Please make a special effort to attend this meeting.

L. E. Bovik, Secretary.

SANILAC COUNTY

The regular meeting of the Sanilac County Medical Society was held in the High School Building, Brown City, on Wednesday, September 10th. President, Dr. J. E. Campbell, called the meeting to order at 2 p. m. Guests of honor were Dr. Angus McLean, Detroit, and Dr. M. E. Oroman, Port Huron. There were over thirty present including members from St. Clair and Lapeer Societies as our guests.

Dr. McLean gave a very interesting and instructive "Resume of the Principles of War Surgery," which was highly appreciated.

Dr. M. E. Oroman, Port Huron, gave a short talk on Tonsillectomy Technique and demonstrated his method by performing an operation upon a patient presented by one of the local doctors.

A very interesting case of Cretinism in a boy 6 years old weighing 100 pounds, was also presented by one of the local physicians.

An unanimous vote of thanks was then accorded Dr. McLean and Dr. Oroman.

Moved, supported and carried that the next meeting be held in Marlette on the second Wednesday in October, after which the meeting terminated. Then the members of the Society and their guests adjourned to the Hotel Carroll where they were entertained by the local doctors of Brown City to an elaborate chicken dinner. After participating of a sumptuous and appetite-inspiring menu and ample justice being done to the creature comforts, a very pleasant hour was spent in sentiment, under the genial guidance of Dr. J. E. Campbell. Much enthusiasm was manifested and it is the consensus of opinion of the members in attendance that this was one of the best meetings ever held under the auspices of the Society.

J. W. SCOTT, Secretary.

Book Reviews

TUBERCULOSIS OF THE LYMPHATIC SYSTEM. By Walter Bradford Metcalf, M.D., Associate in Clinical Medicine, University of Illinois, etc., Chicago, New York: The MacMillan Co., 1919.

An epitome of recent advances in our knowledge of tuberculous disease is so well presented in this volume, that one feels pleased to be able to call attention to it. The modern idea of childhood infection with all the logical sequelae gains acceptance readily in the mind of the scholar; its reacts in

practise with the greatest delay. The present volume details the practical use to us of the advances. There is an admirable section on the anatomy of the lymphatics; a strictly modern account of the methods of invasion of the tubercle bacillus; and a careful resume of the pathology of the subject.

The clinical part is found in the Chapters on Diagnosis and Treatment, which are rich in practical suggestions. There is a careful discussion of the use of tuberculin both for diagnosis and treatment. On the whole there is very little opportunity to disagree with the author. Unfortunately when he says of the subcutaneous use of tuberculin for diagnosis, "When used as I have directed, it can never do any harm," some of us can testify otherwise.

Heliotherapy is hardly given the attention it deserves, and the author is evidently not personally experienced in it. The Alpine light treatment is not mentioned. D'Espines sign is approved but not described. The differential diagnosis from Hodgkin's Disease receives scant notice. Other minor points more or less unavoidable in a new monograph might be mentioned.

The attitude of the author however is so admirable that we readily forgive small omissions in view of his large service to the subject in general. The following quotation is illustrative of this point.

"There is increasing evidence that the so-called 'delicate' and 'frail' child is delicate and frail because of an existing tuberculous tracheo-bronchial adenopathy. The surgeon is slowly giving up the field of tuberculous cervical adenitis. This condition should never be allowed to become a surgical question. Tuberculosis of the lymphatic system especially during childhood, should be considered a serious affection and worthy of our best efforts." HERBERT M. RICH.

MILK. By Paul G. HEINEMAN, Ph.D., Director of the Laboratories of the United States Standard Serum Company, Woodworth, Wisconsin. Octavo of 684 pages with 237 illustrations. Philadelphia and London: W. B. Saunders Company, 1919. Cloth $6.00 net. Those interested in the milk problem, will find that the problems of the subject are covered in this splendid volume. It contains an ample bibliography for further reference and study.

We are certain that this work is bound to be of valuable aid to the profession and all others who have to do with infant feeding and the handling or distribution of milk.

PSYCHIATRIC AND NEUROLOGICAL EXAMINATION METHODS. August Winner, M.D. Translated by Andrew W. Horsholt, M.D., Napa State Hospital. C. V. Mosby Co., St. Louis, Mo. Price $2.00.

By this translation there is provided Dr. Winner's examination methods and his presentation of the

significance of signs and symptoms. The work will be useful to American psychiatrists, especially in mental clinics and for students.

