arrangements may be made to return by the special train.

INDIVIDUAL TRIPS.

Individual trips over the B. & O., or any of the roads from Washington, D. C., to City of Mexico and return will cost: Fare, $71.50; Pullman berths there and return, $46; meals both ways, $30; total, $147.50. Five dollars and seventy-five cents extra through one gateway, say Eagle Pass, and returning either via Laredo or El Paso. This route is made in about six days and will require a change of cars at St. Louis, Mo., and San Antonio, Tex. The rate from New York will be the Washington rate, plus $7. The Philadelphia rate will be the Washington rate, plus $4.50. The Baltimore rate will be the Washington rate, plus $2. The Pullman charges will be the same, $46 going and returning from these cities. Intermediate points in proportion, both fare and Pullman.

Sale of tickets from New York and Washington over the trunk lines will be from November 5 to 8, inclusive only, at the rates mentioned above.

OFFICIAL TRAIN SPECIAL.

Special service is arranged for with the American Tourist Association of Chicago, under escort of Mr. Reau Campbell, general manager, who will provide a special train of sleeping and dining cars to run through from Chicago, Cincinnati and St. Louis to the City of Mexico and return, connecting with the B. & O. Rd. trains from points East and North. This will be the official train and route, and will run on the following special schedule:

Leave Chicago.....Ill. Cent. R. R.
Leave-Cincinnati.. B. & O. S. Ry.
Leave-St. Louis.....Iron Mtn. Route
Arrive Little Rock.

Tuesday Nov. 10, 10 A. M.
Tuesday
10, 9 A. M.
Tuesday

Wed.

10, 8 P. M.

66

II, 8 A. M.

5 P. M. 13, 7 A. M. 13, 7 P. M. Saturday" 14, 11 A. M. Saturday 14, I P. M. Saturday 14. 6 P. M. Saturday 14, 7 P. M. Saturday 14, 10 P. M. Sunday 15, 7 A. M.

"

The only stops going down will be at San Antonio, Texas (where passengers from New Orleans and the South may join special train), and at Zacatecas, Mexico. On the return stops will be made at Queretaro, Aguas Calientes, San Luis Potosi, Tampico and Monterey, with side trips to Guadalajara and Guanajuato, if the party so desire.

The official train will start on the return trip after the close of the congress in ample time to make the above stops and reach Chicago, Cincinnati and St. Louis December I, the time of the tour being twenty-one days. Itinerary will be published in the City of Mexico.

The train is scheduled to go and return via

St. Louis and the Iron Mountain route. Arrangements will be made for those desiring to return via the Southern Pacific and New Orleans and Illinois Central railroads, if notification is made before starting, and tickets secured accordingly.

The rates for the official train are as follows: From Chicago to City of Mexico and return, $190.10.

From Cincinnati to City of Mexico and return, $189.05.

From St. Louis to City of Mexico and return, $183.55.

This includes railway and sleeping car fares; meals in dining car; meals at hotel in the City of Mexico; special street cars at stopping places; steamer on Panuco river from Tampico, and in fact every necessary expense of the trip of twenty-one days; if extended, the charge will be $4.75 per day per person.

A splendid train of palace sleeping and dining cars is being specially prepared. Supplies for dining cars will be taken from Chcago. The cuisine is placed in competent hands. Waukesha water served at all meals and wine at dinner.

A double berth is assigned to each person. Man and wife have the entire section. Berths and sections reserved for the complete tour.

Railroad tickets should read as per itinerary above and over the following roads in Mexico:

Mexican International Railway, Eagle Pass to Torreon.

Mexican Central Railway, Torreon to City of Mexico.

Mexican Central Railway, City of Mexico to Tampico.

Monterey and Mexican Gulf Railway, Tampico to Treviño.

Mexican International Railway, Treviño to Eagle Pass.

A rate of one fare will be made from all important points plus $5.75 for the return via Tampico.

Payment for special train accommodations may be made on the train at Chicago, Cincinnati or St. Louis, the amount of which is $122, when the passenger presents his round trip railroad ticket or passage to City of Mexico.

Berths and sections may be reserved by addressing Reau Campbell, general manager American Tourist Association, 925 Old Colony building, Chicago, Ill., inclosing check for $30, which will be deducted from the final payment made on the train, or returned if, for any unforseseen reason, the party cannot go. Or the total amount may be remitted to Mr. Campbell, if desired, which will be returned if trip is not taken.

