2. The higher members of the pyridine series resemble in physiological action the lower members of the chinoline series, except (1) that the former are more liable to cause death by asphyxia, and (2) that the lethal dose of the pyridines is less than one-half that of the chinolines.

3. In proceeding from the lower to the higher members of the chinoline series, the physiological action changes in character, inasmuch as the lower members appear to act chiefly on the sensory centres of the encephalon and the reflex centres of the cord, destroying the power of voluntary or reflex movement; while the higher act less on these centres, and chiefly on the motor centres, first as irritants, causing violent convulsions, and at length producing complete paralysis. At the same time, while the reflex activity of the centres in the spinal cord appear to be inactive, they may be readily roused to action by strychnine.

4. On comparing the action of such compounds as C,H-N (chinoline) with C,H13N (parvoline etc.), or C,H1N (collidine) with C,HN (conia, from hemlock), or C10H10N, (dipyridine) with COHN, (nicotine, from tobacco), it is to be observed that the physiological activity of the substance is, apart from chemical structure, greatest in those bases containing the larger amount of hydrogen.

5. Those artificial bases which approximate the percentage composition of natural bases are much weaker physiologically, so far as can be estimated by amount of dose, than the natural bases; but the kind of action is the same in both cases.

6. When the bases of the pyridine series are doubled by condensation, producing dipyridine, parapicoline, etc., they not only become more active physiologically, but the action differs in kind from that of the simple bases, and resembles the action of natural bases or alkaloids having a similar chemical constitution.

7. All the substances examined in this research are remarkable for not possessing any specific paralytic action on the heart likely to cause syncope; but they destroy life either by exhaustive convulsions, or by gradual paralysis of the centres of respiration, thus causing asphyxia.

8. There is no appreciable immediate action on the sympathetic system of nerves. There is probably a secondary action, because after large doses the vaso-motor centre, in common with other centres, becomes involved.

9. There is no difference, so far as could be discovered, between the physiological action of bases obtained from cinchonine and those derived from tar.

Section 2 removes doubts as to the time when the Public Health Act, 1872, came into force, and renders legal the proceedings of a sanitary authority which were previously open to question.

Section 3 declares that all the powers, liabilities, and obligations of a sanitary authority acting previously to the passing of the said Act apply equally to the urban sanitary authority to whom such responsibilities were transferred.

Section 5 prescribes the manner in which two or more sanitary authorities may agree jointly to appoint a medical officer, etc.

Section 19 confers special powers on the chief officer of police in any district for the recovery of his expenses from the authority in default with respect to the removal of nuisances. Orders of the Local Government Board may be enforced by a writ of mandamus.

Section 21 requires every urban sanitary authority, when the Local Government Board by order so direct, to make due provision for the proper cleansing of streets, the removal of house-refuse from premises, and the cleansing of earth-closets, privies, ash-pits, and cesspools within their district; with a penalty of 5s. a day upon the sanitary authority who fail, without reasonable excuse, for seven days after notice from the occupier, to remove the refuse or to cleanse the places above referred to.

Section 33 enables any sanitary authority, subject to the provisions of the Sanitary Acts, to buy up any water-mill, dam, or weir which interferes with the proper drainage of or the supply of water to its district, and, for the purpose of supplying its district with water for drinking and domestic purposes, to purchase either within or without its district any land covered with water, or any water, or right to take or convey water.

Section 40 enacts that every notice given on behalf of a sanitary authority shall be deemed to be sufficient if it be written or printed, or partly written and partly printed, and is duly signed.

Section 41 prohibits works from being executed at all if disapproved of by the sanitary authority, unless they can be shown to be in conformity with the law.

Section 45 enables sanitary authorities to make by-laws for regulating the lodging and treatment of hop-pickers.

Section 47 enables the Local Government Board to enforce certain provisions with relation to houses let out in lodgings, without necessitating previous application to the Board. The sanitary authorities are now further empowered to make regulations for the ventilation of rooms, the paving and drainage of premises, the separation of the sexes, and the notices to be given in case of any dangerously infectious or contagious diseases.

Section 50 provides that, upon representation to any sanitary authority that the water in any well, tank, or cistern, public or private, or supplied from any public pump, and used, or likely to be used, for domestic purposes, is so polluted as to be injurious to health, such authority may apply to the petty sessions for an order to remedy it. After summons the justices may make an order directing the well, tank, or cistern to be closed, or the water to be used for certain purposes only, or providing otherwise as shall appear to them to be requisite to prevent the use of the water for drinking purposes. The justices may also cause the water to be analysed at the cost of the authority. The expenses incurred by the authority are to be charged upon the funds applicable to their general expenditure. An appeal to the quarter sessions is given against the order, and the justices, if they dismiss the application, may award costs to the party summoned.

