in the case of calculous anuria and can be carried out in a very short time.

The

DR. L. J. LADINSKI said that he had had two cases of calculous anuria, in one of which the calculus was triangular in shape, and clogged the mouth of the ureter and disturbed the passage of urine. patient was being observed by several physicians, but just the fact Dr. Keyes brought out was noticeable-that no attention was paid to the kidneys. The calculus was wedged above the ureter and caused obstruction to the flow of urine, and then the pelvis of the kidney dilated and allowed the urine to pass, but no attention was paid to this until the patient had an acute attack of uremia. The speaker saw him during the attack, and after waiting twenty-four hours the patient consented to an operation. He died, and the post mortem examination showed that the other kidney was in bad condition. The second patient had an enlarged pelvis of the kidney. After incision he passed a calculus through the urethra.

DR. KEYES closed the discussion. He said that he had never employed the anterior incision in nephrotomy. He believed that it had been made use of very largely a few years ago, but he thought the general idea of most operations of this kind was to see the kidney, as well as to feel it. The posterior cut impressed him as being more convenient. He agreed with the speaker as to the anterior route in nephrectomy. In the first place, when the kidney has been suppurating for a long time it is just as well to attack it from in front and clean it out that way. Regarding Dr. Kohn's contention as to the infectiousness of these cases, he had never seen but one such case, and certainly the conditions there did not mean hyperinfection. He inferred that one might encounter infection of the ureter or of the

pelvis of the kidney and gangrene, just as in the appendix. He believed, though, that this condition has not been found in this type of cases. There may be some mild colon infection of the kidney first infected, and often the opposite kidney is incapable of taking up the work thrown upon it, for the reason of infection, but he could find no pathologic ground for claiming that such a kidney is hyperinfected.

Regarding the employment of X-ray,

he said that every patient suspected of having a stone in the kidney is sent to have X-ray pictures taken, and about half of the plates are reported as "not satisfactory." The photographer always wants to take another picture, and the patient complains that the expense is too great. In one case he knew of a picture being taken of a man who came in from Tuxedo who had a pain in his left side. Stone in the kidney was suspected. He brought back a beautiful X-ray picture, showing a stone in the right kidney. He had pus in the kidney, and everything that would indicate this condition. The speaker's impression was that both kidneys should be operated on, as here was a man with a pain in the left side and an X-ray picture of a stone in the right kidney, and he, the speaker had always found the pain in the side that contained the stone. He believed very strongly in X-rays, and thought they would be very useful when they proved infallible, but that day has not yet arrived.

A Father's Love for His Daughter.

"The love of a father for his daughter is, I think, the very purest love that earth can know, the love that comes the nearest to what we all imagine the divine love to be. The love of a husband for his wife, when it endures the storm and stress which mark the period of mutual adaptation, is wonderfully beautiful; yet it had its birth. in passion, and the memories of its early years remain to keep it very human. The love that is given to a father or a mother is strong and deep and lasting; yet it lacks the exaltation and supreme emotion which are necessary to the love that has no flaw. The love of a father for his son is intense and overmastering; yet there is a touch of personal pride, of almost conscious egoism, in it, which renders it not wholly selfless and serene. But the love of a father for the girl child who has been born to him is more than any other love on earth, in its purity, its unalterable constancy, its power of self-sacrifice, its profound delight, and its infinite tenderness." -H. T. PECK in the February Cosmopolitan.

ANTIPHLOGISTINE, calomel, codeine and strychnine are the principal remedies for pneumonia.-Med. Summary.

The Cincinnati Lancet-Clinic

A Weekly Journal of Medicine and Surgery.

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Over and over again within the past twenty-five years the writer has felt called upon in pursuing the functions of a journalist to direct attention to a know-nothing spirit of exclusiveness which has pertained in the city of Cincinnati during the past half century. It is just about fifty years since the riots of the American party took place in the streets of Cincinnati and elsewhere. Those riots did incalculable injury to the city in every particular, and hastened to stop its growth and remained as an incubus throttling the municipality for just fifty years. It is not half a decade since the various boards in the city government were petitioned on the part of working men and labor unions. to employ only home-grown labor. The shell is cracked beyond repair. The city is bursting forth through all such bonds, and now may be witnessed a condition which is quite the opposite to that which has heretofore pertained. New capital in unlimited quantity has poured into the city, new and gigantic improvements were planned, and are now being carried into effect. More than fifty millions of dollars, as stated by a contemporary newspaper,

are to be expended within the precincts of the city of Cincinnati during the present season. It is possible that twice this great sum of money will be expended for material and labor alone in a construction of new enterprises, including buildings of every character.

