that when 10 o'clock on the following morning was suggested for the next meeting, Dr. Carr prophesied that the patient would not live that long and I shared in his opinion. On the following morning the temperature was 101° F. with a pulse of 106. The pain in the abdomen had lessened and the patient had lost the anxious expression. She felt comfortable and was disposed to eat. At noon on the seventh day the temperature again rose to 103 F., where it remained until 5 P. M., falling to 101 at 9. At 1 P. M. on the eighth day it was 103° F., falling soon after to 100°. From that time it continued, remittently, at a mean of about 101 F., falling at 3 A. M. on the tenth day to 99° F., and then rising continuously, till at midnight it had reached 104°. It then assumed a remittent type with a mean of about 101° F. till the fifth day, when it fell to normal with a pulse of 80. The inunctions, which had been kept up to this time at intervals of four hours, were discontinued. The temperature again began to rise till five days later it was 102° F. with a pulse of 116. Inunctions were again begun every four hours and the temperature fell reaching normal two days later, where it remained. Three ounces of silver ointment were used in this case.

Particularly striking in this case was the rapid relief of symp. toms after the use of the ointment. In twenty-four hours after its employment the pelvic pain had disappeared, the tongue had begun to moisten, the diarrhea had ceased, appetite had returned and despondency had given place to an expression of comfort. This is the usual reaction to the silver as has been pointed out by Crede.

UROGENITAL COLIBACILLOSIS.

In an article entitled "Two Cases of Urogenital Colibacillosis" (from the University Clinic for Skin and Venereal Diseases at Berlin, Professor Jadassohn, Director; Deutsche Medicinische Wochenschrift, April 11th, 1901), Dr. Wilhelm Karo reports a case in a man of 65, who had had dysuria and cloudy urine for a year. Eight days before the time of examination, and without ascertainable cause, he developed a sudden swelling of the left testicle, with much pain and fever. The urine was cloudy, but

otherwise normal; and the cloudiness was not removable by filtration, sedimentation, or acids. The cloudiness was found to be dependent upon the presence of the bacterium coli communis; and expression of the seminal vesicles showed them to contain almost pure cultures of that organism.

The fluctuating scrotal tumor was punctured, and a thin, greenish pus containing only the bacterium coli evacuated. Under Urotropin administered in 0.5 gram (7 grains) doses three times a day, the dysuria gradually disappeared and the secretion cleared up. With iodin vasogen and the thermophor the sensibility of the scrotal tumor was entirely relieved.

Nine days later the patient had a sudden chill, became cyanotic, with respirations 45 per minute, pulse small, 120, temperature 40.7° C. (105.3° F.), and singultus. Another abscess appeared at the lower pole of the testicle; this was opened. Nevertheless his condition became steadily worse, so that the testicle had to be removed that night.

He recovered slowly, though steadily. In three weeks cicatrization was complete, and the patient's strength had increased pari passu. The Urotropin had been continued steadily, the urine was clear, and contained no bacteria; there was no dysuria. The cure was permanent.

He was a

The second case was of a more chronic nature. man of 27, who had had gonorrhea several times, the last attack of which resisted all manner of treatment. Four days before Karo saw him he had taken two teaspoonfuls of ordinary gunpowder. There was an immediate violent diarrhea, followed by swelling of the right testicle with fever and pain. The urethral discharge contained no gonococci; but the urine was cloudy and contained an abundance of bacterium coli. They were also found in pure culture in the secretion of prostate and the seminal vesicles.

In a few days a fluctuating tumor formed at the lower end of the affected testicle; evacuation thereof gave a sero-sanguineous fluid with abundant bacteria of the same kind. The fever and the pain then ceased, and the enteritis was controlled by calomel and rhubarb. In the course of a short time the urine cleared up under the daily administration of 1.5 grams (221⁄2 grains) of Urotropin, and the bacteria disappeared entirely.

Selections.

