part of the body it means, according to the views set forth, a loss of function in the sympathetic ganglia, or, in other words, anaemia of these knots of nerve tissue. In plethoric headache, pulmonary congestion, congestion of the womb, congestion of the enteric mucous membrane, and in various forms of hemorrhage, we have never failed to contract the arteries in the affected region, by applying heat over the sympathetic ganglia, supplying the arteries with contractile nerve fibres, apparently proving the real disease to be located in the anaemic ganglia; cold over the spine, increasing the appetite, the general nutrition and the vigor of the patient.

Let us take another example of medication, to illustrate the effects induced as due to the action upon nerve centers; and as speaking an example as we know is that of oxygen by inhalation.

This gas if pure and properly diluted by a gas of lighter specific gravity, is easily absorbed by the capillaries of the lungs, and from our own observation acts almost precisely as the cold over the spine. The first effect of inhalation is to strengthen the muscular action of the heart, and the tone of the arteries, increasing the volume of the pulse, and rendering it incompressible.. It gives a glow to the whole system, and warms the body, denoting thereby a general dilatation of the capillaries, and increased metabolic changes, and thus an increase of heat; and if taken in low conditions of health, it will soon begin to increase the appetite, by the very action noted.

Speaking of the effects of the inhalation of oxygen, the late Samuel S. Wallian, in his work upon "Oxygen and Other Gases in Medicine and Surgery," calls attention to the fact that oxygen always develops the appetite. He says: "The majority of invalids to whom we have administered this agent, have almost all experienced at the end of a few days, this need of reparation, as indicated by the appetite. This is an important point, since it indicates what is being accomplished in the heart of an organism of which the blood has been better oxygenated, a phenomenon accompanying reconstructive metamorphosis. Beddoes,

and all those who, like him, have employed oxygen, have been struck by this remarkable influence on the digestive function; but minds wholly occupied with the treatment of phthisis have not sufficiently comprehended what conclusion would be drawn from this invaluable action of oxygen toward the reconstruction of an enfeebled organism."

Caillens, however, one of the first to prescribe vital air in phthisis, very clearly saw that "it is by restoring the vital energies that this gas acts as a curative means."

According to this exposition of the effects of oxygen, it evidently either stimulates the ultimate cells of all tissues to more active processes, directly; or else its first action is upon the vaso-dilator nerve centers, causing a general expansion of the arterioles throughout the body, thus "restoring the vital energies." Oxygen should only be administered properly combined and prepared for therapeutic purposes, or it will be found insufficient in action, and not only so, but injurious, also, on account of the chlorine and other gases contained in that prepared for commercial uses. The combination most widely endorsed by all competent writers upon the subject, consists of two parts of pure Oxygen, one part of Nitrogen Monoxide, and one per cent. of Ozone.

This formula is in use by the London Oxygen Hospital, and is undoubtedly the best for administration in the majority of cases, because it is pure, unirritating to mucous membranes, and will be absorbed by the capillaries to the full requirements of the patient.* It is almost impossible to give an over dose of oxygen, as the system invariably rejects more than is required; the patient turning away from the inhaling tube immediately a sufficiency has been inspired. Oxygen alone, is too dense in its specific gravity for absorption by the capillaries, and has too great a local oxidizing effect, therefore its dilution with a gas of lighter specific gravity is necessary to obtain successful results.

Cold over the spine has been successfully used in all spasmodic forms of disease, by expelling the excess of

*The Oxygen obtained in the Walton Laboratory, N. Y., is thus combined.

blood from the motor nerve cells, and by its action on the sympathetics at the same time, inducing expansion of blood vessels through the system, and a better nutrition of the organs, tissues, and muscular system; therefore permanently driving the excess of blood from the nerve centers through the greater demand for it, by the better nourished body; thus curing the disease.

In many forms of skin disease, cold over the spine will quickly relieve and cure; and in neuralgias, as well as in neuritis, it is, in the majority of cases treated, entirely successful. Enough has been said for one paper to demonstrate somewhat the effect of the circulation upon the nerve centers; and the action of those centers upon the systemic circulatory apparatus in health and disease, according to the amount of blood circulating within them. Our object has been to evidence the wide field of treatment that is open to the profession, by the study of the central nervous system as the originating source of disease in general, and the value of investigation into the effects of drugs upon these centers, as judged by their action upon the expansion and contraction of blood vessels. It is with the hope that we will create interest in what we are convinced is a study of deep importance to the profession, and to those under their care, that we terminate this writing.

The Significance of "Degeneration" to

the General Practitioner.*

By HALDOR SNÉVÉ, St. Paul, Minn.

Chairman Section of Nervous and Mental Diseases, Minn. State
Medical Society.

FOR

OR the past few years the press, both medical and lay, has been full of what has popularly come to be known as "degeneration"; a word made notable by Max Nordau's book; and as each special branch of study has a great many technical expressions which simply cover up meanings to the uninitiated, I have adopted for our purpose here the word "degeneration," which really means in the sense that I use it, the anthropology of degeneration. I have also endeavored to avoid as far as possible technical names of all kinds. Now what do we mean by degeneration? For our purposes it means a decadence or defect of the mental and moral qualities of an individual.

As I hope to show you later, this is both frequently associated with, and dependent upon, physical degeneration or defects.

Let us first have a short glance at the history of crime, insanity, and prostitution in its broadest sense. Among the savages homicide has been frequently considered proper and justifiable; among certain African tribes it is counted proper

*Read before the Minnesota State Medical Society, June, 1897.

to extinguish life in old and useless people, by beating them on the head with a club.

Among more civilized peoples, as for instance, the vikings of old, it was not considered a murder to take the life of a slave at the caprice of his master, or to carry away treasures after conquering the owners; in our own times, war, or the murder of large numbers of individuals in battle, is still considered justifiable. Murder, parricide, infanticide and robbery, have not always been considered crimes, and crimes are acts which vary with the conceptions of right and wrong that may exist at a given time in a community.

Insanity in ancient times, was only a manifestation of possession by a demon or unclean spirit, and the treatment of the insane corresponded to this conception.

To-day it is our proud boast that medicine has established the fact that insanity is a disease.

The history of prostitution is a varied one. In Greece, prostitution was quite an honorable profession at one time, and fallen women were the advisers of the Great.

of

In the time of Louis the XIV and XV, an almost analogous condition existed. At other times these offenders have been compelled to wear red gowns as badges of shame, have their ears cut off, and even be flayed alive. Paupers, idiots and imbeciles are other classes degenerates that will here only be referred to in passing. V. Krafft-Ebing has designated all of the classes referred to above by the appellation, "Nature's step-children," a peculiarly happy name.

The legal treatment of these unfortunates at different times in the World's history would fill volumes. Briefly it may be said that the primordial idea was punishment; and it may also be said that the primordial idea of punishment was vengeance. "An eye for an eye" and "a tooth for a tooth", it read; later it was also for the intimidating and deterrent effect that punishment would have on crime; and to-day it may be said that punishment for crime is a combination of the foregoing, together with-more prominently -the protection of society. It is of burning importance