course of mercurials and iodides for three and one-half years. Wasserman reaction in October, 1911, was negative. Shortly afterward an eruption appeared over the lower abdomen. At this time he was taking ten drops of saturated solution of iodide of potash three times per diem. Another Wasserman reaction in January was negative. Eruption on abdomen was polymorphous, slightly inflammatory, bullous lesions later appeared. Withdrawal of the iodide and substitution of arsenic in form of Fowler solution, lesions on skin quickly disappeared. Diagnosis: Dermatitis medicamentosa. Case 4: Mr. M., age 25, September 15, 1912. cre. Complained of general malaise, headache and papular eruption on face and neck. A lesion was present on the dorsum of glans penis that had the essential characteristics of a chanHis medical attendant had begun treatment at appearance of sore. The eruption appearing four days after treatment was inaugurated. This prescription was withdrawn, but before his face had cleared up the characteristic rash appeared on the body. This was forty days after exposure, corresponding closely to the average time. I believe the facial lesions were purely an iodide eruption anticipating the true syphilitic eruption. The tertiary manifestation of syphilis are essentially atypical in every respect. Cardio-vascular, cerebro spinal and the osseous systems are involved in so complex a manner that without a clear history of the case a diagnosis without a Wasserman reaction would be well nigh impossible. A deviation from the ordinary tertiary symptoms occurred in Case 5: Mr. L., married, five children; youngest three years of age. Apparently healthy. Initial lesion of syphilis ten years ago. Never took specific treatment. Complained of a swelling in scrotum and eruptions on both legs. Dr. Neuberger in consultation. We decided it was an unusually large hydrocele, with epididymo-orchitis, complicating tertiary syphilis. Aspiration of twelve ounces of fluid, clear and low specific gravity, revealed on palpation characteristic involvement of testes, gummatous syphilides were found on both legs. Mixed treatment was instituted, with a slight recurrence of the hydrocele, but improvement of the syphilides. In conclusion, I would hastily recapitulate what I wanted to impress in this paper: First: The diagnosis of syphilis by the primary sore should be held inefficient, other lesions so constantly resemble it that men with great experience confess their likelihood of making mistakes. Second: Eruptions of secondary symptoms are often simulated by drug dematoses, such as iodides. Lastly: The Wasserman sero-diagnostic test should be used in every case as a means of diagnosis, and after the course of treatment has been administered since it is the one infallible guide from which we may determine whether or not this dire disease has been eradicated. Let us not assume too optimistic an attitude; believing that syphilis responds readily in every case to salvarsan and the mercurials, but ever mindful of the insidious nature of the disease, safeguard the vital interests of our country, posterity, from the ravages of syphilis. REPORT OF THE LIBRARY COMMITTEE. The Library Committee of the Luzerne County Medical Society reports the addition of 140 volumes during the year 1912, exclusive of reprints, pamphlets and duplicates. This does not include the Maris Gibson collection, which numbers about 240 volumes, some of which are duplicates. Of the number received, twenty-two were bought by the Society, sixteen were presented by various publishers, two by authors, three by the Library Exchange, four by the Surgeon General, and two by the U. S. Pub. Health Service. Publications, chiefly bound volumes, were received from the American Surgical Association, American Laryngological Association, American Laryngological, Rhinological and Olotogical Society, College of Physicians, American Proctological Society, Phipp's Institute, N. Y. Obstetrical Society, American Urological Association, Bellevue Hospital, Philadelphia Hospital, Ontario Medical Society, Pathological Society of Philadelphia, Marine Hospital Service, Dr. Samuel Dixon, Commissioner of Health; Dr. A. Jacobi and Dr. B. S. Keator. We are indebted to Dr. Charles McIntire for the usual number of periodicals which are kept on file during the year and later bound by the Society. Among our own members who have contributed either volumes or journals during the year are Drs. Buckman, Carr, Fell, Long, Guthrie, Miner, Wetherby and Taylor. The Library now numbers 5,250 volumes, exclusive of reprints, pamphlets and duplicates, and exclusive of the Maris Gibson Library of about 240 volumes, not yet catalogued, which with case for holding same were donated during the year by the widow and children of the late Dr. Maris Gibson of this city. There are fifty periodicals on file. LEWIS H. TAYLOR, CHARLES H. MINER. DEATHS AND CONTAGIOUS DISEASE (See tables of figures.) [From Wilkes-Barre Record Almanac, 1912.] For the twelve months ending November 30, 1912, there were 1,162 deaths in the city of Wilkes-Barre, fourteen more than the previous year. In considering these totals it must be remembered that all deaths occurring in the Wilkes-Barre hospitals are counted in the totals. Often these are out of town cases, especially accident. The city ought not by right have such cases added to its mortuary record. All still births and premature births are also added to the list. It is doubtful whether these should be counted in the death record. If the out of town cases dying in the hospitals and still and premature births were deducted, a much better showing would be made. The latter alone number 109 for the past year. The 1912 mortality rate, based on a population of 71,000, was at the rate of a trifle over sixteen deaths for each thousand of population. As usual, pneumonia heads the list with 137 deaths, thirtytwo more than the previous year. In 1912 there were 122 deaths as the result of accidents, ten more than the previous year. All deaths in the Wilkes-Barre hospitals are included in the totals, although a large number of the victims are from out of town places. Heart disease numbered 127 deaths in 1912-twenty-eight more than the previous year. Tuberculosis caused eleven less deaths in 1912 than in 1911. The deaths from cancer for three years have been about stationary-thirty-two for 1912, thirty-one for 1911, and thirtytwo for 1910. In 1909 there were 44. There were thirty-nine deaths from cholera infantum in 1912, four less than in 1911. The deaths from cholera infantum and other infantile stomach and bowel complaints combined numbered about seventy-three in 1912, as near as can be judged from the way in which physicians report the cases. During 1912 there were seven deaths from typhoid fever, the same number as the previous year. In 1907 there were twenty-six deaths, the highest in ten years. The high record of 1910 (twenty-two cases) was due to a mild epidemic of the disease in Wilkes-Barre and vicinity. In previous years out of town cases were included in the Wilkes-Barre totals, although they do not belong there. They made Wilkes-Barre's record worse that it really is. There were three deaths from diphtheria reported in WilkesBarre in 1912 out of 192 cases reported. The table shows a great reduction since 1895, when there were eighty-eight deaths out of 299 cases, and in 1892, when there were 130 deaths. Under antitoxin the deaths from diphtheria have averaged twelve a year during the past ten years, while for the five years preceding the use of antitoxin the deaths averaged eighty per year. In 1912 there were fifty-three cases of scarlet fever and two deaths, while in 1911 there were 114 cases and one death. The proportion of deaths to the number of cases varies considerably from year to year. In 1902, for instance, there were 409 cases and fourteen deaths. In 1911 there was a serious epidemic of measles in the early part of the year, the new cases numbering 1,245 in January alone and 469 in the previous month. In all there were 1,987 cases for the twelve months and eight deaths attributed to measles. Some deaths resulting from complications following measles or coupled with the disease are not reported as measles, although caused by that disease. Not all of the cases of the disease are reported, some families not having physicians. The way in which this disease fluctuates is shown by the above figures. In 1898 only one case was reported, |