I cannot too strongly call your attention to the fact that the symptoms in the form of local discomfort and pain are often insignificant, while the local signs on superficial examination seem inadequate to explain the systemic disturbance.

Occasionally this pain is cramplike and epigastric in situation. The common duct was about twice normal size hut thin walled and free from stones or any type of obstruction. Simulate insanity is the primare verrucktheit French, the imbecility of the first grade of Ray and Nichols, the monomania of Spitzka, the chronic intellectual mania, or chronic mania, without incoherence, of asylum reports. Throbbing over the whole body. He was, however, afraid lest her suspicions should be aroused if further medication were insisted on, and so I reluctantly gave up the case. The non-panel doctors are already pointing to this demand as something degrading the whole profession. Meanwhile, the author calls attention to the fact that of two individuals of the same age, similar habitus, and suffering under the same disease, the one dies, the other recovers, though both had been treated in the same manner. It is imperative of course to restrict, by proper consultation and rules, the performance of any medical or surgical procedure to those yvho have proved their capability.

Alvord expresses surprise that so strong an array of quotations could be adduced expressing unbelief in the possibility of such an event. This is due to the fact that disturbances in development of pneumatization greatly influence the structure of air spaces and also the appearance of non-pneumatized canal (c), sclerotic area between pneumatic cells (s).

Stiffness, severe rheumatism after rest. All are now agreed that no age is exempt, tho this point also has been disputed. DISEASES OF THE MEDULLA OBLONGATA. Harvey, of Indianapolis, had employed the peroxide of hydrogen in the cleansing of the cavities of pelvic abscesses with benefit. There are no epidemics or endemics of scrofula as of other infectious diseases, nor does it spread by a fixed contagion as syphilis does. How is the pain produced? I suggest the stimulus arises in the ulcer, passes to the spinal cord, and is of such intensity as to irritate the sensory nerves, and the pain is felt in the epigastrium, according to the law that stimulation of a sensory nerve causes a pain referred to its peripheral distribution.

This neurosis in activity imposes an imbecility upon the will in the direction of a single, but powerful appetite. All of the physicians who had seen him thought he had cancerous disease of the stomach. The physical signs impn and an X-ray picture taken before her discharge showed great shrinkage of the cavity of the empyema.

Three other persons who took the same amount of the poison recovered on account of early and abundant vomiting and purging, whereas in the fatal case the symptoms were delayed When chloroform is inhaled through a tracheal canula, so as to avoid the reflex action caused by the irritation of the naso-pharyngeal mucous membrane produced by the chloroform vapor, there is a quickening of the respiration and sometimes a complete cessation of inspiration, which Knoll considers to be due to the reflex actipn from those fibres of the vagus which produce inspiration; but after division of the vagus, there is a slowing of the respiration and cessation of expiration, due solely to the central action; this effect is caused also by intravenous injection of chloroform. By this method the boundary membrane of the lymph space ife rendered more distinct, and opacities or striations caused by bendings or duplicatures of this extremely delicate membrane may readily be mistaken for pathological conditions. The breast contained a few hard nodules which were scattered throughout the gland, but the muscles were apparently not involved. Discharges from the abdominal cavity by the early agglutination of the peritoneal surfaces.

Very professional job. Thanks again Dave

Thomas King - Shoeburyness