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Resolved, That the Medical Society of the County of Orange, in meeting assembled, protests against the enactment of such a bill as con

trary to the best interests of the people of State The Pan-American Congress will be an ex- of New York. -cellent opportunity for a mid-winter vacation

Resolved, That a copy of this protest be forwith scientific advantages.

warded to each Senator and Assemblyman repreNever before in its history has the New York

senting this county. County Medical Association been as strong and Resolved, That a committee of three be aphealthy as it is to-day.

pointed to take such action as may seem best Reports from several counties show an

fitted to accomplish the defeat of this and simiprecedented activity in the enrolment of new

lar measures. members.

(Signed) C. I. REDFIELD, President. Ask your secretary for a few application

M. A. STIVERS, Secretary. blanks and send them to your friends. It is a great favor to them and of little trouble to you.

SOCIETY NOTES. Fotential enthusiasm is of no value as such- BUFFALO ACADEMY OF MEDICINE.—At a meeting held make it kinetic.

December 20, 1904, Dr. C. A. Bentz read a paper on "A Chairmen of committees are incompetent as Case of Tuberculosis in the Domestic Turkey.". Dr. N.

G. Russell on “Lympho-Sarcoma of the Intestines and long as they wait for work to come to them.

Kidneys from Cases of Nephritis,” considered in conThey should look for work to do.

nection with urine examinations, No duty is too insignificant for the man who is New YORK CELTIC MEDICAL SOCIETY.-At a meeting capable of large affairs.

held December 22, 1904, Dr. C. J. McGrath read a

paper on “Gastric Ulcer and Its Surgical Treatment." Dr. E. A. Sharp, of Katonah, member of the

BROOKLYN SOCIETY FOR NEUROLOGY.–At a meeting Westchester County Medical Association, read

held December 29, 1904, Dr. Joseph Frankel read a a paper entitled “Private Colonies for Epileptics” paper on "Contributions to the Symptomatology of the at the meeting of the National Association for the Posterior Fossa." Dr. Robert Kingman on “Mirror Study of Epileptics and the Care and Treatment

Writing."

MEDICAL UNION.–At a meeting held December_28, of Epileptics, which was held in Boston, Novem

1904, Dr. A. E. Woelmert read a paper on “Urinary Exber 22d.

aminations." Dr. Francis P. Kinnicutt, member of the New CORNING MEDICAL AssocIATION.–At a meeting to York County Medical Association, has returned

be held January 5, 1905, Dr. Frank H. Starr will read a

paper on “Recent Advances in Orthopedic Surgery." to town from Morristown, N. J.

METROPOLITAN MEDICAL SOCIETY.–At a meeting Dr. Francis J. Quinlan having resigned from held December 27, 1904, Dr. H. Lilienthal read a paper the Committee on Publication, Dr. William R. on “Some Recent Advances in Surgery," and Dr. A.

Wiener on “Some Observations on the More ConservaStone has been appointed to succeed him.

tive Treatment of Protracted Cases of Acute Otitis Dr. William L. Russell, of Poughkeepsie, Media Purulenta, with its complications." member of the Dutchess County Medical Association, discussed the importance of recognition and appropriate care of distinct phases of mental de- Book Reviews. fects before the New York State Conference of Charities and Corrections, which recently met at THE PRINCIPLES OF HYGIENE. A Practical Manual Syracuse.

for Students, Physicians, and Health Officers. By D. H. Bergey, A.M., M.D., Assistant Professor of

Bacteriology, University of Pennsylvania. IllusOPPOSE OPTOMETRY BILL.

trated. Second edition, thoroughly revised and enResolutions passed in opposition to the Optom

larged. Philadelphia, New York and London: W.

