sponse on the part of the profession than that which has already been made. "Madame DePage herself is now on her way across the Continent and will visit as many cities and see as many people as possible in order to deliver her message. "With kind regards, "Sincerely yours, "(Signed) J. M. T. FINNEY." The efforts of the Committee of American Physicians for the Aid of the Belgian Profession are directed toward the relief of civilian physicians and their families in the northeastern or invaded portions of Belgium. The purpose of Madam DePage is to establish additional field hospitals and further other Red Cross work in the southwestern part of Belgium. In a recent letter she says: "The big conflict of the present war is still in the future; the most terrific fighting of all will come this spring. We must foresee the coming slaughter and be prepared to render instant aid to the thousands of wounded, friends and foes, who will fall within our lines." The following is an extract from a letter from Dr. J. Riddle Goffe, under date of January 26, 1915: "The fact that the English Government has announced that it will no longer continue to grant its monthly stipend to the British Commission for Relief in Belgium comes with somewhat startling disappoint ment." The work of relief must now depend almost exclusively upon contributions from the United States. This means that our efforts must be redoubled if we are eventually to reap the benefit of what has already been done and carry the Belgian people through to the time when their own meager harvest can supply their actual necessities. It must be constantly kept in mind that the status of the 1,400,000 utterly destitute in Belgium are still standing in the bread line or hovering around the soup kitchens. A recent communication from Dr. Jacobs of Brussels, gives a heartrending picture of the condition of Belgian civilian phystcians and their families. The following letter is self explanatory: "DAYTON, OHIO, February 25, 1915. "My dear Doctor Simpson: Pursuant to a resolution passed by The Montgomery County Medical Society, Feb. 5, 1915, authorizing a committee of three of its members, to raise a fund for the relief of the Physicians of Belgium and their families, the pleasant task was immediately started with the result in dicated by the inclosed New York draft for $304.50. We but join you and the other members of your splendid Committee in the hope that every farthing of this offering may reach our afflicted brethren in Bel gium and that the end is not in the far distance when lasting, permanent relief may be their heritage. "MONTGOMERY COUNTY MEDICAL SOCIETY, "C. L. PATTERSON. SOCIETY NOTICES. } Committee." To reach the hospital: Automobiles take Huntington Avenue to Calumet Street, Hillside Street, Parker Hill Avenue, to top of Hill. By electrics: Huntington Avenue through Brookline Village to Waite Street. LYMAN S. HAPGOOD, M.D., Secretary. 6 Garden Street, Cambridge, Mass. AMERICAN ASSOCIATION OF IMMUNOLOGISTS. annual meeting will be held at Washington, D. C., May 10, 1915. -The MARTIN J. SYNNOTT, M.D., Secretary, AMERICAN POSTURE LEAGUE.-The second annual luncheon of the American Posture League will take place at the Hotel Astor, New York, on Saturday, March 13, at 1.30 P.M. The Central Committee on Public Health Organizations, which meets in New York on the same date, has been invited to attend the luncheon. Several of its members are officers or directors in the Posture League. The after-luncheon program will set forth the educational, scientific and welfare aspects of the work of the organization. The President and founder of the League, Miss Jessie H. Bancroft, will preside and will speak on the history, plan and work of the American Posture League; other speakers will include Dr. Fred. erick R. Greene, of Chicago, first vice-president of the American Posture League, and secretary of the Council on Health and Public Instruction of the American Medical Association; Dr. Joel E. Goldthwait, second vice-president, and Dr. E. G. Brackett, both of Boston; Dr. Eliza M. Mosher, Dr. Henry Ling Taylor, secretary, and Dr. S. Josephine Baker, of New York. Dr. Percy W. Roberts will present an important report of original research conducted by the League; Dr. Anna L. Brown will tell of the National contest on Posture being conducted by the Young Women's Christian Association, and Mr. Harry O. Bullock will speak for the Brooklyn Rapid Transit Company, relative to the seats in the new subway cars, which the Posture League designed in coöperation with the construction engineers of the company. The annual meeting for the election of directors and officers will occur earlier in the day. H. L. TAYLOR, M.D., Secretary. RECENT DEATHS. DR. JAMES F. DONNELLY, who died on February 25 at Nish, Serbia, was a graduate of the University of Louisville and a practitioner in New York City. He went to Serbia in November, 1914, with an American Red Cross unit. The cause of his death was typhus. DR. O. K. SPRENGEL, Surgeon-in-chief of the public hospital at Braunschweig, Germany, and president of the German Surgical Association died recently of septic infection at the age of 62. DR. JAMES PECKHAM CAMPBELL, who died on Feb. 27 in New York City, was born in Lewes, England, on August 18, 1833. Migrating early to the United States he became a student at Syracuse University, of which at his death, he was the oldest living graduate. After studying medicine he was for a time a surgeon of the Cunard steamship line and later settled in the