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As a preface to my paper, I wish to acknowledge my indebtedness to the President of this Society, to our last ex-President, to the ex-President of the Ohio State Medical Society present, to Dr. Thomas, Dr. Barnes, Dr. Dickson and all others who have confirmed my diagnoses, watched the results of treatment, or in any way have aided me in my work; and to thank them for their very complimentary remarks in the discussion of my previous papers. Having my work characterized as the greatest discovery of the age by one member, my name associated with that of Jenner by another, and another give expression to his pride that a member of this Society had done what I have; would be exceedingly gratifying to me at any time, but especially just now when I am promulgating ideas which must arouse the indignation of every great medical professor in the world,

Why I should have been selected to read a paper to the Society on the "Advancement of Surgery" is incomprehensible to my mind, unless it was for the purpose of inducing me to post myself more thoroughly upon the literature of the subject. Sure it is, that I, probably of all the members, have paid less attention to the serial productions, as published in our overloaded journalism, than any other member here. And I think it is a well understood fact, that I read less of our periodical literature, as well as our secular papers, than any other member of this community. What has stood the test of ten years' popular favor becomes a part of our texts; and compared to-day with what has been introduced as novel and good, not one-tenth part bears the test of the decade. For this reason I have declined to place any of my

It is just make believe, this "war" in Europe last June, but to 40 physicians of the Calcasieu Parish Medical Society, meeting in a Lake Charles, La., restaurant, it might well be the start of World War III. They are getting ready in earnest for the fourth annual U. S. civil defense exercise—planning emergency procedures, reviewing assignments for the society's 98 members, and discussing aggressions of the paper enemy.Already, the "enemy" is supposed to have invaded a friendly nation abroad. In three days, according to the exercise blueprint, the President will call Congress into session. On July 12, some 165 nuclear bombs would rain on key American targets, and tens of millions would die—all on paper. Of course it is not going to happen, but this night of Tuesday, June 25, is the last time for the medical society to plan its role in the test because the next

Since the publication of my paper on "The Autoserosalvarsan Treatment of Syphilis of the Central Nervous System,"1 thirteen additional cases have been treated. It is not the purpose of this communication to report these cases. During the clinical study of these twenty cases, however, many practical questions have arisen, a brief discussion of which appears to be timely. The points which I propose to discuss are along the lines of safety, efficiency and convenience. They are three in number:The problem of asepsis.Time of withdrawal of blood for serum.Dosage and dilution of salvarsanized serum. I. THE PROBLEM OF ASEPSIS In an early one of my last series of eleven cases an accidental infection of the spinal canal occurred. This patient has completely recovered from the infection, but the possibility of the recurrence of such an accident demanded such a critical review and revision of methods as would

In the course of my experience in the treatment of urinary and fecal fistulæ, as I encountered new difficulties, I have described from time to time the cases and the means by which I endeavored to overcome them, but all, especially the more recent of my results have not been published. The object of the paper, of which this is an abstract, is therefore, to set these latter before the profession, and to combine them with what I have already written. In this way, I hope to communicate, in amore systematic manner the results of my experience and observations, in this department of the subject of fistula, which have extended over a period of 34 years. The object of my method of treatment, preparatory to the performance of the operation for the closure of a fistulous opening, is to prevent and overcome the injurious effects of incontinence of urine, and

It appears to me that no apology is necessary in introducing the subject of this paper. It is onty a few years since the opening of our great National highway brought the Northwest Territories into touch with the rest of the world; and only a few years further back since these vast plains and mountains, which are now so quickly becoming the homes of civilized man, were regarded as an inhospitable desert, fit only for the buffaloes which roamed their solitudes and the Indians subsisting on the chase. The past five years have been epoch-making so far as our great West is concerned. Coincident with, and following on the building of the Canadian Pacific Railway, a flood of light began to illumine the Eastern intelligence, and as a consequence settlement has steadily and in a gradually increasing stream poured into the Territories.It will be readily understood that a country

A glucose-specific test paper which is sufficiently sensitive to react with the small amounts of glucose present in urine from normal persons in the fasting state can be used to discriminate between urine samples containing more than and those containing less than 1 to 1.5 mg of glucose per 100 ml of urine. This provides a screening method for significant bacteriuria in an apparently healthy population since urine samples, obtained under standardized conditions from subjects in the fasting state with such bacteriuria, contain either very little or no glucose.

