anti-alcoholic wave has swept over this country, and you will find it to your advantage to be very rabid in your detestation of this innocent fluid. Therefore declare to your acquaintances that you would not even prescribe tinctures or any medicinal agencies prepared with alcohol. You might even find it a good move to use a gas jet for testing urine samples. Therefore invite a number of friends to your office and, after exorcising the spirits, throw away your alcohol lamp.

One thing of importance I must not omit, -be singular and eccentric in your manners. Singularity fills the general run of mankind with wonder, and from wonder to admiration the transition is obvious. Never under any circumstances affect ignorance of the cause of a complaint; place it in the pancreas or pineal gland, if you have no other local habitation ready at the moment. Be always ready with an answer to every question a lady puts to you; the chance is she will be satisfied with it; do not care whether there be, or be not, a possible solution of it.

Never, my dear friends, omit to take your fee; it is astonishing how the aurum solidum will quicken your faculties. You will always find it of great use to belong to some particular sect in religion. Attend church regularly; you will then obtain your share of the patronage of the members thereof. It is related of a celebrate

sician, who

was the son of a dissenting minister, that every time he was called out of his father's church, which was quite often, the preacher would stop in the middle of his discourse and say, "Dear brethren, let us offer up a prayer for the recovery of the patient to whom my son is gone to administer relief." It is not said how much this circumstance tended to the celebrity of the eminent physician, but I have little doubt that it brought him many a patient.

ner and supper, and you may depend upon being often made the subject of conversation and you will be considered very clever.

If you can make yourself talked about you have little to fear. If you depend solely upon your medical knowledge, judgment and experience, how fearful will be the opposition with which you will have to struggle! Where one man of sterling ability succeeds in practice, ten of the most shallow pretentions obtain the confidence and smiles of a discerning public. I would urge you very strongly to keep a carriage whether you can afford it. or not. People consider that a physician who drives in a carriage must be skilful, and he is patronized accordingly.

Evidently the writer has figured the gullibility of people about right, but when he recommends such as the above course for the attainment of that success for which every physician should strive, he is far from striking the right spot.

From present accounts the banquet to be given by the American Editors' Association in Washington will be one of the features of the week of the Medical Congress. The secretary has made extensive arrangements and is pushing matters in his own energetic way. As the reception and banquet will be on Monday night it will form a good introduction to the festivities of the week. A number of foreign delegates will be present, and a good time generally is expected.

Among the many guests who will be present is Mr. Ernest Hart, the able editor of the British Medical Journal.

THE INTERNATIONAL MEDICAL CONGRESS.

quiring for information regarding the Congress, and expressing a determination upon the part of the writers to attend.

We, in this issue, give all the information at our command.

The cost of membership to the Congress is ten dollars, and this can be paid in advance, securing certificate of membership and early registration, thus avoiding all the trouble incident thereto after getting to Washington. Even if a member at the last moment should be unable to attend, he is entitled to the volumes of transactions, which will cost the full price of membership, and will be well worth the money.

A large number of foreign delegates is assured.

We believe the coming Congress will settle a good many things, and to the benefit of the profession. Let all then who desire to encourage and foster the main body of the medical profession of America at once send on to the secretary, Gen. Jno. B. Hamilton, the membership fee ($10) and as much more as can be spared from their bank accounts.

Prominent among those called into consultation over the disease of the German Crown Prince were Prof. Gerhardt and Bergmann, Docent Tobole and Wagner, and also the English laryngologist, Morell Mackenzie. A small tumor, the size of a pea, was found upon the posterior portion of the left vocal cord. Prof. Virchow examined a portion of it microscopically, and found it to be benign in character; still, it must not be forgotten that experience has shown similar tumors to change in their nature later on.

-A man in Brooklyn recently told a mother that she ought to change her physician, as the one then attending her, Dr. Cruickshank, did not possess the skill "necessary to attend a sick dog." Dr. Cruickshank brought against him and won a suit, the Supreme Court awarding him $1600 damages.

SOCIETY PROCEEDINGS.

ST. LOUIS MEDICAL SOCIETY.

Stated meeting June, 11, 1887, the President, S. Pollak M.D., in the Chair. F. D. Mooney, M.D., Secretary.

Dr. T. F. Prewitt, presenting a case, said: I have here a case of aneurismal varix of the

popliteal space. I operated on the man five weeks ago. I found a rather interesting condition of things. The surgeon who operated on him before stated to the patient that he had cut down and tied the artery above the opening between the artery and vein. When I cut down on it I found the artery patulous throughout. I suppose that he tied the artery with cat-gut; that it was absorbed and the lumen of the vessel was restored. If so, it is a very interesting fact, and so the aneurismal varix was established thoroughly.

