teresting point was the beginning and the character of the onset. Thereare no symptoms except the fever; the tongue was slightly coated.

DR. ROBINS: I would like to state, if in order, that when the doctorsof the city have cases of consumption they should report same to the Health Department. It is required by the ordinance law that they be reported. These records will be of great value to us, and if some member of the society ever wanted to write an essay on the consumptives of the city and the conditions surrounding them and houses where consumptives have lived, such information would be accessible.

I wish to say that the laboratory of the Health Department is prepared to help the doctors of the city in a great many cases. Where they have patients with sore throat, and are suspicious of diphtheria, time can be saved, and the diagnosis quickly cleared up. We are prepared to make the Widal reaction as well.

DR. KINCHELOE: I have a case that I would like to report. I think it is a case of encephalitis; patient, a man, aged fifty. On the 13th of January, early in the morning, I was called to see him. During the night previous he had had what he called an attack of blindness. He awoke and sat up and said he fell over. When I saw him he gave this history. Six weeks ago a tree had fallen and a limb had struch him on top of the head and he sustained a scalp wound about two inches in length. A doctor attended him and made an examination and told him that he did not think the skull was injured. The scalp wound healed readily and he went along at his work. He was a mechanic. He had been going around for over six weeks after that and this attack came on suddenly in the night. I saw him the next morning, his pulse was 46, and his temperature subnormal; rational, and suffering some little pain. I saw the case and I did not know exactly what to do. I put him on the bromides and the iodide of potassium and on strychnine. At that time the pupils were not dilated, but a week later the pupils became dilated. After getting him under the iodides well the pupils came back to normal, pulse 70 to 80, and the temperature practically normal. Even if he would turn over in bed or rise up he would have what he called blind spells; he was not delirious until a week after I saw him and staid that way for a few days, but at the end of three weeks he was getting along pretty well; he sat up in bed and could hold a knife and fork in his hands. A week ago he sent for me; he had gotten so that he had dropped the knife and fork. The man became delirious and has remained that way. We did not know what to do. His family would not allow him to be operated on. He has been in this condition for a week- He seems to be giving symptoms of softening of the brain. I would like to know if you gentlemen think it is necessary to trephine him at the site of the injury. There is no depression of the skull. I would like to know what the Society thinks is the proper thing to do.

DR. SPEARS: Is he a drinking man?

DR. KINCHELOE: No, he gets drunk occasionally on court days, but he is not what you would call a drinking man.

DR. RICHARDSON: It is a very interesting case. I would think that the proper treatment is to trephine in the region of the original injury-in the region of the superior longitudinal sinus, not right over it but to one side. In patients in which we have an encephalitis the pulse usually runs higher and the temperature higher than in the case you report. The time elapsing after the receipt of the injury before the symptoms developed would certainly point to encephalitis. It does come on later.

DR. SPEARS: I think the doctor would be justified in having trephining done. While the symptoms are not marked enough to point to any particular locality, still he has the history of severe blow, and is becoming progressively worse, and I believe the man should be trephined at point of injury and given benefit of the chance. The operation itself is not particularly dangerous, and while a fracture or even a clot may not be found, the relief of pressure which exists somewhere may bring about a fortunate recovery.

[From our Dublin Correspondent.]

THE LATE PROF. BIRMINGHAM, M. D.

The Dean of the Medical Faculty, Sir Christopher Nixon, addressing the professors and students of the Catholic University, Dublin, Ireland, spoke as follows:

Gentlemen:-Since I became connected with the School of Medicine, more than a quarter of a century ago, I have had to make on several occasions obituary references to colleagues with whom I was associated; but I can truly say that I have never had to undertake so sad or so painful a duty as that which falls to my lot to-day in referring to the death of my former pupil, colleague, and devoted friend, Professor Birmingham. In the full vigor of a brilliant and well-trained mind, after passing the period of storm and stress through which all scientific workers must pass, when all that brings fame and fortune is almost within one's grasp, "death breaks the vital chain" and robs both him and us of the fruits for which the seed had been so industriously sown. The whole thing is unutterably sad, too sad indeed for empty expressions of regret. Just eighteen years ago Prof. Birmingham succeeded me as Professor of Anatomy, and from that time up to the present he held a dual position in the school. He was respousible for the working of the anatomical department; and, as Registrar, upon him devolved the organization of the school as a whole, the several details of its financial arrangements, and, in many respects, the work for which, as Dean, I am nominally responsible. In every phase of his work he was brilliantly successful; and yet amidst all his labors he found time to make for himself a name distin

guished among the ablest men of his own special science as a man of original powers of observation and research.

If I might briefly analyze Birmingham's splendid abilities, I would do so under three heads-as a teacher, as an original observer, and in reference to those qualities which made him personally so attractive to all who knew him. As a teacher, he was the nearest approach to the ideal that I ever had experience of. With the most thorough grasp of his subject, he possessed the rare gift of making it transparently clear, and by a bright and vivid description invested it with such interest as to excite the rapt attention of his pupils. Whatever the subject matter might be, it was presented in a way so striking and complete, so full of illustration and so precise in form, that even to the first year's student the description of a bone was as interesting as the practical points in surface anatomy were to the most advanced student.