practice of his profession at Norfolk, Va., and in New York City. He is survived by three daughters and three sons. DR. LUTHER GRAVES TOWNSEND, a retired Fellow of The Massachusetts Medical Society, died at his home He in Townsend, Mass., March 1, aged 70 years. was born in Nashua, N. H., Dec. 12, 1844, and was graduated from the Harvard Medical School in 1871, serving as house physician at the Boston Lunatic Hospital and at Deer Island after graduation. practised at Townsend the rest of his life and was a member of the school board of that town from 1880 to 1900. He [From the Medical Clinic of the Peter Bent Brigham years ago. Nothing is known of his family with Hospital, Boston, Mass.] the exception of one brother and his family, all of whom have always been well. The mother is living and well. There is no history of paralysis or other nervous disturbance in her family. The mother does not use alcohol. The father drank at times. There are three healthy sisters. aged 21, 13 and 8 years. All children were normal deliveries, healthy infants and walked before one year of age. THE impulse given to the study of this type of muscular atrophy came in 1886 when Charcot and Marie1, and Tooth' coincidently in the same year published papers reviewing the myopathies. Separately they established from clinical and pathological observations that the peroneal form, beginning usually in early childhood and involving the extremities only, depended upon neural as well as muscular degeneration and CASE 1. Plates I and II. Sam F., 24 years old, isolated it between the myopathic (muscular has always lived at home, never having been able dystrophies) and the myelo-pathic (anterior to work. poliomyelitis) affections. The characteristics of the affection as originally described by Charcot and Marie are: Complaint: "Weakness of legs and arms." Past History: Internal strabismus of the left eye was present at birth. He had measles at two years. four years of age. Entropion of both lower lids chicken pox at three years and whooping cough at began at 17 years with falling out of the lashes and chronic irritation since that time. 1. Progressive muscular atrophy beginning first in the feet and legs, not appearing in the hands and arms until several years later, the progression of the atrophy being slow. 2. Relative integrity of the muscles near the trunk, or at least much longer preservation of these than of the muscles of the distal ends of the limbs. 3. Integrity of muscles of the trunk, shoulders and face, 4. Fibrillary contractions in the atrophying Reported at a medical meeting at the Peter Bent Brigham At about this time the fingers of the left hand and Hospital, November 10, 1914. Received for publication Dec. 22, 1914. Present Illness: Began at the age of seven years when weakness was noted in his feet, making walking difficult. Weakness and atrophy increased until at the age of 14 years the muscles above the knees also seemed to be involved and he fell down constantly wholly unable to walk and moved about by crawling. when walking about. At 16 years the patient was almost immediately of the right became weak with PLATE 1. the present time he clumsily washes and dresses himself, using his hands in a flail-like manner but can perform no complex movements. His mentality appears normal. Physical Examination: Shows head and body, including the shoulders and buttocks, well developed and nourished. Skin and mucous membrances are normal. Eyes show entropion of both lower lids with a low grade chronic conjunctivitis and a left internal strabismus. Pupils react equally to light. Tongue is clear and protrudes without tremor. Chest is well formed, expansion good. Lungs and heart are normal. Systolic blood pressure is 120 mm. of mercury. Abdomen is fat and somewhat protuberant, no masses or tender areas are made out. Patient sits or lies with both knees flexed at right angles to the thighs from contracture. There is evident equino-varus of both feet, most marked on the right, also a marked degree of external rotation of the whole lower right leg from atrophy and weakness of the vastus medialis. The legs are short as compared with the body, giving the patient a dwarfish appearance. Atrophy of all muscles of the legs below the middle third of the thigh is evident but to some extent obscured by the thick layer of subcutaneous fat. The hands and arms show a marked degree of atrophy and paralysis below the middle third of the upper arm, comparable with that of the feet and legs. The thenar and hypothenar eminences of both hands are absent. The hands are flattened with the terminal phalanges slightly flexed. The biceps on the right is capable of flexing the arm. The left biceps cannot accomplish this. There is practically no muscular movement below the elbows. On the left there seems to be slight weakness of the shoulder muscles. The hands and feet are about two-thirds normal size and length. The knee jerks, Achilles jerks, plantar, biceps and triceps reflexes of both sides are absent. There is no ankle clonus or Babinski sign. The cremasteric and abdominal reflexes are present. While the patient was in the hospital fibrillary tremor at a rate of about 8 per second was noticed in his pectoral, biceps and triceps muscles, especially on the left, brought on by any attempt to move the arm. A tracing was made, by connecting the arm by electrodes with the electrocardiograph galvanometer (Plate III), and by means of an air-containing cuff around the arm connected with a recording tambour (Plate