In this case the embryo is the product of a healthy ovum from the mother, united with a syphilitic spermatozoon from the father, hence it is diseased ab viritio. Syphilitic toxines are formed and diffused from placental vessels into the circulation of the mother for a period of nine months. Through this process the mother becomes absolutely immune from the disease. Under the most tempting conditions for infection, viz., lacerated cervix, vagina, or perineum, or the child with mucous patches on its mouth, tugging at an excoriated and fissured nipple, the mother will not contract the disease from the child, not because she already has the disease but rather because her system has been rendered immune. The germ of syphilis is unable to get through the fœtal membranes, and the mother, hence, is not infected; but the toxines do get through and by their growth and long-continued action on the system causes an ideal immunity.

A MOST INTERESTING CASE OF RAPID AND IRREGULAR GROWTH is presented at present writing in that of Patrick Casey, a lad of fifteen, and residing in Bridgeport. On Thursday night, October 3d, Patrick was struck dumb, and has written on his pad the fact that once or twice during the last few weeks, at school, he found himself unable to speak, and that the teacher thought he was shamming and punished him. But his growing twelve inches in two months is a question more difficult to understand than the loss of his voice. During the Summer vacation he worked at the oyster dredges along the Bridgeport shore, and devoured seed oysters in great quantities, and it may be that they are responsible for his astounding growth. On October 7th, he gained a little over the mark of six feet two inches. One leg and one arm are noticeably growing faster than their mates, and before he is much older he will be crooked. In addition to the looseness of his teeth there are other marks of growth so rapid that it is imperfect. His toe-nails are coming off, and some of his joints squeak when he moves. His hair also grows very rapidly, requiring to be cut twice a week. Altogether the case is one of unusual interest.

THE BENEFITS OF SPECIALISM.-Dr. W. K. Simpson, in New York Medical Journal, says: "After having considered the evident present tendency toward specialism, it might be well to consider the debt that the profession owes it. The relief from former ignorance and chaos has been the result of men devoting themselves to special work. The microscope and pathology are brilliant examples. Special surgery has allowed the explorations of

regions of the body with impunity which in former times were closed to all knowledge, yielding results which seem but little removed from the miraculous. Look at it as we may, specialism is a natural culmination of the advancements made in the science and practice of medicine, and, as a result, gynecology, ophthalmology, neurology, orthopedics, laryngology, otology, dermatology, and many others have reared domains of their own which are far from being circumscribed; and it has not been the work of narrow-minded men, but men of broad minds and actions that have put specialism on a sure foundation and doubtless have made it the practice of the future."

RHEUMATIC APPENDICITIS.-Dr. Brazil and Dr. J. E. Frazer, of England, have published several cases of what they call rheumatic appendicitis, in which they think that the inflammation of the appendix is due to uratic deposits. These cases when treated by a salicylate of soda are relieved with magical rapidity.

THE PHYSIOLOGICAL EFFECTS OF EXTRACTS OF THE SUPRARENAL CAPSULES.-By George Oliver, M.D., and E. A. Schäfer, F.R.S. (Journal of Physiology, London, July, 1895). By the result of numerous investigations it is claimed by the authors that the suprarenal capsules are to be regarded, like the thyroid gland, as ductless, yet as strictly secreting glands. The material which they secrete as an active principle seems to increase the tone of all muscular tissue, and especially to produce this effect upon the heart and arteries. On the other hand the removal of the capsules produces extreme weakness of the heart and muscular system generally, and great want of tone in the vascular system, a similar effect to that produced by disease of these organs (Addison's disease). "It may be fairly concluded therefore that one of the main functions, if not the main function, of the suprarenal capsules is to produce a material which by direct. action upon muscular tissue produces that tonic contraction which is essential to the physiological activity of the tissue." These experiments have been recently confirmed by Szymonowicz and Cybulski.

MEDICAL SOCIETY REPORTS.

LITCHFIELD COUNTY SOCIETY.-A special meeting was held in Norfolk on July 9th, Dr. F. H. Wiggin presiding. It was the most fully attended meeting ever held. There were many guests of the society from other parts of the State and New York; among others Dr. Seth Hill, President of the Connecticut State Medical Society, Professors Lindsley and Carmalt of Yale University, Dr. Bulkley and Dr. Porter of New York, and Prof. Welch of Johns Hopkins University.

