sensitizing substance to the uterine mucosa. 2. Fixation of the embryo is aided by the activity of the corpora lutea.

3. The corpus luteum is apparently essential for the development of the embryo early in

pregnancy.

4. The presence of corpora lutea militates against ovulation, i. e., lengthens the sexual cycle, at least in the guinea pig.

5. The presence or absence of corpora lutea means presence or absence of menstruation, and possibly their hypo or hyper-function means, in part at least, dysmenorrhea or menorrhagia.

6. The activity of lutean secretion affects development of the mammary gland, even to free secretion of milk.

The patient, Miss J., was born at Jamestown, N. Y., of healthy Norwegian parents, May 27, 1874, and moved to Cannon Falls, Minn., when three years old. She had typhoid fever when four years old and was very sick, so much so that she had to learn to walk again after her recovery. She moved to Minneapolis when fifteen years old and was never out of the state of Minnesota after that. When sixteen years old she cut her left leg on a nail, suffering a rather severe injury near the ankle. This left a jagged infected wound that was slow to heal. The patient ascribes her elephantiasis to this

injury. Otherwise she was always in good

BIBLIOGRAPHY.

Dick: Surgery, Gynecology and Obstetrics, 1912, Vol. 15, p. 588.

Frank: Surgery, Gynecology and Obstetrics, 1914, Vol. 19, p. 618.

Novak: Surgery, Gynecology and Obstetrics, 1915, Vol. 21, p. 646.

Novak: Journal American Medical Assoc., Vol. 67, p. 1286.

Frankel: Archiv. Für Gynecologie, 1910, Vol. 41, p. 705.

Loeb: Journal American Medical Assoc., 1906, p. 416.

Loeb: Medical Record, 1910, Vol. 77, p. 1083.

Loeb: Deutche Mediciniche Wochenschrift, 1911,

Vol. 37, p. 17.

Loeb: Proceedings of the American Physiological

Society, Vol. 37, XXII.

Schafer: The Endocrine Organs, 1916.

Paton: Regulators of Metabolism.
Stohr: Text Book of Histology.

ELEPHANTIASIS: REPORT OF A CASE IN MINNESOTA.

A. N. BESSESEN, M. D., Minneapolis, Minn.

Elephantiasis is a disease of such rare occurrence in Minnesota that I am taking the liberty to report a case that was under my care during the last year of her illness, which was gradually progressive, with only slight remissions, up to the time of her death.

health, normal mentally, and of cheerful disposition. She lived at home and worked in a local laundry where she was on her feet most of the time.

At the age of thirty she first noticed a slight swelling on the left leg at the ankle near the nail injury. This gradually extended but was painless and gave no trouble except for the deformity. The limb continued to enlarge from that time regardless of treatment by various medical men. The limb finally became so large, in the course of years, that the weight and awkwardness interfered with walking and she had to give up work. She suffered no other discomfort or pain, except that at intervals she would have an attack of elephantoid fever.

When the circulation seemed to stop in the limb, it would become very pale with a feeling of pain; this would be followed by an intense redness, almost erysipelatous, with elevation of body temperature. The limb would become enormously swollen, and in two or three days the skin would break where most distended and discharge large quantities of watery fluid. This would result in a rapid reduction in size of the limb until it seemed only two or three times larger than normal. The skin abrasion would heal promptly and the condition of elephantiasis would gradually return to its former size and probably somewhat larger, extending toward the body. At the time that I was first called, she was in such an attack more severe than at any previous time. The disease at that time involved the left hip as well as the thigh and the lower leg. The calf of the leg measured fully thirty-six inches in circumfer

ence. Later, after the attack had subsided, I saw her at my office and the limb measured thirty-four and one-half inches about the calf, and thirty-two and one-half inches about the knee. At the time the accompanying picture was taken, the limb measured thirty-two inches about the calf and twenty-nine and three-quarter inches about the knee. I did not find evidence of tuberculous or syphilitic infection, although no Wassermann test was made. I desired to show her case to other medical men but she had become so sensitive of her condition that it was with difficulty that I could obtain her consent to an examination of her blood by Dr. Guah, a native of India. He made an examination for filaria, and while he may have found a single one, he could not be certain, and the patient would not permit a second examination. Dr. Guah said, however, that the case was in every way similar to elephantiasis so common in India.

