LOCAL COMMITTEE OF ARRANGEMENTS.

(With power to increase their number.)

A. Y. P. Garnett. M. D., Chairman, District of Columbia; the Surgeon-General U. S. Army; the Surgeon General U. S. Navy; the Supervising Surgeon-General U. S. Marine Hospital Service; J. H. Baxter, M. D., District of Columbia; C. H. A. Kleinschmidt, M. D., District of Columbia; N. S. Lincoln, M. D., District of Columbia; J. M. Toner, M. D., District of Columbia. Lists of Vice-Presidents, Secretaries, and Councilmen for each Section were named by the Committee of Arrangements, but as it was not practicable to ascertain at once who would accept the places assigned them, or who of those who had been announced in the medical press as declining to accept positions before the present rules and organization had been adopted as given above might wish to withdraw such declination, the final adjustment of these offices was referred to the Executive Committee of the Congress, and all correspondence in relation thereto was transferred to the Secretary-General of the Congress.

On motion, the Committee of Arrangements adjourned, subject to the call of the Chairman of the Committee.

JOHN V. SHOEMAKER,

Secretary of the Committee of Arrangements.

TREATMENT OF CHOLERA DURING THE ALGID PERIOD.-Dr. Georges Rigoletti attributes the principal symptoms of the algid period of cholera, such as lowering of the temperature of the exterior of the body, cyanosis, change of countenance, inextinguishable thirst, difficulty of respiration, epigastric constriction, hiccough, vomiting, muscular cramp, prostration, general collapse, and paralysis of the heart, to a lack of the normal proportion of water in the blood. Two indications correspond with the symptomatology:

1. To restore to the tissues their normal water, and to the blood its normal serum, in order that it may perform its functions.

2. To excite the nervous force and stimulate the heart. To fulfill these indications Dr. Rigoletti proposes the hot bath, containing ammonia and wood ashes.

The bath is prepared with water of a temperature ranging from 100.4° F. to 104° F.; about one quart of aqua ammonia and a sufficient quantity of wood ashes. The duration of the bath is from fifteen to twenty-five minutes, and it may be renewed in the same day, and for many days in succession, according to the case. To avoid the ammonical vapors, the patient is so covered as to prevent their reaching the head. The patient, on being removed from the bath, is covered with warm blankets, which favor and maintain reäction. Frictions with camphorated alcohol are also to be practiced, and aromatic infusion of chamomile and spirits are to be administered. If the reaction come on too violently, it is to be moderated by ordinary measures. The efficacy of the bath is more prompt when the algid state is least advanced. The method was used in 1884 with much success in the epidemic at Naples, and the official report as to its value is as follows:

1. The hot alkaline bath administered at the beginning of the algid period stimulates the peripheral circulation and increases the power of reäction.

2. The nervous forces are strengthened; the patient is so much relieved that many times during the day he requests the bath; the constriction of the epigastrium diminishes and disappears.

3. The pulse, often imperceptible, is gradually strengthened; the features become more natural, and the face even sometimes becomes flushed. Anuria almost always ceases in the bath.

4. Diarrhoea continues, but the vomiting and hiccough disappear with the administration of the bath.

5. The ammonical vapors excite cough and interfere with respiration, and for this reason it is necessary to protect the patient from them. However, the effect of the vapors is beneficial in that they increase the power of the voice, and render it less rough and more intelligible. In conclusion, the hot alkaline bath is a powerful therapeutic agent in the algid period of cholera, and its effects are most constant.

Dr. Rigoletti concludes his paper by stating that reäction, un

der treatment with the bath, is always prompt, occurring within twenty-five minutes; complete, as shown by the disappearance of all algid symptoms, and constant, having never failed in twentythree cases in which the algid condition was treated by its use. He considers it the remedy, per excellence, for this period of the disease, and much superior the intra-venous injections of salt water proposed by Dr. Hay men, and to the subcutaneous alkaline injections of hot water suggested by Prof. Cantani.-Journal de Médecine de Paris, May 10, 1885.

