All further local treatment was stopped. From this time progress was satisfactory, and the patient left the hospital well on the 22d day.

Case 2-Patient, I-para, æt. 19, admitted to hospital after being in labor 12 hours. The presentation was occipitoposterior, and delivery was effected by forceps. On the eighth day the temperature was 105° F., and pulse 136. Cultures showed streptococcus and staphylococcus, and blood examinations showed all three organisms to be present. From

these vaccines were made and injections commenced of 25,000,000 streptococci and 250,000,000 staphylococci. Rigors continued at intervals for 30 days. Seven injections of vaccine were given at intervals of two days, increased to double the quantity at each injection. For 10 days vaccines were withheld, to be repeated again as the temperature kept high. On the 40th day of illness 10 cc. blood taken from the patient gave no cultures. The improvement was going on steadily when patient left hospital against advice.

The Abdominal Belt T. W. Kilmer reTreatment of Pertussis ports the result from letters of inquiry in regard to the value of the abdominal belt in whoopingcough, sent out to pædiatrists in various parts of the United States, to which 45 replies, covering over 550 cases, were received. The results are given in tabulated form, and show 484 out of 556 patients improved (nearly 88 per cent.), and only 72 showing no improvement. Most of the replies were of interest on account of their testimony to the good effects of the belt in the prevention of vomiting. This was the chief benefit claimed by him, and he is pleased to have the support of these additional witnesses. A large number of cases with complications were reported in the answers, but he finds by further inquiry that in most cases these existed before the adoption of the belt treatment. Drugs were also used in many of the cases, but the effect of the belt on the vomiting was marked, independent of the medication.

Cancer in Children.

Philipp, P.W. (Zeit

The

schrift f. Krebsforschung, Vo. 5. H. 3, 1907). The author compiled all the accessible cases of cancer in children from the literature, altogether 396 cases, 93 of which were positive. The percentage, according to a compilation of Lubarsch, amounts to about 0.03 (four among 12,500 autopsies). Cancer of the digestive tract is the most common, the liver and the pancreas being more frequently affected than the stomach. The intestinal segments present the same successive susceptibility as in adults. ovaries are very frequently involved. The skin cancers occupy the third rank in order of occurrence. Up to the seventh year of age children are practically free. from cancer. The majority of the patients were between 9 and 15 years of age. Boys and girls are attacked with the same frequency. In the former the cutaneous and intestinal cancers predominate; in the latter, ovarian carcinoma is the most common. The histological structure presents the same relations as

in adults. The course, from the appearance of the first manifestations to the end, varied from five weeks to eight years. Metastases are not very common. A true cancerous cachexia is not apt to develop, on account of the usually very rapid course. The prognosis is gloomy. From the etiological point of view, irritation and traumatism enter into consideration. The theory to the effect that chronic irritation in a general way favors the development of cancer is borne out by the observation that carcinoma of the stomach, œsophagus, uterus, mamma penis is of very rare occurrence in children.

Chronic Kidney Dis- Klimoff (Folia Uro

eases in Children. logica, No. 2, 1907).

The following conclusions are arrived at by the author:

I. Chronic nephritis is not of uncommon occurrence in childhood. All the forms of chronic nephritis which have. been described in adults seem to affect children as well.

2. The clinical determination of definite forms of chronic nephritis meets with greater difficulties in children than in adults.

3. The etiology of so-called chronic parenchymatous nephritis remains unknown in the majority of the cases.

8. In youthful nephritic patients having oedema the body weight should be ascertained every day..

9. The daily measurements of the daily amount of urine passed by nephritic patients present certain features characteristic of the disease in children.

10. Daily determinations of the albumin contents, according to Esbach's method, permit the estimation of the daily fluctuations in the excreted amount of albumin.

II. The discovery of new clinical landmarks serving for the differential diagnosis is highly desirable for the accurate and detailed recognition of the various types of nephritis.

12. The condition of nephritic patients is aggravated by the internal ad

ministration of sodium chloride, as well as by the partaking of salted foods. F. R.

Ciaccia (Rivista di Cystitis in Infancy. Clinica Pediatrica, April, 1907). Various forms of cystitis have been observed in children, including tuberculous cystitis, gonorrhoeal cystitis and coli cystitis, the latter being the most common and the most important. A number of theories have been propounded to explain the origin of the vericular infection. In the author's opinion the existence of phimosis is extremely important

a general way this factor has not been given the importance it deserves in this connection, predisposing as it does to balano-postitis, and through this to an inflammation of the urethra by the colon bacillus.

In 15 cases of cystitis in young children observed by the author the best results were obtained from the administration of urotropin and helmitol. Sero therapeutic attempts have been made in cases of coli-cystitis, and a rapid recovery

II cases of cystitis due to the colon bacillus, observed in the pædiatric clinics of the University of Rome. Among these cases seven concerned girls and four boys. The pathogenesis of this disease still remains somewhat obscure. Meanwhile, this cystitis of early infancy is of greater practical importance than would seem to be the case. Numerous febrile affections with a protracted course and uncertain diagnosis are referable to infection of the bladder with the colon bacillus, and the true state of affairs can only be determined by the microscopical and bacteriological examination of the urine.

