existed should be allowed to attend school, and any person exposed to a contagious disease should not attend school for at least two weeks after the last exposure. While whooping-cough was not particularly fatal to older and more robust children, it might be contracted at school and communicated to other members of the family. He thought it was of the greatest importance that pupils should have nothing in common, as it was well known that children with contagious diseases often attended school for several days before it was discovered that such was the case. Such diseases might be communicated by pencils, drinking cups, books and clothing. An examination of the pupils should be made daily for the prevention of contagious diseases. An examination should be made twice a year of the eyes and ears of each pupil, and outside inspection was important when children were absent from school.

Hygiene in Its Relation to the Primary School.-Dr. Guzman, of Mexico, followed with a paper on this subject, and among other things he said that aid to the physician must come from the teacher. In his belief, teachers should be trained to help the inspecting physician so as to be able to discover diseases produced by illdirected school work, contagious diseases in the school, examination of the physical condition of pupils at the time of their entrance to school, and at regular intervals thereafter.

Cremation in Its Relation to Sanitary Legislation.—Dr. Luis G. Espinoza, of Vera Cruz, Mexico, read a paper with this title. He divided the subject into three parts: (1) The merits and demerits of cremation; (2) the establishment of hygienic regulations in cemeteries and a discussion of their respective value; (3) he concluded in favor of compulsory cremation in contagious diseases.

SECTION ON BACTERIOLOGY AND CHEMISTRY.

The Committee on Standard Methods of Water Analysis presented its report, covering especially physical, microscopic and bacteriologic examination, color, standards of comparison, odor, etc.

Dr. Stephen De M. Gage presented the results of routine determinations of Bacillus coli and the applied water and affluents of the various water filters at the Lawrence Experiment Station, and the finding of both Bacillus coli and Bacillus typhi in these waters. Bacillus coli was found in the affluents more frequently than Bacillus typhi; both germs were present in the applied. Bacillus coli is the more hardy germ of the two.

Dr. Robert Spurr Weston and A. I. Kendall referred to the water purification investigation at New Orleans, and described the

different species of bacteria found in the Mississippi River at that point, together with the various groupings and tests.

Refined Antitoxin Preparations.-Dr. Joseph McFarland was somewhat pessimistic as to the preparation of the antitoxin serums, and said that we are, nearly ten years after their invention, working along the same lines as introduced by the pioneers, having achieved nothing but an increased potency in the serums we prepare. He summed up by saying that it is desirable both to manufacturer and consumer to have antitoxic principles of the different serums separated from the useless substances with which it. is associated and placed at the disposal of the clinician in a refined form.

Typhoid Infection, Its Nature and Treatment.-Dr. Eugene Wasdin says typhoid fever is no more primarily a disease of the intestine than smallpox is a disease primarily of the skin. The symptoms of lung invasion are early, those of the intestines are later. The presence of the bacillus of the blood does not seem of importance. The primary colony endangers the patient. The infection in typhoid fever is, then, in the majority of cases, not by way of the alimentary canal. Municipal hygiene should recognize the organism in the air and its entrance into the respiratory passages.

Drs. William Royal Stokes and John S. Fulton say that, although satisfactory antitoxic serum has been produced for practical use, yet no practical clinic remedy has yet been devised for any of the bacterial infections needing a bactericidal serum; that typhoid and other bacterial infections need not only a highly immune serum, but also a normal serum containing a normal element of the blood of health or the so-called alexin.

The Vitality of the Plague Bacillus in Its Relation to the Public Health.-M. J. Rosenau claims that the plague bacillus is not a frail organism. He covered the points of effect of temperature, moisture, sunlight, food products; the vitality of the plague bacillus in water, disease not water-borne, plague in cold climates and in the tropics, gaseous and chemical disinfectants for the plague bacillus. Clothing and bedding may act as fomites. Bacillus pestis in the male cannot live long, dying at even the body temperature; it keeps alive at 19° C. New merchandise is not apt to carry the disease. Reference was made to the life of the organism on wood, paper, sponge, wool, sawdust, cotton, crash and a variety of objects.

What Standards of Bacterial Purity of Milk Supplies Should be Prescribed by Boards of Health? The author referred to the

large number of bacteria found in both raw and pasteurized milk in the city of New York during the summer. Milk taken under decent conditions does not average 5,000 bacteria per c.c. If kept under 50° F., it does not contain over 100,000 bacteria at the end of 24 hours. The milk of New York contains in summer over 10,000,000 bacteria per c.c. The Health Board has passed a rule requiring that milk shall be exposed at a temperature of 50° F. When the bacteria run under 30,000 and the inspectors say the conditions are good, the dealer gets a certificate from the county society. Dr. Swartz, secretary of the Rhode Island Board of Health, said that it was a difficult matter to make a standard as to how many bacteria constitute a milk that cannot be received. Anything over 500,000 should be excluded. Of most importance is the education of the public as to contaminated and adulterated milk.

The Cause of the Nonnitrification of Septic Sewage in Contact Filters. Dr. H. W. Clark, speaking of experiments made at Lawrence, showed that it was exceedingly difficult to produce a nitrification in contact filters receiving this sewage; that it is caused by the rapid exhaustion of the oxygen in the filter at the time of the application, and that this rapidity of exhaustion varies greatly with different sewages in different stages of decomposition. Mr. Fuller spoke of the use of permanganate.

