(D.): Clam chowder; codfish; roast lamb; onions; peas; milk;

water.

December 18.-(U.): Almost perfect.

(B.): Beefsteak; rolls and butter; coffee and cream. (In bed with the grip.)

(L.) Hamburg steak; bacon; baked potato; coffee and cream; apple pudding.

(D.): Soup; fish; boiled corned beef; cabbage; turnip; parsnip; mince pie; cheese; water; milk.

December 19.—(U.): Slight albumin; casts, both kinds; fatty epithelia; protoplasmic catarrh.

(B.): Whole wheat steamed and cream; beefsteak; coffee.

(L.) Soup; whole wheat steamed and cream; Hamburg steak; horseradish; water.

(D.); Clam chowder; haddock; roast beef and pork, lean; potato; bread; butter; milk; water; lemon pie.

December 20.—(U.): Slight albumin.

(B.): Cream of wheat (has the morphology of hominy) and cream; beefsteak; scrambled eggs; coffee and cream; water.

(L.): Clam chowder; crackers; Hamburg steak; boiled potato; mustard; apple pie; cheese; water.

(D.): Soup; haddock; stuffed veal; carrot; potato; milk; water; apple pie; cheese.

December 21.-(U.): Slight albumin.

(B.): Codfish cake; scrambled eggs; coffee and cream; whole wheat steamed and cream.

(L.) Soup; codfish; turkey, dark meat, and stuffing; onions; peas; squash pie; dates; cheese; milk and water.

(D.): Oyster chowder; one-eighth inch thick slices of cold veal and mutton; baked potato; bread and butter; water.

December 22-(U.): Abundant casts, both kinds; some fatty epithelia; protoplasmic catarrh.

(B.): Cream of wheat and cream; beefsteak; mutton chops; coffee and cream; bread and butter.

(L.): Soup; beefsteak; bread and butter; milk.

(D.): Soup; codfish; roast beef; boiled ham; potato; bread and butter; water; milk.

December 23.-(U.): Almost normal.

(B.): Banana and cream; beefsteak; bread and butter; coffee and

cream.

(L.): Porterhouse steak; Lyonnaise potato; coffee and cream. (D.): Soup; roast lamb and beef; potato; water; apple pie; cheese. December 24-(U.): Slight albumin; bile.

(B.): Whole wheat mush dextrosed and cream; beefsteak; scrambled eggs; coffee and cream.

(L.): Soup; beefsteak; coffee and cream; hot water; English breakfast tea; dates; cheese.

(D.): Pig's feet; entire wheat bread and butter; English breakfast tea; dates; cheese.

December 25-(U.): Almost perfect.

(B.): Hamburg steak; scrambled eggs; bread and butter; coffee and cream; butter.

(L.) Mince pie; water.

(D.): Soup; water; roast turkey; potato; squash; onion; olives; escalloped oysters; chicken pie; plum pudding; mince pie; coffee. (Thanksgiving time.)

December 26.-(U.): Almost normal.

(B.) Hamburg steak; baked potato; scrambled eggs; coffee and cream; water.

(L.): Soup; Hamburg steak and beefsteak; baked potato; water;

cream.

(D.): Clam chowder; codfish; beefsteak; string beans; beets; apple pie; cheese; cream; water.

December 27-(U.): Slight albumin; bile.

(B.) Hamburg steak; bread and butter; coffee and cream.

(L.) Soup; Hamburg steak; biscuited potato; coffee and cream. (D.): Soup; crackers; boiled ham and cabbage and pot boiled greens; mince pie; cheese; water.

December 28.-(U.): Casts, false; filamentous catarrh.

(B.): Hamburg steak; bread and butter; coffee and cream. (L.): Soup; bluefish; turkey, dark meat; onions; celery; stuffing; apple pie; cheese; water.

(D.): Cold lamb and ham; bread and butter; oyster chowder and

water.

December 29.-(U.): Almost normal.

(B.): Hamburg steak; bread and butter; coffee and cream. (L.): Soup; crackers; Hamburg; bread and butter; coffee and cream; water.

