this manner of reproduction most adequately
explains the persistence of amoebic infections.
These sporulating bodies appear to be en-
cysted. If this is so, it would still further ex-
plain the persistence of such infections because
encysted parasites are more resistant to inju-
rious influences. — (American Medicine, Feb. 20,
1904; Chas. F. Craig).
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EDITORIAL.
Jour. M. S. M. S.
The Journal of the
Michigan State Medical Society
All communications relative to exchanges, books for review,
manuscripts, advertising and subscriptions should be
addressed to Editor A. P. Biddle, 57 Fort Street West,
Detroit, Mich.
Subscription Price, Two Dollars per year, in Advance
APRIL, 1904
EMtorial
GOVERNMENTAL SUPERVISION
OF BIOLOGICAL LABORA-
TORIES.
In order that the physicians of Mich-
igan may understand the governmental
supervision of biological laboratories, the
following is submitted:
The question of the manufacture and
sale of antitoxin has been one of con-
siderable interest to physicians of late. It
has come to our knowledge that almost
invariably physicians in discussing this
subject were not aware that all biological
laboratories doing interstate business
were operating under special licenses is-
sued by the Secretary of the Treasury
upon the recommendation of the Sur-
geon-General of the Department of Pub-
lic Health and. Marine Hospital Service,
in accordance with the following Act of
Congress, approved July 1st, 1902 :
"An Act to regulate the sale of viruses,
serums, toxins, and analogous products in
the District of Columbia, to regulate in-
terstate traffic in * said articles, and -for
other purposes."
Owing to the length of this Act and its
legal phraseology it will not be of as
much interest to the physicians as the
rules for inspection and issuing of licenses
which were approved by a Sanitary
Board, consisting of R. M. O'Reilly, Sur-
geon-General U. S. Army; P. M. Rixey,
Surgeon-General U. S. Navy; and Walter
Wyman, Surgeon-General Public Health
and Marine Hospital Service.
It will be observed that these regula-
tions are most specific and adequate for
covering all contingencies that may arise
in connection with the manufacture of
these products.
In this connection it may be well to
call attention to the fact that municipal
biological laboratories and institutions
similarly organized, which do not do an
interstate business, are not under the su-
pervision of the Department of Public
Health and Marine Hospital Service. We
believe that it may well happen without
such responsible supervision as the above
that, owing to political and other condi-
tions, there may be a repetition of the sad
experience of the Municipal Laboratory
of the St. Louis Board of Health.
INSPECTION.
1. The inspection shall be made by an
inspector or a board of inspectors detailed
by the Secretary of the Treasury upon
the recommendation of the Surgeon-Gen-
eral of the Public Health and Marine
Hospital Service.
2. The inspectors shall be commis-
sioned medical officers of the Public
Health and Marine Hospital Service
above the grade of assistant surgeons, or
chiefs of division of the hygienic labora-
tory of the same service.
3. The visit of the inspectors shall be
unannounced.
4. It shall be the duty of the inspectors
to call first upon the head of the estab-
lishment or member of the firm, stating
the object of their visit.
5. The ^proprietor of the establishment
being inspected shall extend every facility
to the inspectors to aid them in their
work. The inspectors shall be permitted
to examine all portions of the premises,
appliances, methods, stables, .bams.
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April, 1904.
EDITORIAL.
159
warehouses, records, and, if requested by
the inspectors, shall be shown the meth-
ods employed in actual operation.
6. The inspectors are authorized, when
they consider it necessary, to interrogate
the proprietor, members of the firm, and
employes of the establishment under oath.
7. The inspectors shall investigate fully
the methods of preparation, storing, dis-
pensing of, and other' details in the manu-
facture and sale of serum, viruses, toxins,
and analogous products.
8. The inspectors shall carefully exam-
ine into faulty construction and adminis-
tration of establishments which would
tend to impair the potency or purity of
their products.
9. It shall be the duty of the inspectors
to purchase in open market or, if they
deem it advisable, themselves to purchase
in the establishment a sample of the
products then manufactured, which sam-
ple shall be examined by the inspectors
for purity and potency or forwarded to
the director of the hygienic laboratory for
such examination.
10. It shall be the duty of the director
of the hygienic laboratory of the Public
Health and Marine Hospital Service to
test samples sent him by inspectors for
purity and potency, and the result of this
examination shall be given to the inspec-
tors, who shall give this report due weight
in making their recommendations.
