the reservoir of the town. The dejections were not properly disposed of, and in the spring when the annual thaw came the germs of typhoid fever were carried down the hillside into the stream and then into the reservoir from which the residents received their drinking

water.

Water is more apt to be impure in winter than at other seasons, owing to the deficient oxidation of organic matter due to the presence of ice upon the surface. After the ice upon which refuse matter has accumulated during the winter breaks up in the spring, there often occurs a considerable increase in the number of typhoid fever cases in large towns and cities. As to the effect of freezing upon the quality of waterin Lake Zurich bacteriological investigations have revealed the maximum number of germs from November, 1889, to January, 1890, to be 202 per cubic centimeter; from January to March, 2,179; from March to April, 2,152; from April to May, 1,425; in May and June, 229. Water of the Potomac at Washington in January, 1888, contained 3,774; in February, 2,536; in March, 1,210; in April, 1,531; in May, 1,064; in June, 348; in July, 255; in August, 254; in September, 178; in October, 75; in November, 116; in December, 967. Most cities send their sewage absolutely without treatment to mingle with adjacent waters from which the drinking supply is obtained. In other words the citizens seem content to drink complacently water containing raw sewage."

Typhoid fever has for many years been the particular scourge of Philadelphia, and these statements have thus a local interest. The city now derives its water supply from the Delaware and Schuylkill rivers,-94 per cent. from the

latter and the balance from the Delaware.

Allen Hazen, C. E., of Boston, who has recently investigated the water supply of this city for the Woman's Health Protective Association, with a view to rocommending the adoption of a system of sand filtration, says, in the Journal of the Franklin Institute:

"An effort is now being made to treat and purify the sewage of Reading before its discharge into the Schuylkill River; but there is no assurance that this treatment as yet is adequate. Aside from Reading, all sewage produced upon the water-shed is discharged directly into the streams.

The water from the Schuylkill for Philadelphia is pumped from two pools formed in the river by dams within the limits of the city. The sewage from portions of the city was formerly discharged into these pools. An intercepting sewer has been constructed, which takes sewage to a point below a dam below the lowest pumping station. The district served by this intercepting sewer is sewered by what is known as the separate system. That is to say, the rain water and sewage are removed by separate systems of carriers, and little, if any, sewage is discharged from the city sewers at any time into the river above the intakes. The river banks above the city limits, and the west side of the river, where the latter forms the boundary, directly opposite the city, are occupied by manufacturing establishments discharging directly into the river. The use of water from the Schuylkill at the present intakes is most objectionable,and the use of water from such a polluted source should be abandoned at the earliest possible moment.

Aside from possible tidal pollution, the Delaware River is much less polluted than the Schuylkill; its flow is greater; its water is softer; it is less subjected to local pollution, and, in every way, it is more desirable as a source of water supply than the Schuylkill; and the same is equally true whether the waters of each are used in their raw condition, as at present, or if each of them should be filtered by equally good systems of filtration."

There can be little doubt that the prevalence of typhoid fever and other zymotic diseases in Philadelphia is attributable directly to the conditions ruling the present water supply, and when the death rate for such diseases is examined, the necessity for action is at once apparent; not only from a human

itarian standpoint, but also from the economic. It is estimated that there are annually about 400,000 cases of typhoid fever alone in the United States, of which at least 50,000 prove fatal. A conservative estimate of the value of each individual to the State is at least

$1,000, and the cost of each case of fever is about $200, hence the enormous loss to the nation through the prevalence of disease will readily be seen. When the expense attached to other diseases that may be attributed to impure water is added to this, the estimate will be swollen to enormous proportions, and the necessity for immediate action becomes patent, so that he who runs may read.

The securing of an abundant supply of pure water will be a measure of incalculable benefit, and will mark a greater progression than any step hitherto taken by the government of this city.

Fiftieth Anniversary of the Northern Medical Association, December 5, 1896. The Northern Medical Association will reach the fiftieth anniversary of its organization December 5, 1896.

With one exception (The College of Physicians of Phila.), it is the oldest medical organization in existence in this city.

At a stated meeting, held September 11th, the motion to celebrate this fiftieth anniversary in a fitting manner was carried and the undersigned committee was appointed to make arrangements for marking this semi-centennial milestone in the path of our professional advancement by a banquet, addresses by the oldest surviving members of the Society and by having a pleasant, shoulder-toshoulder meeting of the profession in general.

The committee, fully appreciating the just pride to which the Association is entitled because of its years, the laudable work done under its auspices, the eminent men, some of whom are living but in our memory by the good they have left behind them, while others are scattered far and near, but all of whom once took part in its proceedings and

launched their first efforts in scientific medicine before its members, and, above all, that this is a semi-centennial jubilation of a pioneer medical association in the city of Philadelphia, the great medical metropolis of this continent, feel that, in asking the rank and file of the profession to do honor by their presence and give support by their subscription, they ask but of each to do honor to himself, his profession and Philadelphia. Moreover, it is a well-recognized fact that in the routine life of the profession of medicine, each member being the autocrat in his own individual sphere, there is a tendency to an alienation from his colleagues and those progressive principles which are so essential to an accurate acquisition of the sum total of that which enables us to fully represent our duty toward our patients, ourselves and sciTo overcome this tendency has always been the aim of The Northern

ence.

Medical Association in all its transactions. The coming together around the festive board on an occasion for common pride and mutual congratulation, like this, carries with it an unity of purpose that makes us appreciate one another's individual strength, while it mitigates the accredited shortcomings in any common end.

