University of New Zealand.

2. Of being 21 years of age. THE University of New Zealand is an examining body

3. Of having attended a course of not less than one only, and is modelled on the lines of the University

hundred lectures in surgery. of London, with affiliated Colleges. The University of 4. Of having attended a course of not less than fifty Otago in Dunedin is the only institution in which a lectures in clinical surgery. complete medical education can be obtained, but pre- 6. Of having attended a course of instruction in liminary education in Arts and Science can be obtained practical and operative surgery. also at Auckland College, University College, Victoria

6. Of having attended a course of not less than one College at Wellington, and Canterbury College.

hundred lectures in medicine. Medical students, unless they are already graduates 7. Of having attended a course of not less than fifty in Arts or Science, must pass a preliminary cxamina- lectures in clinical medicine. tion in English, Latin, Elements of Mathematics, and 8. Of having attended a course of not less than one either Greek, French or German, No candidate is hundred lectures in medical jurisprudence and public admitted to the final examinations for Degrees in health. Medicine unless he has been registered as a medical 9. Of having attended a course of not less than sixty student for at least fifty-seven months previously. lectures on midwifery and diseases of women.

10. Of having received practical instruction in Three Degrees in Medicine are conferred, viz. :

diseases of women. Bachelor of Medicine, Bachelor of Surgery, and Doctor

11. Of having received a three years' course of regular of Medicine.

clinical instruction in the medical and surgical practice Degree of M.B. and Ch.B.—There are an inter- of a hospital containing not less than 100 beds. This mediate examination and three professioual examina- certificate must state that the student has acted for six tions. These are conducted by written questions and months as clinical clerk in the medical wards, and six viva voce. Excellence in one or more subjects at an months as dresser in the surgical wards. Six months examination does not compensate for failure in others. of this hospital practice may be taken at a lunatic

Intermediate examination. This is held not earlier asylum containing not less than one hundred beds. than November in the student's first year, and includes 12. Of having attended six midwifery cases. biology, physics, and inorganic chemistry. The 13. Of dispensary practice for six months, either in subjects of this examination may be taken together or the out-patient department or at a public dispensary, separately, at the option of the candidate.

or with a qualified practitioner. First Professional Examination.—This is held not 14. Of having had instruction and practice in vacci. earlier than November in the student's third year, and nation. includes organic chemistry, practical chemistry, and 15. Of having had clinical instruction in insanity at anatomy. Before admission to this examination the an asylum containing not less than two hundred beds. student must furnish certificates :

Degree of M.D.-A candidate for the degree of 1. Of having attended not less than one hundred Doctor of Medicine must be a graduate of a University lectures on chemistry, including organic chemistry. in Arts or Science, and not less than 24 years of age.

2. Of having received six months' instruction in He must have obtained the degree of M.B. at least two practical chemistry.

years previously, and must have been engaged during 3. Of having attended a course of not less than the interval in the practice or study of his profession. one hundred lectures on human anatomy.

Candidates must send in a thesis on some subject of 4. Of having dissected the human body during two the medical curriculum, and be examined both in periods of six months each.

writing and orally on any one of the following groups Second Professional Examination.—This is held in of subjects :-1. Anatomy and physiology. 2. Surgery November, in the student's fourth year, and includes and anatomy. 3. Medicine and pathology. 4. Public physiology, pathology and morbid anatomy, and materia health and medical jurisprudence. medica. Before admission to this examination, the There are about 120 students in all the year in student must furnish certificates :

the Faculty of Medicine, and the total fees for 1. Of having attended a course of lectures of not less graduation as M.B. and Ch. B. amount to about £110. than sixty lectures, and gone through a course of prac. The following are the lecturers in the subjects of the tical work in physiology.

medical curriculum at the University of Otago :2. Of having attended a course of not less than sixty Anatomy and Physiology.-J. H. Scott, M.U. Edin., lectures, and gone through a course of practical work M.R.C.S. Eng., F.R.S.E. in pathology.

Surgery.-L. K. Barnett, M.B., C.M. Edin., F.R.C.S. 3. Of having attended a course of not less than sixty Eng. lectures on materia medica.

Practice of Medicine.-D. Colquhoun, M.D. Lond., 4. Of having practised the dispensing of medicine M.R.C.P. Lond., M.R.C.S. Eng. for three months.

