inoculation is not necessarily a good vaccination.

5. As a rule, vaccination does not begin to take until the fourth or fifth day, and often as late as the seventh.

6. Do successive inoculations of a calf so attenuate the vaccine virus as to destroy its immunizing power?

MALARIA AND TYPHOID FEVER.Through the South these two diseases will always affect each other and cause difficulties in diagnosis. Dr. George J. Preston, in the American MedicoSurgical Bulletin, in writing on this subject emphasizes these two points:

1. There are many cases in which the differential diagnosis between typhoid and malarial fever can be made only by the blood examination; this of course applies mainly to the early diagnosis. It is a well known fact that in malarial regions the therapeutic test is by no means always to be relied on. Physicians practicing in malarial regions are accustomed to send certain cases away from the locality in which they are living, in order to "break up the malarial fever when it does not yield to anti-malarial remedies.

2. Although it is clear that there is no such disease as typho-malarial fever"-that is, a blending of the symptoms of the two diseases-still, the two diseases may exist simultaneously, and when they are thus both present, the symptoms of each disease are fairly well defined.

*

He

ANEURISM OF AORTA CURED BY MACEWEN'S METHOD.-Bignone (British Medical Journal) relates the case of a man, aged 68, admitted into hospital, November 7, 1894, suffering from aneurism of the ascending aorta. had much pain and sense of oppression behind the sternum, dypsnea, stertor, increased on swallowing, and dry barking cough. In the third sterno-intercostal space a rounded pulsating expansile tumor over which a systolic souffle could be heard. The radial pulses were equal. On November 30 two steel

needles were inserted into the aneurismal sac, and allowed to remain for twentyfour hours, then withdrawn; similar treatment on December 4, 6, and 14. Satisfactory results followed immediately after the first operation, and finally the tumor was reduced to onethird its original size, and the pulsation almost disappeared. A last puncture was made on January 10; the needle seemed then to pass through a fibrous tumor to reach a small cavity in the center. The patient was now able to sit up all day, and walk about without any pain or discomfort.

GLUCOSE AND CANE SUGAR AS FOODS.-Dr. E. H. Bartley has found that since glucose has become a cheap commercial article it has found numerous uses in the arts and as an article of diet. He asks, in the New York Medical Journal, if there is a difference in the effect of cane sugar and dextrose and summarizes the difference in their action when eaten as a food as follows:

1. The former is a natural food while the latter is exceptionally so.

2. The latter undergoes lactic acid fermentation much more readily in the stomach and duodenum than the former, and interferes more with salivary and gastric digestion.

3. The latter is more rapidly absorbed than the former, owing to the gradual formation of dextrose from the latter during absorption. This rapid absorption may overtax the liver and oxidizing process in the tissues, preventing the proper destruction of waste products of cell action.

4. Clinical observations coincide with these deductions. The only doubt to be raised in this respect is as to how far the author has been able to separate the effects of the over-eating of cane sugar from those believed to be due to invert sugar or dextrose. The observations were began long before the reasons for the difference in the action of the sugars was known to the observer. These reasons are brought out here to explain the clinical phenomena.

MARYLAND

Medical Journal.

PUBLISHED WEEKLY.

TERMS OF SUBSCRIPTION, $3.00 a year, payable in advance, including postage for the United States, Canada and Mexico. Subscriptions may begin with any date.

DATE OF PAYMENT.-The date following the subscriber's name on the label shows the time to which payment has been made. Subscribers are earnestly requested to avoid arrearages. CHANGES OF ADDRESS.-When a change of address is ordered, both the old and new address must be given. Notice should be sent a week in advance of the change desired.

TO CORRESPONDENTS.-Original articles are solicited from members of the profession throughout the world. Reprints will be furnished in payment of accepted articles if the author's wish is so stated at the time.

CORRESPONDENCE upon subjects of general or special interest, prompt intelligence of local matters of interest to the profession, items of news, etc., are respectfully solicited. Marked copies of other publications sent us should bear the notice "marked copy" on wrapper.