ISSUE OF LICENSES.
1. Licenses shall be issued, suspended,
and revoked by the Secretary of the
Treasury upon the recommendation of the
Surgeon-General of the Public Health and
Marine-Hospital Service.
2. When an establishment shall have
been inspected in accordance with these
regulations and the report of the inspec-
tor passed upon by the sanitary board of
the Public Health and Marine-Hospital
Service, the Surgeon-General of the Pub-
lic Health and Marine-Hospital Service
shall review the findings of the board and
forward same, together with his recom-
mendations, to the Secretary of the
Treasury for action.
3. The following form of license is
prescribed : ( Omitted. )
4. Licenses shall be good for one year
from the date of issue and will not be re-
issued without a reinspection, the report
of the inspector to be passed upon by the
sanitary board and the Surgeon-General
of the Public Health and Marine Hospital
Service, in accordance with the provisions
of paragraph 3.
SUSPENSION AND REVOCATION.
When faulty methods of preparation,
faulty construction, or administration of
establishments are noted by the inspector,
or impurities or lack of potency of prod-
ucts shall be demonstrated by laboratory
examination, the inspector shall bring the
same to the attention of the manufactur-
er, and if the error is not corrected within
fifteen days thereafter the inspector shall
forward a report of the conditions foimd,
together with his recommendations, to the
Surgeon-General, and, if the faulty condi-
tions, upon review by the sanitary board
and the Surgeon-General, shall be found
to be of sufficient importance, the Sur-
geon-General shall recommend to the
Secretary of the Treasury that the license
of the offending establishment shall be
suspended if the said faulty conditions are
not corrected within thirty days, and if
not corrected within sixty days that the
said license be revoked.
E. M. Houghton,
Detroit.
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EDITORIAL.
Jour. M. S. M. S.
SCIENTIFIC EXHIBIT.
All members are urged to contribute
to the Scientific Exhibit at the next an-
nual meeting of the State Medical Society,
May 25th, 26th and 27th, at Grand Rap-
ids. Pathologic specimens, such as tumors
and organs removed by operation, should
be labeled with the name of the surgeon,
a brief history of the case and a descrip-
tion of the operation performed. New
instruments, apparatus, charts, plaster
casts, photographs, skiagraphs or any-
thing that shows advancement in scien-
tific medicine will be placed on exhibition.
It is the aim of the committee in charge
to make this exhibit an instructive feature
of the meeting. The co-operation of all
is desired. Intending exhibitors will
please communicate with some member of
the committee (see page IV) so ample
space may be reserved.
Thaddeus Walker,
Detroit.
* PAIN IN THE KNEE.
Hoffa* gives some very valuable points
on the pathology and therapy of the fre-
quent cases of pain in the knee occurring
after a slight accident. These cases are
usually diagnosed as "rheumatism," or
"neuralgia of the joint." The patients
are treated with massage, baths, anti-
rheumatics, etc. They wander from one
physician to another; go to the various
hot springs; consult osteopaths and elec-
tro-therapeutists without finding relief
from any of these sources. Hoffa shows
that most of these cases can be diagnosed
and treated as one of the four following
affections :
♦A. Hoflfa.— "Contribution to the Pathology and
Therapy of the Diseases of the Knee-joint/' Ber-
.hner Klinische Wochenshrift, (1904, No. 1).
1. Atrophy of the quadriceps-muscle
after hematoma of the joint.
2. "Derangement interne," displace-
ment of a meniscus.
3. Lipoma of the joint. -
4. Free body in the joint.
1. The atrophy of the quadriceps-muscle
after hematoma of the joint is character-
ized by history of a slight accident, follow-
ing which the patient was confined to bed
for a few days with a persistent pain in the
joint. The patient complained of a pain
inside the patella which is caused by the
lack of tension in the capsule of the knee-
joint. The loosened capsule, which nor-
mally is kept at a proper tension by the
extensors, gets pinched, in moving, be-
tween the condyles and patella. Exam-
ination shows the knee-joint intact and
atrophy of the extensor muscles. Mas-
sage and proper exercise of the atrophied
muscles will promptly cure these cases.
2. Dislocation or laceration of one or
both cartilages of the joint. Symptoms
are: (a) history of slight accident after
which the swelling of the joint persisted,
(b) impossibility of completely extending
the joint, and (c) an elastic swelling an
the inner or outer side of the joint, caused
by the displaced cartilage. The main
characteristic is the pain right in the artic-
ular fissure, where sometimes the loose
cartilage can be felt. Rest will improve
these symptoms, but a slight strain will
cause their return.
