twice carefully examined with the microscope and no pus cells or gonococci found. The patient's discharge has now practically ceased, and the wearing of cotton, which formerly was a source of great inconvenience, has been discontinued, as there is no further need for it. My only excuse for publishing this case is the very rapid way (in my experience) in which a strong solution of permanganate of potash cured a case of gleet which had existed so many years. Odd Fellows' Building. PHANTOM TUMOR.* BY LOUISE DROUILLARD, M.D. MEMPHIS. Hysterical tympanitis, or spurious pregnancy, is a peculiar enlargement of the abdomen occurring in females belonging to the hysterical class. It can be caused to disappear at once by placing the patient under the influence of chloroform. I have two cases of spurious pregnancy or physometra to report. Case I. Mrs. C., white, aged 30, came to me in March, '85, with the following history: Menstruation began at fourteen and was regular. She was married at eighteen and had three children. After a widowhood of two years she remarried, from which time her general health was not good, but she menstruated normally until January of 1895. When I saw her in March of that year there was every indication of preg nancy: nausea, breasts enlarged and areola darkened; also laceration of the cervix from her former pregnancy, with a slight leucorrhea. The same symptoms which had presented themselves in former pregnancies were present. On examination the uterus was found to be the size of a three months pregnancy. I gave her remedies to control the nausea and general instructions in regard to the care of herself, as she lived in the country and could not see me again. At the sixth month she had a severe shock, which produced a flow and threatened a miscarriage, but with rest and remedies the flow ceased. * Read before Tri-State Medical Association (Miss., Ark. & Tenn.), Memphis, December 21, 1898. In August I saw the patient again. At this time the tumor was the size of an eight months pregnancy. Not expecting to deliver her, I made no vaginal examination, but I told her I thought she would. be confined within three weeks. In September, while superintending some work in the yard, she stepped on a little garden snake, which frightened her greatly, and in a short time after returning to the house violent labor pains began. Quantities of gas passed at each contraction, and at the end of four hours the tumor had disappeared, leaving the patient somewhat exhausted from pain for a few days. The following month menstruation returned. In December, two months later, I made an examination, and found the uterus in good position but larger than normal, with endometritis and a laceration of the cervix. The subsequent history is that in 1896 she went through the same experience, it terminating this time at the third month. In 1897 she had a bonafide miscarriage at the end of the fourth month. Since then her menstruation has been regular. Case II. Annie D., colored, aged 33. At the age of sixteen, having menstruated for a year, she was married, and the following year became pregnant, but miscarried at the end of six months. Her husband dying, she remarried in 1890. In 1894, not having menstruated for two months, she called me in because of a slight flow which came the third month. A uterine sedative controlled this, but at the sixth month another flow began. I was absent from the city at that time, therefore Dr. Stanley was called in, and he thought the patient pregnant. Again the flow was controlled. Between the eighth and ninth month I was summoned in the night and found the woman in labor but with no dilatation. In the morning, as there was still no dilatation, I dilated the os with my finger, when a gush of gas and a bloody discharge were the result. In a short time the pains ceased and the tumor disappeared. The uterus in this case did not reach its normal size for some time. Dr. W. W. Taylor examined the case with me and found a small fibroid tumor in the anterior wall. The menstruation came on normally after this and continued so for two years. She is again irregular and says she passes gas through the vagina at the time she should menstruate. Her general health is good. Randolph Building. CORRESPONDENCE. SOME OBSERVATIONS Upon the Proceedings of the Canadian Medical Association at its Recent Meeting. To the Editor of the Monthly: In response to your request that while away I furnish something for your journal, I herewith send you a few observations upon the proceedings of the Canadian Medical Association. The meeting of 1899 has been of more than ordinary interest. First, because the papers presented are of more than usual merit, in that they deal with the subjects from a clinical rather than a didactic point of view, consequently being practical rather than theoretical in character; second, because at this meeting was presented the pruned formulations of committees of long standing upon medical legislation-the culmination of eight years work upon a plan for the advancement of the profession by means of a higher curriculum in the schools and a common