Strictly, Especially the Occasional Inspection Of-Our Mem¬ Permit, At

years ; and this requirement, if it were carried out mittee appointed for that purpose; at least two men strictly, especially the occasional inspection of-our mem¬ should be required for the inspection of any school, and bers, would at once strengthen and broaden the influence the report should be in writing for future reference. of this association and commend it to the state board of 3. The interests of the association demand that the examiners, do much to quiet the present state of unrest work be divided up so as to utilize as many men and and dissatisfaction existing in many medical schools and their influence as possible, if we would broaden our field elevate medical teaching in the eyes of the public out of of usefulness in both higher educational and moral or its present questionable status. ethical standing sufficiently to make membership an Standards acceptable to examining boards could be honor so distinctive that all good schools will desire the established and the variable demand of the different connection. states be gradually molded into a universal and much- 4. At present the four-year high school, or the four¬ needed standard agreeable to all. The result would be teen units for entrance and a four-year strictly graded better-prepared and more uniformly educated physicians, course of study of 4,000 hours is as high as the condi¬ and more ethical relations between the profession and tions of education will permit. the people. The time is ripe for some organized body to 5. If an additional year is wise, then a fifth year assume command and restore confidence by combining following the present four-year plan, which shall be the good accomplished by the several organizations labor¬ strictly practical and bedside in hospital wards, is pre¬ ing in the field. We should stand sponsor for as high ferable; and this association should insist that a hospital standard of medical education as present conditions will controlled by the college is essential to thorough training. permit, at the same time quieting the present feeling of If these suggestions are carried out then this associa¬ uncertainty which is agitating the modern school-world tion will be a great factor and the day will not be distant with the assurance that the schools would be given time when the medical men of America will be recognized all to establish and enforce the demands of to-day, and over the world. Then and not until then will this asso¬ adjust themselves to the changes, at least before some ciation have fulfilled its true mission. other radical change is forced on them. 150 North Eighth Avenue. While I would not detract from the great advances made in the last few years—and every force deserves credit for honest and faithful service—the conditions THE POISONS OF THE TROPICAL TOAD, above are the natural of lack of con¬ mentioned result BUFO AGUA certed effort and unity of action, and but illustrate the necessity of uniform standards applicable to the whole A PRELIMINARY COMMUNICATION country. JOHN J. ABEL, M.D., and DAVID I. MACHT, M.D. Now, I ask, what body is best equipped and qualified BALTIMORE for this work, or into what hands can be placed the Poisons of animal origin, this term in its widest and of to using elevation perfecting medical teaching properly sense, have always been of interest to the student of demands of the not our own meet the present, if Associa¬ medical science, and of late years they are beginning to tion of Medical Colleges? Indeed, we shall be derelict if be of actual value to the medical practitioner. Among we do not assume this responsibility. If every school poisons of animal origin1 may be named the various which is a member would live up to association stand¬ snake venoms, the poisons of amphibia, of fishes (e. g., ards and assume and perform its part willingly and the of of mussels would member¬ fugu poison Japan), (mytilotoxin), enthusiastically, every worthy school seek of scorpions, spiders, bees, ants, beetles (e. g., can- ship, and the vexed problem of standardizing medical tharidin), and other insects. Among poisons derived teaching would be solved. from the organs of mammals may be named those State laws can be made more uniform if the Amer¬ obtained from the thyroid and suprarenal glands as hav- ican Association of Medical Colleges and the Council on ing a very high therapeutic value. Medical Education of the American Medical Association While continuing our studies, in the autumn of 1910, join forces with state boards, and the unfortunate neces¬ on the convulsant action of certain organic dyestuffs, sity for the present differences in grading schools will acid fuchsin, betanaphthol, phenolsulphonaphthalein, have passed ; for there will be no excuse, even commer¬ and tropeolin, we had the opportunity of trying the cially, for the existence of low-grade