why the early authors called this disease "spotted fever." Herpes is more often met with than in any other disease except pneumonia and was important in the diagnosis of the condition. Rash about the elbows and knees was not uncommon and looked like ordinary goose-flesh where the pimples had been rubbed off, and the condition. was due to the constant moving about in the bed

by the patient, causing a wearing away of the epidermis at these points. The leucocyte count was always high and usually ran about 20,000. Nothing was more striking than the variation in the fever curve. The afebrile cases might drop dead without warning, and death was due to the sudden closing of the foramen of Magendie. Complications had been rare in the cases seen at Mt. Sinai, and there had been not a single case of a complicating pneumonia. Lumbar puncture had always given good results. One should never hesitate to use chloroform in the performance of lumbar puncture if the patient was restless and hard to manage. A point to be insisted upon in these cases was forced feeding. It had been shown in cases of tetanus that the best results and

the lowest mortality had been obtained in those cases which had been heartily fed. He confessed that he was partial to baths at a temperature of 104, where the patient was not especially restless. The prognosis in this disease was indefinite. Cases that started hard might have a favorable termination and vice versa. Lysol injected might give good results, but the results could not be proved. One case which had come under the speaker's observation where the meningococcus was associated with the streptococcus, had gotten well with the lysol treatment. There was nothing to be sought for in the anti-toxin treatment.

Dr. Harlow Brooks, in the discussion, said that the symptoms were not due to a specific toxin, but were rather due to mechanical action of the organs on the parts affected. No toxins had been obtained from growths in the cerebro-spinal fluids of animals, therefore it was not reasonable to suppose that an anti-toxin could be obtained to antagonize the effects of a toxin which did not exist. The epidemics had varied from year to year. In 1896-1897, when the speaker first commenced to take an interest in these cases at Bellevue Hospital, the patients presented very commonly a spotted condition. This year he had seen spots in but one or two cases. Hence, he reasoned that the organism varied in its ability to produce symptoms. The organism is found in the nasal secretions of normal individuals, and we must necessarily have conditions other than the organs in itself to set up a meningitis. It was also true that it was difficult to produce the disease in animals. One should be very careful in making a definite diagnosis of cerebro-spinal meningitis due to the meningococcus, because only by the most excellent and careful laboratory methods was it possible to differentiate this organism from the micrococcus catarrhalis and the pneumococ

cus.

Another fact with regard to the organism was that it did not commonly set up metastatic abscesses in the other organs. The kidney alone was the organ of the general viscera involved in this disease. It is truly a disease of the central nervous system and as such it comes properly under the care of the neurologist.

banon Hospital, thirty-five cases and the mortality Dr. Leszynsky had, in his service at the Le

had been 45 per cent. In the first three cases he had used morphine to relieve the pain and hyperesthesia, but since then, in all of the other cases, he had used an aseptic solution of ergot, given subcutaneously every three or four hours. The ergot has proved so satisfactory that he had entirely dispensed with the use of morphine, chloral or bromide in these cases.

Dr. Alfred T. Livingston, of Jamestown, at the request of the president, discussed the paper and remarked that ergot contracted the abnormally dilated blood vessels and if supplied sufficiently early it would in this way control the body organism; but it should be given before the infiltration of the tissues with inflammatory products had taken place, otherwise this effect would not be produced.

Dr. Huber in closing the discussion said that many new points had been brought out by the gentlemen discussing his paper, which had been known by him, but the scope of the subject was so large, that he had felt it necessary to leave out some portion of the matter in order that the speakers following him might have a chance to say something.

IMMUNITY.