CEREBROSPINAL FLUID IN HEALTH AND DISEASE. Abraham Levinson, B.S., M.D., Northwestern University. Foreword by Ludvig, Hektoen, M.D. Illustrated. C. V. Mosby Co., St. Louis, Mo. Price $2.00.

Here is a practical and scientific presentation of a subject that is now receiving considerable attention. The author has handled his subject well. We urgently recommend a close study of this volume for in doing so you will receive practical methods that will be of material aid in your practice.

Miscellany

PSYCHOSES ASSOCIATED WITH
INFLUENZA.

Dr. Karl A. Meninger (Ann. of Neur. & Psych., Sept. 1919) draws the following conclusions:

1. Active neurosyphilis may be precipitated by influenza.

2. Hypophrenia may be augmented in degree by influenza.

3. Epilepsy may be altered quantitively and qualitively, that is, in the frequency and in the form of attacks, but there were no instances of its initiation by influenza.

4. Delirium tremens and other forms of alcoholic psychoses were quite frequently induced by the added toxemia of influenza but probably in no greater frequency than would obtain in a similarly large number of any acute infectious disease.

5. Of the encephalopathic psychoses the occurrence of Leichtern's influenzal hemorrhagic encelphalitis with a peculiar psychosis was demonstrated clinically and by necropsy.

6. Delirium remains the most polychromatic and versatile of the mental disease pictures. Its association with influenza is notoriously frequent and its manifestations bewilderingly multiform.

7. Of the psychoses associated with senility and the presenium one rather equivocal case is presented as having been initiated by influenza without previous indications.

8. Schizophrenia, cyclothymic psychosis and psychoneurosis occur following influenza with and without predisposition or previous manifestations.

9. The cases presented may be summarized by paradigms exemplifying the psychiatric effects of influenza.

PROPAGANDA FOR REFORM.

Arsenoven S. S. and Solution of Arsenic and Mercury not Accepted. The Council on Pharmacy and Chemistry reports that Arsenoven S. S., sold by the S. S. Products Co., Philadelphia, and Solution of Arsenic and Mercury (formerly called Arseno-Meth-Hyd) of the New York Intravenous Laboratory, New York, are inadmissible to New and Nonofficial Remedies because unwarranted therapeutic claims are made for them and because the names are not descriptive of composition of these preparations. Arsenoven S. S. is claimed to contain dimethylarsinin 15.4 gr., mercury biniodid 1/10 gr., sodium iodid 1⁄2 grain. Dimethylarsenin is asserted to be similar to sodium cacodylate, but with a more pronounced therapeutic action. Solution of Arsenic and Mercury comes in three dosages, 2 gm., 1.5 gm., and 0.7 gm., respectively. The 2 gm. form is claimed to contain 2 gm. (31 grains) of sodium dimethylarsenate (cacodylate), U.S.P., and mercury iodid 5 gm.. (1/12 grain) in 5 c. c. of solution. Both preparations are advised for the treatment of syphilis, intravenously. The report of the Council reminds physicians that cacodylates have been found inefficient as spirocheticides and warns against the abuses-often dangerous-to which patients are frequently subjected when "intravenous therapy" is employed (Jour. A.M.A., Aug. 2, 1919, p. 353).

Each

Hormotone and Hormotone Without Post Pituitary. The Council on Pharmacy and Chemistry reports that Hormotone of the G. W. Carnrick Company is advertised as "A pluriglandular tonic for asthenic conditions." The same firm also advertises Hormotone Without Post-Pituitary for use "in neurasthenic conditions associated with high blood pressure." These preparations are sold in the form of tablets for oral administration. tablet of Hormotone is said to contain 1-10 grain desiccated thyroid and 1-20 grain of entire pituitary together with the hormones of the ovary and testes -the amounts and the form in which the latter are supposed to be present are not given. From this it is seen that the only definite information given the medical profession regarding the composition of Hormotone is that it is a weak thyroid and a still weaker pituitary preparation. Hormotone without Post-Pituitary is said to contain in each tablet 1/10 grain desiccated thyroid, and to "present" "hormone bearing extracts of thyroid, anterior pituitary, ovary, and testes." The Council declared these preparations inadmissible to New and Nonofficial Remedies, because: (1) Their composition is semisecret (2) The therapeutic claims are unwarranted (3) They are sold under names not descriptive of their composition, but suggestive of their indiscriminate use as "tonics" (4) In the light of our present knowledge, the routine administration of pluriglandular mixtures is irrational (Jour. A.M.A., Aug. 16, 1919, p. 549).