It is advised that reservations should be made at the earliest possible moment in order that a sufficient number of sleeping and dining cars

Ballard, LaCrosse, Wis.

Title unannounced, Dr. William Mackie, Milwaukee, Wis.

Title unannounced, Dr. N. A. Drake, Kansas City, Mo.

"The Nursing of the Eye," Dr. C. D. Wescott, Chicago.

lowa State Association of Railway Surgeons.

The third annual meeting of this association was held at Marshalltown, October 7 and 8, 1896, Dr. G. W. Coit, president, in the chair. The following papers were read and discused:

"An Unusual Result from the Local Application of Iodoform," by Dr. O. Fordyce.

"Some Results of Railway Injuries," by Dr. D. S. Fairchild.

"Dislocation of the Clavicle," by Dr. J. W. Holland.

"Modern Treatment of Sprains of the AnkleJoint," by Dr. J. C. Cottam.

"Railway Surgery as a Specialty," by Dr. H. C. Markham.

"Duties of Transportation Companies in Relation to the Development of Infectious Diseases," by Dr. J. N. Warren.

"Intestinal Obstruction," by Dr. W. E. Sanders.

"Restoration of Muscular Function After Injury," by Dr. V. B. Knott.

"Syme's Operation," by Dr. P. H. Salter. "Reports of Two Cases of Skull Injury," Dr. V. L. Treynor.

"A Case of Trephining for Epilepsy," by Dr. A. B. Bowen.

"Minor Railway Injuries," by Dr. D. W. Edgar.

Twenty-six new members were admitted at this meeting. The following officers were elected for the ensuing year: Dr. D. S. Fairchild, Clinton, president; Dr. T. J. Caldwell, Adel, vice-president; Dr. A. A. Deering, Boone, secretary; Dr. H. L. Getz, Marshalltown, treasurer.

Des Moines was selected as the place for the next meeting. The Iowa State Medical Journal was made the official organ for the society for the year.

Fractures of the Cranial Vault.

Dr. Senn says that operative interference is absolutely indicated under the following circumstances: 1. All open fractures, including gunshot and punctured fractures. 2. Depressed fractures attended by well-defined symptoms, caused either by the depression or intracranial complications. 3. Rupture of the middle meningeal artery with or without fracture of the skull.

The Successful Removal of a Piece of Wood
Imbedded Within the Brain Thirty-two
Years, Without Impairment of
the Cerebral Functions.

By Z. H. EVANS, M. D., TRAVERSE CITY, MICHIGAN.

The subject of this clinical report is John R, aged 57, late of Co. C. 180th Ohio Volunteers. The history, as related by the patient himself, is as follows: At the battle of Kingston, S. C., in June, 1862, he was acting in the capacity of gunner to one of the fieldpieces, which had been detached from the regular battery to which he belonged. The gun had been run up nearly to the top of a small hill, upon which grew some small scrubby pines, with their branches trailing downward toward the ground, thus obstructing his view of the enemy. In order to overcome this obstacle it was necessary for him to cut them away with an ax. And while doing this the enemy let go a full charge of grape and canister, cutting down everything before it. The patient was struck with what he and the surgeon at the time supposed to be a bullet on the left side of the face, a little below and to the left of the right eye, making an ugly looking wound. This was immediately closed by the field surgeon in charge, and the patient sent to the rear. No inconvenience was experienced from this wound aside from some slight soreness, and at the end of a week he was able to report for duty, and continued to serve his country's cause until the expiration of his enlistment. On being discharged from the service he came to this state, where he commenced the clearing up of a new farm, working on it for years and years, not knowing or even suspecting that he was carrying around within his cranial cavity a foreign substance.

One year previous to his calling on me, while stowing away lumber in the hold of a barge, a plank slipped and fell endwise down the hatch, striking him on the face precisely over the region where he was formerly wounded. The injury inflicted by the falling of this plank caused some pain and swelling of the face, and in the course of two weeks there appeared an abscess, which was opened by Dr. King, then of this city, but now of California. After several weeks' treatment, and as the discharge of pus continued, his friends advised him to visit a neighboring city, where he could avail himself of the skill of a city surgeon. Acting upon this advice he, without delay, made ready and set out for Grand Rapids, which city can boast to-day of having more readymade surgeons and gynecologists "within her

corporate limits" than any other city twice her size in population in this country. On arriving in this city of surgeons the patient fell into the hands of one whom I judge, from his diagnosis and treatment of this case, to have been entirely ignorant of its true character. In this day of our surgical civilization any physician or surgeon who is found so lacking in ability as to be unable to diagnose a sinus from a cancer, and sits by for days and weeks and applies his caustic paste cannot sufficiently be condemned. It was the fate of this old battlescarred veteran to fall into the hands of one by whom this cauterizing process was carried on for weeks with unsurpassed energy, under the impression that he was burning out what he called a spider cancer of the face.

