plish any good results and had sent the patient home. After six weeks, the patient returned, and, to his great surprise, was very greatly improved. After further treatment, he was again sent home apparently entirely cured. His experience has been that many hopeless cases have shown marked improvement after being sent home without hope. Dr. Lord has the greatest hope for these cases when the X-ray is used supplementary to other forms of treatment, and after proper surgical procedures. He depends upon the X-ray only in such cases, or in cases such as this one was, which are wholly inoperable.

Dr. J. E. Summers spoke of a case of this character, which had subsequently gone into the hands of Dr. Lord, in which he (Summers) had carried out the same ideas and had deliberately produced an extensive burn, by reason of which he had lost the case and had not been forgiven. The severe burn had been the means of her salvation, though he had supposed that she would live for very short ime since she also had a serious heart lesion. Dr. Lord had removed the necrotic mass in the breast and she was now apparently well of the malignant condition.

CASE OF GUN-SHOT WOUND AFFECTING SPEECH.

Dr. Aikin presented a man of 27. In June, 1890, he was shot with a 44-calibre bullet. The ball entered just above the middle of the right eyebrow and made its exit to the left of the median line, near the occipital protuberance. He was unconscious for three weeks; he says that his physician afterwards informed him that he lost about 5 or 6 ounces of brain substance and sufficient bone from the skull to measure 33 inches by 5. Upon return to consciousness, he found himself speechless. During the period of unconsciousness he had had at least one Jacksonian fit. Speech returned slowly after six weeks more. He now stammers and hesitates in his speech if he becomes excited He was told that he had a temperature of 112 deg. for one-half hour when unconscious.

At this time his head

was packed in ice to such an extent that an ear was frozen and a large piece sloughed out. Left hemiplegia was complete, motion slowly returning to the leg. There is very marked contracture of the fingers of the left hand. Spasticity is very marked in both left arm and leg. He suffers greatly from vertigo and says that, if he sleeps with his head low and a little to the right, that the cerebro-spinal fluid seems to run into the skull and causes great pain. The right patellar reflex is greatly exaggerated. There is very great jacitation of the left arm and leg. He is blind upon the temporal side of the right eye and the nasal side of the left eye. Gifford here stated that there was left homonymous hemianopsia and that a very interesting thing in connection with the case is that the ball came out to the left of the median line and, yet, the lesion was on the right side, the optic tract having been cut. Hearing was at a minimum on contact, on the left, and at 18 inches on the right. The patient states that he was ambidextrous. There was no mental defect, yet he has no ability to study. Attempts to do so cause intense cerebral pain.

Dr.

Dr. Coulter said that it was quite interesting to note that this man suffered from an irritative lesion, not a paralytic one, and that it was due to the cicatrix in the track of the bullet. One would expect to find decided alterations of sensation and they were present.

CASE OF INSANITY IN LABOR.

Dr. Eskildson presented a paper upon a case of insanity in the midst of labor. He was called to see a woman said to be suffering from a serious attack of biliousness, in an entirely unknown family. A cursory examination, not manual, satisfied him that the woman was in labor. This was not at all suspected by the many women who were present. He requested an examination. The patient looked at him contemptuously, and replied that he was very much mistaken if he thought her pregnant. The evidence of labor pains was even then plainly seen in her face. She reluctantly consented to an examination which showed her to be in the second stage. Information of this fact was given to her upon which she instantly lost her identity as Mrs. B. and took the position that she was a young lady in her father's home: that Dr. E. was her lover, dancing attendance upon her least commands and that her husband was her father. Any attempt to make another vaginal examination at this moment met with the most violent resistance. Since she was a young lady, she could not tolerate for an instant such an outrage Fearing convulsions, he suggested chloroform and forceps. Her husband objected and he was forced to use the bromides. Her pains were so severe as to cause her to throw herself around over the bed and her favorite position was sitting on the bed with her back against his side. She then exclaimed, while looking very lovingly at me, "Oh, Pa, do you think he loves me?" The husband's look of contempt and scorn can better be imagined than described. Dr. E. told the husband that his wife was entirely unaccountable for her actions. At this junction the child was born and the mother screamed at the top of her voice, "Let me have the brat, I will kill it and hide my shame. After delivery she became perfectly quiet, but still thought that she was a young lady. She persisted in this belief until the morning of the fifth day, when she awoke from a natural sleep as Mrs. B.. the happy mother of her fifth child. The day of labor and the following days were a perfect blank.

MOUTH BREATHING.

