tents are not fixed, but in the upper part it is difficult. He related the indications for operation and spoke of the condition of the parts under various circumstances.

Dr. Randolph Winslow referred to cases which he had had of this kind and spoke of the times when the abdomen should be opened and when it should

not.

Dr. R. W. Johnson said he did not believe in doing a laparotomy for small abdominal wounds.

Dr. T. C. Gilchrist then read a paper entitled Protozoic Infections with Demonstrations of Photomicrographs and Specimens.

Dr. C. O. Miller read a paper on the Aseptic Cultivation of Protozoa.

Dr. W. Milton Lewis read a paper on the Relation Existing between Gall Stones and Hepatic Abscess, in which he emphasized the importance of examining the blood by which the diagnosis of septic infection may be decided; a careful examination of the urine and the need of great care in making the diagnosis.

Dr. William H. Welch said that the bile was free from bacteria except at the mouth of the common bile duct. The bile has very slight antiseptic power and it is not easy to explain the absence of bacteria. It is very common for the bacteria to wander from the duodenum into the bile duct. A very large number of bacteria perish in passing down the intestines, but in the duodenum they have not as yet perished and we have a greater number of bacteria and a greater variety. When the bile ceases the conditions are favorable for the growth of bacteria. The formation of circumscribed abscesses is very rare. The bacillus coli communis is very common in the gall passages. There is no evidence that the bacillus coli communis can cause abscesses. He has been much interested in the bacteriological formation of gall stones.

There is a relation between the presence of gall stones and the bacillus coli communis and the formation of gall stones. He has been making cultures from the interior of gall stones and in the great majority of instances he has found a pure culture of the bacillus coli

communis in the interior of gall stones with no bacilli on the outside. The microscopical examination of the pus from liver abscess assists in making the diagnosis. It looks like pus with the naked eye but the microscope shows it is not, but it is only broken down tissue, detritus, etc. This is peculiar to the pus of the liver due to the amoeba ; other kinds do not cause this.

Dr. Lewis said in closing that the amoebae were not found in the pus, but pus cells were found, showing it to be a genuine pus.

THURSDAY, APRIL 25, THIRD DAY.

Dr. John C. Hemmeter read two papers, one relating Experiments on the Motor Functions of the Stomach, and the other on the Effect of Digestive Diseases on the Heart.

Dr. William S. Thayer read a paper on the Relation of the Different Types of Malaria to the Seasons of the Year.

Dr. J. C. Harris asked if he knew where most of these cases came from.

Dr. I. E. Atkinson said that in his experience in treating winter attacks of this disease, if the patient has not had a previous attack he has been in the locality where he might have had it. He believes from a clinical experience that malaria does not originate de novo when the temperature reaches freezing point. Those cases carry the organism in the body and it does not develop until the vitality is lowered.

Dr. James A. Steuart said it had been said to be due to the drinking water as well as the bad air. Often a case will recover, according to Dr. Lewis of North Carolina, by simply changing the source of water supply.

Dr. George J. Preston thought the points that Dr. Atkinson made were the most important.

Dr. J. E. Michael said that he had lived in a part of the country where the disease was more or less common and that it appeared and disappeared with no apparent explanation.

Dr. C. O. Miller spoke of the spread of the disease by drinking water.

Dr. S. A. Keane related his own experience with the disease and how he

had suffered and moved about and the disease went with him. He thinks the system may become hardened against the disease and that may account for its apparently dying out in some regions.

It

Dr. Thayer spoke of the relapses in his cases and said that experiments had been conducted in southern Italy and Sicily in making persons drink malarial water and even the blood of those with the disease without injurious effect. was thought that malaria might be brought by insects just as Texas cattle fever, as shown by Theobald Smith, was given to cattle. There is no proof of this for malaria.

Dr. J. Whitridge Williams then read a paper on the Treatment of Puerperal Fever; a Warning Against the Indiscriminate Use of Corrosive Sublimate; in which he reported a case in which he felt sure that death was caused by the too careless use of corrosive sublimate. In injecting the interior of the uterus some of the solution was left in in sufficient amount to cause the fatal effects.

Dr. J. H. Branham referred to cases in his own practice, but he doubted if Dr. Williams' case died from the corrosive sublimate solution alone.

Dr. B. B. Browne has seen cases in which poisoning was caused even by weak solutions.

Dr. A. K. Bond said that clinically it made no difference what was used, just so we keep the parts clean. He believed in auto-infection.

Dr. Wilmer Brinton thought that most cases of poisoning came from without and if we followed Dr. Bond's idea of auto-infection we take away all personal responsibility and make the attendant careless.

