Quinine.-To promote uterine contraction, has been used 6 times. Forceps.-High operation, II times. Traction-hooks used in a few cases. Low operation, 62 times. Not stated, 15 times. Total, 88. Hemorrhage.-Post-partum, 1; due to premature separation of placenta, 1. The latter case may be of interest. I quote I quote from my notes: "Mrs. W. H. W., age 20, first pregnancy. During the first stage frequent vomiting and very nervous, controlled by potassium and chloral. Child was nearly asphyxiated, and revived after an hour's work. The evening before confinement the patient jumped over a low fence and felt something snap,' as she expressed it. She was faint and very She was faint and very restless. Shortly afterward I was called -when the cervix was about one-half dilated-a profuse hemorrhage occurred. The membranes were immediately ruptured, strong compression made over the uterus, and ergot given. The head firmly engaged, hemorrhage ceased, and delivery soon completed. The child, as before stated, was nearly asphyxiated." Umbilical Cord.-True knot, I case. Shortest cord, 8 inches; longest cord, 42 inches. These were measured on account of their respective lengths, and not as a matter of routine. Amniotic Sac.-A number of cases of premature rupture are noted, and these did not have any particular effect in producing what is termed "dry labor." I believe that, with few exceptions, the sac should not be ruptured by the finger-nail or instrument. Inversion of the Uterus.—I case. Turning.-Bipolar and podalic version performed in 4 cases, 2 bipolar and 2 podalic. Placenta Previa.-5 cases; one a central implantation and fatal to the child. Adherent Placenta. -I case; a true and not an imaginary one. ABNORMAL CONDITIONS OF CHILDREN. Ophthalmia Neonatorum.-1 case. Gastro-intestinal Hemorrhage.-1 case; recovery. Umbilical Hemorrhage.-2 cases; I death. Icterus Neonatorum.—I case; fatal. Syphilitic Cases.-Not noted.. Non-closure of Foramen Ovale.-1 case; died in a few hours. Supernumerary Little Finger.-1 case. Hydrocephalus with Spina Bifida.—ı case; fatal. Spina Bifida.-1 case; fatal in six weeks. Bisexual Organs.-1 case; Died of malnutrition in two weeks. Stillborn Children.-28 cases. Maternal Mortality.-1 case. Antiseptics in Midwifery.—It has been my endeavor to keep in touch with everything in this line. My purpose in presenting this subject is to advocate the keeping of records of important cases, and especially those in which each physician may be particularly interested. It is a very simple matter, taking but a few moments' time if one has printed blanks suitable for the kind of cases to be recorded. At the close of each year a summary is made, and one can tell exactly the number of times chloroform, ergot, or any other remedy has been used, and in fact everything relating to obstetric practice. While these records are not as complete as one might wish, they certainly have been of use to me. At some time in the near future I shall point out some of the more important objects of record-keeping. In regard to the infant mortality the following might be of interest: Ergot used in five (5) cases of still-birth, and I cannot see that this drug had any untoward effect. Still-births occurred as follows: Hydrocephalus, 1; breech, 2; short cord, i; transverse presentation, I; placenta previa (complete), 1; eclampsia, I; no apparent reason (?) (my earlier cases) II cases; large children or large shoulders, 5 cases. A number of these cases occurred where the physical condition of the mothers would hardly warrant giving birth to a live child, they were so run down in health. I have learned that it takes 100 ones to make a hundred, and the physician, with a few exceptions, who thinks he has a hundred or more cases in a year only thinks so. 709 Grand River Ave. Physiological, Pathological, and Clinical Data in the Treatment of Bron chitis and Tuber Y By L. H. WARNER, A. M.. Ph. M. D. [At a reception of eminent medical men in the parlors of Astor Court New York City, on March 7, 1902, the subject of Tuberculosis was under general con sideration, with papers on its special divisions, as follows: Dr. Herman J. Boldt on Tuberculosis of the Pelvic Organs. Dr. Ramon Guiteras on Tuberculosis of the Genito-Urinary Tract. products, as well as the combination of all three, an aromatic pleasant solution, which he has named Triacol. For my experimentations upon the lower animals I selected guinea pigs, rabbits, and dogs, and the results from these tests permitted me to suggest the use of these new remedies, singly, and also combined, as Triacol, in various clinics and private practice. If we review the large amount of literature at our disposal on the physical and pathological conditions which we observe in all bron chial and phthisical patients, we find that almost without exception antiseptic and tonic treatments are recommended, and as a rule creasote, guaiacol, and ferru Dr. A. M. Phelps on Tuberculosis of ginous tonics have been resorted to, not the Knee-joint. Discussion was participated in by Dr. S. A. Knopf, of New York; Dr. W. B. Graves, of East Orange, N. J.; and Dr. T. L. Fogarty, of Brooklyn. The following is Dr. Warner's paper:] Being a constant reader and student of all scientific problems and results elaborated in the European scientific laboratories, I became interested in the reports of Seiffert regarding the new combinations of potassium and sodium salts with guaiacol, and directed my efforts to corroborate, if possible, their findings by first experimenting upon the lower animals, and upon sufficient evidence of their therapeutic value to test same in the clinics. The time has passed when we had to rely upon foreign scientists and chemists to supply us with new chemical products, and learning that Dr. W. C. Alpers, of 45 W. 31st street, this city, had succeeded in forming combinations of guaiacol with sodium, potassium, and morphine, naming the products Sodacol, Potassacol, and Morphacol, I addressed him to supply me with a sufficient quantity of each of the new chemicals to test their therapeutic value. My request was most readily granted, and Dr. Alpers did not hestitate to give me the full chemical