B. Saunders & Co., 1904. etry Bill by the Medical Society of the County The entire range of subjects comprising the compreof Orange, at a special meeting held in Thrall hensive field of hygiene, causes of disease, the study of Hospital, Middletown, on Tuesday, December air, ventilation, heating, water supply, and disposal of 20, 1904.

sewage is based on the most recent discoveries, and WHEREAS, The President of the New York

represents the practical advances made in the science

up to date. The subjects of food, dieting, exercise and State Optical Society has announced that the clothing are practically discussed. The chapters on inhill to define and regulate the practice of optom

fection and immunity have been rewritten and the disetry, which failed to pass at the last session

cussion of the subject is from the present-day stand

point. of the Legislature, will be brought up again for COMPEND OF GYNECOLOGY. By William H. Wells, M.D., consideration; and,

Chief of the Gynecological Staff of the Mount Sinai WHEREAS, The claim is falsely made that 75 Hospital, Philadelphia; Demonstrator of Clinical per cent of the general medical practitioners

Obstetrics in the Jefferson Medical College, Phila

delphia; Fellow of the College of Physicians and of favor this measure; and,

the Gynecological Section of the same; late AssistWHEREAS, We believe from the publications of ant in the Gynecological Department of the Jefferthe opticians who favor this bill that they not

son Medical College Hospital, etc. Third edition, only desire to, but are now actually engaged in

revised, enlarged, with 145 illustrations. Philadel

phia: P. Blakiston's Son & Co., 1012 Walnut street, the practice of a branch of medicine in violation 1903. Price, 80 cents net. of the present medical law; be it

The third edition in the revision has added

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tion on general therapeutics of gynecology and several new operations have been described. A COMPEND OF HUMAN ANATOMY. By Samuel O. L.

Potter, M. A., M.D., M.R., C.P., London. Formerly Professor of the Principles of Medicine in the Cooper Medical College of San Francisco; Author of the “Hand-Book of Materia Medica, Pharmacy and Therapeutics,' "Quiz-Compend of Materia Medica,” “Index of Comparative Therapeutics” and "Speech and Its Defects;" late Major and Surgeon of Volunteers, U. S. Army. Seventeenth edition. Revised and enlarged, with 138 wood engravings ; also numerous tables and 16 plates of the arteries and nerves. Philadelphia: P. Blakiston's Son & Co., 1012 Walnut street, 1903. In this seventh edition all changes of nomenclature and description have been carefully followed. Many plates have been added and old ones replaced by new. The author has endeavored to make this volume deserving of first rank among its kind. SAUNDERS' QUESTION-COM PENDS. Essentials of Nerv

ous Diseases and Insanity, their Symptoms and Treatment, by John C. Shaw, M.D., late Clinical Professor of Diseases of the Mind and Nervous System, Long Island College Hospital Medical School. Fourth edition. Thoroughly revised, by Smith Ely Jelliffe, M.D., Ph.D., Clinical Assistant, Columbia University, Department of Neurology; Visiting Neurologist, City Hospital, New York. Illustrated Philadelphia, New York, London: W. B. Saunders & Co., 1904. Dr. Smith Ely Jelliffe, in making the revision for this new fourth edition, has found it necessary to recast the work entirely, bringing the order of arrangement in accord with the present knowledge of these important subjects. Quite a commendable change in arrangement is the grouping of subjects in such a way as to bring out the natural relations of affiliated nervous disorders. THE ESSENTIALS OF CHEMICAL PHYSIOLOGY, FOR USE

OF STUDENTS. By W. D. Halliburton, M.D., F.R.S., Fellow of the Royal College of Physicians; Professor of Physiology in Kings College, London; Author of Text-Book of Chemical Physiology and Pathology. Fifth edition. London, New York and

Bombay: Longmans, Green & Co., 1904. This edition has been carefully and thoroughly revised, and several changes made in the arrangement of exercises. The elements contained in physiological compounds have been introduced in the elementary course. Within the moderate limits of this work the author has kept abreast with the advances in science. The book is valuable to the student, showing how work can be accomplished in a practical way. SAUNDERS' QUESTION-COMPENDS. Essentials of Anat

omy, including the Anatomy of the Viscera, arranged in the form of Questions and Answers, prepared especially for Students of Medicine, by Charles B. Nancrede, M.D., Professor of Surgery and of Clinical Surgery in the University of Michigan: Emeritus Professor of General and Orthopedic Surgery, Philadelphia Polyclinic; Senior Vice-President of the American Surgical Association; Corresponding Member of the Royal Academy of Medicine, Rome, Italy; Member of the American Academy of Medicine, etc. Seventh edition, thoroughly revised. Philadelphia, New York, London: W. B. Saunders & Co., 1904. In this revision the entire book has been carefully gone over and the section on the Nervous System completely rewritten. The illustrations throughout the text are excellent, showing the anatomy of various parts with unusual clearness. SAUNDERS' QUESTION-COMPENDS. Essentials of Bac

teriology. Being a Concise and Systematic Introduction to the Study of Micro-Organisms, by M. V. Ball, M.D., formerly Resident Physician, German Hospital, Philadelphia; formerly Bacteriologist to

