He advised the establishment of means to educate persons to the profession of nursing; he suggested that efforts be made to have a suitable medical man appointed in every judicial district, to assist the authorities in getting at the truth when medical facts and theories are involved in any suit at law; he desired to see something like reason and justice have a voice in fixing the rank and pay of surgeons in the navy; he thought great good would come of the establishment of a naval medical school; he was anxious that the Association should devise a method for preparing and publishing a register of physicians for the whole country; he earnestly advocated the organization of societies for the relief of the widows and orphans of indigent medical men; he wished to see the Association lend its influence toward the institution of veterinary colleges; he was of the opinion that the organic law of the Association should be altered so as to have the President elected by ballot instead of, as now, merely confirming the selection of a committee; he was opposed to what he termed the stringent restrictions placed upon the social aspect of the Association by a vote at the annual meeting at Cincinnati; and, finally, he was impressed with a conviction that the annual meetings were too short to insure the highest good they were capable of conferring.

We are more and more convinced of the propriety and good sense of this address, and the Association did wisely in appointing committees to investigate many of these points, and report to the next annual meeting.

Report of the Committee on the Rank and Regulations of the Medical Staff of the United States Navy. In this short paper the chairman, Prof. N. S. Davis, states that he furnished the Heads of Departments and members of both Houses of Congress with a copy of the address of Dr. Wood, made to the Association last year. Report of the Committee on Medical Ethics. Dr. H. J. Bowditch made the report, closing with two resolutions: First, that we should look to the qualifications of those who sought professional fellowship with us, and ignore sex in deciding the point. This resolution was indefinitely postponed. But the Association need not hope to get rid of women doctors in this way. They may indefinitely postpone the subject, but it will definitely come back until they have the mora! courage to meet the issue squarely, and define their position to the world.

The second resolution was in reference to Dr. Homberger, who was expelled with great good will.

The Committee on Prize Essays received four papers, but none of them were deemed worthy the prize.

Report of the Committee to Revise the Plan of Organization, was laid over for consideration next year. It proposes many important changes in the organic law of the Association.

Report of the Committee on Medical Education was made by Prof. A. B. Palmer, chairman, who expresses his disapprobation of what was proposed by the convention of teachers in Cincinnati in 1867, and in lieu thereof, presents a plan of his own concoction that he deems feasible, and feels sure would accomplish the end desired.

The Committee on Medical Literature began their service by requesting all the publishers of medical books and journals in the United States to send to the chairman "a copy of all medical books, pamphlets, essays, monographs, periodicals, reports, lectures, proceedings of societies, etc.," that they might issue, as early as convenient after publication. Up to the time of writing the report, no publisher had found it 'convenient' to comply with this simple, not to say modest, request. By some means, however, not clearly defined, the committee came to the knowledge of the existence of thirty-five journals, which they name by title, and of the publication of one hundred and eighty-nine books and pamphlets, which they give the title of, also. The committee declare that it was a pretty good year for medical publications, but a very poor period for sending them around to committees.

Report on Insanity, by Chas. A. Lee, M. D., is a scientific consideration of the subject, giving the proportion of the insane to the whole population in various countries, etc. He considers the insane in the States of this Union severally, and the provision made for them, and finds it inadequate. He points out a better and less expensive plan of caring for the insane than that now in vogue in this country.

John B. Chapin, M. D., contributes a paper On the Provision for the Chronic Insane. He argues that the State is as much bound to care for its chronic insane as for its acute, and, like Dr. Lee, advocates a simpler and more economical plan of providing for most of them in communities on a large farm.

Report on Topography, Climatology and Epidemic Diseases of West Virginia, by Dr. E. Hildreth. West Virginia is a State of mountains, and has a great deal of topography and climatology, but not much epidemic disease. It is full of minerals and mineral springs. We notice that in 1856 nearly sixty-two inches of rain fell in the western part of

the State, and in 1863 but about thirty-seven inches. Quite wide ex

tremes.

A short and interesting Report on the Climatology and Epidemic Diseases of the Dist. of Columbia, is made by Prof. Antisell. Prof. A. thinks consumption especially rife in Washington City-not among the permanent inhabitants, but among the department clerks who come from the rural districts.

Report on Medical Topography, Meteorology, and Epidemic Diseases of Texas, by T. J. Heard, M. D. This opens with a brief account of the general subject, and then treats at great length of the epidemic of yellow fever in 1867, The mean annual average of rain fall for eight years, 1856-65, was 30.67 inches.

Dr. Condie's Report on the Diseases of Pennsylvania, presents nothing peculiar, but the Doctor thinks consumption is relatively on the in

crease.

The Conveyance of Cholera from Hindostan through Asia, to Europe and America, illustrated by four fine diagrammatic maps, is quite intelligible and very likely true.

