and to bed, and put him upon antimonial treatment, with Dover's powder and sinapisms to affected side. I now visited my patient twice daily, and found but little variation in symptoms in the intervals of my visits, but gradually the temperature rose to what (for lack of means to be more definite), I would call an ordinary fever heat; the pulse averaging perhaps 90 for a period of two weeks, tongue slightly furred and moist. At no time was there a total aversion to food. Tendency to diarrhoea. Physical signs during first two weeks of confinement to bed, extreme dulness over the whole of right side of chest; almost total absence of respiratory sounds and a fulness or distension of affected side indicating copious effusion. The treatment during this time was varied according to symptoms. Meeting the diarrhoea, attended with some tenderness of bowels, with bismuth and pulv. ipec.co. and poultices. The medication for pulmonary symptoms consisted in the main of small doses of ant., as already stated, with tinct. aconite, spts. of nitre, and pulv. ipec. co. at night. During all this time my patient made no progress towards recovery, and only once, about the fifth day after having taken his bed, was there even a temporary abatement in his symptoms. The course of attack was more persistent than urgent, gradually reducing the subject's strength, until on the fourteenth day of his con. finement to bed, I found him sinking decidedly, with clammy skin and feeble pulse. Respiration what I here call jerky for want of a better term, and effected only with a moaning noise. I now considered my patient in great danger, and also at the same time found a condition for the most favorable action of a vesicatory, which in my opinion is where the skin is moist, the tongue moderately clean, and the patient is undergoing what we consider a critical change, which is frequently attended with a rapid reduction of strength. This being the time when in my experience we may expect a favorable effect from the blister, I at once applied a large one, and let it remain until full vesication was produced, following with poultices' to chest. The expectoration during all this time was only moderately copious, and very slightly tinged with blood for only a few days. From the time of application of the blistering cerate, followed by its full effects, my patient began to improve; the respiration being easier, the temperature of body somewhat reduced, and a general though very gradual abatement of the morbid condition which had so long pursued its course without any noticeable interruption. Here let me state that the day after the vesicatories were applied, and my patient was put upon ammon. carb. and wine, my friend Dr. Kerr saw him with me, and coincided heartily in the course of treatment, though somewhat inclined to differ as to exact location of the

disorder, leaving me to infer from his remarks that it was pleuritic rather than pneumonic, from which opinion, with all due respect for my friend's skill and merited reputation, I find myself compelled to dissent for the following reasons: 1st My patient could lie best upon the affected side, which is not usually the case in pleurisy. 24. The marked and extensive dulness will scarcely allow us to form that opinion, as in pleurisy we do not often find it to such an extent, and again the character of the pain being at no time that sharp, lancinating stitch, which is so often a striking characteristic of acute pleurisy, imparting to its victims an anxious look and broken, gasping respiration, which in my patient were not prominent. But to return to our report of case. The patient at present is in a favorable condition, cough being a somewhat troublesome symptom for some days; I am at present administering mur. ammon., antimony and spts. ether. nit., with ext. licorice, which seems to ameliorate cough, and promotes expectoration. The points of interest in this case I think are the protracted stage of prodroma, the marked and extensive dulness, protracted and unvaried course under varied treatment, and the decided benefit of the vesications at a time when the powers of nature seemed flagging.

CONSTITUTION AND BY-LAWS

OF THE

Medical Society of the State of Pennsylvania,

AND

CODE OF MEDICAL ETHICS,

WITH A

CATALOGUE OF THE PERMANENT MEMBERS, THEIR POST-OFFICE ADDRESS AND DATE OF MEMBERSHIP.

CONSTITUTION

OF THE

MEDICAL SOCIETY OF THE STATE OF PENNSYLVANIA.

ARTICLE I.

TITLE OF THE SOCIETY.

THE name and title of this Association shall be "THE MEDICAL SOCIETY OF THE STATE OF PENNSYLVANIA.”

ARTICLE II.

OBJECTS OF THE SOCIETY.

The objects of this Society shall be the advancement of medical knowledge; the elevation of professional character; the protection of the professional interests of its members; the extension of the bounds of medical science; and the promotion of all measures adapted to the relief of suffering, the improvement of the health,. and the protection of the lives of the community.

ARTICLE III.

MEMBERS OF THE SOCIETY.

SECT. 1. The Society shall consist of delegates and permanent members.

SECT. 2. The delegates shall receive their appointments from the county societies: Provided, however, that the officers of the Society, and the Chairmen of all committees who have reports to present, shall be delegates ex-officio; and to them and to the permanent members shall be intrusted the management of the business and affairs of the Society.

SECT. 3. Every delegate from a Society not in delinquence, before admission to a seat in the Society, shall produce a certificate of delegation signed by the president or secretary of his county society, and shall sign the rules and regulations.