As to treatment: Replacement of the
loosened cartilage, followed by fixation of
the joint, will sometimes prove effective,
but the classical treatment is incision and
removal of the loosened cartilage.
3. Development of the fatty tumors in
the joint. This solitary subsynoval lip-
oma may vary from the size of a cherry
to that of an egg. It is usually situated
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EDITORIAL.
161
on the internal side of the joint and is of-
ten pedunculated. Besides this solitary
lipoma, Hoffa describes an inflammatory
fibrous hyperplasia of the adipose tissue,
normally situated on both sides of the
patella ligament. Both these conditions
are to be kept apart from the so-called
"lipoma arborescens," which consists of
the fatty degeneration of the "articular
villi." The lipoma of the joint may be
caused by an accident or by irritation of
a loose cartilage or free body. The rec-
ord of these cases show an original acci-
dent'. Then after the first swelling dis-
appeared, an elastic tumor appears, elevat-
ing the patella. Differing from number 2,
this swelling is found on the sides of the
patella, the upper recess of the joint and
the joint fissure proper being free. Par-
oxysmal pains caused by incarceration of
the fatty masses in the joint may also be
present. The treatment should consist of
excision of the fatty tumor. HoflFa men-
tions seven cases that were effectively
cured by this treatment, after splints,
baths, etc., had been tried for years.
4. Free bodies in the joint are easily
recognized by well known symptoms, and
can always be verified by X-ray. The
treatment is surgical removal of the free
body. Max Ballin, Detroit.
Mechanism of Asthma.
Asthmatic paroxysms are due to a vasodila-
tion of the blood vessels of the bronchial mu-
cous membrane. This swelling of the mucous
membrane may be reduced by —
1. Increase of mucous secretion.
2. Vasoconstriction in the affected area.
3. Vasodilation elsewhere or generally.
4. Reduction of the force of the heart's beat.
5. Reduction of the total amount of blood
in the circulation. — (Medical Record, Feb. 27,
1904, p. 341).
Some of the Properties of Radium.
A — ^Radium Rays.
1. a (alpha) rays consist of a flight of posi-
tively charged particles, consisting probably of
either hydrogen or helium, projected with a
velocity of about 20,000 miles a second. These
rays are rapidly absorbed and are stopped by
a sheet of note paper in passing through a few-
inches of air.
2. p (beta) rays are more penetrating. They
consist of negatively charged particles pro-
pelled with a velocity of over 100,000 miles per
second. These particles are the smallest bodies
known to science. They are readily deflected
by a magnetic field. They have been shown
to be identical with the cathode rays produced
in a vacuum tube.
3. 6 (gamma) rays are of an extraordinary
penetrating character. They readily pass
through several inches of lead or of iron and
are very similar in properties to the Roentgen
rays.
B — Heat Emitted from Radium.
Radium does emit a large quantity of heat.
A pound of radium will emit heat energy at
the rate of about 1/15 of a horse power, and
will keep up this rate of heat emission for
probably hundreds of years without any ap-
preciable change.
C — Emanation from Radium.
Radium produces from itself an emanation
or gas which is strongly radio-active. This
can be removed from radium by heat or solu-
tion. One pound weight of this emanation
will initially give out enersry at the rate of
about 10,000 horse power. — (The Montreal Med-
ical Journal, February, 1904 ; E. Rutherford) .
Late Effects of Typhoid Fever on Ac Heart
and Vessels.
The'^ condition of the heart and vessels in
183 individuals who have passed through ty-
phoid fever at Johns Hopkins Hospital has
been carefully studied. It is recognized that
these results are based upon the analysis of
too small a number of cases to justify final
conclusions; the next 200 cases may consid-
erably modify our view. Yet the fact that
these 183 old typhoids are materially older,
from a point of view of their hearts and ar-
teries, than the average individual who has
not had typhoid fever, would tend to support
the views of those who regard this disease as
an active element in the etiology of a consid-
erable number of cases of cardiac hypertrophy
and dilatation coming on sometimes in early
life, as well as an important factor in the pro-
duction of those vascular changes which Ca-
zalis has happily called "la rouille de la vie."
— (The American Journal of the Medical Sciences,
March, 1904, W. S. Thayer).
