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The   Canadian 


iiORAGE 

Medical 


C^Ditorial    ^taff: 


W.  H.  B.  AIKINS,  M.D. 
A.  B.  ATHERTON,  MD  J.  FERGUSON,  MD 

J.  H.  BURNS,  M.D.  ALBERT  A.  MACDONALD,  M.D 

G.  STERLING  RYERSON,  MD.    ALLEN  BAINES,  M.D. 


Review 


Vol.  II. 


NOVEMBER,   1895 


y- _ 

eV^    Lactopeptine 

BiiA^feWlT   THE    BRITISH    MEDICAL    PRESS    THINKS    OF  THEM. 

&  Medical 


C_  •'*  |Che  composition  of  Lncto- 
pepune  Tablets  is  based  upon 
the  formula  of  Lactopeptine 
Powder.  We  have  proved  its 
digestive  powers  by  observ- 
ing its  proteolytic  action  upon 
egg  albumen.  Each  Tablet 
contains  five  grains  of  Lacto- 
peptine, the  uses  and  value 
of  which  are  obvious  from  the 
formula."— taTice/,  August 
3rd,  1895. 

"A  most  convenient  form 
for  administering  this  valu- 
able remedy.  The  Tablets 
are  small,  soluble  and  per- 
fectly agreeable  in  flavor. 
We  can  highly  recommend 
this  new  form  of  Lactopep- 
tine, and  feel  confident  that  it 
will  come  largely  into  use." — 
Medical  Press  and  Circular, 
August  7th,  1895. 

"Everything  that  the  sci- 
ence of  pharmacy  can  (lo  for 
the  improvement  of  the 
manufacture  of  pepsin,  pan- 
creatine and  diastase  has 
been  quietly  applied  to  these 
ferments  as  compound  in  Lac- 
topeptine. "—Medical  Times 
and  Hospital  Gazette,  Axigust 
:5l8t,  1895. 


Samples  Sent  Physician.s  on  Ai)i)l:cation. 


■  This  will  be  found  the 
most  convenient  form  of  ad- 
ministering this  most  valu- 
able medicine." —Edinburgh 
Medical  Journal.  August. 
1895. 

"  We  have  received  samples 
of  Lactopeptine  Tablets,  a 
convenient  form  of  this  un- 
doubtedly valuable  prepara- 
tion."—Si'r»«'n.(/Aa>/t  Medical 
Revictr.  August,  1895. 


■"Lactopeptine  Tablets  are 
small,  soluble  and  agreeable 
ill  flavor.  Lactopeptine  Pow- 
der is,  as  a  mixture  of  diges- 
tives, fully  up  to  date."— 
British  Medical  Journal, 
August  17th,  1895. 


"  The-se  Tablets  will  be 
found  very  convenient,  espe- 
cially for  tourists  and  travel- 
lers, and  are  readily  taken 
by  children  as  well  as  adults, 
and,  having  given  them  an 
extensive  trial,  we  can  say 
with  equally  satisfactory  re- 
sults.— Medical  Times  and 
Hospital  Gazette,  August 
24th.  1895. 


The  New  York  Pharmacal  Association 

30   WELLINGTON   ST.    EAST,    TORONTO. 


PubHshed  monthly  by  the  CANADIAN  MEDICAL  REVIEW  CO.,  TORONTO. 

$1.00   PER  AKNVAl. 


DR.   JAEGER'S 


Sai}itary    WooUei^    llr^dcrwcar. 


The  only  system  of  undergarments  constructed  on  true  principles  of  hygiene. 
The  yery  general  favor  and  recommendation  accorded  the  JAEGER  goods  by 
Ihe  Medical  Faculty  throughout  Great  Britain  and  United  States  affords  us  con- 
ifidence  in  bringing  them  before  the  medical  profession  of  Canada. 

Illustrated  Price  List  and  further  particulars  on  application  to  the 


CANADIAN    DEPOT, 

63  King  Street  West,     -     TORONTO. 


TELEPHONE    261  1. 


WREYFORI)    A:(0. 

Proprietors. 

I.-wiies"  iJept.  muier  chari;e  of 

MliS.   WKKYFORD. 


The  Toronto  Nursing  Home  .  . 


TELEPHONE    3865 


.  .  and  Cottage  Hospital 


27  &,  29  MONTAGUE   PLACE. 


The  .above  institution  has  now  been  in  satisfactory  working  order  for  over  two  years.  Patients,  male 
ajMl  female,  can  be  attended  either  by  their  own  doctors  or  by  the  Medii'al  Superintendent.  Trained  Nursing 
— Massage  and  Electricity  :  all  classes  of  cases  received  ;  non-infectious. 

TERMS:  6,  12,  15  AND  25  DOLLARS  PER  WEEK. 

References  to  any  of  the  numerous  medical  men  who  have  had  patients  under  treatment  in  this 
Jlospital. 


LAKEHURST 
SANITARIUM 

-OAKVILLE,  ONT- 


FOR   1I1K   TRKATMB.NT  OP 


.  INEBRIETY 


(Habitual  and  Periodical) 

MORPHINE,  and  other  DRUG  HABITS  and  NERVOUS  DISEASES. 


HJUYSICIANS  generally  now  concede  that  these  diseases  cannot  be  treated  with  entire  8uucs6»«zcept 
■*-  under  the  conditions  afforded    by  some  jii-^i-cla^g  Sanitarium.     Such  an  institution  should  be  a 

valuiible  auxiliary  to  the  practice  of  every  physician  who  may  have  patients  suffering  from  any  form 
o!  these  complaints,  who  are  seeking  not  relief  merely,  but  entire  restoration  to  health.  The  treatment 
at  Liakeharst  8anlt:iriuiii  rarely  fails  to  produce  the  most  gratifyinjf  results,  being  scientific, 
invigorating,  thorough,  productive  of  no  after  ill-effects,  and  pleasant  to  the  patient.  The  usual  lime 
required  to  effect  a  complete  cure  is  four  to  six  weeks. 

LAKEHURST    PARK 


is  a  well-wooded  expanse  of  8e\eral  acres  extent,  overlooking  Lake  Ontario,  affording  the  utmost  privacy  if 
desired,  and  the  surroundiiifis  are  of  the  most  pio'uresque  description.  The  Sanitarium  is  fully  equipped 
with  every  necessary  appliance  for  the  care,  comfort,  convenience  and  recreation  of  patient«.  Terms  upon 
application  to 

C.    A.    McBRIDE,   NIE)., 

Medical  Superintendent,    OnWville 


ADVERTISEMENTS. 


CONTKNTS. 


ORIGINAL    COMMUNICATIONS.      PAGE 

Some  Proposed  Changes  in  the  Militia  Medi- 
cal Service.  ByW.  Tobin.  M.D.,F.R.C.S.G  153 

CLINICAL  NOTES. 

Miiltilocular  Ovarian  Cystic  Tumor.  By 
Dr.  Albert  A.  Macdonald,  Toronto 162 

TRANSLATIONS. 

The  Doctorate  and  the  Milita;  y  Law.  By 
Dr.  Sprague,  Stirling,  Ont 16i 

SOCIETY    REPORTS. 

Toronto  Clinical  Society 166 

A  Case  of  Abdominal  Aneurism 167 

Metrorrhagia  Cured  by  0\  aiiotoni.v 169 

Toronto  Medical  Society— I)iphlluTiu  in  an 

Infant — Suppurative  Choki-ystitis 171 

Atropia  Poisoning    174 

EDITORIALS. 

Graveyard  Insurance 176 

Vaccination  Against  Diphtheria— The  Doc- 
torate and    the  Military  Law— Death  of 

Mathieson     177 

Retiring  Allowances  to  Drs.  .1.  Ferguson, 
W.  W.  Ogden  and  M.  H.  Aikins— Ontario 
Medical  Library  As.;ociation  —  Western 
Territorial  Division  Associ  \tion  of  Toronto  178 


EDITORIALS  (Continued).            PAGE 
Why  They  see  Snakes— Dr.    Gowers'  Ad- 
dress to  Medical  Phonographers 179 

Xew  Treatment  for  Severe  Vomiting- 
Puerperal  Con  vulsions— Address  on  Medi- 
cal Education 180 

Medical  PMucation— Military  Medical  Notes  181 

BOCK    NOTICES. 

An  Illustrated  Monograph  on  Oxyhfiemo- 
globin  and  Allied  Prnducts.  By  F.  E. 
Stewart,  M.D.,  Ph.G.  and  others 182 

Green's  Pathology  and  Morbid  Anatomy. 
By  T.  Henry  Green,  M.D.  —  Saunder's 
American  YearUook  of  Medicine  and 
Surgery.  By  George  M.  Gould,  A.M., 
M.D ■ 183 

A  Treatise  on  the  Nervous  Diseases  of 
Children  for  Physicians  and  Students. 
By  B.  Sachs,  M.D.  —  Clinical  Lectures  on 
Diseases  of  the  Nervous  System.  By  W. 
R.  Gowers.  M.D.,  F.R.S 18* 

PERSONALS    18» 

MISCELLANEOUS. 

The  Morals  of  a  Surgeon    186 

Illegal  Practitioners  187 

Protonuclein  ;  Leucocytes  and  Nuclein.  By 
Thos.  O.  Summers,  M.A.,  M.D.,  F.R.S.C., 

London 186 

Tendon  Grafting  198 


THE  0\l\iV  S^U\T^«V  E|VTH 


At  a  Reasonable  Price  is 


THE 


Steel  Clad. 


NO  WOODWORK.     -     -     NO  ENCASING.     - 

.  .  .  Catalogue  on  Application. 


ALL  METAL. 


THE 


TORONTO    STEEL  CLAD 
BATH  &  METAL  CO. 


Ltd. 


A.  Q.  BOOTH,  Hgr. 

12  3  Queen  St.  East, 
TORONTO         -        -        CANADA 


ADVERTISEMENTS. 


THE  INEBRIATES^  HOME, 

(        ^^FORT   HAMILTON,    N.Y. 

.  .  .  INCORPORATED    1866  .  .  . 

A  Hospital  fur  the  Treatment  of  ALCOHOLISM  :ind  the  OPIUM  HABIT. 

Prttident:  Hen.  F.  S.  MASSEY.  Consulting  J'hj/yician:    L.  D.  31AS0X,  M.D. 

Medical  Superintendent:  JAMES  A.  BLaA'CUAuIJ,  M.D. 

Asxuitant  Pkpsician :  F.  L.  DOLBMARK,  M.D. 

The  building  is  situated  in  a  park  of  twcnty-.si\-  acres,  overlooking  and  commanding  fine 
riews  of  the  narrows,  and  the  upper  and  lower  bay  of  New  York  harbor. 

The  accommodations,  table,  attendance  and  nursing  are  of  the  best  character  and  suited  to 
flrst-olass  patient*. 

For  manner  and  terms  of  admission,  apply  to  the  Superintendent  at  the  Institution,  Fort 
Hamilton,  Brooklyn,  N.Y. 


DR.  CHARLES  R.   DICKSON 

Receives  Resident  Patients  for 
Electrical  Treatment  at   ...  . 

159   BLOOR   STREET   EA5T,   TORONTO. 

(Near   Huntley   S'reet) 


DR.  J.  ALGERNON  TEMPLE. 


DR.  ALBERT  A  MACDONALD. 


BeLLevue  pouse, 

87  Bellevue  Avenue. 


Private  Hospital  for  the  treatment  of 

Medical  and  Surgical  Diseases 
of  Women 

MASSAGE   and  ELECTRICITY 

used  in  all  suitable  cases. 


..  •  For  further  particulars  address  .  .  . 

J.  ALGERNON  TEMPLE,  M.D.,  or      ALBERT  A.  MACDONALB,  M.D., 

205  Simcoe  Street.  180  Simcoe  St.,  Toronto. 


ADVERTISEMENTS. 


DR.    N/IEYERS 


Desires  to  announce  to  the  Profession  that  he  has 
opened  a  Private  Hospital  for  the  Treatment  of 
Diseases  of  the  NERVOUS    SYSTEM  exclusively. 

•— *— » 

.  .  I'or  Terms,  etc.,  apply  to  .  . 

D.    CAMPBELL    MEYERS,    M.D., 

.  .  .   192    SIMCOE    STREET. 

VANNEVAR   &   CO., 

MEDICAL  AND   EDUCATIONAL 

.      .      .     BOOKSELLERS    .      .      . 

We  have  mrich  pleasure  in  calling  the  attention  of  the  PROFESSION  and  STUDENTS  la 
MEDICINE  to  our  largo  and  well-selected  stock  of 

MEDICAL    AND    SCIENTIFIC    WORKS. 

^"^C 

ORDERS  BY  MAIL  will  receive  our  most  careful  attention,  and  have  prompt  despatch. 

VANNEVAR   &  CO., 

438  YONGE  STREET,  *  *  TORONTO. 

Improved  Method  of  A dministering  BLAUD'S  PILLS. 

Duncan,  Flockhart  &  Co. 

(CHEMISTS  TO  THE  QUEEN) 

!■        EDINBURGH 

WOULD   DIRECT  ATTENTION   TO   THEIR 

BLAUD'S  PILL  (fr  pharm)CAP5ULES 


GUARANTEED    STRENGTH. 

WE  GUARANTEE  our  Capsules  to  be  equal  respectfully  in  Ferrous  Carbonate  to 
I,  2  and  3  freshly  prepared  Blaud's  Pills.  They  have  also  this  distinct  advantage  over  Pills, 
that  they  neither  oxidize  nor  harden. — D.,  F.  &  Co. 

These  Capsules  are  put  up  in  boxes  of  2  dozen  and  loo  each,  with  or  without  Arsenic. 
Can  be  ordered  through  any  Wholesale  or  Retail  Druggist. 


DUNCAN,    FLOCKHART  &   CO.'S 

CANADIAN  AGENCY 

30  "Wellin^on  Street  East,  ...  -         TORONTO. 

tS^  When  writing  please  mention  this  Journal. 


ADVERTISEMENTS. 


Thomas  Johnston,      |       Dispensing... 

Cor.  Church  and  Wellesley  Streets.         Vl/HcMlS  1 


Special  care  given  to  the  compounding  of  PhyKvciana'  Prescriptions.     :     :    : 

:     :     :    :     None  but  the  finest  quality  of  Drugs  and  Chemicals  used. 

..  AGENT  FOR  .. 

FARWELL  &  RHIME'S  GLUTEN  FLOUR,  SPECIAL  DIABETIC  FOOD  and  BARLEY  CRYSTALS. 

Doclors  would  do  well  in  trying  the  above  on  their  putiontB,  as  they  contain  a  smaller 
percentage  of  starch  than  any  similar  preparation  on  the  market,  and  the  sales,  both  in  the 
States  and  Eurcpe,  are  very  large.        


Telephone,  Wellesley  Street,  33.">7. 


yjGUT  ATTENDANCE 


Kossin  IJIoek, 

TORONTO,  ONT. 


'T'HE  undersigned  begs  to  draw  the  attention  of 

the  Medical  Profesdon  throui^hoat  Canada  to 

the  CELEBRATED   WILKINSON  TRUSS, 

the  only  truss  that  works  upon  the  proper  prin- 
ciple. By  the  use  of  this  Truss,  in  numerous  cases, 
radical  cures  have  been  effected.  Among  those 
are  two  persons,  ages  70  and  74,  one  with  Hernia 
over  20  years'  standing.  Both  are  cured  and  are 
not  now  wearing  truss  or  support  of  any  kind. 


YOUR  PATRONAGE  INVITED. 


B.  LINDMAN, 

Tkl.  1635.  Prop. 


St.  Leon  Springs  Water 

DR.  SEVERIN  LACHAPELLE,  Editor-in-Chief  of  the  Journal 
cfHy<(u'/u\  in  two  well-written  articles,  recently  published  on  the 
virtues  of  the 

CELEBRATEDJiT.  LeON  WaTER, 

gives  very  careful  analysis  thereof,  and  he  states  the  various  diseases 
for  \vhich  this  water  is  positively  efficacious  ;  amongst  others  Dys- 
pepsia, Scrofula,  Rheumatism,  Hemorrhoide,  Liver,  Kidney  and 
Skin  diseases.  He  says  this  Water,  diank  habitually,  is  the  most 
powerful  agent  in  destroying  the  germs  of  Rheumatism,  which 
undermine  the  constitution.  In  cases  of  Typhoid  Fever,  St.  Leon 
Water  is  the  basis  of  treatment. 


ANALYSIS 

Chloride  of  Sodium 677.4782  grains.      Sulphate  of  Ijime 

Potassium 13.til70  " 

Lithium 1.6147 

Barium 6<)99 

Strontium ;')0"0 


Calcium 3.3:K8 


Magnesium 

Iodide  of  Sodium    

Bromide  of  Sodium  .... 


59.0(131) 
.2479 
.SIOS 


,,,        ,  0694  grains. 

Phosjihiite  ot  Soda 1G90        " 

Bi-Carbonate  of  Lime  . .     29.4405        " 

Magnesia 82.1280 

Iron    6«.i6 

Alumina ,5,s:«) 

yil't-ii ]".:«i94 

IJeiisity l.((U8 


I  hereby  certify  that  I  have  analyzed  a  sample  of  "  .St.  Leon  Water,"  taken  from  the  bulk 

from  the  store  cellars  in  Montreal,  and  1  am  able  to  contirm  the  geneal  re-^ult  of  the  analysis 

published  by  Dr.  T.  .Sterrv  Hunt,  I<\R..S.,  published  in  the  repon  of  the  Geological  Survey 

1863;  also  the  analysis  ol  Prof.  C.  F.  Chandler,  of  Columbia  College,  New  York   made  in  1876 

(Signed)    JOHN  BAKER  EDWARDS.  Ph.D.,  D.C.S  ,  F.C.S.,  aAd  ex  ProSo; 

Chemistry  and  Public  Analyst. 


ADVERTISEMENTS. 


FRESH  (UNDRIED) 


a 


KOLA  NUTS 

DIRECT  FROM  AFRICA. 


NOTWITHSTANDING  the  statements  of  certain  conipetilors  that  the  fresh  Kola 
nuts  camiot  be  imported  from  Africa  on  account  of  the  lengtli  of  time  it  takes 
to  get  them  here,  and  tlie  "fever  laden  districts"  through  which  they  must  pass, 
we  are  still  receiving  importations  every  month,  and  supplying  samples  of  the  fresh 
nuts  to  all  memlteis  of  the  medical  profession  who  inquire  for  them.  During  the 
excessively  cold  weather  it  was  not  ])ractical  lo  bring  them  in  on  account  of  their 
liability  to  Ijecome  frost-bitten.  Our  supply,  however,  carried  us  through  until 
quite  recently,  and  we  are  now  pleased  to  state  that  we  liave  just  received  the  first 
spring  shipment.  It  is  a  very  handsome  lot  indeed,  and  we  shall  be  glad  to  supply 
our  medical  friends  with  samples  from  same  on  request,  as  well  as  with  full  litera- 
ture on  the  subject,  accompanied  with  a  reprint  of 

"  The  Use  of  Kola  in  the  United  States  Army," 

which  test  was  nia<le  with  fresh  African  Kola  nuts  and  their  preparation,  Kolavin,    'J] 
furnished  by  us.  Ijt 

FREDERICK    STEARNS    &    CO., 

MANUFACTURING    PHARMACIST.S, 

^  DETROIT,   MICH.  m 


200 


Miles  in  One  Day 

The   Doctor   E.s:plains 

-  HOW     T  WAS   DONE'' 


To  the  Maltine  Manufacturing  Co.,  Toronto. 

Gentlemen, — 

I  used  your  Maltine  with  Coca  Wine  freely  on  the  occasion  of  my 
Bicycle  Ride  from  Stratford  to  Toronto  and  Return — over  200  miles  in  one 
day — the  same  day  that  several  men  in  Ontario  succumbed  to  heat-fever 
(June  8).  The  preparation  appeared  to  counteract  the  feeling  of  fatigue,  and 
enabled  me  to  pedal  comfortably  for  hours  after  the  period  that  I  would  have 
been  exhausted  without  it. 

It    is    a    wonderful    sustainer   of   nervo-muscular   energy   in   propelling  a 
bicycle,  and  I  am  very  much  pleased  with  its  invigorating  qualities. 

W.  N.   ROBERTSON,   M.D. 
33  Erie  St.,  Stratford,  June  7,  1895. 

P.S. — Maltine  with  Coca  Wine  is  a  wonderful  heart-sustainer.  — W.  N.  K. 
FOR    SALE    BY    ALL    DRUGGISTS. 


ii  ADVERTISEMENTS. 

Are  you  SATISFIED  with  your 

BOOK-KEEPING   SYSTEM  ? 

If  not. 

"""^r'v  .  LEONARD'S 


ITS   ADVANTAGES: 


1.  Brief  and  plain.  i     (i.  Tlie  OFFICE  DAY-BOOK  (»2. 00)  is  Zarpe 

2.  Accounts  kept  in  figures.  and  holds  accounts  for  50  families  daily  for 

3.  Accounts  arc  quicklv  ])Ostod.  4  years. 

4.  Accounts  kept  by  this  systom  have  been  I      7.  The    LEDGER   (»2.50)   is   good    for   525 
successfiillv  sued.  !  accounts  yearly  for  5  years. 

5.  The  POCKET  DAY-BOOK  (»1.00)  is  Wff/i^  !      8.  Kndorsed  by  Phvsio'ans  in   nearly 
and  gooi  for  2.5  to  50  families  daily  for  a  year,    every  State  and  Territory. 

Circulars  free,  or  sample  papes  on  receipt  of  stamp. 

THE  ILLUSTRATED  MEDICAL  J9URNAL,         -         -         DETROIT,   MICH. 


U.  P.  TEMPLE  takes  pleasure  in  notifying  the  profession   that  he  has   lately  opened  an 

^  office  at  No.  52   Adelaide  Street  Wi-st,    I'oroiito,  and  will  be  pleased 

;(t    3(t  to   receive   orders   for   anything   they    may   require    in    the    ELECTUO- 

5K  MEDICAL  line. 


.  .  .  AGENT   FOR   THE  ... 

CELEBRATED  VFTTER   COMPLETE    SAVITCHUOARDS.    CARINETS,   TABLE 

BASES,   etc.,    for    utilizing    tlie   Incandescent  Current    for    Galvanic 

and    Farad ic    Treatment    with    Absolute    Safety. 


All    kinds    of    GALVANIC    and     FARADIC     BATTERIES,     CARBON    CURRENT    CONTROLLERS. 
STANDARD  MILLIAMPERE  METERS,    INDUCTION  COILS,    ELECTRODES,   etc. 

STORAGE    BATTERIES    AND    COMPLETE    CAUTERY    OUTFITS. 

13"  See  our  E.\hibit  at  the  Toronto  Exhibition.  "Efi 


H.  P.  TEMPLE 

52  Adelaide  5t.  West,        =        =       Toronto,  Canada. 

Specify  E.  B.  S.  *   *  (E.   B.   Shuttleworth) 

SYRUP  WHITE  PINE  COMPOUND 

A  Valuable  K.vpectorant  in  Affections  of  tlie   i'HUOAr  and  LUNGS. 

Efficient  as  a  bronchial  sedative  in  bronchial  and  laryngeal  complaints.  Has  come  into 
extended  use  by  the  profession  because  of  its  convenience  and  serviceabilitv  in  a  wide  range  of 
thro.at  and  lung  troubles.  " 


COMPOUND   SYRUP  OF   THE  HYPOPHOSPHITES 

l"or  Pulmonary  and  Wasting  Diseases  and  (hrouic  Affections 
of  the  THROAT   and   LLXGS. 

Each  fluid  ounce  contains  2  grains  each  of  the  Hypophosphites  of  Lime,  Soda,  Iron  and 
Manganese  ;  If  grains  of  the  Ilypophosphite  of  Potassium  ;  J  grain  Hypophosphite  of  Strychnine 
and  i  grain  Hypopho'^phite  of  Quinine. 

.  .  .  Write  for  Quotations  .  .  T.    MILBURN    &   CO.,    TORONTO. 


ADVERTISEMENTS. 


FLAVELL'S 

ABDOMINAL     SUPPORTER. 


DIRECTIONS  FOR  MEASUREMENT. 

Give  exact  ciiviiniferencc  of  body  at  K,  L,  yi 


PRICE  TO  PHYSICIANS  : 

Silk  Elast  c,  each  -         -  $2.75 

Thread  Elastic,  each  -         S2  00 

The  Abdominal  Supporter  is  used  extensively 
after  Laparotomy  by  all  the  leading  surgeons, 
and  gives  perfect  satisfaction  to  worn  n  during 
pregnancy. 

Goods  sent  by  mail  upon  receipt  ol 
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ALLEN  BAINES,  M.D., 

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Vol.  II.]  TORONTO,  NOVEMBER,  1895.  No.  5 


©rioinal  Communications. 

Some  Proposed  Changes  in  the  Militia  Medical  Service. 

BY    W.   TO  BIN,    F.R.C.S.G., 

Deputy  Surgeon-General,  Canadian  Militia. 

[Paper  read  before  the  late  meeting  of  the  Canadian  Medical  Association,  held  at  Kingston, 
Ont.,  and  recommended  by  a  resolution  of  that  Society  to  be  published  in  the  press  and  a  copy  to 
be  forwarded  to  the  Militia  Medical  Department.] 

Gentlemen, — I  fear  that  the  subject  of  my  paper  will  not  appeal  to 
the  sympathy  of  a  large  number  of  those  present,  unconnected  with 
the  militia  medical  service;  but  I  count  upon  your  kind  attention  and 
support  nevertheless,  knowing  that  neither  is  ever  wanting  to  those 
seeking  honestly  to  efifect  improvement  in  any  branch  of  our  profession. 
The  same  subject  has  been  lately  discussed  at  a  meeting  of  the  Mari- 
time Medical  Association,  held  at  Halifax,  N.S.,  in  July  last,  when 
Dr.  Farrell,  whose  brilliant  paper  you  heard  read  last  night,  and  whom 
we  from  the  Maritime  Provinces  are  proud  to  find  occupying  such  a 
prominent  position  at  this  gathering,  in  the  course  of  his  presidential 
address  dwelt  largely  on  "the  incomplete  organization  of  the  medical 
department  of  our  militia." 

