culties and sorrow, through storms of hardship and losses, safely into port. ABSTRACTS. Anaesthesia for Prostatectemy. McMechan remarks that the conduct of narcosis for prostatectomy is almost always beset with difficulties and anxieties, and not infrequently with considerable danger. Rarely are patients submitting to prostatectomy good subjects for anaesthesia. They are usually suffering from systemic toxaemia, have but recently recovered from acute retention of urine, or may even be undergoing the agonies of that condition, not to mention the depleting effects of senility, arteriosclerosis, and intercurrent complicating diseases of the heart, lungs or kidneys. While the majority of these patients may be operated upon successfully and returned to their beds alive, still the lowest average mortality of 5 per cent is not entirely satisfactory. Consequently such details of anaesthetic technique as will prevent shock or post-operative complications become important factors in attempting to reduce the present mortality. The question, therefore, arises, what form of anaesthetic technique is safest and most satisfactory for prostatectomy? No one method nor any particular sequence will adequately meet the variable conditions of numerous patients or the exactions of individual operators. However, several methods of local and regional analgesia, as well as several sequences and combinations of inhalation anaesthetics have been proved of superior value in the conduct of narcosis for prostatectomy. It is becoming axiomatic that when local or regional analgesia will suffice for the performance of an operation, general narcosis should not be employed. Cabot suggests that suprapubic cystotomy should be done under local analgesia. This will probably be the operation of choice in 50 per cent of cases. The bladder should be then drained while the patient is up and about until the condition warrants radical intervention. Also in the presence of shock, sepsis and retention of urine local analgesia is invaluable for suprapubic cystotomy. Lanz has developed a two stage technique for the very worst of these cases. Internal Secretions. The chemical and physiologic actions of the internal secretions in the economy are discussed by R. H. Chittenden, New Haven, Conn. (Journal A. M. A., March 4), who first takes up the study of the adrenal secretion. This is a definite chemical substance, crystalline, basic in character and readily prone to undergo oxidation. Chemically, it is a ketone-like body, having the structure of methylaminoacetopyrocatechol, and is now made synthetically. Thus we have both the natural product and the synthetic product available for therapeutic purposes. We understand further that the marked and sudden rise in blood pressure that attends the introduction of epinephrin is due to two causes, an accelerated and more energetic heart action, and a contraction of the smaller arteries and arterioles, especially of the skin and in the region of the splanchnics. Section of the nerve has no effect, showing that the action is directly on the peripheral blood vessels themselves. The natural base differs from the artificial product in that it is optically active and far more powerful in its physiologic action. It is levo-rotary. The animal body, acting here as in some other of its metabolic processes, uses optically active products. It illustrates a form of chemical control by which many of the processes of the body are capable of being modified. The epinephrin poured into the blood, by influencing the blood presure, may influence many important functions. Its specific action in producing glycosuria, apparently by an action on the nervous system through the intermediation of the sympathetic, is not to be overlooked. The importance of this secretion to the organism is apparent when we observe the effects of its extirpation, as well as the effects of its therapeutic use. The facts in regard to the thyroid and parathyroid secretions are equally striking and are stated here. There is also evidence of an internal secretion, affecting the heart and blood vessels and kidneys, in the pituitary body. It is becoming apparent, further, that the ductless glands exercise regulating action on each other; that a disturbance of one is followed by a modification of the action of another. Thus the pancreas and the thyroid seem mutually to inhibit each other. The chemical reactions which are here involved are not yet fully understood. We are only on the threshold of the subject. The ductless glands illustrate certain forms of internal secretion of the greatest importance, but today we recognize that the cells of every organ and tissue are continually forming intermediate and end products which, absorbed by the blood and lymph, may serve as stimulants to other tissue cells and influence the metabolic processes. The recognition of this chemical correlation is shown in the functions of the intestines and the sexual organs, and calls our attention to the importance and general application of the methods of chemical control used by the organism. October. The naked hills lie wanton to the breeze, What wonder is it that the corn is shocked! A JOURNAL OF MEDICINE AND SURCERY Per Published Monthly by Western Medical Review Company, Omaha, Nebr. Annum, $2.00. The Western Medical Review is the journal of the Nebraska State Medical Association and is sent by order of the Association to each of its members. In a pamphlet accompanying this number will be found the list of officers, committeemen and a roster of the membership of our State Medical association. The officers and committeemen are the ones who are officially charged with the management of the State Society for the coming year, and quite necessarily, the plans which they outline will shape the work of the society for this year and to some extent for years to come. Please read this list carefully. If your name is found as a committeeman or a district councilor, begin at once to see how you can best direct and advance the lines of work with which you are especially charged. If each officer and committeeman begins at once to do his or her work, and then does it well, you will hear the well done good and faithful doctor, and it will contribute to the welfare of the association, the profession and our state. Mr. Chairman of Section. Do not wait till next spring to get your list of papers-get busy now. If your name is not among the list of officers or committeemen, you still have a duty, and it is your privilege to help bear the responsibility of membership. Carefully consider the work of any committee in which you are interested or for the work of which you are especially fitted because of natural gifts-education, or your surroundings, by furnishing the chairman of any committee or any of its members with your view and suggestions. No committee can adopt all the suggestions that are likely to be offered, for some may be in direct variance with others that may be given. Every suggestion will be helpful to the committee for they desire to know the wishes of the membership. Every physician in the state who is eligible, should be a member of his or her local society-and by virtue of this, of our State Association. Nesbit (Omaha). State Board Failures. Some time ago an editorial in the Omaha Bee criticised the Nebraska State Board of Health severely on account of the small number of failures in examinations conducted by the board for license to practice medicine. The criticism was evidently based on misinformation and the writer of it was perhaps not unbiased in the premise. The Nebraska Board of Health conducts examinations every spring for medical students who have completed the first two years of the medical course of study and wish advanced standing in the work completed. The subjects in which they are permitted to take examinations are anatomy, chemistry, materia medica and physiology, including practical tests in histology and chemistry. Any student receiving a grade of 75 per cent or over |