nicious?) anæmia of pregnancy, the placenta seems to give rise to a definite hæmolysin. Hunter supports the view that the cause of pernicious anæmia is a gastro-intestinal toxin, by pointing out that in pernicious anæmia, the iron content of the liver, resulting from red cell destruction, may be much larger than that of the spleen, which would be the case, did the hæmoglobin act in the general circulation. Study of the structure of the spleen in pernicious anæmia revealed thickening of the arterioles and consequent lumen reduction. This causes hæmostasis and diversion of some of the blood from the sinus into the cell columns of the pulp. Here the red cells seem to be destroyed directly, or are, perhaps, sensitized, rendering them more susceptible to hæmolytic action in the liver. Since these anatomic changes in the spleen are probably permanent, the occurrence of remissions in the disease point to other accessory causes. Eppinger and King found an increase in unsaturated fatty acids in pernicious anæmia blood. These acids are known to be strongly hæmolytic. Splenectomy reduces their amount. H. U. Gelatinoid Carcinoma (Morbus Gelatinosus) of the Peritoneum. McCrae, T., and Coplin, W. M. L., Am. Jour. Med. Sci., 1916, Vol. 151, p. 475. Report of a case of chronic ascites of three years' duration. A tentative diagnosis of hepatic cirrhosis was made, but did not quite seem to apply to the case, because of the very chronic ascites. There was enlargement of both liver and spleen, which later receded. Fifty-seven successful, and several unsuccessful, tappings were made during the course of the illness, and at first there was obtained the usual type of ascitic fluid, but later appeared small masses of gelatinoid material. At autopsy were found extensive adhesions of all abdominal viscera to each other and to the parietal peritoneum. There was an accumulation of gelatinoid material in the peritoneal cavity, and many nodules of varying sizes were found in the parietal peritoneum and in the adhesions. The nodules were made up of fibrous stroma and gelatinoid matrix, but no definite cellular structure. In fact, with the exception of very scant papilloid growth in a few sections taken from the vicinity of the stomach, it was impossible to detect any histological structure upon which to base a diagnosis. It was assumed that the case is one of gelatinoid carcinoma. Synonyms found in previous reports are: Gelatinous disease of the peritoneum; colloid cancer (Virchow); mucoid cancer; gelatinous ascites; carcinomatous ascites; pseudomyxoma; maladie gelatineuse. H. U. Hydrops Tubæ Profluens. Llewellyn, T. H., and Block, F. B., Jour. Am. Med. Ass'n, 1916, Vol. 66, p. 1018. This condition, also known as "intermittent hydrosalpynx," depends upon the closure of the fimbriated end of the Fallopian tube, while the uterine opening remains patulous. The tube fills with serum as in ordinary hydrosalpynx until the pressure rises sufficiently to cause the fluid to escape through the uterine ostium, whereupon the tube collapses and fills anew. It may be, too, that there is a kink in the tube near the uterine end, which becomes straightened as the tube fills with fluid. Clinically, there is intermittent pain on the affected side, relieved by the appearance of watery uterine discharge. Report of a case follows. H. U. Ventricular Hemorrhage: A Symptom Group. Gordon, A., Arch. of Int. Med., 1916, XVII, p. 343. A report of twelve cases, seven of which are secondary effusion into the ventricles from an original extraventricular bleeding, and five are examples of primary intraventricular hemorrhage. Of the latter, two showed rupture of the vessels of the choroid plexus, two calcarious deposits and thrombi in the vessels of an eroded ventricular wall, and the fifth case showed miliary eneurysm. In the seven cases of secondary intraventricular infusion, the primary hemorrhage in all occurred in the internal capsule. Clinically, these cases differed in that primary intraventricular hemorrhage showed absence of marked paralysis whereas secondary effusions give rise to marked hemiplegia. H. U. The Gastric Mucosa in Delirium Tremens. Hirsch, E. F., Arch. Int. Med., 1916, XVII, p. 354. The most common lesions in the gastric mucosa of persons dying in delirium tremens are punctate, petechial hemorrhages, but without evidence of acute inflammation about them. Therefore, the gastric disturbance noted in delirium tremens is not an acute alcoholic gastritis. The hemorrhages must be regarded as manifestations of an acute toxemia. Hirsch