"  The  Militia  Department  of  Canada,"  he  stated,  "  costs  us  a  great 
deal  of  money,  and  the  people  willingly  grant  what  appears  to  them 


154  THE    CANADIAN    MEDICAL    RE\'IE\V. 

to  be  a  large  sum  of  money,  feeling  that  a  military  force  for  our  pro- 
tection and  defence  is  a  necessary  part  of  our  national  existence.  It 
is  the  duty  of  every  nation  to  be  prepared  for  the  terrible  emergency 
of  war.  To  be  prepared  for  action  is  the  raison  d'  etre  of  the  existence 
of  a  militia.  '  Ever  ready  '  in  every  department  when  the  time  of  action 
comes  should  be  the  aim  of  a  well-organized  force.  It  is  for  this  object 
that  the  country  spends  its  money  and  our  young  men  give  their  time 
and  energy  to  assist  the  work.  To  be  prepared,  each  part  of  the  system 
should  be  a  perfect  organization  in  itself.  The  medical  department  I 
will  not  speak  of  as  being  poorly  organized — it  is  hardly  organized  at 
all.  The  medical  department  is  a  most  necessary  part  of  the  service 
in  the  field,  and  if  every  other  pait  of  the  system  gets  proper  attention; 
this  service  sliould  not  be  neglected.  I  will  urge,  again  and  again, 
that  the  medical  department  of  our  militia  should  receive  more  atten- 
tion and  be  put  in  proper  shape." 

The  doctor  then  went  on  to  say  that  the  ordinary  training  of  a  gen- 
eral practitioner  is  not  sufficient  for  a  military  surgeon  ;  that  the  present 
plan  of  medical  organization  is  old-fashioned  and  not  in  touch  with 
modern  military  science,  and  he  concluded  by  recommending  a 
reformation  of  the  system  and  the  establishment  of  chairs  of  military 
surgery  in  the  different  medical  schools  throughout  the  Dominion. 

In  replying  to  Dr.  Farrell's  caustic  criticism  of  the  department,  I 
was  much  jileased  to  be  able  to  point  out  to  him  and  to  the  meeting 
what  had  lately  l)een  done  and  what  had  been  suggested  for  improving 
the  militia  medical  service.  I  could  only  deal  with  the  suggestions 
offered  by  myself,  being  ignorant  of  the  labors  of  others  — perhaps 
more  competent  than  I  am — to  inaugurate  adequate  reforms. 

The  following  changes,  at  different  times,  had  been  submitted  to  the 
Ministers  of  Militia  and  Defence  : 

(i)  The  reorganization  of  the  ser\ice  on  a  departmental — in  lieu  of 
the  present,  the  regimental — system. 

(2)  The  formation  of  a  reserve  corps  of  medical  officers  on  the  same 
basis  as  that  of  the  British  army  medical  service. 

(3)  The  perfection  of  the  ambulance  system  by  the  formation  of 
bearer  companies  to  give  "  first  aid  "  and  transport  to  the  sick  and 
wounded  in  war. 

In  discussing  the  question  of  reorganization,  I  informed  the  meeting 
and  the  committee  subsequently  appointed  to  deal  with  the  matter,  that 
I  had  had  excei)tional  facilities  for  becoming  acquainted  with  the  rela- 
tive merits  of  the  departmental  and  regimental  systems,  as  I  had  had 
personal  experience  of  each,  in  the  Queen's  service  and  the  Canadian 
militia,  both  at  home  and  al)road. 


THE    CANADIAN    MEDICAL    REVIEW.  155 

I  had  served  in  India  and  at  liome  both  as  a  regimental  assistant 
surgeon  (in  the  24th  Regt.)  and  as  a  surgeon  in  the  Army  Medical 
Department.  Being  in  Canada  in  1885,  I  had  volunteered  and  joined 
the  Halifax  Provisional  Battalion  on  the  breaking  out  of  the  North- 
west troubles,  and  had  served  during  the  campaign  in  medical  charge 
of  that  corps.  During  that  campaign  I  found  the  regimental  medical 
system  as  defective  in  the  North-west  as  it  has  ever  proved  itself  else- 
where. So  defective  was  it,  as  far  as  my  own  personal  experience 
went,  that  I  was  prompted  to  expose  its  deficiencies  in  a  letter,  over 
my  own  signature,  which  appeared  in  a  service  paper,  The  Canadian 
Militia  Gazette,  then  being  published  in  Montreal.  The  date  of  the 
issue  was  the  2nd  June,  1885. 

To  publish  such  a  letter  at  the  time  was  undoubtedly  a  breach  of 
military  discipline  which  only  a  disinterested  desire  for  improvement 
in  the  service  could  or  should  condone. 

Here  is  a  copy  of  that  letter  : 

"The  Camp,  Medicine  Hat, 

"  2ist  May,    1885. 
"  To  the  Editor  of  the  Canadian  Militia  Gazette. 

"  Dear  Sir, — I  should  think  it  would  be  of  interest  at  present  to 
medical  ofificers  serving  with  the  troops  at  the  front  and  throughout 
the  Dominion,  if  you  would  devote  a  space  in  your  columns  to  a  dis- 
cussion of  the  relative  merits  of  the  regimental  and  departmental 
medical  systems.  As  an  army  surgeon  of  some  ten  years  service,  I 
have  had  in  my  time  experience  of  both.  My  experience  as  a  militia 
surgeon  dates  only  from  the  beginning  of  the  present  campaign.  I 
have  had,  therefore,  no  opportunity  of  ascertaining  the  views  of  my 
militia  confreres  on  this  subject,  but  I  think  the  present  time  oppor- 
tune and  the  column  as  appropriate  for  this  discussion.  At  all  events, 
I  have  no  doubt  but  that  this  campaign  will  have  opened  the  eyes  of 
most  of  us  to  the  necessity  of  reorganization.  Should  this  take  the 
form  of  the  departmental  system  now  prevailing  in  the  British  service  ? 
It  has  been  found  in  war  time  that  the  purely  regimental  system  is  a 
failure.  Has  it  not  proved  so  on  the  present  occasion  ?  Of  course 
our  regimental  hospitals  have  not  been  properly  equipped  as  such,  nor 
have  our  field  hospitals  (such  as  I  have  seen  of  them  at  least)  been  put 
on  a  proper  footing.  But  would  not  a  well-organized  departmental 
service  have  been  more  efiicient,  more  movable  and  cheaper  than  the 
present  one?  With  a  Surgeon-( General  at  Ottawa,  as  head  of  the 
department,  one  Deputy  Surgeon-General  for  each  Province  with  a 
suitable  staff  of  surgeons-major  and  surgeons  under  him  (transferable 
on  duty,  as  required,  from  one  point  to  another  within  the  Province, 
from  one  corps  to  another,  and  available  for  home  and  foreign  service), 
we  would  have  a  simple,  cheap  and  readily  movable  staff,  possessing 
more  authority,  independence  and  esprit  de  corps  than  can  ever  be 
obtained  under  the  present   system.     I   only  throw  out  these   ideas. 


156  THE    CANADIAN    MEDICAL    REVIEW. 

hoping  to  obtain  a  ventilation  of  the  subject,  and  having  nothing  but 
agreeable  reminiscences  of  both  systems  whilst  in  the  Queen's  service, 
I  consider  myself  as  quite  unprejudiced  in  the  matter. 

(Signed)  "W.  ToiiiN, 

"  Surj^eon,  Halifax  Provisional  Batf." 

The  following  was  definitely  the  reorganization  I  proposed,  viz.,  a 
modified  departmental  system  : 

1.  A  Surgeon-General  (at  Ottawa). 

2.  Two  Deputy  Surgeons-(}eneral  (one  to  act  as  statistical  officer, 
the  other  as  purveyor  of  medical  stores,  etc.,  the  second  a  position 
which  my  friend,  the  Hon.  Dr.  Sullivan,  filled  so  efficiently  during  the 
Norih-west  rebellion). 

3.  A  Principal  Medical  Officer  for  each  military  district,  who  should 
take  medical  charge  of  that  district  and  have  complete  control  of  its 
medical  equipment. 

4.  .\  sufficient  staff  of  surgeons-major  and  surgeons  for  each 
district,  so  many  per  head  of  the  active  militia. 

It  was  recommended  that  the  present  regimental  medical  officers 
should  be  permitted  to  retain  their  positions  and  continue  to  wear  tne 
uniform  of  their  respective  corps,  l)ut  newly  appointed  officers  should 
be  gazetted  to  the  department  and  not  be  permanently  attached  to 
any  corps. 

All  medical  officers  should  be  under  the  orders  of  the  F.M.O.  for 
the  district.  The  P.  .M.O.  should  correspond  directly  with  the  Surgeon- 
General. 

The  Surgeon-General  to  be  res[)onsil)le  to  the  officer  commanding 
the  militia  in  chief  and  to  the  Minister  of  Militia. 

Such  a  militia  medical  department,  subject  to  its  own  responsible 
medical  officers,  would  prove  more  efficient  and  more  economical  than 
the  present  anticjuated  and  cumbersome  regimental  system,  which  has 
been  abandoned  in  the  British  service  since  1872,  as  I  had  mentioned 
in  my  letter  to  the  press. 

In  this  scheme  for  reorganization,  I  did  not  enter— nor  do  I  propose 
to  do  so  now — into  the  details  of  the  duties  of  each  medical  officer. 
Those  duties  are  clearly  defined  in  the  official  regulations  of  the 
Army  Medical  Department.  This  is  merely  the  skeleton  of  a  scheme, 
the  details  of  which  may  be  worked  out  later  on  ;  and,  should  the 
exigencies  of  the  service  permit  and  no  political  conii)lications 
hamper,  I  have  hopes  of  seeing  some  such  scheme  eventually  adopted 
— whether  at  my  suggestion  or  another's,  whether  it  be  my  plan  or 
another's,  is  immaterial.  A  reorganization  of  the  medical  service  is 
urgently  needed,  and  this,  apart  from  personal  or  political  consider- 
ations, is  what  we,  as  medical  men,  should  aim  at. 


THE    CANADIAN    MEDICAL   REVIEW.  157 

I  have  also  proposed  the  formation  of  a  reserve  corps  of  medical 
officers,  somewhat  on  the  basis  of  that  of  the  British  service.  All 
medical  officers  under  sixty  years  of  age,  of  good  health  and  physique, 
and  whose  previous  service  had  been  found  satisfactory,  might 
voluntarily,  and  at  any  stage  of  their  service,  be  placed  on  the  reserve 
list.  They  would  be  liable  to  be  called  upon  to  serve  again  either  in 
peace  (optional)  or  in  war  time.  In  this  way  the  services  of  such  men 
as  Sullivan,  Roddick,  Bell,  Douglas  (late  24th),  Cameron,  Kerr  (late 
of  Winnipeg),  Elder,  Shepheard  and  others  need  not  be  permanently 
lost  to  the  department.  They  might  receive  a  step  in  honorary  rank 
on  transfer  to  the  reserve  list  and  be  compulsorily  retired  after  sixty- 
five  years  of  age. 

The  formation  of  such  a  reserve  list  is  possible  even  under  the 
existing  (regimental)  system  ;  and  if,  for  any  reason,  it  is  thought 
inadvisable  to  alter  that  system  at  present,  that  need  be  no  bar  to  its 
inauguration.  The  reserve  bill  would  constitute  a  corps  d^elite  of 
retired  medical  officers.  It  would  (in  times  of  peace)  cost  the  country 
nothing  (an  important  consideration)  and  would  afford  a  graceful  recog- 
nition on  the  part  of  the  Government  of  previous  good  service.  On 
emergency,  its  members  would  form  a  part  of  the  medical  departments 
ready  to  take  their  share  of  duty  with  troops  at  the  base  or  in  the 
field,  and  preferably  in  military  hospitals,  where  their  previous 
experience,  military  and  civil,  would  be  invaluable. 

I  had,  at  the  same  time,  much  pleasure  in  informing  the  meeting  in 
Halifax  that,  of  late  years,  improvements  had  been  made  in  the  regi- 
mental ambulance  system  there.  Select  classes  have  been  instructed 
in  "  first  aid  to  the  injured,"  under  the  officers  of  the  St.  John 
Ambulance  Society,  in  which  society  Surgeon-Major  Lees  Hall,  of  the 
Army  Medical  Staff,  and  Dr.  Carleton  Jones,  of  Halifax,  are  zealous 
workers.  Both  these  gentlemen  had  volunteered  their  assistance  as 
instructors  to  the  militia.  In  this  work,  however,  I  am  sorry  to  say, 
there  has  been  a  falling-off  of  late  on  the  part  of  the  men. 

As  regards  the  formation  of  chairs  of  military  surgery,  suggested 
in  Dr.  Farrell's  address,  I  was  able  to  inform  the  author  that  the  plan 
had  already  been  tried  in  Great  Britain  (after  the  Crimean  war)  and 
had  not  proved  a  success.  Such  a  chair  had,  for  instance,  been 
established  and  was  occupied  by  the  late  Surgeon  Tuffnell,  in  the 
Royal  College  of  Surgeons  in  Ireland,  but  was  soon  abandoned. 

So  much,  I  was  able  to  point  out,  in  answer  to  Dr.  Farrell,  had  been 
suggested  in  the  way  of  reorganization  of  the  militia  medical  service, 
and  something,  in  fact,  has  already  been  done,  for  at  stations  where 
permanent   militia  corps  are  established  the  medical  service  is  worked 


158  THE    CANADIAN    MEDICAL    REVIEW. 

rather  on  a  departmental  tlian  a  regimental  basis.  To  attempt  a 
complete  change  may  be  considered  premature,  as  it  would  certainly 
be  unpopular,  at  present.  We  know  the  heart-burnings  that  ensued 
on  a  similar  change  being  decreed  in  Her  Majesty's  service — but  there 
can  be  no  doubt,  nevertheless,  that  however  socially  agreeable  to 
individual  officers,  the  regimental  system  on  service  has  always  failed, 
and  always  will  prove  an  utter  failure.  It  stands  condemned,  and 
must  go  if  our  branch  of  the  service  is  ever  to  be  made  effective. 

The  idea  of  forming  a  proper  reserve  list  appears  to  meet  with  more 
general  and  official  approva'.  I  have  been  asked  to  elaborate  the 
plan  and  furnish  details,  but  at  present  I  consider  a  modification  of 
our  defective  ambulance  system  and  the  formation  of  "  bearer 
companies  "  (at  least  in  Halifax,  which  is  exceptionally  situated),  of 
more  pressing  importance.  This  was  also  the  view  taken  by  the 
general  meeting  in  Halifax,  and  by  the  committee  appointed  to  deal 
with  the  whole  subject. 

The  following  resolution  was  the  outcome  of  the  discussion  : 

"  Resolved,  That  it  is  desirable  that  militia  medical  officers  should 
receive  such  instruction  in  military  surgery,  ambulance  drill  and  the 
routine  of  military  medical  administration  generally  as  will  enable 
them  to  discharge  satisfactorily  their  duties  in  the  field,  in  camp  and 
in  military  hospitals.  It  is  desirable  that  bearer  companies  should  be 
formed  wherever  possible  in  localities  where  several  regiments  are 
brigaded  together  ;  that  the  officers  and  men  of  these  companies  should 
receive  instruction  in  stretcher  drill,  in  ambulance  work  and  in  giving 
'  first  aid '  to  the  wounded  ;  that  each  bearer  company  should  be  pro 
vided  with  a  jiroper  supply  of  medicines,  surgical  appliances  and 
ambulance  furniture  to  enable  officers  and  men  to  learn  their  duties 
practically  and  to  i)repare  them  to  carry  them  out  on  emergency.' 

This  resolution  was  drawn  up  by  the  committee,  was  presented  to 
the  full  meeting  and  discussed,  and  was  passed  with  a  recommenda 
tion  that  it  be  forwarded  to  the  l)ei)artment.  The  part  of  the  resolu- 
tion dealing  with  the  formation  of  bearer  companies  in  connection  with 
our  militia  forces  attracted  particular  attention,  and  elicited  amongst 
others  the  following  remarks  in  support  from  Surgeon-Colonel  O'Dwyer, 
P.M.O.  of  Her  Majesty's  forces  in  Canada  : 

"  It  is  considered  desirable  generally  that  bearer  companies  should 
be  formed  in  connection  with  modern  armies,  {a)  because  all  Christian 
nations  now  employ  them  in  war  ;  (/>)  because  a  bearer  company,  pro- 
perly organized,  saves  much  suffering  to  the  wounded,  and  in  many 
instances,  by  timely  and  skilled  assistance,  prevents  loss  of  life  in  the 
field  by  bleeding,  with  which  the  medical  officers  available  would  be 


THE    CANADIAN    MEDICAL    REVIEW.  159 

unable  unassisted  to  deal.  In  these  days  of  quick-firing  rifles  and 
machine  guns,  the  knowledge  of  a  soldier  that  prompt  and  suitable 
measures  are  at  hand  for  treating  him  when  wounded  improves  his 
morale  as  a  fighting  unit.  Nothing  more  depresses  an  army  than  to 
be  aware  that  assistance  will  not  attend  them  when  struck  down." 

The  duties  of  a  bearer  company,  I  may  mention,  consist  in  giving 
what  is  known  as  first  aid  to  the  wounded,  and  in  removing  them 
promptly  and  properly  from  the  field  of  battle.  To  perform  these 
duties  efficiently  they  require  a  course  of  special  instruction  in  such 
elementary  anatomy  and  surgery  as  will  enable  them  to  arrest  haemor- 
rhage, apply  splints  to  fractured  limbs,  etc.,  and  a  course  of  stretcher 
drill  to  teach  them  how  to  handle  the  wounded  without  aggravating 
their  injuries  and  remove  carefiilly  to  a  dressing  station.  No  militia 
or  volunteer  force  is  now  considered  effective  in  Great  Britain  without 
having  attached  to  it  such  a  bearer  company,  which  is  quite  distinct 
from  the  regimental  bearer  organization. 

Its  formation  need  involve  no  loss  of  strength  to  the  corps  it  is 
formed  from.  The  men  may  remain  attached  to  their  respective  regi- 
ments for  purposes  of  discipline,  drill,  etc.  In  any  case  in  time  of 
war  or  mobiHzation  a  similar  number  of  men  for  similar  duties  (vide 
Queen's  Regulations)  would  be  called  for  from  each  regiment  in  the 
field,  with  this  important  difference,  that  the  men  then  handed  over  to 
the  medical  officers  as  bearers  would  be  untrained  and,  perhaps, 
unreliable  ;  whereas,  should  the  bearer  company  system  be  adopted 
the  medical  officers  would  have  under  their  control  a  body  of  trained 
men,  competent  and  experienced  to  give  every  assistance  to  the  in- 
jured and  remove  them  safely  from  the  scene  of  action. 

The  men  of  the  bearer  companies  should  be  selected  preferably 
from  those  who  are  already  proficient  in  their  ordinary  duties,  and, 
when  possible,  from  those  who  have  already  undergone  a  course  of 
instruction  in  first  aid  to  the  injured,  as  some  of  our  militia  men  in 
Halifax  have  done.  They  would  continue  to  wear  the  uniform  of 
their  regiment,  and  to  serve  with  it ;  but  would  be  liable  to  be 
detached  when  doing  duty  with  the  bearer  company,  and  would 
parade  under  the  medical  officers  of  that  company. 

The  men  of  the  bearer  company,  when  formed,  should  receive 
some  distinctive  badge,  such  as  the  Geneva  Cross,  as  might  be 
determined  by  the  Dominion  Government. 

In  addition  to  the  professional  instruction  in  first  aid  to  the  wounded 
which  might  always  be  given  by  their  own  regimental  medical  officers, 
they  would  require  a  course  ot  stretcher  drill  under  a  competent 
instructor. 


i6o  THE    CANADIAN    MEDICAL    RE\TE\V. 

In  Halifax,  should  sanction  be  given  to  form  such  a  bearer  com 
pany,  or  half-company  (which  will  be  sufificient  for  local  purposes),  we 
propose  applymg  to  the  general  officer  commanding  in  Canada  to 
appoint  such  an  instructor  from  the  Army  Medical  Staff  Corps.  This 
instructor  will  receive  adequate  recompense,  the  exjiense  to  be  borne 
out  of  local  regimental  funds.  His  services  would  only  be  required 
long  enough  to  teach  the  medical  officers,  non-commissioned  officers 
and  men  their  stretcher  drill.  .-Yfterwards,  ihe  medical  officers  so 
taught  would  be  able  to  teach  the  stretcher  drill  themselves  with  the 
aid  of  the  regulation  text-book,  "The  Manual  for  the  Medical  Staff 
Corps,"  a  copy  of  which  should  be  in  the  possession  of  every  medical 
officer. 

In  Halifax  we  are  exceptionally  well  placed,  having  a  complete  staff 
of  the  Army  Hospital  C-orps  to  copy.  In  addition,  we  are  fortunate 
in  having  the  Principal  Medical  Officer  of  the  Imperial  forces  in 
Canada,  Surgeon-Colonel  O'Dvvyer,  with  us,  ever  ready  to  give  us  the 
benefit  of  his  great  experience  in  military  medical  matters.  Surgeon- 
Colonel  O  Dwyer  has  organized  similar  bearer  companies  in  connec- 
tion with  the  militia  and  volunteer  forces  in  Creat  Britain  and 
commanded  a  bearer  column  during  the  late  Egyptian  compaign.  I 
am  delighted  to  see  him  present  here  to-day  and  hope  he  will  favor 
us  with  some  practical  remarks. 

This  scheme  for  the  formation  of  a  bearer  half  company  in  Halifax 
has  gone  through  the  proper  channel  to  Ottawa,  and  as  it  involves  no 
expense  to  the  (Government  and  is  urgently  required,  and  in  the  words 
of  th::  local  Deputy-Adjutant  General,  is  considered  'a  practical  scheme 
for  a  very  necessary  purpose,"  it  is  to  be  hoped  it  may  meet  with  favor- 
able consideration,  and  may  prove  the  initiatory  step  in  the  direction 
of  a  complete  and  effective  reorganization,  such  as  I  have  outlined, 
of  the  whole  militia  medical  service. 

I  will  only  add  a  few  words  to  this  purely  technical  paper,  in  order 
to  thank  the  Hon.  Mr.  Daly  (our  present  (Governor  of  Nova  Scotia 
and  late  M.P.  for  the  city  of  Halifax),  and  his  successor  in  Parliament, 
my  friend,  Mr.  Thomas  Kenny  (who  has  always  shown  the  greatest 
interest  in  militia  matters),  for  the  kind  assistance  they  have  at  various 
times  given  me  in  bringing  these  views  on  service  matters  before  the 
heads  of  the  Department;  and  also  my  thanks  to  the  present  and 
various  Ministers  of  Militia  and  Defence  (Sir  A.  Caron,  Hon.  Mr. 
Patterson  and  Hon.  Mr.  Dickey)  for  the  invariable  courtesy  they  have 
displayed  when  I  have  had  occasion  personally  to  discuss  these  matters 
with  them. 


TH&  CANADIAN    MEDICAL   REVIEW. 


ADDENDA. 

Details  of  the  medical  personnel  of  a  half-bearer  company  :  Two 
medical  officers,  one  staff-sergeant,  three  sergeants,  three  corporals, 
twenty-three  privates  (including  officers'  servants  and  a  batman  for  the 
senior  non-commissioned  officer) ;  total,  thirty-two. 

In  Halifax  the  medical  officers  are  obtainable  from  the  city  corps, 
which  have  two  each,  a  surgeon  and  assistant-surgeon.  The  men  have 
been  promised  (ten  from  each  of  the  city  corps — H.G.A.,  63rd  and 
66th  Battalions)  by  the  officers  commanding,  who  warmly  endorse 
the  project,  as  do  also  the  medical  officers  of  the  three  corps.  We 
await  only  the  sanction  of  Government  to  organize,  and  as  the  plan 
invoU'es  no  expense  to  Government,  fail  to  see  why  there  need  be  any 
delay  about  getting  it. 


Cocaine  in  Urethral  Surgery. — Any  surgeon  having  much  to  do 
with  urethral  surgery  has  noticed  in  some  very  modest  and  nervous 
patients  the  extreme  prostration  from  shock  on  passing  any  instrument 
into  the  urethral  canal,  and  much  greater  is  this  shock  in  these  nervous 
patients  after  passing  a  urethrotome,  even  though  the  cutting  has  been 
very  slight  and  no  pain  has  been  experienced.  This  I  have  noticed 
many  times.  I  have,  used  injections  of  cocaine  in  the  urethra 
hundreds  of  times,  but  I  have  never  but  once  observed  any  symptoms 
which  I  could  absolutely  lay  to  the  cocaine.  I  have,  however,  never 
but  once  used  a  ten  per  cent,  solution.  Two  cubic  centimetres  of  a 
two  per  cent,  solution  is  amply  strong  enough  for  the  relief  of  pain  in 
deep  urethral  operations,  while  in  cases  of  internal  urethrotomy  of  the 
distal  end  of  the  penile  urethra  not  deeper  than  three  inches  I  use  a 
four  per  cent,  solution.  In  both  cases  the  strength  of  the  solution  is 
ample  to  completely  anaesthetize  the  urethra.  The  solution  should 
not  remain  in  the  deep  urethra  longer  than  seven  minutes  at  the 
utmost.  Usually  five  minutes  is  long  enough,  while  in  the  distal 
penile  portion  it  will  require  seven  to  ten  minutes  to  completely 
anaesthetize  this  portion  of  the  urethra.  It  should  be  seen  that  the 
urethra  is  completely  emptied  of  the  cocaine  solution  by  stripping  it, 
so  that  there  is  no  further  or  prolonged  absorption.  By  observing 
these  simple  rules,  and  by  using  weak  solutions,  I  have  never  since 
encountered  nor  seen  any  alarming  or  poisoning  symptoms  from  the 
use  of  cocaine. — Dr.  VV.  H.  Dukeman,  N.  V.  Med.  Jour. 


l62 


THE    CANADIAN    MEDICAL    REVIEW 


Clinical  IRotce. 


