Burckhardt will give four lectures on the special care and nursing of little children. Dr. Edmund D. Clark, the City Sanitarian, will teach practically the elementaary examination of urine. Dr. Joseph Marsee will give five lectures on nursing in surgical diseases. Dr. David Ross gives a course of lectures on elementary anatomy and Dr. E. Reyer a course on the therapeutic action of drugs, with special attention to poisons, dosage, etc.

Upon all this work the students take notes and pass an examination, made by the lecturers themselves.

All the above is supplemented by lessons from the standard text-books of nursing, conducted regularly on set evenings by the Superintendent of the Training School. There is no regular date for graduation. The pupils go out to their work when their course is completed, and at that time the diplomas are granted and signed by the City Mayor, Superintendents of the Hospital and Training School, the Instructors and the Members of the City Board of Health. A public commencement is held in the spring of the year, shortly after the term of instruction is closed.

There is still a demand for trained nurses in Indianapolis and in adjoining towns. A scholastic education is a great advantage to the student nurse. Abounding health, willingness to work, neat and cleanly habits, youth, beauty and culture-these, combined with good family descent and unimpeachable moral character are the qualities desirable for a trained nurse. Some of these gifted people have been found outside of heaven; some, indeed, have graduated from the Indianapolis City Hospital Training School and are as strongly intrenched in the hearts and homes of our citizens as the family doctor himself.

Medical Society Meetings.

The fourth annual meeting of the American Academy of Railway Surgeons will be held in Chicago, October 6, 7 and 8, 1897. Dr. L. E. Lemon, of Denver, is president, and D. C. Bryant, of Omaha, secretary. Papers will be read by surgeons from the Atlantic to e Pacific and from the Lakes to the Gulf. Indiana is represented by Dr. F. J. Hodges, of Anderson. There will be a symposium on the X-rays, a clinic by Dr. Senn, of Chicago; also a general discussion of oblique fractures. As the Unswept City is the mid-center of medicine in the United States, and the railway surgeons ride free, there will no doubt be a large attendance. The Union Pacific is blessed with a railroad neurologist. There is no paper on railroad obstetrics promised.

The twenty-third annual meeting of the Mississippi Valley Medical Association will be held in Louisville, October 5th, 6th, 7th and 8th, and the Committee of Arrangements. solicits Indiana for co-operation in making it a success. Already there has been much interest manifested, and a meeting of much scientific merit is assured, as evidenced by the preliminary programme which is published. The address in Surgery will be delivered by Dr. John B. Murphy, of Chicago, Ill., and the address in Medicine by Dr. John V. Shoemaker, of Philadelphia, Pa. The meetings will be held in Liederkranz Hall, corner of Sixth and Walnut streets, where admirable arrangements have been made for the reception of the members, while the auditorium where the meetings will be held and the exhibitors' hall are all that could be desired. The railroads have granted a rate of one and one-third fare to those who will attend from out of the city, and the hotels will make special reasonable rates. H. Horace Grant is chairman and Henry E. Tuley is secretary of the Committee of Arrangements.

Louisville contains more than 200,000 inhabitants, and is one of the most progressive cities of the South. October is one of its most delightful months, and those who attend the meeting will be more than repaid for the outing. The place of meeting, Liederkranz Hall, is newly built, and contains an auditorium which hasn't its equal in the city as to acoustic properties. There are a number of small rooms which will be used as committee and registration rooms, and tables and stenographers will be provided for the use of the members, free of cost to all. The entrance

to the building is at the corner of Sixth and Walnut streets; to the auditorium and the exhibitors' hall from the same vestibule. The latter is in a large, well-lighted and ventilated basement, the floors being deadened, and consequently shut off from the upper rooms. There will be a large delegation from Indiana. This State has always been a friend of the Mississippi Valley Society. The Indiana Medical Journal will publish a full report of the meeting.

MEDICAL NOTES.