St. Agnes' Hospital. Fifth edition, thoroughly revised by Carl M. Vogel, M.D., Assistant in Pathology, College of Physicians and Surgeons, Columbia University, New York City. With 96 illustrations, some in colors and 6 plates. Philadelphia, New York, London: W. B. Saunders & Co., 1904. The rapid progress in Bacteriology has involved many radical changes in the science, necessitating a thorough revision in this edition. We note the recent advances in the subjects of Immunity, Tuberculosis, Yellow Fever, Dysentery, Bubonic Plague and other infectious diseases. SAUNDERS' QUESTION-COMPENDS. Essentials of Med

ical Chemistry, Organic and Inorganic, containing also Questions of Medical Physics, Chemical Philosophy, Analytical Processes, Toxicology, etc., Prepared especially for Students of Medicine, by Lawrence Wolff, M.D., formerly Demonstrator of Chemistry, Jefferson Medical College; Physician to the German Hospital of Philadelphia; Member of the German Chemical Society, of the Philadelphia College of Pharmacy, etc. Sixth edition, thoroughly revised by A. Feree Witmer, Ph.G., formerly Assistant Demonstrator of Physiology, University of Pennsylvania; Neurologist to the Out-Patient Department of the Hospital for Ruptured and Crippled, New York City. Philadelphia, New York, London: W. B. Saunders & Co., 1904.

We need but mention the fact that this little work has reached its sixth edition. The recent important discoveries in physics and inorganic chemistry have rendered it necessary to make extensive additions almost to every part of the work. The subject of organic chemistry, especially organotherapy and the substituted ammonias, has also been revised and much new matter added. SAUNDERS' QUESTION-COMPENDS. Essentials of Materia

Medica, Therapeutics and Prescription Writing, arranged in the form of Questions and Answers, prepared especially for Students of Medicine, by Henry Morris, M.D., Fellow of the College of Physicians of Philadelphia; Associate Member of the Association of Military Surgeons of the United States; Member of the American Medical Association, etc. Sixth edition, thoroughly revised, by W. A. Bastedo. Ph.G., M.D., Tutor in Materia Medica and Pharmacology at Columbia University (College of Physicians and Surgeons), New York; Assistant Attending Physician in the Roosevelt Hospital Dispensary and to the Vanderbilt Clinic. Philadelphia, New York, London: W. B. Saunders & Co., 1904. Much of the text has been in great part rewritten. There have been introduced articles on adrenalin, stypticin and on the iodine and silver synthetics. Text-BOOK OF CLINICAL DIAGNOSIS. By Laboratory

Methods. For the use of Students, Practitioners, and Laboratory Workers. By L. Napoleon Boston, A.M., M.D., Associate in Medicine and Directory of the Clinical Laboratories of the Medico-Chirurgical College, Philadelphia; formerly Bacteriologist at the Philadelphia Hospital and at the Ayer Clinical Laboratory of the Pennsylvania Hospital. Octavo volume of 547 pages, with 320 illustrations, many of them in colors. Philadelphia, New York, London: W. B. Saunders & Co., 1904. Cloth, $4.00 net ; sheep or half morocco, $5.00 net. Dr. Boston presents a practical manual of those clinical laboratory methods which furnish a guide to correct diagnosis, giving only such methods, however, that can be carried out by the busy practitioner in his office as well as by the student in the laboratory. He has given special attention to outlining in progressive steps the various procedures in clinical technic, such steps being illustrated whenever possible. All the more recent methods for the examination and staining of blood are described and illustrated by original drawings, and the subject of Serum-Diagnosis is very carefully considered. The newer methods for the estimation of Sugar, BenceJones' Albumin, Uric Acid, and Purin have received thoughtful consideration. The subjects of Animal Parasites, Diseases of the Skin, Transudates and Exudates, and Secretions of the Eye and Ear have received an unusual amount of space. Attention has also been paid to Inoscopy and Cyto-diagnosis. Indeed the book contains much useful material throughout, and being the latest work on Clinical Diagnosis, includes the most recent advances along that line. EXAMINATION OF THE URINE. By G. A. de Santos

