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Every physician is aware of the extent to which ivy poisoning may at times proceed; in the severer cases the affliction may amount to more than a nuisance and interfere not only with the comfort of persons who enjoy the great outdoors, but also with the function of military bodies, boys' summer camps, and other institutions that are so closely related to it.Local treatment is unsatisfactory, as indicated by the seven-page list of vaunted remedies in McNair's 1 recent monograph on "Ivy Dermatitis"; and this has led, conformable to the present-day immunity trend, to the development of preventive and curative systems involving both the intramuscular injection of an extract of the plant and the administration of its tincture by mouth.Introduced by Schamberg 2 in 1919, and developed by Strickler3 in 1921 and 1923, such favorable reports have subsequently been published by Alderson,4 Bivings,5 Williams,6

It is scarcely necessary to elaborate on the scope and limitations of the disease long known as ringworm. Every physician can envisage how the term may have come into vogue, and how it was at first applied to a variety of more or less circumscribed lesions, annular and otherwise, which had a tendency toward peripheral spreading and perhaps central clearing. I have no doubt that some cases of psoriasis and syphilis were included in that category in the olden days. After that, with the discovery that in most of such cases fungus could be found, the term ringworm became confined to a more contracted group of lesions, not only circumscribed but even diffuse, which were caused by fungus, or at least in which fungus was found. As it stands today, then, any disease of the skin (with the exception of favus) which is caused by fungus may be admitted into

That the histologic picture at the margins of chronic or subacute cutaneous ulcers often simulates or actually reproduces that of carcinoma cutis is common knowledge to the pathologist. This would especially apply to the more highly differentiated type of epithelioma, approximately grade 1 of Broders.1 It is well known that there are many irritative factors which may lead to mimicry of malignant hyperplasia of the epidermis, such as cutaneous blastomycosis, bilharziasis of the rectum, Paget's eczematoid dermatitis, and around pellagrous dermatitis.2 In all these, the histologic picture may at times be quite good for a malignant growth, but we learned long ago that a malignant condition microscopically was not necessarily a malignant condition clinically; i.e. not a matter of life and death to the patient. In some classes of cases it has thus developed that we have had to require in addition some of such clinical changes as

For several years I have had more or less to do with the mounting and maintenance of gross morbid museum specimens, a large number of which were especially prepared for student-instruction purposes in large medical schools.Suspended in the usual way by ligatures on glass frames, and after handling several times in the course of a year by instructors and students, these specimens have suffered, entailing much loss in time and some of material in repair. If of soft texture (liver), the threads have torn out, if necrotic the detritus has fallen out, and the glass frames are sometimes broken by shaking when the specimen is handled by students. If the mounting medium has become turbid, a more or less thick layer of nontransparent material intervenes between the eye and the specimen. Or, where the specimen is small (parasitic worms) and fastened to a glass slide by gelatin, the latter

The patient, an unmarried white man, aged 40, was admitted to the University Hospital, Nov. 24, 1914. He had joined a ship's crew only four days previously and earlier history than this, therefore, could not be expected. On the day of admission he had been ashore, returning in perfect health, for he was afterwards observed reading in his bunk. At 8:30 p. m. he was seized with chills and sweats, receiving 5 grains of quinin therefor. Half an hour later he was unconscious. His companions said he had fainted. On recovery he complained of headache and pain in the back of the neck. He walked unsteadily to the ambulance and was received in the hospital in a state of forgetfulness, constantly asking where he was, but remembering only a few minutes. In a few minutes he became restless, surly, and so violent as to require mechanical restraint. In four hours

Much has been done in recent years to clarify our views regarding that interesting and rather unusual group of conditions formerly known as purpura. Hemophilia, scurvy and other diseases displaying a tendency to hemorrhage have been weeded out of the group; the coagulation phenomena have been the subject of much careful study, and yet purpura remains an ill-defined borderline condition between internal medicine and dermatology, about which considerable confusion still exists. The case here reported represents a rare if not unique disease, but is presented not so much on this account as because it throws some interesting sidelights on purpura as a whole.REPORT OF CASEHistory.—Mrs. K., a schoolteacher, aged 25, of Irish and Scotch ancestry, seen Oct. 30, 1922, complained chiefly of spots on the skin and burning of the lower extremities. There was no history of any similar condition or undue tendency toward bleeding, on either

I wish first to touch on the injection of paraffin, a substance which, while not an oil, has a similar pathologic significance, besides being closely related chemically to liquid petrolatum. Furthermore, the more recent findings in connection with liquid petrolatum injections throw a side-light on the paraffin ones which justify this digression.PARAFFIN INJECTIONSEvery medical man is by this time aware of the untoward effects which sometimes follow the injection of paraffin for cosmetic or other purposes; so much so, in fact, that the term paraffinoma now has a familiar ring, and that the use of this substance in plastic surgery has been almost abandoned.Davis1 brings out that not every person thus treated develops a paraffinoma—that there must be a predisposition on the part of the patient; and, from this the final verdict for or against paraffin must depend on the frequency of the development of paraffinomas

