vessels carried into the circulation aids in preventing the general body heat rising above normal. Thus we see the value of recording the temperature of the wet, as well as the dry, bulb of the thermometer. This is an interesting subject to pursue into its therapeutic aspect, but verburn sapientis. Passing to the tier composed of special climates, I will merely say that in my opinion too little consideration is shown to the circumstances of the particular place as regards food, lodging, work

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... amusements. So often, while the general climatic conditions are favorable, yet after all, the sending of that particular patient to that particular place is a failure, it is a case of a round man in a square hole, or vice versa, and while the disease may have been placed in the appropriate climate the individual has not. As Julius Braun said so admirably in his classic work on "Baths and Health Resorts:" "You have to consider not only the individual sickness, but the sick individual in climatic therapeutics." There is much to be said, from which the clock's warning face bids me refrain, but do let us remember the advice I heard Frank Buckland, the naturalist, once give: "When you get hold of a fact, pin it down for future use." When found, make a note of it. It is the slow accumulation of these, brought together by many hands, in many lands, which will ultimately give us a scientific climatotherapy. In the recording of cases of phthisis, treated by climate, especially as to results, the history must be sought and reported over long periods to be of real value, and I know full well, this entails much labor and can, with the best endeavors, be only followed in a few out of many cases that are seen. It is not the results of any one man or place that are of so much value as their use with many others; their family likenesses as it were, are brought out and one report aids and corrects the other. Again, for comparison, do let us receive more facts concerning the natural history of phthisis as seen by city physicians, where no climatic change could be noted. Sometimes we congratulate ourselves that while a case of phthisis did not recover, yet it lived for some time, say for fifteen years, and think that here at least we see the retarding effects of a certain climate ; but turning to the pages of such careful observers as Flint, we are led to doubt this special influence when we find similar cases recorded living as long without using such climates. I must now cease giving you these scattered suggestions concerning the principles of climatology and close this brief review of the general subject, to make way for the more important discussion of its various branches, of which the program with its names of authors promises us a rich feast. This is a gathering where the men of the sea, of the plain, of the mountain, of the city and hamlet are drawn from their homes, in many cases hundreds of miles apart, to study and advance the science of climatology. Fourth of July Surgery.-A recent issue of Puck has the following timely skit: "Physician (as he finishes bandaging up Mr. Oldboy, who has unsuccessfully set off some fireworks): ' Well, how do you feel?' Oldboy (in muffled tones): 'Just like a boy again.'" Laughter is the Staff of Life.-Mr. Joshua Billings believes that " Every time a man laughs he takes a kink out •of the chain of life, and thus lengthens it." SURGEON TO THE PRESBYTERIAN HOSPITAL; SURGEON-IN-CHARGE TO ST. JOSEPH'S HOSPITAL. CHICAGO. It has been known for a long time that in exceptional cases an attack of erysipelas has exerted a curative effect on malignant tumors. A number of years ago Billroth reported a case of inoperable sarcoma of the pharynx cured by a severe attack of facial erysipelas. The tumor mass sloughed and the large defect healed rapidly by granulation, leaving a healthy scar upon the site occupied by the tumor. Isolated cases of this kind have been reported from time to time, but the diagnosis was not always established by sufficiently careful clinical observations and microscopic examination of the tumor tissue. The discovery of the microbe of erysipelas by Fehleisen, and the cultivation of the streptococcus upon artificial nutrient media outside of the body enabled investigators to produce erysipelas artificially in the uncomplicated form in man and the lower animals. As soon as it was demonstrated experimentally that simple uncomplicated erysipelas is a disease attended by but little danger to life, the suggestion was made that, if the disease could be artificially produced in man by inoculation with pure cultures, the local and general conditions thus produced might prove useful in the cure or amelioration of inoperable malignant tumors. Of seven persons the subjects of malignant tumors, inoculated by Fehleisen with pure cultures, six developed typical erysipelas; in the seventh case the patient had passed through an attack of erysipelas only a few weeks previously and was, in all probability, still protected against a new attack. This patient was inoculated a second time with a negative result. Fehleisen has seen, by this treatment, a cancer of the breast become smaller, while a case of fibro-sarcoma and another of sarcoma were not materially affected by this method of treatment. Janicke and Neisser have recorded a death from the erysipelas thus intentionally produced, in a case of cancer of the breast beyond the reach of an operation. At the post-mortem it was shown that the tumor had almost completely disappeared, and the microscopic examination of portions that had remained appeared to prove that the tumor cells had been destroyed through the direct action of the microbes. Biedert saw in a child suffering from a sarcoma, involving the posterior part of the cavity of the mouth and pharynx of the left half of the tongue, the nasopharyngeal space and the right orbit, the tumor disappear almost completely during an attack of erysipelas. Kleeblatt reports the case of a lympho-sarcoma followed by infection of the cervical glands, in which the tumors diminished markedly in size under the influence of an inter-current attack of erysipelas, but resumed its former malignant tendencies as soon as the disease had subsided. The patient was afterward intentionally inoculated with a pure culture of the Downloaded From: http://jama.jamanetwork.com/ by a University of Pennsylvania User on 06/15/2015