The representatives of the several county societies were called upon, and each offered a few remarks. Dr. Ralph S. Goodwin of Thomaston read a paper upon "The Physician as a Sanitarian," which brought forth considerable discussion. Prof. Wm. H. Welch urged that every physician should use his personal influence towards the establishment of a national bureau of health. Dr. Wm. H. Welch followed with a paper upon "The Antitoxine Treatment of Diphtheria." Among other things the doctor remarked that "the decision as to its efficacy must rest with the clinician. However, it cannot be questioned that there is a satisfactory experimental basis for the treatment of diphtheria by this antitoxine serum. The disease which is produced in susceptible animals by inoculation with the Loeffler bacillus is, in its essential points, identical with human diphtheria. There is no more impressive laboratory experiment than the demonstration of the power of the antitoxine serum to prevent and to cure experimental diphtheria. Therefore it is difficult to understand why a similar power should fail to manifest itself against the same poisoning in human beings. As to the mode of action of the antitoxine, we are ignorant. It is known that there are two principal theories as to its action-one, the so-called "chemical theory," and the other, what might be called the "vital theory." The former is that the antitoxine neutralizes directly, in a chemical sense, the toxine in the human body. The evidence is, however, in favor of the vital theory-in other words, that the antitoxine acts through the agency of the living cells of the body. If these cells are impaired by pre-existing or co-existent disease, or by the action of toxine itself upon them, we can understand how there may be no beneficial effect. Regarding dosage, I would say that the relation between antitoxine and toxine is a quantitative one. The dose

must be larger, the longer the time after the toxine has been absorbed into the system, and according to the size or age of the individual. As regards the general effect of the healing serum, I would say that the evidence is in favor of the statement that it produces a very evident beneficial effect on the patient. There is, as a rule, a lowering of the temperature, and the treatment tends in most cases to arrest the local exudation, and to mark out more distinctly the line of separation between the healthy and diseased tissue. There is also an unusually speedy separation of the membrane. The objections to the treatment are these: it is not an infallible remedy; it is not a cure-all. It does not prevent post-diphtheritic paralysis; it does not prevent albuminuria; and the question as to whether it causes albuminuria or not is still an open one. In general, the treatment rests upon a sound experimental basis, and statistics favor the conclusion that the antitoxine serum exerts a specific effect, and reduces mortality one-third to one-half. It is the duty of every physician, wherever practicable, to employ this treatment.

This paper was succeeded by one upon "Some of the Newer Remedies Used in Diseases of the Skin," by L. Duncan Bulkley, M.D., of New York. The paper teemed with suggestions which will be of great service to the physicians present.

Dr. W. H. Carmalt of New Haven reported a case of laparotomy for supposed perforation of the ileum in typhoid fever. The case dated from the late epidemic of typhoid fever in Stamford, and appeared in a nurse who had cared for several cases during this epidemic. A few days after her return, she developed the symptoms of a moderate typhoid fever. The temperature did not rise above 101° F., and her mind was clear during the whole time. The petechial eruption appeared on the abdomen at the proper time. On the morning of the tenth day, without having had any diarrhoea, she suddenly complained of very intense pain in the right iliac fossa. This pain increased rapidly, and extended over the whole lower abdomen. I saw her about nine o'clock the following morning, and already by that time her countenance had become markedly pinched, the abdomen decidedly tympanitic, and the temperature had fallen to 99.4°. Her pulse varied between 100 and 112. She complained of pain on pressure throughout the lower part of the abdomen, and her pupils were greatly contracted from the morphine she had taken. Her menstrual flow had begun also on that day. In the afternoon, some of the effect of the morphine had passed off, and she said the pain was not at all like the menstrual pain from which she had often suffered. Diag

nosis of perforation of the ileum was made and I advised laparotomy, to which she at once consented. Her temperature had only risen very slightly during this time, but her pulse had become more rapid. The incision was made at the outer border of the rectus muscle. As soon as the peritonaeal cavity was opened, stinking serum began to flow out from among the distended coils of the intestine. The intestine was examined very rapidly, the patient's condition becoming critical. The coils of intestine were intensely congested, and coated here and there with flakes of lymph. Peyer's patches could be seen through the muscular coat as opaque spots. Quite low down the lymph was more abundant and adherent. I found a perforative ulceration in the appendix, about half an inch from the end of the cæcum. There were two fecal concretions in the appendix but no further ulceration. The distal one-half was unaffected; appeared normal. The appendix was tied off, and removed, but her condition was too low at the beginning of the operation and she died immediately after the completion of the operation.

The question is between an intense gangrenous, sloughing appendicitis and perforation of a typhoid ulcer. The early stage of the disease inclined me to believe that there had not been a sufficient typhoid ulceration to cause perforation. I afterwards learned that she had complained of pain in the right iliac region during her menstrual periods, and that she had from time to time. laughingly expressed the opinion that she had appendicitis. I have made a cursory search of the literature of the subject. Pepper says that he has known septic peritonitis with purulent effusion to occur on the tenth day, and states explicitly that this is not the result of perforation. Fowler, in his book on appendicitis, says that there need be no question between an appendicitis and an ulceration. It has been suggested that the case was one of mistaken diagnosis, and that it was really one of appendicitis from the beginning. The history of exposure to a severe form of typhoid fever, together with the clinical course of the disease, are, it seems to me, sufficient to refute such a statement. There was no wall of lymph in this case, cutting off the appendix from the rest of the peritoneal cavity. If we can make the differential diagnosis between an appendicitis and an intestinal perforation occurring on the tenth day of a typhoid fever, I should like to know how it can be done.

Dr. Wiggin said that it was evident from the history of the case that the patient had had typhoid fever.

Dr. Welch said that the case reported was nothing more than