OF TAPERS 
To be read at the 
TENTH MNNUAL [MEETING 
Of the 
Association of American Physicianj 
To be held in 
WASHINGTON,D. 
On May yj/b and 31 si and June isl, 1895. ABSTRACTS. 
Leucomain Poisoning. 
B. K. RACHFORD, Cincinnati. 
Leucomain poisoning is a form of auto intoxication etio- 
logically related to migraine, migrainous epilepsy, and 
migrainous gastric neurosis. Paraxanthim, the most poison- 
ous of leucomains, is found in very great excess in the urine 
passed immediately after these migrainous attacks, and is 
not found in increased quantities in the urine of these 
patients between these attacks. 
Xanthin, another poisonous leucomain, is found in great 
excess in the urine passed just after one of these attacks, 
and in migranious gastric neurosis xanthin is found not only 
in great excess in the urine, but it is also found in the 
stomach contents. 
The paraxanthin separated from the urine of these cases 
will produce in the mouse symptoms very similar to an attack 
of migrainous epilepsy. 
Some Toxicogenic Germs Found in Poisonous Food. 
VICTOR C. VAUGHAN AND GEORGE D. PERKINS, 
Ann Arbor, Mich. 
Short histories of the symptoms, number of persons and 
results will be given. These will be followed by descriptions 
of the morphological and toxicogenic properties of the germs 
found in the food, as determined by cultures on various 
media, and by their action on rabbits, rats and guinea pigs. 4 
The Effect of the Gaseous Products of Decompo- 
sition upon tfie Health of Animals that are 
Compelled to Respire Them. 
A. C. ABBOTT, Philadelphia, Pa.- 
In a paper read by the writer at the Congress of Ameri- 
can Physicians and Surgeons, session of 1894, were presented 
the results of a series of experimental studies that were 
made with a view of determining in how far the opinion held 
by many with regard to the part played by the air of sewers 
in causing or disseminating diseases, could be supported by 
evidence obtained through the employment of exact chemi- 
cal, physical and bacteriological methods of investigation. 
The outcome of these experiments afforded nothing to 
justify the view that the air of sewers, under ordinary cir- 
cumstances, could be held accountable for either the causa- 
tion or dissemination of infectious maladies. 
Since the presentation of the conclusions embodied in that 
paper, a series of experiments have been made with the 
object of discovering the effect of the gaseous products of 
decomposition on the health and resistance to infection of 
animals that were compelled to respire them. For this pur- 
pose animals, rats and guinea pigs, were confined under bell 
glasses through which was passed continuously, for varying 
periods, the air from over substances (meat infusion, sewer- 
age and urine), in different stages of decay. Some of the 
animals were subjected to this treatment only, while others 
were inoculated from time to time during the experiment 
with cultures of the bacillus of typhoid fever. Of eighteen 
animals on which the experiments were performed, only two, 
which will be referred to in detail in the body of this paper, 
showed any effect; the remaining sixteen presenting nothing 
that could be attributed to the conditions under which they 
had lived for from one to five months prior to their being 
killed. The general condition of these animals during the 
experiments, as determined by their outward appearance, 
appetite and daily fluctuations in weight, was as good as 
that of other animals kept under the ordinary conditions of 
the laboratory. 5 
As a result, the conclusion seems justifiable, that as ordi- 
narily respired, the air of sewers, or that from other bodies 
undergoing decomposition and putrefaction, has either not 
the power of inducing pathological conditions at all, or, if it 
has, such conditions are not demonstratable by such labora- 
tory methods of experimentation as we have practiced on 
rabbits and guinea pigs. 
Renal Affections Following Influenza. 
G. BAUMGARTEN, St. Louis, Mo. 
A report of eight cases, from which it appears that damage 
to the kidneys is a frequent, and sometimes a serious conse- 
quence of grippe. Besides transient albuminuria, there have 
been found acute degeneration of the kidney, acute inflam- 
mation, both forms of chronic diffuse nephritis, and cases of 
persistent albuminuria not plainly belonging to one of these 
groups. The injurious influence on public health exerted by 
an epidemic of grippe may last much longer than the epi- 
demic itself, by reason of renal and other sequels. 
Etiology of Idiopathic Hypertrophy of the Heart 
JAS. T. WHITAKER, Cincinnati. 
Hypertrophy independent of valve disease or obstacle to 
the circulation in the heart itself. The term a misnomer. 
The condition is more frequent than is commonly believed. 
Hypertrophies are due— 
1. To increased resistance in the vascular system. For 
example, arterio sclerosis. 
2. To diseases of the heart muscle from infection, degen- 
eration, etc. 
3. To affections of the nervous system. 
The hypertrophy of age, of work, of plethora, of pregnancy, 
of alcohol. 
Hypertrophy from Bright’s disease, from diseases and 
deformities of the chest, emphysema, kyphosis. 
Hypertrophy from myocarditis, syphilis, gout and diabetes. 
Hypertrophy from irritation of the vagus, from abuse of 
tobacco, from excess in venery, etc. 6 
The Transmission of Mitral Diastolic Murmurs. 
J P. CROZER GRIFFITH, Philadelphia, Pa. 
The object of the paper is to call attention to the fact that 
the ordinary transmission of these murmurs, with a limita- 
tion of sound to the mitral stenotic circle, as usually described, 
by no means always holds good ; but that the murmurs may 
be widely diffused and heard far from the ordinary area. 
The Use of the Differential Stethoscope in the 
Study of Cardiac Murmurs. 
ANDREW H. SMITH, New York. 
The differential stethoscope enables us to hear separately 
two sounds produced at the same time in different localities. 
