the child sulphur, with the result that in a very few days the eruption appeared and the epilepsy disappeared, and in a short time the child was cured. One thing in particular is that, although this theory may be true that many of these diseases are hereditary and many of them may be cured, the trouble is we do not have an opportunity to cure them. If we wish to prosecute this work to the best advantage our chief aim should be to impress upon our patients the fact that the attendance upon the confinement case is not the end of our responsibility. We should demand the privilege, if we are to be the family physician, of watching the child through its younger days, and thus be able to discover any inherited tendency to disease in the child.

J. W. MEANS, M.D.: My ideas have been expressed here; but there is one point that I wish to speak of, and that is the potency. You will frequently hear a mother say that she has given sulphur to the children, and on inquiry you will find that she has given half a teaspoonful at a dose. Now, this being the case, there is no possibility of its being of assistance. But if you give the 30th it will be of some benefit. There is a mechanical and a medicinal effect of drugs. To get the latter we must give potential remedies.

Jos. P. COBB, M.D.: As was stated by the last speaker, my ideas have been pretty well expressed. I believe most thoroughly that constant care and watchfulness will correct and cure many inherent tendencies.

In a large hospital experience I have found that a majority of children, not syphilitic, are afflicted with inherent tendencies to scrofula. Even when prescribing for acute and transitory ailments the constitutional side of the case is always kept in view, not only the personal history of the child but the family history as well is carefully inquired after and its possible effects upon the present condition noted. The different salts of sulphur and calcarea are probably the remedies most frequently employed in this constitutional treat

ment.

DR. GALE: This is a subject which I think should attract the attention of all Homoeopathic physicians. If there is a disease in which our treatment stands pre-eminently out with grand results it is in just this class of cases, and I think, as Dr. Bailey has said, that it is our duty as physicians to watch such cases and such children, and I find if I can get such a child past the seventh year that I have done a great deal towards their growing on to be men and women. The next period is from eleven to fifteen years of age, and then is when a great deal of damage is done and a great many lives lost on account of parents crowding children through our schools. I do not think there is any place that fosters and encourages tuberculosis more than our closely crowded school-rooms, and I am very arbitrary in my advice in that regard. I always insist on the children being

taken out of the school. They say, "Well, they cannot stay out and lose a whole year," and I say that they must be taken out. It is the time that they should be more carefully guarded than at any other time. Sitting in school makes them stoop-shouldered: it gives them impure air and less air than they should have. I want to mention Kali sulphur, as I have found it a very useful remedy. WILLIAM BOERICKE, M.D.: I am very grateful for the discussion brought out by this paper. I did not intend to go into the details of the treatment. I entirely agree with Dr. Means as to the potency of the remedy. As to the treatment of these hereditary cases, I also believe that they must be carefully watched.

PREVENTION OF DEFORMITIES.

BY MILLIE J. CHAPMAN, M.D., PITTSBURGH, PA.

WE read that God created man in His own image, and we conclude that he was in the beginning of perfect form. Then environment must have been responsible for the imperfections which gradually developed. They have existed and have been treated since an early period, as we learn from medical literature. A brief review of the important work in the direction of diagnosing and correcting deformities up to the last two decades is of great interest. Hippocrates wrote a treatise on articulation, in which he taught the proper method of bandaging in cases of infantile deformity of clubfoot. Celsus described the radical cure of harelip. Professor Andry, of Paris, first arranged all deformities under one head. He tried to find out their common causes and establish general principles and indications for their efficient treatment. His publications appeared. in 1741. Stromyer, in 1830, first performed subcutaneous tenotomy for the relief of clubfoot.