Dr. Edmund Andrews, of Chicago, expressed his appreciation of the valuable papers that had been read, and was ready to endorse much that had been said. He objected, however, to the too free resort to laparotomy in any cases, especially in diseases of the cæcum. Many of these affections will recover without resort to surgical interference. The abscess if left to itself will find an exit.He reported a case in which a patient having advanced Bright's disease, of the cystic kidney form, complicated with advanced heart disease, developed an abscess below the umbilicus. Where it came from the doctor in attendance did not know. Finally the fæces began to discharge through the abscess opening. Exploration was resorted to. In following the fistulous opening of the abscess, the operator found that it passed through a mass of fat in the lower outer abdominal wall, then passed inward and upward toward

This disease is evinced by simple inflammation of gums around the teeth, followed by chronic inflammation with or without suppuration, with or without calcic deposits, a gradual destruction of the peridental membrane, with recession and absorption of the alveolar process and gums, concluding with loosening and exfoliation of the teeth. The physician is more familiar with this disease, as it appears to him as a consequence of scurvy, mercurial or iodid salivation.Few diseases have received as many names as that under discussion. More time has been spent in apology for and discussion of new names than in original research as to its etiology. The term pyorrhea alveolaris, which has become so popular, and which I have selected for the title of this paper, does not elucidate the exact condition, since many cases which come to the dentist do not suppurate.Riggs's disease seems a more appropriate title, since to

Every physician should know how to prepare a paper for presentation at a medical meeting or publication in a medical journal. Perhaps the most convincing reason for this is an altruistic one. Since writing is the only means the medical profession has of universally disseminating knowledge concerning new therapeutic concepts, medical discoveries, or clinical experience, it is the moral obligation of every physician who has made an original scientific observation, or has formulated from his own experience a new medical theory, to publish it for the information of his colleagues, and the ultimate benefit of mankind. Another good motive for writing medical articles is a purely selfish one. In addition to the sheer joy derived from effective self-expression, the physician who prepares an article on a certain subject broadens his own knowledge of that subject, for, before he can present his material in a comprehensive manner, he must have a

Mr. President and Gentlemen of the Association of Medical Colleges:—The paper of Dr. Vaughan, which has interested us so much, suggests great changes in medical education. During the past year my attention has been called to some of the details of laboratory work which must be faced by every one of you. Allow me to very briefly speak of some of the results of my thoughts and studies.Laboratory rooms must be light and roomy. Forty square feet of floor is the least amount which will accommodate a single student, and then only in the chemical laboratory. In all other laboratories at least sixty square feet of floor space, not including aisles, must be allowed each student. In the chemical laboratory students' desks may be placed twenty feet from the windows; in laboratories in which microscopes are to be used, fourteen feet is a maximum.The ordinary medical class in

DR. DENNISON OF DENVER, COLO. —We are indebted to Dr. McFarland and Dr. Rochester for their excellent papers read this morning, and I wish particularly to commend Dr. McFarland for his excellent statement of what tuberculosis is. I have no controversy with those gentlemen as to their treatment or the results of their experiments. I object to Dr. Cohen's warning against seeking after a specific for tuberculosis as if it were a will-o'-the-wisp. I commend the work of Prof. Klebs, Dr. von Ruck, Dr. Trudeau, and those men who are in search of a specific for tuberculosis. Their work is to be commended because it is painstaking, and for the hard lines which they are following. In the first place it seems to me impossible that we can prove anything by testing tuberculin on healthy persons, for tuberculin can only affect individuals previously infected with tuberculosis. The assertion of one

In an essay delivered before the Western Ophthalmological and Otolaryngological Association at New Orleans, Feb. 10, 1899, and published by Drs. Würdemann and Murray in the Annals of Ophthalmology, April, 1899, the authors noted the rarity of high myopia in America and the relative frequency of this condition in the ophthalmic statistical reports of Germany and other European countries. A number of statistical tables were given in this paper which have been amplified and are herewith appended. These are taken entirely from the authors' private practice during the last fourteen years, in which 10,500 pairs of glasses have been prescribed, this, of course, including renewals of prescriptions. The following table shows the refraction of 4,690 eyes under a cycloplegic:

The relatively inexpensive mark-sense paper-and-pencil technique for administering a computer-generated and computer-processed health questionnaire is easy for patients to understand, simple to revise, and permits large-scale testing at low cost. The total questionnaire is designed to be administered in two or more portions or levels. Because each level after the first is a more detailed inquiry into positive responses made to questions of preceding levels, this multilevel approach permits the inquiry to be individualized to the patient. The questionnaires are generated from a question library, and the completed forms are read by an optical scanner. A summary of the patient's responses is printed for the physician's use.