We came upon this method of study during an attempt to demonstrate in cultures the same invisible and unstainable mucinoid coating on Torula histolytica1 that we saw in tissue, and which was only inferred to be there on account of the halo which appeared between the yeast cells and the surrounding tissue.For demonstrating the coating by the ink method, one must work fast because the ink dries rapidly. A loopful of India ink is placed on a glass slide, and a loopful of the solid (or pasty) culture material is quickly emulsified in it. A large coverslip is quickly applied and pressed gently, to make the emulsion spread over as great an area as possible. The drop must be small; othewise, too thick a film will result and the halo effect will be obscured. It is better that there shall be insufficient fluid to quite fill the space

Templeton1 and others2 have already indicated the value of high frequency currents in the treatment of various dermatoses requiring excision, and others have indicated the value of the so-called radio knife in such major procedures as amputation of the breast. The present communication, however, has nothing to do with such phases of the field. It is true that Templeton spoke of the usefulness of this modality in performing biopsies and exhibited several photographs. However, the attempt was not made in such presentations to distinguish between the value of the coagulating and cutting currents. It is to this particular phase that the present communication is confined.It has been the experience of doubtless many pathologists to have specimens submitted for histologic examination which have been removed by the coagulating current and in which the severity of the coagulative processes has been sufficient to compromise or even destroy the value

To the Editor:—In The Journal, August 8, page 456, McNair critically reviews our report on the preventive treatment of ivy poisoning. As I directed the studies which, he says, should have been "more scientifically conducted," the duty is mine to point out wherein McNair has not quite grasped the situation.McNair is the author of a monographic treatise on Rhus dermatitis which covers all its phases and includes much original work; apparently he has not perceived the difference between the scope of a monograph and a report like ours, designed to be printed in a publication such as The Journal. Our communication reported our facts to the general medical practitioner, facts of which the doctor could avail himself in his approach to the problem of human welfare. Findings of more abstruse scientific interest could be pointed out only in passing. We did not pretend to exhaust all the ramifications—indeed,

In The Journal, Oct. 3, 1925, page 1066, an editorial appears entitled "The Synthesis of Cholesterol in the Body." It is indicated therein that feeding experiments have shown that cholesterol need not have its source exclusively in the diet.We submit further evidence on this point in the form of Dezani's work (Arch. di farmacol. sper.12:4, 1914). He fed measured quantities of cholesterol to white mice, and on analyzing their entire carcasses, found that the total amount of cholesterol therein was greater than what could be explained on the basis of that ingested.The subject of cholesterol synthesis comes to medical men by various avenues. Foremost among these are the various considerations associated with hypercholesterolemia, in connection with which certain tissue changes may come about or be experimentally induced. Some, notably the atheromatous aortas of rabbits, have been repeatedly and rather uniformly elicited, but others, such as xanthoma

To the Editor:—In The Journal, July 12, Harris and Hauser published their paper on "Bromide Intoxication," in which success therapeutically depended on the replacement of bromine ions by chlorine ions; in this connection may I direct credit for originality where, I believe, credit is due.The principle that the excretion of chlorides could be hastened by the administration of bromides and iodides, and that, conversely, the administration of chlorides hastens the elimination of the other two, was developed as far back as 1902 and 1911 (Sollmann: Manual of Pharmacology). Credit for the application of this biologic fact to therapeutics belongs, however, to the dermatologists Wile, Wright and Smith (Arch. Dermat. & Syph.6:529 [Nov.] 1922). A second report by Wile (Arch. Dermat. & Syph.8:407 [Sept.] 1923) in 1923 included the treatment of bromide intoxication as well as bromide dermatoses. Later, Stevenson (Arch. Dermat. & Syph.12:

TO THE EDITOR: —In connection with Doctor Rosser's article, "Chemical Rectal Stricture" in The Journal, May 23, may I call attention to one by myself, "Camphorated Oil Tumors" which appeared in The Journal, Jan. 7, 1922, as well as two others, "Experimental Production of Paraffin Oil Tumors in Monkeys," in the February issue of the Archives of Dermatology and Syphilology, and "The Danger of Liquid Petrolatum in Parenteral Injections," in The Journal, June 16, 1923?In the last paper, it was pointed out that the dangers were present whether the material was injected into the skin, scrotum or serous cavities and that injections of oil are made even into the larynx and lungs. Dr. Rosser has added another location.I am prompted to write you mainly to supply reference to the work already done in the skin which has thrown light on the nature of the reaction and the pathology