and if wily logic could accomplish such results, the authors certainly had the field to themselves.

While there is little discrepancy in the minds of practitioners generally in regard to the character of the disease under consideration, the question of its essential nature is yet a matter to be determined. This can only be done by accurate etiological and pathological investigation, and the rarity of fatal terminations renders the latter difficult. In the meantime we meet with this class of fevers, probably dual in etiology, prevailing largely in this climate, that run a continued,. grave, typhoid course, but almost always terminating favorably, and that cannot be classed as either remittent or typhoid. Whether this is the Chickahominy fever of Dr. Woodward, we doubt, yet it may be, with the additional factors incident to swamp surroundings and the physical condition of the soldiery under his care. However this may be, the name proved suggestive and acceptable to the South profession, and has been, either as a matter of convenience or necessity —as you like—generally adopted.

No doubt many cases of typhoid fever are completely masked at the onset by the high, remittent temperature range, and upon thorough quininization the true type of disease is disclosed. This high temperature and remittent character at the onset is malarial in origin, and only shows itself in malarial countries. Much error has probably come from denominating such cases typho-malarial, when in reality they were from the commencement typhoid. Such an error was undoubtedly fallen into by Dr. Bemiss in his classical paper on malarial fevers, published in Pepper's System of Medicine. When considering typho-malarial fever, he gave the history of a case that occurred in Charity Hospital as such, when in reality it presented all of the characteristics of pure typhoid fever. If we were to take this as our guide, we would certainly be at a loss in differentiation. The idea that two diseases cannot take possession of and progress in the same system at the same time, is a dogma sustained only by the action of two specific maladies in this relationship, and not then with any great certainty. Such teachings will not hold good with malaria, a well-known characteristic of which is its love for affiliation.

No one who has had a large experience in malarious districts could have failed to note the ease with which these fevers ingraft into every condition, no matter what its origin or whither its tendency. The great antiperiodic, anti-malarial remedy must be given sooner or later in every ailment in these districts.

As we can say but little in regard to the pathological histology of typho-malarial fever, from the fact that it rarely proves fatal, let us contrast its symptoms with those of typhoid fever:

Typho-Malarial Ferer. No prodromes, but usually preceded by evidences of chronie malarial toxæmia, either latent-save in the form of blood changes, hepatic and splenic enlargements, etc.or by well-developed intermittents.

Onset marked by a distinct chill.

The fever often reaches its highest point on first or second day; sometimes intermittent, usually markedly remittent, the oscillations gradually growing less distinct as the fever continues.

Countenance bright and expressive of cheerfulness and hope; cheeks florid, even in the presence of diminished quantity of red corpuscles.

Tongue, at first white fur, then red, flabby, often glazed; as a rule does not indicate serious pathological change; sordes rare.

Pain in head of neuralgic character, and present, if at all, only during early stage of the fever.

Typhoid Fever.

Prodromic stage well-marked, by malaise, headache, disordered digestion, vertigo, disturbed sleep, mental depression,and great muscular weak

ness.

Chilliness accompanies the prodromes, and usually ushers in the febrile stage.

The fever gradually ascends, with a remittent wave, reaching its acme on the evening of fifth or sixth day.

Countenance dull, and expression indifferent,soon passing to drowsiness and stupor.

Tongue early becomes mar ked by a dry brown streak through center; later, generally dry, brown and cracked: sordes the rule in place of the exception.

Headache early, dull and severe, followed by drowsiness, stupor and coma.

Typho-Malarial Fever. Abdomen normal, as a rule.

Movements of bowels but little disturbed.

Eruption rare, and not characteristic when observed.

Rarely fatal.

No specific treatment; quinine useless as an antiperiodic. Pathology obscure,save that referable to malarial toxæmia.

Etiology, mooted.

Typhoid Fever.

Abdomen distended and tympanitic, with gurgling in right iliac fossi.

The constant lesions of Peyer's patches give rise to diarrhoea as one of the most uniform of all of the symptoms of typhoid fever. "The stools are at first dark, but early in the first week they become fluid, offensive, ochre-yellow, resembling pea soup,' and may be streaked with blood. They number from three to fifteen in the twenty-four hours."

Eruption almost constant, and well marked, consisting of fifteen or twenty small rosecolored spots on abdomen, chest and back.

A grave form of disease, from ten to thirty-five per cent. terminating fatally.

