TERMS OF SUBSCRIPTION:

Two DOLLARS A YEAR, when paid in advance, otherwise, $2.50, in the United States, Alaska, Cuba, Porto Rico, Mexico, the Hawaiian and Philippine Islands. In Canada, $2.50. In Great Britain, 10 Shillings. In France, 12 Francs. In Germany, 10 Reichsmarks.

These rates include postage only on subscriptions paid in advance. Extra postage will be charged on subscrip tions not paid within four months, to conform with the new postal laws and regulations pertaining to the second class of mail matter.

The address tab on the wrapper of each copy sent by mail shows the date to which the subscription has been paid.

Money can be sent safely by registered letter, bank draft, check, postal or express money order.

Make all remittances payable to the order of MEDICAL REVIEW OF REVIEWS COMPANY.

DECEMBER 25, 1908.

TRANSMISSION OF TYPHOID FEVER.

There can be no doubt that typhoid fever is frequently contracted from the drinking of water polluted by sewage, and yet it has been impossible to connect outbreaks of this disease with drinking water in about 50 per cent. of all cases. There can be only one explanation of this fact, viz., polluted drinking water is only one of various other means of the patient's infection. In an article upon the "Limitations of Water Analyses as Aids in Determining the Causes of Typhoid Outbreaks" in the last number of the Monthly Bulletin New York State De

positive proof of the existence of typhoid bacilli is commented upon, and we infer that the so-called secondary infection. plays a most important part in the spread of the disease. Colon bacilli found in water are not necessarily of human origin, and, if they are, unless they can be traced to a patient suffering from the disease, they may not be a source of infection. It is evident that if the bacilli are not of human origin, contracting typhoid from such a source is impossible.

In Bulletin No. 44, issued by the Hygienic Laboratory, which comprises the report on 670 cases occurring in the District of Columbia, a large proportion were children under 10 years of age. Concerning this fact the commission conducting the examination says:

"The rather large proportion of cases among children points especially to two factors in the transmission of typhoid fever-contact and milk. Large numbers of children from many households are in free and intimate association in playing, so that the chances of spread of infection among them by direct or indirect contact must be greater than among adults.

"Furthermore, mild and irregular attacks of typhoid fever are known to occur with greater frequency in children. than in adults, so that the spread of infection by contact from unrecognized cases among children must be correspondingly more frequent.

"Children drink more milk than adults, so that where milk is a frequent source of infection a relatively large number of cases among children may be expected.

"In considering the number of cases among children in a community where typhoid fever has prevailed extensively for a number of years we have to take

into account that a proportionately larger number of adults have been rendered partially or completely immune by previous infection.

"Contact between child and child and between child and adult is of a close and intimate nature and such as to favor the spread of the infection of typhoid fever. Considering this fact, along with the known extensive prevalence of the disease among children, we have a possible explanation of the spread of the infection to many of the cases unaccounted for by epidemiological investigations, thus robbing the general problem of some of its mystery. Koch found that 49 of the 64 unrecognized cases of typhoid fever at Trier occurred among children."

The question of contagion, which some of us have ignored, is well recognized in the above statements, and it is further stated in the report that of 523 cases studied in 1907, 19 per cent. were fairly definitely attributable to infection by direct or indirect contact.

The infection of milk is, of course, an occasional cause of typhoid, and the house fly as a carrier of infection has been recently studied by the committee of the New York Merchants' Association and their results published.

These remarks are not to be construed as in any sense favoring neglect of the character of the water supply.

Allen Hazen has formulated the theorem that for every death from typhoid fever prevented by the purification of public water supplies two or three additional deaths from other causes are prevented. To put the matter upon an economic basis: If, for example, the city of Pittsburg should, by reason of having installed a new system of municipal water filters, prevent 100 deaths from typhoid in a year, 200 or 300 deaths from other

causes would also be prevented by the

same means.

Professor Sedgwick and Mr. Scott MacNutt of the biological department of the Massachusetts Institute of Technology state that their observations, presently to be published in detail, corroborate Hazen's estimate, which they assert is a conservative one.

We write to urge a continued study of the various methods of transmission of typhoid fever. If the disease is contagious as well as infectious, an accurate knowledge thereof would modify our methods of dealing with epidemics of the disease. Complete knowledge is far better than partial knowledge in any subject, and especially so in a case of this importance.

PUERPERAL ECLAMPSIA.

In any disease that is not thoroughly understood or in those in which exact knowledge is still lacking there are, as a rule, many and varied theories regarding its origin. Eclampsia is one of these diseases.

