Whether or not she will perfectly recover is a question, yet this much is evident, that tubercular peritonitis is an operable case, and if taken in time, and the diseased structures be thoroughly removed, and the abdomen thoroughly irrigated, can be cured. Let us hope that these conditions may yet become curable by the surgeon, like many other conditions formerly regarded as hopeless are now perfectly relieved by operative interference. We are in the formative stage of tubercular peritonitis. The lines which are to guide us have not been laid down yet, but are to be determined in the future. A literature is to be created. What has been and what is being done in the way of operations for relief and the results therefrom, is the desirable thing to be known. In my opinion, the honest report of a single case will outweigh' all the theory and speculation imaginable.

CONCLUSIONS.

1. Tubercular peritonitis is an operable disease.

2. An early operation is of greatest value.

3. The chronic variety offers the best indications for surgical interference.

4. When the primary deposit is in the tubes (which Winckel declares to be in fifty per cent. of the cases), an early salpingotomy will cure the disease.

5. Operations later in the disease will frequently prolong life and possibly cure.

Correspondence.

My dear Doctor Sim:-I am through my day's work at the Policlinic, and although tired and weary, I have determined to spend a few minutes in writing you a line, to keep up your recollection. I have been here three weeks, and am just in the midst of a special course of clinical instruction, with which I am greatly pleased. The teachers are able and willing to teach, and material abundant. Tuberculosis of the joints, bones and glands, is a fad here, but they find it and show it to you. I have witnessed from one to two capital

From our Chicago Editor.

operations almost every day, and Sunday is no exception. I saw Professor Senn operate yesterday on a six-year old girl for tuberculosis of the hip joint; he resected the head of the femur, made a crucial incision around the trochanter major, took a chisel and mallet and cleaved off the trochanter, turned it back, and examined the head and neck of the bone and found the head honeycombed, the ligamentum teres absorbed, and inroads made into the bony structure of the acetabulum; he then with his chisel and mallet cut off the neck and head of the bone just in front of the trochanter minor; then with a sharp spoon scooped out all osseous as well as soft tuberculous tissue, thoroughly cleansed the wound with hot iodinized water, then turned back the trochanter and stitched it with catgut sutures to the sound end of the femur, then sprinkled the wound with iodoform, packed it with iodoform gauze, pulling out the end through a buttonhole made in sound flesh below the wound for drainage, then closed the wound with five deep silk sutures, then took the catgut and whip-stitched the whole wound, which he thinks will heal without suppuration-which I believe will be the case, as the operating room was aseptic, the party were made as thoroughly aseptic as possible, the hands of the operator and assistant were thoroughly cleaned and washed in soap, brush and water, and then bathed in ether and alcohol, and all those who witnessed it were required to leave their coats in another room. I think it was the most unique operation, all in all, that I ever witnessed; and the beauty of the thing was that the little patient came out from under the influence of the ether as bright and cheerful as a rose. Everything is antisepsis, and at first I thought the teachers here run it in the ground; but since I have witnessed the rapid recoveries I am a firm convert to the belief that cleanliness like godliness, cannot be carried too far. I have not seen a sponge in the Policlinic; they are conspicuous by their absence, and their place supplied by antiseptic gauze. I witnessed today an operation by Prof. Fenger for osteo-sarcoma extending up the leg to a point just above the knee; the inguinal glands were slightly enlarged, so he went into the right groin, cut down upon and ligated the right iliac vessels, extirpated the glands, then amputated

the thigh at upper third and closed the wound, after flushing and packing with antiseptic dressings. He has performed vaginal hysterectomy twice since I have been here, and two laparotomies. This is certainly a superb place to study medicine in all its branches, and if a man does not learn, it is simply because he will not.

D. A. L.

MISSISSIPPI STATE MEDICAL ASSOCIATION.*

At the late meeting of the Mississippi State Medical Association, held in Natchez, on the 20th day of April, 1892, the following preamble and resolutions were introduced:

WHEREAS, The Mississippi State Medical Association was designed and organized exclusively for the purpose of improving and elevating the medical profession in the State; therefore, Resolved, That the introduction of political methods, as place seeking and personal preferment in its management, would be not only subversive of its true intent and purpose, but would result in its utter failure and destruction.

Resolved, That the Association should be absolved from all entanglements and responsibilities other than those for which it was created originally.

Resolved, That a membership which has no higher object or ambition than personal advancement, is not desirable, and should not be encouraged.