thinks that "chronic alcoholism alone is of doubtful etiologic importance in causing chronic gastritis." H. U. The Norwich State Hospital for the Insane, Norwich, Conn., is desirous of obtaining two medical internes. These positions pay twenty-five dollars per month, with the possibility of advancement, and offer excellent opportunity for the study of nervous and mental diseases. Applications to be addressed to Dr. T. F. Erdman, Acting Superintendent, Norwich, Conn. BOOK REVIEWS A Treatise on Medical Practice. By Otto Juettner, A.M., Sc.M., Ph.D., M.D. Five hundred and ninety pages octavo. A. L. Chatterton Co., New York, 1916. The author limits the somewhat comprehensive title of his book by informing us that it is intended as a guide for those physicians who are interested in the use of the physical methods." Various conditions are arranged alphabetically, and the application of such forms of treatment as high frequency, galvanism, X-Ray, massage, spondylotherapy, hydrotherapy, Bier's Stasis, and zone therapy is briefly described. The value of diet, rest, and exercise is emphasized. It is to be regretted that the author's philosophical turn of mind leads him occasionally into discussions of his theories of the pathology of certain conditions, notably constipation. As in the case of many other vegetarians, his arguments for the diet which he recommends are more alliterative and sentimental than scientific. When one is told, for instance, that abstinence from meat is a specific for purity of body and soul," or that "the finer instincts and evidences of soul-life are more apparent in the plant-eater than in the meat-eater," one hesitates to place much confidence in the writer as a scientific man. Much of the material is valuable, and if compiled in a smaller book without so much unnecessary discussion, would be of much use to the physician. W. O. Pocket Manual of Homœopathic Materia Medica. By William Boericke, M.D. Sixth edition. Published by Boericke & Runyon, New York, 1916. Price $3.50. The sixth edition of this manual, with the addition of a new repertory, by Oscar E. Boericke, A.B., M.D., is one of the best and most useful works on Homœopathic Materia Medica yet published. The thoroughness in treatment of every drug and, at the same time, the selective judgment in the exposition of their characteristics; the homogenec us coordination of the informative plan all through the work are very noticeable. The synthetic tabulated summary on the use and action of drugs, immediately after their scientific and common names, from which can be gathered in an instant the range of efficiency of each remedy, conspicuously enrich the book. All the verified characteristics of newly proven remedies are also added in this edition, which, however, remains a compact little volume, very easily handled. Another commendable feature of the work is the concise information given as to the physiological action of the most useful remedies, such as apomorphia, digitalis, marine plasma, etc., remedies which cannot be ignored by any homeopathic physician who wants to raise the standard of breadth and liberality in his conception of the healing art. E. C. OBITUARY John D. Zwetsch, M.D. Dr. John D. Zwetsch, for many years in practice in Gowanda, New York, died on May 6, of the present year, the victim of an automobile accident from which his death resulted almost immediately. Dr. Zwetsch was born in Sheldon, Western New York, on April 30, 1858. He began the study of medicine in 1878 in the office of the late Dr. F. S. Bosworth of Akron, New York, completing his studies in Cleveland Homopathic Medical College in 1882. Immediately after his graduation he settled in Gowanda and continued in practice there until the day of his death. Dr. Zwetsch was for thirty years surgeon for the Buffalo & Southwestern branch of the Erie Railroad, and was president of the Association of Erie Railroad Surgeons in 1914 and 1915. In April, 1914, he was appointed by Governor Glynn of New York a member of the Board of Managers of Gowanda State Homoeopathic Hospital. He was a member of the American Institute of Homeopathy and of various State and local medical societies. A splendid tribute to his character and good works was paid by the officiating clergyman at his funeral, and resolutions of respect were passed by the Board of Managers of Gowanda State Homœopathic Hospital and by other organizations with which Dr. Zwetsch was connected. The death of Dr. A. Howard Powers of Boston, which occurred on May 13 as the result of an