Address: MARYLAND MEDICAL JOURNAL, 209 Park Ave., Baltimore, Md.

Medical and Chirurgical Faculty.

THE Medical and Chirurgical Faculty of Maryland has finished the work of the ninetyseventh annual session and has done it well. Even with the disadvantage of the approaching great national convention so near at hand, the ardor of the State and city physicians was not dampened. The work was up to its usual standard and the discussions were spirited and instructive.

Particularly timely was the special subject of "Typhoid Fever in Country Districts." No theme, with few exceptions, occupies the medical mind more frequently at some seasons of the year than typhoid fever and especially is this disease an important item in the health records of country districts.

In large cities it is not always easy to trace a case of any disease, but in the country, especially remote from large settlements, a case of a communicable disease can often be accounted for. Whether typhoid fever comes through infected milk, water, food, or in

other ways, the great point is to keep it off. Very likely it would be impossible to stamp out the disease entirely, and indeed, a case now and then is valuable (perhaps not for the patient) in order that persons may not grow too careless.

When a disease has been absent from a certain region for several years, persons grow careless towards it; all new material has sprung up and the first approach of the disease finds many victims. This is more especially true of the eruptive diseases which burn over a district once or twice until all available fuel is consumed and then do not return for several years, when new material has grown up.

The discussion of typhoid fever will always be interesting and instructive, as is shown by the number of persons who took part. While definite conclusions were not reached, the general ploughing up of old ground had its advantages and was refreshing to the lazy and busy members who do not read, but absorb.

The two addresses, one by Dr. Starr and one by the president, deserve mention. Dr. Starr entered very thoroughly as a specialist into his subject. His exposition of the cause of neurasthenia and the comparison with financial matters were particularly happy illustrations. When the individual exhausts nervous energy and overdraws his account, so to speak, there is very apt to follow a crisis and either a temporary embarrassment or a total failure which even the most skillful receivers (physicians) cannot prevent or re

large body. The permanent secretary, Dr. W. B. Atkinson, says that this meeting will be a large one and for many reasons it should be a very memorable one. It has not met in Baltimore for twenty-eight years, or since 1867, a few years after the close of the war. The first meeting the Association ever held was in Baltimore. Baltimore has been called by some a slow city because it does not grow up in a night with a mushroom-like increase, but facts and statistics show that it has grown rapidly, steadily and solidly during the past twenty years and in a most substantial manner. Delegates who come here for the first time since the last meeting here will hardly know the city and will be surprised at the great facilities for study and training. The universities, colleges, the medical schools and preparatory institutions have already stamped Baltimore as a literary center and when it is considered that there are seven medical schools in this city and four in Washington at a distance of forty miles, the claim of a medical center is a very just one. In the days of wooden ships the Baltimore clipper was recognized everywhere and while there has been some falling off of that class of shipping since the clipper passed away, Baltimore has shown herself to be an important seaport and the nearest one to Chicago and the west. Her growth in a business way has gone hand in hand with the growth in a literary way and the libraries and fine institutes of learning will all be a source of wonder and admiration to the visiting physicians who will come here in the next few weeks. The local profession has been very generous in helping along the entertainment committee and the desire has been all along from the beginning to keep up a well earned reputation of a hospitable city. The list of public entertainments was published last week and besides this there will probably be numerous small private dinners, lunches and excursions, not on the programme; but at the large general reception to be given on Thursday night every member of the profession in Baltimore should not only contribute his share, as so many have done, but he should come in person and help to welcome the guests and their families and show a true cor. diality which is so becoming on such an occasion. The Committee of Arrangements is composed of men who not only will work but who have shown by solid results that they have worked. Now let all physicians who are

not on this committee and who have not been called on, give their contributions and help these men who have given their time and energies to make this meeting a success. That praise may come to the profession of Baltimore and Maryland, let all physicians of the city and State do each one his and her part.