When an order is made for the removal of a sick person to a hospital, under the 29 and 30 Vict., c. 90, section 26, some difficulty has arisen in consequence of that section referring only to a hospital within the district. It is now provided in section 51 of the present Act, that every hospital declared by the Local Government Board to be within a convenient distance of the district of the authority shall be deemed for this purpose to be within their district. Another difficulty existed in consequence of the omission in the same section of the 29 and 30 Vict., c. 90, to state to whom the order of the justice should be directed; that difficulty has been removed by providing that it may be directed to a police or other officer.

By Section 53 the right and power of complaint given by Section 13 of the 23rd and 24th Vict., c. 77, one of the Nuisance Removal Acts, to any inhabitant of any parish or place, in reference to nuisances on private premises in the same parish or place, is extended to nuisances on public premises, and may be exercised by any person aggrieved.

By Section 54, the 26th and 27th Vict., c. 117, sect. 2, which relates to the inspection of articles of food, is extended to milk, and the proceedings against offenders are facilitated by providing that the justice who is empowered to convict the offender need not be the justice who ordered the article to be destroyed.

Section 55 further extends the powers of that Act by enabling entry, inspection, and seizure to be made upon premises where there is reason to believe that unsound food is kept or concealed, the previous statute only applying where the food is openly exposed or deposited, or kept in preparation for sale.

Section 56 provides for the punishment of persons who, on the letting of houses, knowingly make false representations with respect to infectious diseases therein, by rendering such persons liable to imprisonment or a penalty not exceeding £20.

Quite half of the clauses apply equally to both rural and urban districts. These have corresponding numbers, which facilitates reference.

PURIFICATION OF RIVERS.-We understand that the Local Government Board are preparing a Bill on the question of the purification of rivers.

FROM ABROAD.

BENZOIC ACID IN AMMONIACAL CYSTITIS.

In our number of February 7, page 163, we noticed a paper presented to the Académie des Sciences by Prof. Gosselin and Dr. A. Robin on the treatment of ammoniacal urine by benzoic acid. Since then they have published an extended memoir upon the production and effects of ammoniacal urine, in the Archives Générales for May and June, in which they go fully into the history of the subject, and detail a great number of experiments which they have performed. In another memoir, in the number of the Archives for November, they enter at full length upon the treatment of the cystitis which they have found to be induced by ammoniacal urine.

"In the case of a solution of continuity of the vesico-urethral mucous membrane, the patient is exposed to all the dangers of a general intoxication. It may determine local complications resulting from the immediate action of the urine on the divided tissues, giving to the urinary infiltration quite a character of special gravity. On the other hand, whether a wound of tissue be superadded or not, this condition may be the cause of wellknown effects of a different nature from the preceding. There is first the constant irritation of the mucous membrane of the bladder by this urine, whence comes an abundant secretion of mucus, which favours the decomposition of the urea. This irritation, more or less prolonged, may end in a more or less intense cystitis, which in all cases has a remarkable tendency to become chronic. Another result not less important is that the ammoniacal condition favours the formation of ammoniacomagnesian phosphatic calculi; for, as Prof. Robin has shown that, as the phosphates play an important part in the economy by reason of their property of combining with ammoniawhich they fix and saturate,-so, in the various humours and in the urine, they seize the ammonia as it is formed. Unfortunately, the ammoniaco-magnesian phosphate is insoluble.'