Saxe, M.D., Pathologist to the Columbus Hospital, New York City. 12mo volume of 391 pages, fully illustrated, including 8 colored plates. Philadelphia, New York, London: W. B. Saunders & Co., 1904. Flexible leather, $1.50 net. Dr. Saxe has presented a work on examination of the urine unusually complete, absolutely up to date, concise, yet explicit in all its parts; and it will be found to meet fully the requirements the tudent an practitioner without burdening him with unnecessary analytic procedures. Special attention has been paid to the interpretation of findings as applied to clinical diagnosis, and the student is told what each chemical element and each microscopic structure means when found in the urine. Cryoscopy and other means of functional diagnosis have been given their proper places. The work will be useful because it is practical. PATHOLOGICAL TECHNIQUE. A Practical Manual for

Workers in Pathological History and Bacteriology, including Directions for the Performance of Autopsies and for Clinical Diagnosis by Laboratory Methods. By Frank Burr Mallory, A.M., M.D., Associate Professor of Pathology, Harvard University Medical School; First Assistant Visiting Pathologist to the Boston City Hospital; Pathologist to the Children's Hospital, and James Homer Wright, A.M., M.D., Director of the Clinico-Pathological Laboratory of the Massachusetts General Hospital: Instructor in Pathology, Harvard University Medical School. Third edition, revised and enlarged, with 156 illustrations. Philadelphia, New York, London: W. B. Saunders & Co., 1904. The third edition of this work keeps pace with the great advances made in pathology, and it retains its value as a laboratory and post-mortem guide. Many additions have been made as the methods for the isolation of typhoid bacilli from the feces, Wright's blood stain, and directions for its application to blood films and malarial parasites. Some new photographs by Mr. L. S. Brown on the malarial parasites are particularly interesting.

BOOKS RECEIVED. A LABORATORY MANUAL OF HUMAN ANATOMY. By Lewellys F. Barker, M.B., Tor., Professor and head of the Department of Anatomy in the University of Chicago and Rush Medical College. Assisted by Dean De Witt Lewis, A.B., M.D., and Daniel Graisberry Revell, A.B., M.B., Instructors in Anatomy in the University of Chicago. Illustrated. Philadelphia and London: J. B. Lippincott Company, 1904. Price, $5. TRANSACTIONS

MEDICAL ASSOCIATION GEORGIA, FIFTY-FIFTH ANNUAL Session, 1904. Published by the Association, 1904.

TRANSACTIONS OF THE MAINE MEDICAL ASSOCIATION, 1904. Vol. XV, Part 1.

TRANSACTIONS OF THE ARKANSAS MEDICAL Society, Twenty-ninth Annual Session, held at Texarkana, Ark., May 3, 4 and 5, 1904. Press of Arkansas Democrat Company, Little Rock.

GENERAL CATALOGUE OF MEDICAL BOOKS. P. Blakiston's Sons & Co., Philadelphia.

A TEX-BOOK OF PRACTICAL THERAPEUTICS, with especial reference to the Application of Remedial Measures to Disease and Their Employment upon a Rational Basis. By Hobart Amory Hare, M.D., B.Sc., Professor of Therapeutics and Materia Medica in the Jefferson

Medical College of Philadelphia ; Physician to the Jefferson Medical College Hospital; one-time Clinical Professor of Diseases of Children in the University of Pennsylvania; Laureate of the Royal Academy of Medicine in Belgium, of the Medical Society of London; author of "A Text-Book of Practical Diagnosis,” etc. Tenth edition, enlarged, thoroughly revised and largely rewritten, illustrated with 113 engravings and 4 colored plates. Philadelphia and New York: Lea Bros. & Co., 1904.

