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shrinking of a cavity, tuberculosis is made to disappear fromthe organism. In the Hufeland Society Dr. Heymannbrought forward a patient in whom the ulceration of thelarynx had extended very much, but at the same timestated that he had in the rest no more striking feature""but also no cures. Dr. Hansemann, Virchow’s assistant,then spoke, clearly and lucidly, upon his pathological andhistological experiences in the treatment by Koch’s liquid,and explained his remarks by a- demonstration of macro-scopical and microscopical preparations. Hansemannagreed in the main with Virchow’s well-known state-

ment, but emphasised still more plainly the importantproposition that after the increase of necrosis in thelungs the unaffected tubercle bacilli must be absorbed andthereby propagated, to the great danger to the patient.The speaker summarised the position in the followingterms :-The condition which is excited by the injectionof Koch’s remedy is curable. Still, the method may doubt-less destroy life. The remedy does not destroy all thetuberculous tissue, and even if this be destroyed theorganism may suffer severe changes from its reabsorption.

Berlin, Jan. 24th. ________________

VIENNA.(FROM OUR OWN CORRESPONDENT.)

Koch’s Treatment.

KOCH’S second publication has caused considerable sur-prise in medical circles, and especially the first passages ofhis paper in which all the publications made by clinicalobservers on the action of the remedy were ignored. Re-collecting the statement of Minister von Gossler, that thepreparation of the remedy could not be described (a uniquestatement in view of the great advancement of natural science),the physicians were somewhat astonished by the simplicityof the preparation of Koch’s liquid, the more so as Kochwas found to be following the directions initiated byPasteur’s school, and by the works of the late Dr. Wooldridge,Hankin, and others, without mentioning even the names ofhis scientific predecessors. It must be assumed that Koch’ssecond publication has not been less premature than hisfirst one, and that it has been provoked by Virchow’sreports. The effect of suggestion on the subjective sym-ptoms in patients could not be better illustrated than inthe recent era of Koch’s treatment. At first it was rare tofind a patient subjected to the cure who did not feel betterat least in some way after the injections; but after Virchow’spublication, which has been widely circulated by the laypress, the majority of patients in the General Hospital com-menced to complain of different new subjective troubles whichwere ascribed by them to the action of the liquid, and therewere frequently cases where the patients, formerly highlyenthusiastic, declined to be treated further by Koch’smethod. Certainly the General Hospital, with its constantpressure of space, has not been a suitable place for such anextensive trial as has been made here at the clinics,where about 30 per cent. of the beds were allotted totuberculous and lupus cases-that is, to cases whichwould not have applied for admission to hospital wardsunder ordinary circumstances. It cannot be said thatany case has been cured by the treatment, but itmust be stated that improvement has taken placein some of the cases of surgical tuberculosis. Neweruptions of lupus nodules have made their appear-ance in Professor Kaposi’s improved cases. There is alsoa difficulty in the improved cases as very large doses (5 centi-grammes and more) do not produce any reaction, and onedoes not know how far the dose of the injection can beraised. It is extremely difficult to say anything about thepulmonary ca.ses. It seems that there are two differenttypes. In one of them the temperature curve rises afterevery injection corresponding to the reaction, but returnsto the previous level; while in the other the tem-

perature curve does not return to its former level,and the patients remain feverish after the reaction has

passed. The latter type is the lees favourable forthe treatment, and to it belong most of the fatalcases. Not less difficult is the explanation of theanatomical facts, as the pathological changes occurring inthe course of tuberculous disease have not been fullyrecognised till now, and there is no other diseasewhich ha been more neglected by pathologists on the

Continent on account of its frequency. But in slightcases of laryngeal tuberculosis, where the changes couldbe observed clinically by the laryngoscope day by day,it could be stated that the injections of "liochzn" causedthe rapid and extensive appearance of new ulcerations,sometimes of highly destructive tendency, and at thelast meeting of the Medicinisches Doctorencollegium a.

case was shown where the ulcerative process occurring afterthe injections was an extensive one, which has neverbeen observed by any of the Viennese professors. TliEgDobservations seem to corroborate Virchow’s statement thata dissemination of the tuberculous virus takes placein the body due to the injections. Referring to the dia-gnostic value of the fluid, it has been reported already to THL:LANCET that it produced local and general reaction in casesof leorosy, actinomycosis, and fever (with small doses, oneto two milligrammes) in apparently healthy persons. Theexplanation of the action of his liquid given by Koch inhis recent publication was also not believed to be satisfac-tory in medical circles here. It seems to me that thespecific action of the liquid must correspond to a specificchemical substance contained in the mesoblastic tissuesunder certain pathological conditions-e.g., tuberculosis,lupus, lepra, actinomycosis,-and Koch’s discovery willcertainly stimulate the hitherto neglected study ofpathological chemistry. At present we know only a,

single chemical substance peculiar to tuberculosis-viz cellulose, or at least a substance exhibiting all the reactions.peculiar to cellulose, which was discovered some years ago>in the blood and in the tissues of tuberculous cases byDr. Freund of Vienna. This discovery, reported in THELANCET of 1887, confirmed later by Dr. Kabrhel of Prague,and which is also highly interesting from the naturalist’sstand-point, did not receive much attention.Vienna, Jan. 26th.

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CANADA.

(FROM OUR OWN CORRESPONDENT.) .

Koch’s Liquid.Up to this date the only hospital where Koch’s fluid is

being used in Canada is the General Hospital, Montreal,where seven patients are under treatment.

Amalgamation of Medical Teaching Centres.The vexed question of the amalgamation of the Mon treat.

Branch of Laval University with Victoria Medical Schoolhas at last been amicably arranged and settled by thepassage of a Bill through the Quebec Legislature. Its

quietus was a cablegram from the Pope to Premier Mercier.llTecdieal Reunions.

,

The fourth annual banquet of the Toronto UniversityMedical College was held on the evening of Dec. 4th, some250 guests being present. The Chancellor, replying to thetoast of "Toronto University," compared it to a sturdyoak, whose growth, lacking in symmetry, preserved theelements of strength and at the same time peculiarities:inits constitution which time alone could remedy; the dean,Dr. W. T. Aikins, advocated the founding of a chair inSanitary Science.-Trinity Medical School held its annualdinner on Dec. 5th. The attendance was large, many of itbgraduates, in happy reunion, drinking to the prosperity oftheir alma mater.

Malignant Cutaneous Epitheliomata.Dr. Robinson of New York read a paper on this subject

before the Toronto Medical Society, at the regular meetingon Dec. 17th. Discussing more particularly the treatment.he has found arsenious acid in the form of a paste more suc-cessful in many cases than the knife, scraping, or caustics.

Post-graduate Lectures.The most interesting event in medical circles during the

month of December was a series of post-graduate lecturesand demonstrations given under the auspices of the Univer-sity of Toronto The attendance of practitioners fromwithout the city was large, and testified to the appreciationof the efforts of the Medical Faculty in this new departure.The chief features of the programme were lectures by menof prominence from the United States, one of whom, Dr. A.R. Robinson of New York is a graduate of the University.He delivered two lectures on Eczema—Catarrhal Dermatitis.Dr. Abbe, New York, delivered three lectures, the subjects