denied, and the former if not the latter reason should appeal to everyone.

It would seem that in the Province of Ontario, with her seven thousand or more insane, and her large yearly admissions, an After-Care Association would find plenty of scope for useful activity, and would mark a distinct advance in the consideration of the problems connected with psychiatry in its broadest sense.

The following advice offered to patients who are about to be discharged from the Manhattan State Hospital seems so timely and so apropos that it is worth while quoting in this

connection:

"The superintendent begs leave to offer the following advice for the benefit of the patient who is leaving the hospital, with the view of preventing, if possible, a return of the mental attack:

Those conditions and surroundings which operated in bringing about the first attack should be avoided, and, as far as possible remedied. Where the surroundings were objectionable a change should be made in residence. Bad associates should by all means be avoided. In order to effectually change the surroundings and associates, it is frequently necessary to move to another section of the city, or even leave town and take up life in another community.

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Oftentimes it is embarrassing to the patient to have the subject of the former residence in the hospital discussed. See that the patient avoids all forms of dissipation; endeavor to keep the patient occupied and establish regular hours for meals and for retiring. During the summer months, where it is possible, it is well for the patient to go to the country for a short time at least. The home life should be made as pleasant as possible, and friends should endeavor to encourage and help in every way.

"Inasmuch as it is the practice of this institution to parole for a period of thirty days before discharging a patient, it should be considered a duty on the part of relatives to encourage the patient to return to the hospital once a week during the parole period to consult with his former ward physician in reference to the progress of his convalescence, and to seek from him advice as to the best mode of living. The patient, at the same time, should have instilled into his mind that the idea of these regular visits to his physician is not for the purpose of his possible return to the institution, but rather to prevent a recurrence of his disease, and hence the necessity for a recommitment.

"Whenever a paroled patient declines to return to the institution, it is well to keep him under careful observation, and in the case of any illness, or a suspicious symptom of his former malady, the family physician should be immediately consulted, and then if advice is desired, a letter addressed to the superintendent will receive a prompt answer."

A Simple Staining Method for Gonococcus.

Preliminary Note.-The method here suggested has been found very useful, and because of its simplicity it must appeal to the busy practitioner, by whom so many laboratory procedures are performed with difficulty, and require the expenditure of no inconsiderable amount of time.

The gonococcus is stained by any aniline basic dye, and is decolorized by Grams' method. These facts are taken advantage of by the advocates of the common method of staining where Bismarck brown is used to differentiate the gonococcus.

Our method is simply the application of Nissl's soapy methylene blue solution without any counterstain. The solution is made up as follows:

Methylene Blue B. Patent..
Venetian Soap

Distilled Water

3.75

1.75

1000.

The smears, which should be made on slides (and care must be taken to have them as thin as possible), are fixed in the air and then stained (without heating) for one minute with Nissl's, washed, blotted and are ready for examination with oil-immersion lens.

The two objections to the method are: That there is no counterstain, and other pyogenic cocci may be mistaken for the gonococcus. We feel that if the sinears are thin, so that individual pus cells can be carefully studied, this objection will lose weight; the other objection that any ordinary methylene blue solution would do as well, we have not found to be the

case.

For many years Nissl's stain has been a popular differential cell stain in the preparation of tissue of the central nervous system, and although it is unreliable at times for permanent preparations, its value in the study of sections that are examined at once is of undoubted value, and we have found it is of equal value as a simple laboratory method for the study of the gonococcus.

AN IMPORTANT HOSPITAL SERVICE.

Pasteur clearly proved that all true fermentations, including putrefaction, are caused by the growth of micro-organisms, and pointed out the importance of such organisms in the economy of Nature. In the meantime, Lister, an Englishman, was working quietly in Edinburgh and Glasgow, making practical applications of Pasteur's great discovery to surgery, with results well known to the world.

