describes, he also describes some special varieties, as jaundice in the new-born, heredity jaundice, icterus gravis, etc.

The subject will only become clear and understandable when we realize that jaundice in fact is only a symptom, and that it is only produced in one way, namely, by interference with the discharge of bile through the ducts and tracts, and that it may or may not be accompanied by infection.

This gives us the whole thing in a nutshell. The pathology, signs, symptoms, diagnosis, prognosis and treatment should be described as those of obstruction to the common duct, obstruction to the cystic duct, infection of the gall bladder, infection of the ducts or infection of the liver, etc.

If we will approach the subject from this its true pathological standpoint, the whole question will be at once simple and practical. C. E.B.

Recording Secretary-T. A. Hopkins. Corresponding Secretary-Chas. J. Orr. Treasurer-R. M. King.

Board of Censors-B. M. Hypes, the retiring president.

President Henderson has appointed the following committees:

Election-L. E. Newman, A. Ravold and L. T. Pim.

Publication-Robt. Barclay, W. B. Shields and W. H. Stauffer.

Executive-Jos. Grindon, W. W. Graves and G. C. Crandall.

Library N. B. Carson, F. J. Lutz and W. B. Dorsett.

Microscopy and Pathology-Hugo Summa, W. Bartlett, M. D. Jennings, E. F. Tiedemann and D. L. Harris.

Public Health and Legislation Geo. Homan, Juhn Y. Brown and H. J. Scherck. For two years past the society has enjoyed a period of unusual prosperity; its growth has been decided, its scientific programis have been of a more than usually high class, and it has regulated itself to a business like conduct of its affairs. It appears that 1905 must prove in all points its best year, for not only has it placed at the helm men who can inspire enthusiasm, but the rank and file of the membership are at this time ready to do good thorough work for the society and to

unify and strengthen the position of the profession in the community and before the world.

A LARGE BEQUEST.-The King's Hospital Fund in England has been enriched over $1,000,000 by the gift of Lord Mount Stephen.

FIFTEENTH INTERNATIONAL CONGRESS OF MEDICINE, LISBON, APRIL 19-26, 1906.-W3 have recently received the fourth number of the official journal of the fifteenth International Congress of Medicine which is to convene in Lisbon, Portugal, April 19-26, 1906. It is evident from an examination of this number that the success of the Congress is assured, a wealth of scientific communication is promised and the leading medical men of the civilized world have signified their interest in and attendance at the Congress. Already 188 papers have been definitely promised not including many less studied addresses which will be available. This number of the journal presents the program in so far as it is now completed, and in its latter part it enumerates the committees having in charge the preparatory work in each country participating.

THE NEW YORK STATE HOSPITAL FOR CRIPPLED AND DEFORMED CHILDREN.-We have lately received the fourth annual report of the above institution, and we are pleased to note that so worthy a charity is being prospered greatly. The New York State Hospital for the Care of Crippled and Deformed Children, established by the Legislature of 1900, has been for better than three years open for the reception and treatment of patients. The hospital was established for the care and treatment of any indigent children who may have resided in the State of New York for a period not less than one year, who are crippled or deformed, or are suffering from a disease from which they are likely to become crippled or deformed. Since its establishment the importance of the hospital has received constantly growing recognition, its staff has been made up of the foremost physicians of the State and its management has been ideal. At the present they are enable to announce their early removal from Tarrytown to more commodious and more convenient surroundings at Haverstraw. The work done by this institution and the fact that it confines its benefits to the class who are unable to pay for such treatment gives it class with the most beneficent of charities. It would be fortunate for this class of patients in Missouri, and in many other states, if such an institution were accessible.

REPORT OF THE COMMITTEE ON PUBLIC HEALTH AND LEGISLATION, ST. LOUIS, DECEMBER 17, 1904.

ST. LOUIS, December 17, 1904. TO THE ST. LOUIS MEDICAL SOCIETY: Mr. President.-Your committee on pub. lic health and legislation have the honor hereby to submit their annual report for 1904 -the present year being the first one in the history of the society to witness a standing committee of this name and character.

