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time of administration. In 12 to 24 hours after the chill, he gave 6 to 10 grs. of quinia with of a grain of morphia, afterwards 4 to 8 grs. every 2 to 3, hours with smaller doses of morphia, until 50 or 60 grains of the quinine had been taken. Sometimes 25 grains would be sufficient, with this came a marked diminution in the pulse, a fall of temperature, slower respiration, in short the disease was aborted. All that would necessary after this was a laxative of blue mass, followed by a saline cathartic and elimination by the kidneys. If the disease was seen later in its course, the morphia should be given in smaller quantities but the quinia in the same doses.

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In the discussion of the paper, Dr. Gallagher thought the disease would get well without much treatment under good hygienic rules and good diet, and that the disease was much milder than it was 30 years ago; then the fever and pain being more intense required the lancet; but at the present time he regarded it improper. He doubted very much the power of quinine to control the disease when there was no malarial complication. He depended upon aconite and good diet.

Dr. Hibbard, of Indiana, always looked for the natural tendency of the disease, and was careful about using remedies that would do any harm.

Dr. Scott, of Ohio, said, if his pathology was correct, he could assist very much the obstruction to the flow of blood. In his opinion, the teachings of Todd and Ziemsen had done a great deal of harm, and the lancet and calomel to-day were as potent as any remedies at our command. He did not believe that the lungs never recovered from an attack of this kind, but thought that they fully recovered their functions, even if exudation was never thoroughly absorbed.

Dr. Schenck, of Kansas, differed from his Indiana friend (Hibbard), and observed that a great amount of good could be done by the physician. He liked the supporting plan of treatment better than anything he had ever tried, and was inclined to agree with Dr. Palmer in the assertion that quinia was a very powerful agent in controlling the disease, as he had once an occasion to try it on his own person when suffering from such an attack.

Dr. Murphy, of Cincinnati, did not believe that quinia, nor any other drug would be able to abort pneumonia. The very best authorities agreed that the disease would run a natural course and was self limited. In his opinion there was not much of value in the paper anyway. He thought the main thing for the practitioner to do, was to look out for complication, the pneumonia would get well of itself.

Dr. Yandell, of Kentucky, did not believe pneumonia a disease of itself, but rather the result of malaria or a catarrhal condition. The cause should always be found out and treated, whether this be malaria, struma or syphilis. He had seen malaria everywhere, and did not believe there was a place known where it might not abound. It was the cause of most acute diseases.

Dr. Carpenter, of Iowa, thought that in this disease the patient should be well supported from the start.

Dr. Bailey, of Louisville, thought the disease was the same now as it always had been, and always resorted to antiphlogistic remedies. He thought the cold bath, as had been suggested, very injurious, but believed he had seen the very best results from quinine.

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THE EFFECTS OF MEDICINE IN SMALL DOSES. BY DR. JOHN MORRIS, OF MARYLAND.-The writer thought that altogether too much medicine was given by the profession; that a great many drugs were used in such quantities as could only in part become absorbed; that they then acted as irritants, or passed away out doing any good. He spoke at length of the following drugs, the peculiar action of each when used in minute doses, and the diseases in which they were particularly valuable, i. e., Calomel, Iron, Quinine, Alcohol, Tart, Antimony, Ipecac, Aloes, Rhubarb, Opium, Gelseminum, Squills and Ergot. Nothing new was elicited from this resume of materia medica, and the paper closed with the following deductions:

1st. That the true physiological effect of medicine may be best attained by the administration of small doses frequently repeated.

2d. That medicines thus given are cumulative in their operation.

3d. That the effect of remedies is greatly increased by combination, the manner of preparation, the time and mode of administration.

4th. That large doses of remedies act as irritants; that they produce an abnormal state of the blood, as is evidenced by such conditions as narcotism, alcoholism, iodism, ergotism and bromidism.

5th. That more especial attention should be given at the bed side to the influence of remedial agents, to the end that a greater certainty may be exercised in their prescription.

SECOND DAY, JUNE 6.

