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fore, that it is a fundamental matter that enough of physical signs as well as rational symptoms should be given to make it clear to the reader that there was no error in the diagnosis. I will not consume time in discussing the use of alcohol in the treatment of this disease, but I will venture to offer one criticism, which has not been touched upon in the remarks already made, and that is an important point in the train of reasoning pursued in the paper, namely, the mode of death. The author of the paper in a complimentary manner alluded to remarks of mine upon that point but in cases of pneumonia the mode of dying is not by asphyxia, but in general, death occurs by asthenia, in other words, the patients die from exbaustion. So, whatever benefit alcohol may have in these cases, is in the direction of preventing death by exhaustion or asthenia, and not by asphyxia. I will now venture to suggest that the paper be referred to the author for further elucidation and presentation of facts having an immediate bearing upon its contents.
Dr. IRWIN remarked as follows: In order, in the first place, to satisfy the members of the Section upon the point suggested with reference to the proportion of deaths and the symptoms of the cases brought forward, my explanation is simply this: The exact symptoms of a stage of the disease, so as to get at precisely what stage the lung is in, according to the theory I have brought forward, is not essential, inasmuch as the impediment in the respirating membrane is brought forward as the difficulty which is at the bottom of the trouble, and it does not matter as to the very exact stage of the disease present, so that that condition still exists. Furthermore, I very well understand that if I had brought before you detailed symptoms and physical signs of one hundred and fortyseven cases, there would bave been produced a paper altogether too long to listen to. I have given the method of treatment simply in this brief form to bring it within the limit of the time, the twenty minutes, allotted for reading each paper. As far as the matter of symptoms is concerned, those of pneumonia are so well and so commonly understood, that I took it as superfluous to recite the symptoms of every case on band. As to the remarks of Dr. Davis, he, having not been present at the commencement of the reading of the paper, failed to hear what I had to say upon the important matter to which he has referred. For instance, he said that the impediment to the respiratory act was necessary to exclude oxygen and prevent the escape of carbonic acid, and create a want of a sufficient supply of oxygen to meet the demand consequent upon destructive assimilation. I am not at all surprised to find that the profession is altogether surprised with the results of the treatment. For I have suggested the treatment to a great many physicians and have not found a physician who dared to try it, and the invariable answer has been that they would not dare to try it. I have presented the matter to three different local medical societies, and the in. variable reply was that they would not dare to try it. As to the correctness of diagnosis, of course we expect every physician to meet with probably that number of cases of acute pneumonia, within twelve years' time, and consequently probable mistakes in diagnosis would be scarcely presumable. But I should like to see the matter brought before the profession in such a manner as that they will be willing to risk a trial of this plan of treatment.
The paper was referred to the author for further investigations, etc.
A paper was then read by Dr. Louis ELSBERG, of New York, upon The Bioplasson Doctrine.
The paper was accompanied by diagrams of microscopic observa tions, and was listened to with much interest. It was referred to the Committee of Publication.
Paper presented and read by Dr. A. T. KEYt, of Ohio, on A New Sphygmograph, and the instrument exhibited. On motion of Dr. Davis, the thanks of the Section were tendered to Dr. Keyt, and he was requested to publish the paper in some medical journal as having been read before the Section.
A paper from Dr. STORER, of Massachusetts, and one from Dr. TURNBULL, of Pennsylvania, were referred by vote of the Section to a special committee for examination and disposition.
Dr. N. S. Davis, of Illinois, was appointed chairman of said committee. Section adjourned sine die.
J. K. BARTLETT,
REPORT OF SUB-COMMITTEE OF SECTION ON PRACTICAL
MEDICINE, MATERIA MEDICA, AND PHYSIOLOGY.
The undersigned, to whom were referred the papers entitled, European Winter Cures, by HORATIO R. STORER, M.D., and An Essay on the Use of the Tones of the Human Voice in Diagnosis of Diseases of the Ear, etc., by L. TURNBULL, M.D., respectfully reports that he has examined both papers carefully, and does not find in either of them such matter as would justify their reference to the Committee of Publication under the by-law of the Association directing the mode of disposing of papers in the Sections. The paper by Dr. STORER on European Winter Cures is well written, and contains much that would be interesting both to the profession and the public, if it were placed before them in some one of the more widely circulated professional or even literary magazines. And it is hoped the author will consent to have it take that direction.
