in a caul without medical attendance, said infant having drowned in the liquor amnii. He had also seen on one day two cases of pulmonary abscess, resulting from extension of appendical infection by way of the liver.

A case of severe lymphangitis and phlegmonous cellulitis of the leg, resulting from a small wound on the dorsum of the foot, was described by Dr. Stover. In spite of the fact that nearly all the cellular tissue came away in the discharges, the patient weighed a pound more on leaving his bed than when taken sick. The surface application of iodin seemed to have a pronounced effect in preventing upward spread of the trouble.

An interesting example of tachycardia, over 200 per minute, occurring after a nightmare in a patient who had been subjected to Estlander's operation, was reported by Dr. Lobingier. The patient soon recovered under digitalis and bromides. Dr. Hill made brief mention of a case of marked menopausal tachycardia, in which tincture of passiflora appeared to be of value.

Dr. Black's case of papilloma of the soft palate, shown to the society last fall, has undergone sarcomatous transformation, the growth nearly filling the pharyngeal vault.

Atypical abdominal disease was a subject introduced by Dr Waxham. He related the history of an attack of intussusception of the small intestine in a woman, the only signs or symptoms being obstinate constipation and severe pain. Celiotomy revealed the invagination and about a foot of gangrenous gut, which was removed, and the patient is now convalescent. Similar misleading cases of hepatic and intestinal trouble were presented by Drs. Tyler, Hershey, Whitney and Lobingier.

Two instructive autopsies were reported by Dr. Beggs. In one instance an apparently atypical typhoid case, which was not diagnosed after exploratory incision, proved to be multiple hepatic abscess, secondary to ruptured appendix. In the other, a man thrown

from a wagon upon his head, died after numerous convulsions from purulent meningitis, the result of infection through a broken nose and ethmoid.

After listening to all these savory details eveybody enjoyed the excellent lunch provided by the hosts of the evening.

Denver and Arapahoe The second May meeting was Medical Society. the last to be held before next October. In interest, attendance and the scientific value of the work done, the present year has thus far excelled all the past.

The address of the evening, by Dr. Leonard Freeman, upon malignant tumors of the breast, included many practical points upon the diagnosis of scirrhus. He spoke of the great comparative frequency of malignant growths in this gland, particularly after the age of 35. Heredity, he thinks, does not obtain in more than 25 per cent. of cases. Pain is felt in about half of all instances, being for the most part an occasional sharp, electric pang. Palpation is best performed with the open hand, scirrhus being recognized as a single, sharp-angled, stony-hard nodule. Other growths are often multiple and bilateral. Induration and swelling of the axillary glands is an important sign of cancer of the breast, but similar enlargement may occur from various causes. Adhesions of the growth above and beneath is pretty certain evidence of malignancy. Adhesions to the underlying muscle are most readily shown by raising the patient's arm and trying to move the tumor back and forth in the direction of the muscle fibers. Retraction of the nipple is observed only when the tumor is just beneath this point. When there is present a hard, crater-like ulcer, with surrounding secondary nodules, hard edema of the arm and cachexia, any one can make the diagnosis of breast cancer, but then it is usually too late too save the patient. The safe and right thing in case of slightest doubt as to the nature of a breast tumor, is to operate at once,

removing the growth and exploring the axilla for enlarged glands.

Dr. Beggs next read a concise resume of the pathology of infection. He referred to the most modern views on this most important subject and gave a clear, though necessarily brief, account of the nature of germs and toxins, the results of infection, and the defensive properties of cells, tissues and the blood serum, the immunizing power of which appears to be due largely to minute free granules of lencocytic origin.

Dr. Geo. E. Tyler followed with an excellent paper on gastroenterostomy for simple dilation of the stomach, with report of a case. The patient, a middle-aged man, had suffered for fifteen years with considerable pain after meals and the vomiting of large quantities of fermented food and drink, and had gradually grown worse in spite of correct medical treatment, until nearly bedridden. Physical examination showed the lower border of the stomach at the level of the umbilicus. Dr. Tyler made the diagnosis of simple dilation of the stomach with pyloric. adhesions. This was proved to be correct by an operation for posterior gastrojejunostomy, performed last August by Dr. Leonard Freeman. The Murphy button employed was passed two months later, since which time the patient has greatly improved and is now practically well.

Dr. Rogers exhibited a patient injured in a coalmine last March, having sustained a malar fracture, a Colles fracture and a compound Pott's fracture, with other hurts too numerous to mention. This patient has made already a nearly complete recovery in every respect.

American Congress The recent Congress of American of Physicians. Physicians and Surgeons, with its fourteen constituent societies, had the most successful meeting of its existence at its triennial session in Washington, beginning May 1. Drs. Bonney, Edson, Freeman, Fisk, Packard, Parkhill,

Powers, Pershing and Sewall from Denver, Drs. Hart and Campbell of Colorado Springs, and Dr. Melvin of Saguache were in attendance from Colorado.

The general address of Dr. Bowditch upon medical education and the poem of Dr. S. Weir Mitchell received special attention. Dr. Osler was announced to give a general address upon therapeutics, but was prevented by family sickness, to the great disappointment of many.

A new affiliating society was organized at this session, to be known as "The American Therapeutic Society," with Dr. H. C. Wood as President.

The Decennial Convention for Revising U. S. Pharmacepoia was held May 2 to 5, with a much larger attendance than usual. Fourteen states' medical societies were represented, while over forty colleges of pharmacy and pharmaceutical societies had delegates. As usual, the Philadelphia and New York "authorities" had matters well in hand and carried out their program pretty nearly.

The introduction of average doses was adopted as a concession to the medical men, which we believe will not be valuable or satisfactory. The introduction of maximum safe doses, not to be exceeded without caution mark (!) showing intention, has been clamored for during twenty years, as a protection alike to the physician, pharmacist and patient, and was voted down, and the meaningless "average dose" substituted. Physiological tests were refused, and also the introduction of any serums.

The bars were let down a thetics of definite composition. forthcoming revision will reflect ten years ago than of today.

little for patented synThus we fear that the more the conditions of

One forward step was in authorizing supplements to be issued at intervals between revisions. It is an undeniable fact that our physicians are at present learning their materia medica more from their journals and commercial advertisers than from their pharmacopoeia.

John Hopkins Hospital at this season draws a very large class from all over the country for postgraduate work. Their facilities are very extensive and the uniform courtesy of their entire staff almost equals that shown to visitors by our Denver men.-J. T. MELVIN.

Osler's Clinic. Bacchus makes up his accounts and presents his drafts on the liver for payment in the fifth decade. On the brain in the sixth. The worst feature of paralysis agitans is that it never kills.

Cure old age and you can cure paralysis agitans. Write in large letters: The cure of pulmonary tuberculosis depends wholly on the stomach.

The regular sequence of symptoms in syphilis exists only in the text-books.

A case presenting a pustular eruption in its various stages of development cannot be small-pox.-J. T. M.

Sanitation and Preventive Medicine.......Dr. H. C. Call.