ed with the secondary non-poisonous molecules of the protein because the poison group is common to all while the secondary are different in every one. Here, then, we find that the substance that produces the symptoms of disease has nothing to do with the forces of immunity. This poison group is not a toxin because it does not stimulate the production of antibodies as all toxins do.

The part of the bacteria that does stimulate the immune forces is the secondary non-poisonous molecules.

7. After the production of this enzymelike is once started it increases in amount and activity until it reaches the state when it will destroy the bacteria faster than they can multiply and in this way terminates the in

fection.

8. These enzymes are specific for every type of protein and can be demonstrated by laboratory methods. Now in the type of diseases that do not give an immunity to future infections of the same kind these enzyme soon disappears, but in diseases in which one attack confers immunity this enzyme remains in the circulation, so when this infecting agent gains entrance to the body at some future time, this enzyme destroys it before it can localize and multiply.

9. That the poison liberated from bacteria in certain diseases show a predilection for certain localities in the body and the typical symptoms of this disease is due to the location of collection of this poison, as in pneumonia the lung, meningitis the brain and spinal cord, etc.

Here, then, is the newer, more practical, explanation of bacterial immunity in brief. Do not confuse this bacterial immunity with toxin immunity as we see it in diphtheria. 1. The liability of the body to an infection depends on the infecting agents' ability to live and multiply within the body and not on the bacterial ability to produce a toxin. Natural immunity to any infection is due simply to the inability of that bacteria. to multiply within the tissues.

2. That when bacteria do gain entrance to the tissues localize and multiply the body cells attempt to rid themselves of this foreign protein by a process of parenteral digestion, that is the cells stimulated by the presence of this foreign protein elaborate an enzyme that tends to break it down so it can be used as food or eliminated as waste. That this enzyme increases in amount and activity until it destroys the bacteria faster than they can multiply.

3. That this enzyme is specific for the bacteria, or other protein, that produced it and has the ability to digest this substrate outside of the body, making it possible to demonstrate

the phenomena in the laboratory.

4. That this enzyme or really the immune process stimulator has to do with the secondary non-poisonous molecules of the protein. and not the poison group. and not the poison group. That this poison group, when it is freed of the surrounding non-poisonous molecules, gives rise to the symptoms known as sepsis, namely increased pulse rate, rise in temperature, loss of body weight, etc.

5. That in infections which do not give an immunity after one attack this enzyme is rapidly eliminated, and in infections that are followed by an immunity to future attacks the enzyme is retained within the body and maintains this immunity by destroying the bacteria, when they gain entrance before they .can localize and multiply.

How can we prove and apply this theory or explanation. I can quote you laboratory procedures and results that would take up the whole day but here is one practical illustration that you can verify by consulting any late book in medicine.

Typhoid bacilli isolated from cases of typhoid fever are grown on solid media in an incubator, washed off and treated by heat in such a manner as to destroy their ability to multiply but not change the chemical molecule of their specific protein.

This emulsion or suspension of dead bacteria having been standardized is injected into an individual that has never had typhoid fever. After an interval of a few hours this individual will complain of a little headache, a slight rise in temperature and pulse, in other words present a picture of very mild short-lived sepsis. After an interval of seven to ten days a second injection is given and this is followed after another similar interval by a third injection.

Now, according to the explanation given, this typhoid bacilli in the subcutaneous tissue will stimulate certain cells in the body to produce an enzyme that will destroy or better digest this foreign protein, the subsequent injection increase the amount and activity of this ferment. How can we prove this: First by taking some of this individual's blood, separating the serum from the blood cells, the enzyme always appearing in the serum, and then following a technic advocated by Abderhalden, we demonstrate that this serum contains a substance, enzyme like, that will convert the albumin of dead or living typhoid bacilli into peptone, thus proving the digestive action. Second we demonstrate that this substance is not present in a central or individual who has not had typhoid or has not been injected.

Now from the practical clinical side it has been proved in thousands aud thousands of

instances that individuals thus injected will rarely, within certain time limits, contract typhoid fever when exposed to it, while individuals under the same circumstances that have not been injected contract in the majority of cases the infection.

What has been accomplished in typhoid fever has in a way been possible in scarlet fever, epidemic meningitis and whooping cough.

The reason the prophylactic base of vaccines is limited to-day is that as yet we have not acquired the ability to grow all bacteria out of the body so that they will have the same chemical composition that they have when growing in the body.

In cases where prophylaxis is not possible we can help our patients by having an autogenous vaccine made from the individual in

fection in this way obtaining the proper chemical molecule and helping nature by more rapidly increasing the needed ferment.

