part caused by the blood stream being forcibly driven through a normal or dilated (but not stenosed) mitral opening. Relying upon this evidence, and also upon the fact that the diastolic part of the tracing was not prolonged, Dr. Bramwell concludes that the patient had no organic lesion of the mitral valve. In the absence of a post-mortem examination, which was not obtained in this case, it is difficult to estimate the exact value of cardiographic tracings as clinical evidence. Severe Endocarditis.-Dr. Sansom (Practitioner, Jan. 1888) records a case of severe endocarditis in which the disease was found post mortem to take the form of vegetations with numerous micrococci fringing the free edges of the valves in both the right and left cavities of the heart. He detected during life a patch of pneumonia at the base of the left lung, and he concludes that the lung was the path by which the micro-organisms obtained an entry to the blood. He believes with Netter that the microbe of pneumonia (pneumococcus) may set up a definite form of ulcerative endocarditis, which he calls "pneumonic," and he claims for it a definite clinical history. Leukemia in Pregnancy.-Professor Cameron, of Montreal, details a remarkable case of leukæmia occurring in a pregnant woman. The splenic enlargement was first noticed by the patient at the beginning of her sixth pregnancy. As pregnancy advanced there was an enormous increase of white cells with a decrease of red, the white being to the red 1: 20. During labour and the puerperal period there was no uterine hæmorrhage. The blood in the placental vessels and sinuses was examined with the result that the white corpuscles were found in excess. The mother made a rapid recovery, the red cells increasing in number again, and subsequently became pregnant again. The blood of the child was examined shortly after birth and the white corpuscles were found to be in the proportion of 1: 175, whereas the mother's blood at this time was white to red 1:4. The child was apparently strong and healthy, but it died on the fourth day after birth from an attack of vomiting and purging with purpuric eruption. The illness was attributed to the fact that the mother had clandestinely suckled the child at her own breast. The autopsy on the infant showed that all the blood glands and the bone marrow were healthy. A remarkable feature in the case was the woman's family history. Her grandmother, mother, and brother suffered from symptoms pointing to leukæmia, and two of her own children had well marked leukæmia with diminished red cells and enlarged spleen. Pregnancy and Heart Disease.-Professor Jaccoud has treated this subject in his last volume of cliniques. A point of great interest is the question whether the medical adviser ought to prohibit marriage in the case of young women affected with organic cardiac lesions. Jaccoud divides cases of this sort into two groups. In the first the valvular lesion, though it is manifested clearly by physical signs, yet never produces any consequences; under these conditions the person should not be prevented marrying if she desires. In the second group the lesion has already produced serious complications. Even then he says there is no absolute rule to be laid down. The nature of the complications must be taken into account. If they are pulmonary the case is more serious than one of oedema simply or hepatic congestion. Moreover, the manner in which the patient has borne up against the complications must be considered as well as the more delicate question, the effect prohibition will have upon her in case that she is particularly desirous to enter the married state. The conditions under which the woman will pass her pregnancy must also be taken into account. If she is obliged to work for her living, and to endure fatigue, there ought to be no hesitation in forbidding marriage. NEW INVENTIONS, DRUGS, ETC. PRIZE STUDIES OF TORNADOES.-The American Meteorological Journal, desiring to direct the attentlon of students to tornadoes, in hopes that valuable results may be obtained, offers the following prizes :-For the best original essay on tornadoes or description of a tornado, $200 will be given. For the second best, $50. And among those worthy of special mention $50 will be divided. The essays must be sent to either of the editors, Professor Harrington, Astronomical Observatory; Ann Arbor, Michigan; or A. Lawrence Rotch, Blue Hill Meteorological Observatory, Readville, Mass., U.S.A., before the first day of July, 1889. They must be signed by a nom de plume, and be accompanied by a sealed envelope addressed with same nom de plume and enclosing the real name and address of the author. Three independent and capable judges will be selected to award the prizes; and the papers receiving them will be the property of the Journal offering the prizes. A circular giving fuller details can be obtained by application to Professor Harrington. MESSRS. BURROughs, WellcoME & Co. have sent us specimens of (1) Soluble Saccharin, a substance fully deserving of its adjective. It is sent out in a small flat bottle suitable for the waistcoat pocket and has a screw-cork to which is fastened a tiny spoon for its administration, Two or three of these spoons full we find quite sufficient for a cup of