but good union was obtained in six weeks with probably less than onehalf inch of shortening.

Case 5.-Jerry V., 9 years of age, a resident of South St. Joseph, sustained a compound fracture of the radius and ulna at the middle third of arm. Infection occurred and there was no union at the end of three weeks. The arm was full of pus which was thoroughly evacuated and the bones wired and wound drained. Convalescence was slow in this case and a great amount of care and attention was necessary in the treatment of the infection. However, union finally occurred with but little deformity.

Case 6.-Roy B., 14 years of age, a resident of Cameron, Mo., sustained a fracture-dislocation of the humerus. This case was treated as an ordinary strain, no effort at reduction being attempted until the end of the seventeen days. An effort at this time at reduction was made under anesthesia, the diagnosis of dislocation of humerus having been made. All efforts at reduction failed and the boy was sent to me the same day. An X ray skiagraph showed a fracture just without the capsule of the joint and a subcoracoid dislocation of the fractured shaft.

The anterior incision was made, the ends of the bones placed in apposition, silver wire was used in this case. Union was prompt with slight shortening in the humerus, and a perfect functional result.

Case 7.- Mr. B., 67 years of age, residence, country eight miles south of St. Joseph, was thrown from his wagon when it was struck by a street car in South St. Joseph. He sustained a fracture of the acromion process of the scapula. The deformity was unusually marked, the fragment being drawn forward and downward by muscular contraction. A Lane bone plate was placed with prompt union and a perfect result.

Conclusions.-The results in the open method of treating fractures will depend largely upon the elimination of sepsis. This can be accomplished by the observance of a highly developed aseptic technique. The method should be used in all irreducible fractures and where vicious union with deformity has resulted and in non-union cases. The successful application of the method reduces the number of otherwise hopelessly deformed and ofttimes useless limbs, as the result of fracture and fracture-dislocation.

P

Censor, B. F. Bohan, M. D. Secretary, Paul V. Wooley, M. D.

ATIENT age 40, symptoms for three years. At 18 years had typhoid-pneumonia, and was sick six weeks. Five years following, attacks of rheumatism, not characterized by fever. Began in arms and shoulders and extended over his body, and. as he said, left him when it got to his toes.

Three years ago Christmas day, was crossing the street and had extreme pain in abdomen. Pain lasted until 5 o'clock when he had a hypodermic. Pain lasted twenty-one hours and disappeared suddenly. During the next three years had five attacks per year. These attacks not so severe as the initial one. Took large doses of cathartics which relieved his bowels. Never had superficial pain or tenderness. February, 1911, pain on right side and intermittent, becoming worse and extended to the left side and was felt through the back. Pain was constant and severe and could not sleep at night.

In April, two months later, the pain would come in the morning after breakfast. It would be so severe he had to lean forward to move at all. At this time, losing strength and could not work. By June his weight increased to 122 pounds. About this time found he had pain on his left side and could not sleep on left side. From February to June very much constipated and took a great deal of cathartic.

Three years ago Dr. Jackson and I, on examining him, thought it was a stenosis. On incision and examination of the viscera, we found several inches below the jejunum a bunch. The cecum was extended and the colon contracted and was not over an inch in diameter anywhere. The thing we

decided to do was to shorten the large bowel, and fasten the cecum to the sigmoid. The patient suffered little pain, and recovered shortly.

Left the hospital on the ninth day. Bowels moved five or six times a day in the hospital. Since he left the hospital three or four times per day.

His weight has increased to 130 pounds now. Has been able to work. There is some deficiency in his nutrition. Has to eat in the forenoon and at 5 o'clock must have another lunch. He eats two lunches and three meals a day. His general appearance is steadily improving. He has strength, feels good, eats too much, bowels move too much-and there is the proposition. It is too early to report on his case, but the facts are that he is imprvoing all the time, and his condition is much more comfortable to him than it was before the operation. He states that prior to each bowel evacuation that it is preceded by a large amount of gas.

Dr. S. Grover Burnett asked if this excessive gas expulsion was not from the short circuited and, therefore, unused colon; if nature was not keeping up a certain amount of physiological activity and exercise of the colon and preventing non-use disability by performing muscular acrobatics in handling the gas.

Dr. Hill said the gas no doubt came from the short circuited colon.

SPECIMEN OF HORSESHOE KIDNEY PRESENTED BY DR. C. C. NESLELRODE.

Specimen came from autopsy. Negro woman showing no signs of kidney trouble. Everything found in autopsy normal except kidney. Kidney all in one capsule. These, according to ob

tainable statistics, number about one in eight hundred autopsies.

Dr. Hall: I have seen four of these cases and have not done 800 autopises, but found symptoms where this normally occurred. I think they are more common than one in 800. The kidneys in the fetus develop so closely together that it is a wonder to me that we do not have more of them than we

do. There is nothing remarkable about them. They are simply a slip in development.

Dr. Bowen: The question comes up as to whether there are symptoms. I saw one case last winter in an autopsy on one of Dr. Ayres' patients. Patient died of nose bleed, lasted several days. Red cells down to 2,000,000. In the chest we found marked hypertrophy of the heart. In the abdomen we found nothing but a horseshoe kidney. Do not know whether he had polyuria or high blood pressure. Today I read in Today I read in a medical journal of four cases in which it was thought a number of clinical signs were present. Spoke of one sign-pain when patient bends backward.

Gastric Aphorisms

J. M. Bell, M. D. St. Joseph.

In spite of all declarations to the contrary, the colon, cecum, appendix and sigmoid can only be palpated under the most favorable conditionsthin relaxed abdominal walls.

¶ Sudden death from apoplexy, heart failure, arteriosclerosis, occurs most or immediately frequently during Govern yourafter a hearty meal. selves accordingly.

should be nil, not only to reduce bacThe diet in acute appendicitis terial activity-the empty intestine becomes nearly sterile in a day or two-but for the very practical reason that an anesthetic may be needed upon short notice.-Benedict.

Eczema exists as a result of a diet excessively protein. In the great majority of cases it will subside upon a diet of fruit and vegetables.-Combe, Kellogg, Benedict, Bulkley.

¶ In cases of yellow skin don't focus your attention upon the liver and gall bladder; the pancreas may be the offender, or it may be due to anemia.

No drug ever cured constipation. After going the rounds, try coarse, dry bread, fruit and vegetables, cold water libations and physical exercise, with a regular hour.

strawberries, spinach, lettuce and green leaves of cabbage than from any compound ever put in a bottle.

The larval hyperacidity of Friedenwald is not characterized by an excess of HCl, but rather a hyperesthetic mucosa gastrica and an abnormally early acid wave of normal percentage.

Keep the Consumptive at Home.

Dr. William Porter is emphatic in his advice to keep tubercular patients at home. He says "that it has been conclusively proven that such patients recover as readily in the Mississippi Valley as elsewhere, provided they live right. There is no more need that a consumptive should be exiled, than a patient with typhoid fever."