I found the opening between the artery and vein about opposite the joint; the vein very much enlarged, of a fusiform shape, the enlargement extending for four or five inches up and down, and I tied first a cat-gut ligature about the artery; when I was satisfied that the lumen of the vessel had been restored, I put on a silk ligature above and below. I understand that but a single ligature was applied in the first place-and that is the rule, as you know, in ordinary aneurisms; but in this case, it was not an ordinary aneurism, and the partial interruption of the current would not lead to a coagulation as in the ordinary one. So I tied it above and below.

There was no sac proper; there was nothing but a dilated vein.

originated seemingly from an injury that he I will only remind the society that it received when about five years old. His brother threw a file at him, which struck him behind the knee. He had no particular trouble until nine years ago, when, one day, he suddenly felt a faint sensation run over him, and upon examining his leg found the aneurism existing.

Of course we would expect it to occur at the site of the injury, but why it waited so long before making its appearance, I do not know.

These aneurismal varices are almost invari

three or four times its natural size. Communication between the artery and vein is now occluded, and the patient is cured.

Stated meeting June 18, 1887. Dr.D.V.Dean said of the literature of the subject of Dr. Lutz's specimen, it is quite abundant since Michaelis wrote upon it in 1779 but much of it, especially of the older, is very lax and incomplete. Naegele in 1812 called the tumor kephalematoma. The caput succedaneum is a serous infiltration, or a bloody extravasation into the soft tissues or subcutaneous cellular tissue of the scalp, caused by the difference in pressure between the patulous os and the ring of the os and the wall of the uterus, preventing the return of blood from the protruding part. The kephalematoma subaponeuroticum is produced by hemorrhage under the occipito-frontal aponeurosis and above the pericranium. As this aponeurosis is freely movable and united at its median line but not united to the pericranium at these sutures, the hematoma may pass over both parietal bones. The kephalematoma pericranii is formed under the pericranim which latter, not elastic and closely connected to the skull by the vessels passing into or to it, the two are separated during labor, hemorrhage between the two resulting from the lacerated vessels. It is said to occur once in about every 200 to 300 labors. As the pericranium is united with the sutures, this form of kephalematoma does not pass the sutures or borders, the borders of the separate bones if they occur on each side of a suture, they are separate and distinct hematomata. The great majority occur on the right parietal, just as the left occipitoacetabular presentation and position is the most frequent, the right parietal thereby oftenest passing first to the os and having the least direct pressure; and a majority occur also in primiparæ with male children. The blood remains fluid in this tumor for a long time, favoring the absorption and cure. The reparative process is first observed at the cranial periphery of the hematoma, the reticulated bone formation at the border union of the external periosteum with the bone forming a ridge with a reentrant angle opening toward the blood. This reticulated new bone substance also forms on the surface of the cranium and on the under surface of the pericranium or external periosteum. If this forms uniformly over the upper surface of the blood, a smooth bony covering will be formed in a short time. If the bony development be not uniform and be disturbed by pressure and otherwise, the bony covering may be quite uneven and like wormian bones. Ultimately the blood is in part absorbed, in part organized or replaced by reorganizing material, and the new bone covering unites

In

firmly with the original cranium. The kephalematoma pericranii has no connection with the diploe. The points of diagnosis are quite interesting. In the subaponeurotic hematoma,the blood can be freely moved about by pressure over or across the sutures. the pericranial hematoma the blood cannot be thus moved past or over this suture. Early after its occurrence, the blood pressed from the center towards the periphery forms a perceptible ridge, as it cannot recede or evade the angle of junction of periosteum and the cranium. If the pressure be from the periphery towards the center, this ridge is not felt or caused, as the blood is readily pressed from this angle toward the center. Later, after the bony ridge is formed around the circumferential border, the bony ridge is plainly felt by pressure from or toward the center. Later also, pressure upon the surface causes crepitation much like that of parchment. It is quite likely that with modern antiseptic precautions, aspiration followed by compression may be of value and may change the practice up to the present so generally expectant.

Dr. Lutz's specimen is interesting from its size. The diploe is plainly visible in the original parietal bone, and the reticulated bony formations are plainly visible on the surface of the original parietal bone in the cavity, as well as on the under surface of the new bone covering. Trabeculæ of organizing material not yet clearly fibrous or bony also connect the two inner surfaces, apparently formed in the blood. I thank the doctor for bringing the bone again, and I will submit the bony net-work to a microscopic examination. On examining the specimen again, I think the rough portion covering the lower part of the hematoma at this side is composed of the Wormian like portions not forming a smooth continuous surface or bone.

I

Stated meeting, June 25, 1887.

DR. H. C. DALTON presented a specimen: have here a very interesting tumor which was connected with the liver of a widow æt. 50 years. She came in with a diarrhea and died of enteritis-the tumor having nothing to do with her death. The postmortem notes pertaining to the tumor are as follows: "On the under surface of the right lobe of the liver, to the right of the vena cava, covered by peritoneum, was a spherical tumor the size of a goose-egg. On cutting through the tumor and liver, they were found to be unattached except by contiguity of tissue. Internal to the capsule of the tumor, was a mass of dark soft remains of a former clot of blood; this