The problem is to saturate the carbonate of ammonia of the urine without employing substances which may form insoluble salts, or such as are possessed of poisonous qualities. In this way we may be able to prevent, at least in part, the local and general accidents which are due to the absorption of ammoniacal urine and to the contact of this with divided tissues. In any case such neutralisation would serve as a powerful adjuvant to the treatment ordinarily employed in diseases of the urinary organs. Carbonate of ammonia is a very alkaline salt, being almost a base by reason of the facility with which its carbonic acid is displaced, and our object is to select among the acids such of them as are best qualified to meet the object mentioned above. The authors, after passing in review the objections which exist to the employment of the various other acids which have been resorted to for this purpose, come to the conclusion that benzoic acid, formerly recommended by Alexander Ure, is the only one which meets the contingency. This is rapidly transformed into hippuric acid, and exerts no ill effect upon the economy, persons both in health and ill being able to take from two to six grammes per diem without detriment. Hippuric acid, thus formed, increases the acidity of normal urine, and in ammoniacal urine prevents the formation of phosphatic deposits by combining with the ammonia, which without it would have formed with the phosphate of magnesia contained in the urine an insoluble ammoniacomagnesian phosphate. The hippurates in general, and especially the hippurate of ammonia, are very soluble. Benzoic acid is very slightly soluble in cold water, which constitutes one of the difficulties of its employment; but it may be given in suspension in mucilaginous or syrupy mixtures. A formula is-Benzoic acid, 1 to 3 parts; neutral glycerine, 4 to 6 parts; and mucilaginous mixture, 150 parts. As a general rule, only one gramme (fifteen grains) per diem should be given at first, this quantity being rapidly increased to three or four grammes. To many patients as much as six grammes may be given, providing this quantity be not persisted in for too long a time, as indicated by dryness and a sense of smarting in the pharynx. The production of acidity or neutralisation of the urine does not take place at once, the extreme limits of time which have been observed being from five to nineteen days, the mean period being from seven to eight days. This effect is announced by the diminution of phosphatic deposits, pus, and blood, and by a modification in the odour of the urine, the fetidity of which is gradually lost.

Four well-marked cases are given, and the authors appropriately reprint an interesting case related thirty years since by Alexander Ure, in his paper "On the Treatment of Phosphatic Deposition," published in the Provincial Medical and Surgical Journal, February 11, 1843, and "Braithwaite's Retrospect," vol. vii. The following are the conclusions of Prof. Gosselin and M. Robin's memoir :

"1. The ammoniacal condition entering in part into the production of the accidents which supervene after operations on the urinary organs, it is highly desirable to prevent or diminish it. 2. Benzoic acid and the balsams which contain it, and probably other vegetable productions (as salicine, cinnamic acid, etc.), conduce to this result. 3. The hippuric acid which is produced acts in several ways--(1.) By forming a hippurate of ammonia which is less poisonous than the carbonate. (2.) By retarding the decomposition of the urine, and the consequent production of the carbonate. (3.) By preventing the formation of insoluble phosphatic deposits, which are a cause of cystitis, and may become the point of departure of calculi. 4. The administration of benzoic acid should be recommended for the subjects of ammoniaco-purulent cystitis, and especially those of them who have to undergo operations on the urinary organs."

JABORANDI AS A DIAPHORETIC AND SIALOGOGUE.

M. Albert Robin communicated to the Therapeutical Society (Gazette Hebdomadaire, November 20) an account of his investigations into the effects of this drug, in which he has been engaged in Prof. Gubler's ward at the Beaujon. Under its influence the urea is at first diminished in quantity in consequence of the quantity of the urine being diminished; but after some days both these are increased, and the same may be said of the chlorides and the uric acid. This last has not been found either in the sweat or saliva, but the urea has been met with in the proportion of 3.12 grammes per litre. In a case of albuminuria the amount of albumen diminished during the first twenty-four hours from 17-20 grammes to 15:40; but the diminution was not permanent except in one case, in which it continued reduced from 14:40 to 12 grammes. The temperature increases in ten or twenty minutes, rising from 37° to 39° cr 39.8°; the pulse also increases (from 96 to 105, for example). During the sweating the temperature falls to 37 73,37·6°, or 37·2°, and, when this is terminated, to the original 372. For the next two days after the administration both pulse and temperature remain lower than the normal rates. When the sweating commences, a true experimental asystolie" is produced, the tension diminishing notably; but next day the tension is reproduced and becomes sometimes more considerable than in the normal state. The jaborandi therefore seems to act on the vaso-motors, diminishing tension by paralysing them and facilitating the passage of the blood through the capillaries of the skin. In several cases in which it was given in minutely divided doses, there was neither sweating nor salivation, an abundant diuresis taking place, so that the urine increased from 750 to 1380 grammes. The effect of jaborandi on animals is very marked: guineapigs are seized with salivation, weeping, and diarrhoea, true ecchymoses being found in the intestines, and dogs become instantly salivated, their gastric secretion being also much increased.