Early in the year a more explicit definition of the powers and duties of the committee under Art. XVIII of the by-laws was requested by us, and this was granted in the form of an ordinance by the society. Acting thereunder a number of subjects of local, State and National concern were brought to the notice of the society as worthy of attention, and some of these were carefully considered last winter and spring.

The local matters thus presented were the public milk supply, garbage collection and removal, enforcement of the law against deposit of sputum in public places, and the medical inspection of public school children; and on these several topics your committee would report as follows:

Public Milk Supply.-As a result of careful inquiry it appears that St. Louis possesses a law covering this subject that is workable and is applied for the protection of the consumer, the penalties provided for adulteration or other fraudulent practice by dairymen and milk dealers being generally enforced by the courts.

An attempt made in the early part of the year by this class to repeal this law and sub

stitute therefore a measure in their own in

terst failed, and far as known, no hostile legislation in this respect is now pending or intended. However, the working efficiency

of the city chemist's office for several months past has been seriously embarrassed by the failure of one branch of the Municipal Assembly to authorize the employment of indispensable office help; and at this time no relief appears in sight.

Garbage Collection and Removal.-As will be remembered litigation in a case appealed to the State Supreme Court resulted last year in a decision by that court to the effect that the the existing contract let by the city board of health to a private contractor was void, which necessitated legislation by the Municipal Assembly to meet the emergency, the outcome of which the assumption by the city of this work April 1 last, the service being placed in charge of the street department.

It is but fair to remember in this connection that such work, entirely novel here as a municipal undertaking, was almost precipitated on the city and under extraordinary circumstances the opening date of the Louisiana Purchase Exposition being but one month distant, and in attempting to rightly estimate the value to the public of the city's work in this respect these changed conditions must be kept in mind, as it is probable, that the gross volume of garbage to be removed was increased not less than twenty per cent over the highest figure of any former year by the throngs of visitors to the Fair, the transient daily population being very likely near 100,000.

Being duly authorized, your committee last month sent postal card inquiries to every member of the society requesting an expression of opinion as to the "value to the public of the present municipal service

as compared with the work done prior thereto under private contract," it being considered that no other equal number of persons could speak so intelligently on the subject by reason of the fact that a large proportion of the members are constantly passing in all directions through the city, and further because of their opportunities for close knowledge of all transpiring within the household visited that concerns the family health and comfort.

Of the total responses received about 67 per cent report the present service an improvement over the former arrangement, the emphatic, but in some instances coupled with commendation often being unqualified and suggestions as to further betterment. About conditions, while about 15 per cent express 18 per cent report no improvement over past through having no garbage to dispose of, or no opinion on the question submitted, either having methods of domestic disposal, or for

other reasons.

Complaint is made of the miscellaneous character of garbage containers used, of their rough usage by drivers, and of the insolence of the latter; of leaking, over-filled and foulsmelling wagons, and of the streets used by them as main routes for delivery of the loads.

The expression in favor of municipal service as against the former plan is almost unanimous, this opinion being based either on principle or observed practice, although a few maintain that domestic destruction of garbage is the only true course.

The Deposit of Sputum in Public Places. -The law forbidding this practice has undoubtedly worked a very considerable change for the better so far as expectoration on sidewalks, in street cars, etc., is concerned, but the enforcement of this ordinance by the po

lice appears to be inefficient and perfunctory to a degree. Much of the offense arising from this source throughout the year was due to visitors here not informed as to the law. Altogether the effect of this measure on the habits of the home population has been educational and salutary.

Medical Inspection of Public School Children.-No progress has been made toward bringing about this important sanitary innovation, the hearing granted to this committee last spring by the committee on instruction of the Board of Public Schools be. ing void of fruitful results. It seems clear that history must repeat itself and that here as elsewhere numerous children must die of infectious diseases communicated during school hours before this reform can be accomplished.

In State affairs the principal concern that has engaged the attention of the committee is the forwarding of the project for a State sanatorium for persons in the earlier stages of consumption, this work being a direct inheritance from a special committee formed in 1902, which was authorized to press the subject upon the attention of State officials and the General Assembly in every proper manner-this was done, but unsuccessfully, as the event proved.

