partner, and this ought of itself to be a sufficient reason against such alliances. But beyond this we have the danger to the offspring, which, serious enough when one parent is a victim of the disease, is increased fourfold when both are tuberculous. There are still other good reasons why consumptives should not marry, the dangers of child-bearing and the detrimental effects of sexual intercourse, for example. While something can be accomplished by education, restrictive laws against the marriage of the tuberculous will be needed to reach those who will not voluntarily deny themselves for the public good and the welfare of posterity. McSwain believes a national law would be required to be effective, but we should do what we can in the way of educating the public as to its necessity. fection of fæcal matter in the bed-pan apply exclusively to diarrhoeic stools, and are insufficient in regard to solid fæces. 2. The deep action of a 10 per cent. solution of cresol soap and a 20 per cent. solution of calcium chloride, upon solid fæcal matter, remains very slight even after prolonged action. 3. The frequent appearance of solid stools (one-fifth to one-third of all cases of typhoid fever) necessitates distinct specification in the various rules for disinfection, instructive pamphlets, etc., with a proper modification of the rule intended for diarrhoeic stools. 4. Caustic soda, in a 15 per cent. solution, has a considerably greater deep action than the above-named agents, but it can be employed in certain special cases only. 5. In a general way, a 10 per cent. cresol-soap solution will have to be employed, but the duration of its action upon solid stools will have to be extended considerably beyond the time of two hours, as stated in the rules of disinfection now in use. F. R. THERAPEUTICS AND RADIOGRAPHY UNDER THE CHARGE OF G. M. MACKEE, M.D., Radiologist and Radio-Therapeutist to St. Vincent's and the Red Cross Hospitals. HolC.S., The X-ray Treatment C. Thurston of Exophthalmic Goitre land, M.R., etc. (Archives of the Roentgen Ray, July, 1908). As a result of the treatment and careful observation of 20 cases of exophthalmic goitre Holland has noted the following points: 1. In nearly all the patients there was an immediate drop in the pulse-rate following upon the first three. or four exposures, and this, in some of the cases, was very noticeable. Further, the pulse-rate remained reduced. 2. The muscular tremors, and general nervousness also, almost always showed signs of improvement from the first and continued to improve during the course of the treatment. In two of the cases the pulse became normal and the tremors, etc., quite disappeared. 3. The circumference of the neck, taken over the most prominent part of the gland, in some cases diminished notably, while in others no diminution in size occurred. Perhaps what was more noticed was that in cases where the gland was tense and hard, and where there was throbbing, almost always after a few exposures the gland became softer and less tense and the throbbing diminished. 4. The exophthalmos was not materially altered in any of the cases. where it was a marked feature. The author's description of the techniques employed is very unsatisfactory for the reason that he fails to mention the strength of current, type of apparatus, vacuum and many other important points. To avoid radiodermatitis the ray was filtered through two layers of thick boiler felt. The exposures were of 10 minutes' duration on alternate sides of the neck, two or three times weekly, according to the effects noted. Attention is called to the possible dangers of overtreatment, and mention is made of a case treated by Dr. Bruce where about 120 exposures were given in one year and which were followed by symptoms suggestive of myxedema. The author considers the findings of the Mayo brothers as being very interesting. These excellent observers began experimenting with the X-ray treatment of exophthalmic goitre in 1903. They had noted, in operating upon cases of cervical adenitis which had been exposed many times to the X-ray, that the lymph system was greatly sclerosed. Acting upon this hint, they tried its effect upon exophthalmic goitre. They were unable to produce a cure, but reported great benefit, especially as regards the amelioration of the general nervousness, the muscular tremors, the tachycardia and, lastly, the exophthalmus. They further add that the benefit was sufficient to give this method a place in the treatment of Graves' disease, or, at any rate, to make it a preparatory treatment to a prospective surgical operation at a later period. Oxygen in Medicine A Contribution, with and Surgery Report of Cases. By William Seaman Bainbridge, M.D., of New York city (New York State Journa! of Medicine, June, 1908). In this contribution Dr. Bainbridge gives a very clear and exhaustive résumé of the therapeutic history of oxygen from the time of its discovery by Priestley to the present day, his purpose being to stimulate scientific interest in a subject which has so long