AMPUTATING and
TREPANNING CASES.

Combined in one for any
Capital Operation.
Contents as Cut Represents.

1 Liston's Knife, large. 1 Liston's Knife, medium. 1 Liston's Catlin, large. 1 Metacarpel Saw. 1 Capital Saw. 1Liston's Bone Forceps. 1 pair Thumb Artery Forceps. 1 Amputating Scalpel. 1 Tenaculum. I Field Turniquot. 1 Esmark's Bandage Complete, with chain band, etc. 1 Galt's Trephine, with handle. 1 Hey's Saw. 1 Trepanning Elevator. 1 Trepanning Brush, 12 Needles Silk, Wire, Wax, etc. In 8 neat Mahogany Case lined with leather.

List price, $35.00, reduced
price, net, $22.50.

The

The New Diphtheria Anti-Toxine. The progress of medical science at the present time is so rapid as to almost make one dizzy to keep pace with it. The particular field of activity a few years ago was in the isolation and identification of the various specific disease germs and the demonstration of their causative relation to the diseases in which they are found active. This cleared up the mists in which we had been groping and showed us clearly the enemy at which we had been firing at random for ages and cycles that are past. This has shown us a better choice of weapons and given us a far greater accuracy of aim. The therapeutic results are not slow to follow.

The science of physiological chemistry has given us some surprising results, with far more promising indications for the future, along the line first laid down by the immortal BrownSequard. It is to be regretted, although, per

haps, unavoidable, that it should have been brought somewhat into disrepute by charlatanist imitators.

But the particular field of progress now seems to be in the domain of bacteriological chemistry, in which great achievements are being accomplished.

The discovery made by Jenner years ago was purely one of empiricism. He found out that, if he would fire in a certain direction through the mist, he would hit the enemy. But he did not know who or what the enemy was. Now we know definitely not only the smallpox enemy, but the hosts of others of a somewhat analogous nature. Having first revealed them to us, the bacteriological laboratory is now preparing for us the most efficient weapon with which to combat and, possibly, exterminate these microscopical hosts.

The profession is already aware of the work of Pasteur in elaborating the preventive treatment of hydrophobia. Also, the work of various investigators that demonstrated the antag onism of the erysipelas toxines to cancerous growths. The latest achievement in this line is the prevention and cure of diphtheria by means of the diphtheria anti-toxine, which has been accomplished by Prof. Robert Koch, of Berlin.

Thus far it shows a success of 100 per cent. when used as a preventative and also when used on the first day of the development of the disease; 97 per cent. when used on the second day, its value declining rapidly when employed after the second day. Subsequent experimentation may still further perfect it, or, on the other hand, experience with especially severe epidemics may reduce the record of its efficiency. The technique of the development of the antitoxine is thus described by Dr. Hermann M. Biggs, who was sent by the city of New York. to investigate the subject:

"Bacilli are taken from a patient suffering from diphtheria, and after these have have been

proven of the genuine diphtheria species they are put away in broth, and after six weeks a new crop has formed. A small number of the bacilli are injected under the skin of the animal which is to be rendered immune. The swelling produced by the injection subsides after a short time, and a second and somewhat larger dose is administered. Thus the doses are increased from day to day until the virus ceases to have any perceptible effect on the animal. Then, when neither its temperature, appetite, nor digestion is affected, its blood contains the antitoxine, and this, when injected into the system of the diphtheria patient, has the beneficial effect above mentioned."

We select, also, the following from the longer statement made by Dr. Cyrus Edson, of the New York City Board of Health:

"The new anti toxine treatment for diph

theria which has been worked out in the Koch Institute for Infectious Diseases in Berlin promises to be one of the most important discoveries of modern medicine, and, so far as can be judged from the data at hand, will afford us the means for not only protecting persons from diphtheria who have been exposed to the disease, but also a certain means for the cure of the disease when cases are subjected to treatment in the early stages.

"One of the most important and significant features of the treatment depends upon the absolutely innocuous character of the remedy, it having apparently no influence, either favorable or unfavorable, in health or in disease, excepting as to its power of neutralizing the poison of diphtheria; so while it has enormous capacity for good, its use is absolutely devoid of danger. The treatment is based upon the following observations:

“First-In diphtheria, death, as a rule, is due to the poisoning by a chemical substance (a toxine) produced by the diphtheria bacillus in the throat and absorbed by the system from the throat.

"Second-A certain degree of immunity, which is temporary only, is afforded by one attack of diphtheria, and this immunity is the result of an acquired tolerance of the toxine. This applies to both animals and man.

"Third-If large animals, such as horses, cows, goats, etc., are inoculated with minute but increasing quantities of the toxine,' as derived from cultures of the diphtheria bacillus, they become gradually tolerant to its poisonous action, and will withstand the introduction of larger and larger quantities through the immunity which is acquired from smaller doses. "Fourth-The immunity thus produced is

the result of the development in the blood of some substance (anti-toxine), which has the power of neutralizing the poison (toxine) produced in diphtheria, and in an'mals, which have been highly immunized (i. e., capable of withstanding very large doses of the toxine through repeated inoculations of doses, minute but constantly increasing in size), the blood, even in small quantities, acquires the power of neutralizing very large, even fatal, quantities of the toxine.