M. Gubler observed that he had recommended M. Robin to employ the divided doses, in consequence of his having observed that diuresis occurred the next day or day but one after taking a large dose. He supposed that if the portion of the jaborandi which remained in the system after three days proved thus diuretic, this effect might be at once produced by giving small divided doses. A small quantity thus does not suffice for influencing vascular tension, acting only on the kidney. M. Gubler believes that the sweating determined by this drug depends upon the diminution of the tension which it canses, but that a complete equation cannot be established between this diminution of tension and the sweat. Another factor is the secretory irritation of the glands-an irritation acting on the kidney, and inducing diuresis.

At the Biological Society (Gazette Médicale, November 21), Dr. Ball also read a note of some experiments that had been made with this substance by himself and Dr. Hardy. After having collected the urine of the preceding twenty-four hours and administered a bath, they gave the patient next morning an infusion of jahorandi, formed of four grammes of the leaves and 500 of boiling water. The sweat was retained during four hours by means of a caoutchouc covering with which

enveloped the patient. Some coffee was given in order to prevent vomiting, which often occurs, and the urine passed during the day was carefully preserved. In ten experiments three results were obtained:-1. The quantity of urea excreted in the urine was always diminished. 2. The sweat always contained a certain portion of the urea. 3. On adding together these two quantities the total was always (excepting in one case) inferior to the amount excreted in the urine only the day before. Traces of urea were also found in the saliva, but in too small a quantity for quantitative analysis. As a general rule, the quantity of urine on the day of administration was much diminished, and the proportion of urea was much increased. There were, however, exceptions to this rule. The mean quantity of the diminution of urea excreted after the administration of the jaborandi, as compared with that excreted prior to this, was 6.78 grammes. The greatest difference amounted to 19.60 gr., and the least to 0.60 gr. In one exceptional case the quantity of urea found in the urine and sweat exceeded that found in the urine on the day before by 1.70 gr. The mean quantity of urea excreted in the sweat was 114 gr., the maximum being 3·10 gr., and the minimum 0·25 gr.

TREATMENT OF PERTUSSIS.

M. HERVEZ DE CHEGOIN recommends (Union Médicale, November 14) the administration of quinine on the following grounds:"When we examine with care the course of this disease we always find that it succeeds to a catarrhal affection of the airpassages, and that it is consequently never a primary disease. We are struck also by the paroxysms which characterise it, and are renewed at irregular intervals, but with a true intermittence. I have been led to form my opinion on the nature of pertussis by observing what takes place in other organs. Whenever any tissue, parenchymatous, membranous, or muscular, becomes the seat of inflammation or of simple congestion, the nervous element which enters into the composition of this tissue participates in its suffering, and continues to suffer, because it is more sensitive, when the primary affection of the entire tissue has disappeared; and as, according to a law appertaining to the nervous system, an intermittent form is almost always assumed, the symptoms are renewed with circumstances that may lead to error as regards this secondary condition. How often do we find in adults that, after the ordinary duration of a bronchitis, the cough which was thought to be lost is renewed at nearly regular hours, no longer accompanied by the catarrhal expectoration, but with a spasmodic condition inducing a secretion quite different from that of the cold? In the same way, after inflammation of the tissue of the uterus, when the material state of the organ has regained its natural conditions, the pains nevertheless persist, but under an intermittent form. The same remark may be applied to all the other organs, and it is at once seen that the antiphlogistic treatment must be followed by another form of medication.

"In applying these conclusions to pertussis, we observe that it is generally after fifteen or twenty days of a catarrhal affection of the upper air-passages that the cough takes on the convulsive character which distinguishes it, and that it recurs in paroxysms. But the intermittence is not regular, because another cause which has its seat in the ventricles of the larynx also gives rise to paroxysms which disturb the regularity of the purely nervous paroxysms. This is the secretion within the larynx itself of a matter of gelatinous aspect, which also induces cough when it is accumulated in a certain quantity, and renders expectoration necessary.

"Consequent on this manner of viewing the disease, the treatment which seems to me rational consists in giving quinine in doses varying with the age of the child, and in applying on each side of the larynx a small blister (mouche de Milan), which may be dressed with half a centigramme, or even less, of the sulphate of morphia. These special means do not prevent the employment of gentle aperients and some ipecacuanha lozenges. In the cases which have come under my care, the pertussis has been cured in from twenty-five to thirty days."

SANITARY REGULATIONS AT GOOLE.-The inhabitants of Goole having failed to form a Local Board district, the Government has decided to do so. An inquiry has been opened by Mr. Harrison, C.E., on behalf of the Local Government for this purpose.

REVIEWS.