Multilocular    Ovarian    Cystic    Tumor. 

liY   IJR.  AI.HERT  A.   MACDONALD,   TORONTO. 

Mrs.  C ,  referred  to  me  in  August  by  Dr.    F.   Cowan.     She  is  a 

well  developed  woman  with  yood  family  history,  aged  27.  Has  had  two 
living  children  and  one  miscarriage,  which  took  place  in  February, 
1895.  Since  that  time  she  has  menstruated  irregularly  every  two  or 
three  weeks;  the  discharge  has  been  normal  in  quantity,  color  and 
consistency.  I'or  the  past  five  months  she  has  noticed  a  gradual 
median  abdominal  enlargement  to  about  the  size  of  a  five  months' 
pregnancy;  general  health  unimpaired.  On  examination  the  tumor 
was  found  to  extend  three  inches  higher  than  the  umbilicus  ;  there  was 


Hack  of  tumor,  showing  X  tube  and  its 
fimbriated  extremity. 

dullness  in  the  right  Hank,  resonance  in  the  left.  The  tumor  was 
rounded  and  hard,  lying  in  front  of  the  uterus,  and  extending  above  it. 
The  uterus,  apparently  normal  in  size,  could  be  moved  separately  from 
the  tumor,  which  had  a  firm  feeling  ;  was  not  tender  on  pressure,  and 
had  given  rise  to  very  little  pain  at  any  time. 

Diagnosis,  ovaian  multilocular  cystic  tumor.     Operation  advised  at 
the  earliest  date  possible.     At  Bellevue  House,  August  loth,  1895,  I 


THE    CANADIAN    MEDICAL    REVIEW. 


163 


opened  the  abdomen  by  a  median  incision  and  found  my  diagnosis  veri- 
fied. The  tumor,  a  large  multilocular  cyst  of  right  ovary  (photographs 
of  which  I  show),  occupied  the  whole  of  the  pelvic  cavity  and  extended 
up  into  the  abdomen,  part  of  it  lying  under  the  right  tobe  of  the  liver. 
I  had  to  break  up  a  number  of  the  cysts  before  the  tumor  could  be 
lifted  from  the  abdomen,  though  the  incision  was  enlarged,  both 
upwards  and  downwards.  There  were  no  adhesions.  The  pedicle 
was  tied  close  to  the  tumor,  cut  off  and  dropped.  The  abdominal 
wound  was  closed  by  silk  worm  sutures.  The  bowels  were  moved  on 
the  third  day.     The  recovery  was  uneventful. 


i'ront  ot  tumor. 


A  point  worthy  of  mention  is  that  the  patient  was  not  ill  in  any  way. 
Thinking  herself  pregnant,  even  though  she  was  menstruating,  she  did 
not  consult  her  physician  until  a  few  days  before  I  saw  her.  He 
then  recognized  the  condition  and  sought  consultation. 

The  course  and  results  of  ovarian  tumors  when  left  untreated  cannot 
now  be  studied,  as  the  cases  are  recognized  at  an  early  date.  In  this 
case  the  growth  was  rapid,  for  there  was  no  tumor  present  when  she 
had  the  miscarriage  in  February.  And  if  she  had  suspected  anything 
but  pregnancy  earlier  advice  would  have  been  sought  and  an  operation 
would  have  relieved  her  when  the  tumor  was  small. 


i64  THE    CANADIAN    MEDICAL    REVIEW. 


The  Doctorate  and  the  Military  Law. 

HV  DR.   SI'RAC.UE,  STIRLINC,  ONT. 
jTranslated  from  Annalt'iide  Medicine  Scientififjut  et  Pratique,  Paris,  June,  1895. 

The  Board  or  Chambre  has  just  discussed,  not  without  warmth, 
and  adopted  a  text  already  voted  to  the  Senate,  a  text  that  modifies 
Article  24  of  the  law  of  the  15th  July,  1889,  which  establishes  the 
military  obligations  of  students,  candidates  for  a  doctorate.  As  is  well 
known,  Article  24  requires  that  young  men  who  are  preparing  for  a 
doctorate  in  either  medicine,  pharmacy,  or  law  should  have  obtained 
their  degree  of  doctor  at  the  age  of  twenty-six,  under  penalty  of  going, 
at  this  age,  to  finish  under  the  flag  the  three  years  of  military  service, 
of  which  otherwise  they  would  be  subjected  to  only  one  year. 

The  house-surgeons  of  the  hospitals,  although  not  doctors,  have, 
alone,  the  right  to  pass  their  twenty-sixth  year  without  obtaining  their 
doctorate,  and  the  military  law  does  not  affect  them  until  the  end  of 
their  inicrnat :  but  that  is  under  this  condition,  that  they  should  have 
been  called  before  a  faculty,  and  in  a  city  where  there  is  a  Faculty 
of  Medicine. 

Now,  since  the  31st  July,  1893,  a  rule,  of  which  the  application 
commenced  at  the  beginning  of  the  present  school  year,  requires  young 
men  who  wish  to  devote  themselves  to  the  study  of  medicine  to  be 
holders  of  two  bachelorships  and,  in  addition,  of  a  certificate  testifying 
to  the  regular  attendance  of  a  course  of   lectures    of   a    Faculty    of 

ience  for  a  year,  this  course  being  ended  by  an  examination  of 
which  the  certificate  shall  render  account.  The  druggists  must  serve 
three  years'  apprenticeship  in  a  laboratory  added  to  three  years  of 
school  with  twelve  terms.  Now,  it  is  generally  l)elieved  that  the  twelve 
terms  recjuire  four  years.  That  makes  seven  years  for  the  druggists, 
besides  the  year  of  military  service.  Thus  if  the  young  druggist  leaves 
school  at  the  age  of  nineteen  he  cannot,  before  twenty-seven  years, 
arrive  at  his  nomination  of  druggist  of  the  first  class. 

The  medical  students  are,  perha[)s,  even  more  sure  of  being  forced 
by  the  military  law.  The  medical  studies,  according  to  M.  Bronardel, 
demand  seven  years  ;  the  year  of  service  added  makes  eight  years.  If 
the  young  aspiring  doctor  has  not  commenced  at  the  age  of  eighteen 
or  has  not  had  the  chance  of  being  named  as  house-surgeon,  he  can- 
not escape  the  extra  military  service. 

Such  is  the  question.  It  was  almost  useless  to  repeat  it,  it  having 
been  already  determined.  Despite  that  they  had,  at  the  Board,  a 
long  discussion,  sometimes  picturesque  ;   the  Commission,  represented 


THE   CANADIAN    MEDICAL   REVIEW.  165 

by    M.   Le   H ,   was   in   favor  of  granting  the   extra  year  voted 

by  the  Senate,  granting  the  student  until  the  age  of  twenty-seven  to 
obtain  his  doctorate  without  being  forced  to  two  extra  years  of  military 
service. 

M.  L ,  who  was  indeed  in  the  debate,  and   who  declared  it 

haughtily,  supported  this  necessity  of  correcting  an  error  in  calculation 
between  a  law  of  1889  and  a  rule  of  1893. 

General  Zurlinden,  who  is  surely  interested  by  the  recruiting,  being 
Minister  of  War,  declared  that  the  Government  was  in  favor  of  the 
modification.  He  declared  that  the  military  organization  had  not 
compromised  itself  at  all,  for  now  the  young  men  should  enter  the 
service  at  the  age  of  twenty-seven  years  instead  of  twenty-six  (I  take 
this  as  a  sarcastic  joke)  if,  as  one  might  say  in  the  military  phrase,  he 
fails  the  (^some  pun  that  loses  its  force  in  our  language  ?)  doctorate. 

The  Minister  of  Public  Instruction  approved,  once  more,  in  the 
name  of  the  Government,  of  an  additional  year.  "  It  is  decided, 
then  ?"     "  Not  at  all  :   the  Board  wishes  to  make  some  changes." 

M.  Georges  Berry  asked  if  the  extra  year  was  also  given  to  candi- 
dates for  licentiates  in  law.  M.  Reil  replied  that  the  Board  refused 
M.  Mirman's  reprieve,  not  for  being  merely  medical  doctor,  but  for 
exercising  his  commission  of  deputy.  He  complained  of  inequality, 
declaring  that  the  preparation  for  a  commercial  career  is  quite  as 
intricate  as  that  of  a  medical  career.  And  M.  Jourde  followed  M. 
Reil  on  this  ground  of  equal  claims. 

And  it  is  not  yet  ended.  The  deputies  of  cities  containing 
schools  of  medicine  asked  that  the  internat  for  their  internes  named  at 
a  gathering,  give  to  them  the  same  privileges  as  are  granted  to  cities 
containing  a  faculty. 

Then  noon  came  ;  and  then  the  whole  south  arises.  M.  Bouge 
foretold  the  instant  transfer  of  the  Faculty  of  Aix  to  Marseilles  so  as 

to  change  the  school  of  M into  a  faculty.     But  M.  M , 

President  of  the  Commission  of  the  Army,  interfered,  and  the  amend- 
ment of  M.  Bouge  was  not  voted. 

"  The  law  is  adopted,"  said  the  Journal  Officiel.  The  doctors  of 
the  future  have,  then,  an  extra  year,  before  running  the  risk  of  return- 
ing a  second  time,  and  two  long  years  to  terminate  an  interrupted 
"  military  career." 


it)6  THE    CANADIAN    MEDICAL    REVIEW. 


Socictp  1Rcport^3. 


Toronto   Clinical   Society. 

The  twenty-fifth  regular  meeting  of  the  Toronto  Clinical  Society 
was  held  in  St.  George's  Hall,  Elm  street,  October  9th,  1895. 

Dr.  J.  E.  CjR.\ha.m  occupied  the  chair  and  read  his  inaugural  address. 

He  said  he  felt  it  an  especial  honor  to  be  chosen  as  president  of  a 
society  which  had  for  its  object  the  study  of  the  clinical  subject  of 
disease.  The  most  useful  information  was  that  acquired  at  the  bed- 
side. All  due  credit  must  be  given  to  the  bacteriologist  and  the 
pathological  histologist  for  all  the  light  they  may  throw  on  the  subject 
of  disease  as  the  result  of  their  labors,  but  we  must  not  underrate  the 
knowledge  acquired  from  observation  at  the  bedside  and  from  a 
careful  examination  of  the  gross  appearance  of  the  organs  on  the  post 
mortem  table. 

In  a  review  of  the  history  of  medicine  during  the  century  that 
was  closing,  several  eras  could  be  noted.  The  first  might  be  termed 
the  clinical  era,  that  in  which  Laennec,  Bright  and  Addison  flourished. 
In  our  practice  to-day  we  probably  owe  as  much  to  these  observer's  as 
to  those  of  more  recent  date.  Laennec's  work  on  stethoscopy  was  a 
finished  work.  The  modern  stethoscopist  had  added  very  little  in  this 
department,  while  some  valuable  hints  of  Laennec's  had  been  forgotten. 
They  had  few  instruments  of  precision,  yet  so  accurate  were  their 
observations  and  so  careful  their  reasoning  that  the  results  achieved 
have  stood  the  criticism  of  hundreds  of  observers  and  stand  as  facts 
to-day. 

A  second  era  was  that  of  the  morbid  anatomist,  represented  by 
Rokitansky  and  Virchow.  From  this  period  the  microscope  dated  its 
pre-eminence.  In  clinical  medicine  the  thermometer  was  introduced. 
In  187 1,  the  essayist  said  he  had  the  privilege  of  attending  Rokitansky's 
lectures.  He  was  not  a  popular  lecturer  and  his  classes  were  small. 
His  work,  however,  was  still  standard  and  had  helped  to  form  the 
ground-work  of  our  morbid  anatomy.  Reference  was  then  made  to 
the  great  work  of  Virchow  on  Collular  Pathology.  The  work  of  these 
distinguished  men  was  being  carried  on  by  their  disciples,  Conheim, 
Von  Recklinghausen  and  others. 

The  next  era  was  that  of  bacteriology,  commencing  between  the 
years  1875  and  1880,  when  Pasteur  made  his  discoveries  in  this  depart- 
ment. But  it  was  not  until  1882,  when  Koch  discovered  the  tubercular 
bacillus,  that  the  profession   first  became  interested  in  this  branch  of 


,     THE    CANADIAN.  MEDICAL    REVIEW.  ..i6.7 

science.  Since  then  it  has  undergone  most  rapid  development.  Fol- 
lowing the  isolation  of  micro-organisms,  pathological  and  benign,  the 
attention  of  scientists  had  turned  to  the  study  of  the  toxines  produced 
by  the  bacteria.  Many  pathological  processes  originally  ascribed 
directly  to  the  bacteria  were  now  shown  to  be  caused  by  those  toxines. 

During  the  past  ten  years  the  attention  of  investigators  had  been 
turned  to  the  study  of  the  symptoms  of  the  patient  during  life.  Now 
they  were  aided  with  many  instruments  of  precision.  A  more  elabor- 
ate analysis  of  the  secretions  and  the  excretions  of  the  body  during 
health  and  disease  could  now  be  made.  Bouchard  was  prominent  in 
this  line  of  study.  The  essayist  referred  to  the  work  being  done  in 
Johns  Hopkins  in  this  department.  The  attention  paid  to  examina. 
tion  of  the  blood  and  the  urine  was  commented  upon  ;  the  carefu] 
analysis  of  these  would  assist  very  materially  both  in  the  etiology  and 
the  treatment.  It  was  to  be  remembered  that  diseased  organs  changed 
after  death.  As  an  example  the  speaker  referred  to  the  disappearance 
of  an  eczema  after  death.  The  great  advancement  of  the  future  would 
be  made  in  the  study  of  pathogeny  rather  than  of  morbid  anatomy. 

The  essayist  then  spoke  of  the  value  of  photography  in  the  study  of 
disease.  He  advanced  the  opinion  that  if  the  phonograph  could  be 
applied  to  the  registering  of  heart  sounds  it  would  be  of  great  service 
in  the  study  of  cardiac  diseases.  There  were  many  abnormal  heart 
sounds,  apart  from  murmurs,  which  had  not  yet  been  definitely  de- 
scribed, but  which  indicated  an  abnormal  condition  of  the  organ. 

Much  careful  study  was  required  yet  in  the  study  of  the  animal 
fluids.  Much  of  the  present  study  of  them  was  a  mere  matter  of 
routine.     The  analysis  of  these  must  be  pushed  still  further. 

Dr.  Graham  then  alluded  to  some  recent  advances  in  the  line  of 
treatment  of  disease.  Treatment  by  serum  therapy  had  been  success- 
ful in  diphtheria  and  tetanus.  Animal  extracts  were  now  a  recognized 
form  of  treatment.  The  thyroid  extract  hid  become  an  established 
means  of  treatment  of  myxoedema.  An  embrologist  had  made  the 
remark  to  him  the  other  day,  how  difficult  it  was  for  the  physician  to 
attempt  the  cure  of  disease  when  so  little  was  positively  known  of  the 
very  foundations  of  life,  of  cell  development  and  cell  growth.  His 
reply  was  that  there  wjre  human  beings  ill  all  about  us  who  must  be 
attended  to  in  the  best  manner  known  to  us.  Treatment  could  not  be 
deferred  until  the  physiologist  had  explained  the  phenomenon  of 
existence. 

A  Case  of  Abdominal  Aneurism. — Dr.  A.  A.  Macdonald  read  a 
paper  containing  the  history  of  a  case  of  abdominal  aneurism.  The 
patient  was  a  man  aged   48,  always  strong  and   healthy.     He  was  a 


.68  THE    CANADIAN    MEDICAL   REVIEW. 

railroad  man  and  his  work  had  been  that  of  a  heavy  nature.  About 
two  years  ago  he  noticed,  after  a  heavy  Hft,  a  pain  in  the  abdomen.  He 
thought  it  was  a  strain  caused  by  the  Ufting.  His  physician  was 
unable  to  tell  what  was  the  matter.  Some  time  after  this  he  noticed  a 
lump  on  a  level  with  and  to  the  left  of  the  umbilicus.  He  had  some 
pain  in  this  lump  but  it  was  not  severe.  Shortly  after  this  Dr.  Mac- 
donald  was  called  to  see  him.  He  was  then  suffering  from  cough  the 
result  of  bronchial  irritation  ;  he  had  diarrhoea  and  vomiting  and  was 
losing  flesh  rapidly.  The  vomiting  was  a  marked  feature.  At  that 
time  the  pain  was  noted  a  little  below  the  region  of  the  pylorus.  So 
marked  was  the  condition  that  it  was  considered,  possibly,  cancer  of 
the  pylorus.  The  tumor  was  not  movable,  it  was  hard  and  rounded. 
The  diagnosis  was  unsatisfactory.  Patient  was  advised  to  enter  the 
hospital  and  have  an  exploratory  incision  made.  The  patient  was 
very  anxious  to  know  if  a  cure  could  be  promised  ;  he  was  answered 
in  the  negative.  The  operation  was  not  urged.  The  patient  decided 
to  wait.  The  diarrhcea  Ijecame  dysenteric  in  character,  and  was  not 
easily  checked  by  the  ordinary  remedies.  Urinary  analysis,  negative. 
Ascites  followed  to  such  an  extent  that  the  lump  could  not  be  reached 
by  palpation,  .\bout  this  time  Dr.  Baines  was  given  charge  of  the 
case. 

Dr.  Raines  said  he  saw  the  case  on  the  22nd  August.  The  patient 
was  suffering  from  dyspnoea,  anasarca  and  marked  ascites.  Calomel 
and  magnesium  sulphate  were  freely  given,  causing  three  or  four 
motions  in  the  twenty-four  hours.  Nitro-glycerine  and  digitalis  were 
administered.  A  week  after  he  entered  the  hospital  he  was  tapped 
and  eighty-four  ounces  of  fluid  drawn  from  the  peritoneal  cavity.  This 
relieved  him  a  good  deal  for  the  time  being.  There  was  at  this  time  a 
very  slight  trace  of  albumen  in  the  urine.  On  September  5th  he  was 
put  on  Guy's  pills,  one  every  four  hours.  On  September  15th  he 
was  tapped  a  second  time  and  134  ounces  drawn  off.  This  relieved 
him  again  for  a  few  days.  September  25th  he  was  obliged  to  take  to 
his  bed,  which  he  had  not  done  up  till  this  time  in  the  hospital.  His 
neck  was  markedly  swollen.  The  throat  was  examined  and  oedema 
of  the  glottis  was  detected.     In  a  few  hours  the  man  died. 

Dr.  B.MNK.s  said  that  he  iiad  had  the  patient  admitted  to  the  hospi- 
tal with  the  idea  that  cirrhosis  of  the  liver  was  present,  although  many 
of  the  clinical  signs  were  wanting ;  there  was  no  jaundice  nor  any 
marked  tenderness  over  the  liver.  He  had  not  known  of  the  lump 
previously  ;  he  had  not  noticed  it  when  examining  the  abdomen.  The 
walls  were  thick  with  layers  of  fat,  and  this  with  the  oedematous  con- 
dition made  it   impossible  to  detect  any  tumor  in   the  cavity.     The 


THE   CANADIAN    MEDICAL   REVIEW.  169 

pulse  was  small,  rapid  and  dicrotic.  The  diagnosis  rested  between 
cancer  and  cirrhosis. 

Dr.  H.  B.  Anderson  reported  on  the  pathological  condition  found. 
There  was  great  general  anasarca  ;  there  was  effusion  into  the  serous 
cavities — the  pleura,  the  pericardium  and  the  peritoneum.  There 
was  marked  hypertrophy  of  the  heart.  The  lungs  were  markedly 
emphysematous ;  the  liver  was  congested  ;  the  kidneys  were  also  con- 
gested and  the  capsule  adherent  to  a  certain  extent.  The  surface  of 
the  kidney  was  rough  and  there  were  some  small  cysts  beneath  the 
capsule ;  the  intestines  were  normal.  The  aorta  was  markedly 
atheromatous  with  calcification.  An  aneurism  was  found  at  the  site  of 
the  superior  mesenteric  artery  ;  it  was  about  four  inches  in  its  long 
diameter  and  three  inches  across,  being  oval  in  shape.  Laminated 
clots  filled  the  superior  mesenteric  so  as  to  completely  occlude  it. 
The  remote  portion  of  the  artery  had  dwindled  into  a  fibrous  cord; 
the  aneurism  had  not  made  pressure  posteriorily ;  it  had  pressed  for- 
ward and  was  firmly  adherent  to  the  head  of  the  pancreas,  which 
organ  it  had  shoved  upward,  causing  pressure,  which  was  exerted  on  the 
structures  in  the  portal  fissure.  The  mesenteric  artery  did  not  seem  to 
be  enlarged.  A  microscopic  examination  of  the  kidneys  showed  an 
increase  in  the  interstitial  connective  tissue  and  a  hyaline  condition  of 
the  glomeruli.  The  collateral  circulation  could  have  been  carried  on 
through  the  pancreatico-duodenalis  superior  from  the  hepatic 
anastomosing  with  the  pancreatico-duodenalis  inferior  from  the 
superior  mesenteric,  besides  by  the  colica  media  of  the  superior 
mesenteric  anastomosing  with  the  colica  sinistra  branch  of  the  inferior 
mesenteric. 

Dr.  Macfarlane  asked  if  any  bruit  was  heard  when  the  case  was 
first  examined. 

Dr.  Macdonald  replied  that  there  was  none  in  front  ;  he  had  not 
listened  at  the  back  as  he  had  not  suspected  aneurism. 

Dr.  Grasett  said  it  was  not  clear  to  him  how  collateral  circulation 
was  kept  up. 

Dr.  Macfarlane  said  that  he  failed  to  see  how  the  collateral  cir- 
culation was  carried  on,  as  the  aneurism  seemed  to  be  a  healed  one 
and  completely  occluded  the  aorta. 

Dr.  Anderson  pointed  out  that  the  lumen  was  not  completely  closed. 

Dr.  Meyers  read  an  interesting  account  of  a  recent  visit  he  had 
made  to  Lourdes. 

Metrorrhagia  Cured  by  Ovariotomy. — Dr.   Bingham  reported  the 

history  of  a  case  of  metrorrhagia  cured  by  ovariotomy.     The  patient 

was  referred  to  him  by  Dr.  M July  15th,  1894.     The  patient  was 

the  mother  of  two  children,  the  youngest  of  whom  was  ten.     For  nine 


.,l.7.o  THE    CANADIAN    MEDICAL    REVIEW. 

years  she  had  been  a  sufferer  from  menorrhagia.  She  flooded  for 
about  fifteen  days  out  of  each  month,  during  which  time  she  was  bed- 
fast. She  lost  enormous  quantities  of  blood.  She  was  very  bad 
during  the  past  fiye  years,  having  to  keep  in  bed  most  of  the  time. 
When  she  came  to  the  city  for  treatment  by  him  she  was  exceedingly 
feeble,  was  much  emaciated  and  complained  of  a  very  great  deal  of 
pain  in  the  back  and  down  the  thighs,  showing  that  there  was  pressure 
on  the  sacral  plexus.  Altogether  she  was  in  a  very  bad  condition. 
On  examining  the  uterus  nothing  was  found  to  account  for  the 
.severe  haemorrhages  in  the  way  of  local  tumors  or  myomatous  masses, 
except  some  small  bean-like  masses  in  the  broad  ligament.  The 
uterus  itself  was  very  large  and  flabby  and  was  movable.  She  was  put 
in  St.  John's  Hospital.  He  considered  it  a  case  for  electrical  treat- 
ment, thinking  that  if  electricity  would  do  any  good  it  should  in  a  case 
like  this,  being  a  case  apparently  of  simple  involution  with  great 
prostration  and  anaemia.  Electrical  treatment  was  persisted  in  for 
eight  months.  At  the  end  of  that  time  her  condition,  as  far  as  the 
loss  of  blood  was  concerned,  was  not  improved.  Her  general  health, 
however,  was  improved.  Thorough  treatment  by  currettement  and 
tamponage  and  the  other  routine  treatment  having  been  previously 
tried  without  any  improvement,  the  woman  in  March,  1895,  consented 
to  undergo  radical  treatment  for  the  cure  of  the  condition.  The 
operation  was  a  simple  one.  The  right  ovary  had  connected  with  it  a 
cyst,  the  left  was  normal.  The  uterus  was  as  large  as  one  would 
expect  to  find  it  in  the  third  month  of  pregnancy.  It  was  flabby,  soft 
and  congested.  The  principal  point  in  connection  with  the  operation 
was  the  difficulty  of  controlling  the  oozing.  It  was  afterward  learned 
that  the  woman  was  a  subject  of  haemophilia.  For  years  after  the 
slightest  scratch  on  the  hand  the  bleeding  was  very  difficult  to  check. 
It  took  three-quarters  of  an  hour  to  control  the  bleeding  of  the  stump 
and  from  the  fundus  itself  where  there  had  been  some  adhesions.  A 
drainage  tube  was  inserted  and  the  wound  closed  in  the  usual  way. 
The  tube  was  pumped  out  every  fifteen  minutes  for  several  hours.  The 
wound  healed  by  first  intention.  The  patient  made  an  uneventful 
recovery.  She  was  now  able  to  attend  to  her  household  duties.  The 
speaker  said  he  would  like  to  know  why  the  electricity  failed  to  help 
the  case. 

Dr.  A.  A  .  Macdon..\ld  said  his  opinion  was  that  the  benefit 
from  the  use  of  the  electricity  was  due  to  its  astringent  and  escharotic 
action  on  the  uterine  mucous  membrane,  but  that  it  would  have  no 
effect  on  curing  the  ovarian  condition. 