A computer-generated and computer-processed health questionnaire has been evaluated for patient acceptance and reliability of content. Various formats have been tested and it was concluded that a mark-sense paper-and-pencil questionnaire offered significant advantages over a cardsort questionnaire. Studies of administration techniques showed that administration by a specially trained clerk is advantageous.

I am here to-night to tell you a little of what I know about "The Swedish Movement and Massage Treatment," and if some things should seem strange, or you should think that I have claimed rather much for it, I beg you to remember that all that I have to say is based upon facts, and that I am here not as a special agent for myself, but as one who wants to lay before you a clear and true representation of what has been done.As Herodotus observed the curative effects of gymnastics on his own delicate health and thereby was brought to use movements in therapy, so did the Swede, Pehr Henrik Ling, in the beginning of this century, study the movement treatment, because he had cured himself of rheumatism in the arm by gentle percussions. Ling had been a fencing master and instructor of gymnastics, but now

For twenty-four hundred years, and probably during all preceding ages, some of the best minds the the world has ever produced have studied and coped with phthisis, and, in spite of the accumulated knowledge of all those years, about one-fifteenth of the human family falls a victim to it yearly. There is not a clime in which it does not exist, nor a period of life in which it does not occur. The rich and poor, the civilized and uncivilized, become its prey. Since it cannot be cured, it is but reasonable to try to prevent it, and much has been done in this direction during the last century. What percentage of deaths was due to consumption in the days of Hippocrates cannot be known, but that it was large would appear from his words in speaking of a certain period, viz., that "consumption was the most considerable of the

To those who have given study to the above subjects they rank them first in importance. They know that to construct a perfect water closet or privy vault, the complete mastery of the laws governing gases and organic germs must first be made. What is any house, however elegant in appearance, or expensive in construction, without either one or both of these appliances of the most recent pattern, but a modified "Black Hole of Calcutta?" It is but a place of confinement where malaise, headache, debility, and low vitality dwell, and where the organic germs of fever, diphtheria, scarlatina, measles, cholera and small-pox find their habitat.The sanitarian of to-day, to be at his best, should be familiar with all that chemistry can teach, mechanics demonstrate and engineering plan. So vast, intricate and numerous are the laws of sanitation, we can, at present, no more make them all subservient to

The property of diphtheria toxin-antitoxin mixtures to produce immunity in animals has been known for a number of years. Successful results have been obtained in the immunization of horses (Park, 1902), goats, guinea-pigs, etc. Theobald Smith suggested the immunization of children by this method, but no one undertook it until 1912, when von Behring made the attempt.In May, 1913, von Behring1 reported the results obtained in human beings with mixtures of diphtheria toxin-antitoxin. The combined substances were either neutral or slightly toxic to the guinea-pig, but the definite proportions of toxin and antitoxin were not stated. The early reports of von Behring and his co-workers2 were so favorable that we determined to make a similar attempt at the Willard Parker Hospital. The scarlet fever pavilion offered us exceptional opportunities to determine the efficiency of this prophylactic treatment against diphtheria.Mixtures of diphtheria toxin and antitoxin were accordingly prepared

It is generally accepted that focal and other infections are the cause of many cases of arthritis. It is the belief of some that all cases are due to this agency alone, but dispassionate students of the disease are almost unanimous in the belief that other factors also play a rôle, and that focal infection is often only the "match to the priming," even when operative. There is also strong evidence that focal infection may arise as the result, as well as the cause, of the arthritic syndrome. In any event, the manner in which bacteriologic infection exercises its influence has not been made clear. There are cases of arthritis undoubtedly characterized by bacteria in situ and even by the formation of free pus; but the evidence that all cases of arthritis are caused and perpetuated by bacteria in the joint tissues is far from convincing. The inclination to ascribe

