517 



apeutic and balneological practice, and the theories of hardening 

 and strengthening according to periods of life, and to the condi- 

 tions of previous general health. 



The appreciation of electricity as a remedy has been enhanced 

 by obstetricians, pediatrists, and general practitioners. It is but 

 lately that we have been told (P. Strassmann, Samml. Klin. Vortr., 

 1903, no. 353) that a newly-born and an infant up to the third 

 week are perfectly insensible to very strong electrical currents. 

 The incompetency of mere experimental work, not corrected or 

 guided by practice, cannot find a better illustration, for there is 

 no more powerful remedy for asphyxia and atelectasis than the 

 cautious use of the interrupted or of the broken galvanic current. 



The domain of preventive therapeutics expands with the in- 

 creased knowledge of the causes of disease. That is why immun- 

 izing, like curative serums, will play a more beneficent part from 

 year to year, and why the healthy condition of the mucous mem- 

 brane of the nose, mouth, and pharynx, which I have been advis- 

 ing these forty years as a prevention of diphtheria, has assumed 

 importance in the armamentarium of protection against all sorts 

 of infectious diseases. 



Amongst the probabilities of our therapeutical future I also 

 count the prevention of congenital malformations, which, as has 

 been shown, are more numerous than is generally known or pre- 

 sumed, and often the result of intra-uterine inflammation. In a 

 recent publication F. von Winckel (Samml. Klin. Vortr., 1904, 

 no. 373) emphasizes the fact that the general practitioner or the 

 pathologic anatomist sees only a small number, that indeed the 

 majority are buried out of sight, or are preserved in the specimen 

 jars of the obstetrician. The known number of malformations com- 

 pared with that of the normal newly-born varies from one to thirty- 

 six to one to one hundred and two or more. They are met with 

 in relatively large numbers on the head, face, and neck alto- 

 gether in 53.2 % of all the 190 cases of malformation observed in 

 Munich during 20 years. A number of them is the result of heredity, 

 of syphilis, or other influences. How many are or may be the result 

 of consanguineous marriages will have to be learned. In all such 

 cases the treatment of the parents or the prohibition of injurious 

 marriages will have to be insisted upon. The number of those 

 recognized as due to amniotic adhesions or bands is growing from 

 year to year. Kiimmel could prove that of 178 cases, 29 were cer- 

 tainly of that nature. External malformations have long been 



1904, Mr. Thompson Walker alluded to the collection of ten cases with status 

 lymphaticus in which death had occurred at the commencement of chloroform 

 administration, or during it, or immediately after the operation. In addition to 

 the usual changes, a hyperplasia of the arteries had been noted, leading to narrow- 

 ing of the lumen. 



