Hemorenon hydrochloride. This is chemically ethylaminoacetpyrocatechin hydrochloride. It possesses the same properties as the active principle of the suprarenal gland, but is much less active, a 5 per cent. solution of it being equivalent to a 1:1000 solution of adrenalin, suprerenalin, etc.

Iodochloroform. A 5% solution of iodine in chloroform recommended as an external hemostatic.

Iodomenine. A bismuth albumen compound; insoluble in acid media but decomposed in alkaline solutions. Intestinal astringent.

Lecibrin. This is stated to be a combination of lechithin, obtained from brain substance, with nucleo-proteins.

Malourea. Another trade name for veronal.

Medinal. This is chemically the sodium salt of diethylbarbituric acid or more briefly sodium veronal. It is soluble in about five parts of water. The dose is 5 to 15 grains. It may be given hypodermically, the hypodermic dose being 50 to 75 minims of a 10% solution. May also be given by rectum, 5 to 8 grains, dissolved in a dram of water.

Neoform. Chemically this substance is similar to xeroform, only containing iodine instead of bromine. In other words, it is chemically bismuth oxytriiodophenate. It is a yellow powder which has a faint odor, insoluble in water or alcohol, etc., and is recommended as an external vulnerary. Nizin. This is a trade name for zinc sulphanilate. Novozone. This is another one of the many trade names for magnesium dioxide or peroxide, MgO2.

Parabismuth. Synonym for bismuth paranucleinate. Peroxydol. Trade name for pure sodium perborate. Propaesin. This is chemically the propyl ester of paraamidobenzoic acid. It is a white powder, slightly soluble in water, freely soluble in alcohol and also in fixed oils to the extent of about 7 per cent. It possesses decided local anesthetic properties and is claimed to be altogether non-toxic and non-irritating.

Quietol is chemically the hydrobromide of valeryldimethyl aminooxyisobutyrate of propyl. A crystalline substance soluble in water and recommended as a sedative in nervousness and hysteria.

Sabromine. This is chemically monobrombehenate of calcium. It is recommended to be used instead of the alkaline bromides and is claimed to be free from bromism.

Soamin. Chemically sodium paraaminophenylarsinate. Also called arsanilate.

Sodophthalyl. This is a soluble combination of phenolphthalein. Chemically it is disodoquinone phenolphthaleinate. It is a laxative and can be used hypodermically.

Succinol. This is stated to be a purified tar obtained by the destructive distillation of amber. It is recommended as an antipruritic, in psoriasis, eczema, etc.

Sulfidal. This is a trade name for colloidal sulphur. Tannosplenoferrin. This is said to be obtained by the action of tannic acid on the aqueous extract of the spleen. It is a granular, reddish brown powder.

Tannyl. This is claimed to be a compound of tannin and oxychlorcasein. It is a grayish brown powder, almost tasteless and insolube in water. Intestinal astringent.

Vasoconstrictine. This is one of the numerous trade names for the active principle of the suprarenal gland.

Xaxaquin. This peculiar trade name is applied to quinine acetylsalicylate. It is on the market in 3 gr. tablets only and it is of course claimed to combine the properties of both quinine and aspirin.

The Explosion of the Theory of Heredity.*

By A. LAPTHORN SMITH, B.A., M.D., M. K. C. S., Montreal, Can. It is quite natural that the people of three thousand years ago should have thought that all the qualities and accidents which befell the race were due to hereditary transmission. They saw the offspring of each animal and plant around them resembling its ancestors down to the most minute details, while the changes which took place in any species as the result of altered environment, such, for instance, as the loss of the hind legs of the whale and the seal when they became water animals, occurred so slowly that they were not able to observe them. Even in our own time, when breeding of animals has become a science, and when a colt can be produced with extremely thick, strong legs, for going slowly, or long and thin ones for great speed, and a cow can be produced which will give a large quantity of milk or cream, according to the breed of the father, it is no wonder that people have grown to think that everything depends on heredity, and that little or nothing depends on environment. This idea, which is quite correct and of great commercial value when applied to the breeding of plants and animals, is quite erroneous and most unfortunate when applied to mental and physical disease. The idea, for instance, that tuberculosis was hereditary and unavoidable has cost millions of lives which are now being saved because the whole world has discovered that the disease is contagious and preventable. But this change in opinion did not come by chance; indeed, it was opposed by many of the ablest pathologists long after it had been generally accepted by the profession and widely suspected by the public. Those who stoutly maintained that tuberculosis was contagious had to swim against the stream of medical opinion long after Koch had discovered the contagious bacillus. The same thing exists now with regard to consumption. The

