Italian physician from the words Pella "skin" and Agra "rough," "rough skin." About the year 1810 Marzari first called attention to the relation between pellagra and maize, and in 1842 Balardini suggested the theory of its being due to spoiled maize caused by the growth of fungus on the grain. In certain parts of Europe the disease has been quite prevalent, and has followed the introduction and culture. of maize from America. It seems strange, but nevertheless true, that in the original homes of maize, America and Asia, it has not prevailed to any great extent, probably due to more favorable climatic conditions. The pellagra zone is a small one when compared with the area over which maize is cultivated. It is pretty generally accepted by those who have studied the disease that it is a sort of intoxication produced by toxic substances of a chemical nature as a result of a parasitic or fungus growth developed on the Indian corn. The theory has also been advanced that it is an auto-intoxication produced by a constant and almost exclusive diet of Indian corn. However this may be, it is an established fact that pellagra generally occurs among the poor classes who subsist largely on corn, and observation has also shown that in pellagarous localities, during epidemics, the corn is of a very poor and unhealthy quality. There seems to be no special predilection for any particular nationality, age or sex, all being equally susceptible. It is neither hereditary or contagious. The disease seems to be one of great chronicity. Pellagra is both an epidemic and euredimic disease which occurs only in those who have been fed on spoiled maize. It is characterized by digestive disturbances, erythemia, and great nervousness. Some cases develop grave cachexia or even insanity. The disease seems to prevail with more virulence in the spring of the year, the symptoms gradually abating during summer and winter, but to reappear the next spring, provided, however, the cause has not been removed. It is more or less insidious in its invasion, usually the first symptoms being gastro-intestinal distur bances, soon to be followed by erythemia of the skin and in a short time involvement of the nervous system. It is a slowly advancing toxemia, with the brunt of the disease falling ultimately on the nervous system. The disease has not prevailed to any extent in this country, and opportunity for its study has been very limited; and, for the present, need not be looked forward to with any great degree of alarm. The treatment resolves itself largely into that of prophylaxis and such tonics as iron, quinine and strychnine with proper sanitary surroundings. Good It is not with any desire to enter the politiCitizenship. cal arena, or to take part in party or factional discussions, but simply as a private citizen to express a few thoughts along the line of good citizenship. It has long been a more or less fixed impression in this country--our boasted land of the free-that the professions should steer clear of politics, and especially has this been applied to those engaged in the practice of medicine, and the ministry. We grant the correctness of this view only to a certain extent. It would certainly be beneath the professional dignity of our honored profession to wallow in the gutter of ordinary ward politics, and to an even greater extent would it be out of place for the ministry to do so. While this is true, there stands at the door of every citizen composing our Commonwealth the demands of good citizenship. As physicians, our life work is, and should be, that of healing the sick and advising the healthy along the lines of sanitary science. Yet we should have time to keep conversant with the great questions that stand for good and evil in the government of our country. The physician owes a duty to himself, to his family, and to his country, in having a voice in the government of the greatest country in the world. Just at this time, on the very threshold of a national election the question of National Government should receive more than just a passing notice by even the followers of Aescula pius. The ministry has of late been aroused to the importance of its duty to the country, not only as a great spiritual force, but as a force in maintaining and uplifting the purity of our governmental, as well as social, affairs. There is possibly no class of men-with the exception of the ministry-that can weild a greater influence for good than the medical profession. It becomes us, then, as men, as good citizens, to exercise this privilege to make the government by which we are governed the best in the world's history. There is no legacy that we can bestow on our posterity that can equal that of a good and honestly administered government under whose rule those coming after us can sally forth to meet the stern problems of life, feeling that there are equal privileges to all, and special privileges to none. A NOTABLE MEDICAL MEETING. The thirty-fourth annual meeting of the Mississippi Valley Medical Association was held in this city October 13, 14 and 15, at the Seelbach Hotel. This is one of the oldest and most important Medical Associations in the Middle West, and its meetings are always well attended, and bring together a good number of the foremost men in the medical profession. The record of the Mississippi Valley Medical Association stands out in bold relief as one of scientific advancement, its program always bearing the names of some of the great leaders of American medicine. The local physicians and the Jefferson County Medical Society may justly feel proud of having the distinguished honor of entertaining the Mississippi Valley Medical Association, and the manner in which they did it. Some of the distinguished physicians present were: Recent Progress in Medical Science. Antimeningitis Serum.