lieved by hot applications, but vomiting continued intermittently. At two-thirty that afternoon, he had a chill lasting ten minutes, and temperature rose to 104°-pulse 112. A sponge bath and enema were ordered; bowels moved well, temperature dropped to 102°, pulse 116; vomiting stopped, pain but slight and limited to region of gall bladder. Patient had a fair night, but at ten next morning had another chill lasting ten minutes, temperature rose to 103°, pulse 130; slight rigidity of upper right rectus, lower part of abdomen soft; no mass could be detected, but on palpation pain over gall bladder was apparent. Vomiting started again after the chill. I diagnosed typhoid infection of gall bladder, and advised immediate operation. Family asked for further consultation, and when consultants arrived patient was having another chill, so we had to postpone consultation for twenty minutes. After this chill temperature 103°, pulse 140 and barely perceptible, and patient quite blue. Diagnosis agreed to by consultants, patient operated on immediately. Gall bladder distended with a blackish pus, and at tip a necrotic spot just ready to rupture. The usual cholecystotomy was performed, the patient put to bed in as good condition as he was before operation. Next morning temperature 99°, pulse 100, and from there on an uneventful recovery.

CASE. II. ECTOPIC GESTATION-TUBULAR ABORTION.

Mrs. T―, aged 25. Family history negative, has been married six years. Had three abortions before giving birth to a child. Has one child three years old, labor easy and normal; menstruation returned eight months after labor, and from that time on has occurred every three weeks; flow lasts five days, rather pro fuse and without pain. Seven weeks ago flow occurred at regular time and lasted ten days associated with cramping pain in left side.

In a week's time flow returned again and pain at this time was so severe that she was compelled to remain in bed for two days. In a few days, however, she felt perfectly well and went out for a buggy ride, and on getting out of the buggy on her return she was again seized with this cramping pain, and it was so severe

that she fainted; she was taken into the house, put to bed and quietly rallied and next day was up again. From this time on there was an intermittent flow from the uterus, slight in character. At the end of four days on getting out of bed one morning she was again seized with this severe pain and I was sent for. I found her with pulse of 96, temperature 97°, anxious expression, no rigidity of abdominal muscles; on digital examination I found uterus normal, cervix rigid, and no mass in either fornices or cul de sac. There was no discoloration of areola and no history of morning vomiting. I told the family I suspected extra uterine pregnancy, but could not find sufficient local symptoms to advise operation. As I was leaving the city for two weeks I told her to remain in bed, and if she had the least trouble to summon a physician immediately. On my return two weeks later, she informed me that she had had no more severe attacks, although there was still a cramping in left side increased on exertion and that the flow during this time had been intermittent. At this examination I found a mass the size of a large marble in the cul de sac, and another on left side as large as three fingers. Operation was advised and agreed to by consultant, Dr. Witherspoon, and also the family. She was removed to St. Thomas' Hospital and just as I opened the peritoneum there was a gush of bright red blood, showing that rupture had occurred from the examination just before operation. A large blood clot was found in cul de sac and a partial tubal abortion on left side. Patient stood the operation well and is now on high road to recovery.

This case well illustrates several common points concerning ectopic gestation -- namely, that amenorrhea is often absent, that in many cases there is no change in areola and no vomiting, and that the most common termination is tubal abortion and not rupture.'

ECONOMICAL. A society of women in Berlin has recently presented a petition to the Prussian Minister of Education, praying for the prohibition of corsets in young ladies' schools on the ground that this garment is prejudicial to the health of the growing girl.- For the prevention of "waist."

Becords, Begollections and Beminiscences.

SPECIAL NOTICE.

The Association of Medical Officers of the Army and Navy of the Confederacy will hold its next annual meeting in Louisville, Ky., Tuesday, Wednesday, and Thursday, June 6, 7. and 8, 1905. JNO. S. CAIN, M. D.,

DEERING J. ROBERTS, M. D.,

President.

Secretary.

Obituary.

