The symptoms of this case were, then: prostration, fever (with its secondary nervousness, restlessness and delirium), irregular and rapid pulse and respiration, and severe pain in the neighborhood of the apex of the heart. The valvular lesion caused by the endocarditis gave rise to its characteristic murmurs and subsequently to an increased area of cardiac dulness and an accentuation of the pulmonic second sound.

But it is its etiology and in the sequence of its lesions that the chief interest of this case lies. The initial high temperature and all the other symptoms point to an acute infection of the body, doubtless of bacterial origin, and perhaps a late manifestation of some former disease. In regard to this latter possibility, although the child was under careful observation, no illness except that of typhoid fever had occurred during a number of years. Typhoid fever rarely leads to endocarditis even its active stages; so that there is no reasonable probability that it could be the cause, nearly three months after its subsidence, of an isolated, non-septic endocarditis associated with pain, high fever, and herpes labialis,-the last symptom especially indicating an infection from without the body.

In regard to the nature of any possible infection from without, the family history and the presence of nodules on the fingers subsequent to the attack indicate that the infection may perhaps have been of a rheumatic nature; while the well marked herpes labialis, the general prostration, and the moist rales in the left axilla indicate that it may have been of a pneumonic nature. As between these possibilities the weight of evidence rather favors the belief in the rheumatic origin of this case. But this question, interesting as it is, is of much less interest than the one as to whether the endocarditis was primary or secondary, and on this point, I think, the case gives no uncertain answer, for, whether the nature of the infection was pneumonic or rheumatic, it is clear that the germ did not produce its usual local lesions whether in the lungs or in the articulations and, perhaps in consequence, acted with unusual force on the endocardium and produced much more pronounced symptoms of endocarditis than are usually observed.

Such an occurrence is not at all improbable. It is now well known that typhoid bacilli occasionally pass through the intestinal walls without causing any of the characteristic lesions and produce local manifestations elsewhere and even general septicemia. In

an analogous manner, the germs of pneumonia might pass through the lungs in exceptional cases without producing any characteristic lesion and yet cause a lesion of a vulnerable endocardium in the left side of the heart.

In ordinary articular rheumatism the micro-organism, which is supposed to be its cause, after its entrance into the body, has a long route to traverse before it becomes localized, in consequence of slight traumatism or greater vulnerability, in some special joint or joints. It seems quite possible that this micro-organism might be arrested in its course through the body and become primarily localized upon a cardiac valve rendered vulnerable by an overstrain from work or from too boisterous exercise. It was the view of our fathers in medicine that rheumatism might in exceptional cases commence in the heart and later manifest itself in the joints. From this view many of the modern text-books of medicine have departed, at least in regard to the acute form, with scarcely adequate cause, it seems to me. In the case here reported careful examination failed to find any involvement of the articulations, there was no rusty sputum or other characteristic sign of a central pneumonia, and the transitory moist rales in the left axilla were not heard at the very outset of the disease and were more likely to be caused by the already disordered cardiac action than to have any causal connection with the latter.

Of course no clinical case can be absolutely conclusive, and an autopsy in this case, had the child died, might have revealed something quite unexpected and shown a primary local infection remote from the heart. As it is, however, from purely clinical considerations we are rather forced to the belief that the infection in case took place at the time of the illness, and that the germs entered the body from outside and were localized primarily in the endocardium, and that it was a case of primary simple acute endocarditis. And as a clinical case of disease in a child it is gladly offered in honor of him who has been for so many years our guide and our inspiration in clinical pediatrics.

ASSOCIATION OF THE ALUMNI OF THE ALBANY MEDICAL COLLEGE-TWENTY-SEVENTH ANNUAL MEETING.

The twenty-seventh annual meeting of the Association of the Alumni of the Albany Medical College was held in the Alumni Hall on Wednesday, May 2, 1900. The usual informal reception was held in the college library, where photographs were exhibited and greetings exchanged, between the hours of 9 and 10:30 A. M. Provision for the reunion of the decennial classes had been made by the assignment of the various rooms of the college for the separate classes, and before the general meeting the classes of '70, '75, '80 and '90 met for the reports of the class historians and for renewals of college acquaintance. The annual meeting was called to order by the President, Dr. James H. Mitchell ('81), of Cohoes, at half past ten o'clock.

The following members of the Association, with invited guests, students of the college and others interested were present: H. B. Maben, ('57); M. Felter, ('59); A. Vander Veer, ('62); J. O'Flaherty, ('64); T. D. Crothers, ('65); C. E. Witbeck, ('66); L. Hale, ('68); W. H. Murray, ('69); D. C. Case, W. Haiies, ('70); G. Conkling, G. L. Ullman, ('71); D. H. Cook, ('73); J. D. Featherstonhaugh, H. E. Mereness, ('74); J. W. Houser, C. C. Schuyler, E. A. Wood, ('75); M. J. Lewi, ('77); J. H. Cotter, E. D. Fuller, W. O. Stillman, ('78); E. A. Bartlett, ('79); E. C. Collins, D. F. Donoghue, C. B. Herrick, G. S. Munson, M. H. Strope, W. C. Wood, ('80); J. H. Mitchell, T. W. Nellis, ('81); F. A. Palmer, W. B. Sabin, W. W. Scofield, ('82); J. F. Reilly, T. F. C. Van Allen, ('83): T. C. Carroll, M. MacHarg, E. H. Rider, ('85); A. S. Capron, ('86); A. MacFarlane, C. H. Moore, H. V. Mynderse, ('87); J. Archibold, ('89); J. M. Mosher, ('89); E. V. Colbert, W. H. Happel, G. T. Moston, A. G. Root, E. S. Simpkins, ('90); W. S. Ackert,W. H. Conley, C. E. Davis, J. W. Wiltse, ('91); W. G. Lewi, C. F. Theisen, ('92); R. E. Doran, T. W. Jenkins, J. W. Russell, ('93); W. H. George, G. W. E. Goodell, W. S. Hale, J. R. McElroy, A. Sautter, ('94); W. J. Wansboro, ('95); F. T. Clark, J. C. Sharkey, ('96); I. Applebee, C. G. Cole, W. C. McCulloch, C. H. Richardson, C. J. Slocum, G. W. Timmers, ('97); D. J. Jenkins, C. W. Skelton, A. H. Traver, E. A. Vander Veer, ('98); J. M. Adey, A. E. Garland, P. H. Moak, ('99); F.