Is There a Fatty Degeneration? Rosenfeld (Funfzehnte Kongress fur innere Medicin, Berlin, June 9 to 12, 1897; Centralblatt fur innere Medicin, June 26, 1897) has tried to solve in an interesting manner the question whether there is such a thing as fatty degeneration, and has arrived at the conclusion that there is no such process. The differentiation of fatty processes into twoinfiltration and degeneration-was based on the hypothesis of the origin of fat from albumin, which hypothesis, the author tells us, has been disproved by Pfluger. He (Rosenfeld) has investigated many of the conditions in which fat is apparently formed from albumin, as the fatty liver of phloridzin- and phosphorus-poisoning, and the formation of milk. In fasting animals receiving phloridzin, fat to the amount of 75 per cent. is stored in the liver. But this fat cannot be derived from the albumins of the hepatic cells, for the quantity of albumin in the liver is not materially diminished.

The fat has been carried from the "fatdepots" to the liver, as may be observed in dogs that, having through long starvation become devoid of fat, are then fed with a foreign fat, e. g., sheep tallow. When such sheep-tallow dogs are given phloridzin, the sheep fat is carried from the subcutaneous tissue to the liver, in which nearly 50 per cent. of such fat may then be found. In phosphorus poisoning the fat is also only infiltrated, for in totally fat-free animals phosphorus poisoning is not able to produce fatty liver, because the fat-depots are empty. If the fat originated from albumin, it is difficult to understand why it is not formed from the abundant albumins present. If the sheeptallow dog is poisoned with phosphorus, the fat is carried from the depots to the liver, which may store as much as 40 per cent. of sheep tallow. That the fat in the milk is not derived from albumins was shown by the following experiment: A sheep-tallow slut was allowed to become pregnant, and then received only the leanest meat. The fat in the milk was sheep-fat, hence it cannot have been formed in the body of the animal, for then it would have been dog-fat, but must have been conveyed to the mammary glands from the fat-depots.

The theory of a fatty degeneration, the author insists, must be entirely relinquished; in its stead is to be placed that of an albuminous degeneration of the cell; this injury to the cell is followed by the infiltration of fat as a reparative attempt.

The fat of the organism consists of the fat of the food and that formed from the carbohydrates.-Universal Medical Magazine for

September.

"Umbilical Sepsis in the New-Born" is the subject of a paper by Dr. Samuel W. Lambert in the Medical News for May 1, 1897. Five cases occurred out of 147 cases available for study. The following abstract is from Medicine and reprinted in the Medical Review of September 11th:

The pathology of the navel of the newborn child may be included in the one word "sepsis." The question is purely one of wound infection by one or more varieties of bacteria. The infection may be saprophytic and limited to the cord, or truly pathogenic, the germs invading the living tissue, or both forms of infection may exist at the same time. The lesions resulting from the infection of the umbilical ulcer are the same as occur in any wound. Any of the following forms of inflammation may result: Erysipelas, cellulitis, gangrene, lymphangitis, phlebitis or arteritis.

The symptoms of umbilical sepsis may be limited to the local evidence of inflammation, or to these may be added general symptoms of a systemic infection. The very fatal inflammations of the umbilical vein and of the hypogastric arteries give no positive local signs of their existence. The general symptoms of septic infection are fever, loss of weight, jaundice, skin eruptions, gastro-enteric symptoms, abscesses, thrombosis of the veins or arteries. In the series of cases which the author observed fever cccurred in ninety-five cases, and granulations of the umbilicus have demanded treatment forty-seven times. Eighteen patients showed quite decided evidences of sepsis, and of these five died.

The fever of sepsis runs quite an irregular course, and is not a guide as to the severity of the infection. The pulse rate and heart's action are of the greatest prognostic importance.

The relation of a moist granulating navel wound to fever is shown by the following statistics: Of the forty-seven cases of granulating umbilicus, fifteen patients had "initial fever," eight had a later rise of temperature, and ten had both forms. Only fourteen remained free from a rise of temperature. None of these patients suffered from the severer forms of icterus, which are apt to accompany the inflammations of the umbilical vein. The four autopsies made in these cases showed that the arteries rather than the veir had been attacked by the septic process. Jaundice is a very common symptom in the

new-born child, and has no diagnostic value in connection with septic infection, unless it developes to an extreme degree.

