 and 1833. Aitken would add 1311

and 1403. Wilson has gotten from different authorities 1558, 1591, 1610, 1626, 1627, 1642, 1643, 1647, 1655, 1688, 1709, 1730, 1737, 1738, 1757, 1758, 1767, 1772 and 1788. Watson mentions 1782; Dr. Rush, 1790; Webster, 1795, 1797, 1798 to 1803. Many epidemics in Europe and America from 1788 to 1890. Condie gives 1787 and 1805 to 1827; Currie, 1807; Condie, 1816, 1826, 1830, 1832 and 1837. Many from 1837 to 1850-51; 1843, 1847, 1848, 1857, 1858, 1860, 1864, 1867, 1874 and 1879. Among the chief epidemics may be mentioned 1762, 1782, 1787, 1803, 1833, 1837, 1847 and 1889. Texas will remember 1889, 1890, 1891 and 1892.

The epizootics of 1872 and 1880 will be remembered by all lovers of the horse-the doctor's faithful friend. Those were epidemics of influenza, as shown by the morbid anatomy. I had a favorite saddle horse standing in a livery stable where there were a few less than forty horses. Thirty of these began to cough the same night or early morning. By evening of that day all were coughing.

This reminds me of the loss of two fine cows in Kentucky from what I there called "Texas fever." Here I would call it "Spanish fever." So in Italy they spoke of la grippe as the "German disease." In Germany they called it the "Russian pest." In Russia they would not foster the child, but said it was Chinese catarrh." In America we can safely say it is a "foreign devil," and petition against its naturalization.

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Our chronological table is valuable in several respects. It certainly upsets the old idea that the epidemics were cyclical.

Hand in hand walk an epidemic and pandemic catarrh. With a promise not to be prolix, and with obvious design, I give a few lines from Wilson: "In the year 1830 began a series of epidemics remarkable for their wide diffusion and the rapid succession with which they followed one upon another. The disease began in China; in September it reached the Indian archipelago; it swept into Russia and invaded Moscow in November; in January, 1831, it was raging in St. Petersburg; March found it in Warsaw, April in eastern Russia and Silesia;

in May it prevailed in Denmark, Finland and a great part of Germany, and in the same month it fell upon Paris; in June it was in England and Sweden; it was still sweeping about middle Europe and lingering about Great Britain at the end of July; in the early winter it swept southward into Italy and westward across the Atlantic to North America, and was still harrassing the inhabitants of certain regions of the United States in January and February, 1832. Meanwhile it continued in the east, spreading to Java, farther India and the Indian archipelago. It continued in Hindostan after it had died out in Europe. But in January, 1833, it again visited Russia, and rolled thence southward and eastward over most of Europe. It is recorded that by February it had reached Gallicia and eastern Prussia; in March it was in Prussia, Bohemia and Warsaw, and had extended it to Syria and Egypt; in April to many parts of Germany and Austria, and to France and Great Britain. Midsummer found the disease yet prevailing in some districts of Germany and north Italy, and in the early autumn it was in Switzerland and eastern France; in November it visited Naples. Epidemics so frequent, so widespread and so unsparing of individuals wherever the disease appeared, could not fail to excite a deep and general interest."

In the same paper I recently saw recorded the deaths of the eldest son of the Prince of Wales, two cardinals in the church of Rome, and innumerable peons, like myself, in the great work of life. Sir Morell MacKenzie, one of our distinguished specialists in throat and lung diseases, fell a sacrifice to la grippe; Dr. De Hays Agnew more recently. Truly, it is no respecter of persons, nor is it baffled by surroundings. Epidemics have flown on the wings of the swift over Europe in six weeks, or have gone creeping on the feet of the sloth in six months.

Writing of 1833, Watson says: "On the 3d of April of that year the very day on which I saw the first two cases that I did see of influenza, all London being smitten with it on that and the following day-on that same day the Stag was coming up the channel, and arrived at 2 o'clock off Berryhead, on the

Devonshire coast, all on board being well at that time. In half an hour afterward, the breeze being easterly and blowing off the land, forty men were down with the influenza, by 6 o'clock the number was increased to sixty, and by 2 o'clock the next day to one hundred and sixty."

Condie, writing in 1858, says: "In its several visitations in this country it has usually commenced in one of the Eastern States and extended southward along the seaboard with more or less rapidity. In 1807, however, it showed itself first in New York, spreading thence, as from a center, in every direction. It reached Canada on the north and the Southern and Western States in the course of three months. The amazing rapidity with which it diffused itself over the American continent resembled more the fleetness of the wind than the natural course of a disease." Plainly, this also shows that there is something in the atmosphere that is the exciting cause. Yet it is to a limited degree portable and contagious. Much proof could be offered, but it is unnecessary. Watson calls attention to numerous instances "in which the complaint has first broken out in those particular houses of a town at which travelers have recently arrived from infected places." Wilson quotes Drs. Guiteras and White: "An American gentleman in bad health contracted the disease in London, improved, suffered a relapse shortly afterward in Paris and died there at the end of December, 1879. His body was embalmed and sent home. Following the exposure of the remains of this person to the view of his family in Philadelphia there was an outbreak of influenza, with characteristic symptoms, which affected, in the first place, members of that family; afterward, friends living in close intercourse with them; next, the medical attendant of some of them, and, finally, the housekeeper and a patient or two of one of the physicians who wrote the paper, the whole number affected in Philadelphia being eighteen at the time of the publication of the account. Subsequently two or three other cases were developed, but the disease did not extend beyond the immediate circle of those in direct communication with the invalid.”