any of the manly sports. The only permanent reminder of his days as a scorcher will be the hump which he will always carry, or the deformed finger-joints, lame heart, or deformed nose. ""T is true 't is pity and pity 't is 't is true'' that men show so little common sense in the use of the bicycle, when with a proper saddle to prevent urethritis and the erect position as in horse-back riding, to secure good respiration, it might, if used with moderation, be one of the most healthful as well as most convenient methods of transportation or recreation.

Preventive Medicine is to-day the great search-light of our profession, sending its rays into the dark places of the earth and giving notice to its inhabitants of impending danger. Theories are developing into facts, prophecies are being fulfilled, and the Roentgen rays of the laboratory are finding the causes of diseases as our fathers in medicine could not discover them. Healthy people are not predisposed to disease from any source. The various forms of bacilli may invade the healthy organism and not find a resting place. Or should they obtain a temporary lodgment they may be met and expelled as rude invaders by those faithful sentinels of nature-the leucocytes or white blood corpuscles. If, however, the system shall become depleted from any cause, then colonies of bacilli may take up their permanent abode in different portions of the body, more especially the lungs, as in tuberculosis, and carry on their work of destruction.

The people of this country are thinking and speaking about these things, and are ready to learn new truths. Consequently public opinion is progressing. State Medi cine meets the public with new facts, gives proof of the danger, and shows a way of prevention. Our State Socie

ty is willing to assume its share of responsibility in furthering public education. Each member of the society should be a committee of one to provide the greatest good for the greatest number by his own personal teaching, by rendering aid to the health officers of the town in which he lives, and by impressing on one member of the legislature the importance of correct state laws.

A Class of Fatal Cases Presumably

Due to Intestinal Ptomains.

By E. D. Ferguson, M. D., Troy, N. Y.

Something of over twenty years ago a case occurred under my observation that created in me a profound interest and became the subject of considerable thought and reading. The patient, a man about forty years of age, had the appearance and history of robust health. I had known him for several years and his sturdy figure had impressed me with a favorable view as to his ability to resist disease and his chance for many years of life. He was taken quite suddenly with abdominal pain and became rapidly very ill, so that on the second day I saw him in consultation. From the condition and clinical history, we could fairly exclude intestinal obstruction and peritonitis, but vomiting, which had begun early in the trouble, had continued, and instead of becoming offensive in odor, as would have been expected in obstruction, was of a watery material which later showed small brownish flakes which gradually grew darker. The vomiting was frequent but not violent, and at times was rather a regurgitation than a vomiting. His pulse was rapid, the countenance anxious, the complexion somewhat "muddy," although he had naturally a dark skin, and the sclerotic lost its pearly clear

ness, although not to a degree to lead me to pronounce it colored with bile. The movement of the bowels did not throw much light upon the case, but the color, though dark, was not a healthy brown, neither was it a green nor a black. There was quite a degree of tympanites, but no notable tenderness.

The man was evidently "sick unto death," though he retained his mental faculties in a fair state during the greater part of his illness. The vomited material grew darker, finally almost a "black vomit ;" his pulse became very rapid, and just before death the temperature rose to a very high point-over 105° F. No post-mortem examination was made, nor do I now think that any positive result could have been obtained from one, in view of the limited knowledge of pathology then in our possession.

Here was a case that I was unable to classify. That it was not a common disease was evident; nor could I assign it to any of the recognized forms of fever or local inflammations. That it was toxic in its origin seemed the only rational explanation, but none of the mineral or alkaloidal poisons would furnish a similar clinical history. The animal poisons seemed the more probable basis of explanation, and I recall my disappointment, when some few years thereafter, I read Boehm's article on sausage, fish, and cheese poisoning, in Ziemssen's "Cyclopædia,” without securing definite aid in unravelling the tangle. I had awaited the appearance of that volume with this case in mind, and though disappointed in the hope of definite aid, my opinion that I had seen the work of some animal poison was strengthened in a general way.

However, I had been unable to secure evidence that the patient had taken any food likely to cause the trouble,

or different from that taken by other members of the family. Hence I finally evolved the idea that this was a case of auto-infection, though the conclusion was based upon a process of exclusion rather than any reliable evidence from pathological investigations.

About ten years thereafter I witnessed a similar course of events in a girl about ten or twelve years of age. The onset was sudden, there being considerable abdominal. pain, fever, and vomiting, with rapid failure in the vital forces. The vomiting was possibly more regurgitative in character than that of the first case, but the colored and finally "coffee-ground" appearance of the material from the stomach recalled the former case and led me to anticipate the fatal issue, which occurred in slightly less than three days from the time of onset. By this time some progress had been made in the chemistry of decomposition. Alkaloids had been secured from animal tissues, and a presumption was beginning to take reasonable grounds in favor of the intervention of bacteria in the process. The work of Selmi, of Bologna; Gautier, of Paris; and Brieger, of Berlin, had begun to throw a degree of valuable light upon this somewhat obscure field, so that rather definite notions were possible, and I began to speculate somewhat on the various links in the chain represented by my two cases. The dark or coffee-ground vomit had impressed me as an important element in the evidence, for I felt that I could exclude upon reasonably good grounds the presence of gastric ulcer in any of its forms as the source of the hæmatemesis. In piecing together the more prominent signs and symptoms as I have related them, I came to the conclusion that the first step was due to the presence and functional activity of some micro-organism in the intestinal