In a special article now running through several issues of The Journal A. M. A., the subject of immunity is treated in an elementary way. It makes interesting reading for the general practitioner, who is apt to be dazed by the terms used in scientific articles on this subject. Our knowledge of immunity comes into play in all branches of medical practice, and the physician who does not keep in touch with the advances on this subject is apt to feel left behind. The Journal explains the difference between natural and acquired, active and passive immunity. The powers of the sera of animals after being inoculated by various diseases have made wonderful changes in the practice of medicine. This branch of science is only in its infancy. Some physicians have expressed the hope that science would yet master all infectious diseases. Progress, however, is baffled in many respects, and the things that we do not yet know leave a wonderfully stimulating field of observation open for the student to enter.

BOOKS RECEIVED.

FIRST ANNUAL REPORT OF THE HENRY PHIPPS INSTITUTE, FOR THE STUDY, TREATMENT AND PREVENTION OF TUBERCULOSIS. A brief account of the work of the first year and a reprint of the lectures delivered under the auspices of the institute during the year. Published by the Henry Phipps Institute, 238 Pine street, Philadelphia, 1905.

TRANSACTIONS OF THE LUZERNE COUNTY, PA., MEDICAL SOCIETY FOR The Year EndING DECEMBER 31, 1904. Voi. XII. Organized March, 1881. Wilkes-Barre, Pa.; The E. B. Yordy Company, printing and blank bookmaking, 1904.

TRANSACTIONS OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA. Third series. Vol. XXVI. Philadelphia: Printed for the college, 1904.

THE OPHTHALMIC YEAR-BOOK. A Digest of the Literature of Ophthalmology, with Index of Publications for the Year 1903. By Edward Jackson, A.M., M.D., Emeritus Professor of Diseases of the Eye in the Philadelphia Polyclinic; President of the American Academy of Ophthalmology and Oto-Laryngology; Ophthalmologist to the Denver County Hospital, St. Anthony's Hospital and Mercy Hospital, Denver, etc. With forty-five illustrations. The Herrick Book and Stationery Company, Denver, Col., 1904.

THE INFLUENCE OF GROWTH ON CONGENITAL AND ACQUIRED DEFORMITIES. By Adoniram Brown Judson, A.M., M.D., Orthopedic Surgeon to the Outpatient Department, New York Hospital, 1878-1903; Statistical Secretary of the New York Academy of Medicine; formerly Chairman of the Orthopedic Section, New York Academy of Medicine; formerly President of the American Orthopaedic Association; Member of the American Medical Association; Fellow of the American Academy of Medicine; formerly Surgeon U. S. Navy. Profusely illustrated. New York: William Wood & Co.

A HAND-BOOK OF NURSING, REVISED EDITION FOR HOSPITAL AND GENERAL USE. Published under the direction of the Connecticut Training School for Nurses, connected with the General Hospital Society, New Haven, Conn. Philadelphia and London: J. B. Lippincott Company, 1905.

A REFERENCE HAND-BOOK FOR NURSES. By Amanda K. Beck, Graduate of the Illinois Training School for Nurses. Philadelphia and London: W. B. Saunders & Co., 1905.

Diseases of thE BLOOD. By Prof. Dr. P. Ehrlich, Director of the Royal Institute for Experimental Medicine, Frankfurt a./M.; Prof. K. von Noorden, Professor in the Medical Clinic of the Frankfurt City Hospital; Dr. A. Lazarus, Privat Docent in Internal Medicine, University of Berlin; Dr. F. Pinkus, formerly of the University of Berlin. Edited with additions by Alfred Stengel, M.D., Professor of Clinical Medicine in the University of Pennsylvania. Authorized translation from the German under the editorial supervision of Alfred Stengel, M.D., Professor of Clinical Medicine in the University of Pennsylvania. Philadelphia and London: W. B. Saunders & Co., 1905.

A TEXT-BOOK OF MEDICAL CHEMISTRY AND TOXICOLOGY. By James W. Holland, A.M., M.D., Professor of Medical Chemistry and Toxicology, and Dean, Jefferson Medical College, Philadelphia. Fully illustrated. Philadelphia and London: W. B. Saunders & Co., 1905.