THE LATENCY OF GRAVE SYMPTOMS IN THE PUERPERAL STATE.-Dr. W. O. Priestley, in a paper on the Occasional Latency and Insidiousness of Grave Symptoms in Connection with the Puerperal State, concludes that,

1. In many cases going wrong, it has been observed that the uterus was inordinately large, thus indicating a dilated cavity, in which clots or fluid, which ought to be discharged, are retained, and which may thus become the nidus for the possible development of diseased germs. Further, in an imperfectly contracted. uterus, the sinuses or large viens remain full of clot, or of fluid blood, which is more or less apart from the general systemic circulation; and is thus, like the back-water of a stream, stagnant, and ready to become a source of peril. Clots should, therefore, always be carefully removed from the uterus, as they form for some time after delivery; and pressure with other means should be conjoined to promote full contraction.

2. The occurrence of a rigor at any part of the puerperal period should never be disregarded. It is nearly always the forerunner of some less or greater commotion in the system, although the mischief it portends may not be observed until the suspicion excited by its advent has well nigh died out.

3. The presence of rheumatic or obscure pains in the joints or muscles, even if they be flitting and transient, should be taken as indicating a possible contamination of the blood-current; and the case should be watched the more closely, if the patient be de

pressed in spirits, or if she be prone to be apparently hysterical. If, with these symptoms, there be no evidences of deviation in any special organ, the heart should especially be watched, with the view of ascertaining if there be any indications of deposits in the valves. The sudden appearance of a bruit with the heartsounds may be the precursor of embolism either in the pulmonary, or in the general systemic circulation. The temperature should also be carefully recorded, as it is probable that, in all cases of insidious puerperal disease, the thermometer will indicate some rise of temperature.

4. It should be remembered that patients who are inert in temperament, and who lead inactive lives during pregnancy, are more prone to puerperal ailments than others of more active disposition, and thus require more careful supervision.

5. The treatment of suspected cases should consist of putting the patient in the best possible hygienic conditions, and improving vitality by the administration of quinine and a good but judicious diet.

7. As it is probable that all germs of disease are imported from without, and that those of a less virulent character only find an opportunity of developing themselves in the bodies of women whose vitality is below the normal standard, it may be possible in many cases to prevent disease altogether by improving the health of the patient, and by the proper use of antiseptic precautions both during and after delivery.-British Medical Journal.

MORTALITY IN MEXICO.-The City of Mexico is entirely without sewers or drainage. With the accumulated filth of between three and four hundred years, the sanitary condition cannot be anything but miserable. As a consequence, the mortality reaches the exceptionally high rate of fifty per thousand annually. Guanajuato, a Mexican city of 58,000, has a death rate of seventyfour per thousand. The chief diseases are intestinal troubles, often of alcoholic origin, pneumonia, bronchitis, tuberculosis and typhus,

EXCISION OF THE HIP.-The Cincinnati Lancet and Clinic gives a summary by Dr. William Alexander, at the close of an interesting paper upon excision of the hip, published in the Liverpool Medico-Chirurgical Journal.

1. That hip disease should in the earlier stages be treated by that absolute and perfect rest of the joint that we now appreciate so well and know so much better-thanks to Mr. H. O. Thomashow to apply, without at the same time producing general debility of the system through the the restraint and confinement necessary in former times to secure sufficient rest to the joint.

2. That this treatment, thoroughly and persistently carried out for a long period, will cure a very large percentage of cases of joint disease.

3. That unfortunately this treatment cannot or is not properly or persistently carried out among the poor, with whom a persistent attempt to carry out after a certain stage of the disease has been reached only leads in many cases to a useless limb after many years, and probably in a majority to death, either during the process of cure or soon after, from the exhausting effects of the local disease, and not, as some erroneously think, from an inherited constitutional debility.

4. That many of these patients could be saved by excising the joint when a decided second stage of hip disease has been reached, and that excision is most safely and advantageously performed by severing the femur above the trochanters, clearing out the acetabulum, and maintaining the opposing bones so far apart that their surfaces can resume a healthy condition, and the aperture between become filled up with fibrous tissue. By this means an excellent false joint is formed, or, if the adhesions become too firm, a good stiff joint.

5. That the advent of the stage of the disease suitable for excision is indicated by the repeated formations of abscesses and sinuses round the joint. Then excision, as described, seems to offer better results, both locally and generally, than rest and waiting to see what will turn up.

6. That when the supra-trochanteric mode of excision cannot be performed with any chance of success, on account of the ex