The Journal of the Chemical Society. J. Van Voorst. WHILE for obvious reasons it is of importance that everyone who is engaged or interested in scientific investigation should, as far as he is able, endeavour to keep himself au fait with the facts relating to the progress of inquiry, the possibility of so doing has been until recently exceptionally difficult, not only on account of the rapid increase of scientific literature at the present day, and to the accumulation of memoirs which are continually presented to the various scientific societies, but also from the fact that some of the most valuable communications, especially those in connexion with chemistry, were only to be found distributed through foreign journals, thus requiring at the hands of the reader both leisure, facility of access, and acquaintance with the language.

Until within the last two years, the Jahresbericht für Chemie was the only publication which embodied a concise summary of chemical and physical investigation, and though this work has been much consulted, and has proved of great assistance to chemists, the fact that its information was necessarily a year behindhand, and that it was published only in the German language, has always, with many English and American readers, considerably lessened its value as a work of reference.

The Chemical Society of London, taking the Jahresbericht as its model, has determined to publish, in connexion with its own proceedings, an abstract of every paper relating to che mistry, and its applications to physiology and the arts, as soon as such paper has appeared in any scientific periodical, whether home or foreign. By means of an efficient staff of abstractors, and a committee of publication, who are responsible for the accuracy of the abstracted matter, it has succeeded in producing a compendium of chemical information, such as to render its monthly journal unrivalled among the chemical literature of the time. The early pages of the journal are occupied with the communications read before the Society; while the remainder, about eighty pages, is devoted to the abstracts, which average about 130 pages per monthly number. These latter are carefully arranged, according to their subject-matter, under the heads of General and Physical Chemistry, Inorganic, Organic, Physiological, Chemistry of Vegetable Physiology, Mineralogical, Analytical, and Technological Chemistry. By this arrangement future reference is greatly facilitated. The abstracts, though not necessarily intended to be perfect substitutes for the original papers, nevertheless constitute accurate and faithful analyses of the memoirs to which they are related. They are not mere outlines of the authors' communications, giving the barest information in a disjointed and unsatisfying manner; on the contrary, they are thoughtful, carefully condensed précis, embodying the whole of the substance of the original without unnecessary details, and placing the subject before the reader in a manner in which it is most likely to be read and appreciated.

The publication of the Chemical Society in its present form meets the expressed requirements of a large section of the scientific world; to many, indeed, it is almost impossible to over-estimate its value. It obviates the tedious necessity of perusing a host of foreign periodicals-a task too often neglected,-while it enables the reader, without any great expenditure of time, to make himself accurately acquainted with the progress of scientific work.

The Mutual Relations of Druggists and Physicians: an Address before the Graduating Class of the Massachusetts College of Pharmacy, April 22, 1874. By CHARLES E. BUCKINGHAM, M.D., Professor of Midwifery and Medical Jurisprudence in the Medical Department of Harvard University. David Clapp and Son, Boston, U.S.

THE above address is reprinted from the Boston Medical and Surgical Journal of May 7, 1874. The main feature to be noticed in it is the strong recommendation which it contains for increased education amongst those who are about to become druggists or pharmaceutists; so that, in the future, the proprietor of every drug store and laboratory may be noted for his scientific acquirements, rather than for his knowledge of fancy goods and patent medicines. This portion of the pamphlet applies with equal force to the chemists and druggists of our own country; the remainder contains many useful hints, and much good advice for our cousins across the

water, which would scarcely be found applicable here, on account of the somewhat different complexion of the business details.

The Medical Temperance Journal, October, 1874. William Tweedie, 337, Strand.

THE last quarterly number of the above little journal, which has lately reached us, contains a paper on Health and Education, wherein the sanitary movements of the present day are very ably discussed. The writer passes in review the different Health Acts which Parliament has passed, but expresses an opinion that sufficient attention has never yet been paid to the most fruitful cause of all diseases and excessive mortalitythe habit of drinking which is so deeply rooted in the population. Amongst the remainder of the contents is a very interesting report furnished by Dr. E. A. Parkes, M.D., F.R.S., Professor of Military Hygiene in the Army Medical School at Netley, on the good effects, or otherwise, of the issue of a spirit ration to the men during the march to Coomassie in the late Gold Coast campaign. The evidence adduced goes to prove that those men in the force who were teetotalers sustained all the fatigues of the march, and furnished a relatively smaller number of sick than their companions who received the small spirit ration issued. At the same time it must be said that the majority of the opinions collected are in favour of a small issue of rum, given with the evening meal, diluted, after the termination of the day's work.