*N, Y. Med. Jour.

insurance companies, which employ thousands of doctors to eliminate hazardous lives from their business, have laid great stress on the importance of inquiring into the heredity of the applicant, but have never asked any questions as to their having been exposed to the contagion of consumption and cancer. While a wonderful and beneficent change has come over public opinion with regard to consumption, the views held as to cancer and insanity have remained almost where they were a hundred or two hundred years ago. And yet I believe that I can prove that cancer is not hereditary at all, any more than insanity and drunkenness are, and to remove the mental suffering of those whose parents have acquired these diseases is the principal object of this paper. Moreover, as long as cancer, insanity, and drunkenness are believed to be hereditary, no efforts will be made to prevent them. Those who have had such parents will simply sit down and fold their hands and wait for the inevitable blow to fall upon them.

Let us, then, begin with an inquiry as to the cause of cancer. That it is worth while inquiring into is evident from the fact that, according to the census of 1890 it destroyed 18,536 lives in the United States alone. Ten years later the number reached 29,475, or nearly one-third more. One out of every twelve women who die after forty-five and one out of every twenty-one men are killed by it. In the whole of the United States it killed in the year 1900, 11,354 men and 18,039 women. All over the world. in fact, it has increased about thirty per cent, during the decade. What is responsible for this awful sacrifice of human life? Without hesitation I must say that it is due to the terrible mistake which has been made of considering as hereditary and unpreventable a disease which is highly contagious, and which, consequently, could be eradicated from off the face of the earth within the next ten or twenty years. One of the first steps, therefore, is to educate the public out of this most unfortunate tradition of heredity.

It is strange that the contagiousness of cancer has not made more headway during the last twenty years, for such men as Shrady, of New York, and McEwan, of Glasgow, so long ago as twenty years, said: "Cancer is essentially a local disease, and the opinion that it is a constitutional or hereditary one is productive of the most dire results." The writer, during the last thirty years, whenever he has met with a case of cancer, has taken great pains to ascertain whether the father, and mother of the patient had suffered from it; the result of his inquiries has been that it was quite the exception to find any sign of heredity. In order to ascertain whether other practitioners ha! had the same experience he wrote to several medical journals asking their readers to communicate with him on this point. Fifteen physicians replied, giving reports of over fifty cases of death from cancer in their practice, not one of which had a cancerous father or mother, or even a grandfather or grandmother who had died from cancer. Another doctor wrote: "I do not think that one case in ten of

mine had an immediate ancestor affected with the disease." I have already said that the insurance companies had done a great deal to propagate the hereditary theory of cancer. And yet it would pay them to recognize its contagiousness and so to see cancer stamped out.

To sum up: The bubble of the heredity of consumption has been burst and requires no further argument. Cancer, which has been considered an hereditary disease, is largely on the increase, just as consumption is on the decrease. One of my correspondents, the medical health officer of the model town of Bernardstown, Mass., in which every death has been recorded, with its cause, since 1864, writes me as follows: "From 1864 to 1874, one death from cancer, and forty from tuberculosis. From 1874 to 1884, three deaths from cancer, and twenty-six from tuberculosis. From 1884 to 1894, eight deaths from cancer, and seventeen from tuberculosis. From 1894 to 1904, twenty deaths from cancer, and seven from tuberculosis." Simply because cancer is still believed to be hereditary and no precautions are taken toward stamping it out, while consumption is recognized to be contagious and is being rapidly stamped out. So it is of the utmost importance that the popular idea of its heredity should be changed; for until it is, no steps will be taken to isolate it and people will put off having it removed while it is still possible to remove it entirely.

