"Treatment of Tubercular Glands of the Neck" was the title of Dr. Leonard Freeman's paper. These glands are particularly liable to infection, because of their nearness to points of infection. From 10 to 25 per cent. of these cases develop phthisis. General treatment is always indicated, especially by way of prophylaxis against relapse following operation. Cod-liver oil, syrup of iodide of iron, creosote, etc., are useful here to build up the resisting powers of patients. Hygienic measures are of as much importance as in pulmonary tuberculosis. A high, dry climate is, if anything, more favorable than the sea coast, the disease in the former instance being less prevalent and less severe. The infection usually enters through the teeth, tonsils, pharynx or scalp, but ointments and counter-irritants are of doubtful utility. Tincture of iodine and green soap are most reliable. As an injection, 10 per cent. sterilized iodo form in ether or boiled olive oil is perhaps the most efficacious, but these injections are uncertain and cannot reach the deep glands. The majority of cases are generally best treated by operation. Pulmonary tuberculosis is no contraindication unless far advanced. Dr. Freeman referred to curetment, cauterization and complete extirpation, the last named being the operation of choice. Nerves when cut may be reunited. with sutures with little permanent damage. Statistics on this subject are quite uncertain.

Dr. Melville Black, in the succeeding discussion, referred to the almost invariable association of hypertrophied tonsils with tubercular glands. Complete removal of the tonsils undoubtedly has some favorable influence in the early stage of enlarged tubercular glands. Enlarged tonsils tend to undermine the general constitution. The glands under the angle of the jaw are most commonly concerned in this connection. Dr. McHugh regards local and general treatment of no avail, and advises extirpation. Saline solution is especially useful, because of the necessary length of the operations. Dr. Singer thought cod-liver oil almost a relic of barbarism, while Dr. Spivak defended the use of oils and fats.

Dr. H. G. Wetherill, of Denver, gave a graphic report of eight coincident cases of ectopic pregnancy, all occurring in his private practice during a period of a little more than eight months. Seven patients recovered. The one who died succumbed to a very rapid and profuse hemorrhage, following incision by the vaginal route. All types of ectopic pregnancy were encountered, including a case of intraligamentous rupture. The ages of the feti varied from three weeks to six and one-half months, the latter

being 101⁄2 inches in length. The interesting fact was brought out that in some cases only epigastric pain was present, with tenderness, however, over the seat of the trouble. There was commonly a constant complaint of rectal tenesmus. The essayist prefers the abdominal route, and deems irrigation unnecessary. Hot salt solution by hypodermoclysis is invaluable. It is best not to operate during shock, but rather to wait, stimulate gently and give plenty of water. Operate after reaction, with the usual precautions, packing with gauze if necessary. No salts or other purges should be given for a week after the operation, small and frequent rectal enemas being used instead. Dr. Wetherill's paper was accompanied by the exhibition of specimens and photographs.

"The Nervous and Mental Phenomena of Aneterio-Capillary Fibrosis and Atheroma" was the title of an able didactic article by Dr. J. E. Courtney, of Denver. He considers the different lesions all as parts of a single process. The condition is more frequent than formerly and occurs earlier, owing to the hypertension of modern life. It may be mechanical, anabolic or toxic in origin, including in particular alcohol, rheumatism and syphilis. The virus is especially liable to affect the arch of the aorta, circle of Willis and the middle meningeal and cerebral arteries. Common manifestations are premature senility, melancholia and chronic nephritis. There may be dizziness on stooping. Many so-called functional disorders are really arteriosclerotic in nature. Prodromal to apoplexy are numbness, aphasia, irritability and paresthesia. Of therapeutic service are milk, cereals, vegetables, sodium iodide and nitroglycerin. Two important points in early diagnosis are a high tension pulse, and lowering of the second aortic sound, as heard near the angle of the scapula. Dr. Courtney illustrated his paper with some exceptionally fine postmortem sections showing fat plaques and chalk deposits.

Dr. C. L. Wheaton, of Denver, read a paper on the etiology of uterine and pelvic disease. He called attention to the difference in environments of women in various stations of life, and the perilous period of young girls approaching puberty. In the sedentary life of female boarding schools, about 75 per cent. show some menstrual derangement. Mental labor is more fatiguing than physical. Outdoor sports, baths and massage should be encouraged. The follies of fashion, as related to dress, cause displacements of the womb and paresis of the diaphragm. Indiscretions in the menstrual period are a prolific source of future suffering from endometritis and sterility. Labor and the puer

perium lie in the borderland between health and disease. Absolute rest is required during involution. The abdominal band, if worn, should be so adjusted as not to press the uterus down into the pelvis.

The therapeutic applications of the X-rays was the subject of an authoritative resume by Dr. George H. Stover, of Denver. The fact of radiotherapy was first called to his attention by the patients themselves, while taking skiagrams. It is a curative agent in lupus and in surface epithelioma and rodent ulcer, and should be tried first in these cases. It is also of value in Hodgkin's disease, and to prevent recurrence of cancer. In glandular and visceral carcinoma surgical measures should be first employed. The Roentgen rays are always of more or less service in relieving pain. Dr. Stover reported briefly a case of lupus of the leg (cured); one of carcinoma at the base of the bladder (pain and hemorrhage relieved); cancer of the cervix, facial epithelioma of several years' duration (apparently cured); and Hodgkin's disease (very favorable results). The Tesla coil is more powerful than the static machine, and, according to Stover, is not more likely to produce dermatitis. In applying the rays, unaffected parts should be covered with sheet lead. A moderately low vacuum is indicated for surface treatment; a fairly high vacuum for internal growths. Treatment should be given for from five to fifteen minutes, every day at first. A month's trial at least is necessary to come to any definite conclusion. The outlook for radiotherapy is very encouraging.