Under authority of the resolutions passed by the society on the 5th ult., the committee has mailed copies of the said resolutions to every medical society in the State whose address could be found, to the councillors of the Missouri State Medical Association, to the members of the State Board of Health and every health officer in Missouri, and to the home address of every member of the Senate and House of the 43d General Assembly in anticipation of the meeting of that body next month. In addition special letters were sent to the Governor and Governor-elect inviting their attention to the matter, and further personal letters were sent to all the medical members in both houses asking their special consideration of the promised bill, so that the ground has been pretty well prepared in a preliminary sense for our successors in this work. So far as ascertained the sentiment of the medical profession in all parts of the State is as a unit in favor of the action recommended.

It is the belief of this committee that this movement would command a wider general support of the proposed institution were advocated as constituting in fact an important addition to the educational resources and teaching equipment of the State, rather than presented in the guise of a hospital, or as being in any sense of a strictly medical character.

.

A bill is now before Congress for "preventing the adulteration or misbranding of foods or drugs, and for regulating traffic therein, and for other purposes' which passed the House last session (where it was known as the Hepburn bill) and is at this time pending in the Senate (where it is known as the Heyburn bill).

It has been materially amended since it passed the House, and has been under discussion within the last ten days, but some opposition appears to have been developed and the outcome is uncertain.

It seems to be a measure framed in the public interest, and no reason is evident why this society should not urge the Missouri Senators to give it their support, and the committee would so recommend, as this matter was referred to them for investigation and report.

All of which is respectfully submitted.
GEORGE HOMAN, M. D.
R. M. FUNKHOUSER, M. D.
F. L. HENDERSON, M. D.

ANNUAL ELECTION OF THE MEDICAL SOCIETY OF CITY HOSPITAL ALUMNI.-The following officers were elected at the annual meetof the Medical Society of City Hospital Alumni to preside over the destiny of that society during 1905: President-John Green, Jr.; Vice-President-L. H. Behrens; Secretary R. E. Kane; Treasurer-Hudson Talbott. The annual banquet of the society was held at the Mercantile Club on the evening of January 5th. In many respects it was one of the most notable the society has given, making a most auspicious inauguration of the new year.

A NOVEL METHOD OF TREATING DRUNKENNESS. Drunkenness, which has of late years developed to an alarming extent in Norway, has caused the authorities of that country to try an original method of curing drunkards of their vice. A foreign exchange gives a brief outline of the method pursued, which is as follows: The drunkard is carefully locked up in a room from which all communication is cut off. He is given for food bread which is soaked in port wine. At first the individual eats bis bread with pleasA few days suffice to make him thoroughly disgusted with it, and after about eight days of this form of diet he is allowed other food. The disgust acquired by this procedure is as a rule lasting. The very simplicity of this method will commend it as worthy of a trial. Med. Age.

ure.

THE REVIEWER'S TABLE

Books, Reprints, and Instruments for this department, should be sent to the Editors, St. Louis.

PROGRESSIVE MEDICINE. A Quarterly Digest, Advances, Discoveries and Improvements in the Medical and Surgical Sciences. Edited by Hobart Amory Hare. M.D., Professor of Therapeutics and Materia Medica in the Jefferson Medical College, Philadelphia. Assisted by H. M. R. Landis, MD. Vol. VI. No. 3. September 1, 1904. Philadel phia and New York: Lea Brothers & Co. ($6.00 per annum )

This number is an epitome of the literature of the year on the following subjects: Diseases of the Thorax and its Viscera, including the Heart, Lungs and Blood Vessels; Dermatology and Syphilis; Diseases of the Nervous System; Obstetrics.

The first contribution on the Thorax and its viscera is by William Ewart, M.D., F.R.C. P., Physician and Joint Lecturer on Medicine at St. George Hospital, London. Ewart has always carefully edited this department and his comments and summaries are to be depended upon as being select and valuable. In this volume he is especially explicit in his review of the subject of Tuberculosis, sixteen pages are devoted to this subject alone. Next foliow the pleura, lungs, blood vessels, lymph circulation, and last the heart. The recent important advancements of knowledge are thoroughly presented.