The banquet will be given at the Hotel Walton on the exact anniversaryDecember 5, 1896-at 8 p.m. The per capita assessment has been fixed at $5.00. Please send your subscription or cheque to Dr. Updegrove, P. O. B. 2904, Station S, before the last mail of Saturday, November 28th.

DR. S. UPDEGROVE, Treasurer,
DR. S. WOLFE, Secretary,
DR. I. P. STRITTMATTER, Chairman,
Committee.

Cutting Glass With a Layer of Oil.

Pour oil into the bottle until it reaches the level where it is desired to cut off the glass. Then heat a poker in the oven until it glows, and plunge it into the oil. A report follows, and the job is done. At the exact level of the oil the glass is cut off smooth.

This is explained by the fact that bottle glass cannot stand a sudden rise of temperature: under such circumstances it bursts along the line where the temperature is raised.

EDITOR OF THE MEDICAL AND SURGICAL REPORTER:

While there is a paucity of literature or reference in medical writings to the subject of anesthesia during sleep (see Dr. Cleaver's article in THE MEDICAL AND SURGICAL REPORTER of October 31, 1896), yet from the few published experiences there is no doubt as to the possibility of its accomplishment. H. C. Wood, in his Therapeutics and Materia Medica, says that "experiments made in the Philadelphia Hospital have proven that persons sound asleep may be chloroformed without their being awakened." In THE REPORTER of March 5, 1881, is a reference to some experiments made by Dr. Quimby, cited from transactions of American Medical Association, which go to prove the same thing. Also

in THE REPORTER of September 18, 1886, is another instance given, but as the subject may have been in a condition of stupor, this particular case is not conclusive.

Several years ago I succeeded in chloroforming a sleeping child three or four years old without awakening it, and afterwards reduced a dislocated shoulder. There is no question in my mind but that healthy children in sound sleep can be chloroformed without being wakened if proper precautions are taken, but there is a probability that more difficulty would be encountered in producing a similar condition in a sleeping adult. Respectfully,

J. W. HUFFMAN. PRESCOTT, IOWA, November 12, 1896.

What are the inducements to the study of medicine? Let us consider the financial aspect of the question first. The easiest and quickest way to a competence is to locate at some country "Corners," out of reach of competition, and where a living may be expected almost from the start. The first year's receipts will be from five to eight hundred dollars; there will be an increase for a year or two, but then comes the limit of ambition, and, although the physician is practically assured of as good a living as most of his neighbors, he is isolated from his natural companions and doomed to a hard routine of long drives over rough roads, often at night, and particularly at the very seasons when the weather is most inclement. *A. L. Benedict, in Lippincott's.

"Doctoring" may pay better than pitching hay, and if the country practitioners represented simply the uneducated young men who study medicine "for what it is worth," our sympathies would be due not to the doctor, but to his patients. Unhappily for the former, and fortunately for the latter, so many good men are forced by circumstances to practice in the country that the standing of country doctors is far higher than their meagre recompense would indicate. There are also undesirable quarters in most cities which afford a paying practice almost from the beginning, but it is difficult for a physician thus located either to grow into a better practice or to save enough to make a fresh start. While the country doctor may console himself with the thought that without

himself, or some one in his place, much suffering would result, the city resident is as needless as he is unfortunate, for his patients could easily send for one of many practitioners within a few blocks. No better advice can be given to a young physician than "Locate where you are willing to live."

Such a choice of residence, however, involves the ability to meet expenses for two or three, perhaps four or five, years, without relying on a professional income. Several eminently successful physicians have stated their first year's collections at from fifteen dollars to two hundred and fifty.

The new treatment of diphtheria is a practical application of the latest advances of experimental bacteriology. The general facts upon which it is based are briefly these: Certain bacteria, when developing in the organism of an animal or man, produce an albuminoid poison called a toxin, which, circulating in the blood, causes disease. For example, the Klebs-Loeffler bacillus, growing in the throat of a child, generates a toxin that produces the systemic condition called diphtheria.

If some of these bacteria be removed from the organism and placed in artificial media, such as broth, under proper conditions they will grow and multiply and produce the same toxin as before. This toxin may now be separated from the bacteria by filtration, and if introduced into an organism by inoculation it will produce the disease as readily as if it had been formed in the organism. But the virulence of the disease thus produced will vary with the quantity of the toxin injected. Moreover, if the first dose given is so small as to produce only slight illness, a larger quantity may be introduced a few days later without producing a corresponding effect; and progressively larger doses may be administered from time to time, until at last the animal receives with impunity doses many times larger than could possibly be borne at first.

In the case of the diphtheria toxin for example (obtained, as has been said, by growing the diphtheria bacillus in meat broth), if fifteen drops of the filtrate containing the toxin be injected into a vein of a horse, the animal will be severely poisoned. But by repeating the

*From Harper's Weekly.

injection from time to time in progressing doses, at the end of three or four months the animal will bear a dose of two hundred times the original quantity. In other words, the animal has become immune to the disease.

If now a vein of the immune animal be opened and some blood withdrawn, the serum of that blood (the other constituents being removed) may be injected into the system of another animal or a human being without ill effect, and the animal or human being thus inoculated becomes immune to the disease, in virtue of the inoculation. More than that, if the organism inoculated had already acquired the disease, the inoculation, within reasonable limits, is curative. For example, if a child has been exposed to diphtheria, inoculation with theserum of a horse rendered immune to diphtheria as above described will prevent development of the disease. At a. later stage inoculation tends to cure the disease.

These are the facts as applied in thenew serum treatment of diphtheria.