D. Bigarel, K. A. Campbell, G. P. Coopernail, J. L. Crofts, T. H. Cunningham, W. E. Curtin, L. K. Dugan, L. Emerick, J J. Gallup, R. Gilmore, H. H. Gormly, L. H. Humphrey, 2d, H. A. LaMoure, G. Lenz, H. H. Loussararian, C. G. Lyon, W. G. Mack, L. D. Masson, P. McPartlon, S. D. Miller, L. F. O'Neill, W. H. Petrie, W. W. Sanford, W. A. Stearns, E. A. Sweet, A. A Wood, ('1900); S. B. Ward, (Hon.).

The President introduced Professor William Hailes, M. D., who delivered the following address of welcome to the alumni on behalf of the college faculty:

Fellow Alumni:

ADDRESS OF WELCOME

On behalf of the faculty I extend to you greeting and a cordial welcome to your alma mater. We are proud of our alumni, scattered far and wide over many states of our glorious Union. We thank you for the effort you have made-for the sacrifices you have endured-to be with us to-day. We are proud of our faculty, a harmonious, united, enthusiastic band of teachers, not only maintaining but raising the standard of medical education in a way which cannot but meet with your hearty approval and that of every man who loves his noble profession. It pains us to inform you of the illness of the founder and the most energetic member of our alumni, Dr. Willis G. Tucker, who has been quite ill and confined to his home by a severe attack of La Grippe with complications. We are happy, however, to say that he is, we hope, convalescent, but still exceedingly weak, and his progress toward complete recovery must necessarily be slow. His absence is particularly unfortunate and noticeable at this our annual gathering where he always has been of inestimable service.

Our beloved member, Dr. F. C. Curtis, also has been disabled in consequence of ill-health, and is at present at Aiken, S. C. In a recent letter from him he says he hopes to be in Albany in a few days. We rejoice in the fact that his life which at one time was despaired of, is, we feel, spared to us for continued usefulness.

We welcome you to our Bender Laboratory, now in the fulfillment of its beneficent mission in preparing our alumni for the better mastery of disease, as well as rendering them more efficient in the increasingly important department of preventive medicine. We welcome you to our new hospital, which by united and sustained effort, we have erected at a cost of $250,000, free and unincumbered by debt and now thoroughly equipped and officered to carry on its beneficent mission of turning misfortune into joy and sending light and happiness into homes previously enshrouded in gloom.

We have the advantage of a most excellent X-Ray outfit which is of frequent service in surgical procedure. We have also for our instruction, a fine electrical projection apparatus, by means of which the embryological development of organs and tissues can be studied, and sections

from the various parts of the body thrown upon the screen with great brilliancy and in their natural colors. The study therefore of minute anatomy, both in health and in disease, becomes an exceedingly interesting and absorbing pursuit.

Occasionally, a ripple crosses the placid pool of our college life. Not long since, while speaking to the class in the darkened lecture-room, the boys-as boys will occasionally-became hilarious, and when one particularly beautiful specimen was upon a screen a rich, sonorous voice exclaimed from out the depths of the darkness—“Wonderful!" Then the boys tittered and laughed at the interruption. A little later, a second section appeared on the screen, when a second interruption occurred and the voice exclaimed:-"Marvelous!" Again, a burst of laughter greeted the exclamation. A little later a third interruption took place, when the voice said:"Truly beautiful!" My patience, by this time, was exhausted, and observing silence for a moment, I remarked: “Nobody in our audience, this afternoon, imagines for a moment, that that much abused Hebrew prophet, Balaam, is in our midst, but we are all quite certain that Balaam's Ass must have strode in here to-day, for he has spoken thrice. " It was difficult to hold the boys in check, and pandemonium reigned for a moment. The perpetrator of the offense was unknown to me, but retributively he lost his real name and ever after was known among his fellows as "Balaam's Ass."

Again I welcome you to our brotherhood and bespeak for you the exquisite pleasure that comes from social reunion, the renewal of old associations, the hand-clasp, the sound of familiar voices, the comparison of experiences, the turning back of the once familiar but almost forgotten pages in memory's book, the talking over of old times with fellow-students now absorbed in life's stern realities, but each and all with a warm spot in his heart for his beloved alma mater.

On motion of Dr. Walter H. Conley, the thanks of the Association were tendered Dr. Hailes for his interesting address.

On motion of Dr. D. H. Cook, the reading of the minutes of the last annual meeting was dispensed with, and the minutes as printed were adopted.

The Recording Secretary presented the following communication:

To J. M. Mosher, M. D.,

Recording Secretary, A. A., A. M. C.

May 2, 1900.

MY DEAR DOCTOR.—I desire to resign from the office of treasurer, after having served for six years. Respectfully,

Dr. MacFarlane moved the acceptance of Dr. Van Allen's resignation and a vote of thanks for the valuable and extended service he had rendered the Association. Carried.