No specific treatment; quinine useless as an antiperiodic.

Pathology well understood, and consists in certain characteristic lesions of the Peyerian patches and solitary glands. Mesenteric glands and spleen enlarge and soften.

A special typhoid germ, resulting from the decomposi-. tion of typhoid stools, and many times radiating from a central point where one case has contaminated the water, and assuming epidemic proportions.

NOTICE OF REMOVAL.-Dr. T. Gaillard Thomas has removed from 294 Fifth avenue, New York, to 600 Madison avenue, between 57th and 58th streets.

STATE MEDICAL SOCIETY OF TENNESSEE.-We had hoped to give the proceedings of the State Society in full, but find our space so limited as to render it impossible. We will therefore be compelled to content ourselves with publishing the resolutions adopted and the list of officers elected.

The following was introduced by Dr. A. P. Warterfield of Union City:

WHEREAS, The use of alcoholic liquors as a beverage, and the too frequent indiscriminate prescription of them by the medical profession, leads to very great harm to the physical constitution, the mental and moral worth of the Commonwealth, and to unspeakable injury to the happiness of our common community, therefore be it

Resolved by the Tennessee State Medical Society, That we adopt the following extract of a paper from the transactions of the International Medical Congress at Philadelphia, read by Ezra M. Hunt, A.M., M.D, viz: "That if to-day no physician would advise any patient to the use of alcoholic drink, but would restrict it within the close limits of his particular prescription, the limitation would be in harmony with the present demands of therapeutic knowledge. It is not merely that the morals of society would get a glorious health lift, but the act would knock away the false prop which now upholds so many in the use of alcohol and relieve us of being accessory to the perverted habits of multitudes. If men and women will call it good because they like it, they must cease to quote the medical profession as authority until there is proof that it has some ascertained value as such. If they wish to use it under the plea of medicine and make self-prescription for their own gratification they must not do it by our sanction. The facts as to food dismiss it as such. The facts as to medicine confine it within boundaries so narrow that we must, in fealty to real science and right practice, hold it closely within its limits. Wandering beyond these it must in no wise identify us with its vagaries. Because it finds a place in our therapeutics it behooves the medical profession to locate and define it"; therefore, be it

Resolved, That alcohol is not shown to have a definite food. value by any of the usual methods of chemical analysis or physical investigation; that its use as a medicine is chiefly that of a cordial stimulant, and often admits of substitution; that as a medicine it is not well fitted for self-prescription by the laity, and the medical profession is not accountable for such administration or for the enormous evils arising there

from; that the purity of alcoholic liquors is in general not as well assured as that of articles of medicine should be. The various mixtures when used as medicine should have definite and known composition, and should not be interchanged promiscuously.

Dr. T. J. Happel of Trenton, offered for adoption the following resolution, passed recently by the Gibson County Medical Society:

Resolved, That the Medical Society of the State of Tennessee renew its efforts to secure the adoption by the next Legislature of measures to regulate the practice of medicine and surgery in the State of Tennessee, and to this end, be it further

Resolved, That a committee of five be appointed by this Society to memorialize the Legislature to that effect, and to use their influence where it will do most good to secure the enactment of some good law to accomplish the desired end.

The following committee was appointed in accordance with the above resolution: Drs. F. L. Sim, A. P. Warterfield, N. D. Richardson, Thomas Menees and T. J. Happel.

By Dr. D. D. Saunders of Memphis :

Resolved, That the Medical Society of the State of Tennessee indorse the effort now being made in the Congress of the United States to have a commission appointed to investigate and report on the experiments now being made in inoculation for the prevention of yellow fever. It is regarded as a scientific step in the right direction, and our representatives are requested to support the measure.

By Dr. T. K. Powell of Dancyville:

Believing that the actions of the committee appointed at the meeting of the American Medical Association, held at New Orleans, to act in conjunction with a previous committee appointed by said Association, at the meeting held in Washington City in 1884, for the purpose of inviting the International Medical Congress to hold its next meeting in America, year 1887. and to make arrangements for said meeting, have been prudent, dignified and impartial,

Resolved, That we, the members of the Medical Society of the State of Tennessee, heartily approve the actions of said committee and hereby request all delegates sent by this Society to the American Medical Association at its next meeting, to be held in St. Louis, to sustain said Association in its efforts to make the anticipated meeting of the International Congress

a success.