far as climate is concerned, I think Georgia is just as good as any other place in the world. [Applause.] Why? If we will take the history of climates in consumption, we will find that every State, every spot, yes, every corner in the world, has been advocated for consumption. Each place has been boosted for a short time; that place becomes filled with the germs of the disease, and then they have to shift to another place. If our patients will do what they ought to do in Savannah or in Georgia, or in any other place, they will do just as well. The only difference is this: A patient, when he pays to do a thing, will do it more freely, and will pay more attention to his case than if he does not pay for it. The climate here is just as good as it is elsewhere. Let us put the patient in the open air; let him do what he does in Colorado, and save him the money, trouble and discomforts of being in a charitable institution. [Applause.]

Dr. J. C. Johnson, of Atlanta: This is a scientific meeting, and no man wants to go on record as making an unscientific remark. The doctor did not listen attentively to what I said, or he misquoted me. I did not say that by simply not having to cough he would not cough. I simply said that which we all wish to bear in mind, and with which I am sure you will agree, namely, that pathology is perverted physiological action, and the nearer we imitate physiological action in the treatment of diseases the more we will accomplish. I said, that inasmuch as cough was an exaggerated expiration, it must be preceded by exaggerated inspiration. If you hinder or restrain that, you accomplish much in arresting irritation. I did not say anything against expectorants or sedatives to control cough.

AUTOINTOXICATION IN ITS RELATION TO

NEURASTHENIA.

BY B. P. OLIVEROS, M.D., SAVANNAH.

I feel that many apologies are due from me to the members here assembled for writing upon a subject which, from its title, would indicate my many inequalities for handling it, and yet my only excuse can be that a subject of such vast interest to the medical profession. of such wide importance to the laity, may be discussed by the humblest of us with the hope that one poor little point may be brought forward and attract the attention of some fertile brain.

It is not my intention to go into the scientific reasons of autointoxication or perverted metabolism, for Bouchard and others have undoubtedly proven the doctrine to be a scientific one, but simply to apply the doctrine to a disease or ailment about which just as little is known, about which there is just as much conjecture, and which is of just as much importance to the medical profession to-day as any known disease.

Our attention is attracted daily by death carrying off, in a few hours, individuals who are in the prime of life and the best of health. Whole families of healthy people being made fatally ill by some food which has supposedly undergone some chemical change, or what is called perverted metabolism. So also may I call to your minds another picture of sudden lunacy, murder and suicide, or its minor phases of mental aberrations, perverted dispositions, nervous and muscular breakdowns with all their concomitant line of symptoms, such as loss

of muscular force, weakness and irritability, mental depression, circulatory and digestive disturbances, persis tent and insistent thoughts of a troublesome nature, the desire to die or to see others die, that sense of unrest, that mental irresponsibility, or the peculiar phase of a single notion of getting away from an impending death by self-destruction. Such is neurasthenia.

Ever since the sixteenth century have physicians written about this disease, but it was only in 1868 that it received its name. But how little was known about the disease in the sixteenth century, how little in 1868! How little at the present day!

It is generally supposed that heredity may be a predisposing factor, hereditary constitutional conditionanything in an earlier generation that might be conducive to a weakened, nervous system, in fact, one authority says: "Those predestined to nervous disorders may go through life without being attacked by a psychosis or grave organic malady, but they very rarely escape neurasthenia." This, to say the least, is a very broad assertion in the face of present-day observation of the disease, since we know there seems to be no immunity, either by way of constitution or heredity; the strongest man with the best of family histories, the athlete from the family of athletes. No race that is civilized can escape it, and yet it seems we can lay more claim to it as an American disease since it seems to be on the daily increase in this country, probably due to the American manner of living, the hurried and persistent struggle for a livelihood, our mode of education, our strenuous hustle, crowded cities, and want of time for brain rest and recreation. However, it is no longer a disease of the brain-worker, the artist, the professional man; we find it in the high-strung, in the lethargic, in the highest, in the lowest. It no longer seems to be a nervous break

down from overwork, for we find it in the ignorant, the laboring man, in the working woman.

There must be some other reason than the commonly accepted one of overtaxed brain to account for this condition, so impartial in its findings, so general in its attacks and so common, especially in this, our country. May it not be referred to the present day foods, the many adulterations, our hurried manner of eating them, our abuses of alcohol combined with our strenuous existence? Is it not possible that a malassimilation, a faulty metabolism, has been going on before a mental shock, a grief, a severe sickness of any other one of the many causes given for this disease, which, as I have said, may show itself in any class or grade of persons?

This brings us to autointoxication and especially to intestinal intoxication.

Absorption from the intestine is very slow, likewise does the organism form poison and yet is not poisoned; but when this shock or grief or whatever else happens, it does seem that in some way the absorption is increased, this poison more slowly eliminated, hence a neurasthenic condition due to an autointoxication.

One may not always complain of any inconvenience from constipation, for instance, but at the same time if a person of a constipated habit should get caught just when there is a slow absorption taking place, where there is absolutely no elimination in process, by some great shock or a severe spell of sickness, surgical operation, we all recognize the fact that it is our first duty to correct this constipation, because symptoms immediately show themselves, such as feverishness and nervous phe

nomena.

So I believe when a healthy, robust person becomes neurasthenic, or develops a case of neurasthenia, there has been going on a slow absorption, a chronic autoin

toxication which has been paid no attention to until the direct cause, the shock, the grief, the sudden loss of wealth, or the breaking down of an overworked brain strikes the person who presents the fertile ground.

It is on account of this unsuspected self-poisoning, this perverted metabolism which is constantly going on within so many of us that the world is so full of neurasthenics.

As the healthy man is not attractive to the microbe of any disease, so is not the non-absorbing or self-intoxicating man subject to a neurasthenia when the blow falls.

We know that fecal matter is toxic, it makes no differ ence what this toxicity may be due to. We pay no attention, in this paper, whether it be ammonia or potash, or the union of what organic principles, the fact remains that it is toxic and that absorption takes place through

the intestines.

It is said by many that constipation is compatible with health, that where there is constipation there is less chance of absorption, owing to the hardness of the fecal matter, or because when there is constipation absorption has been completed; be this as it may, I believe that there is much truth in this supposition; in other words, I believe there is much less danger in the constipation than there is in the putrefaction of this same fecal matter; by that I mean the metamorphosis of digested matter and also that which the intestinal tube itself offers us, the constant presence of micro-organisms and the putrefactive agents carried in with the foods themselves.

We know that the small intestine, and more particularly the large intestine, is capable of sending putrefactive material into the blood. We also know that bile, where it is not at fault itself, is capable of prolonging the arrest of fermentation; at least, it does so, to a small ex