The paper of Dr. TURNBULL On the Use of the Tones of the Human Voice in Diagnosis of Diseases of the Ear, is written in good style, and contains an account of some experiments of interest and value. Much the larger part of the paper, however, is occupied with an account of the progress of otology, and is made up of historical facts already fully accessible to the profession in recently published works. We, therefore, recommend that the paper be returned to the author, with the request that he separate that part of it relating to his own experimental investigations, and furnish it for publication either in the Transactions of the Association or in some leading medical periodical, as he may choose.
N. S. DAVIS,
['This was coinplied with by its publication in the Transactions of the Association for the Advancement of Science.]
ADDRESS IN PRACTICAL MEDICINE.
DR. AUSTIN FLINT, President of the Section of Practical Medi. cine, Materia Medica, and Physiology, read the following address:
MEMBERS OF THE ASSOCIATION: During the past year there has been no lack of activity in physiological researches. To a con. siderable extent these have related to either the confirmation or interpretation of facts already ascertained ; and, for the most part, so far as they have reference to new developments in knowledge, their importance is to be determined by further investigation. What I shall mention, therefore, as properly, at this time, coming within the scope of “advances and discoveries,” will not require
A French physiologist, Malassez, has devised a method for an accurate enumeration of the red and white corpuscles of the blood. The process is as follows: “The blood to be examined is diluted with 99 parts of a liquid composed of one volume of a solution of gum Arabic of a sp. gr. of 1020 with three volumes of a solution of equal parts of sulphate of soda and chloride of sodium, also of a sp. gr. of 1020. The mixture, containing one part of blood in one hundred, is introduced into a small thermometer tube with an elliptical bore, the sides of the tube being ground flat for conve. nience of microscopical examination. The capacity of the tube is. to be calculated, by estimating the weight of a volume of mercury contained in a certain length. The tube is then filled with the diluted blood, and the number of corpuscles in a given length of the tube is counted by means of a microscope fitted with an eye. piece micrometer. In this way, the number of corpuscles in a given volume of blood can be readily estimated. In man the number in a cubic millimetre of blood (a millimetre
= to about. a's of an inch) is estimated at about four million.” 1
| Flint's Physiology, vol. i., 2d ed., 1875. For Malassez's article, entitled “ Nouvelle méthode de numeration des globules rouges et des globules blanc du sang," vide Archives de physiologie, Paris, 1874, tome vi. p. 32 et seq.
It seems surprising, in view of its obvious importance, that a simple and exact method of enumerating the blood-corpuscles should be a novelty. The importance of it relates to both physiology and pathology. It is important, in the first place, to deduce from a sufficient number of observations the range of variation in the number of the red and white corpuscles which is compatible with health. In the second place, the enumeration of the corpuscles in different parts of the vascular system may lead to important conclusions. According to the observations of Malassez, the red corpuscles are about equally numerous throughout the arterial system, and the proportional number is greater in the blood of the veins than in the arteries. He has found the largest proportion in the splenic veins, and the smallest proportion in the hepatic veins, the inference, therefore, being that red corpuscles are generated in the spleen, and that there is more or less destruction of them in the liver. It may be that this plan of investigation, continued and extended (which is analogous to that by which Bernard made the discovery of the formation of sugar in the liver and its destruction in the lungs), will lead to the elucidation of the genesis of the blood-corpuscles, and to an increase of our knowledge respecting their functions. These results may be of much service in relation to pathology. In a more direct relation to the latter, the enumeration of the red corpuscles may be expected to give precision to our knowledge, on the one hand, of plethora or poly. æmia, and, on the other hand, of anæmia. This is especially desirable, inasmuch as the degree of these morbid conditions, and even their existence, are not determinable with accuracy by the morbid phenomena to which they give rise. It may indeed be imagined that to count the number of red and white corpuscles in a certain quantity of blood, will be found to have a practical value in diagnosis comparable to the movement of heat by the thermometer.
An interesting problem relating to alcohol in the system seems to have been solved. It has been for some time a vexed question to what extent alcohol, when ingested, is eliminated, as such, from the body. Some have held the opinion that it passes into the blood, and is expelled through the emunctories unchanged; others have claimed that it is a food. The recent experiments of the late lamented Anstie, assisted by Dr. Dupré, appear to show conclusively that even when a considerable quantity of alcohol is ingested, the proportion excreted by the kidneys, lungs, skin, and