Pathology.-W. 8. Roberts, M.R.C.S. Eng. 5. Of having attended the post mortem examinations Midwifery and Diseases of Women.-F. C. Batchelor, of a hospital containing not less than one hundred M.D. Durh., M.R.C.S. Eng., L.R.C.P. et L.M. Edin., beds, for two periods of six months each.

L.S.A, Third Professional Examination. The third profes- Materia Medica.–J. Macdonald, L.R.C.P. at 8. sional examination is held in November in the student's Edin., M.R.C.S. Eng. fifth year, and includes surgery, clinical surgery, medi. Medical Jurisprudence and Public Health.-F. cine (including therapeutics and insanity), clinical | Ogston, M.D., C., Aberd. medicine, surgical and medical anatomy, midwifery and Ophthalmology.-H. L. Ferguson, M.A., M.D. diseases of women, medical jurisprudence and public Dublin, F.R.C.S. Irel., L. K.Q.C.P. Irel. health. The following certificates are necessary to Mental Diseases.-F. T. King, M.B., C.M., B.8c. admit the student to this examination :

Edin. 1. Of having been registered as a medical student at Clinical Medicine and Surgery.—The Honorary Staff least fifty-seven months previously.

of the Dunedin Hospital.

REVIEW OF CURRENT MEDICAL Treatment of Scarlatinal Nephritis.
LITERATURE.

Saundby (Birmingham Medical Review, September,
1901), approves of the treatment of this condition
advocated by Kerley, namely, irrigation of the colon

with hot water as the best means of restoring the PEDIATRICS.

functions of the kidneys in scarlatinal nephritis. It of the Abdominal diminished or when convulsions occur. In a child aged

should be employed whenever the quantity of urine is Congenital Absence Muscles with Distended and Hypertrophied three years, 500 to 750 cubic centimetres of water at a

temperature of 43° C. should be introduced by means Urinary Bladder.

of a rectal tube passed into the rectum for a distance

of 2.5 centimetres. If the water is returned at once it Osler (Bulletin of the Johns Hopkins Hospital, must be repeated, and irrigation should be continued November, 1901), records a case of this extremely rare condition. The author could only find reports of two

every six or eight hours. After three or four adminis.

trations, the kidneys generally commence to act, and similar cases—one in the Clinical Society's Transac

abundant diuresis takes place. tions (Vol. 28, 1895), by R. W. Parker, and one in the Transactions of the Pathological Society of Acute Fatty Degeneration of the Liver. London (Vol. 47), by Dr. Leonard Guthrie. The author's case was that of a boy aged six years, who was

Lister (Scottish Medical and Surgical Journal, July, admitted to the hospital in 1897, complaining of 1901), reports the case of a girl aged six years, who was stomach trouble, and difficulty in passing urine. His suddenly taken ill with slight jaundice, severe vomitfamily history was good. His chest had been deformed ing, pain, hæmorrhages, fits, coma, and death, the from birth, but he appeared to have had good health

whole illness only lasting twelve days. The liver was till the second summer, when he had severe stomach

felt to be enlarged throughout, and leucin was found trouble. There had been recurrences of these attacks

in the urine. Post-mortem the liver was found to be each year, some of these had been gastric attacks, but considerably enlarged. It was in an advanced stage of others, and apparently the chief iroubles, had been fatty degeneration, fragments floating readily in water. with the urine. The attacks lasted four or five weeks,

When cut, the surface was of a canary-yellow colour, and had been getting more frequent lately. On

There was also an increase in the connective tissue examination the patient was found to be a poorly elements of the interlobular tissue. The author nourished child, somewhat anæmic, and complaining of considers that the condition was due to the entrance of pain chiefly in the hypogastric and lower umbilical some poison into the system, and one naturally thinks regions. There was a remarkable fulness in these

of phosphorus, but no history could be obtained of regions, which were occupied by an ovoid mass

there being the least probability of the child having corresponding to dilated bladder. The urine

taken phosphorus in any form ; further, the urine obtained by catheter was free from albumin, and showed no trace of this poison, and no sign of it was contained a good many leucocytes. In the erect

found in the liver. It was possibly a case of acute posture the attitude was remarkable. It was not quite yellow atrophy, but the fact that the liver remained symmetrical, being fuller on the right side than on the enlarged throughout is against this diagnosis. left. The navel was stretched and distended. Above

