tion of philosophy, my conviction has always been that it is far better for a man to wear out than to rust out. Brain work, study and persistent application has been a great comfort to me, as well as a great help; it has enhanced the enjoyment of daily life, and added largely to the pleasures of the lecture room and of authorship; indeed, it will always, I am sure, if wisely regulated, be conducive both to health and longevity. A man who abandons himself to a life of inactivity, after having always been accustomed to work, is practically dead."-The total number of ex-Confederates in the present Congress is seventy-seven, Hon. Alexander Stephens. and other civilians excepted. In the Senate there are four Union soldiers, and in the House fifty-one. In the Senate there are nineteen ex Confederate soldiers, and in the House fifty-eight.In New York, during 1879, there were 25,332 births, 28,165 deaths and 8,385 marriages. The police force of the metropolis arrested 65,486 persons, one third of whom were women, and 133,201 people from foreign lands sought friendly shelter and homes at our gates. This seems incredible, but figures do not lie, and the records of the police and other departments give these returns. Of those arrested, 12 were sent to State prison for life, 21 were sentenced to ten years and upward, 70 to five years, and 273 to two and a half years and upward. The blood red hand of the assassin has struck somebody on nearly every one of the 365 days now concluded, and two men are now under sentence of death in the Tombs.

BOOK NOTICES.

THE NATIONAL DISPENSATORY. Containing the natural history, chemistry, pharmacy, actions and uses of medicines, including those recognized in the pharmacopoeias of the United States, Great Britain and Germany, with numerous references to the French codex. By Alfred Stille, M. D., LL.D., and John M. Mairsh, Phar. D. Second edition. Published by Henry C. Lea.

That a second edition of a work so stupendous in aim and so rich in fulfilment should be announced and issued within six months after the appearance of the first, shows the wisdom of the publishers and compilers in publishing it. One cannot look even casually through its seventeen hundred pages, without being impressed with the wonderful patience and critical research which has been expended upon its compilation. Its value as a reference work is greatly enhanced by several minor points new to dispensatory arrangement. The first of these is a very complete therapeutical index, in which is concisely gathered the scattered information upon any clinical fact treated of in the entire work; thus, under the title fever, there are no less than 270 references embracing the various forms of hay, hectic, intermittent, milk, puerperal, relapsing, scarlet, traumatic. typhoid, typhus, yellow and other fevers; under leucorrhoea over one hundred; and under ulcers nearly two hundred. Altogether there are about seven hundred headings and eight thousand references in this index. In the general index of subjects there is a further reference to more than thirteen

thousand medicinal substances treated of in this compendium. Another useful point is the naming of doses in both troy weight and the metrical system; thus imperceptibly familiarizing all who use the work with the relations of the latter with the former, and thus paving the way for its general introduction.

In treating of each drug the name both officinal and vulgar is given, followed by the synonyms in German and French. Then follows the botanical description, which in most cases is a model of concise and perspicuous English. The next in order is the chemical constituents, with the methods of separation, symbols, date of discovery. and in many cases comparative views of eminent chemists. Then follows a list of other medicinal species of the same plant, and a comparison of their values, and the adulterations and substitutions which are frequently offered and the tests by which they are detected. The pharmaceutical methods both of officinal preparations and others are there very clearly stated, which ends what may be called the first division of the subject.

So far we have nothing but praise for the able manner in which the subject is treated; but passing now to the discussion of the physiological action of medicine, there is much that is censurable. In the first place, everything is ignored except experiments that have been made by what are termed regular practitioners. It is well known that Eclectics and Homoeopaths have contributed something to this department of medicine, and there is abundant evidence to show that the whole idea of using physiological effects as a basis of therapeutics as now understood and practised was developed outside the regular school, and is now simply appropriated by them.

In fact, a large proportion of the experiments made by the so-called physiological school, is a repetition of what had been determined and published outside of recognized authority many years previously. Fifty years before Dr. Sidney Ringe took advantage of the well known physiological effects of ipecacuanha, and made drop doses of the wine fashionable as a remedy against idiopathic emesis, the disciples of Hahnemann were well acquainted with its virtues in this respect.

Still this is an error of omission and probable prejudice; and as far as the physiological action of each drug is stated, although in many cases meagre compared with what it might have been, it is couched in concise and clear phrases, which convey lucidly the idea to be expressed.

The main fault to be found with the work, however, is in the description of the medical uses of the drugs treated upon. When it speaks of the bichromate of potash as having no other therapeutic value than for the removal of venereal warts, ignoring entirely its splendid curative power in certain high grades of inflammation in the mucous surfaces of the nares, larynx, trachea, body of the uterus, and fallopian tubes, in congestions of the liver and kidney, and in periosteal and syphilis rheumatism; when it speaks of veratrum viride merely to condemn its use altogether as scientifically illogical and practically dangerous; when it speaks of fungus musaricus, with which we ourselves have cured many cases of epilepsy, as of doubtful reputation and no longer used in medicine; when it speaks of gelsemium as one of those too numerous remedies which have no better ground for their use than the power of depressing the pulse and nervous system, and that it unfortunately does not reduce temperature except in doses that threaten life itself; when it confounds grindelia robusta with grindelia squamosa; when blue cohosh is spoken of as probably destitute of medicinal power; when helonias is said to be only useful in atonic dyspepsia; when damiana has not the slightest influence on the sexual function; and when podophyllum is limited in its uses to habitual constipation and torpor of the liver, it merely evidences not only a lack of research, but natural inaptitude for therapeutic discrimination. The whole department of therapeutics in this work is crude, inaccurate, retrogressive.

