Positive Diagnosis of Abdominal Disease by the Roentgen Ray. The Diathermic Current in Medicine. The Status of the Roentgenologist. .... .398 .204 .244 140 CLAUDE T. UREN, M. D., Omaha, Neb. Nystagmus .303 A. S. von MANSFELDE, M. D., Ashland, Neb. Puerperal Eclampsia .447 The Carnegie Investigation-The Council on Medical Education A. M. A. A Moral Anachronism.. 494 The Forty-Fifth Annual Session of the Nebraska State Medical Associa- 271 386 .169 The Propagation and Dissemination of the Bacillus Tuberculosis. W. P. WHERRY, M. D., Omaha, Neb. Syphilis of the Nose and Throat... H. W. WIGHTMAN, M. D., Omaha, Neb. 12 457 A Review of the Use of Salvarsan in Diseases of the Nervous System.... 60 524 Nebraska lund. e4, 4-20-1926 WESTERN MEDICAL REVIEW A JOURNAL OF MEDICINE AND SURGERY Published Monthly by Western Medical Review Company, 701 So. 13th Street, Omaha, Neb. Per Annum, $2.00, 20c per copy. The Western Medical Review is the journal of the Nebraska State Medical Association and is sent by order of the Association to each of its members. Entered as second-class matter at the Postoffice of Omaha, Nebraska, under the act of Congress of March 3, 1879. Telephone Douglas 1290. The age at which, in the alimentary tract of infants, the various digestive ferments first make their appearance has an obvious bearing on the possibilites of artificial feeding at early ages. There has been a widely prevalent, though frequently contradicted view, that the starch-digesting enzymes do not manifest themselves in the early days of infancy-hence the obvious proscription of starch-containing food materials from the dietary at this period. Jacobi and Heubner have both long contended that food containing starch can be utilized during the first month. of an infant's life. The earlier contrary conclusions have been based on post-mortem search for diastatic ferments in the appropriate glands of the digestive apparatus, as well as an Omaha Public Library examination of the feces for evidences of residul amylases and other enzymes. The ingenious method of Dr. Alfred F. Hess of New York, whereby intestinal contents can be removed by the use of the duodenal catheter, has made it possible to obtain data regarding the pancreatic and intestinal secretions which have hitherto not been accessible to direct examination intra vitam. It is of decided interest and physiologic import to learn through the application of the new experimental and diagnostic procedure, that even before new-born infants have been put to the breast, that is, before there is any food factor to incite secretion, the three familiar pancreatic ferments are found in the intestine. Dr. Hess reports that, although the amount of pancreatic secretion is still very scanty during the first week of life, it contains the starch-digesting enzyme with increased regularity. In older infants, a month or more of age, there is a decided augmentation in the amylolytic power of the pancreatic juice. Without attempting to interpret the functional significance of the occurrence of an enzyme at a period when, in normal nutrition, it can scarcely be called on for participation in the digestive process, it is apparent that the findings quoted must modify the point of view of those who still debate the digestibility of starch in early infancy. J. A. M. A. Some New Evidence on the Tobacco Question The consideration of tobacco and its dangers has heretofore been largely based on the amount of nicotin contained in the smoke. But there are other products of tobacco which must share the responsibility. Among these are carbon monoxid gas, prussic acid, furfural and some others. Although all of these compounds admittedly are poisonous, their danger depends on the quantities in which they are taken. Recently investigations have been made of some of these toxic products, and the results are of considerable interest. The fact that the action of certain kinds of tobacco has been attributed to the prussic acid in their smoke has induced the Wurzburg hygienist, Prof. K. B. Lehmann, to investigate the charge. He has found that the amount of this compound produced depends somewhat on the rate at which the tobacco is smoked. The slower the current of air through a cigar, the smaller the amount of prussic acid formed. The entire amount found, however, is too small to account for the effects. So far the burden of the blame for the ill effects of smoking would appear to rest on nicotin. Investigations made by the London Lancet indicate that the ordinary cheap cigaret contains the least nicotin in the smoke and the pipe the most, the cigar occupying an intermediate position. Assuming, then, that nicotin is the essentially injurious substance in tobacco, the cigaret would appear to be the least harmful form, provided that the amount of tobacco consumed was no greater in this form than in others. The general impression, however, is that cigaret-smoking is the most pernicious form of indulgence in tobacco. This might be accounted for in part by the facts that the form of the cigaret makes it possible for young persons to indulge in it when they would not smoke cigars or pipes, that in older persons it lends itself to overindulgence and that the smoke may be inhaled with less irritation and, therefore, that more of the products may be absorbed into the system. Further investigations indicate that the most injurious forms of smoking are not those in which nicotin prevails but those in which there is a larger proportion of furfural. Furfural is about fifty times as poisonous as ordinary alcohol. There is a probability that the least harmful tobacco will turn out to be that which yields a minimum of furfural in the smoke. Although the amount of nicotin present in the cheaper grades of cigarets is practically negligible, the amount of furfural appears to be sufficient in itself to account for the bad effects attributed to cigaret-smoking. The use of tobacco in its various forms is so general that the subject is of almost universal interest. The Journal of the American Medical Association thinks that the smoker is entitled to know the dangers and the safest methods of using tobacco, while educators and all who have anything to do with the young, whether by example or by precept, will appreciate scientfiic facts with which to back up wise deductions from experience. The Taboo on Moderate Drinking The use of alcohol is receiving some hard knocks these days. A prominent railway system, not content with the general rule heretofore in force on railways forbidding employees to drink while on duty, now forbids employees to indulge at all in drinking out of employment hours, or in any other conduct which will . impair their health or make them less alert and less capable while on duty. The owner of one of the nation's pets-a prominent baseball team-announced that moderation in drinking is not sufficient; the players on his team must leave alcohol entirely alone and abandon cigarets. The justification for such rules may be found not only in the difficulty of being moderate in indulgence, but also in the cumulative and after-effects of dissipation. The world is moving; the old fetich of "personal liberty" at whatever cost of danger to the public at large seems to be losing its power. The time may come when every man to whom the life and safety of others are entrusted may be expected or even required to be as abstemious as the ball-players and railway employees just mentioned. J. A. M. A. Senator Owen "Because of his activity in the interest of public health, United States Senator R. L. Owen, of Oklahoma, has been a shining mark for the National League for Medical Freedom and all of the interests that this unholy organization unofficially represents. Senator Owen was opposed for his seat in the senate by ex-Governor Haskell, a prominent and popular citizen. It was thought by his enemies that with such a man, their many, if somewhat shady, interests would be able to defeat for re-election a man who had been doing so much injury to the cause of dopers, poisoners, charlatans, quacks and the pseudoreligious practitioners of medicine, by shedding the light of public investigation on their shady practices. Our very active friend, Dr. Crutcher, who seems to have plenty of money behind him, toured the state and boldly attacked Senator Owen for his stand in behalf of the proposed Department of Health, otherwise known as the Owen |