"Fifth-When animals have thus been immunized, blood is withdrawn from the circulation in quantities varying with the size of the animal, and is employed through injections underneath the skin for the treatment of cases of diphtheria, and anti-toxine thus introduced neu

tralizes the toxine absorbed into the circulation of sick persons from the throat, and thus renders them artificially unsusceptible to its action. By this method it is apparently possible to protect any person from the contraction of diphtheria when he has been exposed to the disease and infected, if the symptoms have not yet appeared, and also to cure nearly 100 per cent. of cases where patients are treated in the early periods of the disease. Unfortunately, however, for the rapid and general use of this substence for the treatment of diphtheria, its production requires the constant surveillance of skilled and trained men; a comparatively long period, often four to six months, is necessary to render animals immune to the disease, so that their blood can be employed for the treatment; and finally, when thus rendered immune, they can furnish only sufficient blood, as a rule, to treat a comparatively small number of cases. Therefore, the production of the substance must necessarily be costly, and it can only be produced in sufficient quantities and be placed at the disposal of poor people by municipal and state sanitary authorities."

The City of New York has taken steps to establish stations throughout the city for the treatment of patients afflicted with diphtheria.

The Eucalyptus Tree.-4 Cherished Idol Broken.

According to the investigation made by the Department of State, the anti-miasmatic properties of the eucalyptus trees are almost entirely mythial.

"It is even asserted that not a single instance of health improvement by means of the plant has been satisfactorily established. In Italy it has been cultivated on a very large scale, particularly in the neighborhood of Rome, without accomplishing any results convincingly favor

able. The popular notion that where the eucalyptus thrives there can be no malaria is so far from being correct that there are natural forests of native eucalypti in Australia in which pestilential miasma reigns supreme.

"One notable experiment was made in 1870 at a distance of one mile from the city of Rome in a locality known as the Three Fountains,' where there was an ancient convent. In that place malaria had been so prevalent and destructive of life that it was commonly known as 'The Grave.' A few monks made a practice of going hither every morning after the sun had cleared away the fog, planting as many eucalyptus trees as they could during the day and returning to Rome in the evening. Seven years later, owing to the greatly improved condition of the climate, the monks took up their permanent residence at the convent. This event made such an impression that the Government offered a reward for the culture of the eucalyptus.

"Nevertheless, a few years later, notwithstanding that 55.000 of these trees had been planted at the Three Fountains, malarial fever became as bad as ever there, causing many deaths in a colony of convicts that had been established on the spot. Dr. Montechiare, a physician of Rome, decided that the efficacy of the tree for the improvement of the air was no greater than that of the elm or pine.

"Prof. Crudeli declares that of all diseasebreeding germs the microbes of malaria are most widely disseminated and most readily find conditions suitable for their propagation, excepting only the bacteria which cause blood poisoning. The malarial germs dwell in the soil and are developed in moist and warm weather. They require a temperature of at least 68 degrees Fahrenheit in order to multi ply and diffuse themselves in the atmosphere. Human beings then take them into their lungs in breathing, and in this way they get into the blood. Malaria producing soils are to be found in nearly every part of this globe."

Thorough drainage and cultivation of a country, with destruction of all decaying vegetation, including fallen trees and fallen branches, seems to be successful in dispelling malaria. The great Ohio Valley is said to have witnessed this complete transformation within the past few years.

Do you know of the recent reduction in price of P. O. Money Orders? Three cents will get an order up to $2.50, and five cents up to $5.00. This cost is very trifling, and it is the safest way in which to send money by mail-it is absolutely safe-safer than by registered letter, and that costs eight cents.

Original Communications.

Short articles on the treatment of diseases, and experience with new remedies, are solicited from the profession for this department; also difficult cases for diagnosis and treatment.

Articles accepted must be contributed to this journal only. The editors are not responsible for views expressed by contributors.

Copy must be received on or before the twelfth of the month for publication in the next month. Unused Manuscript cannot be returned.

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than ything else.-RUSKIN.

Editor MEDICAL WORLD:-On page 334 E. M. N. describes a case of epilepsy. 1 would suggest the bromide of lithium, 20 grains, three to six times a day. The scar should be cut loose from the bone, subcutaneously, and kept free by daily mass ige.

The question asked by Dr. Walling (page 334) is of great importance. I think two improvements should be made in the communion service the use of individual cups, and the disuse of wine. The practice of passing a cup from lip to lip ís filthy, and liable to transmit the most loathsome of diseases. There are men who must not touch, taste, handle or smell anything alcoholic; and for their sakes an unfermented grape juice should be substituted for wine.

Dr. Shaw ought to find relief from the iodide. of rubidium, with massage of the joints, chamois skin underwear, oil inunctions and the use of resorcin in full doses, to render the intestinal canal aseptic. If not, she must go to Southern California, and stay there.

Dr. Bobb (page 334) may have a case of calculus on hand, and should examine the patient's bladder. If not, inject into the urethra a few drops of cocaine in petrolatum, ten grains to two drams, passing it into the neck of the bladder.

Dr. Oehme may restore the register of his thermometer by heating up to 105°, and then plunging the bulb into cold water. But he will have to test the instrument again, as it may not register correctly. The best way is to get a new one, and do not try to get the mercury down by jarring it, but only by swinging free.

Will Dr. W. F. (page 335) give his patient a 20 grain suppository of quinine every other This may clear day for a week? up the diagnosis. I would take a look at the hygienic con