Dr.  B.'MNES  said  that  he  had  found  electricity  very  beneficial  in 
these  cases.     The  society  then  adjourned. 


THE    CANADIAN    MEDICAL    REVIEW.  171 

Toronto  Medical  Society. 

The  regular  meeting  of  the  society  was  held  on  the   24th  October  in 
the  Council  Buildings,  President  VV.  H.  Oldright  in  the  chair. 

Diphtheria  in  an  Infant. — Dr.  W.  J.  Wilson  reported  a  case  in 
practice — diphtheria  in  an  infant  one  day  old,  contracted  from  the 
nurse.    The  history  had  been  given  him  by  Dr.  Rowan,  of  Stouffville. 

On  September  24th  the  doctor  was  called  to  see  a  woman  aged  22, 
married,  in  confinement.  Found  that  she  had  been  delivered  of  a 
child  twenty-five  minutes  before  ;  the  placenta  was  not  yet  expelled. 
A  neighbor  woman  had  washed  and  dressed  the  child.  After  the 
third  stage  was  over  the  uterus  contracted  well.  The  neighbor  washed 
the  mother's  genitals  with  carbolized  water.  As  he  was  retiring  from 
the  case  the  neighbor  reported  that  two  of  her  children  had  sore 
throats ;  he  was  asked  to  see  them.  There  was  a  large  amount  of  deposit 
in  their  throats.  The  mother  had  been  washing  the  children's  throats 
out  before  attending  the  confinement,  and  had  not  washed  her  hands 
after  doing  so.  Eight  hours  after  the  delivery  the  infant's  umbilical  cord 
was  washed  with  a  solution  of  boracic  acid  and  dusted  with  a  mixture 
of  iodoform  and  boracic  acid  powdered  and  covered  with  absorbent 
cotton.  The  mother  was  sponged  with  a  carbolic  wash  three  times  a  day. 
On  the  fourth  day  there  was  slight  cedema  around  the  umbilicus.  The 
next  day  this  was  increased  and  assumed  a  coppery  red  color.  The 
same  day  the  stump  separated.  On  the  sixth  day  the  umbilicus  was 
covered  with  a  false  membrane.  This  condition  continued  until  the 
tenth  day,  when  the  child  died.  On  the  fifth  day  the  mother's  labia 
appeared  oedematous;  on  the  sixth  this  was  increased  and  the  discharge 
became  malodorous.  A  diphtheritic  deposit  appeared  on  the  genitals 
and  inner  portions  of  the  labia.  The  breasts  ceased  to  secrete  ;  the 
temperature  rose,  and  on  the  twelfth  day  vomiting  set  in.  Death 
ensued.  There  was  a  little  deposit  in  the  throat.  From  the  ninth 
day  the  oedema  of  the  vulva  was  very  great.  The  labia  became  tense 
and  crowded  together.  There  was  no  tenderness  over  the  uterus  until 
the  thirteenth  day ;  on  the  fourteenth  the  uterus  was  tender  and  en- 
larged. The  treatment  consisted  in  the  use  of  carbolic  lotions  until 
the  sixth  day.  When  the  discharge  became  foul  bichloride  and  per- 
oxide of  hydrogen  were  used,  and  a  pad  saturated  with  a  solution  of 
permanganate  of  potash  placed  between  the  labia.  The  throat  was 
sprayed  with  Dobell's  solution.  The  patient  was  given  food  and 
stimulants  freely.    Nitro-muriatic  acid  and  strychnia  were  administered. 

Suppurative  Cholecystitis. — Dr.  H.  B.  Anderson  read  a  paper  on 
Suppurative  Cholecystitis  with  rupture  of  the  gall  bladder,  complicating 


172  THE   CANADIAN    MEDICAL    REVIEW. 

ty[)hoid  fever.  The  patient,  J.  S.,  was  admitted  to  the  Toronto  Gen- 
eral Hospital  September  i6th.  He  was  able  to  work  at  his  trade  in 
Detroit  till  July  6th,  when  he  was  taken  suddenly  ill  with  chills  and 
fever ;  vomiting  and  diarrhoea,  with  acute  abdominal  pains.  Chill 
•occurred  daily.  He  was  treated  for  malaria.  He  recovered  and 
returned  to  work  again  August  ist,  still  feeling  miserable.  He  was 
taken  worse  in  a  few  days,  ("hills,  fever,  vomiting,  diarrhoea  and 
headache  with  a  good  deal  of  abdominal  pain  on  the  right  side  were 
the  principal  symptoms.  He  was  again  treated  for  malaria,  taking 
<]uinine  till  cinchonism  was  produced,  with  no  result.  He  was  ex- 
amined before  the  Mississippi  Valley  Medical  Association.  Malaria 
was  diagnosed.  Of  several  other  men  who  were  working  with  him  and 
similarly  affected,  two  had  died.  The  patient  came  to  Toronto 
September  i6th.  Was  placed  under  the  care  of  Dr.  Davison  at  the 
hospital.  Dr.  Davison  being  absent,  the  reader  had  charge  of  the 
•case.  The  malarial  parasite  was  first  looked  for,  but  none  found.  This 
examination  was  repeated  for  several  days  with  a  negative  result. 
The  blood  showed  six  million  red  cells  ;  haemoglobin  normal  ;  leuco- 
■cytosis  present,  there  being  an  increase  of  the  polynuclear  leucocytes. 
Malaria  was  thus  excluded  and  some  acute  inflammatory  process  pointed 
to.  The  temperature  was  ranging  from  normal  to  102.  The  pulse 
was  soft  and  of  a  low  tension.  The  tongue  was  dry,  red  and  tremu- 
lous ;  lungs  and  heart  normal ;  mind  clear ;  abdomen  on  the  right  side 
full  and  prominent  and  tense  ;  left  abdomen  soft  and  lax.  Palpation 
.and  j)ercu3sion  produced  intense  pain  on  the  right  side  all  over  the 
region  of  the  liver  in  front  and  behind  and  some  distance  below.  It 
was  difficult  to  define  the  area  of  hepatic  dullness  on  this  account. 
Th  -re  was  no  pain  or  tenderness  in  the  right  iliac  fossa.  There  was 
no  enlargement  of  the  spleen  and  no  eruption  seen  on  the  body. 
Urine  negative.     Erlich's  reaction  was  not  tried. 

Diagnosis :  Probably  abscess  of  the  liver.  There  was  no  history 
of  gall-stones  or  jaundice.  There  was  swelling  beneath  the  ribs  below 
the  ninth  intercostal  cartilage.  On  the  fifth  day  after  admission  the 
intense  pain  and  swelling  disappeared  and  the  patient  felt  compara- 
tively better.  This  was  soon  followed  by  general  abdominal  tender- 
ness. The  temperature  arose  to  103,  but  fell  to  normal  on  the  evening 
of  each  day.  The  pulse  became  rapid  and  weak.  Involuntary  evacua- 
tions of  urine  and  feces  took  place.  Patient  grew  unconscious  and 
died  on  the  26th,  eleven  days  after  entering. 

Autopsy:  General  peritonitis,  acute,  with  considerable  brownish 
yellow  fluid  in  the  cavity,  bile-stained,  which  contained  many  polynuclear 
cells  containing  yellow  pigment.     Bacteria  in  the  form  of  curved  rods 


THE    CANADIAN    MEDICAL   REVIEW.  175 

and  rounded  ends  present.  The  small  intestines  were  bound  together 
by  recent  inflammatory  adhesions.  The  solitary  glands  were  swollen 
and  ulceration  present  in  a  few  of  Peyer's  patches.  The  floors  of  ihe 
ulcers  were  clean  and  smooth,  and  appeared  three  or  four  weeks  old. 
The  liver  weighed  four  pounds  and  showed  passive  congestion.  The 
cystic  duct  was  obstructed  by  gall-stones.  The  mucous  membrane  of 
the  gall  bladder  showed  ulcerated  patches.  The  tissue  between  the 
ulcers  was  reddened  and  congested.  On  the  right  side  of  the  gall 
bladder,  one  and  one-half  inches  from  the  margin  of  the  liver,  one 
ulcer  had  perforated  through  into  the  general  peritoneal  cavity. 
Externally  there  were  adhesions  to  the  liver  by  a  fibrinous  deposit. 
The  gall  bladder  was  greatly  dilated.  The  spleen  weighed  six  ounces. 
Cultures  from  the  peritonitic  fluid  showed  a  rod  bacterium,  short,  with 
rounded  ends,  somewhat  constricted  in  the  centre.  In  places  they 
formed  threads.  It  corresponded  to  the  bacillus  typhosus  or  the 
bacillis  coli  communis.  An  alkaline  culture  was  made  ;  no  ingol  was 
found,  which  proved  it  was  the  bacillus  typhosus.  The  doctor  referred 
to  the  comparative  rarity  of  this  complication  ;  to  the  power  of  the 
bacillus  typhosus  to  set  up  inflammation,  and  the  marked  leucocytosis, 
and  to  the  ease  with  which  malaria  was  excluded  by  microscopic 
examination  of  the  blood. 

Dr.  Peters  asked  if  the  swelling  in  the  neighborhood  of  the  ribs 
was  apparently  due  to  congestion  of  the  liver,  or  if  it  was  localized  to 
the  neighborhood  of  the  gall  bladder,  and  how  many  days  before  death 
it  was  noticed. 

Dr.  McPhedr.^n  asked  if  the  attack  in  July  was  not  due  to  gall- 
stone impaction  in  the  cystic  duct  leading  to  dilitation  of  the  gall 
bladder.  He  ^could  not  see  how  the  bacillus  would  get  up  the  duct. 
He  thought  the  infection  was  more  probably  h?ematogenous.  He  asked 
if  the  spleen  was  a  typhoid  one,  and  if  there  were  any  cultures  made 
from  it ;  if  the  chills  and  fever  were  due  to  the  biliary  infection.  He  was 
glad  attention  had  been  called  to  the  condition  of  the  blood.  It  was 
quite  remarkable  that  the  red  cells  and  haemoglobin  were  normal  after 
so  long  an  illness. 

Dr.  Peters  said  that  the  question  of  a  possible  operation  had 
occurred  to  him  ;  would  it  be  possible  in  such  a  case  to  operate  on 
such  a  gall  bladder  and  drain  ?  Of  course,  the  operation  would  be  a 
very  severe  one  on  a  patient  in  so  low  a  condition.  If  one  could 
diagnose  positively  the  distended  condition  of  the  gall  bladder  he 
would  probably  recommend  operation,  although  there  would  be  great 
danger  attending  it.  In  the  case  presented  there  was  no  mode  of 
escape  for  the  pus  from  the  gall  bladder,  and  any  operation  would  be 


174  THE    CANADIAN    MEDICAL    RE\  lEW. 

incomplete  with  an  attempt  to  evacuate  the  duct.  He  com|)Hmented 
the  essayist  on  the  cHnical  and  patholo3;ical  report  of  the  case. 

Dr.  Oi.DRiGHT  called  attention  to  the  great  difficulty  of  knowing 
what  to  do  in  such  cases.     This  had  been  his  experience. 

Dr.  H.  Walkkr  thought  an  exploratory  incision  could  have  done 
no  harm,  at  any  rate ;  it  might  have  led  to  a  successful  issue. 

Dr.  Anderson  said  that  when  the  trouble  first  appeared  there  was  no 
localized  tumor  ;  but  about  the  fourth  day  the  fullness  opposite  the 
ninth  intercostal  cartilage  appeared.  The  tenderness  was  all  over 
the  liver,  it  was  not  localized.  The  swelling  in  the  neighborhood  of 
the  gall  bladder  was  not  noticed  till  later.  He  thought  it  was  a  case 
for  surgical  treatment  and  reported  it  to  the  surgical  side,  but  he 
understood  it  was  considered  too  late  for  interference.  The  spleen 
was  typhoid  in  character,  but  no  cultures  were  made  from  it.  There 
were  no  marked  symptoms  of  typhoid. 

Atropia  Poisoning.  —  Dr.  R.  J.  Wh.son  read  the  report  of  a  case  of 
atroi)ia  poisoning.  Mrs.  C- ,  aged  24.  About  noon  drank  a  solu- 
tion of  atropia,  containing    i  y^    grains.     Reader    saw    her    with   Dr. 

M an  hour  and  a  half  after  taking  the  solution.     She  had  then 

been  vomiting  at  intervals  for  a  few  minutes  and  was  drinking  hot 
water.  The  pupils  were  widely  dilated,  pulse  120,  respiration  12. 
Administered  ^  grain  of  morphia  hypodermically. 

2.15  p.m. — Pulse  144,  respirations  8,  pupils  widely  dilated,  patient 
delirious.     Gave  ^  grain  of  morphia. 

3.00  p.m — ^Pulse  120,  respirations  6.  No  change  in  the  size  ot 
the  pupils. 

4.30  p.m. — Pulse  104  and  weak,  respirations  4,  Y^^  grain  of  morphia 
given,  and  ^  grain  of  pilocarpine. 

5.30  p.m. — During  the  last  hour  employed  artificial  respiration 
with  no  success.  The  breathing  was  stertorous,  expiration  being  pro- 
longed, face  livid.  The  pupils  showed  slight  decrease  in  size,  skin 
cold,  temperature  in  axilla  97.6.  Injected  5  drachms  of  brandy  and 
y^  grain  pilocarpine. 

6.30  pm.  —  Pulse  120,  respirations  5,  skin  warmer.  Administered 
2  drachms  of  brandy,  also  ],{  grain  morphia  and  )'i  grain  pilocarpine. 

7.30  p.m. — Pulse  120,  stronger,  respirations  6,  m  irked  decrease  in 
the  size  of  the  pupils.      Injected  i  >4  drachms  of  brandy. 

8.00  p  m. — ^Respirations  7,  consciousness  returned,  more  color  in 
face. 

8.30  p.m. — Respirations  8,  recognized  faces,  but  could  not  see 
small  objects  distinctly.  Had  diplopia.  Bathed  limbs  and  chest 
with  hot  water,  and  applied  hot  water  bottles  to  body. 


THE   CANADIAN    MEDICAL    REVIEW.  175 

10.00  p.m. — Respirations  9,  slight  perspiration  on  chest. 

11.00  p.m. — Pulse  120,  respirations  12,  perspiring  freely.  The  fol- 
lowing day  patient  could  not  see  to  read,  but  on  the  second  day  the 
vision  was  quite  normal.     Recovery  was  uninterrupted. 

Dr.  Wilson  reported  a  second  case  :  A  little  girl,  aged  5,  had  taken 
a  quantity  of  linimentum  belladonna.  The  child  was  quite  red  when 
he  saw  it  an  hour  after.  The  temperature  instead  of  being  subnormal 
was  abnormally  high,  being  108,  and  after  the  death  of  the  child  it 
had  risen  to  no.  Another  feature  was,  the  child  had  tetanic  spasms 
coming  on  about  four  hours  after  she  had  taken  the  belladonna. 

Dr.  Oldright  pointed  out  that  the  maximum  doses  in  the  B.  P. 
were  too  large.  In  a  prescription  he  had  written  he  had  put  down 
grain  1-25  of  atropia.  When  he  visited  the  patient  next  day  she  had 
an  eruption,  the  face  was  flushed  and  the  throat  was  dry.  She  did 
not  repeat  the  dose.  He  found  that  the  druggist  had  put  in  25m.  of 
solution  of  atropia,  making  a  2m.  dose,  a  much  larger  one  than  had 
been  ordered,  being  about  1-12  of  a  grain.  The  dose  in  the  B.  P. 
was  I  to  4m. 

The  president  stated  that  he  had  changed  in  a  prescription  con- 
taining atropia  r-ioth  to  i-2oth  by  writing  the  2  heavily  over  the  i  in 
the  denominator ;  but  the  druggist  had  misconstrued  it  to  mean  ^. 
After  taking  a  dose  the  patient  had  a  very  uncomfortable  night.  He 
related  two  other  cases  where  the  patients  had  taken  a  quantity  of 
belladonna  liniment  instead  of  some  other  medicine  meant  for  internal 
use,  by  mistake.  But  by  the  use  of  morphia  and  the  stomach  lube 
recoveries  took  place  in  both  cases. 

Dr.  James  McCallum  related  the  case  of  an  old  man  who  was 
undergoing  treatment  for  his  eyes,  atropia  gr.  4  to  the  ounce  being 
used  for  eye-drops.  He  was  brought  to  the  hospital  in  a  state  of 
delirium,  and  it  was  impossible  to  tell  whether  he  was  suffering  from, 
alcoholism,  atropine  poisoning,  or  pneumonia.  But  the  following 
day  discovery  of  the  physical  sign  of  pneumonia  on  3ne  side  of  the 
chest  revealed  what  the  true  condition  was. 

Dr.  Webster  reported  a  case  in  which  an  eruption  appeared  on  a 
young  girl  who  was  wearing  a  belladonna  plaster.  He  had  had  another 
case  in  which  ^  grain  tablets  of  belladonna  had  produced  toxic 
effects.  The  same  dose  repeated  in  pill  form  had  no  such  effect. 
He  referred  to  another  patient  in  whom  i-ioth  of  a  minim  fid. 
ext.  produced  a  very  severe  headache  and  marked  dryness  of  the 
throat. 

The  society  then  adjourned. 


176  THE    CANADIAN    MEDICAL    REVIEW. 

lEMtorials. 

Graveyard  Insurance. 

Many  attempts  have  been  made,  in  every  country  where  life  insur- 
ance offices  are  to  be  found,  to  obtain  money  fraudulently  by  securing 
policies  upon  persons  who  were  known  to  be  diseased.  These  attempts 
have,  no  doubt,  succeeded  on  many  occasions,  but  the  prospects  for 
schemes  proving  successful  in  the  future  are  rapidly  growing  less. 

In  order  to  work  such  infamous  plans  of  fraud  several  parties  must 
be  in  each  other's  confidence.  The  risk  must  come  through  some 
agent  of  the  company ;  the  insured,  or  the  person  who  is  to  be  made 
beneficiary  under  the  policy,  must  be  in  the  plot ;  and  the  doctor, 
who  is  to  pass  upon  the  risk,  has  his  share  in  the  transaction. 

Now,  it  is  well  to  remember  that  the  companies  have  several  means 
of  obtaining  information 'regarding  risks,  which  those  who  have  evil 
intentions  should  bear  in  mind.  Among  the  companies  there  is  an 
exchange  of  inforniali  jn  as  to  risks  that  have  been  rejected,  and  of 
medical  men  who  are  not  deserving  of  trust  either  because  of  care- 
lessness or  dishonesty.  There  are  also  private  bureaus,  which  make 
it  their  business  to  find  out,  by  careful  enquiry,  information  about 
agents,  doctors  or  applicants. 

Another  thing  that  should  be  borne  in  mind  is  that  persons  of  bad 
health  are  almost  invariably  known  to  a  certain  number  of  people  as 
not  fit  subjects  for  life  insurance.  When  a  policy  is  sought,  and 
obtained,  upon  such  persons,  it  soon  becomes  noised  abroad;  and 
the  agents  of  rival  companies  and  the  bureaus  of  information  learn 
the  main  facts.  In  this  way  it  soon  reaches  the  head  office  of  the 
company  upon  which  the  wrong  has  been  practised.  Immediate  steps 
are  then  taken  to  ascertain  the  true  condition  of  affairs. 

Still  further,  it  must  be  borne  in  mind  that  the  country  is  full  of 
those  who  carry  policies  in  the  several  companies  and  societies.  If 
any  one  of  these  policyholders  comes  to  hear  of  the  fact  that  the 
company  he  is  interested  in  is  being  victimized,  he  is  very  likely  to  give 
away  his  information,  and  in  this  way  defeat  the  attempted  fraud. 

It  must  be  said  for  the  medical  profession  that  very  few  indeed  of 
its  members  would  be  party  to  any  attempt  at  fraud  in  this  way. 
But  even  to  these  very  few  scoundrels  we  would  utter  a  word  of  warn- 
ing. The  fraud  is  almost  sure  to  be  found  out,  and  may  lead  to  very 
grave  results.  Even  if  it  be  not  definitely  discovei*ed,  it  is  likely  to 
be  strongly  suspected,  and  the  doctor  may  thus  lose  a  valuable  con- 
nection, and  the  patronage  of  the  numerous  companies. 


THE    CANADIAN    MEDICAL    REVIEW.  177 

Vaccination  Against  Diphtheria. 

At  the  opening  meeting  of  the  German  Medical  Congress  at  Lubeck, 
Dr.  Behring  read  a  paper  on  the  antitoxine  treatment  of  diphtheria, 
which  is  worthy  of  note.  He  stated  that  the  mortality  from  diphtheria 
had  considerably  decreased  in  all  hospitals  in  which  it  had  been 
introduced.  He  denied  that  this  was  due,  as  was  asserted,  to  the 
mild  character  of  the  cases.  He  estimated  that  in  the  last  twelve 
months  in  Germany  alone  at  least  1,000  had  been  saved  from  certain 
death  by  the  serum.  Dr.  Behring  repeated  the  statement  made  by 
him  in  Vienna  that  it  would  be  possible  by  the  aid  of  the  serum  to 
reduce  the  mortality  to  5  per  cent.  Further,  he  declared  without 
hesitation  that  the  400,000  doses  prepared  by  the  institution  under 
the  supervision  of  himself  and  of  Dr.  Erlich  had  not  contained  any 
injurious  matter.  He  thought  it  was  time  to  begin  general  vaccination 
of  children  with  the  serum  as  a  preventive  of  diphtheria.  It  had  been 
found  possible  to  manufacture  serum  of  such  strength  that  the  injec- 
tion of  only  half  a  cubic  centimetre  ought  to  suffice  to  give  complete 
immunity  to  children  who  are  not  already  attacked. 


The  Doctorate  .\nd  the  Military  Law. — Dr.  Sprague,  of 
Stirling,  has  kindly  furnished  us  with  a  translation  from  a  French 
journal,  which  appears  on  another  page.  This  is  most  interesting  in 
view  of  the  agitation  which  now  exists  in  Ontario  to  raise  the  standard 
of  medical  education  and  prolong  the  course  of  study. 

To  GET  the  feeling  of  the  medical  men  on  lodge  and  contract 
practice  in  Toronto,  the  Western  Territorial  Division  of  the  city  are 
circulating  the  following :  I  the  undersigned  medical  practitioner 
agree  not  to  do  any  lodge  or  contract  practice  as  soon  as  ninety-five 
per  cent,  of  the  medical  men  of  the  city  sign  this  agreement,  and  when 
present  contract  expires.  

Death  of  Mathieson,  "The  Eye  Doctor." — On  the  17th  ult., 
there  died  in  this  city  a  somewhat  remarkable  character,  who,  for  many 
years,  and  in  spite  of  frequent  convictions  of  violation  of  the  Medical 
Act,  carried  on  a  business  as  an  "  eye  doctor."  His  method  was  to 
charge  so  much  a  week  for  medicines.  He  had  a  considerable  hold 
on  the  imaginations  of  the  country  people,  who  frequently  came  great 
distances  to  be  "  doctored"  by  him.  He  had  formerly  been  a  private 
soldier  in  a  Highland  regiment. 


178  THE    CANADIAN    MEDICAL  REVIEW. 

Retirinc  Ali.owances  to  Drs.  J.  Ferguson,  W.  W.  Ogden  and 
M.  H.  AiKiNS.— After  long  delay  and  much  discussion  the  Senate  of 
the  University  of  Toronto  passed  a  statute  through  all  its  stages 
placing  these  gentlemen  in  the  same  position  as  though  they  had 
resigned.  The  medical  faculty,  though  by  no  means  unanimously, 
decided  to  send  a  committee  to  wait  upon  the  Government  to  oppose 
the  confirmation  of  the  state.  Drs.  I.  H.  Cameron,  A.  McPhedran, 
and  Prof.  Pike  composed  the  deputation  fro-n  the  faculty.  At  a  later 
date  Drs.  W.  W.  Ogden  and  J.  Ferguson  were  heard  in  behalf  of  their 
contentions  that  the  statute  should  be  confirmed  and  the  payments 
made.   The  statute  was  confirmed  by  the  (Government,  November  5th. 


Ontario  Medical  Librarv  Association. — A  meeting  of  the 
Board  of  the  Ontario  Medical  Library  Association  was  held  on  Friday 
evening.  The  following  officers  were  elected  :  Dr.  J.  E.  Graham, 
president;  Dr.  L.  McFarlane,  ist  vice-president;  Dr.  L.  L.  Palmer, 
2nd  vice-president  ;  Dr.  W.  J.  Greig,  treasurer;  Dr.  N.  A.  Powell, 
curator  ;  Dr.  J.  H.  Hamilton,  secretary.  The  report  of  the  Treasurer 
was  the  most  favorable  one  we  have  had  for  years.  It  showed  that 
the  receipts  had  been  able  to  keep  pace  with  the  expenditures.  This 
is  due  to  the  fact  that  a  donation  from  the  Ontario  Medical  Associa- 
tion had  been  received,  and  that  by-law  xxxii.,  providing  for  the  collec- 
tion of  the  annual  fee  of  $2  from  each  member,  has  been  put  into 
operation  for  the  first  time.  The  hope  was  expressed  that  members 
would  respond  promptly  and  by  so  doing  help  the  Board  to  make  the 
library  still  more  useful  to  its  members.  The  report  of  the  Curator 
showed  a  substantial  increase  in  the  number  of  valuable  books,,  jour- 
nals, etc.,  and  many  promises  of  donations  were  mentioned.  The 
Curator  also  reported  that  arrangements  had  been  completed  so  that 
members  of  the  Ontario  ^Medical  Association  could  procure  the  loan  of 
books  from  the  Surgeon-Cieneral's  Library  in  Washington  at  cost  of 
express.  This  is  a  very  valuable  privilege  for  those  engaged  in 
research. 

