of Medicine of West Virginia University, informs us that beginning with the session of 1909, in addition to 15 units of secondary work, one year of collegiate work, including courses in physics, chemistry, biology and modern languages, will be required for admission.

Dr. W. Henry Wilson, registrar, announces that on or before January 1, or before January 1, 1910, the Hahnemann Medical College of

The Diagnosis of Phthisis.

Samuel Gee (Clinical Aphorisms).

1. Before the appearance of physical signs it is the presence of some or all of the following facts which leads to a diagnosis: Hæmoptysis, cough, loss of flesh and color, slight rise of temperature and hereditary liability to the disease; but, above all, the detection of tubercule bacilli in the sputum.

2. The absence of physical signs of disease in some cases of slowly progressive pulmonary consumption, ending in death, is more remarkable.

3. Tubercular phthisis going on to the formation of cavities is not extremely uncommon even in infants under a year old.

4. Therapeutics must begin before physical signs have developed, for if you wait for physical signs you wait too long.

5. Always say these things to a patient whom you suspect to be phthisical: (a) Get yourself weighed by the same machine each time to see if you are losing weight.

(b) Use a thermometer two or three times each evening to see if there is any fever.

3. Hæmorrhage from the bowels in enteric fever, if it occurs not later than the second week, may be disregarded. after that time it is a serious symptom. Late and copious hæmorrhages are a frequent precursor of perforation.

4. Enteric fever seldom begins with a rigor; pneumonia often does. In the former disease the temperature rises slowly; in the latter it rises rapidly.

5. The febrile onset of secondary syphilis may be mistaken for enteric fever, and an incipient syphilide may be

indistinguishable for a few days from typhoid spots.

6. Typhoid fever, marked by incessant raving delirium, is hardly to be distinguished from meningitis, especially when the typhoid delirium sets in un

6. If besides auscultation and percussion these three points give negative results you may infer there is no phthisis.

disease and before the eruption appears. In some of these cases the eruption never develops. A negative Widal test may be expected early in the disease.

AN INTERNATIONAL MONTHLY REVIEW OF CURRENT MEDICAL LITERATURE

ESTABLISHED 1895

Edited by DANIEL LEWIS, M. D., LL. D.

PUBLISHED BY THE

sembles. Dr. Corbin believes the period

of infectiousness is of short duration, reaching its maximum in the prodromal period of usually 24 hours and before the appearance of the eruption, and prac

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MAY 25, 1908.

RÖTHELN OR GERMAN MEASLES

The fact that rötheln so simulates scarlet fever and measles renders the dif

ferential diagnosis often difficult. For

this reason we often find a case of this disease reported as one or the other of the more serious diseases, especially during the course of an epidemic of one or the other.

In Hospital of April 4, 1908, we find a report of the study of rötheln by Drs. E. W. Grodoll and H. E. Corbin, which they recently presented to the epidemiological section of the Royal Society of Medicine. These observers agree that the disease is definitely a specific infectious one and

ond day unless faucial catarrh persists. The clinical features of the disease are described as follows:

"Prodromal Period. - Usually none; if present, very short, seldom more than 24 hours. Of 85 cases which were seen last year, in 60 the rash was the first, or among the first symptoms. Other prodromes are sore throat, vomiting, enlargement of lymphatic glands and moderate. pyrexia. Less frequent are shivering, headache, giddiness, coryza and pain in the back and limbs.

“Rash.—This usually commences on the face and scalp, as discrete pale pink spots, but not infrequently the spots come out on the face, trunk and extremities simultaneously. When the face is first affected, the rash will disappear from it within 24 hours, and will then be seen on the trunk and upper extremities; lastly, the lower extremities are invaded. The rash involves the skin of the face right up to the lips. In most cases the rash becomes so confluent on the trunk and extremities the day after its appearance as to present a uniform pink or scarlet erythema, which is often punctate. As the rash has by this time disappeared from the face, the resemblance to mild. scarlet fever is very striking. Sometimes the discrete spots fade and vanish without becoming confluent; less often they become confluent so as to form irregularly shaped macules, though the macules are not usually so large as those of measles. Still less frequently the rash takes the form of a scarlatiniform ery

thema on the trunk and limbs from the very commencement, avoiding the face. The duration of a rash is rarely longer than three days; often it is shorter.

"Glands. The superficial lympathic glands are often moderately enlarged and tender. Those most commonly affected are the mastoid and posterior cervical, so that some stiffness of the neck results; but all may be implicated. They do not become matted together, and suppuration is extremely rare. Of 67 cases last year in which a note was made as to the state of the glands, enlargement was observed in 52. In 18 cases several sets of glands were involved.

"Pyrexia.-In 41 cases observed all through the attack the temperature rose above 99° F. in 15. In 44 cases admit

ted after the rash had come out the temperature was above 99° F. in 20. The highest temperature recorded in these 85 cases was 102.8° F. Seldom is the temperature raised for longer than 24 hours. “The conjunctive are often, but by no means always, injected. In only 29 of the 85 cases is a note made on this pointin 19 there was injection, in 10 there was not. The conjunctival affection causes itching and smarting of the eyes with lachrymation, and occasionally photophobia. Sometimes there is a slight watery discharge from the nose, with itching and sneezing. Desquamation may follow; usually it is slight and branny, but it may be profuse; rarely is it 'pinhole.'

"It was pointed out during the discussion that the clean mouth, the absence of Koplik's spots and the invasion by the eruption of the circumoral region—rarely, if ever, noticed in scarlet fever-were features of the disease of great value in the differential diagnosis."