Bursae of the Neck.
According to Verneuil, there are three fairly
constant bursae of the neck:
1. Subcutaneous antethyroid or prae thyroid.
This was described by Beclard and lies in the
loose areolar tissue over the Adam's apple.
2. Deep subhyoid (Boyer's bursa). This was
described by Malgaigne and is situated be-
tween the hyoid bone and the throhyoid
membrane.
3. Superficial or sushyoid bursa. This was
described by Verneuil and lies between the
geniohyoid and the geniohyoglossal muscles.
Methods of Treatment.
1. General and local absorbents.
2. Simple incision and drainage.
3. Drainage and the use of a local irritant to
produce adhesive inflammation.
4. Partial excision of the cyst wall.
5. Complete extirpation. This is by far the
most satisfactory method of treatment— (T/if
American Journal of the Medical Sciences,
March, 1904; Willis S. Anderson).
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COUNTY SOCIETIES.
Jour. M. S. M. S.
Countp Society? IRcwa.
Ai^LEGAN COUNTY.
Allegan County Medical Society held its an-
nual meeting in Allegan, Feb. 5th. The following
officers were elected: President, Milton Chase,
Otsego; Secretary-Treasurer, G. G. Taylor, Al-
legan; Delegate, W. H. Bills, Allegan; Alternate,
S. T. Chase, Otsego. The visiting members were
entertained at dinner by the local members.
G. G. Taylor, Sec'y.
BAY COUNTY.
Bay County Medical Society held its annual
meeting in Bay City, Jan. 11th. The following
officers were elected: President, M. Gallagher,
Bay City ; Vice-President, R. W. Brown, W. Bay
City; Secretary, A. W. Herrick, Bay City; Treas-
urer, C. H. Baker, Bay City; Delegate, J. Mc-
Lung, Bay City; Alternate, F. E. Ruggles, Bay
City. A. W. Herrick, Sec'y.
CALHOUN COUNTY.
Calhoun County Medical Society held its first
quarterly meeting for 1904 in Albion, Tuesday,
March 1st, seventeen members being present.
The new president, J. C Borwn, occupied
the chair. After the routine business was trans-
acted, the scientific program, consisting of a
study of business methods, was introduced by a
paper from T.. E. Sands on "Fees and Col-
lections." Ihe discussion which followed this
paper was so long, interesting and important as
to consume the allotted time of the meeting, and
the other papers were held over. The general
sentiment was that physicians should improve
their business methods, more attention should be
given to the keeping of accounts and rendering
statements ; fees should be so regulated as to be
just to both parties, and after being earned should
be promptly collected.
One new member, A. E. McGregor, was
admitted. Dr. J. H. Reed, of Battle Creek, was
elected delegate and F. A. Waples alternate
to the State Society. The next meeting of the
Society will occur in Battle Creek the first Tues-
day in June.
W. H. Haughey, Sec'y.
GENESEE COUNTY.
Genesee County Medical Society held its regu-
lar meeting in Flint, Jan. 26th.
Owing to the extreme inclemency of the weather
and the temporary suspension of railroad traffic,
the out-of-town members were unable to attend
the meeting. The storm did not dampen the
ardor of the twenty that were present, however,
and the papers, one on "Diphtheria," by Robt. T.
Dullam, and one on "Iritis," by T. S. Conover,
were enthusiastically discussed. Several inter-
esting cases were reported.
President Rumer, in assuming the duties of his
office, addressed the Society as follows :
Fellows of the Society: In assuming the
office to which you have kindly called me, I wish
to assure you that I fully recognize the honor
and compliment implied in electing me to pre-
side over this most scholarly body of men and
women. While I may not be able to preside with
the dignity of my predecessors, nor be able to
address you with the eloquence, wit or learning
of the other members of the Society, I wish to
say that I fully recognize the honor you have
done me, and trust that our scientific \vork and
fraternal and social relations will be both pleasant
and profitable for the next year.
The life of that unfortunate individual called
a "Country Doctor" is a mighty lonesome one,
at best, and the gatherings of this character form
a red letter day in his monotonous existence, for
here he forms pleasant acquaintances and pro-
fessional friendships. He sees the abilities and
excellencies, as well as the deficiencies and short-
comings of his co-laborers. He likewise discloses
to his fellows the merit or lack of merit belong-
ing to himself. In other words, this self compari-
son that takes place in the minds of ourselves
must show our failings and deficiencies,
and where we can profit from others. Then in
this gathering where the specialist, surgeon, and
general practitioner discuss questions of general
interest to all, there should be none so wise but
that might get some light, and none so dull but
that should be able to impart some information.