LIBRARY OF CONGRESS. A. L. A. CATALOG, 8,000 volumes for a Popular Library, with Notes prepared by the New York State Library and the Library of Congress under the auspices of the American Library Association Publishing Board. Editor, Melvil Dewey, Director New York State Library and Library School; Associate Editors, May Seymour, Education Librarian, New York State Library; Mrs. H. L. Elmendorf, Special Bibliographer, Buffalo Public Library. Part 1, Classed; Part 2, Dictionary. Washington Government Printing Office, October, 1904.

STRABISMUS, OR SQUINt. Latent and Fixed. A supplement to The Errors of Refraction. By Francis Valk, M.D., Professor of Diseases of the Eye, New York Post-Graduate School and Hospital; Consulting Ophthalmologist, Thrall Hospital, and formerly Assistant Surgeon, Manhattan Eye and Ear Hospital; Visiting Ophthalmologist Randall's Island Hospitals and Ophthalmologist to the New York Dispensary; Fellow of the New York Academy of Medicine and of the State and County Medical Society; Member of the Greater New York Medical Society and the Society of Medical Jurisprudence, etc. G. P. Putnam's Sons, New York and London: The Knickerbocker Press, 1904.

A MANUAL OF PERSONAL HYGIENE, PROPER LIVING UPON A PHYSIOLOGIC Basis. By American authors. Edited by Walter L. Pyle, A.M., M.D., Assistant Surgeon to the Willis Eye Hospital, Philadelphia; Secretary of the Section on Opthalmology, American Medical Association; Associate Member of the American Opthalmological Society; Fellow of the College of Physicians of Philadelphia, etc. Contributors, D. H. Bergey, M.D., J. W. Courtney, M.D., George Howard Fox, M.D., E. Fletcher Ingals, M.D., Walter L. Pyle, M.D., B. Alexander Randall, M.D., G. N. Stewart, M.D. (Edin.), Charles G. Stockton, M.D. Second edition, revised and enlarged. Philadelphia, New York, London: W. B. Saunders & Co., 1904.

DIET IN HEALTH AND DISEASE. By Julius Friedenwald, M.D., Clinical Professor of Diseases of the Stomach in the College of Physicians and Surgeons, Baltimore, and John Ruhräh, M.D., Clinical Professor of Diseases of Children in the College of Physicians and Surgeons, Baltimore. “These few rules of diet he that keeps, shall surely find great ease and speedy remedy by it.”--Burton. Philadelphia, New York, London: W. B. Saunders & Co., 1905.

DISEASES OF THE LIVER, GALL-BLADDER AND BILEDucts. By H. D. Rolleston, M.A., M.D., (Contab.) F.R.C.P., Physician to St. George's Hospital, London ; formerly Examiner in Medicine in the University of Durham and Fellow of St. John's College, Cambridge, England. Fully illustrated. Philadelphia, New York, London; W. B. Saunders & Co., 1905.

ATLAS AND EPITOME OF GENERAL PATHOLOGIC HisTOLOGY. By Docent Dr. Hermann Dürck, of the Pathologic Institute, Munich. Authorized translation from the German. Edited by Ludvig Hektoen, M.D., Professor of Pathology in Rush Medical College, Chicago. With 176 colored illustrations on 80 lithographic plates and 36 figures in black and colors. Philadelphia, New York, London: W. B. Saunders & Co., 1904.

GALL-STONES AND THEIR SURGICAL TREATMENT. By B. G. A. Moynihan, M.S. (London), F.R.C.S., Leeds. Fully illustrated. Philadelphia, New York, London: W. B. Saunders & Co., 1905.

OF

THE

OF

Original Articles.

AN ATYPICAL CASE OF APPENDICITIS." Presenting Some Unusual Features Found at the Operation.

BY W. B. REID, M.D.,

Rome, N. Ý.

abdomen revealed a large umbilical hernia, asso-
ciated with a general tympanitis. There was a
marked tenderness over McBurney's point, asso-
ciated with board-like rigidity. The pulse was
110; temperature, 101; respiration, 24.

EXAMINATION OF THE URINE.
Total quantity not obtained. Color, yellow.