***

ENGLAND has become much interested of late in the study of stenography for physicians and has formed a Medical Stenography. club or society with a journal on shorthand. In these days of quick action and many occupations, there should be a tendency towards condensation rather than expansion, and if papers and discussions are to be reported verbatim, medical journals will be more unreadable than they even are now. What the average man wants nowadays is facts and not padding and what the average writer gives to the public is a few facts with much padding.

Stenography has its uses, but it should not be introduced to preserve the senseless utterances of so many men before their societies. What is needed is not a rapid writer who can take down every word, but a man with clear judgment and full knowledge of the subject who can record what is important and leave out the unnecessary. Long introductions, tedious relation of numerous cases much alike, vain repetitions, all tire an audience and should not be also imposed on the reader who is wise enough to abstain himself. Let papers be as long as the rules of the society allow and the discussions within the time limit, but let the secretary make records in as few words as possible and then such records will be read.

Not only are there more medical journals in this country and perhaps abroad than are needed, but the simultaneous publication of the same matter in several of them shows that one at least could do the work of six. If long discussions and a tedious relation of many cases with self-adulation and self-advertising are to be published verbatim then the average journal will not be read at all.

Few medical writers at the present day can put forth matter that will stand a literary test. This is an age of condensation and hurry; the laggard is left behind. Medical stenography will hardly find a foothold in this country.

Three cases of beriberi have been reported on a vessel at Delaware Breakwater Quarantine.

There are twenty-five Bulgarian women studying medicine at the Faculty of Nancy in France.

The Flint Club of Baltimore will entertain some of the delegates of the American Medical Association.

It looks very much as if Asiatic cholera would break out again in Europe as soon as the warm weather has set in.

All the money necessary for the entertainment of the delegates to the American Medical Association has been pledged and most of it has been given.

The members of the Arundell Club of Baltimore will entertain the women physicians who visit that city as delegates to the American Medical Association.

The Louisiana Supreme Court has decided that the mere refusal of a druggist to fill a physician's prescriptions does not entitle the physician to damage for libel.

Subscribers to the entertainment fund of the American Medical Association will not receive tickets to the general reception on Thursday night until they have paid.

The Maine Academy of Medicine and the Journal of Medicine and Science have succeeded in having a bill passed by the Maine Legislature to regulate the practice of medicine in that State.

At the meeting of the Association of American Medical Colleges, the medical schools of Baltimore, with the exception of the Johns Hopkins Medical School, will oppose the proposition to require a four years' course.

Dr. Edward M. Schaeffer read a paper entitled "The Hygiene of Bodily Culture" at the Tenth Annual Meeting of the American Association for the Advancement of Physical Education, held at New York last Thursday. In Brazil there is one medical school for every 7,001,167 population; in Russia one for every 14,403,317; in New York one to every 428,418; in Virginia one for every 551,999 and in Maryland one for every 178,478 population.

Dr. John Morris, the Secretary and Treasurer of the old Rocky Mountain Medical Associa tion, will entertain the surviving members of that defunct body at the Athenaeum Club, Baltimore, on Tuesday evening, May 7, at half past six o'clock.

Dr. T. M. Drown of the University of Pennsylvania, class of 1862, has been elected president of Lehigh University. Dr. Drown was formerly Professor of Chemistry in that institution; later at the Boston Institute of Technology and more recently was chemist to the Massachusetts State Board of Health.

Dr. Edward Shippen, a retired surgeon, died in Baltimore last Monday at the age of sixty-eight. Dr. Shippen was graduated from the University of Pennsylvania and after serving as surgeon in the war practiced in Philadelphia and about fifteen years ago he made Baltimore his home. Dr. Shippen was a lineal descendant of Edward Shippen, the first mayor of Philadelphia.

The annual prize of 300 marks offered by Professor Unna of Hamburg for the best essay on some subject in the domain of dermatology was not awarded in 1894, and therefore the amount has been doubled for 1895. The subject selected for consideration is: "An investigation as to the accuracy of the propositions recently made that callagenous, elastic fibers and fixed (pigmented) connective-tissue cells dip down into the normal prickly layer." The competition is unrestricted. Essays must be submitted to Leopold Voss, Hohe Bleichen 34, Hamburg, before December, 1895, from whom also further particulars can be learned.

