Baking a tube will lower the vacuum for a time and may be repeated as often as necessary without injury if it is properly done. The life of a tube may be greatly prolonged by proper care in opening and closing the current passing through it. Two forms of apparatus are used for exciting the x-ray tube: the static machine and the induction coil. For many reasons the current from a static machine is the ideal one for x-ray work. It has the high oscillation, the voltage and safety to patient and operator. The machines used by many are not of sufficient current quantity for deep penetration but are much preferable for therapy. A static machine for both photography and therapy should have at least sixteen revolving plates, and the plates should not be over thirty inches in diameter.

These large machines are cumbersome, require considerable office room and a one-half horse-power motor to operate them. For this reason many operators prefer the coil. A large coil is necessary for photographing the deeper parts just as a large machine is necessary for the same character of work. With the proper tube and coil, or machine as the case may be, the next point for consideration is the radiance and its regulation for the different kinds of work. For photography, the tube should be adjusted according to the part to be penetrated, the hand or foot requiring a much lower vacuum and shorter exposure than the shoulder or hip.

A radiograph is a shadow picture, and its definition between different intensities of shadows depends upon the density to the ray of the substance photographed. As the ray is reflected from a plate about one inch in diameter and the outlines in the shadow are produced by the diverging rays from this small focusing plate, it may be readily seen that the shadows would be magnified more or less according to the relation between the object, the dry plate and the reflecting plate in the tube. If the tube is near the object and the plate some distance from it the shadow would be greatly magnified. If the tube is some distance and the object near the plate, the shadow would be very nearly normal in size. The locating of foreign bodies and the study of fractures requires exposures from two directions, preferably at right angles to each other, when the exact condition may be estimated, allowance being made for the divergence of rays in

bodies not central to the focus point of the tube. The distance of the tube from the plate is very important and should vary according to the character of the part and the intensity of the tube's radiance.

There has been some difference of opinion as to what the therapeutic agent is. Some have contended that it is the electricity in the form of an induction curient around the tube, but this hypothesis has been pretty generally abandoned. It has been noted that deeper structures are markedly influenced, and even skin surfaces on the side opposite the exposure, and induced currents could hardly be expected to accomplish such results. Believing that the light is the only feature of the various components of the x-radiation which has such penetrating power, we are forced to the conclusion that the therapeutic results must come through the light, and further, we find the other lights, sun, violet and red have therapeutic value.

Reasoning from this standpoint we are disposed to believe that there are many functional and organic disturbances of the deeper tissues which may be susceptible to cure or improvement by this agent, and it is difficult for the most conservative operator to avoid an attitude of uncertain expectancy toward the future development of light therapy.

Abstracts.

STATISTICAL REPORT ON CREOSOTE AND CREOSOTAL IN PHEUMONIA.*

BY DR. I. L. VAN ZANDT, FT. WORTH, TEX.

Last March Dr. Van Zandt sent out a number of circulars to many medical journals and to a few individuals, asking the following questions of those who had used creosote or carbonate of creosote (creosotal) in the treatment of pneumonia: 1. Do you

*Abstracted from the Medical Record, October 11th, 1902.

believe creosote ever aborts pneumonia? 2. majority of cases are mitigated by it? 3. cases which, having plenty of time, were by it?

Do you believe the Have you ever found entirely uninfluenced

In response he had over seventy letters and cards and five verbal statements, a large proportion of which he tabulated. To the first question 37 physicians, reporting 762 cases, said "Yes;" 15, reporting 187, said "No;" and 19, reporting 177, failed to answer. Therefore, of those reporting, a little over two-thirds admitted the abortive effects of creosote. To the second question, 57, reporting 1,022 cases, answered "Yes;" 2, reporting 10 cases, said "No;" and the remainder failed to answer. To the third,

23 said "Yes;" 31 "No;" and 16 failed to answer.

Of 1,130 cases reported, 56 were fatal, 24 of them being accounted for as follows: 12 were complicated, 9 others were over the age of 67 (in some instances complicated), 3 were alcoholic (of which 2 were complicated), 1 was far advanced when treatment was begun, and 1 used "creosote products." The mortality in this series is a little over 5 per cent., and, as the recognized death rate is 25 per cent., the author claims that the treatment saved 226 lives.

