in the Pharmacopoeia. In the excited cases hyoscin hydrobromate is of great value; it is powerful, some patients bear it badly, but used with caution it will often produce satisfactory results. Finally in considering the therapy of acute insanity, we must always be mindful of attention to the general health of the patient.

THE best site for an urgent tracheotomy is through the cricothyroid membrane. To hold the opening apart a couple of hair pins bent at the end may be used as retractors.- American Journal of Surgery.

APPENDICITIS IN CHILDREN.- Dowd, in the Medical News, Sept. 23, draws conclusions upon appendicitis in children from seventy cases between two and fifteen years old, occurring in his practice. The cases are classed as (1) Early cases, operated within forty-eight hours; (2) Later cases of varying activity; (3) Interval cases. In group one the rapidity of the progress of inflammation is remarkable, but operation gives good results. Group two has a mortality rate of about one per cent. in this series; immediate operation is advocated by many surgeons who counsel delay in the same stage of adult cases; this is because the omentum in children is small and fails to wall off the infection. In group three there is no mortality and there are no peculiarities.

Among the symptoms and signs, pain was always present, but its expression in children is seldom definite; vomiting is noticeably constant; rigidity is very well marked over the point of inflammation, the muscles reacting to slight stimuli; hence palpation is better before anesthesia than after. The disease is more rapid and insidious than in adults; leucocytosis is comparatively higher; constipation is not the rule. Early pneumonia often simulates appendiceal trouble, as does hip-joint disease occasionally. Children bear operation well and they more often survive a general peritonitis than adults.

Do not consider too lightly a history of "growing pains" in the extremities in children. These symptoms may be due to a grave osteomyelitis.- American Journal of Surgery.

WHEN IS A PHYSICIAN JUSTIFIED IN PERFORMING AN ABORTION? An observant reader of medical journals will notice in their pages both the appearance of an increasing number of articles written by honest and capable physicans on the methods of safely performing abortions for medical purposes, and the printing in the news columns of more and more frequent notices of persons sent to jail for performing criminal operations. Those having much to do with medico-legal work of the latter kind know full well that the borderland between these two classes of cases is drawing closer and closer, and that the matter as to when an abortion is justifiable must be thoroughly discussed in the near future both in our medical societies and in the criminal courts. It is to be hoped, therefore, that certain persons who now possess an enviable professional reputation in the community in which they reside, will desist from any longer performing abortions alleged to be undertaken for the benefit of the patient, but really executed with the object of hiding the shame of one who has been seduced, or of preventing an addition to the family of those in wedlock. In all pregnant women where the physician believes that the life of the patient is endangered by carrying a child in utero until it becomes viable, as in cases of hemorrhage from detached placenta, the operation of abortion should be performed only after due consultation with another reputable physician, with the minister of the church attended by the patient, and with the next of kin of the woman to be operated upon. The conscience of the physician in charge and the laws of the state in which he resides must decide in each case as to whether or not an abortion is to be performed. Thus, the tenets of the Catholic church distinctly forbid the performance of an abortion for any cause whatever, and the laws of Pennsylvania do not permit the aborting of one who has become pregnant through rape.-H. W. C. in Pennsylvania Medical Journal.

A SUBCUTANEOUS tumor with a history of puncture or the presence of a minute scar in the overlying skin, usually means that one is dealing with an inclusion-or-so-called Ranvier cyst. --American Journal of Surgery.

The "Just as good" fiends are now pirating.-Insist on

MILK OF MAGNESIA

Registered in the U. S. Patent office, Sept. 12, 1905.

(MgH2O2). FLUID. ANTACID AND CORRECTIVE.

This form of Magnesia is efficient in Antacid and Corrective indications. Especially so in the Gastro-Intestinal irritations of Infant, Child, and Adult life. THE CHAS. H. PHILLIPS CHEMICAL CO., New York and London.

OPENING ADDRESS, VANDERBILT UNIVERSITY MEDICAL DEPARTMENT, SESSION OF 1906 - 1907.

BY DUNCAN EVE, A. M., M. D.

