and Krönig have shown the mortality of sepsis to be 5 per cent. with uterine canal undisturbed; increased to 22 per cent after curetting. 7. In cleansing sloughing inoperable cancer, following invariably with the cautery. In view of the fact that more than half the cases are seen too late for operation at all, and that recurrence is the result in a large percentage even with the best operators, we certainly are in duty bound to bend our energies to prevention, and to early discovery where preventive measures fail. As a profession we are responsible for the attitude of the lay mind toward “change of life." Many in our own ranks are, I fear, still asleep, who should be vigilant for their patients during and after the menopause. Nor should we wait always for our patients to mention ills they so often think too slight. Rather should we take the initiative and with a few questions tactfully put, discover whether there be irregularities calling for examination. A patient not prepared for examination at our office may take most kindly the suggestion that we call at her home next day. This paper will be of value if it shall stimulate to greater vigilance on our part, and incidentally to better teaching of the laity regarding a very critical period in woman's life. Twenty nine per cent of primary cancers are uterine; 52 per cent occur in women who have not borne children (Cullen.) 75 per cent of cancer of the body occur after the menopause. There is no "first symptom" of cancer of the uterus. But a leucorrhoea that persists between the menstrual epochs means disease of some kind and should be thoroughly investigated and cured. Atypical flow is the other symptom to be strictly accounted for. The menopause may pass normally in the following ways: Menstruation may simply at the proper age fail to appear, that function terminating abruptly without further symptoms. Or the flow may become gradually less each month and finally cease altogether. Or it may take place irregularly as to time, skipping one, two or three months and varying as to quantity, then cease. But any irregularity other than these mentioned, and especially any excessive flow, should be regarded with suspicion even at this period in woman's life. It is morally certain that among the patients of this company of doctors are some this day with uterine cancer as yet unrecognized. It is our duty to find them. Let me conclude with a few practical hints. 1. Uterine hemorrhage occurring one or more years after the menopause generally means malignancy. 2. Tissues already abnormal are more liable to malignant degeneration. Hence the importance of a healthy endometrium and repair of badly healed lacerations of the cervix. 3. A uterus of normal size can be the seat of extensive cancerous degeneration. 4. A patulous os means something abnormal in the uterine cavity, endometrium or uterine wall. 5. Safe use of the curette lies in strict observance of asepsis, and correct diagnosis of the conditions to be treated. 6. Advanced years do not necessarily contraindicate even serious operation. One woman may be young at eighty, another old at forty. 7. The last page of Cullen's book on Cancer of the Uterus is given to Thornton's plea for early recognition of malignant disease of the uterus. It should be read by every physician in the land. GLEANINGS DYSMENORRHEA.-With galvanism we may do with the menstrual function what we will. We may increase it, we may decrease it, we may stop it. Dysmenorrhea, due to an infantile uterus, is first treated by using the negative pole of the galvanic current attached to a small metal olive. This is applied at the external os, and by its action gradually enlarges the cervical canal, thereby allowing entrance into the uterine cavity, of other instruments. A slowly interrupted faradic current is then applied which stimulates the myo-metrium, and eventually will cause an increase in size and an improvement in the muscle tone. Membranous dysmenorrhea, so difficult to treat by other means, yields readily to the application of the negative pole. This is attached to an intra-uterine electrode with a metal tip 14 inches long, the positive pole being attached to the abdominal pad. The current is gradually increased to 30 or 40 milliamperes, and continued for ten minutes. Treatments are given twice a week, during the inter-menstrual period. By this means the endometrium is kept from becoming hard and thickened, under which conditions it almost requires labor pains in its expulsion. Many cases have been cured in this way, in from two to three months, although some have proven more troublesome.-Neiswanger. N. A. J. of H., November, 1905. Apropos of the modern treatment of tuberculosis, the following is taken from the daily press: SHORTAGE OF EGGS.-When General Chaffee visited Fort Bayard in New Mexico, where the tuberculosis patients of the army and navy are treated on the modern principle of keeping them in the open air and stuffing them with highly nutritious food, he asked a group of convalescents whom he saw, if they had any complaint to make. One of the number who was on the up track, whose allowance of raw eggs had on that account been slightly reduced, stepped forward, made the proper salute, and said that he had a complaint to make. With military precision, General Chaffee ordered him to state it: "My supply of eggs, sir, has been cut down to fourteen a day." The General promptly dismissed the complaint, and now tells the story as an example of the lengths to which the modern methods of grappling with the white scourge have been carried. Patient "Isn't that a pretty big bill?" Doctor.