Washington, recently, having been called to that place to assist Dr. Ferguson in a difficult surgical operation.

Dr. Walter M. Ely, of Walla Walla, Washington, will leave for Chicago, March 1st, to take a special course on the eye, and will be gone from Walla Walla for about six weeks.

Dr. D. M. Angus, of Prosser, has been appointed assistant physician at the Western Washington Hospital for the Insane, at Steilacoom, to succeed Dr. Schafer, who resigned.

Heavy Medical Fee Allowed.-The claim of Dr. D. H. Rand, of Portland, Oregon, for $1,200 for the surgical operation on Dr. E. H. Pardee on September 14, 1896, has been allowed against his estate by Judge Ogden and the executors of the estate.

Dr. D. W. Ward, for some years located at Forest Grove, is now in Dawson. He writes that he has taken up a claim on the Klondike, and expects to clear a nice sum of money for this winter's work, and to be home next fall.

The Oregon State Board of Medical Examiners granted licenses to the following physicians at their meeting in January: C. H. Grimm, J. E. Webb, Adolph M. Moechl, J. C. Twichell, M. G. McCorkle, H. H. Shaw, J. T. Monk.

Dr. Geisendorfer, a well known physician of Arlington, Oregon, and Dr. Ruedy, who was formerly a resident physician for two years at the Good Samaritan Hospital in Portland, have formed a partnership and will open a branch office in The Dalles, Oregon.

Dr. Arthur E. Burns, of Tacoma, Washington, who with his wife has enjoyed a summer's outing upon the Pacific and in Oriental ports, has returned to his home. Dr. and Mrs. Burns were recently in Portland, where they were entertained by members of the medical profession.

Dr. F. S. Easton, of Spokane, although 79 years of age, is making preparations to start for the Klondike in the early spring. The doctor has spent 30 years in the west and says that he will make the trip overland from Spokane, that being the route for him.

Dr. Hatton, who arrived in Victoria, B. C., by the Empress of China, has been for some years a resident practitioner of Japan. He now contemplates the invasion of the golden Klondike, which is already commanding considerable attention beyond the sea.

Dr. Belle J. MacDonald, who has had a wide experience in nervous diseases under the most eminent physicians of New York City, has established a sanitarium at her residence, 125 13th street, Portland, Oregon, for the treatment of a limited number of private cases.

Dr. S. D. Brookes, of the Marine Hospital Service at Port Townsend, Washington, and Mrs. Brookes tendered a farewell party at their quarters at the hospital, in honor of Dr. and Mrs. S. G. Stimpson, who are to leave in a few days for St. Louis, where Dr. Stimpson will relieve Dr. A. H. Glenran, formerly of this station.

Dr. A. H. Mitchell, of Warm Springs, Mont., has returned from Alaska. The doctor was surprised to find how easily they crossed the much talked of Chilkoot pass. He thinks the road between Big Hole and Deer Lodge, Mont., is more difficult and dangerous. The doctor has lost none of his enthusiasm from his trip, and thinks the wealth is almost inexhaustible.

Dr. A. H. Deekens, of Tacoma, Washington, has gone to Alaska as an examiner for the New York Life Insurance Co. As the company pays the doctor one hundred and fifty dollars a month and all expenses, it gives him an opportunity to see the country and is quite a favorable opportunity to visit Alaska at the expense of some one else. The doctor retains his offices in Tacoma and will reoccupy them upon his return.

Dispensing Physicians.-You can save money by dealing direct with the manufacturers. Why don't you make the profit paid the middlemen? Try us once and see what you can save. We are the base of supply We not only sell but manufacture ourselves everything in the pharmaceutical line. We give physicians 40 per cent. discount from the usual list. Other houses give you 25 per cent. We deliver freight orders for pharmaceuticals free of charge. Goods guaranteed. Catalogue on request. The Mercer Chemical Co., Omaha, Neb.

Dr. F. M. Kemp, Assistant Surgeon, U. S. A., has been appointed surgeon in charge of the Klondike relief expedition, and left Vancouver with the expedition for the north. Dr. Kemp is a six footer, athletic and powerful, and is well fitted for the trip. He graduated at Long Island College Hospital in 1893, was interne at that hospital for two years and later had medical charge of the Soldier's Home at Dayton, Ohio. He entered the service a year and a half ago. It is expected that a post will be established in the Upper Youkon, and in that event Mrs. Kemp will join the doctor in his temporary northern post.

EPSOM SALTS.

The stomach will not reject it if prepared in this way: Put a tablespoonful in a teacup and add two or three tablesponfuls of boiling water, stir well, decant, and reject the residuum. Add a little lemon juice, let the mixture cool, and give to the patient. If in the country, beyond the reach of lemons, vinegar will make a first rate substitute. Repeat the dose every four hours until the bowels respond. The quantity of water may be varied to suit the caprice of the patient.-[Parcels, in Prescription.