DR. G. S. WEST.- Died at his home in Palestine, Texas, December 27, 1904, Dr. G. S. West, aged 81. Dr. West was one of the most distinguished surgeons in the Confederate army, and was the first one to whom a commission was issued by the war department. Dr. West graduated from the Medical Department of the University of New York in 1854. When yellow fever broke out with great violence in Norfolk, Virginia, in 1856, he went from his home in New York to the stricken people and gave his services freely to all classes. After the epidemic was over the citizens were so pleased with him and so grateful that they gave him a residence and guaranteed him $3000 a year to remain amongst them. He accepted it. When the war broke out they said to him, "We know you wish to go North and go in the Union army; do so. After the war, return to us, and live with us." Dr. West said, "I cast my lot with the South when I came here. I will enter the Southern army." He did so, and filled many positions of honor and usefulness. During those terrible last days around Petersburg and Richmond he was

chief of the operating staff in the field. I was on duty with him in the hospitals in Georgia in 1864, and new him well. Our acquaintance and friendship remained unbroken up to the day of his death, and I rarely ever met a man who possessed as he did so many excellent and lovable qualities. In his latter years he became very deaf,- due to the cannonading about him at the downfall of the Southern capital and Petersburg,- and while able to make a living he underwent many privations. His only child, a son, died after reaching man's estate. His devoted wife is his sole survivor. Peace to his ashes; and may that peace that passeth all understanding be with his bereaved helpmate and companion through all her struggles and adversity.- Daniel's Texas Medical Journal.

Editorial.

"PUBLIC CARE OF THE INSANE PENDING COMMITMENT."

"

Some months ago, in one of the largest cities of the country, a young foreigner became suddenly insane at his boarding-house. He was hurriedly sent to the nearest police station in a patrol wagon, locked up as a prisoner for a day or so, growing constantly more maniacal, then sent in the patrol wagon again to another police station, where the city physician would find it more convenient to examine him. By the time he arrived at the second station he was in a state of intense maniacal excitement. After a struggle with half a dozen policemen, he was finally overpowered and thrust into a restraint chair, where he died within half an hour, without ever having been seen by a physician. "At about the same time in the same city a foreigner, equally obscure, became insane and shot at his room-mate. He was taken at once to a police station in a patrol wagon, kept there for two days, then taken to another station more convenient for the city physician to visit, where he was kept another day, and finally was seen by the physician, who then ordered him sent to the detention hospital.

"These incidents-illustrating the unmedicinal treatment which insane suspects frequently undergo-coming to our attention suggested an inquiry into the methods of various cities as regards public care of the insane pending commitment. Accordingly, we addressed inquiries to the

mayors of a dozen leading cities as to the method by which insanity is determined in each-whether by jury trial or by medical examination, whether patients are arrested, how and where they are detained pending commitment, if patients are conveyed to the asylum by the sheriff, whether women attendants are required for women patients, and whether nurses are sent from the asylum to convey patients thither.

"Accurate answers to these few questions would pretty fairly indicate the degree to which medical authority controls in a community; for we do not hesitate to say that the trial of insane patients by jury, the arrest of patients, their transportation in patrol wagons, their detention in police courts or jails, their conveyance to the asylum by the sheriff or by the police, the failure to furnish nurses from the asylum to escort patients, all indicate archaic conditions, and show that in any city where they exist the intelligent physicians have been unable to influence public affairs as they should. The answers received show all grades of treatment. In one city, our letter was handed to a member of the detective force for reply. His answer would lead one to infer that our inquiry referred to the criminal class. He states that 'insane suspects are arrested, detained in the emergency hospital, and are held there for observation; then they are tried by a board of physicians appointed by the Superior Court to try the case, and in the event of a verdict of guilty they are committed to an insane asylum. There are women attendants appointed by the sheriff who have the custody of the female patients. The sheriff has charge of all insane cases.'

"It will be seen that the writer entirely ignores the first step in the commitment process, namely, the manner in which patients reach the emergency hospital. In like manner, from the very city where the incidents occurred which are mentioned at the beginning of this article, we are cheerfully assured that patients are detained in an emergency hospital awaiting inquiry as to insanity. Various cities do not undertake to dodge the question, but frankly state that "suspects are taken to the jail or police station at first.

"In cities where there are detention or emergency hospitals the general public may suppose that patients are immediately taken there. As a matter of fact, patients in these cities also are taken first to the police station or to the jail by policemen, in patrol wagons, in precisely the same manner as a common drunk. In the majority of the replies, the expressions used are those associated with the treatment of criminals — patients are arrested,' held in police stations or jails, 'tried' by jury or judge or even by a board of examiners, sent to the asylum in charge of the sheriff or his deputies. All this is so commonplace that it probably does not arouse in any of us the quick sense of shame which it should Does it shock us that in one city the coroner determines the mental state