So many hypotheses have been advanced in this condition that Zweifel has well termed it "the disease of theories." The earlier writers considered eclampsia as a disorder of the nervous system, but according to Dr. J. Whitridge Williams this conception is no longer entertained. Lever, as a result of his experience, claimed that eclampsia was identical with uræmia. In 1870 Spiegelberg advanced the theory that the convulsions were due to ammonium carbonate in the blood, but this is not so. In 1884 it was suggested that bacterial infection was a cause of this disease, but culture from the blood of such cases gave negative results. The theory of autointoxication is much more

promising, and is practically the one generally accepted today.

All modern writers are agreed that eclampsia is always a preventable affection. Some time back Stoltz drew attention to the fact that pregnant cases with œdema were less likely to have eclampsia than those in which it was absent.

Now comes another theory. In the September number of Archiven für Gynækologie A. Dienst has an exhaustive paper on this subject in which he favors. the idea that eclampsia is the result of overaccumulation of fibrinogen and fibrin

ferment in the blood. He claims that the increased physiological demands of pregnancy induce hyperleucocytosis, with the consequent destruction of leucocytes. This destruction liberates fibrinogen and fibrin ferment. The Doctor further claims that a large proportion of the leucocytes are destroyed in the placenta, and it is possible that all the milder disturbances of frequency are the results of this destruction. As the liver is unable to neutralize the excess of fibrinogen, a vicious circle is formed, and pregnancy kidney, dropsy and eclampsia are liable to follow. The fibrin ferment is certainly an amboceptor, and experimental re

search has demonstrated the possibility of obtaining an antifibrin ferment.

The theory certainly seems a plausible one, but it is too early to draw any definite conclusion from the evidence thus far obtained. W. B. J.

PLAGUE ON THE PACIFIC COAST.

The last number of Public Health Re

ports received from the United States Public Health and Marine Hospital Service gives gratifying assurance that the plague has practically disappeared.

In San Francisco the last case occurred in February, 1908. Oakland has had no new case since November, 1907, and in Seattle, Wash., the last cases were in October, 1907.

On the entire Pacific coast there have occurred a total of 180 cases and 91 deaths.

The search for infected rats and other possible sources of infection is being continued by the department. The danger is passed, and the entire country is under the greatest obligations to Surgeon-General Wyman and his subordinates for their effective management of what might have become a serious situation.

Medical Society, County New York.At the one hundred and third annual meeting of the Medical Society of the County of New York, held on November 23, the following officers were elected: President, Dr. H. Seymour Houghton; first vice-president, Dr. John E. Weeks; second vice-president, Dr. Joseph Brettauer; secretary, Dr. John Van Doren Young; assistant secretary, Dr. J. Milton Mabbott; censors, Drs. Charles G. Ker

ley, Henry M. Painter and J. Riddle Goffe.

The Study of Old Age.-It is announced that the share of the Nobel prize which goes to Professor Metchnikoff is to be devoted to a continuation of his studies on old age.

School Surrenders Charter.-A petition has been filed by the stockholders of the Western Pennsylvania Medical Col

lege, Pittsburg, asking permission to surrender all powers contained in its charter and for a dissolution of its corporation. The petition states that the corporation has sold and conveyed to the University of Pittsburg all its real estate, equipment and physical assets.

Cholera in the Philippines.-During the week ended September 26 there were 314 cases of cholera, with 184 deaths, in the city of Manila, and during the same week 1122 cases, with 745 deaths, were reported from the provinces. During the succeeding week 67 cases of cholera and 33 deaths were reported from Manila, and 1666 cases, with 977 deaths, from the provinces. On account of two cases of cholera having occurred on the United States Army transport Sheridan the steamer was disinfected and held in quarantine for seven days.

Medical Alumni Lectures.- The Yale Medical Alumni Association has arranged for its twelfth series of lectures on medical topics to be given at the university this fall and winter. The first lecture of the series was by Dr. Edward R. Baldwin, '90, M., of Saranac Lake, N. Y., on the subject "Hypersusceptibility of Tuberculin in Tuberculosis: Its Physiological and Clinical Importance." The lecture will be delivered in Osborn Hall on Tuesday evening, December 1, and will be followed by a reception at the house of Dr. Henry L. Swain, '84, M., at 232 York street. The committee in charge of the alumni lectures consists of Dr. Wm. H. Carmalt, professor emeritus of the principles and practice of surgery; Dr. Wm. F. Verdi, '94, M., and Dr. John Edward Lane, '94, clinical assistant in medicine.

active control of Harvard University policies means a great deal more than the bare statement of fact carries. During the last quarter of a century only a few men in this country have exercised as great an influence on American university education as President Eliot. Few men have been so original; none have been more courageous. But while Harvard will be the immediate loser, the cause of the higher education and of a lofty civic conscience in this country will, we anticipate, gain by the greater leisure and free

dom which will now come to him. Certainly the country will not let him retire. any further. He was Harvard's; now he will be, in a larger sense than ever before, the servant of the citizens of the country. And this, judging from his past services, will be a matter for general congratulation.