FOREIGN AND

COLONIAL

CORRESPONDENCE.

AMERICA.

PHILADELPHIA, September 25. HYDROPHOBIA: DR. HAMMOND ON THE MORBID ANATOMY OF THE DISEASE; HIS LIBEL SUIT AGAINST THE "MEDICAL RECORD -STATES "MEDICAL DIRECTORY "-AMERICAN EDITION OF ZIEMSSEN'S "SPECIELLE PATHOLOGIE UND THERAPIE "THE UNITED STATES ARMY MEDICAL SERVICE -CONVENTION OF EX-CONFEDERATE SURGEONS-MEDICAL JOURNALS IN AMERICA.

A MONTH or two ago the public prints were agitated with the particulars of the deaths of three or four individuals from hydrophobia, and column after column of type was set with learned and unlearned opinions on its pathology and treatment. Several well-known medical names figured conspicuously in large type in the daily journals, that irrepressible individualthe modern interviewer-having visited them for the purpose of obtaining their sentiments on the spinal cord, nerve-cells, corpuscles, etc.-subjects which, by the time they reach the public eye through the medium of an unscientific reporter, become wonderfully confused and very heterogeneously commingled. It was thought by many in the profession and out of it that some of those whose views were thus quoted were rather self-satisfied at the prominencé given them by this temporary notoriety, although it was perhaps unavoidable. The excitement of the hour having subsided with the death and burial of the subjects of the disease, the scientific aspects of the case became matters of interest to the profession at large, and, in a more presentable shape than had hitherto been accorded them, they were introduced and discussed in the various medical and medico-legal societies, of New York especially, in which city and vicinity the cases had occurred and been submitted to post-mortem examination. At a special meeting of the Neurological Society of that city, Dr. Wm. A. Hammond, whose name is associated with numerous interesting investigations into nervous phenomena, referred to the case of a man named McCormick, who had died from the effects of the bite of a dog. In examining the cortical substance of the brain he found the external layer of nerve-cells almost entirely replaced by oil-globules, the rest being filled with a highly refracting granular matter, which proved also to be finely divided oleaginous particles. So in the next stratum of cells, but to a much less marked extent, was there a similar substitution. The other portions of the encephalon, as the corpora striata, thalami optici, and cerebellum, were somewhat injected, but not otherwise transformed. The changes in the medulla oblongata were, in his view, more interesting. The grey matter of which the nuclei of the pneumogastric and hypo- i

glossal nerves are composed was decidedly granular, consisting of oil globules and amyloid corpuscles, with extreme atrophy or almost total obliteration of the cells. The spinal cord presented a similar condition, so far as the grey matter was concerned. He was disposed to regard the symptoms of the disease, such as the delusions and excitement attendant upon it, as referable to the changes of structure which post-mortem examination had exhibited in the various portions of the nervous system.

The views of Dr. Hammond were freely criticised and honestly dissented from by several excellent observers. It was contended, for instance, that the pathological appearances were insufficient and inconclusive; that the very authorities which he had quoted did not confirm him in his deductions; that several previous examinations had been made abroad, in which no satisfactory results had been obtained; that, according to Fleming, whose work on hydrophobia he justly lauded, recent microscopic examinations in similar cases had shown nothing but intense congestion; that the cadaveric lesions noted after rabies resemble (according to Röll) those which result from acute narcotic poisoning, and that it is not at all unlikely that McCormick was labouring under the narcotic influence of atropia; that, according to Trousseau, "the pathological changes found after death are only those dependent on the asphyxia which occurs in the later stages"; and that the view that a healthy dog could produce hydrophobia by a bite inflicted in a moment of temporary anger only-not madness in its full signification-was untenable and not borne out by the language of Fleming, who was quoted by Dr. Hammond as confirmatory of this view, although he expressly states that "no wound, injury, or bite from a healthy dog will produce the specific disease we term rabies." So it may be safely averred that the pathology of this terrible affection still remains a mystery, in spite of the well-meant efforts of recent Cisatlantic investigators, and that the profession requires more light to enable it to form any decided opinion on the subject than has yet been thrown upon it.