The following was offered as an amendment: "And that this Association condemns the action of the Legislature taking from it the power to nominate the members of the State Board of Health." This was declared out of order as not being germain to the main question, and on the suggestion of a member, was offered as a substitute, which, after some discussion, was withdrawn, and the vote was taken on the main question, which resulted in laying the resolutions on the table.

Most of the friends of the resolutions left the same evening. On the next morning when the minutes of the day before were read, everything pertaining to the resolutions was expunged from the record.

Comment is unnecessary. It is simply necessary to know the facts to enable all to judge and decide not only the merits

* From our Mississippi Editor.

and demerits of the resolutions, but also of the animus which prompted the very peculiar way of disposing of them.

Quite a number of physicians in all parts of the State, believing that the time has come when the medical profession of the State of Mississippi should form a more efficient organization for the cultivation of the science of medicine, for the elevation of the standard of the profession, and the diffusion of the true principles of medical ethics, cordially invite the co-operation of all who appreciate the necessity of such an organization. If we would keep in line with the march of the profession in other States we must rise to a higher plane. Make membership honorable by excluding all political methods, and by avoiding all entanglements and responsibilities other than those pertaining to the real duties and legitimate interests of the profession. Organization has ceased to be an experiment, and the beneficent result achieved by it, both international, national, State and local, are no less gratifying than universal. But to be permanent and efficient all such organizations must be wholly unselfish and devoted to one single purpose, in which all members may co-operate on terms of equality, untrammeled by caucuses, rings, and combinations. The benefits of such organizations are not intended for the members of the societies, nor even for the medical profession itself; all mankind should be the beneficiaries of their philanthropic labors.

In accordance with the above, the following circular has been issued:

JACKSON, MISS., May 5, 1892. Dear Doctor-A number of physicians propose to organize a State medical society to be known as the Medical and Surgical Society of Mississippi. Among those who have already joined are: Drs. J. M. Greene, C. R. Henderson, J. W. Bennett, F. L. Fulgham, B. F. Ward, H. H. Hughes, J. M. Taylor, Geo. K. Harrington, B. F. Kittrell, T. A. Catchings, I. P. Partin, M. J. Thompson, W. F. Hyer, T. R. Trotter, F. D. Smythe, Chas. D. Mitchell, P. Fairley, R. S. Toombs, B. M. Bishop, D. T. Price, and W. G. Gamble. We would be glad to have you unite with us as one of the original or charter members, and you are cordially invited to do so. If you think favorably of this movement please write at once to Dr. J. M. Taylor, Corinth, Miss., Dr. W. F. Hyer, Meridian, Miss., Dr. R. S. Toombs, Greenville, Miss., or to the undersigned.

Yours truly,

WIRT JOHNSTON.

Society Proceedings.

MEMPHIS MEDICAL SOCIETY.

April Meeting.

Dr. B. F. Turner, the essayist for the evening, read a most interesting paper on Locomotor Ataxia, illustrating the paper with diagrams and cases.

Dr. Williams saw two cases locomotor ataxia in which diarrhea was absent. First case passed out of his hands in preataxic stage. Second case had unequal impairment of papillary action. Charcot's joint he only saw once. Thinks patellar reflex always present. Another point omitted by essayist is the occasional crises, in which patients appear to improve. One case treated for hysterical vomiting by a friend of his; afterward tried reflexes and found them absent, and developed with ataxia.

Dr. Crofford While many symptoms are present in locomotor ataxia, a number may be absent. Usually lesion is in lumbar cord, and, if higher up, the lower cord reflexes would be unaffected. Five factors make up reflex movement: 1, sentient and inf.; 2, afferent nerve; 3, center; 4, efferent nerve; 5, motor termination. If cutting off in intestinal canal of afferent nerve from center in cord, derangement is bound to follow. Man cannot walk because afferent nerves are cut off; he cannot feel; this is why there is loss of co-ordination.

Dr. Sale had hoped etiology of disease would be discussed. Contrary to former opinion, is due to former epidemics of la grippe. Trousseau draws out the feature of muscular sense beautifully and its aid by sight, formerly believed to be due to excessive venery, next syphilis, any general causes, catching cold, etc.; most his cases due to this-influenza. One case especially occurred many years ago: after lagrippe a sense of numbness in abdomen was noticed, and felt sure of posterior myelitis; patient died in six months from impairment of respiration as last symptom. Therapy-nothing curative; constant current, silver nitrate; coal tar derivatives are palliatives. Dr. Turner, in concluding, thanks Dr. Williams for calling attention to laryngeal, intestinal, and other crises, he himself