NINETEENTH ANNUAL REPORT OF THE STATE BOArd of HEALTH AND VITAL STATISTICS OF THE COMMONWEALTH OF PENNSYLVANIA. Transmitted to the Governor, December 7, 1903. William Stanley Ray, State Printer of Pennsylvania, 1904.

NINETEENTH ANNUAL REPORT OF THE STATE BOArd of HEALTH AND VITAL STATISTICS OF THE COMMONWEALTH OF PENNSYLVANIA. Vol. II. Transmitted to the Gov

N. Y. STATE JOUR, OF MEDICINE.

ernor December 7, 1903. William Stanley Ray, State Printer of Pennsylvania, 1904.

THE AMERICAN YEAR-BOOK OF MEDICINE AND SURGERY. Being a Yearly Digest of Scientific Progress and Authoritative Opinion in All Branches of Medicine and Surgery Drawn from Journals, Monographs and TextBooks of the Leading American and Foreign Authors and Investigators. Collected and arranged with critical editorial comments by J. M. Baldy, M.D.; Samuel Horton Brown, M.D.; J. Chalmers DaCosta, M.D.; J. Leslie Davis, M.D.; W. A. Newman Dorland, M.D.; John H. Gibbon, M.D.; Virgil P. Gibney, M.D.; C. A. Hamann, M.D.; Barton Cooke Hirst, M.D.; D. Braden Kyle, M.D.; Walter L. Pyle, M.D.; J. Hilton Waterman, M.D. Under the general editorial charge of George M. Gould, M.D. Surgery. Philadelphia and London: W. B. Saunders & Co., 1905.

THE AMERICAN YEAR-BOOK OF MEDICINE AND SURGERY. Being a Yearly Digest of Scientific Progress and Authoritative Opinion in All Branches of Medicine and Surgery Drawn from Journals, Monographs and TextBooks of the Leading American and Foreign Authors and Investigators. Collected and arranged with critical editorial comments by Samuel W. Abbott, M.D.; Archibald Church, M.D.; Louis A. Duhring, M.D.; D. L. Edsall, M.D.; J. Claxton Gittings, M.D.; J. P. Crozer Griffith, M. D.; Reid Hunt, M.D.; Walter Jones, Ph.D.; A. O. J. Kelly, M.D.; John Marshall, M.D.; Nat. Sc.D.; J. H. W. Rhein, M.D.; Davis Riesman, M.D.; Alfred Stengel, M.D.; A. A. Stevens, M.D.; G. N. Stewart, M.D.; Reynold Webb Wilcox, M.D. Under the general editorial charge of George M. Gould, M.D. Medicine. Philadelphia and London: W. B. Saunders & Co., 1905.

A TEXT-BOOK OF THE PRACTICE OF MEDICINE, FOR STUDENTS AND PRACTITIONERS. By Hobart Amory Hare, M.D., B.Sc., Professor of Therapeutics 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 Therapeutics," and "A TextBook of Practical Diagnosis." Illustrated with 129 engravings and 10 plates in colors and monochrome. Philadelphia and New York: Lea Bros. & Co., 1905.

THE INTERNATIONAL MEDICAL ANNUAL. A Year-Book of Treatment and Practitioner's Index. 1905, twentythird year. A résumé of the year's medical literature, by thirty-six department editors, with added articles by noted specialists. New York: E. B. Treat & Co., Price, $3.

MONOGRAPH-MOSQUITOS, or Culicidal of New York State Bulletin. Published by the University of the State of New York. Issued by the New York State Museum. Ephraim Porter Felt, State Entomologist. Albany, New York State Education Department, 1904.