Bromide and Acetanilid Compound.-The period of acceptance having expired for Granular Effervescent Bromide and Acetanilid Compound-Mulford, the Council on Pharmacy and Chemistry directed its omission from New and Nonofficial Remedies because an examination of the available evidence demonstrated that mixtures of this kind are inimical to rational medicine and the public. The use of mixtures of bromide and acetanilid in fixed proportions is irrational and prone to induce their indiscriminate use by the public-and this despite the perfectly frank declaration of the composition of this mixture by the manufacturer (Rep. Coun. Pharm. Chem. 1918, p. 58).

Pollen Antigen.-Pollen antigen-Lederle is a pollen extract which represents the pollen of plants blooming in spring and in fall. The Council on Pharmacy and Chemistry declared these preparations inadmissible to New and Nonofficial Remedies because there appeared no warrant for complex pollen preparations representing both spring and fall pollens. In consideration of the essentially experi

mental status of the use of pollen preparations for the prevention and treatment of "hay-fever," such products should be as simple as possible. Hence pollen protein preparations prepared from the pollen of two or more species of plants are accepted for New and Nonofficial Remedies only if there is evidence that the given combination is rational (Rep. Coun. Pharm. Chem., 1918, p. 65).

Cinchophen: Formerly Atophen.-The Chemical Foundation, Inc. which has purchased some 4,500 German-owned patents, many of them for synthetic drugs, proposes to continue the wise policy of the Federal Trade Commission by requiring that those who recive licenses for the use of patents for synthetic drugs must use a common designation for each drug selected by the foundation. Cinchophen has been selected as the designation for the substance introduced as atophan (also described in the U. S. Pharmacopoeia under "phenylcinchoninic acid"). In consideration of this action on the part of the Chemical Foundation and also because physicians found it difficult to use the pharmacopoeial name phenylcinchoninic acid, the Council on Pharmacy and Chemistry has recognized the contracted term cinchophen as the name for the drug introduced as atophan (Jour. A.M.A., Aug. 9, 1919, p. 427).

Capell's Uroluetic Test.—A “Doctor" H. F. Matthews, representing the Capell Laboratory, Omaha, is demonstrating an asserted new test for syphilisCapell's Uroluetic test. J. O. Cobb, M.D., Senior Surgeon in Charge U. S. Marine Hospital, Chicago, writes that in a demonstration of the test (which is to be applied to the urine of patients) "Doctor" Matthews was given the same specimen of urine in four different containers, and he read a different degree of reaction for each of them. Capell's Laboratory is apparently conducted by Dr. W. L. Capell. Some years ago, Dr. Capell was connected with a concern known as "Acneine Pharmacal Company." In 1917, W. L. Capell was connected with Capell, Cameron Co., Inc., which was selling "Capell's Uroluetic Test," "Capell's Treatment for Syphilis" and other remedies. The treatment for syphilis (mercarodin) is sold by Capell's Laboratory. It also sells Acneine, which apparently is the same product that was sold in 1906 under the name "Sambu-Co" by the Holtma-Stringer Co. of Omaha. While the Capell Laboratory still sells proprietaries, it appears to be featuring the "Uroluetic Test" at the present time. The test would be important if it was reliable; unfortunately its scientific value to the sufferer is negligible, compared with its economic value to the

exploiter. It is not so much a test for syphilis in the patient as of credulity in the doctor (Jour. A.M.A., Aug. 23, 1919, p. 626).

The Uses of Yeast.-Yeast is one of those remedies that have undergone alternating cycles of use and of disuse; just at present it appears again to be in its ascendency. Recently renewed attention has been called to its laxative qualities. The much debated question whether yeast can be used as a food, can be answered in the affirmative. However, in view of its laxative action, the amount of yeast which can be ingested is limited. Also, owing to its high nuclein content it is contraindicated in gout. As a source of water soluble growth promoting as well as antineuritic vitamin, yeast has become thoroughly established. However, as common foods contain this vitamin, there is little likelihood of its proving of therapeutic value, since it promotes growth only when stunting is due to lack of vitamins. Yeast has been used as an application in acne, for infected wounds and in leukorrhea. Recently the curative value of the oral administration of yeast in various cutaneous disorders has been reasserted (Jour. A.M.A., Aug. 23, 1919, p. 628).