and so generally been consigned to the realm of the pseudo-scientific and the "quack." He reviews what has been done by others in subcutaneous injections. of oxygen, in intravenous infusion, in obstetrics, in gynæcology, in pædiatrics, in general therapeutics and in surgery. While he has for a number of years employed the gas by various methods, in the present communication he deals exclusively with his experiments in the abdominal administration, reporting a series of 16 cases in which it has been employed by him with very satisfactory results. Cyanosis was found to be lessened, the surfaces of the wound became redder, the pulse and respiration improved and shock. was distinctly lessened. Blood pressure was not materially influenced. Abdominal tenderness and pain were much less than often follows laparotomy, there was less nausea and vomiting, the bowels moved more readily, the appetite was better and the patient was not so restless. A series of animal experiments, scientific records of which were accurately kept by Dr. Harold Denman Meeker, are also detailed by Dr. Bainbridge. These expe riments were made upon cats and were conducted along the following lines: (1) To determine the absorbability of oxygen. (2) To determine its effects upon (a) blood pressure, (b) pulse, (c) respiration, (d) degree of anesthesia, (e) time of recovery after anæsthesia. (3) To effect a comparison between the results upon the above when oxygen is employed and when air is employed. (4) To determine the danger point of intra-abdominal pressure as manifested by a fall in blood pressure, respiratory embarrassment and cardiac failure. (5) To determine the effect of oxygen upon adhesions in the abdominal cavity. A study of these experiments leads to the following conclusions: (1) Oxygen is completely absorbed in the abdominal cavity. (2) It is a slight respiratory stimulant. (3) It is a slight (3) It is a slight cardiac stimulant. (4) It has but little effect upon blood pressure when the pressure of the gas is moderate. (5) It tends to bring an animal quickly from deep anæsthesia. (6) It hastens the recovery of an animal after discontinuance of the anæsthesia. (7) A pressure of more than 1500 mm. of water may cause collapse. (8) Oxygen tends to prevent the formation of adhesions. (9) It quickly changes a dark blood to scarlet in cases of anoxæmia. (10) It stimulates intestinal peristalsis. (11) It is not an irritant to the peritonæum or abdominal viscera. In conclusion, Dr. Bainbridge evolves a scheme of possibilities for oxygen therapy. While it is not his purpose to advocate the indiscriminate and careless use of oxygen "by those whose tendency it is to follow every therapeutic will-o'-thewisp." he wishes to stimulate practical interest in a subject which his own experi 1907). The observation to the effect that the sulphur preparations are often of very unequal efficiency is referable to the more or less finely distributed form of the sulphur in the preparation employed. In the author's experience, a constant and uniform effect was obtained by means of pared by rubbing up a quantity of still a 30 per cent. sulphur ointment, premoist, newly precipitated sulphur, with an ointment vehicle (pasta sulfuris pultiformis). The employment of this sul phur paste was followed by favorable results in cases of scabies, acne vulgaris, seborrhoea of the scalp, pityriasis versicolor, herpes tonsurans, and all forms of seborrheic eczema. Certain cases of chronic eczema as well as fresh efflorescences of psoriasis were likewise favorably influenced. The preparation was painted on the parts two or three times daily, or it was rubbed into the affected skin segments. F. R. ORIGINAL COMMUNICATIONS. MENTAL AND OCULAR OVERSTRAIN IN THE EDUCATION OF CHILDREN. The consequence of educational overpressure are somewhat vividly brought to the attention of the physician when children are sent to him in the early spring with a history of being unable to keep up in their studies. After the continuous strain of the winter's school work there seems to come in March and April to many children a period of reaction which shows itself in physical lassitude, nervous irritability and brain exhaustion. Mental overstrain in children is usually more pronounced in girls than in boys, but in both sexes the physical signs and symptoms are much the same. The child becomes irritable and peevish at home or perhaps querulous and depressed, while at school he will find difficulty in concentrating his attention on his books and seems unable to comprehend as easily as formerly what he is being taught. In many instances the child is still able to master some studies, although in other classes he may be considered stupid or dull. He may have some days in which he grasps and takes in what he is told in brilliant fashion, only to be overcome again with incapacity and mental confusion within a short time. Headache is the chief objective symptom of which the child voluntarily complains, as children do not, as a rule, analyze and express their mental sensations