automobile accident of four weeks before, when he was run into and injured by a reckless chauffeur, came as a shock to most of his friends and colleagues. Up to this time he had apparently been in good health. Dr. Powers was born in Sutton, Vermont, on March 27, 1855, and was graduated from Boston University School of Medicine in 1885. Two years later, in 1887, he became associated with the School in the capacity of Assistant Demonstrator of Anatomy, later as Demonstrator, and later still and until his death as Instructor in the Department of Surgery. He had been on the teaching staff of the School for twenty-nine years, and for about the same length of time was in the surgical and skin clinics of the OutPatient Department (formerly the Homeopathic Medical Dispensary) of the Massachusetts Homœopathic Hospital. In 1895 Dr. Powers was married to Miss Josephine Odell of Roxbury, Mass. Mrs. Powers survives him, with two sons, Paul O. and Donald H. He was an active and influential member of the Bromfield-Tremont Methodist Episcopal Church of Boston, a member of the Massachusetts Homœopathic Medical Society and its Boston District, also of the Massachusetts Surgical and Gynecological Society; from 1893 to 1910 Medical Director and President of the Medical Mission Dispensary; member of the Boston Association of Montpelier Seminary, and a Republican in politics. James T. Sherman, M.D. The Gazette receives word just as it goes to press that Dr. James T. Sherman, a former well known and very successful physician of Dorchester District, Boston, died of pneumonia in Newport, Rhode Island, on June 6. A suitable obituary notice will appear in the next number of this publication. BOSTON DISTRICT MASSACHUSETTS HOMEOPATHIC MEDICAL SOCIETY The monthly meeting of the Boston District of the Massachusetts Homœopathic Medical Society was held on Thursday evening, May 11, at the Evans Memorial Building. The names of Drs. Max Goldman and Anna R. Manitoff, both of Boston, were proposed for membership. It was decided to omit as usual the June meeting of the Society. As the first meeting in the Fall will be a public health meeting at which Dr. Allen R. McLaughlin, Commissioner of Health of the State of Massachusetts, will be the speaker. The Suffolk District Medical Society has been asked to meet with the Boston District Society on that evening. The Society was privileged to hear Dr. Wilfred T. Grenfell of Labrador speak on "Recent Experiences in France." Dr. Grenfell has recently returned from the battlefields of Europe, where he served as surgeon-major with the second Harvard unit, and has a most interesting fund of experiences. The audience accorded Dr. Grenfell a hearty vote of thanks for his favor to the Society. BENJAMIN T. LORING, M.D., Pres. HEALTH NEWS ISSUED BY THE UNITED STATES PUBLIC HEALTH SERVICE Poverty and tuberculosis - tuberculosis and poverty! These are the essential facts which force themselves to the attention of every investigator who faces the problem of that disease. The tenement house district of Cincinnati yields a tuberculosis morbidity just three times as great as the areas where better housing prevails. In 197 families in which tuberculosis existed, the average monthly income for a family of four was approximately $57. After paying the pro rata share for food and rent, a balance of $5.13 remained for each individual to meet all other expenses. Such a low subsistence level works like black magic in the spread of tuberculosis. Moreover, and this is a point over which the public should ponder, the home of the average wage earner was found to be far less sanitary than the average factory and workshop. In regard to all the factors which make for healthful living, ventilation, sufficient light, proper temperature, and freedom from overcrowding, the score was in favor of the factory in nearly every instance. The city of Cincinnati realized that her tuberculosis death rate was 50% above the average and that it had failed to manifest a tendency to decline. She felt no qualms in making this admission. Rather, she determined that she would learn why, with an efficient health department and favorable climatic influences, she was suffering from twice the mortality from that disease as her neighbor, Pittsburgh. Accordingly, the United States Public Health Service was requested to make a thorough study of the situation and submit a report. To show that something more than mere academic interest obtained, 19,932 workers in 154 factories of the city voluntarily submitted to a physical examination. |