The report was, on motion, accepted, and referred to the executive committee for publication.

On motion, the faculty adjourned until to-morrow at 12 M.

FRIDAY, June 8th, 1855.

The faculty was called to order by Dr. ROBERTS. The procedings of the previous meeting were read by the secretary, and on motion, approved of.

Dr. Roberts, from the Committee on the Chartered Rights of the Faculty, presented the following report:

BALTIMORE, June 6th, 1855.

The committee appointed to inquire into the chartered rights of the faculty, were directed at the last annual meeting of the faculty, to "examine into the subject" of the report made at that meeting, and if they "deemed it advisable," "to consult counsel."

Since the adjournment of the faculty, the committee has not "deemed it advisable" to consult counsel, simply for the reason, that in their judgment the funds in the hands of the treasurer were not sufficient to justify the expense. The subject being one of vital importance to the stability of this corporation, in the opinion of your committee, renders it necessary that such an investigation should be made at the earliest practicable moment. The more so, because of the fact, there is to some extent a difference of opinion in reference to the "practical good" to result from such investigation. The sooner the whole subject is examined into and finally settled, the sooner will the members of the convention, and the medical profession at large, know what is the position they occupy, and what value is to be placed upon their charter, a charter accepted and acted upon for so many years, with manifest advantages to the profession and the public, and solemnly guaranteed to them in perpetuity "forever."

All of which is respectfully submitted,

GEORGE C. M. ROBERTS,
JOSHUA J. COHEN.

The report was accepted, and referred to the committee on publication.

On motion, the remainder of the reports of the standing committees were called for. The recording secretary

stated that he had received from Dr. Bailey, of Cambridge, Md., the chairman of the committee on Pathology, a letter stating that he had been unable to make any report from incessant professional occupation.

On motion, the committee was excused.

The secretary read a letter from Dr. E. H. White, the chairman of the committee on Therapeutics, stating that he was ready to report, but was unable to be present.

On motion, his report was referred to the executive committee for publication, but was not handed to them. Dr. Steiner made the following report from the committee on Chemistry:

The progress of Chemistry has been so rapid in the present age, that it is found, by the closest student, a herculean task to keep pace with it even theoretically; but to combine an experimental application of newly discovered principles with the mere theoretical knowledge, would involve such immense labor, that each one shrinks from it. Hence we find, even among those who have devoted their lives to the cultivation of this science, but few who allow themselves to work in its varied apartments. Each wishes to select some province, in which he can hope to labor so as to command all that is known of it, and, if possible, contribute additional discoveries. lf this be the case with the chemist, how must it be with him who is obliged to examine the many branches which belong to his professional studies, and to keep himself posted up in the contributions which each is making towards the thorough perfection of his profession. The physician cannot expect to be a thorough chemist; but he must be ready to avail himself of the lights Chemistry sheds on his path, and must have his eyes opened so as to recognize those lights.

The committee feel that in preparing a report on Chemistry for the State faculty, it is expected of them not to travel over the whole domain, but only that part which is specially interesting to the physician. And this is also a wide field. It would require far more space than is allowed them for this report. They, therefore, propose introducing short notices of some points which Chemistry has elucidated in the past year, which seem to them important as well as interesting to the profession.

I.

One of the problems, which the profession has been trying to solve for years, is the existence or non-existence of a local cause for the affection called Goitre. Its prevalence in certain countries for ages, seems to point to the existence of such a local cause. Thus, in France, England, Spain and Germany, this "morbid enlargement of the thyroid gland" is common in the neighborhood of mountainous districts. In this country certain localities are notorious for the same reason, and it seems "to prevail as an epidemic." Gibson quotes, from Trask, the statement, "that it is so common a disorder at Windsor, in Vermont, that hardly any female is exempt from it;" and he quotes the general conclusion as to the cause, that "it prevails in valleys at the bottom of the highest mountains, which are particularly exposed to the influence of easterly and southerly winds."* Most writers are disposed to consider the disease as "most frequent in low, damp, confined spots, where the stagnant atmosphere is seldom stirred by wholesome breezes; and where the sun in summer has great power."† M. Maumene has attempted the investigation of the cause of this disease, guided by the lights of Chemistry, and has succeeded in producing some results, which, if not absolutely explaining the cause, yet point the way along which an explanation may be obtained.