In closing let me repeat again, the more simple and practical, at least to my mind, explanation is this one based on the ferment or enzyme theory. Metchnikoff came near to this explanation years ago, in his white cell work, but it was too simple and he strove to find a more complicated one. This explanaThis explanation easily falls in line with our knowledge of normal metabolism and digestion. The cells of the body are always changing foreign bodies that they come in contact with so they can eliminate them or use them as food. This is true in as low a form of animal life as the

ameba or the jelly fish and this low form, too, demonstrates the use of these ferments as a protective force not only physically but mechanically as any one can testify who has injudiciously held a jelly fish in his hand.

Abderhalden in his work along this line of specific ferments has shown that when proteins, originating within the body itself, or abnormal as in pregnancy, cancer, etc., the cells of the body elaborate an enzyme specific for this proteid the purpose of which is to eliminate this substance. This gives us the foundation for our new serological tests for pregnancy and cancer.

Otitic Pneumococcic Bacteremia.-A. S. Tenner New York (Journal A. M. A., July 17, 1915), reports a case of simple otitis media, in which bacteria were found in the blood cultures on the

ninth day of the disease, following a lowering of the temperature and a general bettering of the symptoms. The condition is sufficiently rare, he considers, to be reported. Recovery was retarded a little by the complication of a bowel trouble, but was otherwise complete.

PSEUDO-INFLUENZA VS. INFLUENZA

VERA.*

(A CASE OF CATARRHAL FEVER.)

By E. D. BURNETT, Anchorage. Recently a woman 24 years old came to me. I found the following train of symptoms: Bad breath, coated tongue, mildly inflamed throat, stuffy nose, hearing slightly impaired, tenderness over both kidneys and over urinary bladder, pulse 96; temperature 102, no appe

tite and soreness in the muscles of the neck

and shoulder. She gave a history of a chill two hours before coming to my office.

A visit to the patient's bedside next morning verified a diagnosis of pseudo-influenza or

catarrhal fever. I found much of the soreness in the muscles and over the bladder and

kidneys gone; temperature 99 2-5, pulse 84, tongue cleared up, mild bronchial cough, nose open, throat clear, hearing about normal, and patient's appetite returned.

So we have here a pen-picture of pseudogrippe, or catarrha! fever. This woman gave a history of mild nephritis when 15 years of age, otherwise our case would have presented the simple train of symptoms found in a socalled "acute cold."

I call your attention to the tendency of many of the profession to call a simple catarrhal fever la grippe. I urge you to make one or two extra visits and strive to be more Let us remind you that pseudoaccurate. influenza rarely ever runs a temperature longer than 36 hours and above 101 degrees, and is followed by a mild bronchial cough with a "running nose" for four or five days

providing the case has intelligent treatment. We know that influenza vera has a more severe train of symptoms, is far more prostrating, is more likely to be accompanied by complications, and should have careful after-treatment.

Let us impress these differences upon the laity as we strive to educate them in prevent

ive measures.

to

Cunshot Fractures.-Perthes declares that too many fail to realize that the wound must be dressed without disturbing the immobilization. Any jar or displacement while the wound is being dressed does more or less harm. The plaster cast must be applied in such away as to prevent this entirely while allowing free access the illustrations of casts wound. He gives some which permit this and also protect against soiling the edges of the window in the cast. When the wound has healed, then extension and other measures can be applied as for a simple fracture. *Read before the Oldham County Medical Society.

COUNTY SOCIETY REPORTS

Boone The Boone County Medical Society met with Jno. Walton, at Sayler Park, O., June 16, 1915. Meeting was called to order by President H. H. Hays. Members present were, Hofer, Rankin, Hays and Nunnelley. Visiting guests were Furnish, Lehmann, Gracely, Holt, Gordon, Hannah, MeKim, Phinney, Mingus, R. H. Crisler, Corlton Crisler and Hubert Walton.

L. C. Hafer, asked for withdrawal card to become a member of the Campbell-Kenton County Medical Society, since he has moved to Covington. J. S. Lehmann read a paper on "Feigned Disease, " with report of cases which was very instructive and brought out a hearty discussion. G. C. Rankin read a paper on "Inversion of the Uterus, with Report of a Case," which was very much appreciated by all present.

There being no further business to come before the society it was moved and seconded to extend to Dr. Walton a vote of thanks for the excellent dinner and entertainment of Boone County Medical Society. This was one of our best meetings and am sure all felt well repaid for coming.

Motion carried to adjourn.