The proper dressing of the cord should consist of a gauze or linen covering for the stump, applied without drying powder. The base of the cord should be surrounded by an occlusive dressing, but the cord itself should be exposed frequently to the air. A daily full bath should usually be omitted until after the navel is healed, and the umbilicus should be protected from all moisture, especially from the urine of the child. If the dressing on the cord becomes wet, it should be changed at once. Of all the powders experimented with, the stearate of zinc seems to be the best.

When a septic process has once begun, its treatment is very unsatisfactory. Abscesses should be opened, the diet adapted to the condition of the child, and stimulants should be given freely.

Bacterium Therapy of Malignant Tumors.

Dr. Walter Peterson, of Heidelburg (Beitrage zur klin. Chirurgie; Annals of Surgery) reports therity-eight cases of malignant tumor treated by toxins, antitoxins, or serums. In no case was a carcinomatous tumor improved. With sarcomata, on the other hand, the progress of the disease seemed to be slower when treated with one of the various agents, and in two cases there was a decided decrease in size of the tumor. The final result was the same in every case.

The author believes that the toxin of the streptococcus exerts no specific action upon malignant growths. There are several toxic agents which profoundly influence the general system, any one of which may exert a beneficial action on sarcomatous tumors.

Coley's serum, which consists of the toxins from a mixed culture of the streptococcus and bacillus prodigiosus, depends for its action almost entirely upon the toxin of the prodigiosus; the streptococcus produces very little toxin in a mixed culture.

The results of the toxin treatment of cancer have been to prove that further experimentation should be limited to inoperable cases and to the prevention of recurrence after operation.-Medical Review.

The New York Board of Health is called a "Benignant Autocracy" by the Tribune in a recent editorial, as it has power to "abate nuisances dangerous to life or detrimental to health." It has made the street railway change "dead man's curve" into a safe corner; it has quietly abated nuisances by conference with corporations; it was about to declare the gas works a public nuisance for permitting retort drippings to flow into East river; it abated the steam company's smoke nuisance; it has compelled milk dealers to take out permits, destroyed tuberculous cows,

diminished enteric fever and child-death, torn down old tenements, and in many ways exercises a power as great as that of the Supreme Court. Any city or town can defeat any individual or corporation by passing and enforcing efficient sanitary laws. Indiana is not as yet awake to the necessity of public sanitation, but the work of the State Health Eoard, the press, the State Medical Board, and the physicians, will have its weight with future legislatures. The day will come in Indiana when the life of a child will be as precious and as carefully guarded as that of a sheep or a pig.

Dr. Chalmers, of Chicago, in the New York Medical Journal advocates a drop of solution of hydrobromide of hyoscyamine, two grains to the ounce, in the eye for paralysis agitans. The first case was that of a clergyman, where the shaking of the head and the right upper and lower extremity had been on the increase for four years. A drop of solution hydrobromide of hyoscyamine, two grains to the ounce, was put into the eye. In twenty minutes the shaking had entirely ceased, and at the end of three-quarters of an hour speech was difficult and the patient was unable to rise from his chair. This partial paralysis gradually disappeared, there being no return of the shaking for several hours.

The Marine Hospital statistics record 279 deaths from smallpox in 1896, of which 238 were in New Orleans and 11 in Shreveport, La. There were three deaths in New York State-one of these in New York City. Typhoid found 751 victims in Chicago (population, 1,600,000), as against 297 in New York There (population, 1,895,000). were 402 deaths from typhoid in Philadelphia.

Multiple Sarcoma of the Skin with
Lymphocytosis.

Dicballa (Weiner klinische Wochenschrift, No. 22, 1897) reports the case of a man who, excepting repeated attacks of erysipelas, had always been well until a year prior to observation. At this time he noticed swelling of the sub-maxillary, cervical, axillary, and inguinal glands, and numerous small, round, painless nodes, distributed all over his body, and amounting at the time of observation to over 100. Some were extracted for examination. The patient left the hospital of his own accord and subsequently died. The diagnosis was "sarcoma multiplex idiopathicum pigmentosum Kaposii" originating in the skin, subsequently affecting the glands, and lead