Let us now take up another gigantic bubble, the heredity of insanity, which cannot be exploded too soon. What misery has been entailed upon perfectly healthy people by the ever present spectre overshadowing their lives, that their mother or their grandfather or their aunt was insane. This heredity of insanity has been so much abused in making statistics that on this point they are quite unreliable. For instance, the son of a clever man marries, has a large family, quarrels with his wife, leaves her, contracts syphilis, gets a gumatous tumor on the brain, and goes to the asylum. His very clever daughter marries and has uræmic convulsions with her first child and also becomes insane. Evidently these two cases of insanity have absolutely nothing whatever to do with each other, and yet her case would surely be classed as hereditary, because her father died insane. Here, again, insurance companies and the superintendents of insane asylums have handed down this false tradition from generation to generation, so that the profession, and the public through them, have been trained to believe that it is true. On the contrary, I am convinced that a child born of the most clever and most intellectual parents may become insane, if improperly fed or badly brought up, while a child of weak minded, or even insane, parents may grow up to be an intellectual giant if transplanted soon after birth to a highly intellectual environment and if properly fed. Idiots and those having organic disease of the brain are not referred to at all in this paper. As for the brains of the insane, the writer states that our brains are just what we make them by exercising, cultivating,

feeding, starving, and poisoning them. If his contention can be proved, a great deal of what has been copied from one textbook into another for the last fifty years will have to be abandoned, with the result that thousands of people who are now regarded as hopelessly insane because of supposed heredity, will be treated and cured and restored to their family and friends.

Taking any hundred women in any asylum at random, an unbiased investigation of the cause of their insanity will enable us to group probably ninety-five of them under one or two headings; first, those caused by defective nutrition of the brain, and second, those caused by poisoning of the brain. Under the first heading we must place those women whose brains are starved by reason of insufficient food or light or air; second, those whose blood cannot nourish the brain because of increased demands upon it, such as lactation, pregnancy, insomnia, or exhausting hemorrhages; third, those in whom the brain is starved, because some great mental impression so affects the sympathetic nerve as to take away the inclination for food, and to prevent its digestion if eaten; and fourth, those whose brains are starved because some abnormal pelvic condition is irritating the sympathetic, which irritation is expressed in the brain by contraction of the circular fibres of the arterioles; so that no matter how rich the blood may be, an insufficient supply of it is able to reach the brain cells. In the category of insanity from poisoning, we must include cases of autointoxication by ptomaines and from defective digestion and assimilation, whereby the proteids do not reach the ultimate stage of urea, but stop at the formation of creatin, creatinin, xanthin, or uric acid; second, the cases of defective secretion by the liver and kidneys, so that poisons such as bile and urea accumulate in the blood and inundate the brain cells, instead of being removed as fast as they are produced; third, insanity after operations, which if not due to iodo form should rather be called septic delirium from blood poisoning.

Let us now look a little more carefully into the bearing of each of these conditions as a factor in the causation of insanity.

Starvation of the brain is due to anæmia. Every practitioner of twenty years' experience can recall many cases, mostly in young women, in whom the brain failed to work correctly from this cause. One of the first cases of insanity which came under the writer's care was a young woman who became violently insane owing to a disappointment in love, and who had to be sent to an asylum. How did the brain become starved in this case? The process is easily explained; any all absorbing passion or occupation takes away the appetite and even paralyzes the function of digestion. This young girl was so much in love that for nearly a year before she had had no time or inclination for food, and her blood became anæmic. When the disappointment came she absolutely refused to eat, and a few days later her brain had become so entirely deprived of nourishment that reasoning came to a