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AMEN ESIA.

have written special text-books on the test showed a decided trace of sugar. subject of appendicitis, have not mentioned the possibility of the complication which we encoun

MICROSCOPICAL EXAMINATION OF URINE. tered in the case about to be reported, and that no

A drop of precipitate, thrown down by the similar case is recorded in the literature stamps centrifuge, showed a few pus cells and a large it of sufficient rarity to warrant placing a single number of granular and hyaline casts. The diagcase on record.

nosis of traumatic appendicitis was made. Dr. Howard A. Kelley, in his text-book on Owing to the bad condition of the heart and “Operative Gymnecology," describes a condition kidneys, it was thought best to defer the operaunder the name of Physometra, using it to desig- tion for a few days. I advised that the bowels be nate a collection of gas in the uterus, associated moved immediately by a high enema, that the with sepsis. The cause of the tympany in Kel

starvation treatment of Ochsner be followed, and ley's case was the bacillus ærogenes capsulatus. that the case be kept under the closest observaThe cause of the condition which we encountered

tion. was found to be due to bacteria, which will be On March 11, 1904, I saw the case again and described later.

found the condition somewhat worse. The tem

perature had varied during intervals from 100 to The family history was negative.

103 ; the pulse from 90 to 114 per minute. The PERSONAL HISTORY.

patient was then removed from the country to On February 20, 1904, I saw Mrs. E. W., with the hospital, a distance of seven miles. her family physician, and obtained the following On admission, the record shows a temperature history: Age, 19; married at the age of 28; one

of 102; pulse, 114, and respirations, 24. The child. PREVIOUS HISTORY,

heart was in bad condition, being very irregular, Her general health had always been good, with intermittent, and the pulse of very poor volume. the exception of a chronic indigestion, associated

Examination of the abdomen at this time with mild attacks of pain in the abdomen. She

showed a general tenderness, more localized in had also suffered from shortness of breath on

the right side. A tumor in the same region, the climbing stairs or making quick exertions. After

size of a small apple, could easily be palpated standing and working hard, she had also noticed

and distinctly outlined. The previous diagnosis some swelling of the feet and ankles.

was confirmed and the evidences of abscess forTHE PRESENT SICKNESS.

mation very suggestive. The amount of urine On February 17th, while riding with her hus- passed during the previous ten days had averaged band, she was thrown from a sleigh, striking on

about 12 ounces. the right side and shoulder. The same night, a

Owing to the bad general condition and the severe pain gradually developed in the left hypo- state of the heart and kidneys, we determined to chondrium. This lasted all night, and toward keep the case under observation, and by treatmorning settled to the right lumbar and right ment try to improve the work of these organs. iliac regions. The pain remained of a dull, ach

The patient was then placed on a strict liquid diet ing character during the next day, but the ab- and given three pints of distilled water daily. domen gradually became more sore and tender The bowels were unloaded by small doses of to the touch. On February 19, 1904, the family calomel, followed by a saline. From the date physician was sent for, and obtained the history of admission-March 11, 1904, to March 31, as given above. He found the abdomen some

1904—the patient ran an irregular temperature, what distended, markedly sore over McBurney's varying from 100 to 103 degrees. The pulse was point, but no rigidity. The respirations were irregular, intermittent and of poor volume, vary20; pulse, 90, and temperature, 100.

ing from 90 to 120 beats per minute. She conPHYSICAL EXAMINATION.

tinued to pass large quantities of albumen and General appearance very stout and fleshy. sugar. The average amount of urine passed was Color somewhat sallow. Height, 5 feet 4 inches. 15 ounces per day. Nausea was a continuous Weight, 175-180 pounds. The heart showed evi- and distressing symptom, but no vomiting ocdences of fatty degeneration, but no murmur was

curred. Pain was not complained of at any time, heard. Examination of the chest showed the but the soreness and tenderness in the right side lungs in a normal condition. Examination of the gradually grew worse. The tumor in the appen

dicular region increased to the size of a small 1 Read at the Twenty-first Annual Meeting of The New York

cocoanut. As it seemed impossible to improve State Medical Association, New York, October 17-19, 1904.

