ing, for a longer or shorter period, the action of venereal virus, but without neutralizing it, or eliminating it from the system. It is also true that mercury does at times so change the character of Syphilis, as to cause it to appear in some stubborn form of cutaneous disease; or it may not give external evidence of its presence, till it manifests itself in some disguised form in a future generation.

This brings us to the question: CAN SYPHILIS BE CURED? In tertiary syphilis, there are often grave doubts. It depends entirely on what part or parts are involved. If the brain is the organism affected, much will depend upon what parts are involved, and the extent of the invasion. But in the primary or secondary stages, it is always curable by intelligent, vigorous Eclectic treatment. But how do we know that our cases are radically cured? May not the disease be simply disguised, as is often the case when treated with mercury? We answer: "No; for no other strange or obstinate malady follows Eclectic treatment, either in the patient, or his children. There are no troublesome syphiloids to curse his life, as well as to constitute an indelible disgrace to medical practice."

In classing iodide of potassium as one of the main reliances of the Old-School, I do not mean it to be understood that we discard the remedy; I say that the iodide alone, or with any of the mercurials, will never assure a permanent cure in syphilitic diseases. We further assert, that by the mode of using the iodide employed by them, they do not get out of the drug anything like what it is capable of accomplishing. It is by this time pretty well understood by Eclectics that the alterative action of medicines becomes more than doubled by judicious combination. This fact is eminently true of the iodide of potassium prescribed in connection with vegetable alteratives. You will get results from four grains, that otherwise could not be obtained with ten. It will be found that by judicious combination the action of vegetable alteratives will be wonderfully multiplied, and it is owing largely to that fact, that Eclectics have had such marked success in the treatment of blood-diseases.

In the literature of Syphilis our Old-School friends have

done wonders, leaving little more to be desired. But when it comes to the treatment, Eclectics are masters of the situation. Let it be borne in mind, however, that failure sometimes takes place from keeping a patient too long on one kind of medicine. It should be changed occasionally, as the system becomes accustomed to the same medicine continued too long. There is a difference of opinion as regards the best form for preparing medicines. Some prefer fluid extracts; others give the preference to the concentrated active principles in the powder form, when they can be thus prepared. I have been led to give the latter the preference. I do so first, from the notorious unreliability of many of the fluid extracts, their unavoidable variation in strength. It is well known that no two specimens of roots or barks, contain equal amounts of active principles; and many of them little, or none at all. Secondly, because with the concentrated preparations, or at least with most of them, I have had a gratifying degree of success; not alone in the treatment of Syphilis, but all blood and skin diseases, where alteratives are indicated. I find as far as alteratives are concerned, the following combinations to meet the general indications:

The last prescription will be found to act well when there

is muscular pain, or pain in the head.

The truth is, vegetable alteratives are the best, where such medicine is indicated; and as Eclectic physicians are far in advance in a knowledge of such agents, it follows that they are better prepared to meet successfully, not Syphilis alone, but all diseases requiring an alterative treatment.

DISEASES AND DEFORMITIES OF THE SPINE. By ROBERT A. GUNN, M. D.

Mr. President and Gentlemen of the Association:

I have listened with much interest to Prof. A. J. Howe's report on "The Recent Progress of Surgery," and in consequence of its general excellence I regret that I am compelled to take issue with him regarding the value of the Plaster-ofParis jacket in the treatment of spinal curvatures. We have been inclined to look to Prof. Howe as authority on surgical questions, but it is evident from his remarks on this subject that he is a mere novice in this important department of surgery. He could not otherwise have made so many ridic ulous assertions in so short a time. All the objections Dr. Howe offers against the use of the plaster-dressing are either entirely unsupported by fact, or are those met with by the careless and inexperienced operator.

Let us examine these objections in order, and see how far they are supported by known physiological and mechanical laws.