General Edema without Albuminuria in it there was seen on either side the attachment of the recti to the sternum and costal margin. The skin over

Children. the abdomen was thin; the veins a little prominent. F. L. Batten (Pediatrics, September, 1901), describes When recumbent the belly flattened out in front, and a case of this nature, which he considers a typical one extended at the flanks. Coils of intestine could be

of Herringham's toxæmic drop-y. A boy, aged four seen in peristalsis. There was extreme relaxation of years, had an attack of dropsy similar to the present tbe abdominal walls so that the finger could be passed one a year ago. He was then ill for a month, but everywhere to the spine. The liver, spleen and kidneys completely recovered. His present illness began a could be felt easily. The bladder could be felt as a week before he was seen by Batten, with swelling of firm ovoid body reaching almost to the navel. He the legs, face, and abdomen. He had never had scarlet could not raise himself off the bed without turning fever, and was a well-nourished boy. The eyes were over. As he made the attempt the abdomen was puffy, the abdomen ædematous with free fluid in it, thrust forward and slight contraction was seen of the and there was cedema of the legs. The heart was expanded abdominal muscles and recti. The deformity normal, and there was no albumin in the urine; the of the thorax was also remarkable. The lower part of

average quantity of urine for the 24 hours was 10 the sternum was thrust forward, forming almost a ounces, and the specific gravity was always high-1028 right angle with the xiphoid cartilage. There to 1035. The ædema rapidly diminished, and the boy also a condition of cryptorchidismus. The testes could left hospital in fourteen days, quite well. General not be felt in the groins. Osler states that the deficiency ædema in children without albuminuria is seen in in the abdominal muscles and the high position of the marasmic infants, in congenital sy philis, in the later bladder are associated conditions due to arrest of stages of tuberculosis, and in association with diarrhea development. He was not able to say whether the bladder and anæmic conditions. was adherent to the umbilical scar. Guthrie regarded the hypertrophy of the bladder and the dilatation of

MEDICINE. the ureters in his case as secondary, due to the fact

The Temperature of Phthisis Treated by that being firmly connected with the umbilical scar, it was unable to contract downward and to empty itself Open Air Methods. completely. In its effort to do so it became hyper- Dr. D. Lawson, senior physician Nordrach-on-Dee trophied and dilated, and the accumulation of urine Sanatorium, describes (Medical Press and Circular, caused backward pressure and dilatation of the December 18th, 1931) a new graphic method of showing ureters.

the temperature. The temperature is taken four

was

hourly, and the highest and lowest readings of each that below was not collapsed. During life the preseries of four days are averaged and marked on a chart, sence of volvulus was not suspected. The patient was each space of which therefore represents a period of 96 admitted as an ordinary case of colica ab ingesta, and hours. The space between the highest and lowest later the diagnosis of thrombosis or embolism of the curves on the chart so obtained is blackened in, and the mesenteric vessels was inclined to. The author thinks irregular band of ink thus got gives a better idea of the the mass of damson skins played an important part in course of the case than the usual temperature curve, the formation of the volvulus, as gall-stones in the On the same chart the amount of sputum and the body intestine may cause rotation. The red fluid was proved weight are graphically represented. In the case of an to be blood by the guaiacum test, and by microscopical active lesion undergoing arrest, the black band is at examination. first broad and especially on its upper margin, irregular ; as improvement takes place, the breadth of the band Pulmonary Incompetence in Mitral Stenosis. diminishes, showing less diurnal variation in the Bryant (Guy's Hospital Reports, Vol. 55), gives temperature and the band, as a whole, falls. With this records of 16 cases of functional pulmonary incom. character of the temperature the weight curve rises peience from his own experience at Guy's Hospital, and the sputum curve falls. Dr. Lawson puts forward and the results of post-mortems in nine cases. He a strong plea for the rectal method of taking states that in all the post-mortems on cases of advanced temperatures, claiming for it greater accuracy, and also mitral stenosis he has seen, there bave always been that it gives indications of a rise twelve bours before thickening, dilatation, and atheroma of the branches of such could be detected in the axilla or mouth.