A Series of Plans for the Collection and Statistical Arrangements of Facts in Regard to Climatological and Sanitary Conditions of the various States, were prepared by Wm. R. Thoms, M. D. There can be no doubt that the time has fully arrived when the Am. Med. Ass. ought to adopt some uniform method of having its statistical and scientific reports of this character made. Whether the plan presented by Dr. Thoms is the best, we can not decide, but the Doctor has paid much attention to these affairs, and seems to take hold of them con amore. The past volumes of the Transactions contain immense papers on these subjects, but so irregular and confused in their arrangement as to be but of very little value.

Report on American Medical Necrology, made by Dr. C. C. Cox, records the death of eighty-eight of the members of the Association which had come to his knowledge since the last annual meeting. The chairman had given such obituary notices of them as he was able to obtain some pretty full, others a mere mention of time of decease. During the year, many eminent men of the profession went to their final rest.

Dr. J. S. Hildreth of Illinois, read the Report of the Committee on Ophthalmology. The object of his paper is to arouse attention to the claims of ophthalmology upon the profession, and does so by showing the advances made in this branch of medical science, and what is re

quired in order that diseases of the eye may receive the attention they demand from the profession. This demand is to be met, "First-By increased accommodations for this class of patients, the present being entirely inadequate. Second-By providing for a more general, thorough instruction." The author thinks that the instruction given on this subject in our medical schools, entirely insufficient, and that a general understanding of ophthalmology should be required by all candidates for the degree of Doctor in Medicine.

Dr. L. A. Sayre of New York, presented a Report on the Treatment of Club-Foot without Tenotomy. Dr. Sayre holds that in the vast majority of cases of club-foot, the essential lesion is paralysis and not spasm of a certain muscle or group of muscles. The correctness of this idea being admitted, the indications for treatment are, "First-To restore the foot to its normal position, and to so retain it; and SecondTo seek to develop the paralyzed muscles, that they may at last be sufficient of themselves to counteract those acting in opposition." He insists that the earlier we begin the treatment, the more surely and more rapidly will success follow. Various methods of treatment are noticed and objections to them pointed out. In the majority of congenital deformities, if taken immediately after birth, the hand can readily bring the foot into its normal position, while it can be easily retained there by the simple application of adhesive plaster. Full directions for applying this are given. Cases occur in which the muscular rigidity will not yield readily to manipulation; in these, a constant tractile force becomes necessary. For keeping this up, the plan suggested by Mr. Richard Barwell of London, is considered by far the best. In this plan, the elastic force of rubber tubing is employed. Full directions are given in reference to the plan of treatment.

Dr. Sayre believes that in most cases, tenotomy is not only useless, but positively injurious--that only in those cases where the muscles heve become permanently shortened or the fascio have become contracted as the result of inflammation, is tenotomy justifiable.

An improved club-foot shoe is illustrated and described, and a number of cases reported in detail, illustrative of Dr. Sayre's plan of treat

ment.

We regard this report as a valuable one, and believe that it is well calculated to lead to a more philosophical treatment of club-foot than that usually instituted.

Dr. Gurdon Buck presented A New Method of Reconstructing the Lower Lip, after its Removal for Disease, illustrated by Two Cases of

Epithelioma. With the accompanying drawings, Dr. B. has made a very plain presentation of a very neat and satisfactory operation.

A New Treatment for Congenital Talipes, by Dr. I. N. Quimby, consists of the application of adhesive straps and a roller, when the child is from three to four weeks old.

The Treatment of Syphilis by Hypodermic Injection, is recommended by Dr. L. Elsberg; but we question whether the method has any special advantages.

Dr. P. F. Eve's Safe and Effectual Operation for the Radical Cure of Varicocele, consists of cutting away of a part of the thickened scrotum, and, if necessary, tying the enlarged veins with animal ligatures.

A HANDBOOK OF VACCINATION.

BY EDWARD C. SEATON, M. D.,

Medical Inspector to the Privy Council. Philadelphia: J. B. Lippincott & Co. 1868. Pp. 383.

For two generations no separate work on vaccination has issued from the press. It is true that nearly every standard work on the practice of medicine has treated the subject more or less fully, but still much has been left unsaid that was imperiously demanded for the full cultivation of the student in this branch of medical science.

As the consequence of this state of affairs, there is now existing among practising physicians, a great want of a clear, well-defined and unwavering idea of what vaccination is, and how far it can be relied on to prevent variola. To one who has made no inquiry in this direction, this declaration may seem like a wanton and unsupported charge against the profession. But let any one investigate the premises, and he will be surprised to find how many practitioners in good standing there are who have no well-settled convictions whether it were better to vaccinate a child within the first year of its age, or wait until it be five; nor are they sure whether vaccination is a certain protection against variola; whether we should re-vaccinate; whether it is possible to tell, by examining the cicatrix, the amount of protection; whether the virus recently from the cow is better than that long descended through human systems; whether scrofula may be transmitted through vaccination, or, worse still, syphilis; and have no definite conclusions on many other points relating to vaccination, whereon they should be