her general condition, we determined to operate shape, according to age, the younger tending towithout further delay.

ward a round, while the older were very irreguOPERATION.

lar. The potato cultures were much more irreguOwing to the degeneration of the heart mus- lar in shape and of a darker color, even showing cle, general anesthesia with ether or chloroform a tendency in the older colonies of a yellowishwas considered too hazardous, so I determined brown or dirt color. The gelatin stick cultures to try local anæsthesia. Ethyl chloride "was used showed an abundant growth, along the line of to anæsthetize the punctures, when the hypoder- puncture, grayish-white in the early growth, but mics were given and the skin incision made. tending toward the yellow as the culture aged. A 2 per cent. solution of nirvanin was used A few gas bubbles developed in some of the culhypodermically, for deep anæsthesia. The total ture media. The addition of a slight amount of quantity used in the work was two grains. The milk sugar to each tube of gelatin, and then foloperation was carried out without causing the lowed by a stick culture, showed practically the patient any pain or suffering. An incision, two same macroscopic appearance, but with this disinches in length, was made over the most promi- tinction, that there was an abundant development nent part of the tumor. The skin was incised, of gas bubbles. and I then proceeded carefully through the mus- MICROSCOPICAL EXAMINATION OF SOME OF THE cles and came to the upper wall of a large abscess.

CULTURES. This was opened, and, to my great surprise, a rush of foul-smelling gas came through the small

A. The hanging drops of all the specimens, incision which had been made. The sound was

both gelatin plate, stick and potato, showed no

mobility. B. All the specimens examined took exactly like that of a pin-hole prick in an over

both the fuchsine and menthylene blue readily and distended intestine, filled with gas. In fact, that is what we all thought had happened, that a coil rapidly parted with the colors by Gram's method.

c. The microscope showed a wide variation in the morphological appearance of the different specimens. All showed the same rod appearance with rounded ends. Many colonies were typical of the bacillus coli communis; the average size in most of the specimens ranged from 1 to 3 micromillimeters in length and from 0.2 to 0.7 micromillimeters in breadth. Many specimens showed a large number of bacilli of a much

smaller size, and with much more of the appearGAS... ance of a micrococcus. The general appearance of

these small bacilli was about the same, being short -Rus.

rods with rounded ends, the size varying some

what, but, in the mean, ranging from 1 to 2 VERMIFORM

micromillimeters in length and from 0.1 to 0.5 APPENDIX.

micromillimeters in breadth. These smaller bacilli drew my attention to their close resemblance to the bacillus lactis ærogenes described by Sternberg. This suspicion I believed not to have

been well founded. My second thought on the of intestine had become adherent to the super- question, however, is not at all dogmatic, and ! ficial wall of the abscess, and had been acciden- hope my final decision will be materially assisted tally incised. As the abscess cavity partially by the discussion, which you men with a more emptied itself of gas, pus, filled with gas bubbles, varied and wider experience in bacteriology may began to pour forth.

have to offer. Remembering the facility with which certain We all know the reputation of the colon bacilbacteria form gas, the suspicion of what had lus to such a marked variation, both in morphotaken place came to my mind. Closer examina- logical appearance and biological characteristics. tion through an enlarged opening showed a pus Sternberg, in speaking of the bacillus coli comcavity, and sticking up, firmly adherent to the munis, says: “Numerous varieties have been bottom, the end of a gangrenous appendix was cultivated by different bacteriologists, which vary found. The cavity was mopped free of pus and in pathogenic power, and to some extent in their packed with gauze. No effort was made to re- growth in various culture media; but the differmove the appendix.

ences described are not sufficiently characteristic BACTERIOLOGICAL EXAMINATION OF PUS. or constant to justify us in considering them as The Koch gelatin plate isolation cultures, after distinct species." being in the oven at a temperature of 90 degrees, Under certain circumstances some of the rods showed an abundant development of small white in pure cultures have been observed by Escherich colonies. Some of these were of a creamy white to present spherical, unstained portions at one with a tendency toward a brownish. They re- or both extremities, which closely resemble fracted the light sharply when held near the spores, but which he was not able to stain by the window. The colonies showed a variation in methods usually employed for staining spores,

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