S. B. NUNNELLEY, Secretary.

Carlisle The Carlisle County Medical Society met at Milburn, June 1st, with President H. A. Gilliam presiding. The following were present: H. A. Gilliam, J. F. Dunn, R. T. Hocker, H. T. Crouch, G. W. Payne, W. L. Mosby and T. J. Marshall; also Drs. Merritt and Higdon, of Fancy Farm, who were elected honorary members of the society.

The meeting was opened with prayer by R. T. Hocker; after reading and adoption of the minutes of the last meeting, the committee on arrangements reported that the Baptist Church had been secured for place of meeting and that dinner would be served at the hotel.

The regular program was then taken up.

H. T. Crouch read a very interesting and instructive paper on "Puerperal Eclampsia," from his own personal experience eclampsia was most apt to occur during labor, he covered the subject thoroughly and brought out a general discussion by Dunn, Payne, Mosby, Hocker, Marshall and Merritt, Crouch closing.

The society adjorned for dinner, reconvening at 1 p. m.

A. R. Higdon read a paper on "Medical Ethies," which was enjoyed by all present and brought out a general discussion by all.

On motion the following committee was appointed to revise schedule of prices for this county: Marshall, Dunn and Mosby.

Motion carried that after this meeting all papers read before this society be turned over to the Secretary to be published in the Journal.

Christian The Christian County Medical Society met in regular session Tuesday, June 15th, at the Jennie Stuart Memorial Hospital with President Gates presiding. There were thiry-six members present and the following visitors: L. E. Burch of Nashville, D. P. Curry of Bowling Green, and W. R. Frey. E. M. Frey, T. L. Jones, J. M. Robinson, W. E. Bartlet, B. C. Boon, B. E. Escue, L. P. Trabue, of Todd county, and J. W. Crenshaw and G. H. Hatcher, of Trigg county.

After the reading and adoption of the minutes of the last meeting and the transaction of some new and old business report of cases were called for and the following cases were reported:

F. M. Stites, a case of "Diabetic Gangrene." W. S. Sandbach, a case of "Gonorrhea in an Eight Year Old Boy."

T. L. Jones, "A Case of Gonorrheal Ophthalmia."

L. P. Trabue, a case of "Pellagra."

W. R. Frey, a case of "Hip-Joint Disease."

W. H. Watts presented a clinical case. History, negro, female, age 35, married, eight children, two dead. mother died of pneumonia. Present trouble began three years ago. Weight then 135 now 113. Pain and gas in abdomen. Relief after passing gas. Pulse 120, temperature normal. The chair appointed Drs. Burch, Frey, Crenshaw and Bell to make examination and diagnosis. Report by Dr. Burch, tuberculosis of many organs with abdominal adhesions.

J. G. Gaither presented a case showing transplantation of bone into the tibia resulting in a useful limb.

F. M. Stites read a paper on "Home Treatment of Epilepsy." Says great help can be rendered the unfortunate and laid particular stress upon family history. Begin treatment early. Do not punish children for the so-called "Fits of Anger," they may be epileptic attacks. Recommended the use of bromides.

W. R. Frey: A very excellent paper. Dr. Stites has covered the field. Family history and early treatment very important.

L. E. Burch: Look carefully for all sudden unconsciousness, licks on the head and in such you are justifiable in throwing up a flap for further examinations. In trephining remove the dura.

A. Sargent: Do not see any use for the bro

mides. Use electricity and spondylotherapy. It is either traumatic or toxemic.

F. M. Stites, (Closing): I am very thankful for the discussion. The bromides keep down injury while repair is going on. Very much abused. Should not lay aside.

At 12:30 we repaired to the large basement room where we enjoyed a delightful barbecued dinner prepared by Mrs. Wanda Williams, superintendent of the hospital, and her efficient assistants. Dr. Crenshaw returned thanks and the guests all did ample justice to this appetizing "A Paper, He re

menu.

J. W. Crenshaw read a paper on Practical Rather Than Connectional." futed the idea that here is anything in the study or practice of medicine that makes the doctor an unbeliever in the one true and only God. He condemned in strong terms the "Dope Doctor" the proprietary and patent medicine dispenser. He closed by urging us to lend ourselves to the encouragement and support of the A. M. A. and the Journal in its efforts in upholding the dignity of the profession.

Discussion by Harned, Curry, Keith, Caudle. and the essayist in closing. Dr. Crenshaw was made an honorary member of the Christian County Society by a unanimous vote.

66

L. E. Burch in a paper on Menstrual Dis

orders outlined the normal menstruation in order that we might more fully understand the disorders. He took up the three principal forms of disorders, dysmenorrhea, amenorrhea and metrorrhagia He dealt with each form in detail and gave us medical treatment for each disorder, making his paper one of the greatest of importance to both the general practitioner and the surgeon. Discussed by Bell, Frey, Sargent, Trabue, and Gaither.

