On the Nature and Significance of the Crescentic and Flagellated Bodies in Malarial Blood

existenrce of any and every degree of even organic disease of the 1ear t. In as' henic cascs exposure for from fifteen to thirty minutes to a temperature of 115° to 1200 F. in the tepidarium-the thermometer hanging three feet from the floor level-will usually induce mild but sufficient diaphoresis without distress of any kind, and may be followed by some appropriate ablution, any intense thermal or mechanical stimulation being, of course, out of the question. Even this modified form of bath is probably inadmissible in severe cases of aortic regurgitation, compound valvular lesions, dilatation from adherent pericardium, or fatty degeneration, but in simple cases of aortic and mitral stenosis and mitral regurgitation it is often beneficial in many ways. An important subject, to which a mere cursory reference is alone possible at present, is that of the properties and uses of the so-called excitant or heating compresses-cold, wet compresses eovered in such a way as to preclude evaporation. The powerful influence of their continued application, in promnoting the resolution of chronic inflammations and catarrhs, the absorption of old and hardened exudations, and the relief of various neuralgic and spastic affections, is one of the best-ascertained facts, and its precise modus operandi one of the most interesting problems of hydrotherapy. Fortunately, however, the fact itself of the efficacy in question of this apparently trifling procedure is one which can be readily tested by any practitioner. X few words must be devoted to the subject of the methodicaldrinking of cold water. As collated and in part diseovered by Winternitz, the effects of this procedure may be briefly summarised as follows: 1. Immediately after the drinking of cold water the pulserate is lowered, probably by stimulation of the pneumogastric fibres, but soon returns to the normal. 2. The temperature falls in the stomach and also, to a noticeable degree, in the rectum, a fact which may find clinical application in inflammatory conditions of the pelvic organs; conversely, cold enemata reduce the temperature of the stomach. 3. Catabolic processes are stimulated, and there is true diuresis, the excretion of urea, as also of the other urinary constituents, being markedly increased. 4. Peristalsis and the portal circulation are stimulated, and also (in consequence, perhaps, of the latter effect) the excretion of bile. 5. Bocker has attributed to water drinking an improvement in the respiratory qualities of the red blood corpuscles. Most of the above effects are more marked when the water taken is imbibed gradually, rather than in larger quantities at a time but with longer intervals. The value of pure water as a diuretic is perhaps hardly yet sufficiently appreciated. Dropsical effusiols may sometimes be relieved by its free administration, alternated with periods of nearly complete abstention. I would suggest also that in view of the proofs advanced by Dr. lHaig of the tendency of alkalies to induce chronic uric-acidaemia, their routine administration in cases of gout and rheumatism. except, perhaps, in the hope of dissolving actual calculi, is hardly justifiable, and in pure water we possess at least one, available substitute. Its power of increasing tissue waste indicates water drinking as a remedy for obesity. What place, then, are we to assign to hydriatic procedures as a class in the modern therapeutic armamentarium? Obviously their scope is far wider than that of any individual drug. The modern renascence of hydrotherapy was contemporaneous with the final close of the reign of authority and tradition in the healing art and the dawn of the epoch of science. A wave of therapeutic pessimism had swept over Europe, anid sectarian hydropathy was the outcome of an instinctive return to first principles, a feeling that it would be necessary to begin over again and to build upon surer foundations. But Priessnitzian hydropathy was no less arbitrary and empirical than the system it pretended to supfrsede, and it was not until the attention of scientific observers had been secured that the extravagant claims of fanaticism were replaced by the sober assertions of reason. I-n France this was the case almost from the first, but it occurred later in Germany and England. Meanwhile the new seience of pharmacology had stolen into being, and it began to be perceived that the so-called rival systems were not necessarily rivals at all, but complementary factors of the one true method, their apparent antagonism being due to an imperfect understanding of their respective functions. In practice there can be no doubt that the benefits of really appropriate medication are augmented by the simultaneous employment of hydriatic procedures. To such other elements of rational treatment as are constituted by massage, medical gymnastics, the scientific regulation of diet, aero-therapeutics, and the various electrical methods, the natural relationship of hydrotherapy is sufficiently obvious. Its amalgamation with these has already proceeded far, and is destined, probably, to proceed much further in course of the construction of that concrete and organised system which we dimly apprehend as the gaol of therapeutic endeavour.