A Testimonial to Dr. Byron Robinson.The students of Dr. Byron Robinson of Chicago are erecting a bronze bust of him. The affair is in the hands of Dr. Benjamin Orndoff, 2277 Wilcox avenue, Chicago, Ill.

Dr. Thomas E. Satterthwaite received. the degree of doctor of laws from the University of Maryland at the celebration of Academic Day in Baltimore November 11, 1908.

Dr. John F. Erdman was appointed professor of surgery for the ensuing year at a meeting of the board of directors of the New York Post-Graduate Medical School and Hospital held October 7, 1908.

L'Argus de la Presse, destroyed by a terrible fire six months ago or more, is completely reorganized and re-established at Faubourg-Montmartre. L'Argus des Revues, special publication, has never ceased to be published. With regard

to the Argus de l'Officiel and the Archives de la Presse, both are in operation, as in the past.

American Association of Obstetricians and Gynecologists.-At the twenty-first annual meeting of this association, which was held in Baltimore, Md., on September 22, 23 and 24, the following officers were elected to serve for the ensuing year: President, Dr. William H. Humiston of Cleveland, Ohio; first vice-president, Dr. James Edgar Sadlier of Poughkeepsie, N. Y.; second vice-president, Dr. William A. B. Sellman of Baltimore; secretary, Dr. William Warren Potter of Buffalo, N. Y., re-elected; treasurer, Dr. X. O. Werder of Pittsburg, Pa., re-elected. The next annual meeting will be held in Fort Wayne, Ind., in September, 1909.

An English-Chinese Lexicon of Medical Terms, prepared by Dr. Philip B. Cousland, has just been published in Shanghai. Though the author is an Englishman by birth, he has based his book largely upon the medical dictionary of Dr. George M. Gould of Philadelphia, a high compliment to American scholarship. Dr. Cousland has recently published a translation of Professor Halliburton's edition of Kirkes' "Physiology."

DEATHS.

ADAMS.-In Oakland, Cal., November 20, 1908, Dr. Frank L. Adams, aged 50 years.

ALLEN.-In Pittsfield, Mass., November 6, 1908, Dr. Justin Allen, aged 82 years.

AMES.-In Danvers, Mass., November 12, 1908, Dr. Azel Ames, aged 63 years. ANGLE. In Brockton, Mass., November 20, 1908, Dr. Henry Frederick Angle, aged 68 years.

APPLEWHITE.-In Brookhaven, Miss., November 21, 1908, Dr. Rufus Revill Applewhite, aged 70 years.

ATKINSON.-In Staunton, Va., November 18, 1908, Dr. Benjamin M. Atkinson, aged 78 years.

BABBITT.-In East Orange, N. J., November 23, 1908, Dr. George E. Babbitt, aged 49 years.

BARKSDALE.-In Laurens, S. C., November 6, 1908, Dr. John A. Barksdale, aged 87 years.

BEAN.-In Rutland, Ohio, November 2, 1908, Dr. George H. Bean, aged 67 years.

BECHTEL.-In Philadelphia, Pa., November 12, 1908, Dr. David K. Bechtel, aged 63 years.

BLACKWELL.—In Perth-Amboy, N. J., November 18, 1908, Dr. Lewis S. Blackwell, aged 75 years.

BOONE. In Colorado Springs, Col., November 10, 1908, Dr. George P. Boone, aged 32 years.

BOYNTON. In Burlington, Vt., November 14, 1908, Dr. Charles Smith Boynton, aged 72 years.

BROWN.-In Ludlow, Vt., November 2, 1908, Dr. Charles A. Brown, aged 49 years.

BROWN. In Elkins, W. Va., November 5, 1908, Dr. William A. J. Brown, aged 50 years.

BULA.-In Indianapolis, Ind., November 10, 1908, Dr. Rolla W. Bula, aged 60 years.

BUTLER,In Smithdale, Mass., November 1, 1908, Dr. Franklin E. Butler, aged 59 years.

CAMPBELL.-In Rochester, N. Y., November 6, 1908, Dr. Joseph Gills Campbell, aged 38 years.

CANTLIE.-In Montreal, Canada, No