the pulmonary arteries in the lungs. These marked

structural changes in the branches of the pulmonary A Case of Volvulus of the Ileum, with arteries may be looked upon as the result of the Severe Intestinal Hæmorrhage.

increased tension produced in the pulmonary circula

tion by the obstruction at the mitral valve. Syphilis J. H. Bryant (Clinical Society's Transactions, Vol. probably does not play any important part in producing xxxiv., 1901) reports i he above on account of the great pulmonary artery degeneration. The most important rarity of hæmorrhage per anum with any form of acute

physical sign of functional pulmonary incompetence is intestipal obstruction except intussusception, The the presence of an early diastolic murmur, which is patient, a male æt. 21, was admitted to Guy's Hospital most frequently heard in the third left intercostal September 18th, 1900, for pain in the abdomen. He space, midway between the left sternal line and the bad always enjoyed good health, and felt quite well left nipple line, but it may be heard in the second or until an hour or two after his supper on the previous fourth spaces in the same line. Some physicians night, at which he ate a large amount of 'damson think that this early diastolic murmur heari in the pudding. He was suddenly seized with severe pain in

above-mentioned situations is created at the mitral the umbilical and hypogastric regions about 10 p.m. on

valve itself. Bryant, however, considers this interpreSeptember 17th, and was admitted to the hospital soon

tation to be most unlikely, for he has never heard the after midnight. On admission he appeared to be in

crescendo or mid-diastolic bruiis produced at the great pain, and rolled ahout from side to side and mitral valve in these spaces, and he cannot see how a groaned. Temperature, 99°; pulse, 80; respiration, stenosed mitral valve could produce an early diastolic 24. The pain was paroxysmal in character, and the

murmur in this position. There is no doubt that an abdomen was not distended. The lower part was rigid. early diastolic murmur can be heard in cases of mitral Two ill-defined masses could be felt, one just below

stenosis at the point of cardiac impulre, and between and to lett of umbilicus, and the other in the hypo- the impulse and the left border of the sternum ; but gastric region. The pain continued throughout the

the author does not consider that there is any justificaday, and in the evening, about 8 o'clock, he became

tion for interpreting the early diastolic murmur very collapsed and passed about a pint of bright red audible most frequently in the third left space midway blood, and a large mass of undigested damson skips, between the left border of the sternum and the left about the size of a tennis ball. He became very nipple line, as being the direct result of the mitral blanched, and his pulse went up to 160, being feeble lesion. He considers the theory of this murmur being and running in character. The abdominal wall was due to dilatation of the pulmonary artery and functional very rigid, especially in the hypogastric region, and incompetence more satisfactory, and supported by the appeared to be extremely tender, out no tumour could very definite morbid changes found in the pulmonary be made out after the motion. Nothing abnormal was

artery and its branches in autopsies on advanced cases felt per rectum. In spite of hypodermic injections of

of mitral stenosis, strychnine and infusions of normal saline solution, he Functional Incompetence of the Pulmonary became more and more collapsed, and died at 5.30 a.m.