Western  Territorial  Division  Association  of  Toronto. — A 
meeting  of  this  Association  was  held  at  4  p.m.  on  Thursday,  October  loth, 
1895,  at  Broadway  Hall.  In  the  absence  of  the  President  Dr.  Albert 
A.  Macdonald,  the  Vice-President,  was  called  to  the  chair.  After  the 
reading  and  confirming  of  the  minutes  of  the  previous  meeting, 
business  arising  out  of  the  minutes  was  taken  up.  Prescribing  by  drug- 
gists, repeating  prescriptions,  etc.,  was  now  discussed  at  length.     The 


THE    CANADIAN    MEDICAL    REVIEW.  179 

opinion  was  expressed  that  the  work  already  done,  and  the  meeting  of 
representatives  of  the  Druggists'  Association  and  members  of  this 
Association  has  been  productive  of  some  good  and  a  better  feehng 
and  understanding,  the  druggists  seeming  wilHng  to  conform  to  our 
views  and  to  meet  our  requirements.  The  discussion  of  "  club  prac- 
tice "  came  in  for  a  large  share  of  attention.  It  was  admitted  by 
almost  all  of  the  members  present  that  it  was  an  evil  which  should  be 
got  rid  of,  and  at  the  same  rime  harsh  measures  were  not  urged.  One 
of  the  members  held  an  opposite  view  ;  he  said  that  the  members  of 
his  clubs  were  most  considerate  and  that  he  had  received  from  one  of 
his  clubs  as  much  as  $3.00  a  visit.  It  was  resolved  that  the  members 
of  last  year's  committee,  Dr.  Spence,  chairman,  should  be  continued 
and  that  they  should  find  out  the  feeling  of  the  medical  men  of 
Toronto  on  the  question  of  "  club  practice  "  by  sending  out  circulars, 
etc.,  and  that  the  committee  should  report  at  the  next  meeting.  The 
question  of  "bad  pay  patients"  was  discussed,  and  it  was  agreed  to 
accept  Dr.  Mennie's  offer  to  undertake  the  management  of  a  "  black 
list,"  and  to  give  him  all  possible  support.  The  meeting  was  then 
declared  adjourned. 

Why  They  See  Snakes. — Dr.  A.  E.  Davis,  in  the  Post  Graduate 
for  October,  reports  the  results  of  a  large  number  of  examinations  of 
fundi  oculi  in  patients  suffering  from  delirium  tremens.  In  all  the 
blood  vessels  were  dilated  and  tortuous.  He  points  out  that  the  hallu- 
cinations in  ninety  five  percent,  of  these  cases  are  those  of  sight,  and 
he  believes  that  the  "snakes"  seen  are  most  likely  these  vessels,  which  lie 
in  the  anterior  layers  of  the  retina,  being  perceived  by  the  rods  and 
cones  which  lie  in  the  posterior  layer. 


Dr.  Gowers'  Address  to  Medical  Phonographers. — The  British 
Medical  JournaHox  October  5th  contains  the  inaugural  address  de- 
livered by  Dr.  W.  Gowers  before  the  Society  of  Medical  Phonograph- 
ers on  "  The  art  of  writing  in  relation  to  medical  and  scientific  work." 
Dr.  Gowers  characterizes  the  present  mode  of  longhand  as  littte  less 
clumsy  than  when  the  Phrjenecians  and  Egyptians  first  gave  alphabeti- 
cal writing  to  mankind.  He  sets  forth  the  unmixed  advantages  of 
shorthand  in  the  recording  of  clinical  and  other  scientific  data.  It 
enables  the  student  to  make  a  perfect  epitome  of  his  lectures,  more 
useful  than  any  text-book,  and  yet  give  more  attention  to  the  subject 
than  if  he  took  no  notes.  Experiment  shows  that  two  hours  a  day 
with  a  lesson  each  day,  in  a  fortnight  a  person  can  write  at  the  same 
speed  as  longhand  and  at  the  end  of  a  month  secure  its  practical  use. 


i8o  THE    CANADIAN    MEDICAL  REVIEW. 

New  Treatment  for  Severe  Vomiting. — Dr.  C.  L.  Greene,  of 
St.  Paul,  in  Northwestern  Lancet  for  October,  claims  that  he  has  ob- 
tained good  results  in  uncontrollable  vomiting  by  intubation  of  the 
larynx.  His  theory  is  that  unless  the  glottis  is  closed  so  as  to  fix  the 
diaphragm  vomiting  is  not  possible  in  the  adult.  To  prevent  the 
necessary  fixation  of  the  diaphragm,  a  tube  is  placed  in  the  larynx.  This 
permits  the  free  ingress  and  egress  of  air,  and  obviates  the  spasmodic 
closure  of  the  glottis.  When  abdominal  muscles  contract  the  stomach 
is  pressed  against  the  diaphragm.  This  yields,  and  the  contents  of  the 
stomach  are  not  ejected. 


Puerperal  Convulsions. — Dr.  Thad.  A.  Reamy,  in  Cin.  Lancet 
Clinic,  12th  October,  highly  recommends  the  use  of  Norwood's  tinc- 
ture of  veratrum  viride  in  this  disease.  He  gives  twenty  or  twenty  five 
minims  hypodermically.  In  the  course  of  an  hour  it  may  be  re- 
peated if  necessary.  Soon  after  the  depression  the  pulse  falls  in 
pregnancy  and  becomes  soft,  and  profuse  perspiration  sets  in.  If  the 
pulse  again  becomes  frequent  and  hard  the  veratrum  should  be  again 
given.  If  the  drug  is  followed  by  symptoms  of  dangerous  depression, 
these  are  speedily  removed  by  the  hypodermic  injection  of  morphia. 
It  is  noteworthy  that  this  drug  counteracts  the  depression  of  veratrum 
and  at  the  same  time  is  valuable  in  the  treatment  of  the  convulsions. 
It  is  in  this  way  that  the  mixed  treatment  by  veratrum  and  morphia  is 
so  valuable  in  many  severe  cases  of  puerperal  convulsions. 


Address  on  Medical  Education. — Professor  Roswell  Prark,  in 
his  address  on  medical  education  at  the  fifth  annual  meeting  of  the 
Harvard  Medical  Alumni  Association,  said,  from  a  retrospective  view, 
what  had  hindered  the  progress  of  medical  education  in  time  past, 
and  that  which  being  removed  had  permitted  the  rapid  strides  of  the 
last  few  decades,  was  the  malign  influence  of  the  Church.  The 
Church  and  its  authority  had  been  the  greatest  enemy  of  medical  pro- 
gress in  all  past  time.  The  subjects  against  which  its  authority  had 
been  most  obstinately  wielded  were  those  of  anatomy  and  surgery. 
Learning  in  the  Middle  Ages  was  confined  to  the  monasteries,  and 
the  monks  were  taught  that  to  shed  blood  was  without  their  pale,  and 
it  was  considered  inpious  to  mutilate  a  form  which  was  made  in  the 
divine  image.  During  the  fifteenth  and  sixteenth  centuries,  although 
public  lectures  on  anatomy  were  held,  the  professor  did  not  do  the 
dissecting  ;  he  hired  some  barber  to  do  it,  and  himself  simply  expound- 
ed what  the  barber  exposed.     A  recent  step  in  the  way   of  a  medical 


THE    CANADIAN    MEDICAL    REVIEW.  i8i 

extension  course  they  were  adopting  in  Buffalo  was  the  appli- 
cation of  the  Chautauqua  idea.  A  series  of  studies  for  three  years  was 
to  be  laid  down  and  a  certificate  would  be  granted  on  passing  an 
examination  on  the  work.  This  was  simply  an  incentive  to  home 
study.  

Medical  Education. — Dr.  Jonathan  Hutchinson,  in  delivering 
the  opening  address  at  University  College,  Liverpool  {British  Medical 
Journal),  speaking  on  the  subject  of  medical  education  and  referring 
to  specialism,  says  he  considers  it  far  better  to  have  a  general  acquain- 
tance with  all  that  is  around  us,  though  it  be  not  very  deep,  than  slices 
of  profound  knowledge,  placed  sandw'ch-ways  between  layers  of  utter 
ignorance.  His  opinion  on  the  examination  evil  is  that  the  student 
should  be  brought  to  feel  that  his  examinations  so  far  from  being  a 
source  of  harass  and  won;y,  are  really  his  best  friends,  guiding  his  work 
and  at  the  same  time  guaging  his  attainments.  He  recommends  that 
a  carefuUv  prepared  list  of  suitable  questions  be  accessible  to  the  can" 
didates.  He  advises  against  viva  voce  examinations.  To  check 
incompetent  and  idle  men  from  entering  the  profession,  the  key  is  in 
the  hands  of  the  examiner. 


Military  Medical  Notes. 

The  French  medical  officers  can  hardly  complain  of  want  of  official 
recognition.  In  the  last  Gazette  no  less  than  thirty-four  were  created 
as  commanders,  officers  or  chevaliers  of  the  Legion  of  Honor. 


A  CORRESPONDENT  of  the  Army  and  Xavy  Gazette  (London)  com- 
plains that  medical  officers  whose  names  are  put  up  for  ballot  at  the 
service  clubs  are  almost  invariably  blackballed.  The  editor  questions 
the  statement.  

Suroeon-General  Sir  Thomas  Longmore,  C.B.,  of  Southampton^ 
died  suddenly  at  Swanga  last  month.  He  was  born  in  1816,  and  was 
the  son  of  a  surgeon  in  the  Navy.  He  was  educated  at  Merchant 
Taylor's  School  and  at  Guy's  Hospital,  and  entered  the  Medical 
Department  of  the  Army  in  1843.  He  served  throughout  the  Crimea 
campaign  and  in  Bengal  during  the  Mutiny.  He  was  professor  of 
military  surgery  at  Netley  from  i860  to  1891,  and  he  had  been  hon- 
orary surgeon  to  the  Queen  since  1868.  He  was  the  author  of  a 
number  of  works,  among  them  being  "  A  Treatise  on  the  Transport  of 


i82  THE    CANADIAN    MEDICAL    REVIEW. 

Sick  and  Wounded  Troops,"  "Gunshot  Injuries:  their  History, 
Features,  and  Treatment,"  "  Sanitary  Contrasts  of  the  Crimean  War," 
and  a  "  Life  of  R.  Wiseman,  Surgeon  to  Charles  II."  His  "Optical 
Manual"  is  the  standard  work  in  connection  with  the  eyesight  of 
soldiers. 

Thk  death  of  Baron  Larrey,  third  Napoleon's  surgeon,  recalls  an 
adventure  of  his  father,  the  first  Napoleon's  medical  adviser  at  Water- 
loo. .  The  elder  Larrey  bore  so  striking  a  resemblance  both  in 
physicjue  and  in  dress  to  the  Little  Corporal  that  when  he  was  taken 
prisoner  by  the  Prussians  they  thought  they  had  captured  the 
Emperor,  and  ordered  him  to  be  shot.  But  the  doctor  who  was 
ordered  to  bandage  his  eyes  recognized  him  as  his  old  instructor  in 
medicine,  and  at  his  request  Larrey  was  sent  to  Blucher,  who  gave  him 
some  money  and  dismissed  him. 

IBooh  H^oticci?. 

A/i  Illustrated  Monograph  on  Oxyhccmoglobin  and  Allied  Products. 
Pul)lished  under  the  direction  of  F.  E.  Stewart,  M.D.,  Ph.C, 
Director  of  Scientific  Department,  F.  Stearns  &  Co.,  formerly 
Demonstrator  and  Lecturer  on  Materia  Medica  and  Pharmacy, 
Jefferson  Medical  College,  etc.     Detroit  :  F.  Stearns  &  Co.  1895. 

This  illustrated  monograph  of  56  pages  emanates  from  the  scientific 
department  of  F.  Stearns  &  Co.  of  Detroit,  and  is  divided  into  three 
parts.  Part  I.,  by  Dr.  Stewart,  deals  with  Oxyhaemoglobin,  albuminate 
of  iron,  and  peptonate  of  iron.  Part  II.,  written  by  Dr.  A.  B. 
Macalluni,  Associate  Professor  of  Physiology,  University  of  Toronto, 
on  the  absorption  of  iron  in  the  animal  body,  contains  an  account  of  his 
investigations  as  to  the  alisorption  of  both  organic  and  inorganic  iron 
compounds  ;  and  Part  III.,  by  Charles  H.  \\'illiams,  Ph.B.,  Ph.C,  of 
the  School  of  Pharmacy,  University  of  Michigan,  is  on  the  Haemoglo- 
bins and  related  products  of  the  market.  The  publishers  are  to  be 
congratulateO  on  issuing  a  work  like  this  from  their  scientific  depart- 
ment— a  departure  in  the  right  direction.  They  maintain  that  the 
manufacturing  pharmacist  is  comparatively  little  to  blame  for  the 
present  situation  in  regard  to  proprietary  medicines,  in  that  he  has 
simply  supplied  what  is  called  for,  leaving  it  to  the  profession  to  create 
a  demand  for  something  better.  This  the  latter  can  now  do  by 
co-operating  in  the  work  of  their  scientific  department,  and  as  an 
evidence  of  liberal  spirit  they  offer  remuneration  for  such  work  as  may 
be  done  under  their  control  or  in  the  laboratories  of  the  universities. 
This  brochure  is  entitled  to  a  careful  readins. 


THE    CANADIAN    MEDICAL    REVIEW.  183 

Green's  Pathology  and  Morbid  Anatomy.  Pathology  and  Morbid 
Anatomy.  By  T.  Henry  Green,  M.D.,  Lecturer  on  Pathology 
and  Morbid  Anatomy  at  Charing-Cross  Hospital  Medical  School, 
London.  Seventh  American  from  the  eighth  and  revised 
English  edition.  Octavo  volume  of  595  pp.,  with  224  engravings, 
and  a  colored  plate.  Cloth,  $2.75.  Philadelphia:  Lea  Brothers 
&  Co.,  publishers.     1895. 

Green's  Pathology  and  Morbid  Anatomy  has  long  been  the  leading 
text  and  reference  book  in  all  English-speaking  countries,  a  fact;  indi- 
cated by  the  number  of  editions  demanded.  A  knowledge  of  the  sub- 
jects covered  by  its  title  is  essential  to  graduation  and  not  less  so  to 
the  practitioner,  who  must  understand  the  nature  of  a  disease  as  a  pre- 
requisite to  rational  curative  measures.  Thanks  to  the  tireless 
industry  of  laboratory  workers  and  clinicians  these  sciences  are  in  a 
state  of  constant  development,  and  in  order  to  represent  their  existing 
position,  this  volume  has  been  thoroughly  revised  and  new  chapters 
have  been  added.  The  previously  rich  series  of  illustrations  has  been 
increased  with  sixty  new  engravings  and  a  colored  plate. 

The  general  character  of  the  work  is  maintained  throughout  notwith- 
standing the  numerous  additions  by  various  colUiborators,  as  all  have 
imitated  the  desirable  conciseness  and  lucidity  of  the  author.  The 
first  chapter  deals  with  arrested  nutrition,  after  which  eight  chapters 
are  devoted  to  impaired  and  increased  nutrition.  Six  chapters  are 
given  up  to  tumors.  Then  diseases  of  the  blood  and  circulation  are 
considered,  then  fever,  inflammation,  the  vegetable  parasites,  the 
infective  granulomata,  septicaemia  and  pyaemia,  malaria,  and  diseases  of 
the  special  tissues  and  organs,  and  the  last  chapter,  on  the 
pathology  of  the  central  nervous  system  by  Dr.  Mott,  is  a  notable 
addition  admirably  illustrated. 


Saunders  American  Year- Book  of  Medicine  and  Surgery.  Edited  by 
George  M.  Gould,  A.M.,  M.B. ;  assisted  by  eminent  American 
physicians  and  teachers.  To  be  published  by  W.  B.  Saunders, 
925  Walnut  Street,  Philadelphia. 

Notwithstanding  the  rapid  multiplication  of  medical  and  surgical 
works,  still  these  publications  fail  to  meet  fully  the  requirements  of 
the  general  physician,  inasmuch  as  he  feels  the  need  of  something 
more  than  mere  text-books  of  well-known  principles  of  medical  science. 

This  deficiency  would  best  be  met  by  current  journalistic  literature, 
but  most  practitioners  have  scant  access  to  this  almost  unlimited 
source  of  information,  and  the  busy  practiser  has  but  little  time  to 
search   out  in  periodicals  the  many   interesting   cases,   whose  study 


i84  TFiE    CANADIAN    MEDICAL    REVIEW. 

would  doubtless  be  of  inestimable  value  in  his  practice.  Therefore,  a 
work  which  places  before  the  physician  in  convenient  form  an  epitomi- 
zation  of  this  literature  by  persons  competent  to  pronounce  upon  the 
value  of  a  discovery  or  of  a  method  of  treatment  cannot  but  command 
his  highest  appreciation. 

It  is  the  special  purpose  of  the  editor,  whose  experience  peculiarly 
qualifies  him  for  the  preparation  of  this  work,  not  only  to  review  the 
contributions  to  American  journals,  but  also  the  methods  and  discov- 
eries reported  in  the  leading  medical  journals  of  Europe,  thus  enlarging 
the  survey  and  making  the  work  characteristically  international. 

This  work  will  be  replete  with  original  and  selected  illustrations, 
affording  efficient  aids  to  a  right  comprehension  of  the  text,  and  adding 
to  the  attractiveness  of  the  volume.  This  work  will  be  ready  for 
delivery  January  ist. 


A  Treatise  on  the  Nervous  Diseases  of  Children  for  Physicians  and 
Students.  By  B.  Sachs,  M.D.,  Prof  of  Mental  Diseases  in  the 
New  York  Polyclinic,  Consulting  Neurologist  to  the  Mt.  Sinai 
Hospital,  etc.     New  York:  AVm.  Wood  tS:  Co.     1895. 


Clinical  Lectures  on  Diseases  of  the  Nervous  System.  Delivered  at  the 
National  Hospital  for  the  Paralyzed  and  Epileptic,  London.  By 
W.  R.  GowKRS,  M.D.,  F.R.S.,  Physician  to  the  Hospital,  Con- 
sulting Physician  to  University  College  Hospital,  formerly  Pro- 
fessor of  Clinical  Medicine  in  University  College.  Price,  $2.00. 
Philadelphia:  P.  Blakiston,  Son  &  Co.,  1012  Walnut  Street. 
i<S95. 

The  author  delivered  these  lectures  at  the  National  Hospital  for 
the  Paralyzed  and  Epileptic.  They  were  reprinted  from  various  Eng- 
lish medical  journals,  with  the  exception  of  two  lectures,  which  are 
reproduced  by  permission  of  the  J.  B.  Lippincott  Co. 

This  book  is  handy  in  size,  and  e.xcellent  in  print.  The  well-known 
name  of  the  author  is  a  sufficient  guarantee  that  the  purchaser  will 
receive  more  than  his  money's  worth. 

The  table  of  contents  shows  how  the  writer  has  dealt  with  subjects 
attractive  to  the  practitioner.  Among  the  subjects  lectured  upon  we 
notice  a  chapter  on  "Mistaken  Diagnosis,"  one  on  "The  Foot  Clonus 
and  its  Meaning,"  two  upon  "The  Infantile  Causes  of  Epilepsy," 
two  upon  "  Locomotor  Ataxy,"  one  upon  "  SyringoMyelia,"  and  two 
upon   "  Optic  Neuritis." 

There  are  other  chapters  covering  rare  forms  of  nervous  disease. 
Chapters  3  and  4  deal  with  argyria  and  syphilitic  hemiplegia. 


THE    CANADIAN    MEDICAL    REVIEW.  185 

One  feature  of  this  work  is  that  a  chapter  is  complete  in  itself,  and 
so  comprehensive  that  a  busy  practitioner  can  take  up  the  work  and 
tjuickly  come  at  just  what  he  is  looking  for.  We  confidently  recom- 
mend this  book  to  our  readers,  and  believe  that  it  will  be  a  help  of 
great  value  to  the  student  and  practitioner. 


IPcreonale. 


Dr.  J.  W.  Early  has  removed  to  Owen  Sound. 

Dr.  Hotson,  of  Innerkip,  hrs  removed  to  St.  Mary's. 

Dr.  C.  Shuttleworth,  late  of  the  General  Hospital,  has  com- 
menced practice  on  Broadview  Avenue. 

Dr.  W.  T.  Wilson,  of  Dundas,  has  received  an  appointment  as 
assistant  at  the  Insane  Asylum  at  Brockville. 

Dr.  W.  T.  AiKiNS  has  been  appointed  to  the  Senate  of  Toronto 
University  as  representative  of  Toronto  School  of  Medicine,  Dr.  J.  H. 
Richardson  will  also  be  a  member  of  that  body  as  the  representative 
of  University  College  Council. 


Quick  Passage  of  a  Murphy  Button. — In  the  Neiv  Albany 
Medical  Herald,  Dr.  John  M.  Foster,  of  Richmond,  Ky.,  reports  the 
passage  of  a  "  Murphy  button  "  in  less  than  three  days  after  a  resec- 
tion of  the  bowel,  with  recovery.  It  came  away  with  the  first  move- 
ment of  the  bowels — sixty-eight  hours  after  the  operation.  This  is  by 
far  the  most  rapid  union  of  intestine  yet  reported,  and  it  is  in  strange 
contrast  to  the  Nashville  (Tenn.)  man  who  was  operated  upon  by  Dr. 
Cordier  and  myself ;  this  patient  retained  his  button  until  the  15th 
day,  but  recovery  was  perfect. 


The  Archives  of  Pediatrics  will  commence  its  13th  year  with  the 
January  number,  under  the  business  management  of  R.  B.  Treat,  pub- 
lisher, of  New  York,  long  identified  with  medical  publishing  interests. 
The  Archives  has  been  for  twelve  years  the  only  journal  in  the  English 
language  devoted  exclusively  to  "  Diseases  of  Children,"  and  has 
always  maintaiifed  a  high  standard  of  excellence.  The  new  manage- 
ment propose  several  important  changes  in  its  make-up,  increasing  the 
text  fifteen  per  cent,  and  enlarging  its  scope  in  every  way.  The  edi- 
torial management  will  be  in  the  hands  of  Floyd  M.  Crandall,  M.D., 
Adjunct  Professor  of  Pediatrics,  New  York  Polyclinic,  and  Chairman 
of  Section  on  Pediatrics,  New  York  Academy  of  Medicine. 


i86  THE    CANADIAN    MEDICAL    REVIEW. 

A  DEPOT  for  the  sale  of  Dr.  Jaeger's  sanitary  woollen  underwear  and 
dress  material  has  been  opened  in  this  city.  These  goods  are  well 
known  to  the  medical  profession  in  Great  Britain,  on  the  continent 
and  in  the  United  States,  and  have  been  most  highly  recommended 
for  their  purity  and  essential  goodness.  A  price  list  and  full  particu- 
lars will  be  mailed  to  any  member  of  the  profession  on  application  to 
Wreyford  &  Co.,  63  King  Street  west. 


We  would  call  the  attention  of  the  profession  to  a  paper  (published 
in  another  column)  by  Dr.  Thos.  O.  Summers,  entitled  "  Pro- 
tonuclein  :  Leucocytes  and  Nuclein."  This  paper  was  read  before  the 
Section  on  Practice  at  the  meeting  of  the  American  Medical  Asso- 
ciation recently  held  at  Baltimore.  The  paper  was  illustrated  upon 
a  screen,  showing  microphotographs  of  protonuclein  and  its  action 
upon  the  leucocytes  of  the  blood.  It  is  claimed  that  the  introduction 
of  this  agent  will  mark  an  era  in  therapeutics,  and  it  is  sufficiently 
endorsed  to  warrant  a  fair  trial. 


The  Morals  of  a  Surgeon. — What  a  man  does  is  the  proof  to 
the  world  of  what  a  man  is.  Many  good  people  fear  that  the  advance 
of  science  will  bring  about  the  retrogression  of  morals  and  religion. 
AVe  do  not  agree  with  them.  But  if  they  cannot  accept  our  judgment, 
let  them  weigh  well  a  fact  like  this  :  Mr.  Jonathan  Hutchinson,  F.R.S., 
and  e.\-president  of  the  Royal  College  of  Surgeons,  addressed  his  pro- 
fessional brethren  assembled  in  annual  congress  the  other  day,  and  he 
thus  spoke  :  "  I  bore  with  such  equanimity  as  I  could  the  discovery 
that  I  could  not  compete  with  my  frijnd  in  the  ratio  of  successes 
obtained"  (in  operations  for  ovariotomy),  "and,  acting  on  the  rule  of 
conduct  that  I  would  never  keep  a  patient  in  my  own  hands  if  I 
believed  that  someone  else  could  do  what  was  needed  with  greater 
prospect  of  success,  I  gave  up  doing  ovariotomies,  both  in  public  and 
private,  and  used  to  transfer  my  patients  from  the  London  to  the 
Samaritan  Hospital."  Here  is  a  rule  of  conduct  which  has  never 
been  excelled  in  moral  worth  in  any  department  of  professional  life  or 
p-rivate  behavior.  A  most  far-reaching  and  truly  noble  rule  is  this  of 
Mr.  Jonathan  Hutchinson's;  and  the  fact  that  he  announced  it  toward 
the  close  of  his  career  in  the  hearing  of  hundreds  of  his  professional 
brethren,  who  are  almost  as  familiar  as  he  is  himself  with  the  conduct 
of  his  professional  life,  is  i)roof  that  he  sfjoke  mere  truth.  If  these 
are  the  morals  of  men  of  science,  may  we  not  say  of  men  of  all  pro- 
fessions and  callings,  O  si  sic  onines! — The  Hospital. 


THE    CANADIAN    MEDICAL    REVIEW.  187 

Illegal  Practitioners. 

Thomas    Wasson's    Report. 