standard applicable to the entire Dominion. I say few observations, because a letter embracing anything like a full report would be too long. The social features I shall merely mention. The Canadians are excellent entertainers. They remind one in this regard of their mother country. There have been numerous banquets and private receptions. There has been also today a royal spread upon the grounds at the Industrial Exposition, which is in progress here. Those of us from the States are specially entertained, as well as most courteously treated upon the floor. In science caste is forgotten; all men are brothers. The Canadians are very quiet, courteous and accommodating. I asked a native of Canada who now lives in New York City why the people were slower in their movements and less progressive in commerce and material advancement than the people of the States. His reply was: His more paternal gov ernment lessened individual incentive by exacting a tedious process in gaining permission from the mother country to embark in business enterprises. Having once attended a meeting of the British Medical Association, the writer was struck by the similarity of their behavior upon the floor. The Canadian is less conventional, less observant of the technicalities of formal decorum which have grown up and become fixed by long usage in the old country. I would not say that the Canadians feel more kindly to one another than do the British, but it occurs to me that there is a more graceful courtesy observed toward the man in their deliberations-more like one meets with in the States. They are more natural-consequently more eloquent. More than one member became warmed into splendid oratory during each session. There is a sharp sprinkling of French, chiefly from the province of Quebec, but not sufficient to at all change the British dominance in a national convention. INTER-PROVINCIAL LEGISLATION was the plan offered by the Committee on Medical Legislation. The discussion was opened at 11 o'clock by Dr. Roddick, M.P., convenor of the Special Committee to look into the matter. In presenting the report of the committee the doctor briefly summarized the attempt to bring about Dominion registration. He said the question was as old as the Dominion itself. Almost immediately after the B. N. A. of 1867 the medical profession felt that a great mistake had been made by the fathers of Confederation, in that they had not placed professional education under the control of the Dominion Parliament, and left local educational affairs to the local governments. Hence in 1868 a bill was introduced in the Federal Parliament to remedy this apparent defect in the B. N. A. act. Unfortunately the bill was thrown out by the Senate. No further steps were taken till 1894, when, at the convention held at St. John, a committee was appointed to inquire into the question. A scheme of inter-provincial registration was then attempted, but it was found impossible because delegates from the province of Quebec did not offer any hope of making the medical examination in Quebec similar to that in Ontario. Dr. Roddick then took up the question of how far a Dominion measure was suitable. The advice of the law officers of the Crown was that any Dominion measure establishing a central qualification was ultra vires and unconstitutional. He believed that under clause 91 of the British North America act, which granted the Federal Parliament the legal right to make laws for the peace, order and good government of Canada, could be built up a measure which would remedy grievances and disputes between the various provinces as to medical affairs. Such an act would simply organize a body with no powers whatever. The next question Dr. Roddick discussed was the appointment of this new Dominion Medical Board. On behalf of the committee, Dr. Roddick urged that each province have three members on the council, the representatives to be chosen as follows: One nominated by the Governor-General-in-Council; one elected by the various medical boards of each province, and the third, an ex-officio member, the president of the Provincial Medical Council. This was the scheme recommended by the Committee on Registration. It did not disturb provincial autonomy in the least. Further, the committee urged: 1. That the standard of medical matriculation should be raised higher and rendered uniform throughout the Dominion. 2. That the course in medicine be five years in length, the fifth year to be entirely clinical and practical; that at the close of the fifth year a searching examination be held at one large clinical center selected by the Medical Council for the Dominion. In conclusion, Dr. Roddick summed up the main objects of the proposed bill. It would permit a doctor who took the examination to practice in any place in Canada without being subject to the annoyance of having to pass in each province a special examination; it would relieve the present congestion of the medical profession in the country by establishing a standard whereby Canadian graduates would be allowed to practice in the Imperial service or in other countries; and, finally, |