tea. (2) Antipyrin Tabloids (gr. 5). These form a most convenient method of administering this drug. We have several times proved their efficacy in attacks of migraine and have found it most useful to have the drug thus immediately available. (3) Prescription Book. This is a duplicate prescription book of somewhat novel description. The novelty consists in the cover (case) being permanent while the contents can be frequently removed and filed. This allows the whole book to be much thinner and more suitable for the pocket, and also renders reference more easy. New Books, etc., Received. A Text Book of Physiology. By JOHN GRAY M'KENDRICK, M.D., LL.D., F.R.S., Professor of the Institute of Medicine in the University of Glasgow. Two volumes. Vol. I., General Physiology. Glasgow: James Maclehose and Sons. 1888. The Treatment of Hæmorrhoids by Injection of Carbolic Acid and other substances. By SILAS T. YOUNT, M.D. Second edition. Lafayette, Ind., U.S.A.: The Echo Music Co. 1888. Infanticide: an Inquiry into its causes, and their remedy. By FRANCIS VACHER, F.R.C.S. Reprint. Prov. Med. Journal. 1888. Report on Summer Diarrhoea in Leicester. By H. TOMKINS, M.D., B.Sc. Reprint. Leicester Annual Health Report. 1887. Introduction to the Study of the British Pharmacopoeia. By RAWDON MACNAMARA. London: Lewis. 1888. Lupus Vulgaris. By BALMANNO SQUIRE, M.B. London: Churchills. 1888. Annual of the Universal Medical Sciences: a yearly Report of the progress of the general Sanitary Sciences throughout the world. Edited by C. E. SAJOUS, M.D. and 70 Associate Editors. Illustrated with Chromo-Lithographs, Engravings and Maps. Five volumes. Philadelphia and London: F. A. Davis. 1888. Report of The Lady Aitchison Hospital. April, 1888. Lahore: Civil and Military Report of Charing Cross Hospital for 1887. 1888. For the half-year ending 30th BIRMINGHAM AND MIDLAND COUNTIES BRANCH OF THE BRITISH MEDICAL ASSOCIATION. BY THOS W. THURSFIELD, M.D., M.R.C.P. LOND., PHYSICIAN TO THE WARNEFORD, LEAMINGTON AND SOUTH WARWICKSHIRE GENERAL HOSPITAL. I HAVE taken for the subject of my address, one which has interested me for a considerable time. It is "The Social Position of the Medical Profession in this country at the present time." In contrasting the position which is held by the Medical Profession in social estimation, with that of the other learned professions, I think it will be admitted that we do not stand as high as either the Bar or the Church; and yet the attainments of the members of our profession, their character, their self-denial, and their public services are acknowledged on all hands, and should command for them a respect as high as that in which any other profession is held. In former times, it seems as though the great consulting physician was held by all classes in greater respect than he is at present. Even as far back as the days of Homer, Machaon, the army surgeon of the Greeks, was spoken of in the following terms :— Ιητρὸς γὰρ ἀνὴρ πολλῶν ἀντάξιος ἄλλων, which Pope has rendered thus : : "A wise physician, skilled our wounds to heal, D while it is undoubted that the rank and file of the profession are now held in much greater respect than they were in any previous portion of our history. I suppose this is to some extent explained by the fact that medical education, such as it was in former times, was almost exclusively confined to the higher ranks in the profession. In the present day the education of the medical man is pretty much the same for all ranks ; i.e., his professional education and the marked difference M which formerly existed is ho longer Found For the convenience of the public, as well as for our own, our profession may be considered to be dividePRto the ging ranks :-The pure consultant, the specialist, and the general practitioner. No formal division of these ranks has ever been made by law, and can be hardly said to be sanctioned by custom. And yet I think that such a division is pretty clearly recognised within the profession itself: and it would be better if the public could be induced to more clearly recognise the convenience of these distinctions. Not that there is any difference, except that of accident, between many of those who are acting in the different divisions of the profession, for it often happens that the general practitioner is a more accomplished man in many branches of his art than the specialist to whose assistance he frequently resorts, while it certainly is the case that many of those who fill the rank of consultants are able to do so from the fact that they have started in the race of life under greater pecuniary advantages than their fellows. Still, I think that the recognition by the public of these divisions will, in many instances, assist to elevate the social consideration in which the profession is held. Quite recently we have been taught to divide the people of this nation into two great divisions-" the classes" and "the masses." The confidence which is bestowed upon the medical profession comes in equal proportions from both, while the rewards of public service which are at the disposal of the first are mainly withheld from our profession. Much of the res training and disabling legislation which has afflicted us comes from that class of the community which has more to do with |