PATHOLOGICAL DREAMING.-Students of psychiatry have long recognized the similarity which dreams bear to the delusions of the insane. The subject is a deep one-not easy to grasp or illumine. It is somewhat subliminal, and only too likely to excite the scoffs of the uninformed. And yet, although this subject pertains to dreams, it is a very real one. Dreams may not only have a pathological significance-they may be pathogenic. Here is the important point. Dreams may constitute a fruitful nightsoil out of which may grow a crop of poisonous weeds. This is true of the neurasthenic, the hysteric and the insane. The French (Gilles de la Tourette, Janet and others) have shown that in hysteria there is a form of reverie or delirium (which is practically the same as dreaming) in which the patient seems to herself to lead such a vivid and real existence that thenceforth the contents of the dream are an actuality to her. morbid state arise questions of medico-legal importance. The false witness sometimes borne by hysterical patients comes from this sort of mental perversion. Character has been jeopardised by it. This has been called "pathological lying," or, as it was named by Delbruck, pseudologia phantastica. This term is not intended as a mere euphemism for calling a person a liar. It describes, on the contrary, a genuine psychiatrical fact.

From this

We are reminded of this subject by an interesting paper by Prof. Pick, of Prague, a translation of which appears in the July number of the Journal of Mental Science. Pick deals with a rather different phase of the subject-one which is more nearly related to day-dreaming. It is odd that no one has yet, so far as we know, completely explored the psychiatrical architecture of castles in the air. Prof. Pick has taken a class of patients who are evidently neurasthenic rather than hysterical, and whose psychiatrical life is curiously dominated by a succession of dreampictures. The patients, while fully conscious of the unreality of

these reveries (in which respect they differ from patients with delusions), yet react in various ways to them, even to the extent of talking aloud and gesticulating, and are in various ways incapacitated by them. Hence these day dreams, or reveries, are distinctly pathological; in fact, their pathological character was recognized by the patients themselves, who sought medical advice. These dreams have sometimes, although by no means always, an erotic tinge, even associated with onanism. This is the "auto-erotism" of Havelock Ellis. Prof. Pick describes his cases in detail, giving interesting autobiographical notes. It is a characteristic Teutonic paper-minute, exact and instructive.Philadelphia Medical Journal.

REORGANIZATION OF THE AMERICAN MEDICAL PROFESSION. -The plan of the Committee for the federation and interdependence of the National, State and County societies is an excellent one, Membership in the county society becomes a prerequisite to membership in the other organizations. The county organization thus becomes an unit of the state association, and the state of the National body. Each is thereby strengthened and made more powerful, each becomes more cohesive and each develops into an effective, offensive or defensive organization which will command respect and consideration because it represents an organized power which is able to reward or punish, both its friends and its enemies. The medical profession in America is large in numbers but it lacks stability and cohesiveness when called upon to protect its interests against agencies that are detrimental to its welfare. In this it, in no small manner, is similar to that Asiatic nation, the so-called celestial kingdom, which is great in numbers but whose slight stability and cohesive power renders it an easy victim to its enemies.

Reorganization of the medical profession in America is a necessity. This must begin in the county society which is to form the basic part upon which the entire fabric of an organized profession must rest. Upon these is to be built the state organi zation, and from the State societies must come the chosen few who are to wear the senatorial togas in the parliamentary body of the American Medical Association, the body that is to formu

late the policy of the profession on matters of vital interests, the body that is to aid destiny to shape our ends to a satisfactory conclusion, rough hewn though they be, the recommended House of Delegates of the American Medical Association.

As recommended by the Committee, regional, tri-state and district societies, save in a few instances, should be abolished. These, as at present constituted, serve but a slight purpose for good, while on the other hand they weaken and detract from the county and state societies that as federated units are essential to the integrity of the National Association. They are parasitic growths on the medical body politic which sap the life strength of the National organization, and as such should be lopped off and allowed to perish. Let their friends and promotors devote their energies to the upbuilding of their respective state and county societies where their efforts will add to the strength of the profession as a body, and where they will hasten and not hinder the consummation of professional unity.

In the trinity of National, state and county organizations, a federated union, in which each is developed to its greatest possibilities, will the profession find a power, that, like faith, can move mountains.-Courier of Medicine, July.

[We most fully and heartily endorse the above views. It is along these lines that we may expect a strong, united and effective profession.-ED. S. P.]

LEUCORRHEA-ITS CAUSES AND TREATMENT.-There is perhaps, no single condition so distressing to the patient or so exasperating to her medical attendant as leucorrhoea. Except in a few instances, such as specific and septic infections, leucorrhea is almost always secondary.

Speaking broadly, the discharge can have its origin in one or three places: (1) the vagina, (2) the cervix, and (3) the endometrium of the body of the uterus.

The discharges vary greatly in character, depending upon their point of origin.

Vaginal lecorrhea is, always excepting gonorrheal discharge, thin and serous, rarely thick, and still more rarely streaked with blood.