In a former paper,1 introductory to this series, it was related that reliable perimetric observations had been possible in 123 patients in a series of 200 cases of cerebral tumors. These had shown normal fields in twenty-seven instances a tendency toward hemianopsia in forty-two, and colorinterlacing or inversion (dyschromatopsia), with more or less symmetrical constriction, in fifty-three instances. It is our present purpose to give specific illustrations of the cases showing dyschromatopsia and to correlate them, so far as possible, with the stages of an advancing choked disk, especial emphasis being laid on the field deviations coincident with, or antecedent to, the earliest ophthalmoscopic changes.There have been ten cases of tumor which have shown color-interlacing, either in the total absence of a choked disk or with a very incipient process observable in the eye-grounds. As the reader will surmise, therefore, these represent cases in which definite localizing (irritative)

In the examination of the several modes of treating urinary concretions, the question of their indications and contraindications is worthy of special attention, since adherence to a single procedure belongs to the medicine of a remote past. Modern medicine demands that preventive measures be taken in threatened calculous affection at the first sign of coming of hyperlithæmia; that when hyperlithuria exists, medicinal treatment be resorted to; that when calculi are formed, mechanical means be promptly applied for their removal; that when the calculi have been removed, the cure be accomplished by suitable after-treatment; and that when mechanical treatment is contraindicated, a judicious course of palliative treatment be adopted. Therefore the treatment of urinary concretions is now arranged into the preventive, medicinal, palliative, mechanical and post-mechanical treatment.The preventive treatment embraces hygienic, medicinal and mechanical means. The needed hygienic observances comprise diet, exercise, ablutions and raiment. The medicinal means of prevention

Mr. President and Fellow-members of the Ohio State Medical Society: The subject of fever—in its general aspect—has been deemed worthy of so much labor and study on the part of the physiologist, the pathologist and the clinician, and is of such practical import to all who practice our art in any of its branches, that no apology is necessary, I trust, for bringing one of its numerous phases before this society for consideration.Looking at its most constant and evident symptom—the pyrexia—the physiologist points out, and the pathologist, and clinician confirm the probable •existence of heat-producing, heat controlling and heat dissipating areas, situated in the central nervous system, and influencing by their abnormal action the production of this particular symptom.That the pyrexia, however, does not constitute the disease is quite evident, since, it may be absent, controlled or even eliminated, and yet the patient be far from well.While,

[Your attention is invited to a subject which from the humanitarian standpoint is of the greatest importance and of practical value to us as surgeons. Much of the effort of our profession is directed toward the relief or prevention of pain. Distinct advances in our art followed the introduction of the various narcotics, and the science of surgery took a long step forward when the use of sulphuric ether for anesthesia was discovered Sept. 30, 1846, by Dr. Wm. T. G. Morton, of Wellesley, Mass., and chloroform by Sir James Simpson, of Edinburgh, on Nov. 4, 1847; and these names will ever live in our memory.But the great boon of narcosis is not unalloyed. Thousands have died from the effects of the volatile anesthetics, and every time we administer them we take upon ourselves the responsibility of a human life. Ether kills once in 15,000 administrations; chloroform once in

CROUP AND TEMPERATURE IN MASSACHUSETTS.CROUP AND ABSOLUTE HUMIDITY IN MASSACHUSETTS.CONSUMPTION AND TEMPERATURE IN MASSACHUSETTS.SMALL-POX AND TEMPERATURE IN MASSACHUSETTS.DIPHTHERIA AND TEMPERATURE IN MASSACHUSETTS.PNEUMONIA AND TEMPERATURE IN MASSACHUSETTS.SCARLATINA AND TEMPERATURE IN MASSACHUSETTS.TEMPERATURE AND SICKNESS FROM PNEUMONIA IN U. S. ARMIES.SICKNESS FROM CONSUMPTION IN WHITE TROOPS, U. S. ARMY, AND TEMPERATURE.DEATHS FROM CONSUMPTION IN WHITE TROOPS, U. S. ARMY, AND TEMPERATURE.SICKNESS FROM DIPHTHERIA IN MICHIGAN, AND TEMPERATURE.