Dr. L. E. Neale had never seen a case of bichloride poisoning in his life and did not think he had taken greater precautions than anyone else. He agreed with Lusk that it should be used when necessary, once or twice, but not in repeated applications. Its use should be followed by plain boiled sterilized water.

Dr. J. E. Michael thought that the case related was not one of genuine bichloride poisoning. He had not seen one in 2000 cases at the University

Lying-in Hospital. There were few advantages in the use of the bichloride solution and many disadvantages.

Dr. Williams did not come before the Society to report this case of bichloride poisoning so much as to show that in the majority of cases no matter what we use we have the mechanical cleaning out of the uterine cavity whether we used boiled water or the bichloride solution. These solutions cannot always get at organisms, which travel so fast that they are found in the peritoneum in a short time.

Dr. W. S. Smith then read a paper entitled Careless and Unscientific Midwifery with Special Reference to some Features of the Work of Midwives.

Dr. Thomas A. Ashby read a paper on Persistent Uterine Hemorrhage; its Sources, Dangers and Treatment; in which he showed a curette and dilator which he had used with great success.

Dr. R. M. Hall referred to some cases of his with uterine hemorrhage and the difficulty of their treatment.

Dr. George H. Rohé spoke of the use of currettage in stopping uterine bleeding and the removal of the uterus.

Dr. J. R. Uhler said it was important. to make the diagnosis of the cause of the bleeding and then he used astringents.

Dr. T. A. Ashby said that sometimes a small deposit caused a violent hemorrhage.

Dr. George J. Preston read a paper on Tetany, with Report of a Case.

Dr. H. M. Thomas read a paper on Tetany during Pregnancy.

Dr. Samuel J. Fort read a paper entitled Heredity as a Factor in the Etiology of Idiocy.

At the night session Dr. M. Allen Starr delivered the Annual Oration on the Causation of Nervous Diseases. (See page 19.)

FRIDAY, APRIL 26, FOURTH DAY. Dr. W. Milton Lewis read a paper on Melaena Neonatorum.

Dr. R. T. Taylor read a paper on Recent Improved Methods of Infant Feeding with especial Reference to Modified Milk, in which he compared the composition of mother's milk to cow's milk

and showed how to prepare the latter to approximate the former. He said that all baby foods were bad and too many relied on the statements of the manufacturers. He spoke of the necessity of good and pure milk and reviewed the work of the Walker-Gordon laboratories in Boston, where milk of any kind and strength may be ordered by the physician on prescription and among the poor it is distributed free. He urged the necessity of such a laboratory in Baltimore and spoke of the good it would do.

Dr. J. Whitridge Williams did not agree altogether with the tables shown by Dr. Taylor, yet he thought his contribution very valuable.

Dr. F. D. Sanger and Dr. L. E. Neale also discusssed this paper.

As a result of this paper the following resolution offered by Dr. L. E. Neale and amended by Dr. J. D. Blake was carried; that a committeet of three be appointed by the President of this Faculty to investigate the subject of Dr. R. T. Taylor's paper and bring this. matter in some practical form before the physicians of this city and State at as early a date as possible, and finally report at the next meeting of the Faculty. The President appointed Drs. R. T. Taylor, L. E. Neale and W. F. Lockwood.

Dr. Harry Friedenwald read a paper entitled the Significance of Variations in the Caliber of Retinal Arteries.

Dr. Hiram Woods made a Contribution to the Study of Pseudo-Membranous Conjunctivitis.

Dr. William F. Lockwood reported Three Cases of Purulent Otitis Media which ended Fatally.

At the business meeting on Wednesday night the reports of the various officers were read and accepted. The following amendments to the constitution, offered by the Committee on Permanent Location, were then adopted:

ARTICLE X.-Title Dues. To read "For the purpose of defraying the expense of publishing the transactions, of increasing the efficiency of the library and of meeting incidental expenses, each member of the Faculty residing in the city of Baltimore shall be assessed

six dollars annually. The members residing in counties shall be assessed two dollars annually. These assessments must be paid within thirty days after each annual meeting. It shall be competent for the Faculty to levy additional assessments if the emergencies of the treasury should require it."

ARTICLE XI.-Title Dues and Appropriations for Library. "That for the first fiscal year, beginning April 23, 1895, the appropriation to the library, including the salary of the librarian, registrar of nurses, secretary and assistant librarian and assistant registrar of nurses' directory, be $600. In future years the amount to be appropriated shall be determined by the Executive Committee at its first meeting each year, upon itemized estimates submitted by the outgoing library committee at the previous annual meeting."