List  of  persons  prosecuted  and  cases  investigated  by  Detective 
Wasson  and  his  assistants,  Constables  Brown,  Briggs,  McRener  and 
Boyd  for  violation  of  the  Ontario  Medical  Act  in  the  various  parts  of 
the  Province  since  ist  of  January,  with  results  :  R.  S.  Gilmore,  Wiar- 
ton,  fined  $25  ;  James  Beaton,  Kincardine,  fined  $25  ;  Dr.  G.  J.  Fell, 
Ridgeway,  fined  $35  ;  Kickapoo  Indians,  Stevensville,  dismissed ;  J. 
McKelvey,  St.  Catharines,  no  case  ;  Henry  Musson,  Allenburgh,  no 
case  :  J.  S.  Powly,  Toronto,  fined  $30  ;  Mrs.  Gilbert,  Huntsville,  fined 
$27  ;  J.  W.  Black,  Toronto,  fined  $25  ;  M.  A.  Graham,  Toronto,  fined 
$25,  skipped  out  ;  A.  McLeod,  Owen  Sound,  no  case  ;  A.  P.  Stirritt, 
Toronto,  fined  $35  ;  Ruth  Beasley,  Toronto,  fined  $25  ;  Dr.  Wash- 
ington, Crysler,  fined  $50,  has  appealed;  F.  N.  Cadeaux,  Toronto, 
dismissed  ;  W.  D.  McNabb,  Tara,  fined  $25  ;  Mrs.  Bauvine,  Berwick, 
no  case  ;  Mary  A.  Labrick,  Toronto,  left  town  :  T.  A.  Pine,  North- 
brook,  fined  $25  ;  F.  H.  McCarthy,  Ottawa,  fined  $40  ;  Dr.  A.  Oumet, 
Ottawa,  fined  $25  ;  Mrs.  R.  Thompson,  Ottawa,  fined  $25  ;  Mrs.  A. 
McKelvie,  Ottawa,  fined  $25  ;  Mrs.  R.  Lange,  Ottawa,  fined  $25  ;  S. 
Townsend,  Ottawa,  withdrawn  ;  Professor  Gustin,  Orangeville,  skipped 
the  town,  warrant  issued  for  his  arrest ;  J.  W.  Wesley,  Petrolia,  com- 
mitted to  jail  ;  J.  McCarthy,  Paris,  committed  to  jail,  subsequently 
he  paid  his  fine  and  was  released  ;  laid  another  charge  against  Dr. 
N.  Washington,  to  appear  at  Chesterville  on  the  22nd  inst.  ;  J.  Bealing, 
North  Bend,  withdrawn  ;  T.  A.  Pine,  Flinton,  fined  $25  ;  Andrew- 
Robinson,  Maberly,  fined  $25  ;  A.  Finlay,  Mountain  Grove,  fined  $25; 
Mrs.  John  Kane,  Ottawa,  no  case  ;  Mrs.  Enoch  Thompson,  Ottawa, 
no  case;  Mrs.  Ann  Kelly,  Ottawa,  no  case;  Mrs.  M.  Ackland,  Ottawa, 
no  case  ;  Mrs.  Sherron,  Clarkstown,  no  case  ;  Mrs.  Burton,  Bytown, 
no  case  ;  Professor  Glen,  Wasego,  fined  $25  ;  Dr.  Jebb  (oculist), 
Orangeville,  was  billed  for  four  days,  stayed  only  one  day  and  left  as  I 
arrived  there ;  laid  an  information  in  Orangeville  against  J.  W.  Black, 
of  Toronto,  case  to  come  up  on  the  i6th. 

I  have  arranged  with  J.  Hughes,  High  Constable  of  Dufferin 
County,  to  assist  me  in  that  district.  I  am  getting  up  evidence  in  two 
cases  against  qualified  practitioners,  one  east  and  another  north,  for 
investigation  by  the  Discipline  Committee. 

I  have  sent  Brown  to  Palmerston  and  all  through  places  in  that 
section  where  I  hope  to  be  successful.  Next  month  I  intend  to  go  to 
Muskoka  and  Algoma  districts  prosecuting. 

Thomas  Wasson, 

Detective,   C  P.  and  S.  O. 


i88  THE    CANADIAN    MEDICAL    REVIEW. 

Protonuclein :  Leucocytes  and  Nuclein.* 

PA'    THOS.    O.    SUMMERS,   M.A.,    M.l).,    K.K.S.C,   LONDON,   ETC. 

I  BELiEVic  that  St.  Luke  was  the  only  physician  upon  the  Apostohc 
Board,  and  that  he  is  the  generally  accredited  author  of  "  The  Acts 
of  the  Apostles,"  in  which,  describing  the  visit  of  St.  Paul  to  Athens, 
he  declares  parenthetically  this  very  remarkable  historic  note  : 

"  For  all  the  .Athenians  and  the  strangers  that  were  there,  spend 
their  time  in  nothing  else  but  either  to  tell  or  to  hear  some  new  thing."' 

And  this  neophilism  which  the  great  Apostle  of  the  Gentiles  has 
given  as  an  historic  character  to  the  "  City  of  the  Voilet  Crown,"  has 
descended  unto  us  of  later  days,  and  it  may  be  said  with  truth,  that 
among  all  the  workers  in  the  great  field  of  science,  medical  men  are 
most  eager  for  discovery  and  most  earnest  in  the  search  for  the  ever 
unfolding  mysteries  of  truth.  And  notwithstanding  the  fact  that  this 
spirit  of  investigation  has  often  been  held  up  to  us  by  those  who 
profit  by  our  labors,  and  yet  are  ever  ready  to  sneer  at  our  methods, 
as  the  "opprobrium  medicorum,"'  it  will  be  a  sad  day  in  the  history 
of  medicine  when  we  care  not  to   "  hear  or  to  tell  some  new  thing." 

It  is  to  a  new  departure  in  therapy,  developed  by  recent  investi- 
gation, that  I  direct  your  attention  in  this'  paper.  There  is  nothing 
which  has  so  distinctly  characterized  the  tiend  of  modern  therapeutics, 
and  separated  it  from  the  empirical  methods  of  the  past  —which  have 
crowned  our  materia  medica  with  vast  masses  of  useless  rubbish,  as 
the  contribution  of  physiological  products  to  the  control  of  disease. 
It  is  strange  that  we  have  moved  so  long  in  the  light  of  physiological 
discovery  thrown  upon  us  by  the  microscope,  the  spectroscope,  and 
the  ingenious  apparatus  which  makes  our  laboratories  more  wonderful 
to  the  untutored  mind  than  were  ever  the  alembics  of  alchemy  to  any 
age  of  romance  and  sui)erstition — it  is  passing  strange,  I  say,  that  we 
have  so  long  overlooked  the  very  principles  upon  which  alone  a 
scientific  system  of  therapeutics  could  ever  be  established — the  func- 
tional relations  of  the  cellular  elements  of  the  organism.  As  long  ago 
as  that  stormy  time  in  the  history  of  the  British  Association,  when 
the  Thompson-Tyndall  prayer-test  was  convulsing  the  religious  and 
scientific  world,  a  no  less  interesting  discussion  grew  of  that  contest 
upon  the  subject  of  spontaneous  generation.  So  strong  was  the 
antagonism  developed  that  it  affected  even  the  terminology  of  physio- 
logy, Dr.  Lionel  S.  Beale,  the  recognized  champion  of  the  "orthodo.x" 


*A  paper  read  before  the  Section  on  Practice  at  the  Forty--ixih  Annual  Meeting  of  the  .\merican 
Medical  Associatio-i,  held  at  Baltimore,  May  7th  to  lotli,  illustrated  upon  the  screen,  showing 
niierophotograhs  of  protonuclein  and  its  action  upon  the  leucocytes  of  ihe  bloc  J. 


THE    CANADIAN    MEDICAL    REVIEW.  189 

party,  clinging  to  the  principle  of  "  vital  force"  and  giving  to  the 
blastema  of  the  ultimate  physiological  unit  of  the  organism  the  name 
of  bioplasm,  while  Professor  Huxley  gave  the  name  of  protoplasm  to 
that  which  he  and  all  of  his  school  recognized  as  the  "  Physical  Basis 
of  Life."  Nothing  then  was  known  of  the  exact  structural  and  func- 
tional character  and  relations  of  this  peculiar  cell  substance,  which 
appeared  to  act  so  differently  under  conditions  apparently  the  same. 
It  remained  for  later  physiologists  to  show  just  what  part  this  ultimate 
vitalized  material  played  in  the  great  drama  of  physiology.  It  was 
found  that  both  these  great  scientists  were  correct,  but  viewing  this 
cell-blastema  under  different  conditions  their  definitions  differed 
accordingly,  yet  led  up  to  the  same  result,  as  in  the  case  of  Coper- 
nicus and  Ptolemy,  or  to  speak  poetically  : 

"  Like  that  target  discussed  by  the  travellers  of  old, 
Which  to  one  appeared  -arjent,  to  one  appeared  gold  ; 
To  him  ever  lingering  on  doubt's  dizzy  margent, 
Appeared  in  one  moment  both  golden  and  argent." 

The  first  step  in  what  may  be  called  the  new  physiological  system 
was  taken  when  with  the  improved  mechanism  of  the  microscope  it 
was  demonstrated  that  of  the  two  kinds  of  corpuscles  that  float  in  the 
plasma  of  the  blood,  the  larger  and  white  corpuscle,  the  leucocyte, 
was  in  every  respect  a  .perfect  cell,  possessed  of  a  cell  wall,  which 
Dr.  Beale  distinguished  as  "  formed  material,"  a  blastema  or  plasmic 
granular  substance,  in  which  floats  a  body  called  the  nucleus,  and 
within  that  the  nucleolus.  How  many  of  these  may  be  thus  involuted, 
can  no  more  be  estimated  than  can  the  problem  of  time  and  space  be 
solved  by  the  finite  mind. 

The  next  step  towards  establishing  our  new  physiological  system 
was  taken  when  the  leucocyte  was  found  to  be  the  real  unit  of  the 
organism,  the  agent  through  which  all  nutrition  is  accomplished.  Up 
to  a  very  recent  date  it  was  believed  that  all  nutritious  material  which 
had  been  operated  upon  by  the  digestive  agents  passed  directly  into 
the  general  current  of  the  circulation,  floating  freely  in  the  plasma  of 
the  blood  till  it  reached  the  capillaries,  and  then  by  a  reversed  osmotic 
process  was  taken  up  by  the  individual  tissue  cells,  only  that  part 
being  taken  up  by  them  which  was  necessary  to  the  support  of  that 
structure  represented  by  the  cell — the  rest  passing  on  in  a  like  manner 
to  the  other  structures,  until  all  the  parts  of  the  organism  were 
nourished. 

The  red  corpuscle  was  organized  as  the  oxygen  carrier  of  the  system, 
and  the  eliminator  of  carbonic  acid,  but  neither  the  origin  nor  the 


I90  THE    CANADIAN    MEDICAL    REVIEW. 

function  of  the  white  corpuscle  was  in  the  least  understood  by  even 
the  most  skilful  observers.  Later  investigations,  however,  proved  the 
identity  of  the  le,ucocyte  with  the  lymph  corpuscle,  which  was  itself 
supposed  to  possess  as  the  simplest  original  cell,  metabolic  or  tissue- 
forming  functions.  This  gave  a  new  importance  to  the  leucocyte 
and  when  to  this  was  added  the  recognition  of  the  pus  corpuscle  in 
retrograde  metamorphosis  as  nothing  more  or  less  than  a  leucocyte 
under  altered  conditions,  it  was  not  long  before  its  true  significance 
as  the  real  tissue-builder  of  the  organism  was  fully  established.  A 
peculiar  movement  of  the  leucocyte  as  it  goes  along  through  the 
current  of  the  blood  had  long  been  noticed,  on  account  of  its 
resemblance  to  that  of  the  amceboid  movement,  by  which  it  changed 
its  form  apparently  at  will,  becoming  often  so  elongated  and  slender 
that  it  slipped  through  the  walls  of  the  blood-vessels  and  held  high 
carnival  in  the  surrounding  tissues.  All  this  pointed  to  some  mysteri- 
ous power  or  function,  as  yet  unrevealed  to  the  eye  of  the  physiolo- 
gist. A  closer  study  of  its  morphological  characteristics  proved  that 
there  were  several  forms  of  leucocytes,  differing  in  the  number  of 
nuclei  which  they  possessed.  The  simplest,  those  having  but  one 
nucleus,  were  called  mononuclear,  those  possessing  two  or  more 
nuclei  were  called  multi,  or  polynuclear  leucocytes.  In  these  it  was 
seen  that  the  amoeboid  movement  was  most  active.  Vierordt,  who 
has  made  the  most  accurate  observations  upon  the  blood  of  any  other 
physiologist  perhaps,  found  the  numerical  relation  of  the  leucocytes 
to  the  red  corpuscles  to  be  in  health  in  the  ratio  of  i  to  671. 

Now,  we  are  prepared  to  understand  the  next  step  in  the  functional 
history  of  the  leucocyte.  These  bodies,  differing  in  size,  shape,  and 
number  of  nuclei,  were  observed  to  swell  up  and  burst,  pouring  out  a 
plasmic,  granular  mass,  which  appeared  to  be  in  a  state  of  active 
molecular  vibration.  The  nuclei  came  forth  from  the  breach  in  the 
cell  wall  with  some  of  this  blastema  hanging  closely  around  it,  while 
the  rest  of  the  blastema  with  the  ruptured  cell  wall  floated  off  in  the 
blood  current.  Where  there  were  two  or  more  nuclei,  each  one  became 
rapidly  a  perfect  cell  with  its  nucleus  and  nucleolus,  and  in  this  way 
was  established  a  great  increase  in  the  number  of  leucocytes.  This 
process  of  cell  proliferation,  it  will  be  seen,  lies  at  the  foundation  of 
all  nutrition. 

The  next  phenomenon  observed  was  what  might  rationally  have 
been  expected  to  be  established — the  taking  up  by  the  leucocytes  of 
the  proteids  which  are  delivered  to  the  blood  by  the  absorbents  after 
digestion  is  complete. 

As  soon  as  these  proteids  get  within  the  walls  of  the  blood-vessels, 


THE   CANADIAN    MEDICAL    REVIEW.  191 

they  are  immediately  attacked  by  the  leucocytes  and  taken  into  their 
cell  walls  by  that  osmotic  process,  which  is  the  basis  of  all  physical 
action  in  the  organism.  Mingling  with  the  blastema  of  the  leucocyte, 
these  proteids  become  suffused,  as  it  were,  with  a  certain  molecular 
activity  imparted  to  them  through  the  influence  of  the  nucleus,  some- 
thing like  that  observed  when  an  electric  current  renders  nascent 
certain  chemical  agents  that  without  it  are  negative  or  inactive.  It  is 
this  vitalized  pabulum  to  which  physiologists  have  given  the  name  of 
nuclein. 

The  next  step  in  physiological  evolution  is  the  appropriation  of  this 
pabulum  by  the  individual  tissue  cells  of  the  body  as  it  passes  through 
the  capillaries.  And  here  it  must  be  noted  that  no  assimilation  of  any 
nutritive  substance  (except  of  inorganic  origin,  as  water,  etc.)  can  take 
place  through  any  medium  but  that  of  nuclein,  and  it  is  in  the  mul- 
tinuclear  form  of  leucocytes  that  we  find  it  developed.  It  has  long 
been  known  to  physiologists,  but  its  wonderful  place  in  the  economy 
of  the  organism  was  never  known  until  the  close  study  of  the 
leucocyte  developed  its  origin  and  function,  and  in  this  way  cleared 
up  some  of  the  most  hidden  mysteries  of  the  organism,  and  placed  in 
the  hands  of  the  therapist  the  most  wonderful  agent  of  therapeutic 
power  yet  known  to  scientific  medicine. 

To  return  to  our  panorama  of  nutrition,  seeing  that  the  proteids 
must  all  report  to  the  leucocyte  and  be  stamped  with  their  nuclear 
influence  before  delivery  to  the  several  tissues,  the  bursting  of  the 
leucocyte  is  readily  understood,  for  by  this  means  the  nuclei  are  set 
free  to  become  new  cells,  and  a  great  quantity  of  this  cellulized  tissue- 
pabulum  is  poured  out  into  the  circulation,  bathing  with  food  every 
hungry  cell  of  the  several  tissues  through  which  it  floats,  each  cell 
taking  up  that  which  is  necessary  to  its  molecular  activity  and  return- 
ing to  the  current  that  which  belongs  to  other  and  remote  tissues  of 
the  organism.  This  conversion  into  tissue  through  the  circulatory 
system,  of  material,  lifeless  in  itself,  is  the  most  wonderful  phenomenon 
presented  to  the  human  mind.  We  can  not,  of  course,  explain  the 
affinities  by  which  certain  kinds  of  pabulum  are  accepted  and  others 
rejected  by  the  several  tissue-cells  of  the  body  any  more  than  we  can 
explain  the  affinities  between  the  sexes,  often  so  seemingly  astounding. 
We  know  this,  however,  that  the  change  which  goes  on  is  the  elabor- 
ation of  a  vitalized  or  cellulized  substance  which  is  capable  of  entering 
at  once  into  tissues  as  soon  as  it  meets  the  various  cells  possessing  this 
power  of  elective  assimilation.  This  primal  cellulized  pabulum  has 
therefore  been  appropriately  called  nuclein  from  the  mode  of  its 
generation,  and  when   operated  upon  by  the  individual  tissue-cell  it 


192  THE   CANADIAN    MEDICAI.    REVIEW. 

becomes  protonuclein,  after  the  analogy  of  Prof.  Huxley's  nomencla- 
ture, which  represented  its  real  origin.  This  substance  is  rich  in 
phosphorus,  and  has  been  separated  in  active  form  from  the  lymphoid 
structure  of  the  body,  as  we  shall  see  later. 

We  are  brought  now  face  to  face  with  one  of  the  most  formidable 
problems  of  physiology,  the  solution  of  which  will  destroy  many  of  our 
old  pathological  ideas,  upon  which  so  many  therapeutic  systems  have 
been  wrecked.  Up  to  a  very  recent  date  in  the  history  of  pathology 
leucocythemia  was  considered  a  specific  disease.  Upon  the  post  hoc, 
propter  hoc  principle  of  medical  philosophy,  the  rush  of  leucocytes  to 
any  point  of  irritation  was  regarded  as  a  feature,  or  even  as  a  distinct 
stage  of  the  disease.  How  vividly  can  the  memory  of  some  of  you 
recall  the  old  professional  saws,  as  they  were  called  by  those  of  us 
who  sat  at  the  feet  of  the  Gamaliels  of  those  days,  among  which  there 
was  none  more  familiar  than  the  Ubi  irritatio  ibi  fliixtis  1  We 
answered  almost  all  questions  upon  inflammation  with  this  single 
axiom,  as  we  believed  it.  Often  have  I  heard  the  venerable  Gross 
straighten  his  lofty  form  and  declare  in  stentorian  voice  that  imflam- 
mation  consisted  pathologically  of  the  rapid  afflux  of  leucocytes  I 
How  startled  would  he  be  to  learn  that  modern  physiology  has 
demonstrated  that  rapid  afflux  to  be  nature's  reinforcing  battalions  ! 
Every  white  blood  corpuscle  which  gathered  about  that  point  of  irrita- 
tion bore  with  it  the  materials  of  repair,  and  as  still  later  investigation 
has  proved,  also  the  power  of  overwhelming  toxic  germs,  themselves 
in  their  incipiency,  and  protecting  the  organism  against  their  poison- 
ous and  deadly  exudations. 

As  to  the  phagocytic  action  or  cell-eating  power  of  the  leucocytes, 
which  has  been  strongly  claimed  by  some  observers  and  as  strenu- 
ously denied  by  others,  it  is  after  all  a  mere  question  of  difference  in 
the  manner  of  destroying  toxic  germs  which  has  developed  antagonism 
among  physiological  observers.  It  is,  as  I  have  upon  a  previous 
occasion  already  remarked,  not  at  all  necessary  that  because  the 
physiological  or  pathological  function  of  one  cell  is  lost  in  that  of 
another,  we  should  in  speaking  of  such  action  as  a  phagocytic  or  cell- 
eating  process,  imagine  a  mouth  and  teeth  and  all  the  paraphernalia 
of  mastication,  deglutition,  etc.  The  result  is  the  same,  whether  the 
pathological  germ  is  swallowed,  destroyed,  or  neutralized  ;  so  long  as 
the  cellular  influence  of  the  leucocyte  is  the  agent  which  accom- 
plishes this,  it  is  immaterial  whether  we  use  the  term  "phagocytic" 
literally  or  metaphorically,  but  notwithstanding  all  the  adverse  criti- 
cisms of  the  word  as  used  in  this  connection,  there  is  none  given  us 
which  more  emphatically  expresses   the  idea  we  wish   to  convey,  and 


THE    CANADIAN    MEDICAL    REVIEW.  193 

the  difificulty  of  nomenclature  is  anyhow  too  great  to  Hghtly  reject  so 
expressive   a  word,  which,  as    bacteriologists    and    morphologists    all 
admit,  does  certainly  most  vividly  express  the  primordial  condition  of 
which  this  is  the  physiological  analogue.     In  its  last  analysis,  after  all, 
it  is  the  molecular  disturbance  or   change   produced   in  the  germ  that 
deprives  it  of  its  toxic  power.     This  we  know  will  effect  even  chemi- 
cal action.     Upon  this  fermentative  processes  depend.     Isomerism  is 
another  example  of  the  effect  of  molecular  arrangement  or  disarrange, 
ment.     Where  can   you   find  two   substances  more  distinctly  different 
than  sugar  and  gum  arabic  ?     And  yet  they  are  exactly  the  same  in 
composition  and   in  the   proportion  of  elementary  combination,  the 
difference  in  arrangement  of  the  molecules  being  sufficient-to  account 
for  the   difference  in    chemical   and  physical  properties.     With  these 
examples  before  us— and  I  could,  if  time  permitted,  bring  out  many 
others  equally  as  striking— it  is  very  easy  to  see  how  the  slightest  dis- 
turbance of  molecular  arrangement  in  any  germ  will  deprive  it  of  its 
specific  character,  and  by  investing  it   with   certain  cellular  elements, 
emasculate  the  most  deadly  of  toxic  bacilli  and  send  them  harmless 
through    the    blood    currents   of   the    organism.     Having,    therefore, 
found  that  it  is  within    the  leucocyte  that  all   protozoio*  material   is 
developed,  that  upon  the  proliferation  of  the  leucocyte  all  assimilation 
depends,    it    is    but   a   step    further  to    establish   the  action    of  the 
leucocyte  in  resisting  the  effect   of  toxic   germs,  as  well  as  divesting 
them  directly  of  toxic  power.     It  would  perhaps  be  more  accurate  to 
define  this  action  by  the  statement  that  they  are  capable  in  themselves 
of  overcoming  the  pathological  influences  which  are  being  continually 
introduced    into   that    organism.     To   those  whose   daily  experience 
brings  them  face  to  face  with  the  awful  side  of  human  life,   I  think  I 
can  appeal  with  emphasis,  when  I  state  that  there  is  scarcely  a  breath 
we  breathe,  or  a  drop  we  drink,  or  a  morsel  we  eat,  that  is  not  charged 
with  the  germs  of  deadly  disease,  and  if  there  were  not  in  our  organism 
a  distinct  provision  made  for  the  resistance  of  such  germs,  to  use  a 
Pauline  expression,  we  should  "  die  daily."     When  the  tocsin  of  dis- 
ease is  sounded  through  the  organism,  it  is  the  rushing  of  the  leuco- 
cytes  that   constitutes    the   first    physiological   response— to  directly 
resist  a  toxic  agent,  or  supply  the  structure  attacked  with   material  for 
nutrition  or  repair   in   case  of  lesion.     And  yet  there  are  still  those 
among  the  ranks  of  intelligent  practitioners  who  consider  the  increase 
of  leucocytes  as  an  element  or    phase  of   disease  itself,   instead  of 
nature's  effort  to  support  her  crumbling  battlements.     At  this  stage  of 
my  argument,  I  shall,  upon  the  strength  of  what  may  be  microscopic^ 
ally  demonstrated  to  be  the  function  of  the  nuclein-charged  leucocyte, 
4 


194  THE    CANADIAN    MEDICAL    REVIEW. 

make  an  assertion  which  I  have  no  doubt  will  be  considered  somewhat 
arbitrary.  It  is,  that  whatever  of  so-called  specific  effect  lies  in  the 
antitoxine  obtained  from  the  immunized  animal,  as  opposed  to  the 
bacillus  and  the  toxine  of  diphtheria,  is  accomplished  by  the  excite- 
ment of  leucocytosis,  and  after  all  the  end  is  reached  by  the  same 
physiological  process. 