Dr. N. S. Hoff, Ann Arbor, Mich.—I do not believe it will do any good at this time to discuss the possibility of the probability of a four years' course of instruction in our dental schools, because the Faculties Association will do what it pleases, and, naturally, to this we shall have to submit. The matter of arranging the course of study in our own school has been my work for several years. Our institution is not very unlike that of Harvard. We have a medical faculty with high ideals, and our work in the line of scientific medical branches is done in the medical school, and our students are compelled to do that work on the same basis as the medical students. I can readily appreciate the situation in which Harvard finds itself. Our school was early forced to go into the four years' course, not because we wanted

Current descriptions of the pineal gland attribute to this organ the function of producing a secretion which inhibits growth of body and restrains mental and sexual development from exceeding the rate looked on as normal for preadult life. This inference arises from the occasional distinctive precocity of development following invasion of the pineal gland by neoplasms. It is assumed that such neoplasms destroy the gland, and that any resulting metabolic disturbances occur from the deprivation of the body of the pineal's elaborated substances.From a reactionary point of view, the groundwork for such a theory is both meager and unstable. From sixty-five to seventy authentic cases of pineal tumors have come under observation. These have been distributed over more than a century. Copies of the original descriptions are rarely readily accessible. By reason of faulty translations and inaccuracies in quotations, some descriptions of pineal gland syndromeshave come to resemble classical

At the time of our previous communication1 on Malta (Mediterranean) fever in Texas, in which we reported the isolation of the Micrococcus melitensis from two patients ill of continued fever, it was known to us that other cases existed in the vicinity of Langtry, Texas, and it seemed highly probable that the disease had a much wider distribution.The recent work of the British Mediterranean Fever Commission2 has conclusively shown that in the Island Malta Mediterranean fever is almost entirelly contracted trough drinking the milk of infected goats. All the cases observed by us had given a history of drinking goat's milk or of being actively engaged in the goatraising industry. In view of these facts, it was decided to make some study of continued fevers in the principal goat-raising section of the state, to ascertion if possible

Gentlemen of the Association:—Being under the impression that we of the medical profession have failed to secure such recognition of the necessity for sanitary laws and regulations, both State and national, as we earnestly feel should be enacted and maintained, the question naturally arises as to the cause of this apathy, or carelessness, or neglect, on the part of our law-making power? I believe that this is chiefly due to the fact that our efforts have been heretofore too often misdirected, by not addressing ourselves to the people more directly, instead of to the officials, who are, in point of fact, only temporary incumbents generally. A legislator, whether in high or low official position, has one desire that is paramount to all others, and that desire is to not be relegated to private life again. He is willing, and even anxious, to do that thing that he beliveves the majority

INTRODUCTION.The animus of this contribution is the belief of the writers that trophopathy (trophos—food; pathos—disease) has more to do with the cause and cure of the so-called incurable diseases than the profession gives credit to; and to show that our belief is founded on facts, we will immediately proceed to the consideration of the subject in the concrete, to wit: the reading of histories of some patients that have been under our care.CASE HISTORIES.Case 1.—A little more than four years ago, a gentleman brought to our office a friend, who appeared to the senior writer almost moribund; indeed, he feared that the man would die then and there. Examination showed the case to be suffering from an enlarged heart, a fibroid liver and Bright's disease of the kidneys; the urine contained albumen, casts and fatty epithelia. We will here make the note that in our study of

The subject of fibroid tumor of the uterus is too broad to be considered in all its aspects, in the time allotted, before this Society. I have therefore thought it advisable to speak of but two phases of the subject: 1, what cases require operation; 2, methods of operating.Clinical experience demonstrates that only a small percentage of those suffering from fibroids require operative interference for relief. This is so well known that the profession at large have come to regard them as purely innocent growths. This is true in the majority of cases. My experience, based upon more than two hundred carefully recorded cases, justifies me in saying that the majority of women from thirty-six to forty-five years of age suffering from fibroid tumors, do not require operative interference; but this fact increases our responsibility in determining early the cases really requiring operation.A great many women who are

The frequency of "floating kidney" associated with its varied complications, together with the errors in diagnosis, certainly warrant our taking up this subject, and considering it for a few moments before this Association.The experience of the writer both as a general practitioner and consultant, has led him to believe that the existence of a floating kidney is more likely to be misunderstood and taken for something else than any other one disease of the abdominal cavity.I have seen floating kidney treated for "lumbago,"also for so-called "sciatic rheumatism." In another case I saw an able practitioner tap it for "ascites," and still another case where it was mistaken for an enlarged ovary.On the other hand, I have seen an enlarged and pendant "gall bladder" filled with gall stones, mistaken for a movable kidney, and the mistake was not discovered until revealed by an operation. With these few examples,