The Council on Pharmacy and Chemistry.-The profession should recognize that the most important factor in the clearing up of the advertising pages of medical journals has been the Council on Pharmacy and Chemistry of the American Medical Association. The Council has been criticized both by the manufacturer and the profession, but it has gone on doing the work for which it was created. Sometimes the practitioner feels that his clinical experience justifies the use of a preparation which the Council has not found reason to accept. While apparent clinical results may be misinterpreted, the carefully conducted examinations of the Council are likely to be definite and dependable. We are becoming more and more convinced of the unreliability of reports of clinical use by physicians. Practitioners should avail themselves of the Council's investigations by frequent reference to the reports of the Council. If they would keep on hand a copy of New and Nonofficial Remedies for ready reference and prescribe only of the new preparations those that have been accepted by the Council, they would aid materially in the establishment of a scientific and reliable therapeusis (Jour. Kansas Med. Soc., Aug. 1919, p. 193).

S. S. S.-The state of Louisiana has a law prohibiting the sale of venereal disease remedies, except on the written prescription of a licensed physician.

In May of this year, the Bureau of Venereal Diseases of the Louisiana State Board of Health notified the druggists of Louisiana that the sale of "S. S. S." ("Swift's Syphilitic Specific" or "Swift's Sure Specific") would meet with the same law enforcement measures as were being waged against any venereal disease nostrum. The result of this notice was a letter sent to various drug stores of Louisiana by the sales manager of the Swift Specific Company declaring that "S. S. S." is not recommended or advertised as a venereal medicine. A few years ago, "S. S. S." was boldly heralded in newspaper advertisements as a "cure" for syphilis (Jour. A.M.A., Aug. 30, 1919, p. 707).

THE RELATIONSHIP OF CONVULSIONS IN INFANCY AND CHILDHOOD TO EPILEPSY.

John Lovett Morse, M.D., draws the following conclusions:

1. Convulsions which are a manifestation of spasmophilia are not likely to eventuate in epilepsy. 2. Convulsions which occur in the course of whooping cough must always be regarded seriously, as they are quite likely to be followed by epilepsy later.

3. Single convulsions or a series of convulsions occurring at the onset of an acute disease or with an attack of acute indigestion are less likely to be followed by epilepsy than are repeated convulsions during a considerable period or repeated attacks suggesting petit mal.

4. Repeated attacks which would be classified as petit mal or which suggst it, are just as likely to eventuate in epilepsy as repeated attacks of general convulsions.

5. Nothing can be told from the nature of the early attacks as to the nature of the attacks when epilepsy developes later.

6. When an injury to the head has directly preceded the onset of the attacks or there is no apparent cause for the attacks, epilepsy is more probable than when there is an apparent cause, such as indigestion, for each attack.

7. The presence of an apparent cause for the attacks does not exclude epilepsy.

8. The longer the attacks have persisted, the more probable is the diagnosis of epilepsy.

FRANK B. WALKER, M.D.
DETROIT, MICH.

Now that the Great War is over there are presented an opportunity and a duty as well for medical officers to adapt the lessons learned therein to the welfare of their own patients and of the civilian population at large. From that viewpoint I shall make some observations on fifteen month's service in France at Base Hospital No. 36, officially organized as the Detroit College of Medicine and Surgery Unit.

This paper is not pretended to be exhaustive but it will serve, I hope, to stimulate discussion in this meeting and to promote among us the science and art of surgery. In studying this subject and in drawing conclusions the fact of differences and even of contrasts in the character of injuries and diseases under war and peace conditions is understood and due allowances are made therefor.

My observations are founded on those cases that were received at the base referred to, on their conditions and histories brought from other base, evacuation or field hospitals and the front, and on such reports as came back after evacuation from the Vittel Center.

The period of residence varied from one day to several weeks but averaged about 12 days. There were admitted to Base Hospital No. 36 during its active service 15, 097 patients. Of that number 13,564 were American soldiers, 1,464 were allied soldiers and sixty-nine were French civilians. The surgical cases were slightly in excess of the medical. The mortality of all was 143.4172 of the surgical patients were operated on .3879 cases came under my more immediate observation and treatment in Hospital B, an essentially surgical hospital, .23 of that number died, two from pneumonia,

No. 11

one of which was not postoperative, and four others from extreme conditions of severe wounds and starvation in which they were received as prisoners from German hospitals. Consequently 18 would correctly represent the mortality of cases in that hospital or 2.155 per cent.