M. Maumene starts out with the idea that there is some peculiar substance existing in the water which is habitually used by those who are afflicted with goitre. He considers that there is strong presumptive evidence of this, in the fact, that "successive families have been found attacked with goitre when they occupied habitations on certain streams," and that under the same circumstances, goitre has been produced in animals.

Looking at the various substances found in our streams, his attention was directed to the fluorides as those which might be injurious to health, and he determined to use an experimentum crucis, to establish or refute this idea. He subjected a small dog to a diet, which contained for each day, from 5 up to 50 milligrammes of fluoride of calcuim. This he changed for fluoride of sodium, giving at first 20 milligrammes a day and increasing up to Watson's Practice, 483.

*Gibson's Surgery, II, 61-2.

The Chemist, II, 95.

120. After some four months, during which period of time the dog seemed to be in perfect health, "a general enlargement of the neck took place, forming a sort of collar or swelling," attracting the notice of strangers. Five years have since elapsed and the swelling has not disappeared. Now this experiment, though not final and conclusive in its nature, yet must direct our attention to the presence of the fluorides in water as a probable cause of the disease. They are often present only in very small quantities, and without the attention of the analyst is called specially to them, he might neglect them in his examination. If this experiment of of Maumene is supported by additional observations on animals, we shall need a re-examination of the composition of the various streams and springs which supply the countries, where goitre prevails, with drinking water.

Attention has been directed to the origin of sugar, heretofore considered a morbid product of the system. M. Claude Bernard some years since, proved that sugar was contained in the liver of animals and in the blood taken from different portions of the body, and that it had a part to perform in the normal condition of the system. Its presence in the blood, when food containing much starch or saccharine matter was used, had been previously demonstrated. But this presence was supposed to be only the result of a superabundance of such principles in the food, and to be purely pathological. Bernard, from a series of experiments known to the profession, took the ground that sugar could be produced de novo from amylaceous principles, by means of the liver, which organ was most likely the originator also of all the fatty tissues. He considers that the two substances, fat and sugar, are vicarious with each other. Where the liver is forming much fatty tissue, little or no sugar is found, and conversely, where the liver is generating much sugar, it is comparatively devoid of fat. The liver is generally of an abnormal size in cases of diabetes, just as it is in the case of drunkards. In the former case, the size is due to the large amount of work it has to perform in the formation of sugar, and in the latter, to the amount of fatty tissue it is forming. Bernard goes still further, and states if the medulla oblongata be irritated, near the origin of the pneumo-gastric nerve, that the liver begins to secrete very large quantities of sugar, and artificial diabetes may thus be produced.

These views of Bernard are very important to the medical profession. If true, then the treatment heretofore of many cases of diabetes mellitus, has been directed wrongly. If the causa morbi be confined to the liver, and not at all dependent on the nature of the food, it becomes important that the morbid condition of that viscus should be investigated, and that a system of strict regimen, which requires utter abstinence from amylaceous food, should be done away with. It is known to every one that it is a difficult matter to deprive patients of amylaceous food. The stomach revolts against the sole use of nitrogenous material; at least in the manner it is generally given. If the treatment of the disease does not require such regimen, then surely it is subjecting patients to much annoyance by continuing it.

Figuier, in January of this year, read a masterly paper before the Academy of Sciences, in refutation of Bernard's views, which we consider an important contribution of Chemistry to Medicine, and from which we shall quote at some length. It is necessary before doing this, to show how Barnard's view might be sustained, and what supporters it has gained in Europe.

66

Lehman, in the first volume of his Physiological Chemistry, says sugar cannot generally be found in the blood; but in the third volume, written afterwards, he believes with Bernard that 66 while the portal blood contains no sugar, or only traces of that substance, the blood of the hepatic veins is rich in sugar; and states that Schmidt has shown "sugar is a normal constituent of the blood of cats, dogs and men."* In the first volume, he distinctly states that in a normal state no sugar finds its way into the urine, and proves this by experiments made upon himself; but even there and afterwards, he is willing to admit that it may make its appearance in the urine voided, under attacks of other diseases besides diabetes.

Lehman, in a paper published in the May number of the Chemist for this year, also gives the results of a number of analyses of the blood from the Hepatic veins and of the Vena Porta, and considers, from a careful examination of them, that Bernard's opinion, as to the formation of sugar in the liver, is placed beyond doubt. He says that the blood, which issues from the liver by the hepatic

Lehman's Phys. Chem. III, 467-8.