In writing history it is necessary to begin at the beginning, thereafter following our subject along the stream of time until we reach either the end of its course or its present anchorage; but the beginning of our present subject is lost in the haze of the distant past. In the earliest dawn of history we find men fighting; and battles, no doubt, were fought even in the primitive days. The history of the human race is, in fact, a history of battles and their results. But history had no eyes for those who dropped out of the struggle; seldom are we told of the wounded. Nevertheless, we must credit these old time warriors with sympathies which led them to care for their wounded, so that our subject finds a beginning as far back and as undefined as history itself.We may assume that slaves, servants, companionsin-arms, friends or relatives

In presenting the subject of non-absorbent gauze for your consideration I am not offering a new topic for discussion; non-absorbent gauze takes its origin contemporaneously with the antiseptic dressings of Lister. Lister's1 earlier dressings were distinctly non-absorbent; the manner of their production secured it, for muslin was soaked in a heated mixture of paraffin 16 parts, resin 4 parts and carbolic acid crystal 1 part; while still warm the excess of the compound was wrung out. Lister2 shortly thereafter even suggested an 8 per cent. carbolic gauze made in the same manner. The paraffin counteracted the adhesiveness of the resin, and together they precluded a capillarity in gauzes thus treated. The faults of this carbolized gauze were early recognized and were its non-absorbence and its tendency to cake into a solid mass. In turn, Lister2 experimented with corrosive sublimate and cyanid of mercury; the former, he found, combined

Blood pressure sometimes varies in the right and left side, and I believe that it also varies in local parts of the body. For years I have tried to perfect an apparatus for obtaining readings in various parts of the body, but so far without success.In cases of paralysis following cerebral hemorrhage, it is quite usual to find the blood pressure from 20 to 30 mm. lower on the affected side than on the side unaffected. At first thought this would seem to be easily explained; e. g., that, owing to the cerebral rupture with its resultant paralysis, the vasoconstrictor nerves had become paralyzed, thus allowing an arterial and capillary dilatation. The arteries and capillaries thus have a larger caliber, and so the pressure falls. If that were so, the blood supply to the affected side would be increased, and atrophy of the part would not so quickly ensue.

The brief paper which I have to present this evening was suggested by some remarks, with which the society was favored at its last meeting by Dr. Etheridge, entitled a "Preliminary PreliminaryNoteonc Tamponnement of the Vagina in the Treatment of Pelvic Inflammation." It would have afforded me pleasure to endorse the treatment which was advocated at that time, had an opportunity been given for so doing, for I have had occasion to make frequent use of it, and to learn its advantages, during the past eight or nine years.My attention was first called to this subject by reading a paper which was published by Dr. V. H. Taliaferro, of Atlanta, Ga., in 1878, on "The Application of Pressure in Diseases of the Uterus," in which the writer presented many facts and arguments to prove the great therapeutic efficacy of the principle of pressure as applied to the treatment of

In this paper I discuss the pathology of the peridental membrane as observed in constitutional diseases such as mercurial and lead poisoning and scurvy. In former papers I advocated the theory that pyorrhea resulted from simple inflammation of the gums which afterward became chronic, involving the peridental membrane; that it was due to a local factor which would produce this inflammation; that the inflamed membranes became infected with pus germs and as a result liquefaction and degeneration of tissue are produced with or without calcic deposits.The present contribution is intended to show that the genesis and progress of the pathologic state of the membrane due to constitutional causes is precisely the same. The following cases are of interest from this standpoint:Mr. A., 48 years of age, merchant, was suffering from dyspepsia; was poorly nourished and very weak. His physician placed him upon tonics and calomel. In less than

The test paper here described makes it relatively easy to choose the antibiotic best suited for treatment of a given bacterial infection. Each type of test paper bears both a culture medium and an antibiotic and is supplied, dry and sterile, in a transparent envelope. For a given test, the paper is wetted and inoculated and the envelope with its contents is incubated. It is not necessary to wait for the appearance of visible colonies because the metabolic activity of the bacteria is detected by an indicator (triphenyltetrazolium chloride) which is colorless until reduced to a bright red dye by bacterial enzymes. The reliability of the new test was established by a comparative study with other methods in 100 clinical cases. The test paper is easily stored, and the entire unit can be incinerated after use. It is therefore useful in general office practice and should help to make sure that each patient receives the most effective antibiotic.