As these observations were made in the London Fever Hospital, they may be ac

cepted as being based upon ample data, and may be relied upon as authoritative.

THE AMERICAN MEDICAL AS

SOCIATION.

The annual meeting of this association will be held in Chicago June 2-5, 1908. This meeting alone would insure a very large attendance of physicians without the other national meetings, which are as follows:

American Academy of Medicine, May 30 and June 1.

National Confederation of Medical Examining and Licensing Boards, June 1.

National Association of U. S. Pension Examining Surgeons, Palmer House, June 1.

Association of American Teachers of the Diseases of Children, Great Northern, June 1.

American Medical Editors' Association, May 30, June 1.

American Proctologic Society, June 1 and 2.

American Gastro-Enterological Association, June 1 and 2.

Secretaries and Editors of State Journals, June 1.

It will probably be difficult to find satisfactory hotel accommodations unless they be secured in advance, which may be done by addressing the chairman of the Hotels Committee, Dr. L. L. McArthur, 100 State street, Chicago.

The following places of meeting have been announced in the journal of the association:

Practice of Medicine-Sinai Temple, 21st street and Indiana avenue.

Obstetrics and Diseases of WomenSecond Presbyterian Church, 20th street and Michigan avenue.

A Darwin Centennial.-Arrangements are being made by the University of Cambridge to celebrate on June 22, 23 and 24, 1909, the 100th anniversary of the birth of Charles Darwin, and the 50th anniversary of the publication of the "Origin of Species." It is proposed to invite representatives of universities and other learned bodies, together with distinguished individuals, to visit the university on the occasion. A program of the celebration will shortly be issued. The Honorable Secretaries are Mr. J. W. Clark, Registrar, and Prof. A. C. Seward, Professor of Botany in the university.

The Etiology of Trachoma.-The Royal Hungarian Minister of the Interior offers the sum of 1000 crowns as a prize to the author of the best work on the "Etiology of Trachoma." All essays, whether in manuscript or published for the first time in 1907 or 1908, will be

eligible for the competition, provided they are in English, Hungarian, French or German, and that they are received on or before December 31, 1908, by the Minister of the Interior. They should be addressed "Belügyministerium, Budapest, Hungary." The winner will be announced at the inaugural session of the 16th International Medical Congress at Budapest in 1909.

The British Medical Association. The 76th annual meeting of the British Medical Association will be held at Sheffield in July 1908. The president's address will be delivered on Tuesday, July 28, in the Firth Hall of the university, and the sections will meet on the three following days. The annual representative meetings will begin at the close of the previous week, probably on Friday, July 24. The president-elect is Mr. Simeon Snell, F.R.C.S.Edin., opthalmic surgeon Royal Infirmary, Sheffield, and the

honorable local secretary Mr. Sinclair White, M.Ch., F.R.C.S., Ranmoor, Sheffield. The address in medicine will be delivered by Dr. Kingston Fowler; the address in surgery will be delivered by Mr. R. J. Pye-Smith, F.R.C.E.Eng., and the popular lecture, on "Dust and Disease," will be delivered by Mr. Edmund Owen, LL.D., F.R.C.S.Eng.

Endowed Beds for Physicians. Maria L. Campbell has provided for an endowment fund of $20,000 for beds in St. Luke's Hospital in this city for the exclusive use of physicians. Any medical man may avail himself of one of these beds by applying to the hospital superintendent.

Dr. John B. Murphy has resigned as professor of surgery and co-head of the department in Rush Medical College and has accepted the professorship of surgery and head of the department in Northwestern University Medical School and position of attending surgeon at Mercy Hospital.

Dr. A. W. Meyer of the University of Minnesota, and formerly of Johns Hopkins, has accepted the professorship

of anatomy in Northwestern University Medical School.

Dr. A. H. Richards of the College of Physicians and Surgeons of New York city has been appointed professor of pharmacology in Northwestern University Medical School.

The Medical Society of New Jersey will hold the next meeting in Cape May

American Medical Editors' Association will hold its annual session at the Auditorium, Chicago, on May 30 and June 1. A diversified and interesting program has been prepared. Medical editors not members of the association are invited to attend.

The German Society of Tropical Medicine has nominated Professors Nocht and Plehn as delegates to participate in the deliberations to be held in London in the summer or autumn with a view to the organization of an International Society of Tropical Medicine.

A Large Bequest to St. Luke's Hospital. By the will of the late William Wheeler Smith of New York, his entire estate, amounting to nearly $3,000,000, is left to St. Luke's Hospital. During her lifetime his widow is to have the family residence and an income of $8400 a year, and on her death the whole of the property reverts to the hospital.

DEATHS.

ALDRICH.--In Cleveland, Ohio, April 27, 1908, Dr. Charles J. Aldrich, aged 46

years.

ARMSTRONG.-In Lock Haven, Pa., April 17, 1908, Dr. Richard Armstrong, aged 75 years.

BAGWELL-In Greenville, N. C., April 7, 1908, Dr. William H. Bagwell, aged 44 years.

BARRETT.-In St. Louis, Mo., April 6, 1908, Dr. Richard Aylett Barrett, aged 73 years.

BENNETT.In Battle Creek, Mich.,

18, 19 and 20, 1908.

The American Medical Editors' Association. Just preceding the meeting of the American Medical Association the

years.

BLACK.—In Louisville, Ky., April 5, 1908, Dr. Edward Henry Black, aged 88 years.