animals leads to fibrous degeneration of the uterus and Fallopian tubes (most marked in the mucous membrane). The animals' subsequent health and nutrition remain good.

These observations for the most part support the evidence obtained clinically in the human subject after surgical op

eration.

3. The removal of the uterus in a young animal has no influence in preventing the further development of the ovaries. These are capable of ovulating and forming corpora lutea after adult life has been reached.

4. The removal of the uterus in an adult animal does not give rise to any degenerative change in the ovaries if the vascular connections of the latter remain intact.

The latter observations do not support the contentions of those surgeons who advocate total hysterectomy, believing that the functionel activity of the ovary is in some way dependent on the presence of the uterus.

Vaccination and Pertussis.

Vaccination against

smallpox has usually been regarded as inadvisable during the course of any infectious disease, as it is supposed to complicate the disease itself, and in the lowered condition of the patient may "take" with quite unnecessary vigor. This is particularly true of scarlatina, as Jezierski has pointed out. A number of French clinicians, however, have observed that in the case of pertussis, instead of complicating the condition, vaccination seems to have a beneficial action, and, in fact, may prove curative in a considerable proportion of cases. Attention was drawn to this point by Amat in a communication to the Société de Thérapeutique in April, 1907, and since that time Bolognesi and Laborderie

Bo

have published studies on the subject which tend to corroborate this view. lognesi holds that if the child had been previously successfully vaccinated, a revaccination is of no therapeutic value in pertussis, but Amat and Laborderie have both obtained good results whether it was the first vaccination or not if the vaccination were successful. Their combined experience shows that in a fairly large proportion of cases children having pertussis who are successfully vaccinated. show a marked improvement within a day or so of the development of the pustule, and are completely cured in one or two weeks. The rationale of this procedure has not yet been explained. (Journal of A. M. A.)

erally considered that the albumin contained in nephritic urine is derived from the blood. It is assumed that inflammatory changes in the kidney interfere with the integrity of the renal filter and permit serum albumin to pass through and emerge in the urine. Only some of the formed elements are considered as being of renal origin. Schmidt suggests that this view may not be altogether accurate and that perhaps all or almost all of the albumin comes from the renal parenchyma itself. He points out that just as any inflamed organ, for example, the serous membranes or the epidermis, deprived of the cutis may pour out albuminous exudate, so the inflamed kidney may be the seat of an albuminous exudation, which will be the richer in albumin, the fresher, the more intense and the more extensive the pathological process is.

This exudate may therefore be considered as a sort of wound secretion from the kidney. The point is of more than theoretical interest, for the albumin in

physiological or orthostatic albuminuria would probably not have this origin, and by the development of appropriate tests it might be possible to evolve differential diagnostic measures founded on this principle. (Münch. Med. Woch.)

The Use of the Parathyroid Gland for Paralysis Agitans.

W. N. Berkeley considers this question from the three viewpoints of laboratory work, autopsy findings and clinical results. Only properly identified glands should be used, as most of the material on the markets is worthless. Human glands obtained at autopsy and ox glands alone are serviceable. Small doses must be given and continued over a long period, sometimes as long as six months, before any appreciable effects are seen. The author estimates that some 75 patients under his own care or that of his friends have been treated, but he has notes of only 30 cases. Of these 2 de

clined to continue the remedy, 2 have not been heard from, 5 denied any benefit, 3 showed temporary improvement only, and 18 were progressively benefited during the entire period in which they were under treatment. The benefit consisted in diminished rigidity, lessened pain, salivation cured, shaking diminished or cured, voluntary control of the muscles greatly increased, and restlessness and insomnia nearly or quite abolished. The early cases in younger patients responded with more speed and completeness, but unfortunate bedridden patients who had suffered for 15 years with the disease have quite often been remarkably helped. One man of 55 years, with a rapidly progressive type of the disease, bedridden for six months, restless, sleepless and greatly discouraged, was able to sleep again in three weeks, and is now for nearly a year back at his work, going down town every morning on the trolley alone.

