tient, a drawn careworn face, thin and haggard for her age, rounded shoulders and a protuberant belly. On physical examination, I found a crop of chancroids grouped about the introitus vulvae, which naturally explained her latest symptoms. As soon as these were sufficiently healed, I made a thorough examination of the pelvis. The uterus was in a normal position, only slightly enlarged, the cervix presented a small tear, but seemed otherwise healthy; the appendages appeared to be normal; the vaginal outlet was slightly relaxed, but not sufficiently so to necessitate an operation, but all the tissues of the pelvis seemed to be relaxed and devoid of tone. I examined the patient in the standing position and found that then her uterus came down pretty low in the pelvis. The woman was poor and obliged to work and take care of her children. The case seemed to me to be one in which tonics, rest and proper gymnastic exercises were indicated, a course of treatment impossible in this case. I had had my attention called to a brace, called "the natural body brace," invented and patented by Dr. Dewees, of Salinas, Kansas, and highly recommended by Dr, Skeene in his book on Medical Gynecology, for a certain class of cases, of which this woman seemed to be one. Here was a woman naturally weak and delicate, and yet obliged to do hard work. As I have before stated, she was stoop-shouldered, her abdomen was prominent, and on closer examination I found an obliteration of the lumbar curve. From a personal investigation of the brace, a sample of which had been placed in my hands, I made up my mind that if the brace would do anything it would correct these deformities, and so concluded to try it. Here again the result was most gratifying; after she had worn the brace for ten days, her symptoms began to disappear, and now that she has worn it for three months, she tells me that it has given her more relief and comfort than she ever could have hoped for, and that she could not get along without it.

Although being somewhat averse, as probably most of you are, to the use and recommendation of any surgical appliance which is placed on the market and sold directly to the public as more or less as a cure all, I must give this brace credit for the relief it gave in this one case, and its ability to do so in similar cases under similar conditions, that is, where women through lack of means and time are not able to cure themselves by a proper course of gymnastics and training. This brace has for its object the support of the lower part of the abdomen; the drawing back of the shoulders which throws.

the chest out, by the use of several strips of webbing attached to a metallic support which fits in the hollow of the back, thus tending to increase the forward curve of the lumbar vertebrae, and right here there is to me an interesting point. If you will look at the two photographs which I will now pass around, you will see that in the one marked No. 1, the woman has a natural erect position, while in No. 2, she is standing in a position which a good many women occupy most of the time, that is with shoulders stooped, abdomen forward and lumbar curve diminished. If you will notice, I have drawn a line on each photograph which passes through one point placed over the anterior superior spinous process of the ilium and another over the upper border of the greater trochanter of the femur, which corresponds to about the center of the hip joint, both of these points being marked on the model by cross strips of black court plaster, so that the inclination of this line to the horizon, gives us an idea of the inclination of the axis of the pelvis. In No. 1, you will notice that this line forms less of an angle with the horizon than it does in No. 2, in other words in No. 2, the intra-abdominal pressure comes more directly in line with the axis of the pelvis, thereby more readily allowing the pelvic viscera to fall out of the pelvis as it were. How much this position, or even the usual erect position, is responsible for the many ailments to which the human female seems to be heir, remains yet to be

seen.

These three cases I have selected from a number of similar ones, considering them representative of a large class of women who at first sight appear to be suffering from disease of the pelvic organs pure and simple, and yet in whom the real trouble lies somewhere else. In the last case the treatment and the suggestions derived from the use of the brace were entirely new to me.

In regard to the first case, I have long since been convinced of the harm accruing from unnatural sexual relations; these certainly give rise to ovarian congestion, which if kept up for a sufficient length of time may give rise to permanent changes. It is naturally a very difficult subject to deal with. The growing dislike for large families on the part of parents. is not altogether due to the objections of many women to become mothers, but on account of the expense coincident with a large family, a burden which some are not able or willing to bear, a reason which may, however, be more in evidence than real.

Constipation and tight lacing, two habits which often accompany each other, I am certain are more frequently the underlying factors of gynecological conditions, and as such are more frequently overlooked, than will be generally admitted. From a mere mechanical point of view they both tend to force the contents of the pelvis toward the pelvic outlet; from an anatomical standpoint,when the uterus is forced to any extent below its normal plane in the pelvis, its circulation is at once interfered with; not its blood supply, but it cannot empty itself of blood, thereby bringing about a regular venous congestion, with its consequent results.