(D.): Soup; haddock; roast beef; string beans; turnip; apple pie; cheese; water; milk.

December 30.-(U.): Slight albumin; casts, both kinds; filamentous catarrh.

(B.): Hamburg steak; bread and butter; coffee and cream; water. (L.) Beefsteak; bread; butter; water.

(D.): Soup; crackers; corned beef and cabbage; tomato; macaroni; mince pie; cheese.

December 31.-(U.): Abundant cast, both kinds; two fatty epi

thelia.

(B.): Hamburg steak; bread and butter; coffee and cream; water. (L.) Fish chowder; fried soft clams; Lyonnaise potato; mince pie; coffee.

(D.): Soup; trout; turkey, dark meat; onion; cranberries; stuffing; water.

January 1, 1903.—(U.): Slight albumin; false casts; bile.

Please note:

CONCLUDING POINTS.

The absence of sugar, as such.

The meat diet and no uric acid.

That water, hot or cold, when possible, was drank before meals
and on going to bed, so as to keep the urine 1015 to 1020.
That the observer regards fatty ills as coming from:

(1) Retarded and impeded circulation; English idea.
(2) Excess of fat or sugar (that makes fat); American idea.
(3) Fermentation gases, in alimentary canal, as CO,, for
example, that paralyze parts near or remote, thus impeding
the circulation.

Hence the restriction on sugar, as such, and fat food.
Also the use of water to keep the blood at normal
specific gravity. Abnormal high specific gravity
impedes the circulation, as molasses runs slower
than water.

That the microscopic examinations (morphology) of the urine
were made with a one-inch objective supplemented with a one-
fifth inch. Field, two and one-quarter by five-eighths by one-
sixteenth deep, inches. Amice stand with horizontal stage.
That the one-inch brings out casts and catarrhs the best.
That the spiritual kingdom food is not reported.

That the exhibit shows that food, animal and vegetable, is causal. and cural of the marks of fatty ills of the kidney. EQUITABLE BUILDING, 120 Broadway.

[CONCLUDED.]

ORIGINAL ABSTRACTS.

MEDICINE.

BY GEORGE DOCK, A. M., M. D., ANN ARBOR, MICHIGAN.

PROFESSOR OF MEDICINE IN THE UNIVERSITY OF MICHIGAN.

AND

DAVID MURRAY COWIE, M. D., ANN ARBOR, MICHIGAN.

FIRST ASSISTANT IN MEDICINE IN THE UNIVERSITY OF MICHIGAN.

THE CONTAGIOUSNESS OF PNEUMONIA.

WILLSON (Proceedings of the Philadelphia County Medical Society, September 30, 1903) reports three cases of croupous pneumonia in two brothers living in the same house, but not in the same room, and the roommate of one brother. One brother waited upon the other, first taken sick, but the other patient was only in and out of the sick room, without assisting in nursing or handling the sick. An infection by the sputum was unlikely in both the later cases, and the author thinks it was air-borne. He discusses the various possibilities, and points out the great frequency and the clinical importance of pneumococcus tonsillitis.

He also cites an example of pneumonia in a man of eighty-two, following closely a similar attack in his wife, but where also sputum infection could be excluded, and he cites some instructive recent examples of similar occurrences from the literature. In the discussion which fol

lowed the reading of the paper a number of cases were cited. In a hospital epidemic observed by Edsall, the cases ceased after the ward was thoroughly disinfected.

Such cases illustrate the importance of precautions against infection not only in pneumonia, but in all acute diseases of the respiratory tract, a fact long admitted, but rarely acted upon.

THE SERUM DIAGNOSIS OF TUBERCULOSIS.

G. D.

L. M. LOEB (Journal of the American Medical Association, May 23, 1903) brings together many of the facts and opinions concerning the value of the various clinical tests for the diagnosis of tuberculosis, the object of all of which has most importantly to do with the diagnosis of tuberculosis in its so-called insipient stage.