Dr. Lemere read a very interesting paper upon Mouth Breathing. He regarded the nose as the normal channel for breathing, the mouth being used as a supplement in emergencies. When there arises obstruction in the nose, or naso-pharynx, mouth breathing is forced and may continue from the habit formed thus. The nose is a filter for dust and the turbinates are parallel planes for gathering the dust. It is hardly known by the mass of medical men that the arrangement of the turbinates makes the area of the nose greater than that of the mouth. The vascular supply of the nose is so great that it is beautifully adapted to warming and moistening the air for respiration. Sneezing and blowing the nose expel the stagnated dust. Mouth breathing is a frequent cause of pharyngitis. Tuft thinks that 70 per cent of all people breathe through the mouth at night, and that 40 per cent of all deaths between 20 and 50 are due to respiratory disease. The tonsils are the most vulnerable point for tuberculosis. vical adenitis is now less frequent since adenoids are so much more often removed than formerly. Nasal breathing is a very strong point in the prevention of pulmonary disease. It is sometimes forgotten that mouth breathing is absolutely necessary when there is obstruction and it ought

not to be discouraged when obstruction is present. A diminished supply of air causes a vacuum in the lower respiratory tract and induces congestion of the Eustachian tubes and middle ear, interferes with ventilation of the middle ear and leads to deafness. For this reason such measures as strapping the mouth at night to prevent mouth breathing are dangerous when there is a tendency toward deafness. The proper method is to free the nose and naso-pharynx from the obstruction.

SOME UNUSUAL EFFECTS OF IODIDE OF POTASSIUM.

Dr. Gifford read a valuable paper on "Some Unusual Effects of Iodide of Potassium." "I have seen a few cases of rare forms of disturbance, three presenting a phlyctenular eruption of the conjunctiva, two so severe and painful as to require cessation of the iodide. In one vitreous was full of opacities, the fundus not seen. V was fingers at six feet. He was started on 50 grains of the iodide three times a day, to be increased by 5 drops each day. On the seventh day the right eye began to feel badly. On the tenth day, while on 100 grains at a dose, the eye became so painful that he returned. The right eye was deeply congested and much irritated; the upper two-fifths of the limbus cornae was taken up with several partly confluent, flattish pustules of a deep yellow color, the smallest, one-sixteenth of an inch in diameter, the largest one-eighth of an inch. The left eye was to all external appearance, normal. There was no eruption on any other part of the body. Cultures on the pig serum from these pustules showed colonies of the xerosis bacillus and a few of the white pus coccus. These pustules were entirely unique, never before, or since, seen by me. This pus was, without doubt, due to a secondary invasion of the initial lesions produced by the iodide. All the inflammatory symptoms subsided quickly on cessation of the drug, not recurring upon a more cautious use of it.

Another case in a man who had an obstinate irritation in a central corneal scar, showed a small abscess in this scar after a moderate dose of the iodide. The abscess broke through on the inner surface of the cornea. Westhoff reports a case of purulent iritis brought on by a moderate dose of the iodides. Halopeau reports a case of pemphigus followed by condylomata and depressed scars. A serpent ulcer also developed with perforation and staphyloma. He also reports another case of phlyctenular ulcers of the cornea. Bouzitat reports a case of corneal ulceration due to the use of 60 grains of the iodide a day. One eye was entirely lost and the other injured. Kleinberger reports a case of death from 3.5 grams of iodide taken in three days. Peritonitis and death supervened. Since this man took 5 grains of calomel after the iodide, the sequence was made obscure. Groenow reports nine cases of edema of the larynx from the iodide in doses of from 3 to 200 grains. None was fatal.

I have myself seen but one case of decided mental symptoms from the use of the iodide. A child of 4 developed delirium after 25 grains three times a day. I also wish to report one case only of a man of 56 who suffered violent pain in the ball of each foot while on 35 grains of iodide three times a day. Cessation of the pain took place with cessation of the drug, but recurrence took place in greater degree with each fresh at

tempt to use the drug again.

Ricord reported iodic purpura as early as 1847. Fournier reported three cases of this affection on the legs following the use of the iodides. I have seen two cases of this affection. The first was a young woman of 18, with no suspicion of syphilis. There was a beginning atrophy of the left optic nerve. Two or three hours after having taken 30 grains twice, she noticed the reddish spots on the legs. I found petechiae from the size of a pin head to a quarter of an inch. There was neither itching nor pain; the spots were not elevated. Upon continuance of the iodide in the same dose, the spots disappeared, but reappeared when a larger dose was used. Another patient, a girl of 14, another blonde, with a fresh chorio-retinitis of the right eye, twice had a purpura of the skin of the legs while taking 40 grains of the iodide. A few spots showed above the knees. They were not painful, but itched when she perspired freely. These cases were very different from the case reported by McKenzie in 1878 of a babe of five months, who took a single dose of 23 grains and developed at once purpleness of the face with swelling and closure of the lids. Death took place in 68 hours.