As an indication of the rapid growth taking place, the Cincinnati traction lines report an unexpected increase in the ratio of passengers carried in the year 1902 over the previous year. The papers, without exception, are constantly complaining of the inadequate facilities provided by the Traction Company, which shows an increase of cars for the accommodation of the people. The hotels, without exception, are constantly crowded, and a demand is made for a construction of more hostelries. Even the clubs, those great social organizations which are a part of the new century civilization, are crowded with applicants for membership. This is an exceptional condition, almost unparalleled.

The railway terminal facilities are So inadequate as to compel every one of the railroads entering the city to enlarge their facilities for an accommodation of freight and passenger traffic. Cincinnati was the only one great city that has not suffered more or less from a fuel famine during the winter now past. Cincinnati all the time was not only well supplied with fuel, but was able to contribute to other cities, less fortunate in this respect. The great Ohio River, bearing its numerous barges of fuel, has furnished an unfailing supply. This was supplemented. by the railroads, which made Cincinnati a manufacturing centre, able to compete successfully with any other municipality in this or any other country. These conditions are so manifest as to be taken advantage of by manufacturers from abroad, so that there is an accounting for a large improvement of factory interests to be found in the cheap fuel supply. Already the daily papers are clamoring for double.

tracks on the various roads running out from Cincinnati. Double tracks more than double the capacity of single-track railways, and this must of necessity come in vogue in the near future. The roads must meet the exigencies of the occasion, Freights and passengers must be moved, and that at a comparatively low rate. Locomotives are now constructed which have a power from two to six times as great as those which drew the cars thirty and forty years ago. These new ten and sixteen ton locomotives, or perhaps heavier, must be run over tracks which carry a weight of more than one hundred pounds to the yard of rail. What are known as one-hundred and sixty pound rails are not far off in the future. These heavy rails give celerity and smoothness to carriage, which is demanded. New capital in unlimited quantities for investment brings with it a demand for more people, more men to work, and women, too. This means an immigration such as has not been visible in this vicinity at any time in the past. This will demand a line of immigrant cars from New York, Philadelphia and Baltimore direct to Cincinnati. Cincinnati. Such trains are run into Chicago every day. There should be a diversion of this traffic in favor of Cincinnati. Chicago was the first to cultivate this class of immigrants, who came through New York as the entre pot of the nation.

The Pennsylvania Railroad and Baltimore & Ohio road should tap this traffic, and each should bring one or more immigrant cars to the city of Cincinnati every day. This would involve the appointment of an immigrant commissioner for Cincinnati. One was appointed ten years ago, but there was not at that time any immigration whatever to Cincinnati, and the powers that were in command of the city government didn't want any immigrants. A city of isolation was their ideal. They were afraid to approach or lean against the common immigrants, lest they should

be contaminated. Conditions to-day are quite different-the very reverse. Immigrants are wanted. New men to dig the cellars and build the walls of giant structures, as well as little ones. These men must be provided for when they come to Cincinnati, and it will behoove the municipal government right away to make provision for coöperation with an immigrant commissioner. Barracks must be provided for the newcomers. These will be of a temporary character, and only to accommodate the immigrant until he can obtain a future lodgment and home elsewhere. This department of the city work should be under the control of the health

department of the city. These conditions are to be contemplated and will be found realized within a year from this date. In this connection an immigrant agent should be sent to all the cities in Europe, which have a surplus of labor. This commissioner should place on sale in every railroad ticket office in Europe a supply of immigrant tickets, good for passage from the nearest seaport to New York, Philadelphia or Baltimore, and thence over an immigrant line of passenger coaches to Cincinnati. This involves the working out of an immigrant scheme which is altogether feasible, and practically it works to great advantage in Chicago, and would be just as feasible for Cincinnati. It was in this way that Chicago received such an impulse as a municipality and forged ahead of neighboring cities. Their wide-awake business men saw the possibilities and took advantage of them. This may be enforced and greatly improved upon in Cincinnati.

In a consideration of the immigrant features referred to, Newport News as an entre pot for the immediate benefit of Cincinnati is not to be overlooked in a consideration of Eastern terminals for immigrant purposes. Newport News has one of the best harbors on the Atlantic seaboard, and has superior advantages also

in freight and passenger distances. These are not so very material, because Newport News, Baltimore, Philadelphia and New York are comparatively equal in distance from Cincinnati. Already New York sends her people and freight wherever and whenever possible to Chicago for distribution. Cincinnati must be made a distributing point for immigrants and freights of equal importance with Chicago, so far as manufactures, merchandise and passenger traffic are concerned. Therefore, it is apparent that bids must be received from Philadelphia, Baltimore and Newport News for this service. This will involve, as it should, a double trackage of the C. & O. and B. & O. Roads to Cincinnati. The Pennsylvania Railroad will likely in a very near future double track its lines from Pittsburgh to Cincin nati. They are already double tracked and more from Philadelphia to Pittsburgh. The Pennsylvania Road will in the near future expend several millions of dollars in an improvent of its terminal facilities. in the vicinty of Cincinnati. The congestion of freights along the lines of roads leading into Cincinnati is at this time. unprecedented. New accommodations and new facilities providing for a new growth is a necessity which cannot be overlooked

and must be met.

