the army.

It was a man who was able to do what he pleased with his heart; he could make his pulse beat as high as 200 per minute, or he could make his heart stop beating altogether for a minute. He was anxious to leave the army and go home, and played this trick on the surgeons to get discharged.

DR. S. S. ADAMS said that to-day the profession placed very little prognostic importance on arhythmia, and so far as his observation went this condition amounted to very little, at least in children. There were some diseases, however, such as cerebral diseases, in which arhythmia was significant, but in the general run of cases the symptom was of very little prognostic value. He had seen a very interesting case last winter. A woman 75 years of age had come to him with evidences of having had chills. He used the thermometer, and at the same time counted the pulse, and to his surprise the pulse only beat 40, while the thermometer registered 1031⁄2. He then counted the pulse at the other wrist and found that it was 110, corresponding with the temperature. He learned that the woman had been paralyzed on the side on which he had first counted her pulse, and she told him that she used to amuse herself with young doctors by getting them to count her pulse on the paralyzed side.

DR. F. B. BISHOP said that in the treatment of nervous diseases we frequently come across patients suffering from irregularity of the pulse, and especially was this true of the so-called functional nervous diseases, such as chorea, neurasthenia, idiopathic epilepsy, hysteria, etc. Any of these conditions may come on as a sequel to malarial, rheumatic or other fevers, la grippe, scarlet fever, diphtheria, etc., or may follow a severe shock to the nervous system. The most severe cases that ever came

under his observation were due to shock, such as fright. It was hard to say what influence these diseases and shock had upon the nerve centers, but he believed that they produced an unstable condition of the higher nerve centers, and that after the cause had subsided the nerve centers were left in such a condition that they were incapable of adjusting themselves without assistance. Now, as the sympathetic and vaso-motor systems are under the influence of the higher cerebral centers, and these higher centers are out of unison and transmitting false impressions and impulses to the various organs of the body, even the brain itself, causing the subject to conjure up all sorts of imaginary conditions, it is perfectly natural that the heart should come in for its share of these false impressions and get out of kelter also.

Dr. Claytor, in closing the discussion, said that in regard to the use of digitalis for diagnostic purposes, as mentioned by Dr. Acker, he thought there were cases where it was a great aid to diagnosis. If digitalis were given in a case of valvular lesion showing arhythmia and the irregularity disappeared it was a good sign, showing that the arhythmia was due to some mechanical cause or temporary weakness, while in cases where the myocardium was degenerated the digitalis would have but little effect. On the other hand, in certain cases, digitalis might produce arhythmia of the pulse. He had seen such cases. were some authorities (Huchard), however, who claimed that it was impossible to produce arhythmia by the use of digitalis in a sound heart. In regard to Dr. Kleinschmidt's remarks he could only say that it required a physiologist to reply to them and that he did not feel competent to do so. As to the arhythmia of old age, this was generally the

There

result of myocarditis, but the real danger lay in intercurrent diseases, such as grippe, pneumonia and the like. In regard to family predisposition, which Dr. Morgan spoke of, a case had been reported by Richardson where both the father and mother had this irregularity, which continued all through life. As to the Doctor's own intermittence, however, he thought it might be due to indigestion, the use of tobacco or some such cause. As to the case of the bicycle rider which he had mentioned, it was possible that the man had a weak heart and that the riding simply developed this latent weakness. The case mentioned by Dr. King seemed to have exactly the form of arhythmia described by Huchard as "arhythmia angoissante paroxystique essentielle," where the

heart was irregular for days or months, and then the irregularity disappeared, to return again later, and where there was no heart lesion. As to the cold baths spoken of in connection with Dr. King's first case, it seemed to be an example of the beneficial effects of hydrotherapy, so well known in the treatment of certain nervous diseases. The second case followed on an attack of influenza, and Sansom had reported 25 per cent of arhythmias in an analysis of 100 cases showing cardiac disturbances following grippe. The case reported by Dr. Behrend was a very interesting one, and there were very few such cases on record. As to Dr. Adams' case, he did not attempt to explain it. Dr. Bishop's case was one of nervous origin and was very interesting.

The method has not been in use a sufficiently long time, however, to warrant a positive statement in this regard. (4) The method is simple and inexpensive. The gray and white matter of the brain retain their normal appearance; hemorrhages are readily seen, etc.

DISCUSSION.

DR. LAMB said: The question in my mind regarding the successful use of the Kaiserling method is as to the future result of the preservation in glycerine, which is not a good preservative, and how these specimens will look in future years.

DR. GLAZEBROOK said: As to the permanency of the preservation of the specimens, Kaiserling advises that the fluid be kept in a dark place, because exposure to light injures the action of the fluid, and that he was now experimenting with specimen exposed both to daylight and to artificial light.

A PLAN FOR THE ESTABLISHMENT OF A MILK LABORATORY IN THE CITY OF WASHINGTON.

BY S. S. ADAMS, M. D.

The members may remember that in 1891 I presented to the Society a plan for the sterilization of milk, having secured for the purpose one of the most

complete dairies in the country. After securing the farm and calling to my assistance Mr. Clifford Richardson and other scientists, we finally produced a good quality of milk. Just as the plan began working to our satisfaction, the owner of the farm returned, and finding that we had discontinued the use of the refuse from his brewery for feeding the cows, said that everything would have to stop unless I agreed to use this refuse. Of course, I refused to do this, so that after spending $2,000 or $3,000 in sterilizing apparatus, it is now standing in the dairy rusting.