The  ultimate  aim  of  all  antitoxic  agents  must  be  the  overwhelming 
of  tlie  toxic  element  of  the  germ,  and  this  can  only  be  accomplished 
by  a  great  excess  of  physiological  tissue-building  material.  Let  us  ob- 
serve the  process  by  which  this  antitoxic  effect  is  brought  about.  In  the 
first  place,  the  physiological  relation  of  protonuclein  would  of  course  pre- 
clude the  ide'a  of  its  action  as  a  direct  specific  antidote  to  a  specific 
poison,  such  as  that  observed  between  chemical  agents,  or  even  physio, 
logical  antagonists,  as  for  instance  the  hydrated  sesquioxide  of  iron 
against  arsenic,  or  atropia  against  morphia,  or  chloroform  against  strych- 
nia. Were  this  the  principle  of  the  functional  activity  of  protonuclein,  its 
therapeutic  range  would  be  limited  to  such  an  antagonism,  but.  as  I 
am  prepared  to  show,  by  careful  experimental  records,  its  effect  is  first 
observed  when  the  system  has  been  thoroughly  charged  with  it,  thus 
preventing  the  expression  of  the  toxic  agent  by  a  preoccupation  of  the 
nutritive  field,  and  an  investment  of  the  attacking  germ.  I  have 
often  noticed  a  leucocyte,  thoroughly  charged  with  original  nuclein, 
adhere  to  the  cell  of  a  sarcoma,  and  after  bursting  itself,  send  the 
round  cell  floating  away  in  the  field  crenated  and  almost  emptied  of 
its  contents.  Such  effects  have  been  observed  also  upon  the  blood 
after  days  ot  treatment  with  protonuclein.  This  appears  to  me  to  be 
the  very  ultima  thule  of  thtirapy  ;  and  the  question  will  be — has  been, 
very  naturally  asked  after  such  developments:  "If  such  be  the 
power  of  a  substance  capable  of  investing,  controlling,  and  overwhelm- 
ing toxic  agents,  where  is  the  limit  of  its  action  ?"  If  I  spoke  the 
truth  boldly,  as  it  should  be  spoken,  I  should  answer  that,  properly 
applied,  I  can  see  no  limit  of  its  resisting  power.  When  side  by  side 
with  my  own  experiments  I  have  observed  what  I  admit  to  be  the 
wonderful  effects  of  antitoxine  in  the  organism  on  the  bacillus  and 
toxine  of  diphtheria,  I  have,  nevertheless,  felt  that  protonuclein  was 
as  far  superior  to  it  in  pathological  results  as  the  whole  realm  of 
pathology  is  greater  than  a  single  disease. 

And  now  we  come  to  the  question  of  practical  interest  to  the 
general  profession,  "  How  is  it  possible  to  extract  this  delicate  sub- 
stance from  the  animal  tissues?"  and  its  corollary,  "What  are  the 
methods  used  to  preserve  its  cellular  activity  ?" 

There  are  three  forms  of  nuclein  material  now  before  the  profession  . 


THE    CANADIAN    MEDICAL    REVIEW.  195 

1 .  Nuclein  made  from  yeast. 

2.  Another  preparation  of  nuclein  taken  from  the  animal  organism 
by  chemical  methods. 

3.  The  third  form,  protonuclein,  is  a  product  taken  directly  from 
the  lymphoid  tissues  of  the  healthy  animal,  the  thyroid  and  thymus 
glands,  the  brain  substance — within  the  area  in  and  about  the  corpora 
quadrigemina,  the  pituitary  body  and  pineal  gland— the  pancreas, 
spleen  and  liver.  No  chemicals  are  used  in  this  process,  the  methods 
of  extraction  being  purely  physical,  and  the  protonuclein  is  kept 
active  by  an  investment  of  gum  benzoin  and  milk  sugar,  which  pre- 
serves it  indefinitely,  just  as  the  germ  of  a  grain  of  corn  is  kept 
potentially  active  by  its  environment.  The  activity  of  the  protonu- 
clein may  be  easily  shown  by  dissolving  some  of  the  powder  in  dis- 
tilled water.  After  the  sediment  has  settled,  draw  off  the  supernatant 
fluid  and  apply  a  drop  of  it  to  a  drop  of  freshly-drawn  blood.  You 
will  see  a  most  beautiful  physiological  panorama,  instantaneous  photo- 
graphs of  which  I  have  here  for  your  inspection.  Protonuclein  is 
richer  in  nitrogen  than  the  ordinary  nuclein  of  the  text-books.  Its 
formula,  as  far  as  it  is  possible  to  be  chemically  accurate  in  quanti- 
tative analysis,  is  C.29  H4,,  Nj,,  P5  O-^.,,  differing  by  about  one  equivalent 
of  nitrogen.  It  will  be  noticed  how  rich  in  phosphorus  this  wonderful 
physiological  agent  is. 

So  much  therefore  for  its  preparation  and  extraction.  The  most 
important  factor  in  the  problem  is  the  answer  to  the  questions,  "  What 
will  it  do?"  "What  can  it  cure?"  "What  will  it  prevent?"  in  the 
great  battle  between  science  and  death.  Were  I  to  give  free  range 
to  my  own  confidence  in  the  therapeutic  power  of  protonuclein  as 
observed  from  day  to  day  for  the  last  six  months,  under  the  most 
favorable  circumstances  and  under  the  direction  of  experienced  and 
authoritative  clinicians,  you  would  discredit  even  the  demonstrations 
of  this  report.  But  if  you  will  consider  for  a  moment  what  a  sweeping 
therapeutic  power  must  belong  to  any  agent  which  is  the  normal 
tissue-builder  of  the  organism  and  the  direct  antagonist  of  its  invading 
toxic  germs,  you  will  see  how  difficult  it  is  to  limit  its  indication  as  a 
therapeutic  agent. 

Its  most  pronounced  results  have  been  observed  in  tuberculosis, 
sarcoma,  diphtheria,  tonsillitis,  and  la  grippe.  In  the  hospitals  in 
New  York  it  has  been  used  with  general  success  in  the  following  dis- 
eases, besides  those  already  mentioned  :  Abscess,  anaemia  (pernicious), 
Bright's  disease,  carcinoma,  colds,  malaria,  tuberculosis  of  bladder, 
ulcers,  and  many  others. 

As  to  dose  and  mode  of  administration,  I  subjoin  to  this  paper  full 


196  THf:    CANADIAN    MEDICAL    REVIEW. 

directions,  which  have  been  carefully  prepared  from  the  closest  clinical 
observations. 

Nothing  has  been  left  undone  to  thoroughly  test  the  practical  truth 
of  what  has  theoretically  been  claimed  for  protonuclein  as  a  therapeutic 
power.  I  believe  with  others  even  more  conservative  and  les.s 
sanguine  than  I,  that  it  will  mark  an  era  in  therapeutics.  Such 
relationship  between  the  pabulum  and  the  individual  ti-sue-cell  of  the 
various  structures  of  the  body,  seems  to  be  the  very  last  analysis  of 
function  in  the  human  organism.  Indeed,  it  has  been  said  by  one 
who  occupies  a  high  position  as  a  medical  teacher  :  "  I  feel  assured 
that  protonuclein  is  to  fill  a  most  important  place  in  the  thera- 
peutic resources— perhaps  the  most  important." 

Up  to  the  time  when  therapy  began  to  look  to  physiology  for  help, 
our  whole  system  was  a  vast  accumulation  of  clinical  reports  without 
one  iota  of  determining  philosophy — a  vast  labyrinth  without  an 
Ariadne  thread  to  guide  the  returning  footsteps  of  our  reason.  I  doubt 
not  that  before  the  close  of  the  nineteenth  century  our  therapists  will 
look  back  upon  the  thousands  of  agents  vaunted  in  the  cure  of  disease 
las  the  modern  soldier  gazes  upon  the  spear  and  shield  of  ancient 
Greece  and  Rome.  The  simplification  of  physiological  methods  has 
been  followed  most  naturally  by  the  use  of  those  physiological 
principles  of  therapy  upon  which  the  normal  curative  conditions  of  the 
organism  depend,  and  without  which  no  scientific  system  of  therapeu- 
tics could  ever  be  formed. 


Tendon  Grafting. — A  new  operation  for  deformities  following 
infantile  paralysis.  At  the  meeting  of  the  New  York  Medical  Associa- 
tion, October  15th,  1895  {Medical  Record,  October  26th),  Dr. 
Milliken  presented  a  boy  eleven  years  of  age,  upon  whom  twenty 
months  before  he  had  successfully  grafted  part  of  the  extensor  tendon 
of  the  great  toe  into  the  tendon  of  the  tibialis  anticus  muscle,  the 
latter  having  been  paralyzed  since  the  child  was  eighteen  months  old. 
The  case  which  was  presented  showed  the  advantages  of  only  taking 
part  of  the  tendon  of  a  healthy  muscle,  which  was  made  to  carry  on 
the  function  of  its  paralyzed  associate  without  in  any  way  interfering 
with  its  own  work.  The  brace  which  had  been  worn  since  two  years 
of  age  was  left  off,  the  patient  walked  without  a  limp,  the  talipes  valgus 
was  entirely  corrected  and  the  boy  had  become  quite  an  expert  roller 
skater.  Dr.  Milliken  predicts  a  great  field  for  tendon  grafting  in  these 
otherwise  ho[)eless  cases  of  infantile  paralysis,  who  heretofore  have 
been  doomed  to  the  wearing  of  braces  all  their  lives. 


ADVERTISEMENTS. 


THE  MOST  COWENIENT 

AMI 

ECOAOMICAL  METHOD 

OF  PRODIXT\G 

LOCAL 
AX^STHESIA 


:;,;WiTH   pat ent^'s pray   a^nd  "stopper. 

0 N ir    T H I , ? D     O F  ,-C  T UAL^sTz^^T 


ETHYL  CHLORIDE  EENGUE  is  an 
anassthetic,  which  is  at  once  rapid  in 
action,  convenient  to  use,  always  re- 
liable, harmless  and  inexpensive. 


Put  up  in  tubes  containing  37  to  40cc.,  and  terminating  in  a  short  tube  with  a  capillary 
orifice,  upon  which  is  fi.xed  a  copper  screw-thread.  On  the  screw  is  a  cap,  also  of  copper,  which, 
being  lined  with  India-rubber,  closes  it  so  tightly  that  the  Chloride  is  prevented  from  evapor- 
ating, and  can  be  used  in  the  evact  qiisviitity  rt^quired  by  the  case  in  hand.  It  is  thus 
extremely  economical,  as  each  bulb  of  El'HYL  CHLOIUDE  liENGDE  contains  sufficient 
for  10  to  15  local  anaesthesias.    Supplied  with  Straight  Stem  or  Curved  Stem  (as  illustration). 

The  use  of  ETHYL  CHLORIDE  is  without  danger  of^ny  kind,  and  It  can  be  applied 
equally  to  skin  and  mucous  membrane. 

^^  Remember  to  specify  ETHYL  CHLORIDE'eENGUE.-^ 


Pwphlet  and  full  particulars     TIEIOS-     LIE  E  JVHI^STGr     cSC     C3C:> 
on  application  to  -*. -». -i. _■_ ■»  v_*      «_^     v_^\ — /_^ 

25  St.    Peter  Street,   Montreal. 


CUT   THIS   OUT- 


Bafe, 


i8p 


CANADIAN  MEDICAL  RE  VIE  W  CO., 
Toronto,    Out. 


Enclosed  please  find  $ i.oo,  for   which  I  request  that  you   enter 
my  name  on  your  list  of  subscribers   to  'he  REVIEW  for  one  year 

from iSg        to  

i8g  At  the  expiration  of  this  time,   if   not  previously  advised   to 

the  contrary,  you  may  retain  my  name    as    a    subscriber,   and  I  zvill 
remit  on  receipt  of  bill. 

Name : _ 

Street  or  P.  O.    Box 

Town 

M  Province  '.. 


ADVERTISEMENTS. 
.  .  THE  ,  . 


TRUSTS  CORPORATION   OF  ONTARIO. 

OflSces  and  Safe  Deposit  Vaults, 

Bank  of  Commerce  Building, 

^^King  Street,  Toronto. 


AUTHORIZED  CAPITAL,       -       $1,000,000 
CAPITAL  SUBSCRIBED,       -  800,000 

Hon.  J.  G.  A  [KINS,  P.O.,   Toronto,   President. 
Hon.  Sir  R.  J.   CARTWRIOHT,   K.G.M.G.,   Kingston,   \  ...      „      .,     . 
Hon.  S.   G.    WOOD,         ....  Toronto,     / 

The  Corporation  is  accepted  by  the  High  Court  of  Justice  as  a  Trusts  Company,  under  the 
approval  of  the  Ontario  Government,  and  is  authorized  to  act  as  Executor,  Admiiii-trator, 

IN  CASE    OF    InTESTACV,   OR    WITH    WiLL    ANNEXED.       TrU8t«-e   UNDER    DEED,   WiLL,   COUKT 

Appointment  or  Substitution.  Receiver,  Couimittee  of  Lunatics,  and  Custodian  of 
THR  Estates  and  Properties  of  Lunatics.  Guardian  of  Children,  also  as  Agent  for 
Gxecutors,  Trustees  and  others,  thus  relieving  them  from  onerous  and  oftentimes  dis- 
agreeable duties. 

The  Corporation  also  acts  as  Affent  in  financial  business  of  all  kinds— Collecting  of  Rents, 
Income,  etc..  Issue  and  Countersigning  Bonds,  Debentures,  etc. 

Our  Deposit  Vaults  are  absolutely  secure,  and  every  convenience  provided  for  the  storing 
of  Valuables  of  all  kinds  at  small  expense.  Wills  appointing  the  Corporation  as  Exectitor  are 
received  for  Safe  Custody  free  of  charge. 

The  employment  of  the  Corporation  will  be  found  prompt  and  economical.  Solicitors  placing 
business  with  it  are  continued  in  the  legal  work  thereof. 

A.  E.   PLUMMER,  Manager. 

FERROL 


A  RELIABLE  PREPARATION  OF  IRON   AND  PURE 

NORWEGIAN  COD  LIVER  OIL  OF 

AGREEABLE  TASTE. 


Useful  in  aU  cases  where   COD  LIVER  OIL  and  IRON 
.  .  .  are  indicated  .  .  . 

Baniple  of  FEllitOLi  jjiven  to  any  pliysiciau  in   rt'gular  practice  on  application. 


Toronto,  Nov.  15th,  1893. 
After  carefully  analyzing  "FERROL,"  I  am  satisfied  that  it  must  prove  a  valuable  acquisi- 
tion to  the  list  of  medicinal  preparations  now  before  the  public.     Its  administration  in  tuber- 
cular troublis  aucoinpaniod  by  aiitcinia  must,  in  most  instances,  be  efficacious. 

Furthermore,  1  am  of  ihc  opinion  that  it  will  prove  a  valuable  remedy  in  children's  diseases, 
in  which  the  administration  of  Cod  Liver  Oil,  Iron  and  Phosphates  is  desiiable.  1  am  not 
surprised  to  find  the  list  of  physicians  endorsing  on  the  daily  increase. 

A.  R.  PYNP:,  M.B.,  Dominion  Analyst. 


FERROL    MANUFACTURING    CO 

HEADOFFce:  205   Spadina  Ave.,  TORONTO. 

.    .    .    Retail  by  all  the  Le.iding  Druggists    .    . 


ADVERTISEMENTS.  : 

THE     BEST     ANTISEPTIC 
F=OR     BOTH     INTERNKU    T^ND     EXTERNAL    WSE. 


Antiseptic, 

Prophvlactio, 

Deodorant. 


LISTERINE 


Non-Toxic, 

NON-lHRlTANT, 
NON-ESCHAflOTIO. 


LISTERINE  is  a  well-proven  antiseptic  agent— an  antizymotic— especially  useful  in  the  manage- 
ment of  catarrhal  conditions  of  the  mucous  membrane  ;  adapted  to  internal  use,  and  to  make  and 
maintain  surgical  cleanliness— asepsis — in  the  treatment  of  all  parts  of  the  human  bodjf,  whether 
by  spray,  irrigation,  atomization.  or  simple  local  application,  and  therefore  characterized  by  Its 
particular  adaptability  to  the  field  of 

PREVENTIVE   MEDICINE-INDIVIDUAL  PROPHYLAXIS. 


LISTERINE  destroys  promptly  all  odors  emanating  from  diseased  gums  and  teeth,  and  will 
be  found  of  great  value  when  taken  internally,  in  teaspoonful  doses,  to  control  the 
fermentative  eructations  of  dyspepsia,  and  to  disinfect  the  mouth,  throat,  and  stomach 
It  is  a  perfect  tooth  and  mouth  wash,  INDISPENSABLE  FOR  THE  DENTAL  TOILET. 


Lambert's  Lithiated  Hydrangea. 

FORMULA.— Each  fluid  drachm  of  "Lithiated  Hydrangea"  represents  thirty  Rrains  of  frksb 
Hydrangea  and  three  grains  of  CHE.MICALLY  puke  Benzo-Salicylate  of  Lithia.  Prepared  by 
our  improved  process  of  osmosis,  it  is  i.vvariably  of  definite  and  uniform  therapeutic 
strength,  and  hence  can  be  depended  upon  in  clinical  practice. 

DOSE.— One  or  two  teaspoonfuls  four  times  a  day  (preferably  between  meals). 


Close  clinical    observation    has    caused    Lambert's   Lithiated   Hydrangea   to   be    regarded   by 
'  physicians  generally  as  a  very  valuable  Renal  Atterative  and 

Anti-Lithic  Agent  in  the  treatment  of 
URINARY  CALCULUS,  GOUT.  RHEUMATISM,  CYSTITIS.  DIABETES    H/EMATURIA,  BRIGHT'S  DISEASE, 
ALBUMINURIA  AND  VESICAL  IRRITATIONS  GENERALLY. 
We  have  much  vahiable  literat\ire  upon  General  Antlseptic  Treatment,  Lithemia,  Diabktm, 
Cystitis,  Etc.,  to  forward  to  physicians  upon  request. 

LAMBERT  PHARMACAL  COMPANY,  St.  Louis.  Mo. 


SOL.    FERRI   ALBUMINATL     <flett» 

Does  not  distil rb  the  most  sensitive  stomach.    Contains  Iron  in  its  most  assimilable  form 
May  be  combined  with  Strychnia  and  Arsenic.    Dose,  one  to  two  drachams. 
When  Prescribing  Specify  "Flett." 


FRED.  W.    FLETT   &   CO.,        -         Pharmacists, 

TELEPHONE  664 ...  TORONTO. 


WHEELER'S   TISSUE    PHOSPHATES. 

Wheeler's  Compound  Elixir  of  Phosphates  and  Calisaya.  A  Nerve  Food  and 
Nutritive  Tonic  for  the  treatment  of  Consumption,  Bronchitis,  Scrofula  and  all  fonns  of  Nervous  Debility. 
This  elegant  preparation  combines  in  an  agreeable  Aromatic  Cordial,  in  the  form  of  a  Glycerite  acceptable 
to  the  most  irritable  conditions  of  the  stomach:  Bone,  Calcium  Phosphate  Ca22P04,  Sodium  Phosphate 
Na2HP04,  Ferrous  Phosphate  Fe32P04  Trihydrogen  Phosphate  HsPOi,  and  the  active  principles  of 
Calisaya  and  Wild  Cherrj'. 

The  special  indication  ot  this  combination  of  Phosphates  in  Spinal  Affections,  Caries,  Necrosis,  Ununited 
Fractures,  llarasmus.  Poorly  Developed  Children,  Retarded  Dentition,  Alcohol,  Opium  and  Tobacco  H.abit, 
Gestation  and  Lactation  to  promote  Development,  etc.,  and  as  a  physiological  restorative  in  Sexual  Debility 
and  all  used-up  conditions  of  the  Nervous  System  should  receive  the  careful  attention  of  good  therapeutists. 

ISotable  Properties:  As  reliable  in  Dyspepsia  as  Quinine  in  Ague.  Secures  the  larjrest  percentage 
of  Benefit  in  Consumption  and  all  Wasting  Diseases,  "  by  determining  the  perfect  digestion  and  assimilation 
of  food."  When  using  it.  Cod  Liver  Oil  may  be  taken  without  repugnance.  It  renders  success  possible  ih 
treating  chronic  diseases  of  Women  and  Children,  who  take  it  with  pleasure  for  prolonged  periods,  a  factor 
essential  to  maintain  the  goodwill  of  the  patient.  Being  a  Tissue  Constructive,  it  is  the  best  "general 
utility  compound  "  for  Tonic  Restorative  purposes  we  have,  no  mischievous  effects  resulting  from  exhibiting 
it  in  any  possible  morbid  condition  of  the  system.  Phosphates  being  a  natural  food  product,  no  substitute 
will  do  their  work  in  the  system. 

DOSE— For  an  adult,  one  tablespoonful  three  times  a  day,  after  eating  ;  from  seven  to  twelve  years  of 
age,  one  dessertspoonful ;  from  two  to  seven,  one  teaspoonful ;  for  infants,  from  five  to  twenty  drops  accord- 
ing to  age.    Prepared  at  the  Chemical  Laboratory  of  T.  B,  WHEELER,  M.D.,  Montreal,  P,Q. 

To  prevent  substitution,  put  up  in  pound  bottles  only  and  sold  by  all  druggists  at  One  Dollar. 

e^  head  the  pamphlet  on  this  subject  sent  you. 


OMNIA  TERRESTREA  QUAE  VENUNT,  PURGAT. 

'*  Harvey's"   Peroxide  of  Hydrogen.    H2  O2. 

Three  grades  nianufactiirod,  Xo.  1,  No.  2,  No.  3.  No.  1  is  medicinal  and  put  up  in  sealed 
bottles:  full  strength  and  absolute  purity  guaranteed  ;  will  retain  its  germicidal  power  undim- 
inished for  years.     No.  2  and  No.  3  not  O.  P.  and  cheaper  grades. 

Harvey's  Acrolozone.     Cs  Hs  0:j  v  O3. 

A  valuable  therapeutical  agent,  prevents  fermeiitMt ion  of  the  food  in  the  stomach,  Dys- 
pepsia, Gastritis,  Ulcer  of  the  Stomach.  Heart-Iiurn.  etc.  Guaranteed  pure  and  full  strength 
always. 

Manufacturing 
Manufactured  SC  /^      /Y  7/  Chemist, 

by-  y^^^^^ //.  Ah^J7^/^jy   Todmorden, 

Near  TORONTO 


I'HE    IDE  A  I. 

HYDKO-CARBON 


COD  LIVER  GLYCERINE. 

(Japible   of  mixing'   with    water,   requires   no 
digestion,  but  is  readily  absorbed. 
Stimulates  digestion. 

Contains  only  active,  soluble  medical  priii(-i])les. 
Will  not  become  rancid. 

Will  not  decompose. 

Mixes  with  all  remedies,  making  it  a  preseiip- 
tion  remedy. 

Will  show  decided  result    within  24  hours. 

Kull  dose  is  one  teaspoonful. 
Is  pleasant,  and  l)oriie  by  the  most  delicate 
stomachs— even  infants. 


COD  LIVER  GLYCERINE 

COMPARISON, 


'Gl.YCEROLE 

MOKIIHC^." 


COD  LIVER  OIL, 
Or  its  Emulsified  Coiiibiiuitions. 

Cannot  be  completely  digested. 

Oppresses  the  stomach. 

Contains  inert  and  insoluble  substances. 

(.'ontains  animal  matter  and  other  putrefactive 
and  rancid-bearing  substances. 

Exposed  to  air,  becomes  rotten  with  germs  of 
decomposition. 

Must  be  administered  alone. 

Must  be  taken  from  four  to  six  weeks  to  see 
any  medical  results. 
Full  dose  is  two  tablespoonfuls. 
Is  olfensive. 


I  woidd  respectfully  call  the  attention  of  physicians  to  the  tact  that  I  liave  received  a  large  stock  of  the 
above  preparation,  and  would  be  pleased  to  have  them  call  and  examine  it. 

HARBOTTLE'S    Rossin  House  Drug  Store. 

MAGNETIC  ROCK  OIL.  !  ^^m^^vy^y^l-v^^^^ 


Trade 

Marked 


JO=HE 


Antiseptic,  Anodyne  jiiul   I'ropby lactic, 

Non-Irritant       For  External  and 

Internal    Use. 


This  Oil  is  highly  recommended,  and  possesses 
.properties  of  great  value  as  a  local  app'ication 
in  diseases  of  the  skin,  and  in  Burns,  Bruises, 
and  in  Acute  and  Chronic  Rheumatoid  and 
Tuberculous  Affections.  It  is  sought  to  intro- 
duccTHIS  INVALUABLE  THERAPEUTIC 
AGENT  exclusively  on  its  MERITS,  and  for 
this  reason  the  Profession  is  appealed  to  through 
the  cohinms  of  a  Medical  Journal. 

Physicians  are  respectfully  invited  to  test 
the  Oil  in  any  and  every  way  they  may  deem 
advisable  to  verify  its  merits.  Oil.  prepaid  to 
physicians,  6()c  per  can. 


ONTARIO  SUPPLY  CO. 

77  Victoria  St.,  Toronto. 

Agents  for  Canada. 


A  RTIFICIAL 


Established 


BEST  LEG  WITH  WOOD  OR 
RUBBER  FOOT.  AND  WOOD 
OR  ADJUSTABLE  LEATHER 
SOCKET 


$50 '470 


Arms  ^''*''  •*""  ''"'*  sock- 

r—    — r    et  Wrist  Joints. 

These   limbs  have   been  en- 
dorsed   by  such    men  as   Prof. 
Esmarch  ;    Valentine  Mott_  M. 
D  ;  Willard  Parker,  M.  D.;  Gordon  Buck,  M.  D.;  and 
scores  of  other  eminent  members  of  the  profession. 


We  make  one-fourth  of  all  Limbs  Supplied  the 
U.  S.  Government  for  Pensioners. 


-TRUSESS,- 


ELASTIC  STOCKINGS,  CRUTCHES,  &C. 
Send  for  catalngui-  and  state  particulars, 
GEO.    R.   FULLER,       BOX  2112 

ROCHESTER,  N.  Y. 


EjIlPIBE  ELflSTiG  6HNDII&E, 

SPECIALLY  ADAPTED  FOR 

VARICOSE   VEINS. 

We  invite  the  attention  of  the  Medical  and  Surgical 
profession  to  the  various  merits  combined  in  our 
liai!da::es  : 

1st.  ITS  POROSITV- the  greatest  in  the  "Empire." 
It  never  causes  itching,  rash  or  ulceration  under  the 
I  aiidage. 

■2nd.  ITS  ELASTICITV,  which  will  enable  the  sur- 
geon or  nurse  to  put  it  on  at  any  required  tension,  and 
which  will  follow  a  swelling  up  or  down,  as  the  case 
mav  be,  a  feature  unknown  to  any  other  bandage. 

3rd.  ITS  ABSORBENT  PROPERTIES— greatest  in 
the  "  Empire." 