ARTICLE XII.-New Article. Trustees. That the Board of Trustees (formed by the Faculty, March 20, 1895) render in writing a report giving a financial statement of their receipts and expenditures during the past fiscal year."

Change Article XII to XIII.

The following amendment offered by Dr. Wilmer Brinton was adopted: "That no doctor of medicine who has graduated since June, 1892, shall be eligible for membership in this Faculty, unless he has passed the examination of the Board of Examiners of the State of Maryland and is recommended for membership by a member of this organization."

Dr. Edward M. Schaeffer offered the following, which was adopted: "That it be the sentiment of the Medical and Chirurgical Faculty of Maryland that free public baths are a much to be desired as a sanitary feature in this community and that the Mayor and City Council of Baltimore are hereby respectfully urged to further their establishment at as early a date as possible."

Dr. S. T. Earle, Chairman of the Committee on Legislation, offered the following, which was adopted: "That a Committee of three be at once appointed by the President of this Faculty to look after the enforcement of the law

to regulate the practice of medicine in this State, who are hereby authorized to employ an agent for the detection of violators and proper counsel for their prosecution and that the State licensing board be instructed to turn over to this committee all surplus funds for the purpose of carrying out the provisions of these resolutions." The President appointed as the committee Drs. S. T. Earle, I. E. Atkinson and Wilmer Brinton.

The President appointed as Trustees of the Faculty Drs. T. A. Ashby, I. E. Atkinson, Wilmer Brinton, William Osler, George J. Preston, G. Lane Taneyhill, L. McLane Tiffany, William H. Welch and H. P. C. Wilson.

Dr. William B. Canfield offered the following, which was adopted: "That the committee having in charge the semi-annual meetings be hereby instructed to endeavor to secure reduced rates from the transportation companies, hotels and boarding houses at the place of meeting and that the committee on programme publish these reduced rates on the programme which shall be distributed and that the programme shall be sent to the members at least five days before the semi-annual meetings."

Dr. John Morris offered the following, which was adopted: That inasmuch as the State Board of Health (Revised Code 1888, Article 43) and the Vaccine Agency (Public General Laws, 1888, Article 43) have not fulfilled the expectation of the medical profession or the people of the State of Maryland nor the purpose for which they were created, therefore the legislative committee hereafter to be appointed be instructed to formulate. measures to be submitted to the next legislature, having for their object a stronger and more effective administration of sanitary affairs."

Dr. Robert T. Wilson offered the following, which was adopted: "That the publication committee publish in the transactions a list of the Vice-Presidents (beginning with the year 1799) as is done with the Presidents."

On motion of Dr. S. T. Earle the following was adopted: "Inasmuch as the committee to whom has been re

ferred the prosecution of violators of the medical practice act may find the present law insufficient to meet all the cases for whom it was intended;

THEREFORE, be it Resolved, That the committee on legislation be authorized to procure such amendments to the present law, from the legislature of 1896, as in the opinion of the committee on legislation and that for prosecution of the violators of the medical practice act may deem necessary."

Dr. James A. Steuart moved a reconsideration of Dr. John Morris' resolution, which was then laid on the table by a resolution by Dr. J. E. Michael.

The following officers for the ensuing year were elected: President, Dr. J. Edwin Michael; Vice-Presidents, Drs. C. Birnie and Charles G. Hill; Recording Secretary, Dr. John S. Fulton; Assistant Secretary, Dr. Robert T. Wilson; Corresponding Secretary, Dr. Jas. M. Craighill Reporting Secretary, Dr. W. Guy Townsend; Treasurer, Dr. W. F. A. Kemp; Executive Committee, Drs. L. McLane Tiffany, Aaron Friedenwald, David Streett, G. J. Preston, President, Treasurer and Secretary ex officio; Examining Board for the Western Shore, Drs. J. M. Hundley, R. Winslow, C. O. Miller, Hiram Woods, S. T. Earle, J. D. Blake, Charles H. Jones and Joseph T. Smith; Examining Board for the Eastern Shore, Drs. W. S. Maxwell, W. F. Hines, W. R. Trippe, B. W. Goldsborough and James M. Bordley. The following appointments made:

were

Committee on Library.-Drs. B. B. Browne, J. D. Blake, H. M. Hurd, G. J. Preston, W. B. Platt.

Committee on Publication.-Drs. John S. Fulton, W. F. A. Kemp, S. K. Merrick, W. P. Chunn, I. R. Trimble.

Committee on Memoirs.-Drs. E. F. Cordell, D. W. Cathell, John Morris, W. A. B. Sellman, J. C. Thomas.