WASHINGTON NOTES.

The regular meeting of the Medical Society of the District of Columbia was held on Wednesday night, April 17, Dr. T. N. McLaughlin, the Vice-president, in the chair.

Dr. I. S. Stone presented two very interesting specimens; one, enormous kidney affected with primary carcinoma. It was thought to be sarcoma at first but Dr. Reed of the Army Medical Museum examined it and pronounced it primary carcinoma. The other kidney of this patient was sound. The other specimen of Dr. Stone's was an uterus that had been removed by abdominal hysterectomy for sepsis following an abortion. The patient died. This case produced considerable discussion, Dr. H. L. E. Johnson maintaining that the operation of hysterectomy should not have been performed. He said that the most important thing was to find out what caused the sepsis. He had been called to see this patient

when she was first taken sick and had sent her to the Columbia Hospital, where she was operated on by Dr. Stone. Drs. Reed, Bovée and Crosson also took part in the discussion.

Dr. J. Wesley Bovée presented several interesting specimens, two cases of Double PyoSalpinx and one of Tubal Pregnancy, with unusual complications. Dr. Atkinson gave a history of the case while he was in attendance before he sent her to Dr. Bovée. Dr. J. Taber Johnson was to have read the paper of the evening, entitled, "Treatment of Ovarian Tumors, including the Technique of Ovariotomy," but the discussion of pathological specimens had consumed so much time, that it was held over until the next meeting and the society adjourned.

The Washington Obstetrical and Gynecological Society held its regular meeting on Friday night, April 19. Dr. J. T. Johnson read an admirable paper on “Symptoms and Diagnosis of Ovarian Tumors." It was freely discussed by Drs. Bovée, H. L. E. Johnson, George Byrd Harrison and T. C. Smith.

Dr. G. B. Harrison reported a case of "Hysterical Croup." It was discussed by Drs. Cuthbert, H. L. E. Johnson, Francis S. Nash and George N. Acker.

The regular meeting of the Clinico-Pathological Society was held Tuesday night, April 16. The meeting was of unusual interest, there being two papers, which provoked considerable discussion.

UNITED STATES ARMY.

One Week ending April 22, 1895.

By direction of the President the retirement from active service April 18, 1895, of Colonel Joseph R. Smith, Assistant Surgeon General, is announced.

Leave of absence for six months, with permission to go beyond the sea, to take effect upon his relief from duty at Fort Columbus, New York Harbor, is granted Captain William P. Kendall, Assistant Surgeon.

Leave of absence for two months, to take effect on being relieved from duty at Fort Huachuca, Arizona, is granted Captain Rudolph G. Ebert, Assistant Surgeon.

UNITED STATES NAVY.

Week ending April 20, 1895.

Passed Assistant Surgeon G. McC. Pickrell detached from United States Ship "Newark," home and two months leave.

Assistant Surgeon L. H. Stone ordered to the United States Ship "Newark."

Passed Assistant Surgeon C. H. T. Loundes detached from Coast Survey Steamer "Hassler" and to Mare Island Hospital.

Assistant Surgeon C. M. De Valin detached from United States Ship "Vesuvius" and to the United States Receiving Ship "Vermont."

Surgeon Howard Smith, retired, leave extended six months to remain out of the United States.

BOOK REVIEWS.

TWENTIETH CENTURY PRACTICE. An International Encyclopedia of Modern Medical Science. By leading Authorities of Europe and America. Edited by Thomas L. Stedman, M. D., New York City. In Twenty Volumes. Volume I. Diseases of the Uropoietic System. Volume II. Nutritive Disorders. New York: William Wood and Company. 1895.

Two volumes of this large library have already appeared and if those to come are as good, the twenty will form a very useful library. It will be necessary, however, to issue them rapidly in order that the first may not become antiquated before the last one appears and in that case they will have appeared long before the close of this century. The first volume contains sections on diseases of