Had the same freedom from prejudice which characterizes the botanical and chemical departments been extended to the physiological and medical, the eminent authors of this notable work would have produced a text book which would long have been recognized as authority; but they have left that privilege, and we record it with sincere regret, to some one else.

G. W. W.

THE MEDICAL ECLECTIC,

DEVOTED TO

Reformed Medicine,

GENERAL SCIENCE AND LITERATURE.

Editors:

ROBERT S. NEWTON, M. D., LL. D.,

Professor of the Theory and Practice of Medicine in the Eclectic Medical College, of New York.

ROBERT S. NEWTON, JR., M. D., L. R. C. S.,

Professor of Surgery and Ophthalmology in the Eclectic Medical College, of New York. Published every month, by THE ECLECTIC MEDICAL COLLEGE, of the City of New York.

VOL. VII.

JUNE, 1880.

ORIGINAL COMMUNICATIONS.

DIPHTHERIA.*

BY H. H. MCCABE, M. D.

No. 6.

Many of the profession and laymen still regard diphtheria as a disease of modern times, but, from facts abundant, it has been known from the earliest times, but not recognized by its present title prior to the times of Bretonneau, of Tours. It seems to have been known to the Asclepiades, Hippocrates, and others of the fathers in medicine. By these it appears to have been classed with malignant sore throat, and so continued until the days of Cullen, who revised the nomenclature of diseases. By him it was classed with cynanche trachealis maligna, and this limitation was recognized until the year A. D. 1817, when Bretonneau differentiated it from other malignant throat affections, and very correctly

* Paper read at the State Medical Association, Indianapolis, May 12, 1880.

named it diphtheria, a membrane or skin. Among the earlier visitations and records of this malady, as mentioned by Macrobius, was one at Rome, A. D. 380. A fatal epidemic appeared in Holland, A. D. 1337, and in the same country in 1517. This was a malignant inflammation of the throat, and so speedy in its work of destruction, that the patient usually died within a period of a few hours after the first symptoms made their appearance. In 1576 an epidemic of the same disease made its appearance in Paris. In the seventeenth century angina prevailed in many parts of Spain, and was there called garrottilla. The victims perished as if strangulated by a cord about the neck. This disease was next observed as an epidemic in Naples, and was called disease of the trachea; it commenced by inflammation of the throat, exudation white, fetid breath, difficult deglutition, the victim dying from suffocation. After the cessation of this epidemic of diphtheria, the history is quite obscure until the year 1743. During this period little notice was taken of angina maligna, but at the last mentioned date it appeared in Paris again, and continued in existence for six years. Gill says: "This time ulcers appeared in the throat; the fauces were ash color; fever, restlessness and delirium came on; the pulse very quick, sometimes hard, at others small; the tongue covered with a white coat, save about its root." Some towns were entirely exempt from its ravages, while others were fearfully scourged. It is stated, sanitary conditions affected its course, also that ill drained and marshy districts suffered far more than the elevated and dry ones. But this only illustrates how easy false conclusions may be deduced from isolated facts, for the very contrary was proved to be true when this malady visited this continent, in 1825, which was an extremely dry year. Notwithstanding, in many parts of the South, the country was laid waste by this destroyer. And in 1828 and 1829, it is said by chroniclers to have been extremely warm and damp, still the victims were equally numerous, particularly in the region south of New Orleans. During the year 1855 up to and including a portion of 1867, as many as 360 deaths occurred in one village in France, the greater portion being under ten years of age. There seemed no difference in low land or elevation, ponds or dry lands, inland or on the coast, visiting alike the hamlets of the rural department and the

palaces of the opulent. The theory that solar rays and the heat of summer lent force to its virulence, was soon exploded by the fact, that soon thereafter its ravages, if anything, were even greater in the extreme cold of winter than in summer. It was found to devastate the country at all seasons, at all temperatures and elevations, with equal severity. Among the characteristic features of diphtheria, most prominent is the pseudo membrane. The fauces are generally primarily affected, and in a large number of cases seem to be limited to this situation. The first appearance is a peculiar redness, accompanied usually by more or less swelling of one or both tonsils. The false membrane in the beginning is semi transparent, turning opaque and becoming thick, finally turning dark and soon almost black from imbibition of blood, and its subsequent decomposition. Sometimes matters vomited may cause colorization. The areas of pseudo membrane present well defined edges or wells, resembling parchment. Sometimes only the tonsils become affected. Sometimes the membrane extends over the posterior part of the pharynx and palatine arches, the uvula, and forward over the greater part of the soft palate; redness extends beyond the edges of exudation and the parts affected. With the forceps the membrane may be removed, revealing bloody points in its stead. Sooner or later this false membrane is thrown off. At other times this exfoliation takes place in three or four days. Again it may be delayed from twelve to twenty days; at others the membrane is renewed three or four times, making the excavation deeper and deeper. These exfoliations are usually cellular elements, fibrine and lymph.

And this is one of the differential points distinguishing true diphtheria from fibrinous laryngitis; in the latter affection it is fibrine and lymph. Diphtheria frequently manifests itself in the lymphatic glands of the neck, behind the angle of the lower jaw. As a rule, the enlargement corresponds with that of the throat. The glandular enlargement usually ends in suppuration. In mild cases diphtheria shows itself in the fauces alone; at other times the affection manifests itself in the oesophagus, the eustachian tube, cheek, the posterior and anterior nares; at other times the eye becomes affected, producing diphtheritic conjunctivitis, causing opacity of the cornea; at times the stomach becomes invaded; at