Valve. September 20th. Just before death a quantity of fæculent liquid poured from his mouth and nostrils. A Brockbank (Medical Chronicle, October, 1901) post-mortem examination was made pine hours after reports a case of this nature. A female, aged 19 years, death. With the exception of some thickening of the was admitted to the Ancoats Hospital complaining of aortic valves, the heart, lupys, liver and kidneys were shortness of breath and palpitation. She had had uo normal. The abdomen was disteuded. On opening antecedent cause for heart trouble, such as rheumatism, the peritoneal cavity, several coils of ileum of a deep chorea, etc., and had been quite well until three years dull red colour were found lying in and just above the previous to admission to hospital. On examination of pelvic cavity. Large Alakes and patches of recent the chest the apex beat was found to be in the fifth İymph loosely bound the coils of intestine together. interspace, 34 inches from the midsternal line. Cardiac One hundred cms. of the ileum, the lowest portion dulness extended as far as this to the left, and threebeing 10:5 cms. from the ileo-coecal valve, were involved. quarters of an inch to the right of the midsternal line. This portion of the gut was found to be attached to a Un auscultation, at the apex there is a short, pre-systolic long piece of mesen tery, which had become twisted murmur terminated by an accentuated first sound, and one and a half complete turns in its longitudinal axis. followed by a double accentuated second sound. No The intestine above the volvulus was distended, but I diastolic murmur was audible. At the tricuspid area the sounds were very accentuated, and the first sound in women than in men, while post mortem records was prolonged into a faint systolic murmur. This show usually that the excess is much larger in men murmur was limited to the tricuspid area, and was not than in women; and this fact would seem to point to conducted away from it. At the aortic cartilage no the conclusion that gastric ulcer is either much more murmur was heard, but both sounds were accentuated. favourable as regards its prognosis in wonen than in Over the pulmonary area in the third left space, the men, or else that frequently the clinical diagnosis of heart sounds were very accentuated and parchment. gastric ulcer is incorrect. Hale White has often like "in tone, the second being double. There is also suggested at the bedside that there is a disease, not a distinct early diastolic murmur running off from the ulcer, met with chiefly in women between twenty and double second sound. This murmur is smooth and forty years old, and that its chief symptoms are gastric “whiffy," and suggestive of a leakage resulting from pain, sickness and hæmatemesis. If there is any ulcer the high pressure in the pulmonary circulation. It is it is probably quite superficial and secondary to the not conducted from one spot, and is scarcely audible at hæmorrhage. A diagnosis between this condition the left edge of the sternum in the same interspace. and true gastric ulcer is extremely difficult, but There are no signs of back pressure in the systemic White emphasises the following points : first, these venous circulation. This case is one of pulmonary patients may show serious gastric symptoms for many regurgitation from functional incompetence of the years, even as long as 15 years, and yet not show any valve, resulting from the high pressure in the pulmonary great wasting, such as is seen commonly in many cases artery. The mitral valve is stenosed, and the right of gastric ulcer ; second, they nearly always have ventricle is hypertrophied. The systolic murmur over intervals of good health, while patients suffering from the tricuspid area is suggestive of dilatation.

gastric ulcer do not nearly so often get intervals of

good health ; third, these cases of bæmatemesis in Beri-Beri.

young women are very frequently associated with

chlorosis, there being no special association between A. Stanley, Health Officer of Shanghai (Journal of

chlorosis and genuine gastric ulcer, for genuine gastric Tropical Medicine, November, 1901) arrives at the

ulcer occurs in men in whom chlorosis is unknown. following conclusions after having made observations on a series of 341 cases of beri-beri. (1) Beri.beri has distinguished from true ulcer, occurs in women from

Another point is that this condition, which is to be a marked degenerative action on heart muscle, which

20 to 40 years of age ; and, further, it is not followed frequently causes fatal circulatory failure. (2) In this

by any of the organic or mechanical results of ulcer. respect beri-beri resembles other toxæmnic diseases such

ation of the stomach. The prognosis is different in the as diphtheria. influenza, and alcohol and arsenic

two conditions. That of true gastric ulcer, in view of poisoning, which often cause peripheral neuritis, and also other toxæmic diseases, such as typhoid fever, good in the condition characterised by pain, sickness,

the possible grave complications, is not good; but it is plague, and acute rheumatism, which do not, or rarely, and hæmatemesis occurring in young women, The give rise to peripheral neuritis. (3) Beri-beri and

author suggests that chlorotic dyspepsia, wbich is so diphtheria are the diseases par excellence in which

common, is nothing but an early stage of the condition sudden fatal heart failure occurs. (4) The heart muscle

which he describes. He cites several cases of hæma. degeneration is not a secondary result of neuritis of the vagus. (5) The heart muscle degeneration takes place which autopsy or operation has revealed no evidence

temesis supposed to be due to ulcer of the stomach, in as a rule before skeletal muscle degeneration, and is the

of ulceration. While no one doubts the accuracy of result probably of direct action of the toxin, and not a

