At the annual meeting of the De Witt County Medical Society, held in Clinton, April 14, 1903, addresses by invitation were made by Dr. L. Harrison Mettler on "The Differential Diagnosis and Treatment of the Cerebral Apoplexies," and by Dr. Bayard Holmes on "Gall Bladder Diseases."

In the year 1559 John Geynes, M. D., a graduate in medicine ́of the University of Oxford, was cited before the College of Physicians for impugning the infallibility of Galen. On his acknowledgment of error, and humble recantation signed with his own hand, he was received into the college.

The French government has just promulgated a new code of sanitary regulations. This code stipulates that three vaccinations. instead of one shall be obligatory. The first is to be made during. the first year of infancy, the second in the eleventh year, and the third in the twenty-first.

Mr. Stevens, the late secretary of the Anti-vaccination League of Milwaukee, died in that city on April 15 of malignant smallpox. He had been in the habit of denouncing vaccination on every possible occasion, as a barbarous practice, entirely without efficacy in either preventing or staying the progress of smallpox.

The Supreme Court of Pennsylvania has denied the Christian Scientists the right to do business as a legal corporation and hold that the practice of the art of healing or curing diseases, as set forth in the books of Mrs. Mary Baker G. Eddy, is injurious to the community and is opposed to the general policy of the law.

A memorial service to Dr. Horace Wells as the discoverer of ether was held at the Center church at Hartford, Conn., recently. A memorial window to him and to his wife was placed, and the medical and dental societies of Hartford attended the ceremony. There is a statue to Dr. Wells in Bushnell Park, Hartford.

Medical students at the University of Chicago have protested against the revival of the supplementary examination on the work of the first two years by the faculty. They designate the examination as "an unnecessary burden and the survival of an obsolete system of medical instruction" and as "an unjust discrimination."

Dr. Howard A. Kelly, of Johns Hopkins has entered suit against the Western Union Telegraph Company for the sum of $2,000 damages, in consequence of the alleged neglect of the company to deliver to him telegrams requesting his professional attendance for an important surgical operation in Cambridge, Md., on October 13, 1902.

The need of assistant surgeons in the medical corps of the navy is very great, there being at the present time twenty-seven vacancies in that grade. Surgeon General Rixey is trying to attract young medical men into the service. The Fifty-seventh congress in its last session provided for an increase of 150 members in the medical corps of the

navy.

Edmund Ludlow, M. D., Northwestern University Medical School, Chicago, 1895, formerly interne at St. Luke's Hospital, Chicago, and at the Central Indiana Hospital for the Insane, Indianapolis, who left his home in Paxton, Ill., in search of health, going first to Silverton, Colo., and then to Los Angeles, died in the latter city April 5.

The Illinois State Medical Society, at its recent very successful meeting in Chicago, decided to hold the next meeting at Bloomington. A variety of clinical and social privileges added much to the value and pleasure of the meeting. The general officers remain the same with the exception of Dr. Carl E. Black, of Jacksonville, who was elected president.

There are thirty-one trained nurses engaged in visiting one hundred and twenty public schools in New York City. Each school is visited every day. Aside from prevention of epidemics the services of the nurses are of value in encouraging habits of cleanliness among the pupils of foreign parentage whose home surroundings are such as not to teach a sanitary mode of life. The service is to be extended.

The City Health Office reports April as a punishing month, the monthly death rate being the highest since 1871, after the great fire. The water supply has been particularly bad, but the greatest proportion of deaths was due to pulmonary diseases, notably pneumonia. Twenty deaths from diphtheria call attention to the neglect of antitoxin treatment in nearly all of them. Since the first of May conditions have been decidedly better.

The American Medical Association at its New Orleans meeting elected Dr. J. H. Musser, of Philadelphia, president for the ensuing year. Vice-Presidents, Dr. G. C. Savage, Dr. I. Dyer, Dr. C. L. Hall, Dr. G. F. Jenkin. Dr. H. F. Newman remains as treasurer, and Dr. G. H. Simmons as secretary. The meeting was one of unusual. value and importance to the association and was held under very favorable circumstances of weather and accommodations. The next meeting is to be held at Atlantic City, N. J.

Settlement of the various suits instituted against the estate of Dr. Thomas W. Evans, the well known Philadelphia dentist, who died in Paris about five years ago, and who left the bulk of his property, valued at over $3,000,000, toward founding a dental institute and museum in this city, having been effected, a meeting of the directors of the corporation formed to look after the details, was held March 30. This meeting was for the purpose of devising means for carrying the testator's will into effect. The proposed institute and museum, which will contain all the valuables and souvenirs that weregiven to the testator by nobility, will be located on property belonging to the estate in West Philadelphia.