The New York Medical Record, in the interests of independent medical journalism, freely criticised, in its issue of August 1, the salient features of the whole controversy from its incipiency in newspaper pseudo-science to its culmination in elaborate discussion in medical periodicals and societies. Some portions of the history of the case naturally excited ridicule, the minutiae admitting of a construction bordering on the reductio ad absurdum. It reflected especially upon the professional sensationalism as exhibited in the publication of the views of medical men in heavy type in the New York Tribune, and sympathised with the public and with younger microscopists in their bewilderment at the descriptions of the microscopical examinations published in the Daily Press, and the accompanying illustrations, of which it states-"one reminded us of a Herald war-map, another was filled with fiends like those of Gustave Doré, while in a third was traced a close resemblance to a representation of superannuated spermatozoa in Réflexions sur le Mariage' or a similar work." It animadverted upon Dr. Hammond for having, as it states, appropriated all of interest in McCormick's brain in the post-mortem examination, when there were several other medical gentlemen present who would have been glad to secure a segment of some important part of the nervous system for after examination, he having cut off the pons varolii, medulla oblongata, and a small section of the upper portion of the spinal cord, and placed them in bottles which he had provided for the purpose. The result is a libel suit instituted by Dr. Hammond against the publishers of the Record, of which Dr. George F. Shrady is the able and worthy editor. The word "appropriate seems to be the precise point of annoyance, which the Record still insists on defining in its issue of September 15, according to Crabb, as applicable to this case. Dr. Hammond was also greatly chagrined at the opinion of the coroner's jury, entirely composed, by the way, of physicians of marked prominence in New York, that the post-mortem investigations in this case (those made by Dr. Hammond) had no value in determining the pathogeny of the disease. The Doctor did not accept the offer made by the editor of the Record to give him the opportunity of a full and free utterance of his views in the columns of that journal, but maintained that it was its duty to retract all the insinuations against him; hence the libel suit. If the case comes to the courts it may offer some points of general interest worthy of detailed reference.

Among the works recently published in this country is a "Medical Register and Directory of the United States,

systematically arranged by States." It is a very useful work for reference, and comprises the names, post-office addresses, educational and professional status, of more than 50,000 physicians, with lists of medical societies, colleges, hospitals, and other medical institutions, besides abstracts of the medical laws of each State, notices of mineral springs, etc. The number of physicians represented in its pages is scarcely an absolutely accurate estimate of the whole number, but must be somewhat of an approximation to it. The work is yet crude and incomplete, giving only an indication of what it may become hereafter; and that, too, in spite of a vast amount of labour expended on it. It is too full of details in many instances, and incomplete or unsatisfactory in the case of the most distinguished members of the profession, although they are said to have been thus curtailed of their deserved proportion of notice from their not supplying the editor with the material for it in time. It is difficult to secure perfect immunity from error in such a work, but the labour in its preparation must have been

enormous.

Speaking of immense works, I am reminded that William Wood and Co., of New York, have just issued the first volume of the great 66 Cyclopædia of the Practice of Medicine," which, fresh from the hands and brains of our German brethren, is to be complete in fifteen large octavo volumes of from 500 to 700 pages each. The work is termed by the publishers "a practical handbook," but the size of the work almost removes it from the category of handbooks or manuals in the strictest sense of the terms. The American publishers have made a special arrangement with the German publisher and editor, and copyrighted the translation. I suppose it will be known as Von Ziemssen's Cyclopædia, he having been its literary accoucheur in Germany, although but few of the articles are written by him personally. The first volume of the series relates to "Acute Infectious Diseases," and includes articles on Typhoid Fever, by Professor Liebermeister; Typhus and Relapsing Fevers and Cholera, by Professor Lebert; the Plague, by Professor Liebermeister; Yellow Fever, by Dr. Hainsch; Dysentery, by Professor Huebner; and Diphtheria, by Dr. Oertel. The well-known names of Schroeder, Wagner, and Rindfleisch are observed among the collaborators, the scope of the work embracing in the fullest extent every department of practical medicine in the 10,000 pages which are suggested as the possible breadth of this magnificent cyclopædia. It is said that arrangements have already been made to publish the work in the French language also.

I referred in my last letter to the condition of the medical service of the United States Army in regard to relative rank especially. The only change that has occurred in this department consists in the fact that promotions are now allowed within it, and that new appointments are being made; but the main question, which involves the consideration of the comparative standing of medical and other officers, will undergo no change until the next session of Congress.

An interesting convention was recently held at Atlanta, Georgia, of ex-Confederate surgeons-those who had opportunities during the late rebellion of collecting many interesting medical and surgical facts from their experience in service on the Southern side. It is to be inferred that they have been stirred to this rather late activity by the magnificent efforts and successes of the Government at Washington in the publication of valuable circulars from the Surgeon-General's office, and in the issue of the large quarto volume of the "Medical and Surgical History of the War of the Rebellion." The war has been over more than nine years, and the delay is not, therefore, quite so favourable to the enterprise as if it had been undertaken at an earlier day, for the freshness and novelty must be, to a certain extent, worn off. Much is to be expected, however, from the personal reminiscences of men whose ability and skill were honourably exhibited on so many fields, and from the judicious preservation of their medical records and statistics.