INTERNATIONAL CLINICS. A Quarterly of illustrated clinical lectures and especially prepared original articles on Treatment, Medicine, Surgery, Neurology, Pediatrics, Obstetrics, Gynecology, Orthopedics, Pathology, Dermatology, Ophthalmology, Otology, Rhinology, Laryngology, Hygiene and other topics of interest to students and practitioners, by leading members of the medical profession throughout the world. Edited by A. O. J. Kelly, A.M., M.D., Philadelphia, U. S.A., with the collaboration of William Osler, M.D., Baltimore; John H. Musser, M.D., Philadelphia; James Stewart, M.D., Montreal; J. B. Murphy, M.D., Chicago; A. McPhedran, M.D., Toronto; Thomas M. Rotch, M.D., Boston; John G. Clark, M.D., Philadelphia; James J. Walsh, M.D., New York; J. W. Balantyne, M.D., Edinburgh; John Harold, M.D., London; Edmund Landolt, M.D., Paris; Richard Kretz, M.D., Vienna, with regular correspondents in Montreal, London, Paris, Berlin, Vienna, Leipsic, Brussels and Carlsbad. Vol. I. Fifteenth series, 1905. Philadelphia and London: J. B. Lippincott Company, 1905.

ALBANY COUNTY MEDICAL ASSOCIATION.

President-William E. Lothridge, Verdoy.
Vice-President-Clement F. Theisen, Albany.
Secretary and Treasurer-Merlin J. Zeh, Watervliet.

COLUMBIA COUNTY MEDICAL ASSOCIATION.
President Otis Howard Bradley, Hudson.
Vice-President-Eloise Walker, Hudson.

Secretary and Treasurer-Hortense V. Bruce, Hudson.

ESSEX COUNTY MEDICAL ASSOCIATION.
President-Warren E. Pattison, Westport.
Vice-President J. P. J. Cummins, Ticonderoga.
Secretary-Treasurer-Albert A. Wheelock, Elizabethtown.

RENSSELAER COUNTY MEDICAL ASSOCIATION. President Charles S. Allen, Rensselaer.

Vice-President-Matthew B. Hutton, Valley Falls.
Secretary and Treasurer-Frederick A. Smith, Troy.

Committee on Legislation-E. D. Ferguson, Chairman; William
Finder, Jr., William L. Allen.

Committee on Public Health-J. B. Harvie, Chairman; D. W. Houston, W. L. Hogeboom.

Committee on Ethics and Discipline—J. P. Marsh, Chairman; H. C. Gordinier.

SARATOGA COUNTY MEDICAL ASSOCIATION.

President-F. F. Gow, Schuylerville.

Vice-President-J. R. McElroy, Jonesville.

Secretary-James T. Sweetman, Jr., Ballston Spa.

Treasurer-Dudley R. Kathan, Corinth.

Executive Committee-Frank Garbutt, Francis W. St. John, F. J. Sherman.

Committee on Membership, Ethics and Discipline-F. J. Sherman, Adelbert Hewitt, Edgar Zeh.

WARREN COUNTY MEDICAL ASSOCIATION.
President-William J. Hunt, Glens Falls.
Vice-President-W. R. Keyes, Glens Falls.

Secretary and Treasurer-Frederick G. Fielding, Glens Falls.

BROOME COUNTY MEDICAL ASSOCIATION.
President-LeRoy D. Farnham, Binghamton.
Vice-President-John H. Martin, Binghamton.
Secretary-Clark W. Greene, Binghamton.
Treasurer-William H. Knapp, Binghamton.

Committee on Legislation-John M. Farrington, John H. Martin,
Benjamin W. Stearns.

Committee on Public Health-John H. Martin, William Henry Knapp, Lester H. Quackenbush.

Committee on Medical Charities-John G. Orton, Clark W. Greene, Frank P. Hough.

Committee on Ethics and Discipline—John G. Orton, F. Allen, John M. Farrington.

CORTLAND COUNTY MEDICAL ASSOCIATION.

President-Charles Depew Ver Nooy, Cortland.
Vice-President-Frank S. Jennings, Cortland.

Secretary-H. S. Braman, Homer.

Treasurer-Emory A. Didama, Cortland.

ONONDAGA COUNTY Medical asSOCIATION.