Van Zandt refers particularly to Prof. W. H. Thompson's report of cases treated with carbonate of creosote in the Roosevelt Hospital. The loss here was 1 in 18, or about 5.5 per cent. A condensed report for five years from this institution gives an average death rate of 35.6 per cent.

These figures coufirm the conclusions of his former article, that a large per cent. of pneumonia is cut short or aborted; almost all the rest mitigated, and the remainder or a very small per cent. not effected by the remedy. He thinks the use of creosote carbonate or creosote in the treatment of pulmonary affections is one of the greatest life-saving discoveries of the Nineteenth Century.

In this connection we may mention that

Sanitatsrath Dr. C. S. Sewening, of Werther (Westphalia) states (Deutsche Aerztezeitung, Berlin, October 1, 1902) that the recent numerous communications regarding the employment of creosotal in pneumonia incite him to publish the good results which he has obtained from the drug in some other affections.

Amongst others he recounts a case of catarrhal cystitis occuring in a surveyor who had worked for several years in a wet coal mine, and whose urine formed a thick, mucilaginous deposit in the chamber. He was ordered:

R Creosotal.

Ol. oliv .......

4 grams (1 dram). .200 grams (6 ozs).

After he had taken this mixture two or three times a day in tablespoonful doses for eight days, his urine became permanently clear.

Another case was that of a young farmer, who came to him about a year ago complaining of a dirty discoloration of the face, hands, etc., being, in fact, a good picture of Addison's disease. Sewening prescribed for him:

R

Creosotal.......
Ol. jecor

4 grams (1 dram) 200 grams (63 ozs),

directing him to take a tablespoonful of the mixture three times daily. After he had taken the medicine twice the spots disappeared, and they have not returned to this day. The man's general condition, also, is perfectly normal.-ED. S. P.

Clinical Reports.

REPORT OF A CASE OF NEPHRITIC CALCULUS.*

BY M. C. MCGANNON, M.D.,

Professor of Diseases of Women and Abdominal Surgery, Medical Department University of Nashville.

The patient was a white woman, aged 37, who has always lived in Tennessee. She has always enjoyed good health, in fact, has never been confined to bed since her girlhood, except as a result of pregnancy. She is the mother of seven children, the youngest being two years old. They were born without in

*Reported at Regular Meeting of the Nashville Academy of Medicine, September 30, 1902.

strumental aid, and she nursed them all. After the birth of the second child, she was not so vigorous as previously. She was told that she had suffered a laceration. The injury was not repaired. She has had one miscarriage which occurred in February last; recovery was uneventful. Menstruation is regular, continues four days, and is without pain.

V. D. She has suffered with a slight leucorrhea for a long time. Ves. Sym. She has no bladder symptoms; no frequency of micturition; no pain in that region, and thinks she passes a normal amount of urine. Her family history is negative.

She came under my observation on the 15th day of August, 1902, on account of blood in the urine. She was quite positive in her statements while giving the following history of her case:

About July 1st, a week before her expected period, she observed that the urine was of a dark brown color. She called the attention of her family physician to the fact. This gentleman made a complete examination of the urine and the patient. He found that the urine contained blood and a great many leucocytes, but no renal casts, and but a small quantity of epithelium. In ten days the urine completely cleared up. One week before the expectation of the next period, blood again appeared in the urine, when she came under my observation. She stated that she was somewhat alarmed because of the blood in the urine, but that she was otherwise perfectly well. She had no pains any. where, or at any time. Her appetite was good, digestion perfect, and bowels regular. She had lost no flesh, and her color was as usual. There was no enlargement of the abdomen, and her clothing did not seem tighter than usual. She had at times some swelling about the ankles, but no puffing under the eyes. She complained of pain in the back and some pelvic distress on much exertion. She said she passed a normal quantity of urine, but it was dark brown in color. It also contained some clots and

strings of blood. The clots were described as being the size of a pea or the end of the little finger.

A sample of urine, gotten by catheter, and examined under the microscope was found to contain red blood cells in profusion; they were irregular in outline and varied in size. Leucocytes were very abundant. There were no renal casts; the urine was natural, and the specific gravity was 1025.