By a unanimous vote a resolution was passed that we invite the Kentucky State Medical Association to Hopkinsville in 1916.

No further business, we adjorned to meet again the third Tuesday in July.

W. S. SANDBACH, Secretary.

Lipskey, Van Leer, Vice President; G. V. Daniel, Paintsville, Treasurer; J. P. Wells, Paintsville, Secretary.

The following applications for membership were received and all applicants were duly elected as members of the society: Eugene Davis, Van Lear; P. P. Meade, Flat Gap; F. M. Witten, Oil Springs; T. B. Bailey, Nippa; W. R. Castle, Offutt; D. H. Daniel, Denver; and Grant Rice, Oil Springs.

After a rousing speech by the President, urging upon all, both the medical fraternity and the laity, the vital importance of cooperating in the great battle for hygiene and sanitation and prevention of disease, in which he was frequently interrupted by applause. The Committee on Program made the following report:

The subject for discussion at our next meeting to be held at the courthouse in Paintsville, on Saturday, July 3, at 10 a. m., is as follows:

Acute and Chronic Diarrhoeal Diseases of Childhood.

(a). Causes-W. R. Castle, Isaac Lipskey. (b). Pathology-Eugene Davis, F. M. Williams.

(c). Diagnosis-D. H. Daniel, T. B. Bailey.

(d). Treatment J. H. Holbrook, J. P. Wells. All are urged to attend and come prepared for discussion for it promises to be intensely interesting and mutually profitable.

J. P. WELLS, Secretary.

Taylor--The Taylor County Medical Society met in the office of the Secretary, June 10, 1915. Present, J. B. Buchanan, O. M. Kelsay, S. H. Kelsay, O. R. Reesor, R. W. Hazelwood and J. L. Atkinson.

Minutes of the April meeting read and approved. The May meeting of the society was held in conjunction with societies of Adair, Green and Marion counties, at Campbellsville.

A clinical case from the county alms house was sent in for examination. The society concurred in a unanimous diagnosis of general tuberculosis, with suppuration and necrosis of the ilium.

J. L. Atkinson read a paper on "The Management of Interrupted Pregnancy." In the discussion of the paper Dr. Reesor called attention to the prevalence of delayed or missing menstrual periods in young women, which they attribute to taking cold

S. H. Kelsay called attention to the possibility of sexual intercourse causing premature delivery. He also says that when there is any difficulty in removing shreds use a douche and the debris will pass away.

The other essayists for the day were absent and the society spent some time in reporting and discussing cases met with in the ordinary round of practice.

J. L. ATKINSON, Secretary.

A. W. Cain, of Somerset, Councilor for this district, gave us a talk along the lines of better organization and the importance of every doctor in Kentucky being a member of his county society.

J. A. Bolin and Carl Norfleet, both of Somerset, were with us at this meeting. Carl Norfleet read a very interesting paper.

The Wayne county doctors present were J. L. Hart, of Millsprings; J. W. Bryant, Frazer; A. S. Cook, Monticello; C. B. Rankin, Monticello; J. F. Young, Monticello.

It was suggested at this meeting that the Pulaski County and Wayne County societies have a joint and open meeting in August at Millsprings. It was left to the secretaries of the two societies to arrange the meeting.

Ice cream and cold drinks were served after which the visiting doctors returned to Somerset, where they arrived at 1 a.m., the next morning. Come again doctors. J. F. YOUNG, Secretary.

NEWS ITEMS AND COMMENTS

The Campbell-Kenton County Medical Society was the guest of Mr. Thos. Cody at a barbecue at his farm on Thursday June 17.

Mr. Cody's reputation as an entertainer assured a good time to every one who attended. The committee had an interesting program arranged.

BOOK REVIEWS

Diagnosis and Treatment of Digestive Diseases by George M. Niles, M. D. Published by P. Blakiston's Son & Co., Philadelphia. It has 575 pages, with one colored plate and eighty-six other illustrations. It aims to deal in an effective manner with the questions, "What is the disorder?" and "What should be done for it?" Part I deals with the general diagnosis and treatment of digestive diseases; Part II, with special diagnosis. and treatment of digestive diseases. Diagnostic methods, discussions of the medical and surgical aspects of cases, general considerations of diet, are important chapters in Part I. The Neuroses. the Gastrites. Tumors of the stomach and the Duodenal Ulcer are some of the interesting chapters in Part II. Diarrhea and Dysentery, Constipation and Intestinal Parasites are some of the important chapters in Part II also. This book has real value and to those who do special work along this line, it is of especial importance.