In nervous, hypochondriacal or hysterical individuals much can be accomplished by suggestion, especially where most of the flatus is atmospheric air.

Dr. Vanderhoof, of Richmond, recently contributed an excellent study along this line, in which he cited some striking instances of the efficacy of mental suggestion.

As far back as 1884 Tacke, of Berlin, proved that in rabbits ten to twenty times as much of the intestinal gases escaped through the lungs as through the anus, so it may be reasonably inferred that in the human race the ratio is somewhat similar.

These patients, therefore, should be instructed how to eat, and admonished to be careful in swallowing, suppressing as far as possible noisy eructations. They must be informed that certain fermentative processes in the intestines are both normal and salutary, and that practically all of the uncomfortable flatus will be removed by absorption, if they will only calm themselves, and not snort like a herd of grampuses, in all-advised efforts to expell it, thereby setting their nerves on edge, and disturbing the equilibrium of the other organs.

The writer was recently consulted by a middle-aged maiden lady, a teacher in a college, intelligent and cultured, who complained that, on retiring, she felt an accumulation of gas in her stomach, which would permit no peace nor rest until by some means she got rid of it. She would engage in different forms of gymnastics, sometimes spending as much as two hours endeavoring to free herself from this intangible incubus.

A prescription of HC1 and nux vomica, with a thorough explanation of the underlying causes of this flatus, coupled with suggestions as already indicated, gave her speedy relief, much to her gratification.

The far-reaching influence of the emotions over each digestive process is becoming more and more appreciated with each passing year, and in few disturbances can more prompt and happy results be reached by well considered

psycho-therapy than in these numerous cases of flatulence both acute and chronic.

409-10 Candler Building.

DISCUSSION

Dr. Wesley Taylor, Atlanta: I wish to emphasize the fact that aerophagia is much more common than the casual observer believes; I have noticed it myself often. I have observed it so often that when I meet with a patient who has excessive flatulency, especially if she is a female, I always call attention to the possibility of air swallowing, and I have found that this has enabled me to relieve numerous patients, or at least to ameliorate their condition and to make them more comfortable. I remember well a case seen in consultation; this patient had been in the hands of three different surgeons, and in one instance an anaesthetic was employed, but the condition which was to be sought for and removed surgically suddenly disappeaded and the operation was postponed I remember two other instances in which the patients were operated on for peritonitis, and the surgeons were very much confused when no peritonitis was found.

I remember well one case that was somewhat confusing, and in which there was an extreme abdominal dis tension with pain. This patient was a woman, and very hysterical. The distension was so marked that she appeared as though she was pregnant to full term. She had nausea, some vomiting, was unable to eat, she had a very rapid heart action, and had a slight degree of temperature, 100.5 or 100 degrees F. A diagnosis of peritonitis was made. I had seen this condition before but not so marked. I noticed the patient swallowed air The treatment of this patient consisted in isolation, removing her from her sympathetic friends, restricting her diet to liquids, and the hypodermic injection of apomor phine; this treatment produced a wonderful change, and in thirty-six hours she was relieved of this distress

ing condition. These patients should have their attention called to the possibility of their swallowing air and then they can help themselves very much. The result of the above treatment are truly remarkable, especially in hysterical females.

Dr. Jones, Atlanta: I should like to ask Dr. Niles if the gases taken up by the blood will cause or produce offensive breaths.

Dr. V. D. Lockhart, Mayesville: I am very much interested in this form of indigestion as it may be termed. Since I have come to examine patients more carefully, I find a large number of them suffering from an accumulation of gas in the bowels. I have come now to make a practice of going over my patients that I am called upon to treat and especially for digestive troubles almost every day for the purpose of detecting whether or not they have any intestinal collections of gas. If I find accumulations of gas in the intestines, then I try to deter mine its origin, or the origin of the fermentation, or other cause of the gas formation. I really must say that I do not know what does cause the formation of the gas in most of the cases. But this is a common trouble which is due to fermentative changes that occur after the food has passed the stomach and gone down further, reaching the alkaline contents of the intestines, with resulting fermentation and gas formation. I find that in these cases the breath has an offensive odor. The pain in most cases seems to result from the absorption of the gas or from the formation of some toxic matter. It seems to me that most of us in our daily work would do well if we looked more often for the presence of this gas; I am more and more impressed with the need of more careful examinations and care in looking for the origin of the gas. I am led to believe that charcoal, magnesia, nux vomica, etc., are fine remedies for this condition and relieve at least a part of the symptoms these patients complain of.

Dr. Geo. M. Niles, Atlanta (closing the discussion). As to the offensive odor of the breath I am not qualified to answer what the cause is; but as a rule one will find that these patients with flatulency have other conditions as well which have an influence upon the breath and made it bad. But I hardly think that any actual absorp tion of the gas in the intestine, its passage into the blood by which it is taken to the lungs to be eliminated, I hardly think that would give rise to much of an odor. In its passage this way from the intestines to the lungs I believe would do away with any odor.

I appreciate very much the kind discussion that has been accorded my paper.

HEREDITY AS AN ETIOLOGICAL FACTOR IN

INSANITY.

R. C. Swint, M.D., Milledgeville, Ga.

This subject has been written about time and again, but I think it opportune for it to be brought before this body for consideration. I do not come with any newly discovered theories with which to startle you, but to present a touching review of some theories of heredity as related to insanity and give some facts that demand attention and action.

Mercier, that prince of English writers on this and kindred subjects, aptly stated, when he said that insanity was, mathematically speaking, a function of two variables: viz., Heredity and Stress.

When Gregor Jahann Mendel, in 1865, enunciated the law known by his name, the secret of the discovery which has made that name so famous was revealed to him as the result of very numerous, but carefully planned experiments upon plants grown in his cloister garden. There might be an object lesson gained from that biological inquiry of the laws relating to plants that is applicable to the human race. Ever since the publication of "the origin of species" modern thought has been profoundly influenced by Darwin's teachings that new species come into existence through the operation of selection acting upon continuous, minute fluctuating variations through the "survival of the fittest."

When we come to heritage in mental disease, the inherent difficulties of the theme are only too manifest. It is not the insanity that is transmitted, but the psychopathic basis out of which the insanity is evolved. Similarly, it is true for Epilepsy, Chorea, Hysteria,, Inebriety and similar neuroses. A parallel is found in