As he failed in his efforts to accomplish a cure, he finally advised the patient to return to his home in this city, as he could treat him there as well and with less expense. The patient, on arriving home, consulted me at my office on the 31st of May, 1894, and on examination of his face I saw at a glance that he was not suffering from cancer. On passing a probe I soon brought it in direct contact with dead and detached bone. Now, with the free use of cocaine I was able to scrape away with a sharp spoon all of this dead material, thus exposing and opening up the posterior ethmoidal cells, as well as the floor of the skull. This accomplished, the dura was exposed, which was much thickened, the result of the long continued inflammation. I now exerted some slight pressure with the tip of my finger on the presenting portion of the brain, and, much to my surprise, a little bloody pus was discharged through a small opening in the brain. I now passed a small probe into this opening some distance, when it came in contact with a hard substance. Now believing that I had a bullet to deal with, I took a pair of Péan's forceps, passed them into this opening and laid hold of this foreign body and drew it out. It proved to be a piece of pine wood measuring in length one and one-fourth inches, by one-third inch in thickness. On removing this body the flow of blood was fearful and could only be controlled by packing the opening in the brain with gauze. This tampon was allowed to remain in situ for twenty-four hours, when it was removed and the parts washed out with plain, clean water. I now inserted a small piece of gauze well into the wound for the purpose of securing free drainage. This method of treatment was carried on for several days, and finally the opening in the brain contracted and pus ceased to discharge. The soft parts were now brought together by means of adhesive plaster and within ten days the external wound had closed. Now comes a very peculiar point in the pathology of this case. Thirteen days after the removal of

this piece of wood from the brain the patient, while sitting in a chair, was seized with paralysis, affecting the same side of the body from which it had been removed. The paralysis was not complete; he could walk by dragging his leg along, while his arm would swing by his side. His intellect was not disturbed: his speech was somewhat thickened, and he found it a difficult matter to express himself—to use his own language-the wrong word was always in his mouth. With this turn of affairs the patient began to look upon the dark side of life and expressed a desire to go and live with his brother in St. Louis. Since his departure from this city I have had no communication with him, although a friend of his has received a letter, in which he states that he has fully recovered the use of his limbs and desires to return to this city and engage in his former work. International Journal of Surgery.

Silver as a Suture Material.

Dr. Credé of Dresden, before the last meeting of the German Surgical Congress, stated that, having visited the clinic of Dr. Halstead of Baltimore, his attention was called strongly to the qualities of silver as a suture material. The fact that his father had recommended silver nitrate as a preventive of ophthalmia neonatorum, also stimulated him to make experiments for the discovery of such silver salts as would best answer the purposes of antisepsis. He has found two salts which seem to fulfill the requirements in a remarkable manner. The first is a combination of silver with lactic acid, which dissolves in the tissue juices, forcing its way into the tissues roundabout, and as a result acting in a deleterious manner upon the bacteria that lie at a little distance. Silver lactate, called actol by the discoverer, has an antiseptic power equal to four or five times that of corrosive sublimate, but inasmuch as it irritates somewhat when introduced directly into the tissues and produces some pain in sensitive patients, another silver salt has been prepared-citrate of silver, known to the trade as itrol, which dissolves only in the proportion of 1 to 3800, and consequently acts even in small quantities for a long time. It is colorless, non-irritating, odorless, finely pulverized, permanent, and possesses evidently the same antiseptic power as the lactate of silver. Credé has used these salts for seven months in the surgical section of the Carola House, of Dresden. Four hundred bed-ridden patients and one thousand ambulatory cases have been treated therewith, so that he is able to affirm that the silver treatment has been sufficiently tried and in all essential points is worthy of professional trial. He uses the remedies for impregnating gauze

and suture materials as well as for powdering the skin about wound-edges. The itrol is especially useful for impregnating sutures, since it only acts when bacteria cause an increase in wound exudate which dissolves the silver salt. Upon decomposition the itrol acts. as a strong antiseptic.