Dr. T. Madsen, of Copenhagen, read a technic paper entitled "Antitoxins and Agglutins; Some Analogous Phenomena of the Variation of Production Arising During Active and Passive Immunization"; followed by a "Description of Certain Laboratory Methods," by Dr. F. F. Wesbrook.

"Types of Bacillus Diphtheria in Clinical Cases" was the title of a paper by Dr. F. F. Wesbrook, Dr. L. B. Wilson and Dr. O. McDaniel. The paper was highly technical and statistical.

There were several reports of committees, and a few papers which were not read, owing to lack of time, as there were no sessions held on Thursday; but these papers and reports will appear in the official proceedings of the association.

The following officers were elected for the ensuing year: President, Dr. Henry D. Holton, Brattleboro, Vt.; First Vice-president, Dr. Walter Reed, U. S. Army; Second Vice-president, Dr. Jesus Chico, Guanajuato, Mexico; Secretary, Dr. Charles O. Probst, Columbus, Ohio; Treasurer, Dr. Frank W. Wright, New Haven, Conn.

New Orleans, La., was selected as the place for holding the next annual meeting, but the exact date was not determined.

MEDICAL EXCERPT.

By T. P. CORBALLY, A. M., M. D.

TREATMENT OF DIPHTHERITIC PARALYSIS.-Dr. Ballan, in his thesis, has contributed an aid to the treatment of diphtheritic paralysis, by the use of sero-therapy. The "Gazette hebdomadaire,” September 15, 1901, says he has again shown to what an extent the anti-diphtheritic serum was efficacious in all the forms of disease caused by the bacillus of Löffler; he has demonstrated its utility in attacks caused by poisonous secretions, as in cases of paralysis following local attacks of diphtheria.

These cases are the results of lesions in the nerve cells of the spine, and especially in the nerve centres; lesions due to the poison which is probably propagated by the infection being conducted through the nerve filaments.

The experiments of Prof. Ferré, conducted systematically since 1896, show clearly the origin of these accidents, and it is this experimental study of paralysis of diphtheritic origin which has enabled this author to show, in a strictly definite manner, the effects of the specific action of the anti-diphtheritic serum in the treatment of such cases.

The observations of M. Ballan are so direct that they leave no doubt as to his conviction, and must satisfy all who examine them. It is only an exact application of the conclusions of M. Ferré and of the sero-therapeutic treatment, reproduced experimentally.

These paralytic cases seem less grave, and yield more readily, when treated early with the serum, which may be used in very large doses without injury to the system, and, indeed, in the cases of Dr. Raulin and in those of Prof. Ferré, reported by Dr. Ballan, we find that doses of 200 cubic centimeters in two months have been administered, and even 140 cubic centimeters in one month. These are facts that show how necessary it is that one should be always prepared to use the serum immediately, and prove also that physicians have in this medicine a veritable specific for accidents, present or remote, produced by the bacillus of Löffler or its toxine.

While the principal object of Dr. Ballan is to show the great value of the serum as a remedy, his secondary object is to urge the immediate application of the remedy, in order to secure the best possible result.

DIAGNOSIS OF PLAGUE.-In view of the recent outbreak of plague in this country, the statement made by Barker (“American Journal of the Medical Sciences," October, 1901) that the diagnosis can be established beyond the shadow of a doubt, is of importance. When dealing with a first case, the most experienced clinician hesitates to pronounce the existence of such a disorder in the community, but if, after a careful examination of the physical symptoms, the juices from the buboes are extracted by hypodermic syringe and examined for bacteria, they will be found to exist. Likewise, the pathological appearances are absolutely characteristic in the great majority of cases. The German Government, recognizing the possibility of a quick and accurate diagnosis, has arranged for definite plague courses at certain of the bacteriological institutes, where men may be prepared for the especial study of the discase. When a suspected case is reported from any source, experts with special plague bacteriological outfits are sent at once to the place, and their report is accepted as final and acted upon immediately.

TREATMENT OF TYPHOID FEVER.-Lieut.-Col. G. Sterling Ryerson, M. D., of Toronto, later British and Red Cross Commissioner in South Africa, at a recent meeting of the Toronto Clinical Society ("Canadian Lancet"), reported that the treatment of typhoid fever was practically the treatment which is adopted in Toronto and everywhere else. Disinfection of the bowel either by means of listerine or boric acid, taken internally, or enemata, were considered in many cases to be remarkably successful. Another form of treatment was that of starvation. They were starved for seven or eight days. He considered that in some cases it might be dangerous, because a number of the men were exhausted when brought in. Nothing whatever to eat for seven days was their treatment; nothing at all except water, and all of that they could drink. The medical officer in charge of these cases, and under whose supervision this plan of treatment was carried out, informed Dr. Ryerson that he had fewer deaths than in any other hospital in Bloemfontein. Dysentery: this was another very prevalent disease, and you hear of a great many men affected with this disease when they merely had ordinary diarrhoea. Dr. Ryerson said that during his service as surgeon with the troops engaged in the suppression of the North-West Rebellion in 1885, he had observed the good effect of several drachm doses of listerine in treating camo diarrhoea and dysentery, caused by drinking the alkali water of the plains.