He objects to the fixation of the vertebral column in these words, "Sliding shoulder-blades, respiratory movements, and yielding abdominal viscera, are incompatible with fixation." He further adds: "A patient while breathing must have an unrestricted range of chest-motion, or some harm is done to the citadel of life. The stomach and bowels present different states of distension several times a day, consequently they cannot be kept evenly pressed upon." It is evident from his remarks, that the doctor would have you believe that fixation is desirable in fractures, but injurious in diseases of the spine. The truth is that absolute fixation of the vertebræ is as essential for the repair of their diseased bodies, as for the union of fractures, and experience has demonstrated that Dr. Sayre's Plaster-of-Paris jacket, properly applied, effects this object more completely than any other apparatus, and that, too, without interfering with efficient respiration. On this subject, Dr. Sayre, himself, writes thus: "At first I was

afraid that the thoracic compression would interfere with respiration, and therefore divided the cuirass in the median line as soon as the plaster was set; I then secured the pelvic portion with a firm non-elastic roller, and the upper or thoracic portion with elastic bands to allow more free lateral expansion of the chest. Practical experience, however, has demonstrated that this is not necessary--but, on the contrary, is injurious, particularly if the disease involves the sides of the bodies of the dorsal vertebræ-and that the complete circling of the thorax in the immovable plaster-bandage in these cases gives the greatest relief, as by this means the ribs are held absolutely motionless, and the respiration is compelled to be diaphragmatic and abdominal. When the thorax is thus firmly secured the anus and perinæum will rise and fall synchronously with the diaphragm, and the respiration be carried on without difficulty, as long as these parts are free from pressure." Properly-adjusted pads over the upper anterior part of the thorax and over the lower part of the abdomen, will also favor natural respiration without disturbing the fixation of the spine.

Again, Dr. Howe objects to the suspension recommended by Prof. Sayre, for no other reason than that he carelessly allowed a patient to prefer her own method of suspension, which was followed by fainting and a failure of his attempt to apply a jacket. Such accidents only occur in the hands of those surgeons who willfully or carelessly neglect the necessary details of the suspension of the patient and the application of the plaster-bandages.

The irritation of the skin and the persistent eczema upon which so much stress has been laid, has not occurred in any case that has come under my observation, nor have I ever heard of such conditions developing when the applications are properly made. When Dr. Howe speaks of using "thin and fuzzy" cloth for bandages, I am inclined to think he has not used the proper material, and that may account for the crumbling of the plaster of which he speaks. Poor plaster will also crumble instead of hardening so as to make the jacket a solid case. In this way we may have the results de

scribed by Dr. Howe, but they are due to carelessness, and go for naught in a rational discussion of the value of the Plasterof-Paris treatment of spinal deformities.

I do not deny that this dressing of Dr. Sayre may 66 sooner or later be superseded," but I do affirm that up to the present time, nothing has been given to the profession that can at all compare with it, either as to the rational principles on which it is based, the immediate comfort and utility to the patient, or the ultimate success of the treatment. The "felt stay" referred to by Dr. Howe, may have some advantages, inasmuch as it is made over a cast taken when the spine is stretched; but the shape of a cast taken in the reclining position is entirely different from that of the body in the erect position, and consequently it cannot be adjusted to give the proper support. to a deformed spine. The advantages claimed for this felt-stay are in reality entirely opposed to the rational principle of treating deformities. It is now universally admitted by all progressive surgeons that mechanical pressure on a protruding part in spinal deformities, rather aggravates than relieves the difficulty in the majority of cases. There is already too much pressure on the diseased vertebrae caused by the weight of the part of the body above the seat of the disease resting on the weakened spine. Now, if we remove his weight by suspension the deformity is overcome; while the plaster jacket continues the suspension and at the same times renders the vertebræ immovable. Under these circumstances, nature soon repairs the diseased vertebræ, and thus a cure is effected. On the other hand, if a jacket is removed every night, or even every week, the pressure on the diseased part immediately operates in re-producing the deformity, and all that may have been gained is immediately lost. This has been the great fault of all appliances heretofore used for spinal deformities, and I am surprised that Prof. Howe should say of the advantages of a jacket at this day, that "it can be put on and taken off at any time." He might as well advise you to dress a fracture carefully every morning, so as to prevent the fragments of the bone from moving on each other and then to remove the dressings at night; or to approximate