Am'MzymiTm'\       Echinacea— Reply  to  Dr.  Beat.  329 
pared  to  show  that  this  effect  was  not  due  to  the  continued  ingestion 
of  small  amounts  of  alcohol  which,  it  is  said,  is  of  value  in  tubercu- 
losis. 
Trypanosomiasis. — What  has  been  said  in  respect  to  tuberculosis 
applies  equally  to  the  dourine  experiments.  Two  of  the  controls  died 
before  the  decease  of  any  of  the  treated  animals,  and  two  other  con- 
trols survived  all  but  one  of  the  treated  animals.  The  period  of 
sickness  was : 
Treated  animals,  48,  61,  64,  66,  71,  93  days. 
Controls,  17,  30  78,  79  days. 
In  other  words,  when  83.3  per  cent,  of  the  treated  animals  had 
died,  50  per  cent,  of  the  controls  were  still  living. 
We  cannot  accept  the  idea  that  an  unbiased  clinician  would  draw 
other  conclusions  from  these  data  than  those  which  we  have  pre- 
sented. Each  of  the  writers  has  had  considerable  experience  with 
clinical  medicine ;  we  are  familiar  with  the  reasoning  of  the  clinicians 
and  also  with  the  great  complexity  and  uncertainty  of  the  evidence 
which  they  obtain.  The  great  difficulty  of  the  clinician  is  the  lack 
of  definite  controls;  he  can  seldom  demonstrate  that  the  patient 
would  have  died  had  he  not  received  a  certain  treatment.  On  the 
other  hand,  it  not  infrequently  occurs  that  a  patient  recovers  when 
the  physician  had  been  certain  that  he  would  die.  Under  such  cir- 
cumstances there  should  not  be  any  diversity  of  opinion  between 
the  clinician  and  the  "laboratory  worker."  Each  must  recognize  the 
limitations  of  his  powers  and  opportunities  and  the  evidence  con- 
tributed by  each  must  be  given  due  consideration  in  determining*  the 
truth.6 
After  giving  full  and  careful  consideration  to  the  comment  of 
Dr.  Beal,  the  writers  wish  to  state  that  they  see  no  reason  to  with- 
draw any  of  their  stated  conclusions,  nor  do  they  agree  that  the  data 
can  be  construed  to  indicate  anything  in  favor  of  the  continued  use 
of  echinacea  in  these  diseases. 
Leigh  T.  Giltner, 
James  F.  Couch. 
6  In  the  published  abstract  the  following  corrections  should  be  noted  : 
Page  227— For  T.  Giltner,  read  L.  T.  Giltner. 
Page  228 — Line  13,  for  "per  se,"  read  "per  os." 
