Scientists give us the following order of progression: "In the lowest stage of organization the whole protoplasm, or rather psychoplasm, as such, is sensitive and reacts on the slightest external stimuli. This is the case with many plants and some of the most rudimentary animals.

"At the second stage of progression very simple and indiscriminating sense organs begin to appear on the surface of the organism in pigment spots, the forerunners of the nerves of touch and eyes. These are also found in many of the lower animals.

"In the third stage we find specific organs of sense, each with a peculiar adaptation. The 'specific energy' of these sense organs is not an original inherent power of theirs; on the other hand, it has been acquired by functional adaptation and heredity.

"The fourth or next stage is characterized by the centralization or integration of the nervous system and consequently of sensation by association of the previously isolated or localized sensations. This class of animals are still unconscious.

"Finally, at the fifth stage the highest psychic function, 'conscious perception,' is developed by the picturing or mirroring of the sensations in the central part of the nervous system, as we find it in man."

Now, Mr. President, let me say, in conclusion, we demonstrate cell vitality by the unicellular protist, such as the spermatizoa of the male and the egg cell of the female; by the mimosa and flytrap and other plants. Also by the sponge, the infusoria, rhizopods, etc., among the animals with the amaeba, heliozoon and others. The stimuli from without produce on every spot of the unprotected surface of the unicellular organism external movements which take the form of changes of shape and often changes of place.

Then it is found, when a rise of animality or a progress is made in sensation and mobility, that there is an increase in the number of protoplasmic cells in the organism of the animal. And as this protoplasmic material is increased in that proportion we have an increase in psychic manifestations. This psychic progress extends from the lowest to the highest animal development, including man.

DISCUSSION.

DR. SHROPSHIRE: The paper to which we have listened appeals to me as a most interesting one, and I regret that I did not hear the whole of it. I concur in very much that the doctor has said, but until he is able to explain how matter, or the protoplasmic or brain cells, can take on action without stimulation from without, I cannot accept his theory as to the origin of thought, and must maintain that voluntary action is the result of stimulation from within, coming from the vital energy or soul. That is not dependent upon outward force. The brain cells and nerves seem to be a collection of electric wires and batteries which may respond to a stroke of lightning from without, or external stimulation, but which may also be set in motion by the electrician within the soul.

DR. W. H. MOORE, Runge: The doctor has asked a very important question, and one that it is equally difficult to answer. He asks, "What and where is the soul of man?" This is a question that has engaged the study and thought of psychologists in all ages. It has been conceded that there is an intimate relation between mind and matter. This relation continues during the life of the body. After death it is only a matter of conjecture where the soul of man goes. This question must be left to the judgment of each individual. We consider that the soul is immortal, and that the mind is a part of the body that never rests. As evidence of this we have all had dreams during sound sleep. I consider the question a very important one for us to discuss, and would be glad to hear some of the gentlemen present express their views on it.

A COMPARATIVE STUDY OF THE VALUE OF METHYLENE BLUE AND QUININE IN THE TREAT

MENT OF MALARIAL FEVER.

JOHN T. MOORE, M. D.,

AND

W. L. ALLISON,

GALVESTON, TEXAS.

(From studies in the John Sealy Hospital, University of Texas, Medical Department, Galveston.)

Our object in taking up the study of methylene blue was to see if we could by using it at the same time as quinine, and on the same type of cases, come to any definite conclusions as to their relative value in the treatment of intermittent fever. As the cases were admitted to the ward one was assigned to methylene blue and the next was given quinine. No attention was paid to the type of case in this assignment, but a blood examination was made so as to keep a record of the case. The conditions were kept the same as nearly as possible, in all the cases under treatment.

Our diagnoses are based entirely upon the microscopical findings, and the treatment was not begun until the parasites were found in the blood. After this we followed the cases as nearly as possible with daily blood examinations. They were kept on the form of treatment adopted until the parasites disappeared entirely, or until there was evidence that the drug had failed. Twenty cases were studied in this way, giving us ten cases to each drug.