The author has many objections of his own and of others to the use of the tuberculin test and its modifications, chiefly among which are: (1) The fact that the test cannot be employed in cases in which the temperature rises above 100° Fahrenheit. (2) That the reaction occurs in “latent and practically healed cases." (3) That opinion has it that exacerbations of the disease when not actually active are frequently caused. (4) That instances are on record of the production of localized and later of general tuberculosis by its use. (5) That even in the case of Koch's new product, "neutuberculin," virulent living tubercle bacilli have been found and rabbits and guinea pigs infected. (6) That not all cases react and that the reaction may occur in healed cases. [It might be said parenthetically that equally as good results have been obtained by tuberculin prepared from dead bacilli as from living ones. The risk of infection is certainly here reduced infinitesimally.]

Still more unsatisfactory than the use of tuberculin are substitutes for it, such as human and animal blood sera and so-called artificial blood sera.

The author also brings up the well-known objection to the animal experiment-its slowness and its almost absolute uselessness should a mixed infection be present. Cultural methods are practically out of the question.

Coming to the subject of the paper, the author describes the agglutination reaction as employed by Arloing and Gourmont, which consists in making glycerin (six per cent) potato culture of the tubercle bacillus, taking care that the colonies are moistened every other day by tilting the tube so that the glycerin solution bathes them. A luxuriant growth is thus obtained which differs from the ordinary culture in that it is soft and can be easily broken up. Subcultures are now made into bouillon containing one per cent peptone and six per cent glycerin. These are vigorously agitated daily to prevent precipitation until a good growth

is obtained. The object of all these procedures is to bring about a culture in which the bacilli are isolated in a suspension and not bunched together. The reaction is now carried out after the same manner of the well-known Gruber-Widal reaction in typhoid fever. Both macroscopic and microscopic methods are recommended to be used conjointly.

After describing various modifications of the methods with the pros and cons, the author calls attention to the results of many investigators, and finally to his own observations, which extend over a series of fiftytwo cases, a number "much too small to be in itself of any value" except that "the results agree quite closely with those of the majority of workers." His conclusions are as follows:

(1) Under various conditions animal sera agglutinate homogeneous cultures of human tubercle bacilli in liquid media.

(2) Such sera may be obtained from the human or animal body without the presence in it of the bacillus tuberculosis.

(3) It is doubtful whether the agglutinative powers are ever due to the specific action of the bacillus tuberculosis.

(4) The presence or absence in the adult human blood serum of agglutinative properties for tubercle bacilli is no decisive evidence of the presence or absence of tuberculosis lesions in the body.

PEDIATRICS.

D. M. C.

BY ARTHUR DAVID HOLMES, M. D., C. M., DETROIT, MICHIGAN.

PROFESSOR OF PEDIATRICS IN THE MICHIGAN COLLEGE OF MEDICINE AND SURGERY.

ADENOIDS AND THEIR TREATMENT.

J. F. DICKSON (Pediatrics, June, 1903) calls attention to the fact that over seventy per cent of ear troubles of children are due to adenoids. How these growths affect the auditory apparatus is a mooted question, and it is our duty to become more familiar with their causes, symptoms and treatment, so that we can more thoroughly and intelligently treat and cure many heretofore incurable ear affections. The author recommends that in cases where impairment of hearing exists with symptoms of adenoid growths, or wherein there are recurrent attacks of earache— frequently followed by suppuration or obstinate nonsuppurative or old chronic suppurative cases with offensive discharge, or in fact any pathologic ear condition for which the cause is not readily found-the nasal pharynx be thoroughly examined for adenoids and, if found, the physician's duty is plain, namely to treat the nasopharynx as well as the ear. Adnoids are found more frequently than is generally supposed, and their removal for middle ear disease most frequently gives prompt and permanent relief, while treatment, without removal, proves quite unsatisfactory. The prognosis with regard to the removal of growths, disappearance of symptoms and improvement of health is good. The tendency to recurrence is only in a very small percentage of cases. The author is emphatic in reiterating that, in patients showing any defect of hearing or tendency thereto, treatment be instituted.