Last spring Dr. Busey sent a gentleman to see me, a Dane, who was familiar with dairies and dairy products and had come to the city for the purpose of introducing pasteurized milk. I found that the Dane was an employe of Mr. Newbold, a gentleman of some means, who was willing to establish a milk laboratory here. After a number of conferences with him and with Mr. Newbold on the subject we concluded that the best thing to do would be to solicit the co-operation of Drs. Kober and De Schweinitz, but during the summer the matter was dropped. After my return to the city Newbold again asked my support, saying that Drs. Kober and De Schweinitz were willing to do their part in supervising the establishment of such a dairy. The plan which he presented I rejected, however. It was a plan which the Dane had conceived for sterilizing milk in bulk at the farm to be sent to the city and opened and distributed. showed him that sterilization was all right as long as the can was unopened, but if he opened the can it was worse than if he had left it alone, for instead of being sterilized it then becomes a good culture medium. Captain Newbold has secured the co-operation of a practical dairyman in the neighborhood of Wash

I

ington who will stock his farm with a healthy herd, build a good barn and have the floor concreted, and use every possible precaution to deliver pure and wholesome milk. The Captain will secure a place in this city where we will have the advantages of cold storage, plenty of ice and plenty of steam for power and pasteurization, with absolute cleanliness and hygienic surroundings. The milk will be separated by the centrifuge. In this way the milk will not only be free from impurities, but we will get milk that has 4 per cent fat, and I have never seen milk delivered that came up to that standard.

A complete laboratory will be established later, where it will be possible to have milk made up according to the proportions written for, just as it is in the Walker-Gordon laboratories. There is no reason why we, here in Washington, should be put to the expense of having foreign capital come in and prepare a high-priced milk. The milk prepared in the Walker-Gordon laboratories is too expensive and costs at the rate of about $30 a month for an 8-months-old baby.

The milk farm, and the persons connected therewith, will be under sanitary control of Drs. Kober and De Schweinitz. The cows are to be tested with tuberculin, and the feeding and care of the animals, together with the care and cleanliness of the dairy utensils, will be closely watched by frequent and unannounced inspections. The success, of course, of the scheme will depend upon the support which the medical profession gives it. If we do not intend to support it we might as well tell Mr. Newbold to keep his money out of the venture. Dr. Kober presented last year a paper to this Society, in which he showed the filthy character of the milk delivered in this city, and I have made some experi

ments, simply by filtration, and I was surprised at the dirt I found in the milk. we use. With the use of the centrifuge all that will be eliminated. The price

pay

of the milk will be ten cents a quart, that is only two cents a quart more than I now and the same price that the Bellevue Dairy charges. Pasteurized milk will be two cents more per quart, with four per cent of cream. This is not intended to be a Nathan Strauss laboratory, but Mr. Newbold says that as soon as the income equals the expenditures he will put in a larger plant and give the poor people milk at low rates. I met Dr. Osler last Monday and he told me that the success of the laboratory in Baltimore was most surprising. I am thoroughly convinced of the integrity of the moneyed man of the undertaking and of the intelligence of the Dane, and with Dr. Kober and Dr. de Schweinitz superintending the details and working to give Washington pure milk, I hardly think that anything more is necessary; but to add weight to the undertaking I suggest that the Society appoint a committee to supervise the work and report to the Society whether or not it is worthy of our support. This is, to my mind, the best opportunity we have had for securing a pure milk supply.

DR. G. L. MAGRUDER said: There is an interesting article in the New York Medical Journal, of October 9, on the result of experiments made in 1896 in Yonkers, to give that place a pure milk supply. The improvement in the death rate of children was remarkable in a short time. Newburg, where the bulk of the milk obtained is not over twelve hours old when delivered, had the next best rate, while Long Island City, Hoboken and other places had woeful mortality rates. But the business in Yonkers was run at a loss of $1,000 in four months last year. They furnished pure milk, pasteurized, in eight-ounce bottles,

to the poor at two cents, and milk and lime water at a cent for six-ounce bottles. Every possible precaution was taken to insure the cleanliness and purity of the milk, such as the bathing of the attendants, the wearing of milking suits, etc. All this Mr. Newbold will, as I understand, require, and as soon as this is announced he will not be able to furnish enough milk for the demand.

DR. S. C. BUSEY said: The Chair understands that this is a proposition coming from a gentleman depending upon his own resources for the establishment of a laboratory where milk may be prepared as an article of diet, and medical

men should be aware of it, and give their support to it or not, as they choose. Dr. Adams submits a proposition that a committee of this Society shall be appointed, not that they shall control it but that

they shall inspect it, and that if the Society chooses it may have that committee report to it whether this system is good, and whether we are gaining anything by this increase in the price of milk, but in no way is there any responsibility on the Society or any obligation upon any member of the Society to take the milk. It is very desirable that we should encourage any effort for the establishment of a laboratory or milk dairy that will give us milk such as we ought to have. If any man will go to a hearing before a committee of the House or Senate when this matter is being investigated, he will come to the conclusion that we do not get milk that is fit to go down our throats. The District of Columbia is unfortunately situated in this matter, surrounded as it is by Virginia and Maryland, for there are not enough dairies within the limits of the District to supply one-tenth of the population. We cannot pass laws, nor can Congress pass laws, regulating or controlling the dairies in Virginia and Maryland, so we will have to pass laws here requiring all milk coming into the District of Columbia to come up to a certain standard, and in this we meet constant opposition. I am impressed with our duty to the people at large, and I think that if we can encourage a man who is willing to furnish a standard milk we should do so.

DR. THOMAS A. R. KEECH said: I find