President George A. Edwards, Syracuse.

Vice-President-Charles B. Gay, Syracuse.

Secretary Thomas B. Dwyer, Syracuse.

Treasurer-Alexander J. Campbell, Syracuse.

Committee on Legislation-A. S. Edwards, A., D. Head, J. B. Allen.

Committee on Public Health-A. J. Campbell, J. B. Dwyer, F. A. Donohue.

Committee on Membership, Ethics and Discipline-F. J. Kauf-
mann, H. F. G. Clark, S. S. Bibbens.
Committee on Credentials-F. J. Kaufmann, H. FitzG. Clark,
F. O. Donohue.

OTSEGO COUNTY MEDICAL ASSOCIATION.

President-Julian C. Smith, Oneonta,

Vice-President-Sylvester G. Pomeroy, West Oneonta.
Secretary-Arthur H. Brownell, Oneonta,

Treasurer-Frank L. Winsor, Laurens.

Committee on Legislation-Andrew J. Butler, Marshall Latcher, Joshua J. Sweet.

Committee on Public Health-Arthur H. Brownell, Milton C. Wright, George E. Schoolcraft.

Committee on Ethics and Discipline-Frank L. Winsor, Marshall Latcher, Arthur W. Cutler.

SENECA COUNTY MEDICAL ASSOCIATION.

President-George A. Bellows, Waterloo.

Secretary-J. Spencer Purdy, Seneca Falls.
Treasurer-Carroll B. Bacon, Waterloo.

TOMPKINS COUNTY MEDICAL ASSOCIATION. President-Chauncey P. Biggs, Ithaca. Vice-President-Edward Meany, Ithaca. Secretary and Treasurer-Royden M. Vose, Ithaca.

ALLEGANY COUNTY MEDICAL ASSOCIATION. President George H. Witter, Wellsville. Vice-President-William Orson Congdon, Cuba. Secretary and Treasurer-Horace L. Hulett, Allentown.

CATTARAUGUS COUNTY MEDICAL ASSOCIATION. President-William H. Vincent, Hinsdale

First Vice-President-Myron C. Hawley, East Randolph. Second Vice-President-Charles P. Knowles, Olean. Secretary and Treasurer-Carl S. Tompkins, Randolph.

CHAUTAUQUA COUNTY MEDICAL ASSOCIATION.
President-Vacil D. Bozovsky, Dunkirk.

First Vice-President-Benjamin S. Swetland, Brocton.
Second Vice-President-Morris Norton Bemus, Jamestown.
Secretary and Treasurer-Henry A. Eastman. Jamestown.
Committee on Legislation-E. M. Scofield, Edgar Rood, J. A.
Weidman.

Committee on Public Health and Medical Charities-L. Hazeltine.
J. L. Greeley, A. F. Soch.

Committee on Ethics and Discipline-H. W. Davis, J. W. Nelson, J. L. Hutchinson,

ERIE COUNTY MEDICAL ASSOCIATION.

President Carlton C. Frederick, Buffalo.
Vice-President-Arthur G. Bennett, Buffalo.
Secretary-David E. Wheeler, Buffalo.
Treasurer-Adolph H. Urban, Buffalo.

Executive Committee-Joseph W. Grosvenor, Marcel Hartwig,
Vertner Kenerson.

Committee on Legislation-Alvin A. Hubbell, Charles Sumner Jones, Thomas H. McKee.

Committee on Public Health-Park Lewis, William H. Thornton, Jacob Otto.

Committee on Membership, Ethics and Discipline-Allen A. Jones, Charles G. Stockton, Grover Wende.

GENESEE COUNTY MEDICAL ASSOCIATION.

President-Albert P. Jackson, Oakfield.

Vice-President-William A. Macpherson, Le Roy.
Secretary and Treasurer-C. Louise Westlake, Le Roy.

Committee on Legislation-A. F. Miller, B. F. Showerman, W. D.
Johnson.