It is interesting to consider Lord Lister's hospital connections. After graduating from the University of London, he spent about eight years in Edinburgh. He then went to Glasgow, where he practised and taught antiseptic surgery in the Royal Infirmary of that city from 1860 to 1876. He was then induced to go to London to take a position in King's College Hospital, and entered on his duties there with the distinct understanding that he was to have complete charge of his own service. In that little service, in that comparatively small hospital, he taught the surgeons of the world the details of his wonderful discovery.

One important point in connection with this bit of history is that if there had been a Chief of Surgery in King's College Hospital Lister would not have served under him, and would therefore have refused to accept the position. On the other hand, if the hospital authorities had offered him the position of Chief of Surgery, with a certain amount of executive work and the duty of supervising the whole surgical department, he would have declined.

A question of much interest to us in Toronto arises in this connection. Would it be well for our Hospital Board to imitate the example set by King's College of London, that is, to import a man from outside to take charge of one of its medical or surgical services? Many of us would say, yes, certainly, if an outsider could be procured who is better fitted for such a posi

tion than any local physician or surgeon. It would be much safer to import a man for such a service than for a whole department. So far as medicine and surgery are concerned, it is generally considered that we have sufficient good material in Toronto for the parallel services which are to be established. Appointments to positions on the science side will require very careful consideration.

DISCUSSIONS AT MEDICAL SOCIETIES.

We learn from the British Medical Journal that Mr. Shattock, President of the Pathological Section of the Royal Society of Medicine, has introduced into his Society an important change in the manner of discussing papers. In his inaugural address he said it had hitherto been the practice after a paper was read for subsequent speakers to make their observations in a set or continuous form. He proposed to substitute during his year of office another method of discussion which might be called that of interruption. He thought such a plan would encourage debate by making it easier for members to take part in it, would elicit opinions more effectually, and would be less tedious to the audience. The method, in short, was that commonly spoken of as the Socratic, as illustrated in the dialogues of Plato. Mr. Shattock thought that the method was particularly adapted for the discussion of scientific questions.

The Journal, in commenting on the new departure, says that under such a method readers of papers will have to stand the fire of questions arising directly out of the subject dealt with. Many men can throw useful light on a question by asking for explanations or by casual remarks who do not care to make set speeches.

THE TARSOPHALANGEAL REFLEX.

This term, which is making its appearance in current medical literature, applies to a dorsal flexion of the 2nd and 3rd toes, or sometimes the 2nd to the 5th toes, when the dorsum of the foot

is lightly tapped. It was first described by Von Bechterew, St. Petersburg, in 1901, and some years later Mendel reported at series of cases in which it had been applied with helpful diagnostic results. It has, when positive, the same significance as the Babinski reflex, indicating some central organic lesion of the motor nervous system. As it sometimes makes its appearance before the Babinski sign, it is another aid to the determining of the question whether the disease under consideration is functional or organic.

The reflex is best elicited by resting the inner surface of the leg and foot on a firm support, the knee being bent, and tapping over the head of the 3rd or 4th metatarsal, the cuboid, or the external cuneiform bone. A negative result under these conditions means little, but a positive can only be interpreted as a lesion of the pyramidal tract.

THE PETITION TO THE CONJOINT COLLEGES.

At the close of the Winter Session last year, petitions bearing 2,792 signatures, including those of 133 Fellows of the Royal College of Physicians, London, and 380 Fellows and 1,500 members of the Royal College of Surgeons of England, were laid before these two bodies, praying that women might be admitted to the examinations of the Royal College of Physicians and the Royal College of Surgeons. It is eleven years since these bodies were last approached on this subject, and the large number of signatures obtained in a period of four months (November, 1906, to March, 1907) is noteworthy. It was thought wise to limit the signatures to medical men only, and in many cases the signatures were accompanied by cordial expressions of agreement with the prayer of the petition and of appreciation of the good work done by medical women. The petitions are now being considered by the two Colleges, and their decision will shortly be announced.