It is useful when we find that a murmur is produced at each 
of two cardiac orifices, but are unable to determine whether 
the two murmurs occur synchronously or alternately. This 
doubt may arise whenever the distinction between first and 
second sound is lost. This distinction is likely to be lost 
whenever the heart’s action is considerably accelerated, 
while at the same time the distinctive quality of the sounds 
is marked by the presence of murmurs. In such cases the 
differential stethoscope enables us to decide whether both 
murmurs occur at the same time, or first one and then the 
other. It also determines whether murmurs produced at 
different orifices by the same act of the heart are, or are 
not, exactly synchronous; an important point in the study 
of the action of the valves in health and disease. 
The Cause of the Exaggeration of Sounds Over 
the Right Upper Chest, Both in Health and 
Disease. 
CHARLES CARY, Buffalo. 
I. All authorities describe a disparity in the physical 
signs, both in health and disease, between the superior lobes 
of the lungs. 7 
2. It is not satisfactorily accounted for by any author 
whose work has come under the notice of the writer, 
3. The right bronchus give off a branch to supply the 
upper lobe immediately at but a short distance from the 
bifurcation of the trachea; this branch is not represented in 
the left side of man. In some animals this branch to the 
upper right lobe springs from the trachea itself, two or more 
inches above the bifurcation. 
4. Our common text books on anatomy, with perhaps one 
exception, make no mention of this striking difference in the 
two sides. 
5. Exaggerated sounds of voice, breathing, percussion and 
fremitus on the right side under like conditions are to be 
accounted for by this bronchus, which serves as a much 
more direct transmitting medium. 
Preparation of Antitoxine. 
H. C. ERNST, Jamaica Plain. 
The paper will consist of an account of some experiences 
in the preparation of the antitoxine of diphtheria. 
A Case of Madura Foot Disease (Mycetoma Pedis). 
J. GEORGE ADAM I, Montreal. 
Report of a case occurring in a man who has lived all his 
life in America. Probably one of the first undoubted case 
reported on this continent. The appearances during life are 
described, and are illustrated by photographs. The results 
of the microscopical examination of the lesions on the foot 
(after the latter had been amputated by Syme’s operation), 
are given, and the resemblance of the lesions to those of 
actinomyces is pointed out. A brief description of the two 
varieties of mycetoma—the black and the white—and of the 
clinical history of the disease completes the paper. 8 
Gonorrhceal Arthritis—Clinical Observations. 
WM. P. NORTHRUP, New York. 
Some cases showing in general these characteristics— 
I. One joint (elbow or knee). 
2' Fusiform swelling, indicating 
3. Periarthritic lesion, with 
4. Synovial effusion, serous probably; 
5. Soon absorbed, leaving 
6. No adhesions. 
7. Exquisite sensitiveness, with 
8. Little local heat and 
9. Little fever (100-101°). 
10. Course, four weeks. 
11. Recovering with perfect joint. 
A Comfortable Way of Using Cold in Fevers. 
FRANCIS H. WILLIAMS, Boston. 
Evaporation of liquids to cool a surface ; some conditions 
affecting this, such as suitable covering, choice of liquid and 
its temperature; use of such a method clinically. 
Some Observations on the Spleen and Marrow in 
a Case of Leukaemia. 
JOHN GUITERAS, Philadelphia. 
The paper will bear principally on the formation of red 
blood cells in these structures. 
Goitre in Michigan. 
GEORGE DOCK, Ann Harbor. 
The object of the paper is to call attention to the preva- 
lence of goitre in Michigan and its vicinity, with the view of 
exciting a greater interest in the subject. Although the 
disease is often so mild that it does not require treatment, it 
is sometimes severe. Allied diseases, like myx-oedema and 
cretinism, do not seem to be less rare here than in other 
places. A relationship with water supply must exist, a point 
to which attention is called in reference to prophylaxis. 9 
Displacements of the Liver. 
J. E. GRAHAM, Toronto. 
A brief account of the literature of the subject; a short 
description of three cases met with in practice; the etiology 
symptoms, diagnosis and treatment of displaced liver; a 
tabulated statement of thirty published cases. 
Carcinoma of the Liver with Cirrhosis. 
M. H. FUSSELL, Philadelphia. 
1. Review of the literature of the subject from article by 
Kelschard Kierer, in Archives de Physiologic, 1876 to the 
present time. Absence of any note of the conditions in the 
English language. 
2. Citations of two cases. 
3. Relations of the cirrhosis to the cancerous growth. 
4. Origin of the cancer cells, whether from the hephatie 
cells or intertubular ducts. 
Forcible Artificial Respiration—Fell-O’Dwyer’s 
Apparatus—Cases—Apparatus Shown. 
W. P. NORTHRUP, New York. 
The paper will contain an account of cases where artificial 
respiration was maintained four, twelve and twenty-five 
hours, in fracture of the skull, with operation, opium poison- 
ing, etc. 
Carosso’s Method of Treatment of Pulmonary 
Tuberculosis. 
H. C. ERNST, Jamaica Plain. 
The paper will embody a brief account of a few cases 
treated by this method during the past seven months, and 
their present condition. On the Direct Faradisation of the Mucous Mem- 
branes of the Stomach and the Intestines in 
Animals—Dogs, Cats and Rabbits. 
S. J. MELTZER, New York. 
Against all clinical expectations, the experiment on 
animals revealed the surprising fact that neither the stomach 
nor the intestines can be brought to contraction by faradi- 
sation of their mucous membranes. Neither can the stom- 
ach be brought to contraction by application of one of the 
electrodes on the mucous membrane and the other direct on 
the muscular sheath of the stomach. The application of 
one electrode on the intestines, and the introduction of the 
other into the rectum, does not produce any contraction of 
the intestines, but kills the animal sometimes.