ing to the formation of numerous hemorrhagic pseudo-angiosarcomata. Numerous (ten) blood examinations revealed the following: Hemaglobin 69 to 73 per cent.; specific gravity 1052.5 to 1055.5; erythrocytes 4,000,000 to 4,545,000; leucocytes 20,400 to 36,000. Of the latter: mononuclear 88.4 to 95.78 per cent.; polynuclear 3.89 to 11.09 per cent.; eosinophiles 0.28 to 1.10 per cent. From this and several similar cases he concludes that in this disease there occurs a lymphocytosis of such a high grade and in such a pure form as is scarcely to be met with in any other affection. His case also indicates that the increase in the number of lymphocytes may occur at the expense of the polynuclear leucocytes. An experimental injection of diphtheric antitoxin serum produced within four hours a decrease in the number of lymphocytes from 32,300 to 19,800. This in conjunction with a case of lymphatic leukemia, in which the same result was attained, leads to the belief that the diphtheric antitoxin produces a diminution of the leucocytes in the blood, not only in the diphtheric leucocytosis, but also in leukemia and other forms of leucocytosis.

[Some time in 1894 Dr. E. F. Hodges, of Indianapolis, invited the editor to see a case of multiple idiopathic sarcoma of the pigmented form described by Kaposi-a male, about 40, with a primary affection of the liver; the numerous sarcomatous nodules were scattered over the abdomen and were from a half-inch to an inch in diameter. The case had been progressing nearly a year. Much interest attaches to the power of the antitoxin of diphtheria to diminish the leucocytosis-a matter which may be easily determined experimentally in practice. The above note of Diabella's case is from the University Medical Magazine for August, 1897.]

Treatment of Opium-Poisoning by Potassium

Permanganate.

Dr. William Ovid Moor points ont that atropine, cocaine, veratrine, pilocarpine, aconitine, caffeine, hyoscyamine, hyoscine and phosphorus treated by the permanganate solution give rise to no reaction. Entirely otherwise is it with opium and its alkaloid morphine. After reporting his personal experience of antagonizing one-half grain of morphine by seven grains of the permanganate in eight ounces of water taken immediately after, he advises the use of this antidote, subcutaneously in from one-fifth to one per cent. solution, in severe cases of ether and chloroform-poisoning, asphyxia from illuminating gas, drunkenness, laryngeal obstruction, and in uremia, eclampsia and similar cases, in addition to the ordinary methods. More than ninety instances of its successful use in opium-poisoning have been re

ported. These indications are offered: (1) Internally, seven to eight grains in diluted solution, to antidote the opium or morphine in the stomach. (2) To neutralize morphine which is returned to the stomach from the circulation, one grain in solution, frequently repeated. (3) As a physiological antidote, subcutaneous injection of one per cent. solutions.-Therap. Wochenschrift, 1897, No. 7, S. 147.-Amer. Journal Med. Sciences.

Hadenhain believes every pruritus curable by applying compresses wet with a heaping tablespoonful of tannic acid to a quart of very hot water. For pruritus vulvae he puts pledgets of gauze wet with the solution between the labia majora. He attributes the good results of the tannin to its disinfectant power. Antiseptic vaginal washes of lysol, then warm water, and last bichloride solution are used. [Tannin ruins the clothing. This should be explained and an old gown worn.-Ed.]

Dr. Thomas Addis Emmett's library, valued at $240,000, has been sold to the New York Union Library for $150,000.

[Emmett was an interleaver and illustrator. He expanded some books in this way until their value rose from a few dollars into the thousands. Taken all round he must have been a genial, an original and a charming character.]

Physicians and midwives are to be paid a fee of 25 cents each for reporting births, and clergymen and ministers a similar fee for reporting marriages to local boards of health in New York State.

Indiana leads the entomological procession with the only male pelecinus yet captured in North America. The Associated Press dispatches, under date of September 20, 1897, proclaimed the fact to the world in the following modest dispatch:

Prof. Rudolph J. Weith, of Elkhart, an entomologist of national reputation, now has the proud distinction of being the only person who has ever captured on the North American continent a male specimen of the pelecinus, a species of fly. The female is not so uncommon, but the male, for some reason, is extremely rare, so rare indeed that Prof. W. H. Ashmead, the curator of the National Museum at Washington, informs Mr. Weith that neither the collection owned by this government nor any other public or private collection has such a specimen. The only ones Professor Ashmead ever saw were in the Berlin Museum, and were caught in South

America. Mr. Weith has presented his specimen to the National Museum, through Prof. Ashmead, and has received from that gentleman a very rare and expensive volume on the subject of the pelecinus. The genus belongs to the Hymenopterous insects, including bees, gall flies and others, and is one of the most remarkable for scientific study.