symbols of his newly-discovered omitting various preparations of cod liver oil. Most antiseptics, however, possess irritating properties and if given singly, especially in tuberculosis, are likely to further irritate the already inflamed mucous membrane which we find in all tubercular conditions. Again, many antiseptics are never resorbed by the lymphatics, hence cannot be taken up into the blood circulation. To assure such a fact, antiseptics must be combined with the elements which form part of the chemical consistency of the blood as a whole. The principal chemical constituents of the blood are sodium, potassium and phosphorus, hence the rational thought of combining guaiacol with the above ele ments. Physiological tests have proven that guaiacol and creasote administered alone, disturb the digestive organs, and the same may be said of quinine and phosphorus, the latter in the form of phosphate salts or phosphoric acid. The administration of guaiacol and creasote is followed by a decrease of both hemoglobin and red cells of the blood, while we note an increase in both after the administration of guaiacol sodium (sodacol) or guaiacol potassium (potassacol). Tubercular patients who had shown no marked improvements in their condition, while taking various ferruginous tonics and expectorants, improved rapidly after Triacol, this new combination of three head, limbs, etc., loss of appetite, severe cough, and is unable to get any sleep at night. Within last six months has lost 23 pounds in weight. Pulse, 122 per minute; temperature, 103°. Harsh breathing râles over entire left lung. Is placed on triacol two drachms t.i. d. and has good rest at night. Expectoration easy. Within 10 days after triacol medication, appears brighter, appetite returns, temperature reduced, cough less severe, and slight gain in weight. Jan. 20. Hemoglobin, 37%. Weight, 109 lbs. Weight, 119 lbs. ' bacteriæ shows Blood. Examination.... March 3d Haemoglobin:. Red Ceus: White 70.90 3.500.000 .-9900.. prompt relief of the patient to such an extent that he is able to follow his daily vocation. Duration of treatment 42 days. Patient is advised to continue on two-drachm doses of triacol t.i.d. Case 13,570 (N. Y. Charity Hospital). Previous history reveals the fact that patient has had former attacks of la grippe and pneumonia. Ever since these attacks has been troubled with more or less cough, accompanied by expectoration of thin, frothy phlegm, which now appears greenish-yellow and clotted. Examination of same reveals bacillus tuberculosis. He complains of headache, pain sputum examinations, etc., speak of tient on April 15th, when he stated he progress made in this case. had gained in appetite and weight, no cough, felt well generally. The superior physiological action of Triacol, as compared with other means of medication, was observed in numerous other cases. Nearly always the administration of cod liver oil, alone and with creasote, mist. guaiacol and creasote was followed by excessive phosphate elimination and no improved condition of the blood of the patient could be noted. However, the phosphaturia greatly declined, and condition of the blood greatly improved after the administration of Triacol in two teaspoonful doses every four hours. This dose may be reduced as soon as the cough lessens, the expectoration becomes clearer, hectic fever ceases, and the general clinical picture of the patient warrants the reduction in the amount of medication. Plenty of fresh air, plenty of good and assorted nourishing food, and hygienic surroundings are the most important factors in the treatment of consumption; but in all cases we require some one of the many expectorants at our disposal. Comparative tests have afforded me the opportunity to study the physiological action of the combined antiseptic salts of guaiacol with potassium and sodium, and also of guaiacol with ethyl-morphine, and proven beyond question the therapeutic value of Triacol. the part involved. Disorders of the Sexual Function in be suddenly overwhelmed. By A. H. P. LEUF, M. D. [EIGHTEENTH PAPER.] Gummata. Syphilitic cell accumulations, gummata, may occur anywhere. They may cause any variety of symptoms, depending upon their location and size. In the brain and cord, they may give rise to the most pronounced motor and sensory disturbances, as well as affections of the special senses, and even of the mind, according to their size and location, and the secondary changes induced in the tissues by irritation and pressure. The cell accumulations are so rapid in these growths that their nourishment is often deficient, causing them to die and break down. This is particularly true of the skin, in which it causes, in this manner, ulcerative destruction, sometimes of considerable area. Interstitial Changes. In the internal organs it is more apt to set up interstitial change, consisting in increase of the connective tissue, with subsequent contraction, leading to more or less atrophy of the essential cells of Selection of Posterior Nerve Roots. Syphilis seems to have a selective effect upon the posterial spinal nerveroots, from which one would expect to find sensory disturbances more often than motor ones, which is the case. Many of these sensory disturbances may be very sudden and severe, sufficient, in fact, to prostrate the patient, and yet disappear in from 24 to 48 hours. It is a well-known fact that most cases of locomotor ataxia are of syphilitic origin. It is also a fact that the later the involvement of the nervous system, the more apt it is to be incurable, though many an incurable case of nervous syphilis is only so because the doctor lacks the courage to push the proper remedies beyond the average dose. Mode of Action of Mercury. There is a general belief that the remedies usually employed for syphilis, and which I have mentioned, mercury and the iodid of potassium, are effective by virtue of a specific antagonism to the materies morbi of the disease, but this appears not to be so. It is due rather to their tendency to produce fatty degeneration, breaking down of the syphilitic cell formations, thus permitting them to be removed. Mercury, in fact, is quite |