In the discussion of the paper of Dr. Gifford, an apparent criticism was made of the size of the dosage reported by him. One speaker reported his uniform success in gradual increase of one grain a day. In answer, Dr. Gifford said that it must not be forgotten that he had been dealing with patients who seemed to be going blind, and it was necessary to use all the iodide which could be safely given and at once. He said that it was very rarely found that the iodides do not agree and are well tolerated. He has found that it is preferable to give the same daily dose in ten divisions rather than in three, as he formerly did. He called attention to the error in the use of the word iodism; the proper word is iodidism.

BUCHANAN COUNTY (MO.) MEDICAL SOCIETY.

W. T. ELAM, President

J. B. REYNOLDS, Vice-President

C. W. FASSETT, Secretary
J. J. BANSBACH, Treasurer.

P. I. LEONARD, official reporter.

Regular meeting, December 2, 1904. The president, Dr. W. T. Elam, in the chair. Minutes of last meeting read and approved. Drs. C. C. Gleaves and C. A. Good were duly elected to membership.

Committee on Banquet reported that arrangements had been made at Hotel Metropole for the evening of December 27, at two dollars per plate. Bill allowed for printing and postage $3.75.

A communication was then read from Mr. Sullivan, secretary of the Retail Merchants Association, asking the co-operation of the society in securing and maintaining legislation for protection against those who do not pay their honest debts. A motion to lay it upon the table was lost. Drs. Leonard and Woodson spoke in favor of receiving the comunication and giving it due consideration. Upon motion of Dr. Leonard the communication was received and the secretary instructed to communicate with the merchants association, expressing the sympathy and indorsement of our society.

The application of Dr. B. W. Toothaker for membership was read and referred to the censors.

The secretary's report for the year was then read, and upon motion was received and ordered spread upon the minutes.

The report of the treasurer showed a balance on hand of $72.39.

The society then proceeded to the selection of officers for the ensuing year. Drs. Deffen bagh and Spencer were appointed tellers. The election was hy ballot, and resulted as follows: President, P. I. Leonard; First Vice-President, A. L. Gray; Second Vice-President, J. F. Owens; Secretary, Chas. Wood Fassett; Treasurer, A. B. McGlothlin; Censor, three years. J. W. Heddens.

Upon motion of Dr. Woodson, a committee was appointed to audit the books of the secretary and treasurer. The chair appointed Drs. Deffenbaugh, Kenney and Spencer.

Dr. Wallace, who was to have presented a paper, was absent from the city. Dr. Lee opened the discussion on Epidemics and presented a number of specimens of cultures.

Dr. O. B. Campbell reported an interesting case of brain tumor, presumably resulting from mastoid disease. Operation was not undertaken and the patient died the third day. Discussed by Drs. Leonard, Dandurant, Deffenbaugh, Geiger, Woodson and McGlothlan. This case will be reported in full in this journal.

Upon motion, Dr. L. A. Todd was selected to open the subject for discussion at the next meeting: "Brain Lesions resulting from Acute Otitis Media."

Upon motion, the installation of officers and president's address were deferred until the next meeting. CHAS. WOOD FASSETT, Secretary. SECRETARY.

Adjourned.

REPORT OF

Mr. President and Gentlemen of the Society:

I have the honor to offer you the second annual report of the secretary of the Buchanan County Medical Society, during the period beginning January 6, 1904.

Including the present meeting the society has held sixteen regular sessions during the year, with an average attendance of fourteen members. At these meetings there has been presented a total of thirty-six papers, exclusive of the various topics which have been presented from time to time for discussion.

No meetings were held during the summer, from June 1 to September 2. At only one meeting, that of January 20th, did we fail to have a quorum present, and the meeting of May 18 was omitted on account of the State society in session on that date at St. Louis.

Two very interesting symposiums were presented during the year, that on Syphilis. March 16, and on Pneumonia, May 4, bcth of which elicited much interesting and profitable discussion.

Twice during the year has the society departed from the beaten path of science, the first occasion being a business meeting on the evening of April 6, at which time various phases of the doctor's business life were presented and discussed. On the evening of June 1st, at the Commercial Club, was held a fraternal smoker, at which several interesting papers were read, and the proceedings of the State society were discussed.