But this reasoning is purely hypothetical, and I have presumed to present these questions for your consideration, hoping that further observations will throw more light upon this interesting subject. Some one has said: "Results are usually of easy observation, but prudence dictates moderation when we attempt to assign reasons for them." Consequently, we must wait for the accumulation of experience and the results of patient, careful observations to develop hypotheses into facts. Theories are of no use to the practical physician, except as they may serve as the groundwork upon which ultimately to build facts that may be utilized. It was not the primal object of this paper to present you with new theories or hypotheses touching therapeutics; nor is this the time or place for me to do so, (and, indeed, some may smile, perhaps, at the idea enunciated,) but it was designed more particularly to bring before you a remedy, in the treatment of dropsical affections truly of great value and efficacy, as evidenced in a series of cases recorded by Dr. Jewett, (vide supra) which I have not time to repeat, and in many other cases within my own knowledge. One other thought: There are lying all about us, in the vegetable world, remedies, that, hitherto, have been disregarded by the profession generally, because employed only by "old ladies" or quacks, partly, because we have not become as familiar with their virtues as it is our privilege-our province. It is unfortunate, I repeat, that a fear of innovation should prevent the regular physician from analyzing and utilizing medicines, which, in the hands of irregular practitioners, have been successes, and have gained for them, perhaps, the merit of discovery, which should not have been the case. It has been thus, to a certain extent, with the remedy before us. Presented to the profession by the regular physicians, it has fallen into the hands of so-called, eclectics, by whom it is much used. Shall we continue to overlook indigenous vegetables, that are plentiful and cheap, preferring in their place, imported and expensive remedies, while quacks, old women and irregular doctors make use of them to great advantage? On the other hand, as "No pent up Utica contracts our powers," let us seek out and employ, for the good of our fellow beings, all that there is for us to use in this almost limitless realm of nature. WILMOT L. RANSOM, M. D. A motion was made to receive and refer the report to the publishing committee. Dr. N. S. Davis.-I am aware, Mr. President, that the hour has come for the next order of business; and yet, I am hardly willing to allow the last paper to be disposed of without one or two remarks. The paper interested me much, because I have had occasion to use the medicine spoken of in the form of the fluid extract, for a number of years past. Speaking of any remedy in the treatment of dropsy; I suppose we all understand that dropsy is a mere symptom of some pathological condition, and may exist as a symptom of a good many pathological conditions. Hence, a remedy may be very successful in diminishing that symptom in one condition, and yet, not be applicable at all, in another. That the apocynum cannabinum spoken of, is a valuable remedy, I have not any doubt. I have prescribed it in the treatment of affections of which dropsy was a symptom, for a considerable time, and have found great diversity in the results of its action, probably dependent upon the actual pathological condition of the patient. I have used it with patients laboring under dropsy from Bright's disease; I have used it in dropsical conditions from cardiac disease; I have used it in cases of dropsy from what I suppose to be simple hyperæmic engorgement of the kidney, without structural lesion; and I am inclined to think in this latter condition will be found its chief value. Acting directly as a sedative to the circulation, it produces some modifying influence over the renal vessels, and probably upon the vaso-motor nervous system generally. That it will be an exceedingly valuable remedy in the treatment of all dropsical cases that depend on a hyperæmic condition of the renal vessels, without organic lesion, I have no doubt. When the dropsy depends upon organic lesion, it may be made temporarily palliative, but, according to my experience it is a difficult remedy to administer continuously through any long period of chronic affections without inducing, in a few days, an excessive irritation of the mucous membrane of the stomach and bowels. It will hardly have this effect, however, in one or two days, when administered in moderate doses. It can be used generally three, four, or five days successively without disturbance. But in carrying it beyond that, I find great caution necessary; there is a constant tendency to a degree of nausea that would require two or three days to recover from. But I must say that, in a considerable number of cases, where the patients were moderately feverish, and where dropsical effusions occurred, as the result of hyperæmia of the kidneys, it has acted favorably. It increased the quantity of the renal secretions in most cases, but certainly not in all. I have thought that when the medicine produces diaphoresis, especially in cardiac affections, there was no action upon the kidneys; but when it is sufficient to modify the circulation and hold it there two or three days steadily without excessive evacuation of the bowels, it pretty uniformly will produce an increase of the action of the kidneys. I think the paper of value and, as far as its experiments go, worthy of commendation. Dr. E. W. Grey.-I appreciate the remarks made by the author of the paper, in reference to the physiological action of the drug mentioned. I think his work is in the right direction and should be encouraged. Certainly I like the clear statements of the paper; but I wish to call attention to what seems to me a source of some inaccuracy. I believe there was no account of the amount of urine; no account of the amount of water taken into the system; and there was no account of the degree of watery saturation of the atmosphere, which would affect the result; there was no account of the condition of the discharges of the bowels. It seems to me these element might have varied the conclusions. It is desirable that in conducting such experiments, every possible element that might have varied the conclusions should be guarded against. Dr. H. A. Johnson.