Dr. George H. Cattermole, of Boulder, read a practical paper on "Scarlet Fever and Other Contagious Diseases in Public Schools." According to official statistics in Colorado, last year there were 139 deaths from diphtheria and croup and 85 deaths from scarlatina, 66 from measles, 92 from whooping cough, and only 12 deaths from the dreaded small-pox. Any child with a cough should be excluded from school during the prevalence of pertussis. Inspection of school children by a medical health officer, notification and quarantine are necessary measures, and should be enforced. The writer alluded to the successful efforts of Boulder physicians to organize for uniform quarantine and disinfection.

The first paper of the last session was by Dr. B. Oettinger, of Denver, on "Delusions, Sane and Insane." The essay brought out some fine, yet important, distinctions. Delusions are the usual cause of commitment for insanity. They may be based on illu

sions, from disorder of the bodily functions, or they may be purely hallucinatory of persecution, apotheosis, etc. Disordered somatic functions play a leading part in nearly every instance. Delusions uncorrected by judgment based on common experience are usually insane. Apparitions are not seldom thought to be seen by the sane, and belong to the same class as hallucinatory illusions. Demonology rests upon ignorance. Delusions of children are due to undeveloped judgment. Eccentric people have delusive beliefs, but do not act upon them.

Dr. Moses Collins, of Denver, gave a detailed account of original observations with the tuberculin test on 24 patients in the Jewish National Home for Consumptives. The lack of unanimity of other observers as to value and safety of the test and its dosage is exemplified in the carefully performed tests described by Dr. Collins. We may conclude that the weight of evidence as to the reliability of the test is in the negative.

Dr. S. D. Van, Meter mentioned in abstract a number of interesting cases in his practice. One was the removal of a vesical calculus encrusted about a copper wire eight and one-half inches in length, the patient being what passed for a man. Another was that of a phosphatic renal calculus weighing 245 grains. One other was the successful replacement of two lost teeth in a boy of II six hours after they had been knocked out. A case of priapism of nine days' duration, due to disorganized blood in the corpora cavernosa, was relieved by incision and washing out. An eruption of tubercular syphilides appeared 12 years after specific infection and complicating an acute variola.

Very practical and suggestive was the paper on surgery of the extremities by Dr. W. L. Dorland, of Pueblo. There have been as great advances in this field as in the surgery of the head or abdomen. Owing to asepsis, the fullest conservatism may be practiced, retreating as needed, and the great vascularity of the hands and feet is a favorable factor. Free incisions, moist gauze drainage and aluminum acetate were mentioned favorably. According to Dr. Dorland, artificial legs are a success.

The last paper which time permitted to be read was that of Dr. Arthur McGugan, of Denver, on "Surgical Care of Insane Women," with special reference to the author's experience in the Michigan State Insane Asylum. He remarked on the great frequency of genital disease in the female inmates, and reported the more or less successful results in 50 operations, involving 25 of these patients.

THE NEW OFFICERS.

The committee on nominations, consisting of Drs. McHugh, Freeman, Boyd, Chipman and Hopkins, nominated for president Drs. W. W. Grant, S. D. Van Meter and Edward C. Hill, all of Denver. The two latter nominees' withdrew their names, and Dr. Grant was unanimously and enthusiastically chosen as president for the ensuing year. Drs. J. M. Blaine and Geo. H. Stover were nominated for the office of corresponding secretary. On his second effort Dr. Stover succeeded in withdrawing, and Dr. Blaine was re-elected. By vote of the society, the secretary was empowered to cast the ballot for the following single nominees of the committee: First vice-president, Sol Kahn, of Leadville; second vice-president, H: A. Black, of Pueblo; third vice-president, T. J. Forhan, of Trinidad; recording secretary, Minnie Love, of Denver; assistant recording secretary, George F. Libby, of Colorado Springs; trustee, Wm. P. Munn, of Denver.

The society also concurred in the nominations of ten councilors made by the special committee of five (Freeman, Forhan, Kahn, Hopkins and Finney) as follows: For one year, Drs. Levy and Campbell; for two years, Drs. Graham and Forhan; for three years, Drs. Bull and Sol Kahn; for four years, Drs. McHugh and Rogers; for five years, Drs. Hall and Work.

IMPRESSIONS AND OBSERVATIONS.

The Pueblo meeting was distinctly a success, largely through the efforts of a few men, including Drs. Corwin, Work and Marmaduke. The attendance of Pueblo physicians was unexpectedly small, but their hospitality was unbounded.

The reception at Woodcroft was a thoroughly enjoyable occasion, participated in by a two-car special of physicians and their friends. A charming night, beautiful home and grounds, music and lawn pictures, refreshments, and a most cordial greeting made the evening one to be long remembered for pleasure without alloy.

The visit of the members of the state society to the State Insane Asylum was more of a treat than could have been surmised by the uninitiated. The patients, to the number of about 560, were nearly all on the shady lawns. The dormitories were clean and well-lighted. The new spiral fire escape renders danger to life from this source extremely remote. The members of the society were pleasantly entertained by Superintendent Busey and his amiable family.

The social quarters of the Minnequa Club, on the shore of Pueblo's lovely lake, were filled with professional guests on the night of June 25, shaking off the cares of practice as they danced.