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sule by sutures securing it to the muscles exposed in the incision, must necessarily cause attachment of the kidney too low down.
The author believes his method* of inserting the sutures and bringing them out and tying them on the surface at the upper angle of the incision is the best way of securing the kidney in its normal position. He reports 184 consecutive nephropexies by this method without mortality and without a failure to secure permanent fixation with subsequent relief of symptoms.—Abstract of a paper read at the second annual meeting of the American Urological Association at Atlantic City, June 9th, 1904.
Large Tumor of Frontal Lobe.- Philip King Brown, San Francisco, and W. W. Keen, Philadelphia (Journal A. M. A., March 11th), report a case of an immense tumor (angiosarcoma) of the frontal lobe. The symptoms were insidious, there was very little pain, but some mental impairment and later blindness. There was also disturbance of the olfactory sense, exophthalmog and other symptoms indicating localization. The operation involved a removal of bone for a circumference of 37 cm. in the left frontal region. The tumor extended back to the limits of
. the incision; it had eroded the posterior wall of the frontal sinus, the orbital plate and the two plates of the frontal bone, as far back as the posterior limit of the frontal. Notwithstanding the pressure on the nerves of the eye and its muscles and on the eye itself, a single dose of five grains of phenacetin controlled the only pain of any note from first to last.
The Limitations of the Value of Nitro-Glycerin as a Therapeutic Agent.-H. P. Loomis has tested the effect of this drug on arterial pressure in patients by means of the sphygmomanometer, and also in animals, and finds that high arterial pressure in man is not perceptibly affected by it nor is dilatation of the blood vessels apparent. Some of the conclusions reached are as follows: The usual dose of nitroglycerin of 1-100 grain is too small to produce any effect in pathological conditions; 1-50 grain is a minimum dose. It is a perfectly safe drug to use. Even in large and repeated doses the author has never seen any ill effects. Its effects are very transient, as shown by the experiments on the dogs, and the ordinary dose of 1-100 grain every four hours could not possibly have any effect on the arteries. Nitroglycerin is said to increase the quantity of urine in chronic Bright's disease, but after keeping accurate records of the daily amount of urine passed, the author was never able to satisfy himself that any increase seen was due to this drug. In conditions due to arterial spasms, so-called, such as angina pectoris, migraine, asthma.
nitroglycerin may be of benefit, in full doses often repeated, but not in arterial sclerosis where the arteries themselves are more or less changed.—Medical Record, March 18th, 1905.
Manuel Garcia : Teacher, Discoverer and Man.-J. E. Newcomb pays a graceful tribute to Manuel Garcia, the inventor of the laryngoscope, who celebrated the hundredth anniversary of his birth on March 17th. Descended from a Spanish family remarkable for its artistic achievements, Garcia reached eminence as a master of singing, and for his studies on the nature of the voice. In the course of these he hit upon the principle of the laryngoscopic mirror, and in 1855 presented to the Royal Society of London the memorable paper entitled Observations on the Human Voice," in which his method was described. At first the importance of the discovery was not realized, but through the efforts of Czermak and Turck the value of Garcia's work was made manifest and the modern science of laryngology rendered possible.—Medical Record, March 25th, 1905.
Radiotherapy and Surgery, with a plea for Preoperative Radiations.-W.J. Morton says that in the treatment of carcinoma the best interests of the patient demand a combination of X-ray and surgery. The new growth must be removed, but the cutting out process carries with it another most dangerous feature, and that is incision of infected lymphatics, and the risk of leaving behind some of the neoplastic cells. On the other hand, radiation will not remove the tumor, but it will clear up of cancer cells all the outlying territory up to the tumor itself, and so render the operation a comparatively safe one. The plan followed by the author is as follows: Practice X and radium radiations thoroughly, say six weeks to two months, before operation; and practice it as well after operation, say for about the same period of time. In this manner we avoid the Scvlla of " soiling the wound,” and the Charybdis of failure to remove the tumor. The radiation should not be carried to the point of producing destruction of tissue, but should just barely give rise to a mild dermatitis. This preoperative radiation does not interfere with wound healing or favor the occurrence of gangrene.: A number of illustrative cases are cited and figured, and the author's general conclusions are summed up as follows: (1) Radiation treatment
1 exerts a retarding effect upon the growth of some cancers; (2) it cures some cases- -the ratio to operative measures is not here discussed; (3) Preoperative radiation will increase the ratio of cures by operation; (4) preoperative radiation transforms some inoperable cases into operable cases; (5) preoperative radiation is recommended as a precautionary measure, probably quite as important as preoperative antiseptic preparation for surgical operation.—Medical Rocord, March 25th, 1905.
Proceedings of Societies.
FIFTH ANNUAL MEETING OF THE CANADIAN ASSOCI
ATION FOR THE PREVENTION OF CONSUMPTION.
The fifth annual meeting of the Canadian Association for the Prevention of Consumption and Other Forms of Tuberculosis, held in Ottawa on March 13th, was both interesting and successful. There were representative men from Montreal, Kingston, Toronto, Ilamilton and London, beside many from the immediately surrounding country. The North-West Territories were represented by Dr. J. D. Lafferty and the Maritime Provinces by the lIon. F. A. Laurence, M.P.