J. Mikulicz, the eminent Professor of Surgery of Breslau University, is on a visit to this country in response to an invitation to read a paper before the American Surgical Association at its meeting in Washington, D. C. While in New York he was tendered several private dinners, and also a reception attended by a number of the leading surgeons. He has also been entertained at luncheon by Dr. Robert Abbe, and at dinner by Prof. Robert F. Weir. By invitation of Prof. William M. Polk, dean of the faculty of Cornell Medical College, Professor Mikulicz held an operative clinic at Bellevue Hospital before a large and representative audience of medical men anxious to witness the dexterity and skill of the famous German operator. The professor, while visiting Philadelphia, was the guest of Prof. W. W. Keen. He will also respond to an invitation to visit the Johns Hopkins Hospital at Baltimore. In Chicago he was entertained by Dr. J. B. Murphy, and held a clinic at Mercy Hospital. From here he went to New Orleans to attend the American Medical Association.

Pamphlets Received.

Mental Hygiene. By Orpheus Everts, M. D.

Does the Practice of Medicine Pay? N. W. Lancet. George R. Patton, A. M., M. D.

Tuberculosis.

Communicable: Preventable: Curable. By

Addison W. Baird, M. D.

Gastrojejunostomy with the McGraw Elastic Ligature, for the Relief of Gastroptosis. Journ. Am. Med. Ass'n, Jan. 17, 1903.

THE

CHICAGO MEDICAL

RECORDER

JUNE, 1903.

Original Articles.

THE SURGICAL PATHOLOGY OF GENU VARUM AND GENU VALGUM.

BY WALLACE BLANCHARD, M. D.,

ATTENDING ORTHOPEDIC SURGEON ΤΟ THE HOME FOR DESTITUTE CRIPPLED CHILDREN, CHICAGO.

All surgical proceedings should be governed and bounded by the indications and limitations of existing pathological knowledge. I do not know that I can add anything to the present accepted pathology of genu varum and genu valgum, but I may be able to demonstrate that there is occasionally a wide divergence between the well known pathological indications on the one hand and the surgical procedures on the other. Although genu varum and genu valgum are usually rachitic deformities, yet it is well understood that a very considerable proportion of these deformities of the legs occur in children in whom no symptoms of rickets are observed.

Eburnation may be premature or dilatory without any actual disease, just as dentition or adolescence may be early or late without pathological significance. The healthy, well nourished child may walk early and have bones that harden slowly, and a deformity of the legs that is only apparently rachitic may develop.

The skiagraphic observation of a large number of cases of genu varum and genu valgum would seem to prove quite conclusively that these deformities very largely follow fixed laws of development.

Different healthy individuals show the normal curves in the long bones to a more or less pronounced degree, and it has been observed that the greater variational tendency lies in the natural curves to exaggerate and become deformities.

American Orthopedic Association, Washington, D. C., May 12th, 1903.

Advanced genu varum generally shows three contributing curves, the primary deviation being usually an exaggeration of the normal out bend in the lower third of the femur. This is the typical first stage.

As the deformity progresses and leverage on the long bones increases, succeeding out bends follow, usually in this order: First, in the upper third of the tibia, and this bend usually becomes the most pronounced; second, in the lower third of the tibia, with a succeeding slight out curve between these last two pronounced bends.

The changed direction of the axis of the lower end of the femur, of course, changes the direction and tilts the normal level plane of the condyle. I have described a typical case of bow leg in which the central deformity point, that is the apex of the deformity, is in the upper tibial shaft. The only logical point of correction, either by osteotomy or osteoclasis, is at the apex of the deformity. There the least correction is necessary to obtain a perfect result, and the leg can be lengthened to the best advantage.

An occasional exception to the usual rule is when the only marked deformity bend is an exaggeration of the normal out curve of the lower femoral shaft. In a bow leg of this character the outer condyle appears to be lengthened and enlarged.

In a considerable number of skiagrams I failed to find a case in which the condyles deviated from normal except in conformity to the altered direction of the lower femoral shafts.

Another exception to the usual rule of development is where the most pronounced deviation from normal occurs in an outward bend in the lower third of the tibia. In cases of this character a correction at any point far removed from the culminating point of the deformity cannot give any compensatory corrective results.

Fig. I. is a skiagram of bow legs and is selected as illustrating several conditions. The child is eight years of age. The original bone deformity was undoubtedly an increase in the normal out curves of the femurs and the secondary tibial out bends subsequently became the most pronounced. Four years of brace treatment have done but little more than to slightly correct the deformity, by opening up the inner knee articulations so that the deformity is nearly doubled when standing. Of course, these bones are now too firm to be affected even slightly by braces which serve only to enrich the instrument makers, and satisfy the parents that something is being done.

The skiagraphic study of genu valgum in various stages clearly