The patient, while in my care, suffered a severe attack of elephantoid fever from February 15th to March 3rd, 1916, a second milder attack from September 22nd to September 29th, 1916, and a third attack from March 10th to 13th, 1917, that proved fatal. The patient died March 13, 1917.

After the death of the patient, the undertaker could not inject the vessels of the left side from the shoulder down. The limb and left side to the shoulder was enormously swollen. Death was probably due directly to pressure of the oedematous tissues on the heart. The skin burst and gallons of watery fluid ran from the body through the break in the skin so that the casket had to be lined with lead to prevent leakage of fluid.

ence. Later, after the attack had subsided, I saw her at my office and the limb measured thirty-four and one-half inches about the calf, and thirty-two and one-half inches about the

of the limb until it seemed only two or three times larger than normal. The skin abrasion would heal promptly and the condition of elephantiasis would gradually return to its former size and probably somewhat larger, extending toward the body. At the time that I was first called, she was in such an attack more severe than at any previous time. The disease at that time involved the left hip as well as the thigh and the lower leg. The calf of the leg measured fully thirty-six inches in circumfer

March 13, 1917.

After the death of the patient, the undertaker could not inject the vessels of the left side from the shoulder down. The limb and left side to the shoulder was enormously swollen. Death was probably due directly to pressure of the oedematous tissues on the heart. The skin burst and gallons of watery fluid ran from the body through the break in the skin so that the casket had to be lined with lead to prevent leakage of fluid.

THE URGENT NEED FOR DOCTORS. Telegrams have been received by the members of the State Council of the Medical Defense stating as follows:

"An urgent need exists for several thousand additional Medical Officers in the Army and Navy, some for immediate work, some for training, and others to be held in reserve. Please urge your State and County committees to speed up enrollment as effectively as possible." F. F. Simpson.

Dr. Thomas McDavitt has been called to a special meeting in Chicago for this purpose. Every member of the State Association is urgently requested to consider fully this matter with a view of entering the Army Medical Service.

THE FORTHCOMING ANNUAL MEETING OF THE AMERICAN MEDICAL ASSOCIATION.

The Sixty-Ninth Annual Session of the American Medical Association will be held in Chicago next month, June 10-14. The Committee on Arrangements is actively engaged in perfecting plans for the comfort and entertainment of the Fellows of the Association and their guests, and every member of the Minnesota State Medical Association should make an effort to attend.

Several special features of general interest are promised.

The chairman of the subcommittee on clinics, Dr. Charles F. Humiston, announces that there will be a series of clinics for the Fellows of the Association on Thursday, Friday and Saturday, June 6, 7, and 8, and on Monday and Tuesday, June 10 and 11. Further announcements regarding the clinics will appear later.

In addition to a patriotic meeting which will be held on Thursday evening, June 13, and which will be addressed by men prominent in public affairs, there will also be a general meeting on Wednesday evening, June 12, at which eminent physicians who have been active in the medical military service of our nation and its allies will take part.

At its recent meeting the Council on Scientific Assembly arranged for meetings of the Section on Miscellaneous Topics, the subject to be taken up being the re-education and rehabilitation of the disabled soldiers. Major Frank Billings, head of this division in the Surgeon-General's Office, has accepted the chairmanship of the section. The subject is one of great importance, especially to medical. men. Further announcement will be made later.

Alumni and section dinners will be held on

Wednesday evening from 6 to 8 o'clock so as

not to conflict with other events which are being planned. The chairman of the subcommittee on alumni and section entertainment, Dr. J. H. Stowell, announces that his committee is co-operating with officers of alumni associations. in arranging for reunions. The committee desires, also, to assist the officers of those sections which desire to arrange for section dinners.