Diffenbach and Langenbeck in Germany, with Bonnet, Guerin and others in France, labored to develop scientific knowledge and orthopaedic surgery. In England, Dr. Little was the pioneer. The subject of congenital clubfoot himself, he could understand the demand for correction of the deformity. His efforts and energy gave London the Royal Orthopedic Hospital. America was not in haste adopting specialties in medical science. In 1834, Dr. David L. Rogers first performed tenotomy in this country. Detmold, a pupil of Stromyer's, in 1837, introduced among us subcutaneous myotomy. In 1842, Dr. Valentine Mott published the result of his studies while a pupil of Guerin, and with great enthusiasm announced his intention to found an orthopedic hospital in New York. His life was not spared to accomplish his purpose. Dr. Henry J. Bigelow, of Boston, published a work in 1845 on orthopedic surgery. In 1876, Sayre gave the world his book on the same subject, which was

so favorably received. He recognized that orificial irritation was a source of reflex nervous contraction. Since that time orthopaedic surgeons have increased yearly in numbers and ability, until to day every great medical centre affords specialists and hospitals where a multitude await their skill in the use of the knife or some mechanical device for correcting deformities. The development of surgical science in the past ten years has enabled surgeons to relieve many a deformity that in earlier times was considered irreparable.

We find in one of the latest publications on surgery that deformities from non-development are only of interest surgically when some apparatus may be applied or some operation performed. But to the mother of a deformed child and to the victim there is an interest beyond the brace and knife, an interest which desires for all others exemption from his fate. We should be swept aside by the tide of progress did we not join the clan who see in the future most hope from the department of prophylaxis. Hence to-day we ask you to consider, not only the distinguishing features of disease and the best methods of treatment, but can we, and how can we, prevent the occurrence of deformities? It is a law of heredity that deformities commonly reappear for four or five generations, and are seldom altogether eradicated in less than ten or twelve. The members of this organization know that suitable medication gives us brighter prospects.

I will first mention the deformities of most frequent occurrence with the causes assigned. Harelip and cleft-palate are classed as non-development from failure of the mother to properly assimilate phosphatic elements of food. It is generally conceded that the same causes producing rickets are at the foundation of this trouble. Spina bifida is also due to similar conditions. Imperforate anus or vagina, anomalies of ears, nose and teeth all show faulty development, and are of intra-uterine origin. Monstrosities having absence of brain or skull, or with hernia of brain substance, are deformities resulting from disease of the nervous system, beginning during intra-uterine life, and rarely survive.

Genu valgum, or knock-knee, and genu varum, or bow-legs, are of rachitic origin. Pigeon-breast, barrel-shaped breast and flat-chest also are deformities of which rachitis is attributed the predisposing condition, but they are acquired after birth. Intra-uterine amputations and congenital malformations which closely simulate fracture

are said to be caused by amniotic adhesions during the first and second months of intra-uterine life. To those who know of the numerous attempts to destroy the product of conception at this period of pregnancy it is not surprising that adhesions exist. If every attempt failed, and adhesions followed, producing these deformities, some neighborhoods would need more than one hospital for cripples. No one can read Hugo's description of the cruel practice of severing muscles, which resulted in the deformity of "the man who laughs," without a chill of horror. But the one who aids. in removing the uterine contents at this period performs a deed less humane. He ends a life, or, when failing in the purpose to destroy, causes ill-health of the mother and deformity of the child. Often its physical body is less maimed than its mental and moral condition. Paralyses cause lamentable deformity. The promontory of the sacrum or the ischiatic spines may make pressure upon the skull during delivery, which will result in facial paralysis. The seventh nerve being injured at the point of exit by the forceps produces this marked deformity. Pressure on the brachial plexus during delivery may later develop infantile paralysis.

Spinal curvatures are acquired deformities. Lateral curvatures are most common, and are generally attributed to muscular weakness and bad position in standing, sitting or sleeping. A recent article by an able authority considers this deformity of nervous origin. In discussing the subject, he says: Lateral curvatures are among the deformities most frequently met with, and at the same time most disastrous in their effect on the development of the human body. Their causes are numerous and varied, but those of most common occurrence are nervous prostration and diseases of the spinal cord. Impaired nutrition, caused by weakened digestion, rapid growth or any derangement, if allowed to continue, will end in impoverished nutrition of the spinal cord, impairing the voluntary application of the nerve force. As one arm is used more than the other, it requires more muscular contractions on the other side to balance the weight of this arm; the result will be greater pressure on the cartilages on that side, which would be counterbalanced by involuntary action of the other if the weakened condition of the nerve did not prevent it. Often we see well-developed scoliosis, which reveals, on investigation, impaired action of the digestive organs, or exhaustion of the nerve-force occasioned by the parents