REPORT ON CLINICAL AND METEOROLOGICAL RECORDS. BY DR. N. S. DAVIS, CHICAGO.-After speaking of the importance of the work under consideration, as the only true method by which we may be able to get at the cause of disease, he hoped for a more extended co-operation on the part of medical men in different parts of the country. For some time past he had been making close observations in this city on the subject. He produced statistics and abundant evidence from meteorological reports, not only here but in Cairo, Davenport and Omaha, to show that the meteorological changes in these parts, giving a high range of temperature and humid atmosphere, co-existed with certain body changes.

The conclusions of the paper were:

1st. That bowel affections begin their annual prevalence when continuous warm weather prevails.

2d. That every subsequent occurrence of several days and nights of high temperature, causes new attacks to be incurred throughout the month of July, less in August, and still less in September.

3d. That it is not simply extreme heat, but the continuance of it for several days.

4th. That continuous high heat, to be effective, must follow a protracted season of cold.

5th. If we compare these deductions with mortality, we find that they are confirmed.

CASES SHOWING THE INFLUENCE OF COLORADO CLIMATE IN CONSUMPTION. BY DR. CHAS. DENNISON, COLORADO.This paper was a supplement to a report made by him last year. He said he wished to avoid the criticism of a certain lengthy report of doubtful cases, "that its publication was very unfortunate for the writer, as well as for the invalids;" that he preferred to look mainly on the bright side, to run the risk of his conclusions being called rose colored by the inconsiderate reader. At the same time he felt keenly the responsibility of drawing conclusions which would lead those seriously diseased to try to prolong their lives in the Rocky Mountain region. The pros and cons should be equally and faithfully represented till at length we could decide, by the evidence of past experience, the best course for all forms of phthisical patients to pursue, so far as climate is concerned. He then gave the history of six favorable and six unfavorable cases, that were chosen from the records of over 100 phthisical patients that had been under his care. From the analysis of these he concluded, that the favorable influence of high altitude in phthisis is best shown in the incipiency of chronic inflammatory and hæmorrhagic cases, and in others as these characteristics exist, the measure and severity of disease, the inheritance and mental state being taken into account, and a partial recovery necessitating a permanent residence.

On the other hand, the unfavorable influence of high altitude on phthisis is shown as the disease approaches or is complicated with the following conditions: Cardiac disease associated with increased labor and abnormal activity, the stage of softening in acute cases (especially with a uniformnly rapid pulse and high temperature) associated with extensive deposit, irritable nervous state, and lack of courage to do in order to be well.

Dr. Bowditch, of Boston, referred to cases where the lower part of the lungs were first affected, and the patients visited. California with considerable benefit, and finally recovered en

tirely after a residence of a year or more in Europe. He had observed also that patients would go to Colorado and other places and get better, and the moment they returned to their old locality they would get worse again. He had always been doubtful about sending patients away from home when they had reached the stage where crackling sounds could be heard in the lungs. He was of the opinion that if patients were sent to Colorado, they should remain there permanently, if they received any benefit from such a change of climate.

Dr. Ulrich, of Pa., remarked that there was a general agreement in the profession, that the object of treatment in phthisis was to better the general condition of the patient, and support nutrition by proper food, and surround him with circumstances favorable to the proper assimulation of that food. He was living in a manufacturing city, and among the mills were found many cases of phthisis, and it became his duty to prescribe for such cases very often. Whenever he was able to induce them to leave their in-door employment, and the impure atmosphere, for some more active, out-door occupation, and surround them with better hygiene, he found that the disease was very much ameliorated, and in some absolutely cured. He thought it was getting too fashionable to send patients away, when a radical change of occupation and living at home would be equally beneficial.

Dr. Kingsley referred to the fact, that patients going from St. Louis to Colorado were very much benefited, but upon returning, the disease had developed rapidly, and the patients died in a very short time.

Dr. Scott, of Ohio, was inclined to agree with Dr. Ulrich, that by change in occupation and mode of living at home, about as much good could be obtained as by sending patients

away.

THIRD DAY, JUNE 7.

REPORT OF COMMITTEE ON BOVINE VACCINATION. DR. H. A. MARTIN, MASS.-Dr. M. said this work was first introduced by him in 1870, and his is now the only original part of the Beaugency stock as it existed in Paris before the war. He presented in full the disadvantages of the other method when

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