Committee on Ethics and Discipline-G. A. Neal, W. A. Macpherson.

Committee on Public Health C. D. Graney, F. L. Stone.

MONROE COUNTY MEDICAL ASSOCIATION.
President-Edward Mott Moore, Rochester.
Vice-President S. Case Jones, Rochester.

Secretary and Treasurer-James Clement Davis, Rochester.
Committee on Legislation-Bleecker L. Hovey, Richard M.
Moore, George W. Goler.

Committee on Public Health-E. Mott Moore, Daniel F. Curtis, S. Case Jones.

Committee on Ethics and Discipline—S. Case Jones, Peter Stockschlaeder, James C. Davis.

NIAGARA COUNTY MEDICAL ASSOCIATION.

President-Frank Guillemont, Niagara Falls.
Vice-President-Allan N. Moore, Lockport.
Secretary-Will H. Potter, Niagara Falls.
Treasurer-Charles L. Preisch, Lockport.

Executive Committee F. J. Baker, A. N. Moore, A. L. Chapin.
Committee on Legislation-C. E. Campbell, A. N. Moore, W. Q.
Huggins.

Committee on Membership, Ethics and Discipline-E. O. Bing-
ham, H. H. Mayne, N. W. Price.
Committee on Public Health-E. Shoemaker, R. H. Wixson,
F. A. Crosby, J. E. Helwig.

ORLEANS COUNTY MEDICAL ASSOCIATION.
President-Edward Munson, Medina.

First Vice-President-John H. Taylor, Holley.
Second Vice-President-Charles E. Fairman, Lyndonville.
Secretary and Treasurer-Howard A. Maynard, Medina.

STEUBEN COUNTY MEDICAL ASSOCIATION.
President-Charles O. Green, Hornellsville.
Vice-President-Frank H. Koyle, Hornellsville.

Secretary and Treasurer-Charles R. Phillips, Hornellsville.
Committee on Legislation-Charles M. Brasted.

Committee on Public Health-John D. Mitchell, Harvey P. Jack Committee on Ethics and Discipline-John G. Kelly, Clair S. Parkhill.

WAYNE COUNTY ASSOCIATION.

President-James W. Putnam, Lyons.
Secretary-George S. Allen, Clyde.

Treasurer-Darwin Colvin, Clyde.

Executive Committee-J. M. Turner, J. F. Myers.

Committee on Legislation-Darwin Colvin, J. F. Myers, J. M. Turner.

Committee on Membership, Ethics and Discipline-G. D. Barrett, M. A. Brownell, A. F. Sheldon.

Committee on Public Health-A. Warnecke, T. H. Hallett.

WYOMING COUNTY MEDICAL ASSOCIATION. President-Zera J. Lusk, Warsaw.

Vice-President-George S. Skiff, Gainesville.

Secretary and Treasurer-L. Hayden Humphrey, Silver Springs. Committee on Membership, Ethics and Discipline-M. Jean Wilson, Lester H. Humphrey, Philip S. Goodwin.

Committee on Public Health L. E. Stage, George H. Peddle,
Mary Slade.
Committee on Legislation-Zera J. Lusk, Zina G. Truesdell,
George M. Palmer.

DUTCHESS COUNTY MEDICAL ASSOCIATION.

President-Irving D. LeRoy, Pleasant Valley.
Vice-President-Guy Carleton Bayley, Poughkeepsie.
Secretary-John W. Atwood, Fishkill-on-Hudson.
Treasurer-Louis Curtis Wood, Poughkeepsie.

KINGS COUNTY MEDICAL ASSOCIATION.
Borough of Brooklyn.

Meets second Tuesday in January, April and October.
President-Arthur Conklin Brush, 29 South Portland Avenue,
Brooklyn.

Vice-President-James Cole Hancock, 43 Cambridge Place, Brook

lyn.