4th.  ITS  EASY  APPLICATION  to  any  part  of  the 
body,  not  being  necessary  to  fold  over,  as  with  other 
bandages,  as  it  follows  itself  with  equal  uniformity 
around  any  part  of  the  abdomen. 

.=ith.  ITS  SELF-HOLDING  (QUALITIES.  No  bother 
with  pins,  needle  and  thread,  or  string,  so  tiresome  to 
surgeons,  as  simply  tucking  the  end  under  the  last  fold 
insures  its  permanent  stay,  until  its  removal  for  pur- 
pose of  cleanliness. 

6th.  The  onlv  Bandage  that  is  SUPERIOR  TO  THE 
ELASTIC  STOCKING  for  varicose  veins. 

Send  SI. 00  for  3-liicli  by  5-yard  Stretched 
Bandage. 


THE  EMPIRE  ABDOMINAL  SUPPORTER 

Is  superior  to  all  others  for  the  following 
reasons : 

Ist.  It  adapts 
itself  to  every 
movement  of 
the  body,  giving 
strong  and  even 
support. 

2nd.  It  pro- 
duces warmth 
without  irrita- 
tion or  sweating, 
as  it  is  pertectly 
ventilated. 

3rd.  In  preg- 
nancy, CDrpu- 
lency,  tumors  or 
other  cases  of 
enlai^gement  of 
abdomen,  it  sup- 
ports the  weight 
of  the  body  from 
the  backbone,  re- 
lieving the  sin- 
ews of  their  over- 
work. 

4th.  Its  easy 
appliance  (lace 
and  drawn  on 
over  the  head  or 
feet). 

5th.  It  is  cheap, 
durable.  It  can 
be  washed  if 
soiled,  proper 
care  being  taken 
to  cleanse  in 
1  ukewarm  water, 
and  dry  in  the 
shade. 

In  ordering 
give  the  measure 
of  the  abdomen. 
The  Supporter 
ehould  be  from 
four  to  ten  inches 
larger,  accord- 
ing to  the  degree 
of  support  re- 
quired. 
PBrrSICIANS'  NET  PRICES— 8  inches  wide,  $2.50  ;   11  inches,  $3.00. 


THE 

EMPIRE  UMBILICAL  TRUSS 


Abdominal  Supporter  with 

Button  inserted  at  the 

navel. 


Is  made  of  the  same  material,  and  pos- 
sesses the  same  merits  as  the  Empire 
Elastic  Bandage  and  Empire  Abdominal 
Supporters,  and  is  pronounced  by  all  who 
have  seen  it  to  be  the  BEST  IN  THE 
WORLD.  All  of  our  goods  are  sent  free 
by  mail  iipoii  receipt  of  price,  and  moiiey 
refunded  if  not  satisfactory. 

In  ordering,  give  the  measurement  of 
the  abdomen. 

Physicians'  Net  Prices. 
-     $1  26 


Infant 

Children 

Adult 


2  50 
i  00 


Manufactured  bj  the  Empire  Manufactufing  Co.,  20  Spring  St.,  Locliport,  HI,  U.S.*. 


ADVERTISEMENTS. 

COLLEGE   OF   PHYSICIANS   AND   SURGEONS 


The  Preliminary  Lectures  will  begin  Septr-niber  16lh,  1895.    The  regular  Annual  Ses.sion  will 
begin  October  l.st,  1895,  iitid  continue  six  ni()nth8. 

For  a  catalogue  or  other  information  write  DR.    TH03IAS   Ol'lE,    Dean, 

College  Buildinj.  Cor.  Calvert  and  Saratoga  Sts 

Medical  Practice  and  Partnership  Office 

ROOM    11,   JANES   BUILDING 

KING    AND    YONGE    STS.,    TORONTO. 


OPENED    FOR    THE   CONVENIENCE   AND   PROTECTION   OF   THE    PROFESSION. 
For  the  Purchase  and  Sale  of  Practices.  The  Purchase  and  Sale  of  Suitable  Properties. 

The  Arrangement  of  Partnerships.  Securing  Eligible  Openings. 

Assistants.     Locum  tenens,  and  Office  Students. 

83" All  Transactions  and  Communications  Strictly  Confidcntial.'^X 

Letters  must  be  direct  from  Medical  Practitioners,  and  must  enclose  stamp  for  reply, 
otherwise  they  will  remain  unnoticed. 

DR.   W.    E.    HAMILL,  -  -  Room  11.  Janes  Buildirg,  TORONTO 

Physicians,  Druggists  and  Dentists 

Desiring  to  locate  in  the  Pacific  Coast  States,  or  purchase  an  established 
business,  should  address   the    MEDICAL    EXCH.\NGE    BUREAU. 

DAVID    D.    LYNCH,    Manager,        -       -       -       -       PORTLAND,  OREGON. 


ACCIDENT    INSURANCE.  ^ 

The  Employers'  Liability  Assurance  Corporation  .| 

(LIMITED)  J 

OF    LONDON,    ENG.  j 

Capital   $5,000,000  (Five  Million   Dollars)  j 

Spoc'al  Policy  covering  Physicians  and  Surgeons  ag.a'nst  Blood  Poisoning.  ^ 

For  rales  and  further  information  apply  to  . 

C.  W.    I.  WOODLAND  j 

'PHONE     1916                                              Chief  Agent  lor  Ontario,   23  Toronto  St.,  Toronto  \ 

?t.  --^-   ^     ^    ^t. — -»■-    ''^^^ — '^ — -^ — '^^   2>- 1.-  ...     2--.^-  ... ^^ ^ -^     -*•     -*-     -*-  -  .^-    -     ...-  .1^  iol 


ADVERTISEMENTS. 


SReOIMU    NOTIOe. 


PHYSICIANS. 

If  you  hare  a  case  of  Eczema  or  any  skin  disease  tbat  vou  consider  incurable,  send  for  a 
sample  of  ECZAMEN,  which  is  invaluable  in  all  skin  affection.  It  destroys  all  parasites  in  the 
skin,  and  is  prepared  from  pure  ingredienls  not  at  all  poiacnous  or  corrosive.  Send  10  cents  in 
stamps  for  sample  box. 

TH!>   IS  A   »IEDICINE  FO.t   PHYSICIANS  ONLY. 

In  prescribing,  write  thus: 

R   Eczamen =  11.      (Bond's) 

Apply  twice  daily. 


LYMAN    BROS.  &  CO., 

Wholesale  Agent. 


J.   R,   BOND, 


Manufacturing  Chemist, 

448  Yonge  St.,  Toronta 


...All  Physicians  are  Prescribing... 

PIL   ORIENTALIS   (THOMPSON) 

Containing  the  New  Aphrodisiac  "Ambrosia  Orientalis" 

Which  the  Medical  Profession  endorse  as  without  a  rival,  linown  to  Ph.,rniacy 
for  Loss  of  Erectile  Power  and  Impotency. 

In  the  Oriental  Pill  the  profession  have  a  formula  designed  with  special  reference  to  the 
Klands  of  the  Reproductive  Organs  of  both  sexes,  which  will  incr.  aso  their  activity 
and  promote  their  secretive  powers. 

5e    Ambrosia  Orientalis grs.  2 

Extract  Saw  Palmetto gr.  J 

Zinc  Phosphide gr.  J 

Strychnos  Ignat   gr.  J 

with  Capsicum  and  Aromatic  Powder. 
Indications.  — Impotency  (functional  and  congenital).  Spermatorrhoea,  Sexual  D'jbility^ 
Weakness  of  the  Bladder,  Test(  s.  Mammae,  or  Ovaries.    Prostatities— valuab  e  as  a  diuretic. 

All  cases  of  loss  of  nerve  power,  Amenorrhea,  Dysmenorrhea,  Leucorrhoea,  Melancholia, 
Hysteria,  Sexual  Apathy  and  all  diseases  of  the  female  reproductive  organs  may  be  greatly 
benefited  by  the  use  of  this  pill. 

One  eminent  gynaecologist  writes: 

'•  The  Extract  will  prove  itself  a  valuable  addition  to  our  materia  medica  for  many  female  diseases,"  and 
that  "the  Oriental  Pill  is  very  reliable,  and  will,  no  doubt,  take  the  place  of  Daniiana.     For  if  Damiana  has 
any  aphrodisiacal  action,  it  is  very  temporary,  and  the  reaction  is  weakening  and  injurious." 
Another  physician,  who  has  a  large  city  practice,  says  : 

"The   result  in  eighteen  cases  (impotency,  etc.)  v/as  very  satisfactory,"  etc.,   etc.;   also  that   "the 
Oriental  Pill  has  secured  me  many  new  patients." 
A  Virginia  practitionf  r  says  : 

"  The  Pil  Orientalis  haa  given  me  more  satisfaction  than  any  other  remedy  that  I  have  tried  for  the  last 
thirty-five  years  for  the  loss  of  sexual  power." 

PRICE,   ONE    DOLLAR,    BY    MAIL. 

In  boxes,  containing  12  bottles,  plain  label,  for  dispensing,  S8.50  net. 
For  literature,  etc.,  address 

THE   THOMPSON    LABORATORY, 

r.O    Box  553.  WASHIXUTON,  D.C,  U.S.A. 


CHINA    HALL. 

Established  1S64. 

TEA,  BREAKFAST  m  DINNER  SETS 

...  In  the  Latest  Decorations  .  .  . 

RICH    CUT   GLASS. 

BANQUET   LAMPS. 


•MPfcCOB/.TtP      CnjN* 


JUNOR  &  IRVING, 

19  Kin^  St.  East,  Toronto. 


ADVERTISEMENTS. 

SPECIAL    NEW    LINES. 


T\\EO\)ORt  SKVi\i\i,  .NirR?,';si^.T  Ulanufaciorer 

BY  APPOINTMENT 
To  the  Principal  London  Hospitals  and  Colleges, 

91  SHAFTESBURY  AVENUE,  LOITDOIT,  W. 

IVe^^v    Antisf^ptio     IiisstniiiioiitsBs. 

No.  55.— Skull's  Antiseptic  SursTioal  S  t.  in  Nickel  Silver  Folding  Case   forming: 
trays  for  Solution,  size  7  x  'i\  x  1  inclies,  cont    iiiins- — 

4  Scalpels,  assorted;  1  Cartilage  Knife;  1  Dissi^cting  Forcep^i;  1  pair  Scissors,  straight;  1 
Double  Blow  Pipe  ;  1  Set  Chain  Hooks:  Needles  in  slide  metal  case. 

The  above  Set,  nickel  plated,  complete,  tn  Doeskin  Pouch,  1 5s.  6d. 
No.  15. — •vkull's    Antiseptic    Dissect  njf   I'ocltet   Cjise,   in   Nickel  Silver  Foiflinff 
Case,    with   movable    Metal    Fi  anics,   forming'   trays    for    Sulntions,  size  6x2x1 
inches,  containing'— 

2  Scalpels,  assorted;  1  Straight  Scissors,  probe  point;  1  Curved  Scissors;  1  Plain  Artery 
Forceps;  1  Artery  Forceps  with  Mouse  Teeth;  1  Artery  Forceps  with  Side  Catch  ; 'l 
Director  with  Aneurism  Needle  ;  1  Probe,  buttoned  ;   1   Probe  with  Myrtle  Leaf. 

The  above  Set,  nickel  plated,  complete  in  Doeskin  Pouch,  £  1   1  Os.  6d. 
No.  21. -Skull's    Antiseptic    Surgical    Pocket   Case,    in    Nickel   Silvei-   Folding 
Case,    with   movable   3Ietal  Frames,   forming  trays   lor  Solutions,  size   6  x  3i  x  1 
inches,  containing  — 

3  Scalpels,  assorted  ;  1  Straight  Scissors  ;  1  Curved  ditto  ;  1  Artery  Forceps  with  Mouse 
Teeth ;  1  ditto  with  Slide  Catch  Disjoint ;  1  Hsemost  Forceps.  Pean's ;  1  Director  with 
Aneurism  Needle  ;  1  Sharp  Double  Scoop ;  1  Fine  Sharp  Hook ;  1  Probe  with  Myrtle 
Leaf  ;  1  ditto,  buttoned ;  1  Needle  Holder  ;  1  Card  Silk. 

The  above  Set,  nickel  plated,  complete,  in  Doeskin  Pouch,  £2  2s 

'Every   Description  of  Surgical  Instruments   and  Appliances  kept  in  Stock  or  Made  to 
Order.    The  Cheapest  and  Best  House  in  the  Trade. 

A   TRIAL    SOLICITED.  ESTABLISHED    1S63. 


TMB     LT^TEST     INiZENTIOlS 

SKULL'S  OKONITE  TRUSSES  for  H  r  ia 

(RUPTURE). 

AWARDS— Gold  Medal,  Paris  Exhibition,  1889  ;  Gold  Medal,  "  World's  Fair,"  Chicago,  1893 
•^SKULL'S  OKONITE  TRUSSES  for  Rupture  are  in  all  respects  the  most  perfect  and  unique  instruments 
ever  offered  lo  the  public  as  mechanical  supports  and  remedial  appliances  for  any  form  of  Kupture  or 
Internal  Prolapse.     Thtse  trusses  are  of  the  best  possible  manufacture  ;  they  are   self-adjusting,  light 
and   comfortable.      The  external  surface  being  compl  tely  covered  with  a  non  absorbent  material 
(Okonite),  of  a  flesh  color,  resembhng-  ivory,  they  cannot  be  detected  when  bathing  ;  they  are  .  bsol- 
utely  impervious  to  moisture,  perspira  ion,  and  the  acid  excretions  ot  the  skin  ;  cannot  rust  or  '.et 
out  o    order,  cause  no  cutaneous  irritation,  will  hold  securely  any  size  protrusion  without  pain,  may 
be  washed  when  necessary  with  impunity,   and  can  therefore  be  worn   any  lenjjth  of   time  in   any 
climate  without  becoming  offensive,  hs  is  the  case  witn  those  constructed  with  leather,  elastic,  and 
other  objectionable  materials  of  a  porous  character. 
^ftKULL'S  OKONITE  TRUSSES  for  Rupture  weijjh  only  a  few  ounces,  and,  being  practically  indestructble. 
Can  be  guaranteed  t<i  last  a  lifetime,  thus  involving  no  further  expense  i  o  the  purchaser  beyond  first 
cost,  and  the  undoubted  advantages  they  possess  over  every  other  truss  extant    onslituie  them  aa 
absolutely  tlie  best,  and  therefore  the  cheapest  tha   can  be  procured.    The  following  ar  ■  .•  few  extracts 
from  the  leading  medical  journals  :  — 
The  Lancet — "  Skull's  Okonite  Trusses  are  the  nio<t  effective  we  have  ever  noticed." 
British  Medical  Journal — "They  are  scientifically  construct  d,  and  give  perfect  support  in  all  cases." 
iledical  Prexs  and  Circular—"  Will  no  doubt  coiiie  into  general  u-e." 

lilustrated  Mfiicul  News — "We  can  with  every  confidence  recommend  them  to  all  sufferers  from  Hernia 
'(Rupture)  and  Prolapsus." 

Thousands  of  Unsolicited  Testimonials  from  all  Parts  of  the  World. 

NOTICE— I  ernplny  no  travellers  or  agents,  and  they  are  only  supiilied  direct,  packeil  in   uooii  cases,  with 

Slain  address  label.s.  by  rettirn  of  mail  on  receipt  of  P.  O.  Order  or  B.nk  Draft,  made  payal  le  to  THEODORE 
KUIjL,  .Shaftesbury  Avenue,  London,  W. 

rSKULL'S  NEW  OKONITE  TRUSSES  are  manuf  ctured  in  three  di-tinct  qualities  at  the  following  prices. 

BestQIy.     Med.Qlty.    Com.Qlty. 
Sinsle  Truss,  fo  •  riglit  or  left  sid.-,        -        each     4.">/6  3,5/o  25/0 

D  ubie  Truss,  for  botli  sides,     ...  «•         91/-  7./-  51/- 

M  BA8URBMENTS  Requirkd. — The  entire  circumference  round  the  body  two  inches  below  the  top  of  the  hips, 
In  a  line  with  the  protrusion.  State  if  the  rupture  is  on  the  right,  left,  or  both  sides,  or  at  the  navel,  and  about  the 
■■iae  of  protrusion,  and  any  special  characteristic  of  the  displacement. 

THEODORE    SKULL,  Surgical  IiiNtrunient  and  .^pplianc  maiiiirartiirtT, 

•1  SHAFTESBURY  AVENUE,  LONDON,  W.  (Two  mintites'  walk  from  Piccadilly,  Cxford  and  C;mbride9  Circase:. 

ESTABLISHED    1863 
Manufacturer  of  all  kinds  of  Surgical  instruments,  Trusses,  Belts,  Obstetric  Binders,  Elastic  Stockings,   Knee 
•C»p«,  Anklets,  Suspensory  Bsuidages,  Enemas,  Syringes,  Pessaines,  Rubber  (Joods.  etc.    Kull  particulars  mailed  free. 


ADVERTISEMENTS. 


We 

have  them 

on  the  List. 


IB I 


'■^-i  5  Grains  each.     ^_^      .  "f  j 


#1      LACTOPEPTINE  / 

"*' 

t.  laclopeptine  conuiinsjil  known  SubsLmccsT 
T  employed  byNaUireinllieDigesiknioial 
kinds  of  Food. 
».  SupfriorloalloiherReinaiicsiorDj.s' 
>  pepsialndigc-slion  and  kindred  ail-  <' 
V  men(s  dueloDijJcsiiveOi'hiiili;    /^W 


*;  Dost?ro4  lAeuiS/infRfArHMfAt  jt 

*  THf  NfWrORK  PMSMAMl  KSSOCMTlOl*  ,«*i 

*  -»    NfW  rORK.  *  i.v 

1 


Inasmuch  as  the  tab- 
1ft  method  of  medi- 
cation has  become  so 
popular,  both  with 
physician  and  patient, 
we  have,  at  the  request  of  a  number  of 
Practitioners,  added  Lactopeptine  Tablets,  5  grs. 
each,  to  our  Hst.  To  further  increase  their  therapeutic 
efficiency,  as  well  as  to  add  to  their  palatabilit)-,  we 
have  incorporated  with  the  Lactopeptine  a  small 
quantity  of  the  digestive  principle  of  the  pineapple 
juice,  which  recent  researches  have  shown  to  possess 
considerable  digestive  power.  To  render  impossible 
any  substitution  of  inferior  products,  each  individual 
tablet  is  plainly  stamped  with  the  initials  N.  Y.  P.  A. 


Always  look  for  these  letters,   doctor,    when    d"s- 
pensing  Lactopeptine  Tablets,  and    caution   your 
patient  to  do  so  w^hen  you  prescribe 
them.  %a«^B^WS7»M[M  w^Wiki^-<^ 

Put  up  in  bottles  containing 

100  3-gr.  Tablets  and  50  s-gr.  Tablets. 


Canada  Branch  : 

30  Wellington  St.  East 


TORONTO. 


xx 


ADVERTISEMENTS. 


XlhoiiisattTids  off  Plhysacians  i 
oo  00  are  now  lUsSinig    .     ,     t 


team  SterS liters  \ 


at  Hospitals  and  in  their  offices,  for  Sterilizing 
Instruments,  Dressings  etc.,  and  recommending 
the  Family  Sizes  to  their  patients  for  Sterilizing 
or  Pasteurizing  milk. 
We  make  Sterilizers  for  every  purpose,  and 
have  circulars  giving  complete  information. 
Address, 

WiLMOT  Castle  &.  Co. 

112    ELM   ST,  ROCHESTER,   N.   Y. 


SUBSCRIPTION 


si.oo 


PER  ANNUM. 


Now  is  about  the  rig^ht  time  to 
■     send  it  to  the 

U0n  medical  Review  Go. 

TORONTO,  ONT. 


DYSP 


Also  Special  Dia 
a7id  Fatrnl  Bi^cu 

I  iirlvnlid 

Pamphlets 

Write  i'  arwell  &/iliiuei 


FLOUR. 


Barley  Crystals, 
Pantry  Flour, 

Europe. 

pies  Free. 

.ertowiVN.y.,  U.S.A. 


BA 

IS'ew  Diuretic,   II 
Gluten  Dyspepsia 

Pamphlet 

Unrlviilt-a  ill 

Write  Harwell 


CRYSTALS 

i'c    Cereal;  also 
i   Diabetes   Flour. 

mples  Free. 

»k  Heulem,  or 
.N.Y.,U.S-A. 


TELEPHONl 
1963 


presentation 
Addresses 

"fST^ErBT  A.  H.  HOWARD,  R.C.A. 

.53  Kins  St.  E.,  Toronto 


ADVERTISERS     IN 


The  Canadian  fledical  Review 


Beoeive  Prompt  and  Ample  Betarns  for  their  Money  Invested. 


ad\'ertisemp:nts. 


™b  standard 

?  WFE  kSSVlRMlCE  CO. 


..OF.  . 

EDINBURGH,  SCOTLAND. 


ESTABLISHED   1825. 


HEAD  OFFICE  FOR  CANADA,   -   MONTREAL. 


TOTAL  ASSURANCE,        ....  qVER  $113,000,000 

TOTAL   INVESTED   FUNDS,        -        -        .  '<         39,000,000 

BONUSES   DISTRIBUTED,           ...  «         28,000,000 

ANNUAL   INCOME, "            5,139,000 

TOTAL  ASSURANCE   IN   CANADA,     -        -  "          14,000,000 

TOTAL   INVESTMENTS   IN   CANADA,         -  "           11,000,000 

World-wide  policies  issued  free  of  charge. 

Thirteen  months  for  revival  of  lapsed  policies  of  five  years'  duration. 


ROBERT  CRAIK,   M.D.,  W.    M.    RAMSAY, 

Dttm  Medical  Faculty,  McOill. 

MEDICAL  REFEREE.  MANAGER. 


A  BICYCLE  that  is  a  BICYCLE  is  the 


STEARNS 

SEE  IT  AT  ... .  Built  to  ride  with  SAFETY. 

THE    BEST   CYCLE    CO. 

'PHONE  582.  iQo  Queen  5t.  West.      -      -       TORONTO. 


ADVERTISEMENTS. 


Fielder  Ulaqfg.  Co., 

442  longe  St.,  Toronto. 


iOiamelled  Ware  for  Hoepitals 
and  Physicians,  and  Cooking 
Utensils  of  any  description. 


Catalogue 
tmd  Price* 
an  application. 


Enamblled  Instruinenf  Trays. 


Enamelled  Bed  Pans. 


OFFICE   OF 

THE  STANDARD  MILK  CO., 
OF  ONTARIO  (Ltd). 


Telephone  3384  . 


Toronto,   Dec.  26th,    1894. 


DOCTOR: 

ONE  MOMENT,  PLEASE! 

We  do  not  want  you  to  recommend  our 
milk  hecause  we  advertise  in,  a  Medical  Journal, 
but  for  the  reason  that  our  milk  is  better  for 
either  the  sick  or  well.  If  ou  are  not  conversant 
with  our  rruethod  of  handling,  please  do  us  the 
favor  of  reading  our  descriptiv  circular,  or  we 
would  he  glad  to  Jiave  you  call  and'  examine  for 
yourself. 

Yours  truly, 

The  Standard  Milk  Co.  of  Ontario,  Ltd., 

601  Yonie  Street, 


TURKISH  BATHS 


204  KING  STREET  WEST, 

0pp.  St.  Andrew's  Church. 


Toronto 


•Phone    12  86. 

These  baths  are  constructed  upon  the  best  scientific  principles,  •whereby  purified  heated  air 
is  circulated  through  the  rooms  continuously,  and  the  impure  air  is  quickly  removed.  The 
largest  marble  plungi/  bith  on  this  continent.  These  baths  have  been  highly  endorsed  by 
the  profession.    Open  every  day  and  ALL  NIGHT.    For  further  particulars  call  or  address 

THOMAS  T.  COOK.  Proprietor 


MASSAGE 


References  from 
Leading  Physicians 

'Phone    128G 


THOMAS  J.  R.  COOK, 

Gradual'  of  West  End  Hospital  for 

Nervous  Diseases,  London,  Eng. 


EXSHAW'S  BRANDY. 

DELBECK  CHAMPAGNE. 

LEST  A  PIS  CLARET. 


Wi 


.  .  .  The  above  goods  are  highly  recommended  -where  stunulants 
are  required,  as  their  age  and  purity  is  guaranteed.  .  .  , 


For  Sai«  by  .  .  . 


GEO.  W.  COOLEY,      . 

Imporkr  of  Bigh-Class  Wines  and  Spirits, 

567    YONGE    STREET,       ....       TORONTO. 


TtLEPHONE    3039. 


} 


v_ 


flDercbant  Zlailore. 


BUSINESS  ESTABLISHED  1842. 

Choice  WOOLLENS,   and  Good 
Work  at  Reasonable  Prices. 

ALSO  A    FULL  RANUE  OF 

FURNISHING  GOODS, 
GLOVES, 

NECKWEAR, 

UNDERWEAR, 
HOSIERY,  Etc. 

57  King  St.  West 

TORONTO. 

T*l*pfaoiie    2468. 


MACNAB  &  CO. 

274  Yonge  Street, 

TORONTO. 

Manufacturers   of 

LADIES' 

AND 

MEN'S 


FURS 


ANTN 

DIPHTHERITIC 
SERUn.  THIS 

ANTITOXIN 


IS    PREPARED    IN 


Our  Own  Bacteriological  Department 

BY   EXPERT   BACTERIOLOGISTS 


Every  precaution  known  to  the  science  has  been  taken  to 
insure  its  reliability      .... 


$3.50    PER   VIAL. 

Flach  vial   contains   looo  normal  Antitoxin    units,  the  full 
curative  dose  for  average  cases 

Directions  for  injecting  the  Serum   accompany  each  vial. 


Correspondence  upon  this  subject  respectfully  solicited. 


Parke,  Davis  &  Cohpany 

WALKERVILLE,   ONT.