Since I have become familiar with the subject it has each day seemed more incomprehensible to me why the Emmet operation has not come into more general use. I have come to the conclusion that the fault lay in defective description of the operation as set forth in most cases, and in the fondness of men for working on the skin perineum, and not in the operation per se. The operation, as described by most of the writers on the subject, is hopelessly mixed up with long discourses on side issues. Too much is left to be understood from diagrams alone, with insufficient attention to details in the procedure. These are prominent faults in the descriptions given by Drs. Emmet and Dudley. Dr. Dudley also obscures his paper, as presented in "Pepper's System of Medicine," by introducing several "modifications." The first of these is one of the essential steps in

The title of this paper may seem rather an ambitious one, since the study of vital and social statistics, and their application to the comparative study of races and nations, is almost too new to furnish many principles that may serve as bases of induction. However, I purpose to state in a fragmentary way a few notes and observations bearing on the subject.More than usual experience as a traveller has brought me in contact with various races of men under different mesological conditions. Experience and observation in this line show that, in spite of physical and moral varieties, there exists practically, for the physician, but one people, since there are no wide differences, biologically or medically speaking, in the human species; and the infirmities of men, notwithstanding their physical inequalities and the extensive range of the nosological table, are much the same the world over, no matter whether they

In presenting this paper I desire to avoid all controversial questions as to the justifiability of vaginal extirpation of the uterus for cancer, but I shall proceed upon the presumption that, by a consensus of advanced professional opinion, it is looked upon as a fixed operation in surgical practice. It shall be my future purpose to discuss some clinical features of the cases requiring this operation, and to call attention to some features of technique.My observations are based upon an experience in eleven cases—nine recoveries and two deaths—but one of which can justly be called primary. The first case was operated upon Nov. 27, 1887, the last, April 28, 1890. There has been recurrence but in two cases; one that of a woman 48, who was operated upon Jan. 11, 1888, after six teen months' previous duration of the disease, had recurrence after twenty months; the other, that of

In imagination, two days ago, I sat in this hall as an inexperienced practitioner of medicine, seeking for some light on the subject of displacements of the uterus, which might be afforded me by the discussion of Dr. Clarke's excellent paper by the many gynecologists present. The discussion, hesitatingly begun, waxed eloquent, grew aggressive and, in the vortex of its climax, many voices of learned men were heard. To me, in my capacity of an imaginary beginner, confusion existed in my mind at the commencement of the discussion, but when the discussion grew in proportions, my mind became a whirlwind of conflicting emotions, because of the many positive, not to be appealed from, opinions, of a diametrically opposite character thundered at us from as many different distinguished specialists.The discussion was begun, as all hot discussions on gynecologic subjects are begun in Philadelphia, by one of the big four of

Somerset Maugham once remarked that he could think of no better training for an aspiring writer than to spend a few years in medicine. Nowadays, more and more voices are heard claiming that a medical education and a few years in practice are certain to squelch, or more likely to ruin, any creative talent, particularly the talent to write.Medicine, preoccupied as it has become with science and technology, may no longer be the same territory where Maugham found human nature without disguise and was creatively stimulated by the experience. Yet with its strict demands for observation and precise description, medicine is still a profession uniquely suited for cultivating the skills fundamental to the art of self-expression. Contemporary scientific literature is not lacking in the exceptional piece that reflects the art of medicine without being short on science and that shows that smoothness of style, depth of perception, and elegance

EFFECTS OF MASSAGE ON THE NUMBER AND HEMOGLOBIN VALUE OF RED-BLOOD CELLS. One of the most interesting and elaborate investigations in the past few years is that of Dr. J. K. Mitchell into the effect of general massage on the blood.1 These observations were made upon thirtyfive people, a few of whom were well, but most of them were suffering from anemia, slight or severe; anemia from hemorrhage and from toxic causes, from chlorosis, from senile and other malnutritions, and one from pernicious anemia. As a rule, in nearly all the cases after massage, there was found a great increase in the number of red globules, and in about half the cases an addition to the hemoglobin also. This increase was found to be greatest at the end of an hour after massage, and after this it slowly decreased. This decrease was postponed more and more when the massage