Hale White's statements, in view of the admitted secondary result of nerve change, (6) Sudden beart difficulty of certainty in diagnosis of gastric ulcer, one failure does not indicate a sudden lesion, but rat) er is is certainly justified as regarding, for the purposes of the result of a gradually increasing heart weakness from cardiac muscle degeneration, which may be of gastric pain, sickness, and hæmatemesis, as one of

treatment, any case presenting clinically the symptoms precipitated by any sudden exertion, but

gastric ulcer. frequently is the result of the principle of "all or

PATHOLOGY. nothing"—the transition from “all " to "nothing being necessarily rapid. (7) The cardiac physical Primary Endothelioma of Pleura. signs in beri-beri closely resemble those found in diphtheria, and are of paramount importance in

Adler (Journal of Medical Research, July, 1901) prognosis and treatment.

reports a case of this nature and describes and

illustrates the microscopical appearances presented Gastric Ulcer.

by the growth. A man, aged 26 years, with no

previous history of any chest trouble, and whose father Attention has been drawn recently on several died of cancer of the stomach, died in the German occasions to the fact that in some cases where

Hospital, New York, after an illness of nine weeks. laparotomy has been performed for the purpose of The diagnosis of a rapidly growing malignant neoplasm excision of a gastric ulcer in patients presenting the of the right pleura was made, and the autopsy conusual clinical symptoms of this disease, no ulcer has firmed this diagnosis. On microscopical examination been found ; and it has also been remarked that the of sections of the neoplasm, it was seen to consist of number of cases met with in the post mortem room alveolar spaces bounded by tracts of connective tissue presenting the signs of past or recent gastric ulcer interlacing in different directions. The central seems to be much smaller than one would expect, portion of these alveolar spaces was crowded with judging from the comparative frequency with which cells with hardly any interstitial tissue ; but towards gastric ulcer is diagnosed during life. In a recent the periphery the cills were seen to be arranged in lecture at Guy's Hospital, London (Guy's Hospital parallel layers supported by bands of fibrous tissue. Gazette, August and September, 1901) Hale White At the very edge of the alveoli there are numerous answers in the affirmative the question : Are not many tubules and wider cyst-like spaces lined with cuboidal patients, supposed to be suffering from gastric ulcer, cells, these latter are either arranged in single rows, or really suffering from some other disease ? According one or more layers of flattened, round, or polymorphous to statistics gastric ulcer is very much more common cells are super-imposed above them. Between the

more

:

fibres of connective tissue the endothelium of the lymph be as fresh as possible. From this tube, four loopfuls spaces is seen in a state of active proliferation, forcing are transferred to a second tube, and a third is inocu. the bundles of fibrous tissue a part by rows and layers lated with from six to eight loopfuls from the one of cells. These cells are in close contact with preceding. Plates are finally prepared and kept at a fibrous tissue on all sides : the endothelium of temperature of 22° C., as the presence of so small an the capillaries appears everywhere quite normal amount of gelatine does not permit of exposure to and quiescent. The surface epithelium of the higher temperatures. After sixteen to twenty-four pleura has for the most part disappeared, but in hours an examination is made with a low power. At those portions of the pleura not directly invaded by the the expiration of this time the colonies of the colon neoplasm, the surface lining bas but rarely remained bacillus appear as round, yellowish-brown, and finely intact ; nowhere, however, is there the slightest evidence granular specks, with well-defined borders, while the of any proliferation of the surface epithelium. This typhoid colonies show a peculiar flagellate appearance, agrees with the results of Glockner (Zeitsch, f. Heil. from two to four fine colourless radicles usually, kunde, Vol. 18) who found not a single well starting from a light, highly refractive central focus. authenticated instance of the surface epithelium of the After forty-eight hours the radicles have greatly expleura or peritoneum,taking part in the formation of tended, and after forty-eight to fifty-six hours the endothelioma. There has been much discussion as to colonies are perfectly developed, and present a picture the exact relations of this form of tumour. At the which strongly suggests the appearance of radishes, present moment the discussion turns on the question : minute interweaving branches being given off in every What is endothelium, what is epithelium, and are direction. No difference can be observed at this time these tumours of endothelial or epithelial origin? If between typhoid and colon bacilli which have been endothelium is a derivative of the mesoderm and as grown as controls in 10 per cent, normal, or bouillon such belongs to the connective tissue group, then gelatine. Leahy's results certainly go to confirm the endotheliomata must belong to a class of sarcomatous differentiating powers of Piorkowski's medium as a tumours. From the time of His until very recently no means of distinguishing between the typhoid and the one doubted that all endothelium was of mesodermal colon bacillus, and he shows drawings and photographs origin. The researches of Hertwig and others have which exhibit in a very marked manner the branched made it very probable that the surfaces of the pleura appearance given in the type-description as characand peritoneum are lined with true epithelium, and teristic of typhoid colonies grown on this medium. Waldeyer bas quite recently proposed to restrict the He sums up his conclusions, tentatively, as follows :term “ endothelium to the cellular lining of lymph (1) Piorkowski's is an extremely valuable method of and blood channels and capillaries—these cells belong. diagnosing a case to be typhoid. (2) The earlier it is ing undoubtedly to the connective tissue group-but to done in the course of the disease, the more likely it is admit the surface lining of pleura and peritoneum into to be successful. (3) The technique is very simple. the group of epithelial cells. If we accept this, the (4) The higher the temperature at which the plates are position of endothelioma of the lung and pleura is kept without melting the better. He thinks, however, plainly indicated. No instance bas yet been credibly that at 22° C. the plates are too liable to melt, and that demonstrated in which an endothelioma took its origin 20° C. answers sufficiently well. (6) Not every typhoid from the surface epithelium of the pleura or from the colony develops marked outgrowths. The nearer the epithelium of the pulmonary alveoli. In every case the temperature can be safely kept to 22° C., the more point of origin was from cells which, even according to numerous are the colonies showing the outgrowths, and ihe latest views, indubitably belong to the mesodermal the more niai ked the outgrowths. (6) The typhoid connective tissue group. The author suggests the colonies are often grouped. (7) B. Coli in pure cul. separation of endothelioma of the lung and pleura ture as a control never shows anything like these from carcinoma and allied epithelial and glandular phenomena of outgrowths. tumours, and places it in the group of connective tissue growths nearly allied to sarcoma.

