tion of vast interests, the highest order of professional skill and learning and executive ability; and

Whereas, The number of officers and soldiers under the direction of the Surgeon-General of the Army, organized as is the Army of the United States, is greater than the command of a division commander; be it

Resolved, by the Medical Association of Georgia, That it is the sense of this body that the Surgeon-General of the Army should have the rank, pay and allowance of a Major-General.

Resolved, That the Medical Association of Georgia requests all the Medical Societies of the United States to join in this appeal. Resolved, by the Medical Association of Georgia, That copies of these resolutions be transmitted to the President of the United States, the Honorable Secretary of War and our senators and representatives in Congress, with the request that all co-operate in attaining the end sought; and further that copies be also sent to the American Medical Association and all other medical societies in the United States, with the request that they join in this memorial to Congress, and urge prompt action upon this subject by our national legislative authorities.

Dr. Kenyon moved that the Chair appoint a committee of three to further the resolutions offered by Dr. Hiers, with instructions that the President appoint Dr. Hiers as Chairman of the Committee. Seconded and carried.

Dr. Edwin H. Sims, of Columbus, read a paper entitled "Some Thoughts on Malpositions and Malpresentations." There being no further business to be disposed of, the Association, on motion, then adjourned, to meet in Atlanta on the third Wednesday in April, 1900.

THE ANTISEPTIC AND ELIMINATIVE TREATMENT OF TYPHOID FEVER.

BY T. VIRGIL HUBBARD, M.D., ATLANTA, GA.

The fact that five hundred thousand people in the United States are annually stricken with typhoid fever, and the fact that at least fifty thousand of this number are sent to premature graves as results of this disease, are sufficient reasons, in my opinion, for bringing it before this Association for discussion, to say nothing of the unpleasant sequelæ with which it often leaves its victim as a living monument to its visitation. While there may be some room for justly criticizing the size of dose and frequency of administration advocated by Dr. Woodridge, there can be no doubt that to him belongs the honor of having combined a number of drugs for the treatment of typhoid fever, which, if systematically and continuously used, will reduce the mortality of this disease. While I have used the same drug, but in larger doses, and not so frequently administered, I am not prepared to say that his method of administration is not the better, for I have never used it that way, and am not willing to criticize his plan before having tried it.

I shall say no more about the etiology, pathology, and symptomatology of this disease than is necessary for an intelligent discussion of its treatment.

I am fully aware of the fact that the views herein expressed are at variance with some of the leading text-books of to-day and also differs from the teaching in most of our medical colleges, but "because a theory of treatment is new, it is not necessarily false, and because it is old, it is not necessarily true." The history of our profession has repeated itself too often to deny the truth of the above proposition. With respect to hoary precedent and text-book authorities, and touching the practices of antiquated eld, it may be as truly said of medicine, and perhaps truer, as it is of law, that in the doctrine there may be logic, but in the letter there is frequently death. Many men have been killed with abundant weight of authority and tombstones cover much loyalty to precedent and authentic error.

So long as we are bound to this vicious heredity either by filial affection or antiquated respect, following in the footsteps of our forefathers and adhering to the same practice, and thus committing the same errors, there can be no real progress in medicine. Who doubts that venesection, now relegated to a deserved grave of oblivion by the rapid progress of scientific and rational medicine, was at that time, as enthusiastically advocated and as vigorously defended as is the cold water treatment of typhoid fever to-day. It is notably true that the most conspicuous and pronounced opponents of the antiseptic and eliminative treatment are almost without exception those men who have never systematically used it in even a limited number of cases, thus placing themselves in the absurd position of condemning this treatment without ever having given it a fair trial.

If the mortality of this disease is not to be taken into consideration in estimating the value of this, or any other method of treatment, but we are to accept the dictum of those who oppose it on the uncertain evidence of their theoretical disapproval, when may we expect a lower deathrate? If this same theoretical skepticism had existed since the discovery of vaccination to the present time, how many human beings would have ever been benefited by Jenner's immortal discovery. Those who hold opposite views may produce eloquent arguments and construct some beautiful theories, but argument is not evidence, and theory is not fact.

The only earthly tribunal, whereby the efficacy of any therapeutic measure may be honestly and fairly adjudged is at the bar of mortuary statistics, and upon this indubitable evidence and this alone, we are willing to stand or fall. We are willing for this treatment to undergo the crucial test of experience and let clinical evidence decide its truth or its falsity.

It is far from my purpose to, in any sense, discount the value of water as a therapeutic measure in the treatment of fevers, when properly used, but as often happens, is it not possible that the pendulum has swung too far, and the Brandt enthusiasts frequently rely on the use of water alone to the exclusion of other valuable agents. So eminent an authority on hydrotherapy as Dr. Simon Baruch says that cold water cannot vie with coal-tar antipyretics for the reduction of temperature, and that the reduction of temperature alone does not fulfill the therapeutic indication, but that the good effects derived from water is due to the shock to the general nervous system, thus stimulating all of the vital organs to greater functional activity.

H. A. Hare and C. A. Holder have examined the statistics and estimate that the mortality of typhoid fever to-day, the world over, is not more than 15%. The same authorities also state that the "Brandt treatinent does not shorten the attack but probably prolongs it. Relapses are much more frequent under it; hemorrhages are more frequent. The frequency of perforation is not diminished." They also state "the cold bath is evidently responsible for the saving, at the most, of but 24%, and it is also evident that this 21% is saved by the favorable effect of the bath on the nervous system, circulation, respiration and toxemia."

Admittedly a germ disease within the intestinal canal, the source from which general infection takes place, does it not seem that the removal of all pathogenic bacteria from the intestine, so far as possible, and the elimination from the system of their lethal products would be the most rational therapeutic indication? What physician or surgeon, if called to treat a case of septicemia produced by a portion of retained placenta, would, in the beginning of treatment, fail to remove the original source of infection? Does not the same principle, though perhaps to a less extent, apply in typhoid fever? To just what extent intestinal asepsis is reached by the administration of drugs, I do not know, but calomel and guaiacol, to say the least, do not furnish a very favorable soil for the development of micro-organisms. If thorough disinfection of the alimentary canal were accomplished, it would be, in my opinion, the least important of the good effects from the administration of mercury, but as demonstrated by recent physiological experiments, it is to the stimulation of the depurative function of the liver and the other emunctories, that we may look for the explanation of the valuable therapeutic effect of this drug. We should also not lose sight of the reciprocity existing between the function of the liver and kidneys, the impairment of one directly influencing the activity of the other. Urea, the biochemical product of the metabolic activity of the liver cells, is, as is well known, the most natural, as well as the most efficient diuretic. In ty phoid fever there is a profound toxemia and it is to the functional activity of the kidneys that we may look for valuable assistance in successfully combating this systemic condition The importance of the kidnéys as emunctory organs in this disease is shown by the fact that the urine contains the germs and their toxins and will convey the disease. Unfortunately, bacteriology and pathology have not reached that degree of