By A. Hamilton Deekens, M. D., Tacoma, Wash.

[Read before the Pierce County Medical Society, October

1897.]

The subject upon which I have chosen to write a paper and read before you this evening is that of chronic catarrhal gastritis, with special reference to its pathology, symptomatology and treatment; therefore, as you well know, I have to call your attention to one of the most insidious, protean and all too common maladies with which we have to deal in our medical career. In fact, its occurrence is so common in this country that it has been aptly called the great American disease. It is a fruitful subject for study and research, and one in which every practitioner is or ought to be, both individually and specially interested, for we are all bound to meet with the disease sooner or later, and it behooves us, therefore, to recognize it early, when it crosses our diagnostic field of vision, and treat it with all the skill and scientific knowledge and precision at our command. For what I may have to say I claim no originality, but I merely want to place before you

in a more or less condensed form the results of a careful study and review of some of the latest contributions and researches on chronic catarrhal gastritis, and the most satisfactory methods of treating it.

Before entering into a consideration of the pathology and symptomatology of chronic catarrhal gastritis, I think it would be well, in order to have a more intelligent understanding of the various changes produced by disease in the stomach walls, that we should briefly consider the more salient points in the macroscopical and physiological anatomy of the membranes which make up those walls, as we can then better appreciate the pathological changes that have taken place in them.

Unfortunately (for the pathologist) the opportunities for studying these changes are not as numerous as he might wish, and the knowledge we do possess has been gained principally through long and persistent experiments on our canine friends, whose stomachs have been treated to a diet of tannic acid or some other like irritant for varying periods of time.

Turning then to the gross anatomy for a moment, we find that this musculo-membranous sac consists of four well marked and distinct membranes or coats, each one of which receives its name on account of its peculiar anatomical characteristics. From within outward these membranes are respectively named the mucous, sub-mucous, (or areolar,) muscular and serous; the serous membrane is a continuation of the peritoneum, and extends over the whole outer surface of the stomach, except along the lines of the greater and lesser curvatures, where it is absent. The sub-mucous, or areolar coat, is made up of loose, spongy or connective tissue, and contains the larger part of the system of blood vessels, capillaries and lymphatics which carry the blood and nourishment to and from the stomach. The muscular coat is the one which gives the stomach its contractile power; it consists of three distinct layers of unstriated muscle fibres, which are continuous with those of the oesophagus; these three layers run in three different directions, longitudinal, circular and oblique, thus giving added strength to the walls. The longitudinal and circular fibres increase in thickness as they approach the pyloric end until they form a strong thick bundle or fasciculus, which guards the entrance leading into the duodenum. This is the so-called pyloric sphincter.

We now come to the inner or mucous membrane, and this

is the one with which we are particularly interested at the present time, as it is the membrane first attacked in all forms of catarrhal gastritis. Some authorities, among whom are Pepper and Osler, deny the existence of a purely catarrhal inflammation, insisting that there is in every case an involvement of other structures or an interstitial inflammation, as well as a glandular or parenchymatous one; and it has been plainly shown by Turck and others that in the later stages of chronic gastritis there is a most marked involvement of the interstitia.

The normal mucous membrane is of a pale, pinkish ash color; it is soft and pulpy to the touch, and in a state of contraction is seen to form itself into numerous wrinkles or ridges, running mostly in longitudinal directions; these are the so-called rugae of the stomach. When the organ is distended these rugae disappear. The mucous membrane is coated throughout with columnar epithelium.

Viewed through a lens a peculiar mammillated or nipple like appearance of the mucous membrane will be noticed; this is caused by innumerable little depressions in the bottom of which open the orifices of the gastric tubules or follicles. These follicles compose the greater part of the thickness of the mucous membrane; they are placed vertically to the walls of the stomach close together, side by side, and are about five millions in number. As they dip into the mucous membrane they branch out into three or four smaller tubular prolongations, and like the rest of the mucous membrane of the stomach are also lined with columnar epithelium. In the deeper parts, however, we find the cells are larger and rounded or polyhedral in shape. The vascular supply to the stomach is very plentiful, several large vessels sending diverging branches which anastamose with each other and produce between the coats a rich vascular net work. The lymphatics are also numerous, their main trunks running, as do those of the blood vessels along the lines of the greater or lesser curvatures. The nerves are principally derived from the right and left pneumogastrics with and in addition a number of branches from the sympathetic, all forming together the gastric plexus.

The pathological changes produced in all mucous membranes, no matter where situated, by chronic catarrhal inflammations are legion, but for all practical purposes are the same. Clinically, however, they may be divided into two main sets of phenomena; the one set showing a condition