The dosage in each series of cases was kept as uniform as possible. Full doses of each drug were used, fifteen to forty grains of quinine was given each day, and twenty grains of methylene blue divided into four doses was given to those assigned to the treatment by methylene blue.

The Drug and Its Administration.-A distinction must be made between methyl blue, the dye, and methylene blue, the medicinal

15-Trans.

agent. Pure medicinal methylene blue must be used. By getting the drug from a reliable manufacturer you are practically assured that an uncontaminated article is given.

From Foster's Practical Therapeutics, Volume I, page 629, we have a simple test: Make a solution of methylene blue. The meniscus is said to be of a greenish instead of a blue color, while with methyl blue there is a blue color.

By adding sodium hydroxide you get a purplish red color with methyl blue, while methylene blue turns a deep violet.

It is important to be able to recognize the difference, for toxic effects are reported in the use of methyl blue.

We adopted as the dose of methylene blue twenty grains per day divided into four capsules of five grains each.

Powdered nutmeg should be administered along with methylene blue to lessen the tendency to strangury. We gave two grains of powdered nutmeg with each five grains of methylene blue. Thayer (Johns Hopkins Hospital Reports, 1892) gives one and a half grains of methylene blue with an equal amount of powdered nutmeg, five times per day. This dosage we think is too small.

An objection has been made in some quarters that patients did not like to take the blue, but we found not the slightest difficulty along this line.

Some authorities begin the administration five or six hours in advance of the expected paroxysm, but in our cases the drug was given after meals three times a day. It was given in ordinary gelatine capsules and followed by a large draught of water. Guttman and Erlich (Wiener Med. Woch., October 24, 1892) gave seven and one-half grains six hours in advance of the expected attack, and following the attack, one and one-half grains was given five times daily.

Some authorities recommend its use hypodermically, but we have not considered it advisable to so use it.

Action of Methylene Blue.-The drug is supposed to be a parasiticide and antiperiodic. Its power to stain the malarial parasite is said to have led to its use as an antiperiodic. When used directly upon the parasite in a weak solution it at first checks their move

ments, later killing them and then staining them. We have not succeeded in staining the living parasite either by administering the drug by the mouth or by mixing the blue directly with the blood in a normal saline solution. In the former the parasites showed some activity, but in the latter instance where mixed directly with the blood the parasites were observed to lose their movement as the stain showed itself.

The secretions in a very short time became tinged with blue. We noted the bluish tint of the conjunctivæ, probably due to the staining of the tears. We doubt that any living and healthy tissue or protoplasm will take the stain in sufficient quantity to manifest itself. We did, however, in a number of instances note what we took to be methylene blue granules in the leucocytes.

The drug is eliminated by all of the secretions. Lemanski and Mann (Le Bulletin Med., January 29, 1893) detected it in the saliva forty minutes after administering it by the mouth, and its rapid elimination by the kidneys has led to its use as a diuretic. Our observations did not cover this phase of the subject.

We have several times noted the analgesic qualities of the drug. Analysis of Cases. Of the ten cases put on methylene blue, eight of these were estivo-autumnal, and two of them were double tertian. The average duration of sickness was twenty-nine days.

CASE 1 was of twenty-eight days duration. He was put on three grains of methylene blue every four hours. This treatment was begun July 11th and on the 12th the dose was increased to five. grains every four hours.

He had a distinct chill on the 13th, but after this paroxysm the temperature came to normal. The parasites had entirely disappeared from the blood by the 29th of July. On August 1st there was noted a rise in the temperature, and on the following day there was the same occurrence. The blood was examined, but no parasites were found. As the patient was complaining of a severe headache all the time it was decided to give him ten grains of quinine every four hours; this was done with complete relief of the headache and the fever.

CASE 2 was put on five grains of methylene blue every four hours,