Secretary and Treasurer-Louis Curtis Ager, Third Avenue and Silliman Place, Brooklyn.

Executive Committee-H. M. Smith (1 year), J. C. Bierwirth (3 years), W. H. Steers (4 years).

THE NEW YORK COUNTY MEDICAL ASSOCIATION. Boroughs of Manhattan and Bronx.

Meets at the Academy of Medicine, 17 West 43d Street, at 8 P. M., on third Monday of each month except July, August and September.

President-Francis Joseph Quinlan, 33 West 38th Street.
First Vice-President-Henry A. Dodin, 1194 Washington Avenue.
Second Vice-President-S. Busby Allen, 53 East 86th Street.
Secretary-William Ridgely Stone, 66 West 49th Street.
Corresponding Secretary-John Joseph Nutt, 2020 Broadway.
Treasurer-Charles Ellery Denison, 68 West 71st Street.
Executive Committee-Parker Syms (1 year), Frederick P. Ham-
mond (2 years), Alexander Lambert (3 years).
Committee on Public Health Charles H. Chetwood, Chairman;
Hermann M. Biggs, Ludwig Weiss, Charles Gilmore Kerley,
George Birmingham McAuliffe.

Committee on Ethics and Discipline-D. Bryson Delavan, Chairman; George David Stewart, Daniel S. Dougherty, Joseph Ellis Messenger, Edward L. Keyes, Jr.

Committee on Legislation-W. Travis Gibb, Chairman; E. Eliot Harris, Harry R. Purdy, James J. Walsh, Constantine J. MacGuire.

ORANGE COUNTY MEDICAL ASSOCIATION. President-Edward Dubois Woodhull, Monroe. First Vice-President-Frank W. Dennis, Unionville. Second Vice-President-John T. Howell, Newburgh. Secretary and Treasurer-Lawrence George Distler, Westtown. Committee on_Legislation-W. S. Gleason, Chairman; M. C. Conner, F. D. Myers.

Committee on Public Health-W. J. Carr, Chairman; A. W. Preston, D. H. Sprague.

Committee on Medical Charities-C. W. Dennis, Chairman; W. I. Purdy, E. A. Nugent.

Committee on By-Laws-W. E. Douglas, Chairman; C. E. Townsend, F. W. Dennis.

ROCKLAND COUNTY MEDICAL ASSOCIATION.
President-George A. Leitner, Piermont.
Vice-President-Edward H. Maynard, Nyack.

Secretary and Treasurer-J. Howard Crosby, Haverstraw.
Committee on Legislation-Robert R. Felter and Samuel S. Carter.
Committee on Public Health-S. W. S. Toms and Norman B.
Bayley.

Committee on Membership-Gerrit F. Blauvelt and William R. Sitler.

SULLIVAN COUNTY MEDICAL ASSOCIATION.
President-H. P. Deady, Liberty.

First Vice-President-Stephen W. Wells, Liberty.
Second Vice-President-George C. Gould, Bethel.
Secretary-Frank W. Laidlaw, Hurleyville.
Treasurer-C. S. Payne, Liberty.

Committee on Legislation-Richard A. DeKay, A. B. Sullivan,
L. C. Payne.

Committee on Public Health and Medical Charities-J. L C Whitcomb, H. P. Deady.

Committee on Ethics and Discipline-O. N. Meyer, George N.
Bull.

ULSTER COUNTY MEDICAL ASSOCIATION.
President-James L. Preston, Kingston.
Vice-President-Frederick Huhne, Kingston.
Secretary-Mary Gage-Day, Kingston.
Treasurer-Alice Divine, Ellenville.

Committee on Legislation-A. H. Palmer, Benjamin F. Neal,
Cornelius V. Hasbrouck.

Committee on Legislation-E. H. Heston, J. Preston, E. Osterhout.

Committee on Public Health-A. H. Reed, E. J. Gallagher, C. V. Hasbrouck.