IV). These plates show graphically the electric disturbance set up by the fibrillary twitching of the muscle and the rate and degree of muscle contraction. The muscle sounds during the PLATE 2. gradual development of contracture so that they could not be straightened. Subsequently the whole lower arm on both sides became involved so that at the age of 20 years he was unable to use either hand. At present there remains ability to move the third and fourth fingers of the right hand to a slight extent. No sensation of pain, cramp or discomfort has ever been felt. He sleeps well, has a good appetite and never becomes nervous or irritable. At PLATE 3. Tracings were obtained by placing the electrodes on the outer side of the left upper arm, one at the upper part and the other at string produced probably by muscular twitchings which result the lower part of the triceps. There are fine movements of the when patient tries to move his fingers. Upper curve is electrocardiogram showing normal cardiac complex. Middle curve is record obtained from a recording tambour connected with an air cuff around upper arm. First portion of the curve shows low waves produced by pulsation of brachial artery; second portion shows large and small waves produced by twitching of arm muscles. Lower curve is record of a time marker beating one-fifth seconds. CASE 2. Plates V and VI. Harry F., 12 years until at present there is no muscular control below old. Complaint: "Cannot walk." Past History: No previous illness. Digestion good. Bowels regular. the insertion of the biceps. His mentality appears normal. Physical Examination: Shows a normal appearing boy of 12 years, well developed and nourished Present Illness: Began at age of seven years except in the musculature of the arms and legs. when he noticed that the right foot became weak Pupils are equal and react to light. Tongue is proand easily tired when walking. The same difficulty truded in the mid line without tremor. Skin and was encountered in the left foot about four weeks mucous membranes are normal. Chest is well herself with difficulty. The weakness and atrophy remain localized to the lower portions of the extremities. Her mentality is normal. Physical Examination: Patient is well developed and nourished except in the musculature of the formed, expansion good. Lungs and heart are rophy gradually progressed until now she is pracnormal. Systolic blood pressure is 120 mm. of tically helpless, being able only to feed and dress mercury. Abdomen is fat and slightly protuberant, no masses or tender areas are made out. Upper extremities show a progressive tapering from the shoulders to the hands which are held in a position of pronation, flexed at the wrists. The lower arm muscles, interossei muscles, thenar and hypothenar eminences show marked atrophy. The biceps and triceps reflexes are absent. Movements of the lower arms and hands are accomplished by flinging movements of the shoulder muscles. The lower extremities show the same type of progressive tapering. The right knee is held in position of genu valgus Both feet show equino-varus which is especially marked on the left. The feet and hands are smaller than those of the average boy of his age and size. The atrophy of the lower legs and feet is even more obscured by the thick layer of subcutaneous fat than in the arms and hands. All muscle power below the knees is gone. The knee jerks and plantar reflexes are absent. There is no ankle clonus or Babinski sign. No muscular tremor was observed. CASE 3. Plates VII and VIII. Mary F., 10 years old. Complaint: "Unable to use hands or feet." Past History: Measles at four years followed immediately by whooping cough which persisted for six months. Present Illness: Began at age of four years about one or two months after the whooping cough, when mother noticed that the child walked peculiarly. picking up feet higher than usual and bringing them down "flail-like." The weakness in her legs gradually increased until she is now barely able to walk. The weakness was first noticed in her hands about two years ago, at which time she could perform any complicated task, but paralysis and at lower arms and legs. PLATE 8. Pupils are equal and react to light. Teeth are in poor condition. Tongue protrudes in the mid line without tremor. Skin and mucous membranes are normal. Chest is well formed, expansion good. Lungs and heart are normal. Systolic blood pressure is 115 mm. of mercury. Abdomen is soft and rounded, no masses or tender areas are made out. The upper extremities appear normal as far down as the elbows. Flexion at the elbows seems weak but not limited. The muscles of the lower arms and hands show marked atrophy; especially noticeable is the absence of the thenar and hypothenar eminences. There is some contracture of the second, third and fourth fingers of both hands in the two distal phalangeal joints, giving the picture of an early "claw hand." Reflexes of the biceps and triceps are transient. No reflexes are present in the lower arms. The lower extremities show marked atrophy and practically complete paralysis of the muscles below the knees. The degree of atrophy is masked by thick subcutaneous fat. Both feet show equino-varus, more marked on the right. Knee jerks, Achilles jerks, and plantar reflexes are absent. No ankle or Babinski sign. The electrocardiograms in all three showed the heart mechanism to be perfectly regular and normal. The special senses, smell, sight, hearing, taste and speech as well as the general sensations of |