Typhoid Baccilli in Blood of Typhoid Fever

Patients, The Bacteriological Diagnosis of Typhoid

Hewlett (New York Nediral Record, Norember 30th, Fever.

1901), presents a summary of observations on the Dr. J. P. D. Leahy, of Napier Hospital (N.2. presence of typhoid bacilli in the blood of typhoid Medical Journal, July 31st, 1901), has recorded some fever patients. The bacilli were obtained by cultiva. experimental results obtained by Piorkowski's urine. tions from the blood of 90 out of 125 cases examined. gelatine method of demonstrating the typhoid bacillus The author's own observations were 24 in number, and and differentiating it in plate cultures from those of 20 yielded the bacilli. The earliest positive results B. coli. The method deserves great attention, in view

were obtained on what are believed to be the fourth of Piorkowski's statemen that he has been able by and fifth day of the disease, and the latest on the this means to demonstrate the presence of typhoid twentieth day. The bacilli were rarely obtained after bacilli in infected drinking water, and in the fæces of the fourteenth day, but there were relapses in three cases of enteric at a stage previous to the appearance cases, in each of which the bacilli were forthcoming on of the Widal reaction, which, of course, is not usually the third, fourth, and fifth day of relapse, the tests developed until the disease has advanced a week or having previously become negative. Cole, and also more. Piorkowski's method is thus described by Auerbach and Unger have each reported one case in Simon (" Clinical Diagnosis,” 3rd edition): Normal which positive results were obtained during the fourth urine of about 1,020 specific gravity is allowed to stand week. until the reaction has become alkaline. It is then mixed with 0:5 per cent. of peptone, and 3.3 per cent.

Mellin's Food Chocolate. - We have received of gelatine, boiled for one hour and filtered immedi. from Messrs. Gollin and Co. a sample of this preparation ately into test-tubes without any further application of which has quite recently been placed on the market, heat. The test-tubes are closed with cotton-wool, Analysis of this product shows it to contain only a sterilised for fifteen minutes in a steam steriliser at comparatively small amount of proteid, viz., 6'55 per 100° C., and re-sterilised after twenty-four hours for ten cent, and mineral matter, chiefly phosphates, amounied minutes. To examine the fæces, one tube is inoculated to 2.63 per cent. It is of excellent flavour, and is an with two loopfuls of the fæcal material, which should agreeable food.