Must he then necessarily remain or become ignorant of the constant progress which is being made in the profession of his choice? By no means. This is shown by the supply of toxin that does the mischief. And I one side for fourteen years, and there had been, apparently, no active catarrhal process in operation during that time. The word" Quarantine" no longer expresses the duration of retention and observation, but now comprises series of restrictive and sanitary measures, destined to prevent the introduction and spread of an epidemic in a locality. - the fallacy of the saying that pain never kills is shown in the disturbance of a plexus or ganglion, or the prolonged irritation of the periph ery, causing shock, exhaustion, mental prostration, and death, whether it be interpreted by the brain as pain or not. For a long time I considered the hereditary nature of the disease where four of the children were affected as being particularly well established. If a candidate fails on first examination he may, after not less than six months' further study, have a second examination without fee. (i) If the lesion is more extensive it may involve not only the central portion, but also the direct fibres on one side of the commissure, in which case there would be total blindness in one eye and temporal hemianopia in the (c) Still more extensive disease is not infrequent from pressure of tumors in this region, the whole chiasma is involved, and total bUndness results.

It is necessary also to add at least as much filtration and protection to the external side of the applicator, for the patient may inadvertently rest the arm or leg on the applicator during sleep, and a severe burn may thus result.

The kidneys also, those great emunctories, are apt to fail, and every surgeon knows that a man, especially an old one, with diseased kidneys, stands upon the brink of a precipice from which he may be precipitated by the smallest agitation. Profuse sweating may occur, either local or general, and sometimes nocturnal.

The most effective method is by means of the ice helmet to be tied under the chin; but this may be improvised by wrapping the crushed ice in a layer or two of cotton cloth and one of flannel, "randevu" laying this in a shallow receptacle of rubber sheeting.

The correspondence of the period of exudation of fibrin with the period of maximum temperature is interesting (kouyolu). The patient must be sat upright in bed as soon as he recovers from the shock and the anesthetic, and must be taken regularly out of bed into an easy chair from the second pathogenesis of the affection based on the pathology of his case. One result, of the injection of serum was an increase of the meningeal symptoms and a marked rise of the cell count. But wHth the usual guarantees, and this additional one, that the rule of the profession is to preserve life when it can. A great variety of dilating instruments has been described, both for intra-laryngeal use from above and for intra-tracheal use from below through a tracheal opening. The glands enlarge slowly and painlessly and show considerable variability in size at different periods. Difficulty in coughing, owing to the impossibility of drawing a full breath, adds greatly to the danger of this complication. Six ounces of urine had been passed. It would then cease to be thought needful to build, at intervals of ten years or so, vast structures in a few localities, costing great sums, and always found ill-adapted to the chronic insane and to the poor as are the hospitals at Danvers and Worcester. There was no scar, no change in the gastric wall as evidence of any previous ulcer.

:iiul when the cavity i.s clean, then the diaphragm is incised for the subphrenic collection.

She complained of much pain in the lower "esenler" left abdominal region, which was discolored and apparently somewhat indurated (numerous blisters, mustard plasters, etc., had been applied). It is otherwise, however, when the process has gone so far that the epidermis presents the concentric arrangement known as cholesteatoma.

Dana's patient was a woman of good physique and mental qualities up to the time of the onset of her illness.

The bowels were badly constipated, and only moved occasionally with the aid of soap enemas. To-day almost every physician believes in the value of the cold bath in the treatment of tj'phoid fever. When faecal or urinary extravasation has occurred, the face is of ghastly pallor, the pain acutely lancinating and the prostration immediately very great.

I cannot give the statistics for such complications in this community, but I feel certain that such occurrences must be very small, much smaller than the number which would die from the increased danger of the operation of excision in all cases over that of gastroenterostomy.

Therefore, inasmuch as this operation is recommended only after the menopause, it would not seem that any harm could be done by bringing the cervix forward. The facial nerve is often involved in In lesions of the pons the patient often has a tendency to fall toward the side on which the lesion is, probably on account of implication of the middle peduncle of the cerebellum (brachium pontis).

Very professional job. Thanks again Dave

Thomas King - Shoeburyness