The Progress of Surgery.

At the recent meeting of the Missouri State Medical Society, Dr. Jabez N. Jackson of Kansas City read the report of the committee on "Progress of Surgery." It was chiefly an appeal in favor of conservatism and of fewer operations. There has undoubtedly been an excess of zeal, especially on the part of inexperienced operators; it has only too often been the object of the rash surgeon to merely prolong life or even to obtain a desirable "specimen"-without due regard to the future of the patient. Every operator should have three things in view: (1) To save life. (2) To preserve function. (3) To conserve form. In brain surgery not as much is now being done as some two or three years ago; and it is better so, since incurable conditions were attacked by over-zealous enthusiasts; such operations have greatly advanced our knowledge of pathology, but have not proven of therapeutic value. In epilepsy it has been proven that excision of the cortex is of no benefit, except in a very few cases of the local or Jacksonian variety, and even here the resultant scar has often proven as bad as the original lesion in producing the epileptic seizures. But tumors having epilepsy as a symptom should be removed. Traumatic epilepsy should be prevented rather than cured, as late operations have not been followed by cure in as large percentage of cases as was hoped would be the result. In microcephalia operation is once more receiving attention, as it has been found that operation has a good disciplinary effect upon the parents or guardians of the idiots, and in this way considerable benefit is ultimately obtained; but it is doubtful if it is advisable except under unusual conditions. In abdominal surgery there have been entirely too many exploratory sections, by amateurs; such operations should be done only by the masters, and in cases of extreme doubt; the average surgeon should not enter the abdomen unless he knows exactly what the condition is and that he is capable of properly treating it after opening the belly. In fact, there are entirely too many attempting to do abdominal surgery; the time has now come to call a halt and to say emphatically that the ordinary doctor should not attempt to do any abdominal surgery excepting emergency work; chronic cases should be referred to the skilled specialist in surgery. In appendicitis there should be more medicine and less surgery, unless expert operators and

experienced ones are at hand; but the tendency is perhaps just now a little too strong to drift back to the do-nothing plan; this also is extremely wrong-worse even that indiscriminate operating-and is to be combatted; the happy mean should here be the rule. Extirpation of the uterus also seems about to be carried to an extreme, especially in inflammatory disease which ought to yield to less radical measures; neither the uterus nor its appendages should be removed for pain alone; ovaries should not be removed save for gross lesions. Hysterectomy for fibroids is to be condemned unless the tumors are causing serious trouble or are liable to do so soon. Conservative, or at least non-mutilating operations upon the female pelvic organs are gaining groundsuch as resection of the ovary, drainage instead of removal of diseased tubes, myomectomy rather than hysterectomy, vaginal drainage in pelvic abscess and some forms of extrauterine pregnancy, currettage instead of salpingectomy in chronic inflammatory but non-purulent disease, removal of an ovarian tumor without sacrifice of the ovary and tube, etc.; and they have much to commend them.-Medical Fortnightly.

The Strengthening and Sterilization of Catgut.

Dr. Donald B. Pritchard of Winona, Minn., writing to the Medical Record, says:

Having seen in some sample journal a two or three line item recommending the preparation of aseptic catgut by first treating it with formalin and then boiling, I thought it worth while to try it. Being much pleased with the result, it would seem but proper that I should bring it more generally to the notice of the profession. After trying various strengths of the formalin, I find the twenty per cent to be the most satisfactory, leaving the gut immersed in it for three and one-half hours. It should then be at once transferred to boiling water for fifteen minutes or longer, if one so desires, when it will be found in excellent condition. Raw gut that bears a weight of thirty pounds will after the formalin treatment lift twenty-six pounds, and boiling it for fifteen minutes does not weaken it. It is curious that the gut which has been prepared for several weeks seems to become nearly as strong as the original raw article.

If one wishes to boil it on spools, care should be taken to wind it very loosely, as it swells and contracts during boiling and might easily be broken. The better plan is to prepare it before winding on spools; then with aseptic hands it can be made ready for storing away in alcohol for future use.

One day I left some gut in the formalin for eight hours and found it rotten. It would lift but six pounds. After boiling for fifteen min