William S. Gottheil, M. D., on Dermatology, gives renewed interest to old subjects by his excellent summary of new knowledge in this specialty.

Diseases of the Nervous System are reviewed in a masterly manner by William G. Spiller, who by the way is one of the most expert judges of good literature of neurology in this country. Spiller is by natural endowments a scholar, research worker and indefatigable clinician. His opportunities are superior, hence his judgments of the best in literature are excellent. For this reason deFor this reason department is always thoroughly reviewed, though space does not permit to cover all that is new in this department. Space should be given to mental diseases and we for one, miss and sadly too, the scrutiny of the literature pertaining to this subject. May we suggest to the editor a department of mental diseases the general practitioner will apprecciate it, and specialists surely will regard it as a distinct advancement in the use fulness of progressive medicine.

Obstetrics is given by Dr. Norris in his usual thorough manner and is valuable because of being practical.

Vol. 1, No. 4, whole number 24, December 1. 1904.

This volume considers diseases of the Digestive Tract and Allied Organs, the Liver, Pancreas and Peritoneum by J. Dutton Steele, M.D. Inasmuch as great advance

ments have been made in this department of clinical medicine during the past few years, the importance of this excellent review is emphasized. Nearly fifty pages are given to the stomach, thirty to the intestines, and twentynine to the liver, pancreas and peritoneum. Jos. C. Bloodgood reviews anesthetics, fractures, dislocations, amputations, surgery of the extremities and orthopedics. Wm. T. Belfield covers genito-urinary diseases, and and J. R. Bradford diseases of the kidneys. Landis concludes the volume with practical summary, entitled Therapeutic Referendum, which is rich in suggestions. and alone worth the price of all for volumes to the busy practitioner.

OUTLINES OF PSYCHIATRY. Introductory Lessons. Designed for the Use of Students of Medicine. By Charles Gilbert Chaddock. M. D., Professor of Diseases of the Nervous System, Marion-Sims-Beaumont College of Medicine, Medical Department of St. Louis University. St Louis: Commercial Printing Company. For sale by Lewis M. Mathews, St. Louis, Mo. (Price $2.50.)

This belated review of such an excellent and timely book by this well-known American author is due to an oversight on the part of the reviewer. He extends apologies to his friend, the author, and to all others concerned. Dr. Chaddock has long since won his spurs in American psychiatry and neurology, and to have in book form his views regarding mental disease, even though they be elementary, is a distinct and valuable contribution to text-book literature. This small book of 228 pages, while giving merely an outline of psychiatry is a worthy manual, and entitled to an extensive acquaintance among the students of medicine throughout this country. In twenty-eight lessons are discussed the essential features of mental physiology, elementary psychology, elementary anomalies of the mind, pathologic delusions; anomalies of the feelings; anomalies of general bodily functions; symptoms of organic nervous disease; the deep and superficial reflexes; the course and terminations of insanity; classification of insanity; emotional depression (melancholia); emotional exaltation hallucinatory insanity; degenerate insanities; paranoia; epileptic insanity; hysteric insanity; insanity due to material causes; toxic and organic insanities; dementia paralytica; syphilitic, senile and other insanities due to gross cerebral disease. The originality of the book commends itself to every alienist familiar with the needs of students. Further, it is of value to physicians as a compend on mental diseases. But the student is the one who will find here, better than in any small work with which we are familiar, the essentials of mental disease, in compact, scientific and truly original form. original form. We congratulate Dr. Chaddock first upon his recognition of the needs of students; second, upon his own original

methods in presenting the outlines of psychiatry so completely, and without a chance for controversy as to the questions of classifications. F. P. N.

SURGICAL EMERGENCIES. Surgery of the Abdomen. Part I Appendicitis and other Diseases about the Appendix. By Bayard Holmes, M.D., Professor of Surgery in the University of Illinois. 8vo, 368 pages. Thirty-nine illustrations in text. Seven plates Sold by subscription. New York and Chicago; D. Appleton & Co. (Boards, $2.00 net, prepaid.)