The Ilon. Senator Edwards took the chair promptly, and opened the proceedings with a brief but appropriate address. In substance he said:
“The business this afternoon, as I understand it, as that of the ordinary annual business meeting, the reception of the report of the Executive Council, and the election of officers. It is gratifying to me, and must be gratifying to all those connected with and interested in the work of the Association, to see such an attendance here this afternoon. It exceeds greatly all my expectations. It shows plainly the interest being taken in our work.
“At one time it was thought unwise to attempt to gather a large meeting this year, but the march of events has created a juncture which, in my judgment, justifies the large and influential meeting gathered on the present occasion.
“In accordance with a previous understanding, Mr. Geo. H. Perley in the IIouse of Commons moved a resolution which led to a very full and satisfactory discussion. The resolution was simply that the time had come when Parliament should take active steps to check the progress of consumption. Practically the same resolution will come up in the Senate whenever we have a reasonably full attendance of the doctors who are members of that body, which I hope will be in a few days. With these remarks, I now declare this meeting open for the transaction of business.”
The report of the Executive Council having been called for, was presented and read by the Secretary. It set out the gracious acceptance of the office of Honorary President by His Excellency, the Governor-General, Earl Grey; that an influential deputation had waited upon the Premier, the Rt. Hon. Sir Wilfrid Laurier, and had laid before him the views of the Association respecting the needs of the country with reference to the devastations wrought by the various forms of tuberculosis. The Premier expressed his sympathy with the object of the deputation, said the ravages of consumption were certainly alarming, and that everyone must feel that something ought to be done promptly. Certain difficulties had been referred to by members of the deputation; that such existed could not be denied; still, he would faithfully report the representations of the deputation to his colleagues for their consideration; and that on the occasion of the visit to Ottawå of the Hon. Premier Haultain, of the NorthWest Territories, a deputation had waited on him and solicited his co-operation. He assured the deputation of his warm interest in the work of the Association, and his readiness to assist in every way in promoting its objects.
Petitions to County Councils.—In appendix No. 6, pp. 51, 52, of the Transactions of last year, section 4 of the report of the Committee on the Relation of the Governments to the Crusade against Consumption in man and the domestic animals, reads as follows:
“To this end, the Executive be instructed to prepare a memorial setting forth the necessity and urgency of the immediate establishment of at least one large sanatorium in each province, and that it is the duty and obligation of the Federal Government to provide assistance for the erection and maintenance of these institutions, as they are a necessity and in the interests of the whole people, and that the Executive forward a copy of this memorial to the municipal body in each province most directly representative of the people, and in provinces where such municipal bodies do not exist, then to the Provincial Assemblies, and endeavor to secure their co-operation and support of our petition, and when secured that the Executive of this Council then make application to the Federal Government to provide such assistance for the erection and maintenance of such institutions.”
A sub-committee was appointed by the Executive Council, Dr. Bryce, convener, by which these instructions were carried out. Petitions were prepared and printed in both English and French. Either directly from the office of the Secretary, or through the members of the committee resident in Manitoba, North-West Territories and British Columbia, the documents were distributed so as to reach the County Councils, the Provincial Boards of Health, the members of the Provincial Assemblies, and the Medical Health Officers in every part of the country.
In response, replies containing assurances of co-operation have been received from widely separated points in the Dominion. They are still coming in, and many more are expected. As a sample of what is being done in this way, we report that, to this date, twenty-four petitions addressed to His Excellency, the Governor-General in Council, have come from British Columbia. In fact, there is but one mind and one voice in that province regarding the matter.
Affiliations.—The British Columbia Association for the Prevention and Treatment of Consumption and Other Forms of Tuberculosis, and the Colchester Association for the Prevention of Tuberculosis, have been recognized as in affiliation with the Canadian Association for the Prevention of Tuberculosis.
Lectures. During the year, the Secretary has, on invitation, lectured on the “ Cause and Prevention of Consumption," in fourteen places in Eastern Ontario, eleven places in Prince Edward Island, nine places in Nova Scotia, and two, St. John and Moncton, in New Brunswick. The Secretary has also been permitted to address the quarterly meeting of the Lanark County Public School Teachers' Association, and the Eastern Ontario Dairymen's Association at the annual meeting in Brockville.
Distribution. In the last year not less than 785,000 pages, setting out "How to Prevent the Spread of Consumption," have been put into circulation, making in all nearly one and a half million pages distributed by the Association.
Parliamentary Action.—The work has probably received its greatest impetus this year through the presentation of the following resolution to the House of Commons: “ That in the opinion of this House the time has arrived when Parliament should take active steps to lessen the widespread suffering and the great mortality among the people of Canada caused by the various forms of tuberculosis." This resolution was brought into the House by the member for Argenteuil, Mr. G. H. Perley. One to the same effect will be brought into the Senate by our President, the Hon. Senator Edwards, at an early date. Thus far the resolution has been received with such general favor that there is room for hope that sooner than could have been antici: pated at our last annual meeting, something effectual may be done to stay the ravages of this plague. In these circumstances, the Executive Council think that the Association has abunda at reason to feel encouraged in its effort to inform the people and to secure the adoption of measures of relief.
The resolution of Sir James A. Grant, M.D., regarding the medical inspection of schools, both public and private, had been sent to the Ministers of Education in all the provinces.
The Treasurer's report showed the state of the finances to