--I am prompted to say a few words in regard to the subject, by a fact from my own experience. In 1853, a patient in this city, a man then about 55 years of age, who had been a somewhat fast liver, was taken with what we supposed, Bright's Disease. He was under the care of my associate, at first, Dr. W. B. Herrick. Upon examination of the urine, I found it contained large quantities of albumen and microscopic tubular casts, with granular matter and a few epithelial cells. It was regarded as a case of Bright's Disease, without any probability of cure. He went on for two or three months under Dr. Herrick's care, and I saw him occasionally, and made an examination of the urine. At length somebody suggested that Indian hemp might do him good. He wanted to try it, as he was sleepless, and as I supposed at the time it was cannabis Indica that he referred to, I thought that possibly it might be well to try it. Dr. Herrick and I concluded to let him get some preparation of it, and it turned out to be an infusion of this apocynum cannabinum. Without knowing anything of its effects except what I gathered from reading a medical journal, we concluded to try it. The result was that he got right along from his first taking it, on the first of January until the latter part of April. There was a decided improvement in his condition, both as to the amount of albumen in the urine, and as to the character and quantity of the tubular casts, and as to the oedema or dropsical effusions in the serous cavities. At the end of that time he concluded to go to Buffalo, N. Y., where he met Dr. Ludlam, who said, at meeting him, "Well, Allen, I expected to see you about dead; I presume you will live long enough to get to New York. Dr. Lud 'am continued the infusion, the patient drinking of it freely; and in the course of a year the old gentleman came back to Chicago with his dropsy all gone, and became a lean, gaunt, dried up old man. He used to play his game of cards as usual, and take his drink of whisky, and live as he always lived. He died about ten years afterwards from some affection of the central nervous system. The only medicine which had any effect upon him was this infusion; and its effect was not to increase the urine, but it stimulated the secretions from the alimentary canal, producing liquid, but not painful stools. I believed then, and still do, that that remedy had much to do with the cure of the case. I have been in the habit of using it rather in the form of an infusion than as a fluid extract. It is less likely to injure the alimentary canal if largely diluted. It did not modify specially the quantity of the urine. Prof. Bartlett.—Dr. Jewell states that the root alone is efficacious. The fluid extracts are made from the root entirely. As to the power of the remedy, in one case 100 pounds of urine was evacuated in twenty-four hours. When you have cases of dropsy a gin tincture is best. Put half an ounce of bark of the root into a pint of gin, and give from half a teaspoonful to three or four teaspoonsful every three hours, using the remedy so as to avoid purgation. The paper was referred to the Committee on Publication. Drs. G. E. Willard, T. G. Bluthardt, of Chicago, and C. N. Cooper, proposed for membership, were referred to the Board of Censors. The Board of Censors submitted the following report: REPORT OF THE BOARD OF CENSORS. In regard to the letter of Dr. Barnett withdrawing charges made against the Society of Macoupin county for medical improvement, we would respectfully report that it appears in evidence that Dr. Barnett associated himself in practice with an irregular physician. In consequence of such association. the Society expelled Dr. Barnett, who preferred the charges now withdrawn. The Macoupin Society is thus placed in an unpleasant situation, for which there seems to be no remedy. The Board of Censors are of the opinion that expulsion from a local society should work expulsion from this Society. The following applications have been presented to us, and we recommend their admission to membership in the Society. Dr. Ransom Dexter, Chicago; Dr. S. O. Richey, Chicago; Dr. W. Godfrey Dyas, Chicago; Dr. A. H. Foster, Chicago; Dr. C. H. Lovewell, Englewood; Dr. C. S. Taylor, Rockton; The report was adopted. A Member-We have adopted the report of the Board of Censors. That report recommends the expulsion of a member from the Society. Are we to understand that as a rule now? Dr. N. S.Davis-The adoption of the report would not work such expulsion without further action. The report simply expresses an opinion that such should be the rule. Dr. C. W. Earle, chairman, presented the report of the Committee on Diseases of Children, as follows: SCARLATINA IN CHICAGO. (PARTICULARLY THE EPIDEMIC OF 1876-7.) BY CHARLES W. EARLE, M. D. Scarlatina is by no means a new disease in the city, but its unusual prevalence during the past seven months, and the consignment of more than 800 persons, mainly children,-to early graves, has brought with peculiar impress the subject to our minds. To place on record what may be of use to the profession in regard to this epidemic, and to make inquiry in regard to certain questions not yet fully decided, are my reasons for choosing this subject at this time. It is a well known fact that Scarlatina, more perhaps than any other disease, is characterized by great diversity in regard to its intensity, complications and sequelæ. There are questions, too, as to the season of the year in which this disease prevails with greatest frequency; the age at which children are most susceptible; the influence of sewerage, poverty and wealth, on the mortality; and the worth or worthlessness of certain drugs as preventives of the disease. In a circular sent to every physician in the city, about April 1st, 1877, I requested information in regard to many of these mooted questions, hoping by the collection of a large number of cases, to add some testimony which would prove useful in future epidemics. Eight hundred circulars were sent,-less than one hundred were returned with answers. My statistics, therefore, |