schools, and the effect of these substances on a tropical toad, Bufo agua. m eh-needed reciprocity between the United States and While engaged in this study our interest was aroused by Canada will be assured, and with European countries the milky secretion which exudes from its "parotid" as well. glands when the animal is greatly irritated. Scraping In this short paper I have tried to point out some of off some of the secretion with a knife, we were struck the strong and important reasons for all three of the by the bluish-green discoloration which appeared on the educational organizations meeting here at this time. I blade soon after it had been used. This observation led us some diluted with predict that their coming together in a bond of unity of to test of the secretion ferric This was found purpose will, of affect every side of this chlorid. reagent to develop the char¬ necessity, vitally color of the great question. The combination of our interests and acteristic green pyrocatechin reaction. As energies for the future promises great things for the this reaction is given by the active principle of the medical profession, and, through them, for the people of suprarenal glands, further tests were at once undertaken this country. with the object of identifying the substance in the toad's secretion which reacts with ferric chlorid as described. In I would make the following suggestions : closing It was not a difficult task to demonstrate that we were 1. This association should a uniform standard adopt a substance which is identical or after with all and enforce here dealing with with, consultation forces interested, allied the Further work this standard by frequent inspections of members. closely to, suprarenal principle. 2. both and members should From the Pharmacological Laboratory of the Johns Hopkins Inspections of applicants University. be placed in the hands of a judicial council or a com- 1. Faust, Edwin Stanton: Die thierischen Gifte, 1905. Downloaded From: http://jama.jamanetwork.com/ by a Simon Fraser University User on 06/03/2015 consistence on the secretion of the demonstrated the small pots in which it gradually acquires the of glands presence curari. A further of the later he obtained of a second in to its supply poisons may body which, respect pharmacologie smeared on action, is to be classed with substances belonging to the from the toads thus treated. The poison is to the of tips of arrows which are shot into game from blowing tubes. digitalis group poisons. A small is killed a arrow in from two to has been from the stag by poisoned The toad regarded earliest times four minutes, a jaguar in from four to eight minutes. as a venomous animal. In the Talmud2 under the name And in to the toad which is engag¬ of tzab (from the root meaning to swell or puff up) it regard particular is differentiated from the frog and is classed with ani¬ ing our attention, Fillio" makes the following state¬ mals whose touch contaminates. Various have ments : peoples There in the of the Amazon made medicinal use of the toad. The Chinese have exists, more particularly regions long a which is a veritable toads and which ' used as a a derived from toadskins species giant among remedy preparation has described under the name of Bufo agua, whose venom which call senso. to a notice Spix they According preliminary it would be worth while to stud}'. It is very probable that this senso is an similar in by Hyashi,3 impure product its is the species from which the aborigines of the Amazon derive to to one more action digitalis, but fifty hundred times the poison with which they smear the points of their arrows, use toad powerful. Western nations also made of the in place of a sort of curara which certain other tribes use. for medicinal several centuries and purposes during Further details in to the use of the of various medical treatises and regard poison European pharmacopeias have not come to our but our of an to the dried toad a Bufo agua yet knowledge, earlier day give prominent own with it abundant that it Thus, in the "Thesau¬ experiments give proof place among therapeutic agents. be indeed when used as an arrow of would very deadly rus Pharmakologicus" Johannes Schröder, published poison. in Leyden in 1672, and in the "Pharmacologia" of humer- in London in Bufo agua (horridus, maculiventris, marinus, Samuel Dale, published 1692, powdered alis, ornatus. ictericus, Lazarus, Rana marina, Bombi- toad is highly recommended for dropsv, bleeding of the nator horridus, Neotes, Pseudobufo and nose and other ailments. In the "London Docidophryne Dispensatory" is the of the or tailless of edited William of agua) largest Anitra, amphibia, 1702, by Salmon, professor physick, a of or more centimeters and a are the neck in attaining length twenty we read, "They (the toads) hung up by breadth of twelve centimeters.

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