Puerperal Infection.

Dr. C. C. Crunn read a paper with this title before the State Medical Society of Indiana. He says:

"Puerperal infection is to be diagnosed from typhoid fever, malaria and sapræmia. In typhoid the Widal reaction is present, spots often occur on the ablomen, the slow onset of the disease and the condition of the tongue ought to clear up the diagnosis. Malaria is the disease most often mistaken for an infection; it might be said that an infection is more often mistaken for malaria, as malaria is a very common complication of the puerperal state. The diagnosis is made by the fact that malaria responds to quinine,

the fever is followed by sweat and return to normal temperature, while an infection causes a continual fever which does not react to quinine. The microscopical examination of the lochia will fail to find any evidences of infection in malaria.

"From sapræmia it is diagnosed by the higher fever and greater prostration, the microscopical examination and more serious symptoms throughout.

"A great deal of controversy ensues as regards to treatment, especially in the use of the curette. Some surgeons claim that the use of the curette is often advisable in these cases, while others say it were better if the curette had never been thought of in the treatment of puerperal

infection. The more conservative view, however, is to use only the dull curette, and only in those cases where there is a great deal of broken-down tissue to remove. In the streptococcic form matters are only made worse by its use, as the protective wall which the tissues are some

times able to form is in this way broken down, and at the time no good could be accomplished, as there is nothing in the way of debris that can be removed.

"In the removal of the uterus there is also a great deal of contention, as some claim in this way the disease can be eradicated, while others claim that this only adds to the general prostration and no good comes from it. At least this operation is advisable in the condition of multiple abscesses of the uterus, which fail to heal. The whole process can in this way be removed from the body and a cure accomplished.

"The use of douches do good in so far as they remove broken-down tissue, and are to be used mostly as an aid to the curette. It is helpful, however, in that it removes debris and checks the disagreeable odor in some forms of the disease. The use of the douche should be done with the greatest precaution as to cleanliness, and is not to be entrusted to anyone except an experienced nurse under the direction of the surgeon in charge.

"Constitutional treatment forms one of our greatest assets. Strychnine and whiskey is our main dependence, as far as stimulation is concerned, and should always be given where there is any degree of prostration. Sponging to reduce fever should be preferred to any antipyretic, as the depression from any of these is apt to cause trouble where there is so much prostration.

"Of late years the use of serum has been advocated in these cases, and I have

seen what appeared to be excellent results from the use of them."-Indiana Medical Journal, October, 1907.

Thyroid Extract in the In the transactions Toxæmia of Pregnancy. of the Washington Obstetrical and Gynecological Society, as found in the October Americal Journal

of Obstetrics, will be noted an interesting report by Fry of "Toxæmia of Pregnancy Relieved by the Administration of Thyroid Extract."

The urinary analysis extended over a period from July 18 to December 14, 1906. At the last examination the specific gravity was 1005, and urea was less than one-half of 1 per cent. No albumin or casts. At the time of the December examination the patient had suffered for two weeks with headache, insomnia and indigestion. He made no change whatever in diet or mode of living, but gave five grains of thyroid t. i. d. The examination of the urine made 36 hours after having begun treatment shows a rise of specific gravity to 1018, percentage of urea to 2.5. The above symptoms disappeared. The tablets were kept up twice daily for two weeks and omitted. Urinary examination became satisfactory, and patient was delivered normally one month ago (March last).

This is a report of unusual interest. The influence of the secretion of the thyroid upon metabolism is by no means settled in the medical mind of today. Some of the assumed facts so glibly quoted by those who operate on the thyroid will not bear critical analysis. That exophthálmic goitre and myxedema represent extremes of the same condition, the one being a manifestation of excessive thyroid activity, the other deficient activity, is not wholly satisfactory to one who has seen the symptoms of both these conditions present in the same patient at the same