Altogether apart from his work as a teacher, work which, taking into consideration its constancy and laborious nature, must have kept his hands full, he found time to carry on the work of research with such brilliancy as to make us realize what he might have done if his had been the usual span of human life. His three papers on the mastoid region, published in 1893 (so important in their surgical aspect as to form the basis of operative procedure in this region), made the name of the young anatomist so well known that a leading aural specialist came to Dublin to confer with him and examine his preparations. His work on the position of the stomach, the anatomy of the peritoneum, and of the abdominal viscera generally is, in some respects, of an epoch-making character, while it exhibits a capacity for investigation which raised the author to a high level as an accurate, painstaking, and original observer. Prof. Cunningham brought out his great work on anatomy, a work representing the collaboration of the leading anatomists of the whole English Empire, with a generous appreciation of a rival professor's services he entrusted the portion of the work dealing with the anatomy of the abdomen to Birmingham, with the result that the concensus of expert opinion gave the palm of merit to Cunningham and Birmingham for their respective articles.

The last aspect under which I may refer to Birmingham was his wonderful capacity of organization, and his striking personality. From the time he took up the Registrarship of the school, in 1887, the institution entered upon its course of progress in every respect and in every detail. Its finances were managed with the ability of a chartered accountant; each professor realized how essential it was to support in every way the man who was devoting his life to the vindication of a principle, and in antagonism to a bitter and relentless denial of educational rights and privileges; whilst the students felt that they were under the influence of one who exacted their respect and gained their affections. Not that Birmingham employed the customary aids to gain popularity or notoriety;

he was a perfectly straight man, with the highest ideals of what was due from man to man, and it was this that largely explained the singular influence which he exercised upon students. He was their truest friend, never more so than when he reproved their faults, set his face against idleness or bad habits, and enforced that degree of discipline and decorum, which, I am glad to acknowledge, is the characteristic of the modern type of the student of medicine. But if he was a disciplinarian,

how just and gentle was his rule, how partial and tolerant his methods, how earnest and thorough was his desire for your welfare, how unassuming and unvarying his relations with you all. You might say of him:

"Rich in saving common sense

And, the greatest only are,

In his simplicity sublime."

We have now the largest and most prosperous medical school in Ireland, and it is largely owing to the untiring labor and wonderful talents of Prof. Birmingham, my pupil, my colleague, and my friend.

Recent Progress in Medical Science.

PEDIATRICS AND THERAPEUTICS.

IN CHARGE OF

GEO. B. JENKINS, M. D.

Propessor of Neurology and Physiology of the Nervous System.

PEDIATRICS.

Modern Pediatrics.-Escherich reviews the various steps taken by pediatrics in its development into a science, and which have considerably extended and clarified the study of pediatrics. Modern pediatrics exhibits a scientific structure including all disturbances of the life processes, arranged according to scientific principles, and in its completeness not reached by any other specialty in medicine. Only a small number of diseases can be considered peculiar to childhood, because they are caused by events which cannot occur in the life of adults, such as the change from intrauterine to extrauterine life, and growth and development. The key to the understanding of the special pathology of the infantile organism is to be found in the study of developmental processes. Between the growing organism of the child and that of the completely-developed adult great differences exist in the reaction called forth by the diseased process, the variations which change constantly in the course of childhood. The author also considers the threefold division of childhood accepted by Vierordt, which he accepts as the most scientific as well as practical.-Am. Med.

Relation of Epilepsy to Convulsions in Children. - Moon urges that a serious view be taken of all convulsions occurring in infancy, and says that we are justified in supposing that even a single convulsion in childhood will end with itself and have no further evil influence on the life of the child. For most of the cases which arise in connection with an extrinsic cause also have a history of heredity or alcoholism in the parents, which are both predisposing causes of epilepsy. Even where there is no such history, and it is assumed that a peripheral irritation is adequate in itself to produce a convulsion in a perfectly normal brain, the mere fact of the convulsions being often repeated makes the brain cease to be normal and creates a distinct pathologic basis for the production of epilepsy. It is impossible to give the precise relation of such convulsions to epilepsy, but Moon believes that a much greater difference is made between these two affections than the facts seem to warrant. -Lancet, Lond.

Scarlet Fever.-Seibert, N. Y. Med. Jour., treats extensively of this condition. Among his conclusions are: (1) It is endemic in New York City; (2) most common among school-children; (3) chief centers for contagion are the schools; (4) direct contact is necessary for infection.

Under the head of treatment he uses a 5 or 10 per cent. ichthyol-lanolin ointment applied to the entire cutaneous expanse two to four times daily and rubbed in well; and disinfects the pharynx with a 50 per cent. resorcin alcohol solution; as soon as the throat symptoms appear the patient is placed in the intubation position, a plug of absorbent cotton saturated with above solution is quickly passed into the naso-pharynx on one side of the uvula, held there a few seconds, and same upon opposite side, when surface of mucous membrane turns milky-white. Repeat until this result is obtained; these applications are to be made two or more times daily, according to the severity of the case, until the throat is free from exudate. Favorable amelioration of symptoms is noted in a few hours.

Fischer (J. A. M. A.) sums up the prophylatic measures in infantile tuberculosis as follows: (1) Insist on each infant being breast-fed; (2) if maternal nursing is impossible, secure wet-nurse; partially bottlefeeding both infants if necessary. The secret of the vitality and endurance of the tenement - house hordes is that they are, or have been, breast-fed. The two prophylactic measures are (1) breast-milk, (2) fresh air and sunshine.

Pneumonia in Infants. Northrupp, Med. Record, N. Y., summarizes the treatment as follows: (1) Castor oil to clear the field; (2) fresh air, cool and flowing; it reddens the blood, stimulates the heart, improves digestion, quiets restlessness, and combats toxæmia; (3) keep baby's feet warm and its head cool; (4) plenty of water inside and out; (5) quiet and rest; (6) correct feeding to prevent fermentation and gas formation; (7) antipyretics, water only; (8) heart stimulants, fresh air,