even when questioned. A careful physician can, however, usually elicit evidences of breakdown in the physical lassitude, nervous irritability, incapacity for mental concen tration, and irrelevancy of thought which make up the picture of mental overstrain. This mental overstrain is often complicated by the presence of eye strain due to visual defects. Unfortunately, the child without some error of refraction is somewhat of an exception in the higher grades of school life. Hypermetropia, myopia and astigmatism increase both in percentage and degree as the child advances from primary grade to the high-school classes. Eye strain in these cases tends to induce and aggravate mental overstrain, since the child with defective vision and asthenopic symptoms is forced to use a tremendous amount of nervous energy and mental application to keep pace with his more fortunate comrades. The more ambitious such a child is the more severe are the symptoms of mental and ocular overstrain, and also the more serious is the resultant damage to brain and eyesight. A child with myopia who is usually intelligent or whose parents are anxious for him to excel in his studies can in a few years so increase his nearsightedness through persistently taxing his eye as irrevocably to destroy his acuteness of vision for distance. The astigmatic and hypermetropic children, however, are the ones who present the severest asthenopic symptoms, such as persistent headache coming on after use of the eyes for close work, intermittent blurring of vision, lachrymation, twitching of the lids and other nervous phenomena. Recently a case came to my notice in which twitchings of the lids and facial contortions of five years' duration entirely disappeared with the correction of an astigmatic defect. A child with a high degree of hypermetropia or of astigmatism, or of both, cannot clearly see without considerable effort of accommodation, and he therefore cannot use his eyes for near work for any length of time without symptoms of eye strain resulting. He may very well be considered dull, lazy or stupid when his inability to concentrate his attention is the real reason for his apparent dislike of study. In marked degrees of uncorrected refractive error there is, of course, a considerable impairment of vision constantly present, and those children are doubly handicapped. When we see a child who is bright mentally, and yet who cannot be induced to open a book either for study or pleasure, such a child in most cases has some ocular defect which is responsible for his distaste of reading. Mental and ocular overstrain, in my opinion, often begins in the early years of school life; its resultant effects are merely cumulative in after years. Even in kindergartens or primary schools there is a great deal of mental pressure put upon young children, and a considerable amount of strain upon the accommodation of the eye occurs when close work is given to children five or six years old. When the child goes into the primary grade there begins to be a great strain upon the memory, in that the present school curriculum calls for memorizing of a large number of isolated facts the relation of which he is unable to comprehend. Even the multiplication table can be made a torture to many children who have apparently little or no taste for mathematics. Some children seem to memorize best things which they read, others memorize best things which they see, but, unfortunately, the school curriculum does not take account of individual peculiarities. A bad visual memory may be due to deficient power of observation because of ocular defect. If that child is forced to use his eyes without the correction of his refractive error he will suffer constantly from headache, blurring of vision and lachrymation. In order to prevent this mental and ocular overstrain the school curriculum should be reconstructed. Young children of primary and kindergarten age should not be given any work at close range, and those of higher grades should have their close work only gradually increased in length and variety. It would be better if, instead of having only one or two half holidays in the week, the younger children at least should have three or more, and the hours of daily mental work even in the higher grades should hardly exceed five or six. A child under 15 is not able either mentally or physically to remain at his desk for consecutive periods. Primary and kindergarten children should spend only about one-third of their school time in their seats, the other two-thirds being devoted to rest and play. A noted English authority on pædiatrics has advised that no school lesson, even for older children, should last for more than 45 minutes, and that an interval of 10 minutes spent in fresh air and exercise, not drill, should always elapse between such lessons. This interval is exceedingly important, in that it gives the eyes of the children time to regain strength after the accommodative strain of the classroom, besides being valuable to avoid mental stress and exhaustion of |