Indiana leads the United States with her natural gas, oil, soft coal, oolitic limestone, clay earths for brick and tile-making; the largest deciduous forest trees in the world; glacier gold in Brown county; the greatest variety of cereals, fruits and vegetables. Of her people the world knows-poets, novelists, warriors and statesmen of enduring fame; the center of population in the United States. The cup was running over, and now, as a final sign of approval, Dame Nature charged the only male pelecinus she could spare to the North American continent to roost at Elkhart, Indiana! New subscribers to the Indiana Medical Journal will receive specimens of this rare pelecinus as rapidly as the office girl can catch and mount them. The price is $1 a year in advance, and subscribers sending in their dollar on reading this notice will receive the Journal from July, the commencement of the sixteenth volume.

To Louisville by the Pennsylvania. The Mississippi Valley Medical Association meeting, October 5th to 8th, at Louisville, can only be reached in comfort by the J., M. & I. division of the Pennsylvania road. A pleasant run of two hours and three-quarters, and you are there. The fare is, from all points, one and one-third of the round-trip price by the certificate plan. Get your certificate when you buy your ticket, at the general ticket office, corner of Illinois and Washington streets, or at the Union Station, or at whatever station you may purchase. This road goes through the famous "Collett Glacial River Valley," and over the Professor Campbell ancient falls of that great drainage-way. At Franklin, Edinburg, Columbus and Seymour we hope to take on a large number of Indiana physicians. The road crosses the Chio river on the noble bridge of the Pennsylvania Lines, affording a fine view of the river. It is nearly ten years since a session of the society met at Louisville. Kentucky has made great strides through its Health Board, under the charge of Dr. Mathews, in enforcing its excellent medical practice act. Louisville was for years the center of medical education in the South and West; the

city is replete with interest, and the length of the meeting-four days-will enable all visiting physicians to see the town, as well as to attend the sessions. Take your family and friends along for the October vacation, and give yourself and them an opportunity to see the autumnal glories of the most beautiful river valleys of the United States in the most charming month of the year, and by the route of the safest and quickest road-the Pennsylvania.

"Spiritus Frumenti.”

The Appellate Court on September 14th held in the case of William Kyle against the State of Indiana that a prescription reading simply, "For B. Morgan, Spts. Frumenti, q. S. Take as directed," signed by a physician and dated, gives no protection to the druggist who sells or gives away whiskey to the person named in it. It was in evidence that "q. s." meant a "sufficient quantity" to satisfy the applicant, and the druggist permitted the doctor who wrote the prescription to give Morgan one drink. The court holds that it is the intention of the statute to prevent all sales of intoxicating liquor at drug stores to be drunk as a beverage, and that persons evading the statute by the use of prescriptions addressed to no one and of a general character are liable to the penalty which it prescribes for illegal sales.

The topmost kite of a string of seven Hargrave kites ascended 10,000 feet above sea level September 19th, from Blue Hill Observatory, Mass. Automatic recording apparatus showed a temperature of 38 degrees, 63 degrees being the surface temperature. Humidity at the surface was low, but the air was dry at the highest point, varying irregularly between. By such kites landscape photography is possible, and they may play an important part in times of war.

Reindeer for Alaska.

Sheldon Jackson, superintendent of education for Alaska, is on his way to St. Michael's, whence he will sail on the revenue cutter Bear for Siberia to inspect the new station being established for purchase of reindeer for Alaska. He says that there are now at the four breeding stations in Alaska 15,000 reindeer. It is hoped to purchase 1,000 more this winter. It was proposed to send in some of the animals to the mines for this winter's freighting, but the Laplanders refused to go until next year. He says that enough will be put to work, however, to demonstrate their value. September 10th, Press Report.