SCARLET FEVER-AN INCIDENT. This disease is one of the most dreaded in the whole calendar of maladies, which is not alone because of the immediate severity of the affection, but also by reason. of the disastrous sequelæ which so frequently ensue after apparent recovery.

A highly reputable physician recently narrated the following lamentable incident: Two young men, both recent graduates of the Ohio State University, one in the employ of the Ohio State Board of Health as its sanitary and hydraulic engineer, and the other his intimate friend,

an architect, simultaneously entered a Columbus street-car and took seats. Soon one had his attention attracted to a mother and child sitting opposite. One of the young men said to the other that he believed that child had scarlet fever, remarking that he had never had the disease and would get out at the next crossing. His companion repeated that he also had never had scarlet fever, and the two left the street-car, commenting upon what they had just seen. The young men went to

their homes and each contracted scarlet fever in malignant form. The Board of Health young man, who was recently married, lived but a very few days, when he succumbed to the malignant malady. His companion and friend is at this writing very sick from the disease, with vague hopes of recovery (has since died). This all occurred within less than a month.

Perhaps there is only ignorance at fault, and perhaps some criminality. The woman. may not have known what ailed her child; that is the only charitable view to take of the case. She may have had it at a clinic, or calling upon a physician. At any rate, it is not known that she was followed up in parade of the street, nor how many others became infected through her injudicious or criminal exposure of her child. Two deaths were caused of a pair of the brightest and most talented young men in the State. To their families the loss is irreparable; to the State, to their profession and friends there seems to have been a blow struck beyond the ordinary. High ambitions were blasted. Here were a couple of young men, budding into great usefulness, and stricken down as by an enemy in the dark. What recourse? Only this: Scarlet fever is a malignant, contagious disease of preventable type. child at fault, with its mother, should have been quarantined as perfectly as possible, and the quarantine established the moment the disease was diagnosed.

The

Some epidemics and some cases of scar

let fever are apparently the most malignant of all the zymotic diseases. At other times the type of the affection is comparatively mild, but always the mildest cases are to be dreaded, as they are so frequently followed by fatal or other bad sequelæ. Every physician is more or less familiar with these characteristics, for good descriptions are to be found in every text-book on medicine. This particular incident tells whole volumes, and shows the inestimable value to the State of a strict enforcement of sanitary quarantine. The zymotic diseases without exception should be quarantined, and this should be of universal application. Whooping cough is by the public very lightly thought of, and usually a physician is not consulted for treatment. The disease is frequently fatal, and demands quarantine conditions.

In a quarantining of infectious diseases there is a world of room for an exercise of judicious discretion, and this shows where a line may be wisely drawn which will serve to designate the special qualifications of sanitary officials. Some men seem to intuitively know, while others, who are apparently just as good and far seeing, appear to be utterly unable to learn or discern what may be termed lines of demarcation.

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Recently, Congress created a cabinet. officer of commerce, to which no objection can reasonably be raised, but of equal importance is the creation of a Cabinet. Officer of Health. The time will come when statesmen will advocate this as they did an officer of commerce. The Government of the United States is a government of growth. One thing evolves into another. Twenty years ago there were corporations, but no trusts which were known as such, and they are now so multiplied as to create a demand for a cabinet officer for their special regulation. It was in just this way that there came a movement for a creation of every one of the cabinet

officers. There came a demand of the times, and it is not known how or when a demand may come for a cabinet health officer, but it will be sure to come. A control of contagious diseases would be a great boon to any government or any country, and the United States comes very near being a recognized leader among the nations of the earth.

THE CINCINNATI HOSPITAL LIBRARY. It is suspected that a majority of the physicians of Cincinnati do not know that they have a personal interest in the great collection of books stored under the roof of the Administration Building of the hospital. This is to let them know that it is theirs to use. At present the library is supposed to be used only for consultation purposes, which should not be the case, but physicians should be encouraged to take out books for reading purposes as well as for consultation. However, this is not now practical for want of a catalogue. Fifteen and more thousand bound volumes without a catalogue! A similar remissness is not likely to be found in any other city in the world. In this the Cincinnati Hospital can well claim to have a treasure that is not only invaluable, but absolutely unique, and sheltered in a location where it would not be possible to save a single volume in case of fire, of which there is a constant danger. If this is not an instance of criminal negligence it will be very difficult to find one.

EDITORIAL NOTES.

THE Ohio State Pediatric Society will hold its next annual meeting at Dayton, Ohio, June 1 and 2, 1903.

THE Medical College of Ohio will hold its Commencement Exercises on Saturday, May 2, at 3 P.M. The alumni dinner will take place at 8 P.M. of same day.