In this volume Dr. Holmes offers the profession a thorough and exhaustive treatise on appendicitis. He follows the plan adopted in the previous volume on Surgery of the Head, and presents in full the more imminent conditions calling for surgical relief. Each topic is abundantly illustrated by clinical reports. While the work is primarily based on the author's experience, especially in diagnosis and indications for treatment, he has also incorporated with this the conclusions and results of other authorities which

he has considered serviceable. The text reads well and the illustrations are well selected and neatly gotten up. For a comprehensive study from any standpoint Dr. Holmes' work is certainly to be recommended. D.

ANNALS OF SURGERY.-The December issue of the Annals of Surgery is a remarkable number and well sustains the verdict of a well-known professor of surgery in one of America's oldest medical schools, that the Annals has achieved an undisputed place as the leading exponent of surgery in the English language. This issue signalizes the close of the first twenty years of the publication of this journal, and the publishers have properly marked the event by issuing a Festshcrift number, which is more than double the usual size, and which is unequalled for the value of its contents, the number and authority of its contributors, and the abundance and quality of its illustrations, many of which are in colors.

The first article is by Professor Orth, of the University of Berlin, on the Morphology of Carcinoma. The conclusion of this, the foremost authority in pathology of the day, that as yet there has been brought forward no proof of the parasitic origin of cancer, cannot fail to interest every thoughtful physicianthe "Bacillus Neoformans," the Parisian novelty, to the judicious and the learned, is a myth and a delusion.

latest

Any word from Professor J. William White on the Surgery of the Hypertrophied Prostate is sure to command widespread attention. In a memoir with this title Dr. White reviews this most important subject up to date, and gives his mature judgment on the questions involved. Always conservative and open-minded, he holds a true balance

and gives to various procedures their respective real values.

In the third article, Mr. W. Cheney, of King's College Hospital, London, reports a rare case of double intussusception, which had its origin in a Meckel's diverticulum, thus adding another to the various abdominal crises to which this not infrequent error of development may give rise.

Professor J. Collins Warren, of Boston, presents an elaborate study of the operative treatment of Cancer of the Breast, based upon over one hunderd cases. A series of beautiful plates illustrate clearly the operative methods whereby he has gained unusually favorable results. Articles by Foxworthy, of Nicoll, of Glasgow, present reflections and Indianapolis, Brewer, of New York, and observations upon various phases of wounds and injuries, which are supplemented by a scholarly paper by Dyball, of Exeter, England, on Parotitis as a complication of certain abdominal injuries.

Alessandri, of Rome, Italy, adds a certain increased cosmopolitan flavor to this number by a study from Italian experience of the use of Divulsion in Esophageal Esophageal Strictures. Warbasse, of Brooklyn, follows with a scholarly report upon a most remarkable and picturesque case of foreign bodies accumulated in the stomach, and giving rise to gastric tetany. The photograph of the articles removed by a successful gastrotomy in this case will provoke unusual astonishment.

Duodenal Ulcer is the subject of a paper by Mayo, of Minnesota. This is illustrated by exquisite plates and is deserving of a place as a classic on the subject.

A handsome colored plate showing Torsion of Entire Great Omentum illustrates a paper on that subject by Scudder, of Boston.

Hernia of the Bladder complicating Inguinal Hernia is the subject of a paper by Shepherd, of Montreal; Pelvic ConnectiveTissue Dermoids are studied by Germain; Stone in the Lower Ureter is the theme of a paper by Fowler, of Washington, D.C., being really a study from the experience of the Johns Hopkins Hospital.

An elaborate and very fully illustrated memoir on Undescended Testicle, from the records of the Massachusetts General Hospital, is furnished by Drs. Odione and Simmons, of Boston. A case of Hypernephroma of the Kidney is detailed by Dr. Francis S. Watson, of Boston, accomppanied by colored plates of unusual delicacy and fidelity to

nature.

In the Transactions of the New York Surgical Society a valuable and interesting series of clinical cases is presented, an excellent mirror of current metropolitan surgical work.