without any additional mixture. Cold milk was afterwards given ad libitum. In only one case did vomiting ensue; the others retained the oil without difficulty. In no case was there any inflammatory reaction on the part of digestive or genito-urinary tract. Besides the oil of turpentine, the children received a five per cent. solution of potassium chlorate in lime-water, with the addition of the syrup of the balsam of Peru. Besides balsam of Peru, diluted with twenty per cent. of alcohol, was applied to the pharynx every two hours. Cold applications were made and ice pellets given. The writer goes on to say that in four cases only the membrane was attached so firmly after twentyfour hours that the doses of turpentine had to be repeated. In all the cases the membrane disappeared entirely within fortyeight hours. The same result is said to have been obtained, without any injury to the kidneys, in the worst forms of septic scarlatinous diphtheria. Bosse's reports are so plain and straightforward, and partake so little of boasting quackishness, that it may be worth while to repeat the experiments. Certainly an impression can hardly be removed from our minds that the doses are so large as to be liable to result in irritation of the intestinal tract, and particularly of the kidneys. But in this case, as in many others, further experience will determine the value of the recommendation; particularly as the results said to have been obtained are, perhaps, partially sustained by those mentioned by me on page 186 of my treatise on diphtheria, after inhalations of turpentine.

In the same treatise I have given a review of the facts and experience concerning the administration of mercury in diphtheria. The literature of that part of the subject has been increased by Annuschat, who recommends hydrargyrum cyanide. He treated one hundred and twenty cases-none of the patients being under one year, and two over fifteen-during September, 1879, and January, 1880. Of these fourteen died. The children were given teaspoonful doses of a solution of 1 to 2 in 1000 of water. Insufflations of the benzoate of soda were also used, and excitants and stimulants were administered when symptoms of debility made their appearance. Every child partook of Hungarian wine and beef soup. Favorable cases terminated in three days; more serious ones required from six to eight days. Sometimes the solution used was 3 to 4 in 1000. But the writer proposes to give smaller doses in the beginning, inasmuch

as serious vomiting is a frequent result. In laryngeal diphtheria the remedy was found to be worthless. No bad consequences were observed so far as the general condition of the children. was concerned.

Coesfelt recommends, instead of steam inhalation, frequent gargling with hot water without any medicinal addition. It was not resorted to more frequently than once in every half hour. Besides, a disinfectant gargle of alcohol, carbolic acid, potassium chlorate, or potassium hypermanganate was used, but the writer does not place much confidence in them. Infants and children who cannot gargle are made to drink every half hour either hot water or hot milk, coffee, or tea. In the latter the diphtheritic deposit was removed in about five days. Gargling removed it in from two to three days. Internal treatment is not required in mild forms of diphtheria, but good diet and a sufficient amount of food is indicated. The septic variety requires gargles of solutions containing carbolic acid, and internally antifebrile remedies with excitants and antifermentatives. In this connection I desire to say a final word in regard to the large doses of chlorate of potassium often recommended in diphtheria. My warnings in regard to the drug have at last been heeded. Extracts from my writings on the subject have been extensively published, and experiments on animals made in Europe, by Marchand and others, have proved my clinical observation of the frequent occurrence of nephritis, and fatal nephritis resulting from the incautious use of the potassium chlorate. A number of fatal cases have been described, and it may be that much carelessness on the part of the public, and many accidents will be avoided in future.

J. Hofmeier reports the recent case of a woman of twentyeight years, who used forty grammes of chlorate of potassium in one and one-half days. The larger portion she swallowed, "being afraid of diphtheria." She died with the symptoms of nephritis, small quantities of decomposed blood being eliminated from the kidneys.

H. Wegscheider had the case of a man of twenty-five years, who took from forty to fifty grammes of potassium chlorate with the same result.

In the practice of Dr. Morjé, I observed lately the case of a

1 D. Med. Woch., 1880, No. 39.

boy of fourteen, who was affected with a slight pharyngeal catarrh. The principal of his school told him he knew all about throats, and to use plenty of potassium chlorate. This he did obediently, buying and using about six ounces in five or six days. The amount he swallowed daily we estimated at about fourteen grammes, three and one-half drachms. About the end of the sixth day the urine was suppressed. In the next five days he excreted about twenty-five or thirty grammes altogether of a black liquid containing immense amounts of decomposed blood, and under the microscope yellow conglomerates, such as Marchand described-at the end of which time he finally died, the victim of his confidence in the medical accomplishments

of his teacher.

THE RELATION BETWEEN GROWTH AND DISEASE.

BY H. P. BOWDITCH, M.D.,

MASSACHUSETTS.

IN acceding to the request of the Secretary to prepare a paper to be read before the Section on Children's Diseases, it seems to me that I can in no way better employ the time allotted to me than in calling attention to the importance of securing statistics in regard to the physique of growing children. The determination of the correct average rate of growth of the human race at different ages, in both sexes and under various social, ethnical, and geographical conditions, has both a theoretical and practical interest, and a brief enumeration of a few of the problems upon which light would be thrown, were the subject thoroughly investigated in different parts of the country, may, therefore, be permitted in this connection.

Military statistics, and particularly those derived from the researches of Dr. Gould' and Dr. Baxter during the late civil war, have shown that the size of adult native Americans is very different in different States of the Union, and even in different parts of the same State. It has even been maintained that natives of the Eastern States, emigrating in childhood to the West, attain to a stature resembling that of the natives of the States to which they emigrate. These observations seem to indicate a direct influence of climate upon the development of the race, and it remains to be shown, by measurements of growing children, at what age this influence begins to be manifested. In other words, the question to be solved is, whether the inhabitants of certain Western States are taller than those of New England because they grow faster, or because their period of growth

Investigations in the Military and Anthropological Statistics of American Soldiers, by Benjamin Apthorp Gould. New York, 1869.

2 Statistics, Medical and Anthropological, of the Provost-Marshal-General's Bureau, by J. H. Baxter, A.M., M.D. Washington, 1875.

is more prolonged. This study of the influence of climate upon development could be advantageously prosecuted in those Western communities which consist almost exclusively of emigrants (and their descendants) from some limited region in Europe.

The question whether the season of the year exerts an influence upon the rate of growth is interesting, in view of the many analogies which vegetable and animal life afford. The observation reported by Pagliani' that, in the case of girls living in the country, the first menstruation occurs much more frequently in the spring than at other seasons, seems to indicate that the nutritive processes of the human body are really influenced by the seasons, and that, therefore, the rate of growth may be expected to depend to some extent upon the varying conditions thus afforded. The problem demands for its solution a very large number of careful monthly or quarterly measurements of the height and weight of healthy growing children.

The determination of the comparative effect of city and country residence, of poverty and riches, of occupation and mode of life upon the rate of growth, presents problems towards the solution of which certain progress has already been made, but a great deal of work still remains to be done, and a systematic collection of observations throughout the country cannot fail to secure valuable scientific results.

Statistics in regard to the size of growing children have been thus far collected chiefly in schools and colleges, where large numbers of children can be readily subjected to measurement. The rate of growth during the school age, i. e., from five to twenty years, has thus been approximately determined. Lyingin hospitals and infant asylums have furnished similar data for early infancy, but between this period and the beginning of school life there is an interval of about four years, during which very few observations on growing children have been recorded. Owing to the fact that children of this age are seldom to be found collected in institutions, it is evident that the necessary data must be obtained by collating isolated observations taken in families where children of suitable age are to be found. In securing and collecting observations of this sort, members of the medical profession have it in their power to render important aid in this branch of scientific research. To secure uniformity

1 Lo Sviluppo Umano, p. 59.