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JAMA. 1892;XVIII(18):563-564. doi:10.1001/jama.1892.02411220025005.
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The following circular has been sent to the profession:

Dear Doctor:  —At this season of the year the practitioner is called upon to treat patients who have spent a large portion of their time in the house during the winter. They have been breathing the confined house air, which, besides being rendered deficient in oxygen by the necessary combustion going on in stoves, lamps, and gas-jets, is, in addition, more or less vitiated by the poisonous emanations of organic life.During most of this time there has been imperfect physiological action because there has been complete oxidation. The inter-cellular spaces of the tissues have become clogged up with products of incomplete combustion—imperfect waste and repair.In consequence of these facts we notice a preponderance of those diseases usually attributed to that indefinite cause —impure blood.Hence, we observe the tendency to scrofulous manifestations—eruptions, glandular swellings, abscesses and ulcerations; also the


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