Delivered at the College, Sept. 19, 1906.

Gentlemen:- In accordance with established custom, I appear before you this afternoon for the purpose of bidding you, in the name of the Faculty of this Institution, a hearty welcome, and at the same time of addressing a few words of counsel and advice to those among you, who for the first time visit this city. And although my theme may prove trite, there is yet no subject more fraught with interest and importance to you. Who are you, my young friends? The sons for the most part, of country gentlemen, now thrown for the first time into the vortex of

a densely populated metropolis. Are you aware of your position? Does the desolate feeling of a stranger induce you to think that you are truly alone in the world, with no one to counsel, no one to observe your course of conduct here? For let me assure you that others, and possibly those who are to influence your future fortunes even more decidedly than the members of your own household your teachers, your friends, your acquaintancesall now watch with eager gaze the career of your "little bark of life," freighted as it is with so much of the happiness of others. Then, let me admonish you, to take heed how you steer; tempest and storm, rock and quick-sand beset you from the very moment you loosen sail; but rest assured, that prudence, determination and watchfulness, will enable you to shun them all.

But, gentlemen, are you aware of the true character of the profession you have selected as your occupation for life? Have you estimated the nature of its duties? Know you that to your hands will be entrusted "the frail skiff of human life," and that as its pilot you are expected to guide it in safety through the myriads of difficulties that beset the perils that threaten it on every side that by the world you are regarded as the "seer who looks into, comprehends, pronounces upon, and regulates the laws and phenomena of vitality"? Have you thought of the almost boundess extent of its duties; how it brings him who aims at a high position in its walks, in close connection with almost every department of human knowledge? Have you reflected too, upon the character of the age in which you live-an age of progress and improvement in all things? Never in the annals. of this earth, with all its chronicled glory and its ancient renown, never has it witnessed a time so interesting, so remarkable as our own. "I know" remarked an eloquent writer, " we may confine our views, and discover, perhaps, in the histories of various nations, specific acts and achievements more wonderful and nearer perfection than any we can boast. Pericles may have gathered around him mightier intellects and cultivated a richer taste, and reared trophies more glorious than any that adorn a modern state. Demosthenes may have kindled a loftier eloquence and Homer a deeper sublimity, than any who speak in our assemblies; "—

all this we grant. But to go further than this, and to say that the ages of antiquity placed humanity higher in the scale of mental and moral progress, than the present, we cannot admit. We must withdraw our attention from singular achievements and isolated facts, and look abroad upon the wide spread race of mankind, and the general aspect of human society. When, I ask, were there ever such great principles of truth, and love, and melioration at work as at the present day; when has philosophy attained such enlarged and liberal views; when has the science of government, been so well understood and practiced; when has religion moved among men in such purity, as at this very time? And shall our profession remain stationary when all else is moving onward? Will you who are destined to be pillars upon which the medical science of this country is to rest, submit to be pointed out hereafter as laggards in the race? Will you, by slothful indulgence, wasteful, ignoble and puny contentedness, let pass the golden era? Will you not rather by your diligence and laudable ambition wreathe a new chaplet of glory for the land of liberty and equal rights? Show to the world, that if in politics, religion and social virtues, America stands among the foremost of the nations, she may also boast of her medical science.

Are you prepared to enter upon such a profession as ours, so full of responsibilities, so exacting in its demands of one who expects to be considered a bright star amid the glorious galaxy that now adorns our age? If so listen to the few words of counsel and advice, I shall now offer and that constitute in a large measure the requisites of success," in the medical student.

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Celsus long since urged the possession of certain physical qualities as essential in the surgeon. "He must possess," said the illustrious Roman, a keen eye, a steady hand, and an unflinching courage, which can disregard alike the sight of blood and the cries of his patient." If then, in the commencement of your career you are lacking in these qualities, there is no ground for despair, for by habit and education you can at least acquire the more important. The distinguished Frank H. Hamilton, Gen. Grant's medical director, and Professor of Surgery in Bellevue Hospital Medical College, had in his early professional life, to