-F. J. Sladen, Baltimore, (Journal A. M. A., October 17), reports the results of the use of Flexner's serum in twenty-one case of cerebrospinal meningitis in the Johns Hopkins Hospital. From their experience they give their impressions substantially as follows: All cases of meningitis in which the meningococcus is suspected should be treated by lumbar puncture and serum injection as soon as possible. The serum does no harm if the case is not meningococcal, and may do good. The course of the disease is changed by the serumthe long-drawn-out cases are not seen, and the terrible sequlæ are rare. The rapidity of the disappearance of the symptoms. and signs with the use of the serum suggests an antitoxic property; the positive chemotaxis for polymorphonuclear leucocytes, and the promoted phagocytosis are the most definite and constant features; finally the reduction in number of the diplococci, the change in the staining properties, and the loss of viability, speak for a bactericidal power, although it is a question whether this may not be explained by phagocytosis. Three of their twenty-one patients died, a mortality of 14 per cent., as compared with 64 per cent. in patients treated without the serum in previous years. One case of the three was a fulminant case, one was complicated with bronchopneumonia of both lungs when received, and the third patient received his first injection on the fourteenth day of the disease, when he was unconscious, in convulsions, and practically in extremis. Sladen and Parker believe that the serum injections should be made daily until there is a drop in temperature and disappearance of symptoms, indicating arrest; and that it should be renewed at any sign of a flare-up. Gonorrhea Vaccine.-W. J. Butler, Chicago, and J. P. Long, Birmingham, Ala. (Journal A. M. A., October 17), report opsonic treatment of gonorrhea in female children in 25 cases. The patient's index was taken every other day with very few exceptions, and every dose was administered and regulated according to the index. Usually from one to several indices were taken before the inoculations were begun in order to test the immunity wave for the individual during this time. No local treatment was employed. As controls, the phagocytic count of four healthy boys was taken to get an average normal to com pare with that of the patients. It is desirable to take at least four cases as a phagocytic count of healthy individuals may vary considerably. On the average the innoculation had to be repeated every fifth or sixth day. Only one strain of vaccine was employed, the authors seeing no advantage in mixed strains. Twelve acute cases, that is patients coming within a few weeks from their infection, were treated. Nine of these patients recovered after an average of 43 days of treatment. The three who did not recover averaged 38 days. There were 13 chronic cases, in II of which the patients recovered after a period averaging 39 days. Five cases, one acute and four chronic, were treated with the Rogers and Torrey serum with pretty uniform negative results. The authors conclude that in the treatment of gonorrhea in female children, gonococcus vaccine is more effective than local applications, which they think in some cases actually delay recovery. In many cases, more particularly those of long standing, the vaccine treatment produces marked improvement and often recovery. This does not hold good, however, in all cases, some requiring a very prolonged course of innoculation. The effective dosage varies in different cases and at different times in the same case. It will be best determined by the opsonic index to gonococcus. They found doses varying from 5 to 50 million very satisfactory. In using the inoculations without the index in these quantities inoculation should be given every fifth or sixth day. Doses up to a 100 million only very exceptionally produce any untoward symptoms, but do not seem more effective than smaller ones. Their experience does not warrant recommendation of serum treatment in these cases. The Intestine In Diarrhea.-J. H. M. Knox, Baltimore Journal A. M. A., October 17), gives the result of the study of the autopsy records and clinical histories of one hundred fatal cases of infantile diarrhea occurring in a series of years at the Thomas Wilson Sanitarium, Baltimore. The findings are tabulated and discussed and the conclusions summarized as follows: "I. Mucus is evident to the naked eye in a large percentage of diarrheal stools of infancy. Its absence renders the presence of serious intestinal lesion improbable. Mucus in large amounts may be found in the stools in all intestinal disorders, but the proportion of cases with extensive intestinal alteration is greater when the quantity of mucus is in considerable excess. 2. The appearance of blood in the diarrheal dejecta of infants suggests an alteration of the intestinal mucosa in proportion to the |