Committee on Ethics and Discipline-A. H. Palmer, A. Stilwell, D. Mosher.

WESTCHESTER COUNTY MEDICAL ASSOCIATION. President Thomas J. Acker, Croton-on-Hudson. Vice-President-Benjamin J. Sands, Portchester. Secretary and Treasurer-Donald T. McPhail, Purdy Station. Executive Committee-Thomas J. Acker, Chairman ex-officio; Georgiana Sands, Portchester; William J. Meyer, White Plains. Committee on Legislation-H. Ernst Schmid, Chairman; William L. Wells, Edward F. Brush. Committee on Public Health and Medical Charities-William D. Granger, Chairman; H. Eugene Smith, William J. Meyer. Committee on Ethics and Discipline-N. J. Sands, Chairman; Peter A. Callan, Henry T. Kelly.

EDITORIAL COMMUNICATIONS.

Articles for publication under Editorial Communications must be accompanied by the name of the author. No name will be used in the publication unless requested by the writer. All such articles can be sent to Dr. C. E. Denison, 68 West 71st street, New York City.

THE SURGICAL TREATMENT OF TUBERCU

LOUS PERITONITIS.

$1.00 PER ANNUM

It

omy are frequently due to non-removal of the focus of infection, which then acts as a source of reinfection. This is convincingly pointed out in a masterly address on the subject by William J. Mayo (Journal of American Medical Association, April 15, 1905), whose wide experience enables him to speak with authority. In St. Mary's Hospital, Rochester, Minn., in a period of ten years, there have been 6,408 abdominal operations performed. Of this number 184 were for some variety of abdominal tuberculosis, and of these 89 were cases of tuberculous peritonitis, with 3 deaths. Many of these patients returned several times with a relapse of the peritoneal condition or some other form of tuberculosis. became evident that tuberculous peritonitis in the large majority of women was secondary to lupus of the mucous membrane of the fallopian tube, and if the latter was not removed it would surely act as a source of reinfection. By patience and care they were able to enucleate tuberculous tubes in 26 cases of tuberculous peritonitis, with 25 recoveries. Whereas 7 of these patients had been operated on by simple laparotomy one to four times previously, not one of them had to be operated on after removal of the tubes. The good results obtained in these cases are very striking, and fully sustain the conclusion that the treatment of tuberculous peritonitis should embrace not only the treatment of the peritonitis, which is symptomatic, but the removal of the source of infection as well, which, in the majority of cases, will be found in the uterine adnexa, appendix, intestines or mesenteric glands.

Laparotomy for the cure of tuberculous peritonitis was first advocated by König in 1884. Inspired by his experience, surgeons performed laparotomy with increasing frequency, and in 1889 König reported the results of a study of 131 operated cases. From the time of his publications laparotomy was accepted as a curative agent by most surgeons and clinicians. Later a reaction set in, and it was claimed by some observers that many patients with tuberculous peritonitis would recover spontaneously and some claimed that more patients would get well under medical treatment than after operation. Careful study of recent literature warrants the conclusion that most observers still believe that laparotomy has a legitimate place in the treatment of tuberculous peritonitis if the disease is not too far advanced. Nor is it established that laparotomy per se is dangerous unless it is done too late. Most clinicians agree that to wait for spontaneous recovery, which is very uncertain, is to expose the patient to dissemination of the tuberculosis and thus allow the favorable moment for operation to pass. Recent statistics show that the ultimate results after surgical treatment are better than after so-called conservative treatment. Tuberculous peritonitis is a symptomatic condition, due to a primary focus of infection in the uterine appendages, appendix, intestines or mesenteric glands. This focus of infection should be removed whenever it can be done without unduly breaking up adhesions or if section can be made in healthy tissues. Relapses following laparot

SPECIAL TRAIN TO A. M. A. MEETING.

The trip on the American Medical Association Special is attracting a great deal of attention, and invitations have been received from various local societies throughout the country providing for the entertainment of the members of the party.