Here wc have a chance in good natured debate
to learn to give and take in repartee and argu-
ment, which is sometimes quite pleasant (for out-
siders). And right here I wish to say that we
might profit by a lesson from our legal brethren,
not only regarding the business end of a phy- '
sician*s life, but their ability to give and take
those "Solar Plexus" blows from each other
with perfect good nature. You can see them in the
court room calling each other right angled tri-
angles or even the hypothenuse of a right angled
triangle and shaking their fists at each other and
in an hour's time you may see them as happy
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Aprii,, 1904.
COUNTY SOCIETIES.
163
and friendly as cherubims. But I fear it will
require a wonderfully active imagination to
picture an attorney as a cherub or cherubim,
whatever that means.
I think these meetings will also have a ten-
dency to do away with much of the petty rivalry,
jealousy, and distrust that is found much too
often among us, and which too often impairs
public confidence in us as well as giving us some
very unpleasant recollections.
I must say that I would like to see at one
of our meetings during the coming year a few
practical papers on subjects of business interest
to the members of our profession. It is a mat-
ter of pride to me and probably to all of us that
there is no class of business men who devote so
much of their time or donate as much of the
things of this world to the less fortunate of our
people as the physicians. We now, through our
sanitary regulations and the result of the earnest
research and study of our leaders in scientific
investigation, are able to prevent epidemics of
communicable diseases which formerly brought
sorrow and desolation to the people, and often
almost depopulated large and populous areas.
Strangest of all, the medical man knows
that while he is doing all of this, he is stopping
his own income; is taking the bread out of his
own mouth as it were. I believe that while it
would not be best for us to substitute the spirit
of commercialism for that of philanthropy, the
spirit of selfishness for that of all-truisms, I do
believe that we might devote a portion of our
time we now spend in philanthropy in considering
how we might best devise ways and means of bet-
tering our own condition.
Then I have wondered many times if we would
make a more united effort regarding medical leg-
islation if we could not accomplish more than we
now do. There is not a physician here in this
room to-day but who ought to wield quite an in-
fluence politically in his community. The people
look to you for advice when in trouble, and they
will listen to you in other matters if you take
the pains to talk to them. And I think that as
intelligent a body of men as the physicians of
this county, if standing with an unbroken front,
could wield public opinion on matters of medical
legislation as perfectly as one could wish. In
other words I think our Society should accom-
plish and will accomplish many things in better-
ing our own condition.
These Society meetings ought to produce
a firmer and more lasting friendship among its
members; a means of putting the business end
of our work on a better footing; a needed re-
laxation from professional grinding; and an
exchange of ideas that should make more suc-
cessful practitioners of us all.
J. C. Willson was chosen delegate to repre-
sent the Genesee County Medical Society on the
Board of Delegates of the Michigan State Medi-
cal Society and H. R. Niles was elected alternate.
At six o'clock a recess was taken and the mem-
bers adjourned to the Dryden cafe, where a
banquet was served.
H. R. Niles, Sec'y.
HILLSDALE COUNTY.
The Hillsdale County Medical Society held its
first meeting of the new year, Jan. 22d, at Hills-
dale.
PROGRAM.
"Exophthalmic Goitre," A. Striemer, Hillsdale.
The subject was very ably handled and the latest
researches were reviewed.
"The Treatment of Some of the Acute Dis-
eases," W. H. Baldwin, Uuincy.
Abstract —
1. Introduction. I am about to present to you
a few thoughts gathered from practical experi-
ence upon this subject. By proper therapeutic
treatment, medicinal and hygienic, many of the
acute diseases can be aborted, the course of many
more can be shortened and nearly all can be al-
leviated and the patient made more comfortable
and complications prevented.
2. Pneumonia — (a) Early Stages.
I. Calomel : Grs. }4 every 3^ hour until 2
grains have been taken. This is done to open up
all the avenues of secretion, excretion and elim-
ination.
II. Epsom Salts : A liberal dose is taken one
hour after the last dose of calomel is given. The
purpose of this is to produce watery elimination.
III. Codeine Sulphate: The patient is given
gr. j4, followed every three hours by gr. J4i to
produce as much physiological rest for the dis-