Committee on Ethics.-Drs. G. W. Miltenberger, W. F. Lockwood, T. S. Latimer, Samuel C. Chew and R. H: P. Ellis.

Committee on Programme.-Drs. Hiram Woods, S. J. Flexner, David Streett, H. Friedenwald and J. N. Mackenzie.

Committee on Legislation.-Drs. S. T. Earle, Jackson Piper, A. Friedenwald, J. F. McShane, J. Mc P. Scott, F. B. Smith, J. D. Blake, J. W. Hocking, Wm. Lee, L. E. Neale, E. N. Brush, C. G. Hill, R. B. Norment.

Curator.-Dr. H. A. Rowland. Committee on Membership.-Drs. T. A. Ashby, J. W. Williams, C. W. Mitchell, W. S. Thayer.

Committee on Preventable Blindness. -Drs. J. F. McShane, J. Frank Crouch, J. W. Funck, R. L. Randolph, H. Woods.

Committee on Union for Public Good. -Drs. P. C. Williams, A. K. Bond, W. J. Todd.

Committee on Milk Laboratory.-Drs. W. F. Lockwood, L. E. Neale and R. T. Taylor.

Delegates to American Medical Association. Drs. I. E. Atkinson, Robert T. Wilson, David Streett, W. Guy Townsend, H. P. C. Wilson, Wm. Lee, H. A. Kelly, J. W. Humrichhouse, James Bordley, W. Green, H. D. Norris, J. C. Hemmeter, W. P. Wyse, W. B. Canfield, F. E. Chatard, J. M. Craighill, J. H. Branham, W. F. Hines, W. A. B. Sellman, Charles M. Ellis, H. M. Thomas, A. Friedenwald, H. Salzer, H. A. McComas, Amanda T. Norris, W. E. Moseley, Charles O'Donovan, A. C. Pole, Alex. Porter, C. H. Riley, N. R. Smith, Claude Van Bibber, C. B. Ziegler, George B. Reynolds, F. D. Sanger, T. C. Price, H. Harlan, E. D. Ellis, John G. Jay, C. G. W. Macgill, S. J. Fort, George A. Fleming, T. C. Gilchrist, J. A. Steuart, W. J. Craigen, J. E. M. Chamberlain.

Delegate to West Virginia Medical Association.-Dr. W. Guy Townsend. Delegates to Pennsylvania State Medical Society.-Drs. J. E. Sandrock and T. J. Brayshaw.

Delegate to Virginia Medical Society. -Dr. T. J. Brayshaw.

The following new members were elected Drs. John J. Abel, Delano Ames, B. J. Byrne, G. H. Carpenter, T. W. Clarke, T. A. Councell, John A. Doerner, Wirt A. Duvall, Edith Eareckson, Cary B. Gamble, Jr., Francis F. Greenwell, William F. Hall, Jerome H.

Hardcastle, Robert Hoffman, C. R. Miller, Joseph C. Ohlendorf, Jr., T. C. Peebles, J. I. Pennington, W. H. Perkins, H. O. Reik, Morris C. Robins, Frank R. Smith, Robert T. Taylor, and Lilian Welsh.

Dr. M. Allen Starr was elected an honorary member.

AMERICAN MEDICAL

ASSOCIATION.

FORTY-SIXTH ANNUAL MEETING HELD IN BALTIMORE, MAY 7 TO 10, 1895.

GENERAL MEETING.

FIRST DAY, TUESDAY, MAY 7.

The forty-sixth annual meeting of the American Medical Association was called to order by the President, Dr. Donald Maclean of Detroit. After an opening prayer by Bishop Paret and address of welcome by Mayor Latrobe of Baltimore, Dr. Samuel C. Chew, chairman of the reception committee, made a few remarks calling attention to the long time since the Association had met here and the great changes which had been made. Dr. William Osler, in the absence of Dr. J. J. Chisolm, spoke a few words and urged the members to attend to their section work and make the meeting a notable one. Dr. Donald Maclean then delivered the President's Address on a Few Living Issues affecting the Practice of Medicine and what came of them. He reviewed the history of medicine and showed what progress we had made. He said that "a National Bureau of Health, superintended by a competent medical authority, who shall be a member of the cabinet, could not fail to secure for the nation benefits beyond the language of dollars and cents. to express. A united and dignified effort on the part of this Association and its allies ought to secure this enactment. The vast importance of such an act is obvious to the members of this Association, and our imperative duty, as it seems to me, is to impress the active and public-spirited statesmen who guide and control the affairs of the nation with the essential truth and value of our views. The very respectable problems of foreign