The object of this paper, gentlemen, is to bring before you the thoughts which have for a long time been dominant in my mind, that physiologically speaking, a woman's genera-, tive organs are the most important organs of which she is possessed they are the ones which essentially stamp her a woman, and that often any interference with her general health will show itself here, and that they are often the first ones to cry out; that the only cases in which these organs are themselves the seat of the trouble, are in those of infection, traumatism or new growth, and these in their turn bring about, by their effect on the general health, a state of invalidism with which most of us are only too familiar. The important point is to seek the cause of the disorder, and if that be a remediable one to remove it, in whatever situation it may be found, for then and then only can we truly cure our patients.

Mrs. Henrietta R. Fales Raker, whose will was recently probated in Philadelphia, left an estate worth $2,000,000. Should her son and daughter die without issue, the whole estate will revert to the University of Pennsylvania and the Pennsylvania Hospital.

It has been said that the hospitals of Paris are in an insanitary condition, and lack accomodations sufficient to meet the demands made upon their resources. As a result of a recent examination, the superintendent of the charitable institutions of Paris asserts that it would require at least $10,000,000 to put the hospitals of that city in proper condition.

EXTRACTS.

MALTINE AND MALT.

Malts may come and malts may go, but Maltine goes on forever. One could not fail to be struck with the force of this statement when witnessing the exhibits which the manufacturers of Maltine made at the recent session of the American Medical Association and at the Nebraska and Minnesota State Medical Societies. At Denver no less than four representatives of the company were in attendance, including Mr. C. C. Neuman, the secretary of the corporation. Mr. Settle, so well known to the doctors of the Pacific Northwest, made all visitors from this region feel that they were among friends.

One fact relative to malt products was specially well presented to the visitors at the Denver meeting, namely, that if a thin malt product is desired that it can readily be made by the simple addition of water to Maltine or any of its heavier preparations. The claims made by a rival company that its

products are better because thinner, were mightily exploded by the methods of exposure employed by the exponents of Maltine at this meeting. And when one stops to think of it, how unreasonable to think anything else but that with a more concentrated and heavier product, the preparation must be of greater consistency. Palatability, consistency and stability, are important factors in a concentrated malt product, but the nutritive and digestive functions are even more important

factors. Maltine contains a very large amount of diastase, sufficient to make it one of the most important of digestive agents, and with this food is more nutritive.

Maltine is, we believe, the only malt extract made from wheat, oats and malted barley, the latter being the base of most products. The wheat furnishes the largest proportion of gluten, and was long ago introduced into the preparation of all the Maltine products.

It is well enough to remember that the name is "Maltine" and not something else sounding very much like it. Various manufacturers, seeing the great and increasing development in the manufacture of Maltine, have sought to reap the advantages "in a name" by denominating their own weak, thin products by some name as near to "Maltine" as the law would permit. While the Maltine people have nothing to say against these aspirants for professional favor, they do not desire that their medical friends shall be hoodwinked into ordering substitutes through a misunderstanding of the fact that the manufacturers of "Maltine" do not make any other "brand" of malt extracts than their own well-known products.

AMYLOLYTIC FERMENTS.

In an article on this important subject by Wyatt Wingrave, M.R.C.S., Eng. (Assistant Surgeon to the Central London Throat and Ear Hospital), in the London Lancet, May 7, 1898, we are informed of a personal necessity that arose in the writer's experience for a reliable starch digestant. A crucial comparative examination was therefore made of many malt extracts and of Taka-Diastase, the tests being conducted both chemically and clinically.

He summarizes briefly: 1. That Taka-Diastase is the most powerful of the starch or diastatic ferments and the most reliable since it is more rapid in its action-i. e.. "it will convert a larger amount (of starch) in a given time than will any other amylolytic ferment." 2. That Taka-Diastase seems to be less retarded in its digestive action by the presence of the organic acids (butyric, lactic, acetic), and also by tea and coffee and alcohol, than are saliva and the malt extracts. This