I had purposed making some allusion to the present status of American journalism, but must defer it to another opportunity. I may, however, state that the Medical Times and Gazette, the Lancet, and other medical serials of Great Britain have a pleasant reception accorded them on the private tables of physicians and in all the medical libraries and society-rooms, and meet with a very numerous list of readers. The Obstetrical Journal is republished by Mr. H. C. Lea, of Philadelphia, a supplement on American obstetrical progress being appended to each number. Gynecology is making wonderful strides in this country. But of this and other subjects more anon.

REPORTS OF SOCIETIES.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY.

TUESDAY, NOVEMBER 10.

WM. WHITE COOPER, F.R.C.S., Vice-President, in the Chair. ON THE ELIMINATION OF UREA IN CERTAIN DISEASES. MR. SAMUEL WEST, B.A. Oxon., read a paper on the above: subject. The method employed for estimating the urea was that described in a paper read before the Chemical Society, by Dr. Russell and Mr. West (Journal Chem. Soc., August, 1874). The cases examined are three of pneumonia, four of rheumatic fever, two of Addison's disease, and one of diabetes mellitus. Pneumonia: The total volume of the urine was much reduced during the fever, returning to the normal during convalescence. The percentage of urea was always high during the fever, and fell suddenly when the fever terminated. There was no more definite relation to be observed than this very general one between the percentage of urea and the temperature. Where the nervous symptoms were very marked, the percentage, though above the normal, was below that of the other cases. The total urea during the fever was in all these cases below normal, and markedly reduced when compared with the quantity of nitrogen ingested. There were several possible explanations of the fact; the most probable were two, of which the first accounted for the apparent disappearance of nitrogen by its being stored up in the body-(a) by retention, in which case there must be a critical discharge during convalescence; or (b) by going in some way to form the nerve-tissue produced in the lungs. The second explanation was that nitrogen left the body by the kidneys, but in some other form than urea, and so escaped estimation. In convalescence the total urea at first was reduced, and subsequently increased, rising gradually to the normal. From a comparisors of these cases of pneumonia with others quoted in books, it was probable that there were two sets of cases of pneumonia, in one of which the total urea was increased, while in the other it was diminished. Rheumatic Fever: As in pneumonia, the total volume of the urine was much reduced. The percentage during the fever was very high; at its termination dropping suddenly, and returning gradually to the normal. Changes in diet produced oscillations in it. The great increase in the total amount of urea mentioned in books was not found to occur in these cases. Addison's Disease: The total volume of the urine and the total urea were much reduced. The percentage of urea, however, remained normal, so that the emaciation and loss of strength might be connected with the loss of appetite, and refer rather to diminished tissue-repair than to increased waste of tissue. Diabetes Mellitus: The total volume of urine was small for the disease, the percentage of urea was not above normal, and the total urea was much increased. The increase was not due in this case to excessive ingestion of food, but probably to increased metamorphosis of tissue. The sugar might probably be referred to the same source, a conclusion notably supported by Schultze and Riess's experiments on phosphorus poisoning, and by Dr. Sydney Ringer's experiments, in which a direct relation between sugar and urea in diabetes was established, and their dependence upon the nitrogenous elements of the food shown. There were probably as many kinds of diabetes as there were factors in its production, and one of these might be self-digestion by pancreation. General Conclusions: The author arrived at the following conclusions:-From the indefinite variations which occurred from day to day in the total volume of the urine and in the total amount of urea, very little information of clinical importance is to be expected. It is to the percentage that we must look for indications of the greatest value. All information which can be derived in disease from the percentage of the total urine can equally well be derived from that of the urina sanguinis; hence the necessity of collecting the total urine of the twenty-four hours is avoided. It is not yet certain that in health a similar relation exists between the percentage of the urina sanguinis and that of the total urine.. The percentage of urea during fever-1, is high, and remains fairly constant as long as fever lasts; 2, does not follow the slight variations of temperature; 3, does not vary with the volume of the urine; 4, shows oscillations with changes in diet (as also during convalescence); 5, falls with the termination of the fever. During convalescence—1, a gradual and progressive