It is no longer an hypothesis, but a scientific fact, clearly and unequivocally established, that certain bacteria are necessary factors in the causation of certain diseases. One question remains only debatable: Which are and which are not germ diseases? It may be debated whether the bacteria and their spores or their poisonous excreta be the actual ma-teries morbi; but this is a question of secondary importance. It is of the very utmost importance to the progress of scientific medicine and surgery that the entire life history of these low organisms should be fully known, to the end that the unscientific rubbish which obscures the subject may be brushed away, and the facts of essential importance brought within reach of the profession in a clear, compact and manageable form. The first essential fact in the natural history of the group is that all these lowly forms belong to the lowest group

Dr. Theodore Diller, Pittsburg, Pa., said that he recently recorded a case in which the bone was eroded over the seat of the tumor. At the time of the operation the bone was found to be very thin, and there was evidence of protrusion over the site of the tumor as in Dr. Keen's case. The bone was eroded, quite thin, necrotic and easily cut away. Dr. Diller's colleague, Dr. McKennan, had a case last winter in which there was also a protrusion over the site of the tumor. But in his case the bone, instead of being thin and eroded, was greatly thickened. Dr. Diller stated that Sir Victor Horsley does not suture the dura mater, as he considers it time consuming and unnecessary, and asked what is Dr. Keen's practice in this particular. He also referred to a case of brain tumor operated on by Dr. R. W. Stewart recently. The patient exhibited the general symptoms of brain tumor, severe headache and a high degree of optic neuritis with several generalized convulsions besides three symptoms which, taken together, seemed to point to the frontal lobe:

1. The lancet; 2. Veratrum viride; 3. Opium; 4. Coal tar derivatives; 5. Ergot; 6. Heat (poultices) 7. Cold; 8. Quinine; 9. Ammonia; 10. Calomel.Mr. President and Gentlemen:—In presenting this subject to this Society it is not my purpose to traverse much of the field of materia medica, nor to notice many remedies, but to confine myself to a very few.And in order to get a better understanding of the subject, I thought it best to choose some well known disease to base our study of remedies upon. I have therefore chosen pneumonia as a type of disease suitable for our purpose. As to whether or not pneumonia be a specific disease, having a certain definite course to run, and depending upon a particular microbe for its cause, or merely a local inflammation depending solely upon local causes, I shall not stop to discuss. I will say this,

Dr. Marcy considered at length the subject viewed from the standpoint of the recent discussion at the International Medical Congress held in Berlin. He reviewed in detail the observations of Metschnikoff upon the power of the leucocytes to surround and destroy, to digest (so to speak), the bacteria when circumstances are favorable. It seemed to the writer quite too early to draw general deductions from these premises and declare that here the entire solution of the problem is found. There is every reason, however, to believe that this is an important discovery of a power which the organism brings to rescue it under favorable conditions from impending danger. The practical deduction of the lesson is that we seek to place the wound in such a condition that the phagocytes of Metschnikoff may be made the active allies of the surgeon. All this helps also, in a measure, to explain the

Acute colitis, in the sense of an acute catarrh of the large intestine, occurs in infants as a primary disease or as a part of the affection which has received, among other names, the designation entero-colitis. If, in what I have to say of it in the latter connection, I shall appear to make an unnatural separation of usually associated lesions, I hope to be excused on the ground that I believe that colitis is a part of the disease which is too often lost sight of, particularly in the treatment of it.It is in this connection with catarrh of the small intestine that the disease is most frequently encountered. It then occurs as a sequence of cholera infantum, or of an acute dyspeptic diarrhœa.In its primary form colitis is usually due to errors in diet, especially when it affects infants which have passed the weaning period. Occasionally

In 1905, Captain Charles F. Craig,1 Medical Corps, U. S. Army, reported a case of Malta fever which had originated in the United States. The patient was a nurse in a hospital in Washington, D. C., where she contracted the disease, probably from nursing infected soldiers. In addition he reported nine cases in United States soldiers, who had become infected in the Philippine Islands. From the introduction to this communication by Captain Craig we quote the following remark:I am convinced that a careful study by use of the Widal test and the agglutination reaction with Micrococcus melitensis, of many of the cases of obscure continued fevers which are prevalent in this country, will result in the demonstration that Malta fever is by no means a rare disease in the warmer portions of the United States, and that many of the so-called anomalous cases of typhoid fever are, in