With special reference to the patho

the Pons.

genesis, the ascending route through the urethra is probably the most common mode of infection. The hæmatogenous route, through the circulating blood, and infection through the bowel walls, are likewise admitted, and have been demonstrated by animal experiments.

severer forms of the diseases occur in children of a few months up to three years of age, and are characterized by a high remittent and intermittent fever, serious disturbances of the general condition and a protracted course. The milder forms are observed in children between 5 and II years of age. In these cases the general condition is but little changed, the fever is moderate, sometimes absent, and the course is brief.

The treatment is symptomatic; diuresis should be stimulated by mild mineral waters; sabol and helmitol are indicated, in very small doses. In chronic cases, flushing with potassium permanganete solution, 1.4000, may prove useful. F. R.

Metastatic Abscess of Bregmaim (Dtsch. Ztschrft. f. Nervenhelik, Vol. 31, 1-2, 1907). Among eleven reported cases of metastatic abscess of the pons six were positively shown to be of metastatic origin, from a primary panaritium, perityphlitic focus, bronchiectatic cavities, otitis, etc. In the case observed by the author the metastatic abscess of the pons had developed as a sequel to suppuration in the kidney. It started in the proximal segment of the medulla oblongata, occupying the entire transverse section in the distal and mesial segments of the pons. The abscess was chiefly located in the left half of the pons, passing towards the right

child had suffered for years from tinnitus and occasional attacks of vertigo. Two weeks after a mild attack of mumps she developed typical Meniere seizures, lasting 10 to 15 minutes, and recurring up to twice a week. It was a noteworthy fact that the left ear, from which the attacks originated, was of such imperfect development that injury of a similarly degenerated organ could hardly have been expected to induce results of this kind. The treatment consisted in the action of a constant current of 0.1 milli-ampere by means of two electrodes armed with moist cotton and applied to the tympano. The sessions were repeated twice weekly, and lasted from 15 to 30 minutes. The attacks promptly diminished in number, as well as in severity. F. R.

A Case of Yeast In- Türk W. (Dtsch. fection of the Meninges Archiv. f. Klin. (Saccharomycosis.) Med., Volume 90,

1907). The author reports the clinical observation of a case of meningitis which, in view of certain concomitant phenomena, seemed to suggest the presence of tuberculosis. The examination of the lumbar fluid, however, served to demonstrate a very large amount of yeast cells, both intra and extracellular. Other microbes were absent. The yeast was shown to be present also all over the meninges when the case came to autopsy. There was no tumor formation, as in the published cases of yeast infection. The author assumes that the yeast found a favorable nutritional soil in the tuberculous body, whereas in a healthy organism it does not, as a rule, possess much virulence. The lymphatic pharyngeal ring was found to be the avenue of entrance at the autopsy. F. R.

Psoriasis.

X-ray Treatment of Max Joseph (Zeits. f. neuvere physikal. Medizin.). While there are many excellent measures for curing different attacks of psoriasis, there is no method of treatment that will surely prevent later outbreaks of the disease. With regard to the efficacy of the X-ray in the treatment of the disease, opinions are at great variance.

A case is cited in which a few exposures to the X-ray caused the complete disappearance of all psoriatic lesions. Relapses occurred later, which were again temporarily cured by the ray. This case illustrates, in the writer's opinion, that

internal treatment with buttermilk, which is both curative and prophylactic. The buttermilk was prepared from fresh milk and given either under exclusion of all other milk or alternating with breast milk or sterilized milk, according to the gravity of the case. The results of this treatment became manifest in the majority of the cases much more rapidly than in other methods, which were frequently compared in the same patients. The stools become regular and lose their foetid character, the pruritus diminishes or disappears and the eruption subsides or even fades away very rapidly, as noted in a number of observations (13 cases). The itching is relieved in the first place, then the eruption subsides and begins to heal. In otherwise obstinate cases of general eczema an almost perfect cure was obtained in 12 days to four weeks.

There is no objection to continuing the treatment for a long time. In the case of children more than one year of age or older thickened soups or porridges may be prepared with the buttermilk, which also serves as a drink between meals.

While the action of buttermilk is complex, its influence is obvious-it arrests intestinal fermentation. Given in certain forms of toxic dermatitis it constitutes a medication distinctly superior to the employment of intestinal antiseptics. These skin affections almost invariably appear in children whose alimentation is deficient in regard to quantity or quality, giving rise to a toxic gastro-intestinal infection which may manifest itself in skin disease. Local treatment in these cases is insufficient and secondary, for the gastro-intestinal intoxication must be controlled in

the first place. The existing auto-intoxication may be kept up even by aseptic milk (breast milk or sterilized milk) — given at regular intervals and in reasonable doses-as the result of fermentation, either because the milk contains too much fat or casein or because the digestive juices of the infant are unable to digest it in the normal way. Buttermilk in these cases serves as a curative food, for it is easily digested on account of its poverty in fats and the very fine division of the casein. It is, moreover, slightly antiseptic through the lactic acid contained in it, which counteracts the abnormal fermentations and the putrefaction of the casein. F. R.

tient was a man 47 years of age, who came under treatment with the symptoms of phlegmon in the left hand and forearm. The disease began with a loss of sensation in the fingers, preceded by paræsthesia, a week before the patient's admission to the hospital. Aside from the phlegmonous manifestations, there existed a number of asphyctic spots on the fingertips. The pulse became palpable only in the subclavian and the proximal portion of the axillary artery. This served to show that the patient had suffered from syphilis eight years previously. Antisyphilitic treatment was accordingly instituted in addition to local applications. of ice, etc. The patient finally recovered after spontaneous shedding and surgical removal of the gangrenous portions of the fingers. F. R.