-"Well, living costs more than it used to, you know." EDITORIAL Books for review, exchanges and contributions - the latter to be contributed to the GAZETTE only, and preferably to be typewritten-personal and news items should be sent to THE NEW ENGLAND MEDICAL GAZETTE, 80 East Concord Street, Boston; subscriptions and all communications relating to advertising, or other business, should be sent to the Business Manager, Dr. WILLIAM K. KNOWLES, 40 Mt. Pleasant Ave., Roxbury, Mass. EDITOR-IN-CHIEF: F. W. COLBURN, M.D. JOHN P. SUTHERLAND, M D. ASSOCIATE EDITORS: W. H. WATters, M.D. Reports of Societies and Personal Items should be sent in by the 15th of the month previous to the one in which they are to appear. Reprints will be furnished at cost and should be ordered of the Business Manager before publication. VACATION AND THE INTERNATIONAL CONGRESS. This season of the year is generally one of relaxation and recreation! The prevailing temperature brings about a state of passivity rather than one of activity and restlessness. People are leaving crowded cities and towns, seeking change, comfort and rest among the hills, by the seashore, in foreign travel. To those in whom fatigue is not a marked condition the sports,golf, tennis, fishing, sailing, tramping, are making an effective appeal. The out-of-door life is making people healthier; they have fewer ailments and seek professional advice less frequently. The heretofore busy physician therefore is less burdened with labor and responsibility, and he too is thinking of seeking recreation such as is furnished by changed environment. The season naturally calls one out-of-doors. Nature is in her most enticing moods, and he is hard-hearted, unsentimental, unappreciative and stupid who refuses to succumb to Nature's wooing. The "simple life" free from cares, far distant from the sound of telephone and other bells; where office hours need not be kept; with long, undisturbed nights, is a dream many an over-worked general practitioner would gladly have converted into a reality; while to others less worn by life's struggle, the pleasure of sightseeing and the education and excitement of foreign and even domestic travel prove more attractive. Of course there are those in the profession for whom the "good old summer time" is not a season of rest. As the heat increases so does their work, and the long days are apt to mean to them long hours of close application to duties. It so happens therefore that the vacation is usually taken when demands of practice are the least mandatory, but, however one's holidays are to be spent, whatever one's fancies may be, the homœopathic practitioner should not forget that the season of 1906 brings to him certain privileges and duties which should be taken into serious consideration when plans for the summer are being made. The "privileges and duties" here referred to are connected with the Seventh Quinquennial International Homœopathic Congress which is to be held in Atlantic City during the month of September. It may be considered a privilege to meet one's colleagues gathered together from distant parts of our own great country, and unitedly to welcome colleagues who come as delegates from other countries; from England, from France, from Holland, from Australia, from Brazil. It may be considered a privilege to discuss in such a gathering the welfare and progress of homœopathy in various parts of the world; to discuss questions connected with drug pathogenesy, with therapeutics, with preventive medicine, with sanitation, and with the "specialties." And it certainly may be considered an inescapable duty to attend such an unusual gathering as this Congress promises to be, and to carry to it the force of one's personality and the weight of one's accumulated experiences and matured judgment to help in the growth and development of medical knowledge and skill. It is perhaps unnecessary to refer to the duties which devolve upon the individual in his capacity as a member of the profession, for they are evident to all whose hopes and ambitions are not dwarfed by self-interests. The Congress is to begin on Monday, September 10th, and end on Saturday, September 15th. Readers of the GAZETTE scarcely need to be reminded that the meeting of the American Institute of Homœopathy, which is usually held in June, has been postponed this year till September in order to be merged into that of the Congress; and that an International Congress meets in this country only once every fifteen years; and that this Congress of 1906 will be the third one held in America. Unusual efforts have been made to ensure a brilliantly successful meeting in September. It remains for members of the profession to make it such a success. And now is the time to lay plans to attend. There is no more desirable place than Atlantic City on the continent in which to spend a week in September; no other place with such peculiar charms and attractiveness combined with such ample accommodations. At the end of the summer, after a period of rest, one can have a rested body and refreshed and more recipient mind for the Congress; in short will be better prepared to give and to receive than is the case late in June at the end of the long season of professional work. In arranging for the summer vacation, therefore, plan to attend the Congress in September. STATUS OF BOSTON UNIVERSITY SCHOOL OF MEDICINE AMONG AMERICAN MEDICAL COLLEGES. It The readers of the NEW ENGLAND MEDICAL GAZETTE Will find much to interest them in the report presented last month to the A. M. A. by its committee on Medical Education. appears in the Journal of the American Medical Association for June 16th, 1906. Very careful tabulation has been made of all the graduates of the medical schools who have presented themselves for registration before the state examining boards. This list is supposed to include every medical college in the country, about 160 in all, and reports the number of graduates from each that have obtained registration in the various states, the number that failed, and the percentage of failures. Three sub-divisions are made,- (1) those institutions where the percentage of failures was less than 10; (2) those with from 10 to 20 per cent; (3) those with more than 20 per cent. Another class is given where complete information was not obtained for some reason. Let us quote a paragraph from the report: "In Class three we will find some thirty-eight schools, with a percentage of failures of more than 20 per cent. It is evident from a study of the medical schools in this country and their work that there are five specially rotten spots which are responsible for most of the bad medical instruction. They are Illinois, Missouri, Maryland, Kentucky and Tennessee. In Table 3 this fact is very well shown. Beginning, for example, with these five states, you will find in Illinois a group of colleges, with 36.8 per cent, 21.5 per cent, and 30 per cent of failures. You find in Kentucky, for instance, a group of five colleges, with 44 per cent, 30 per cent, 25 percent, 37 per cent, and 25 per cent of failures. You find in Maryland a group of five colleges |