less severity. Always look upon "growing pains" and tonsillitis with suspicion. I have noticed in some cases that the removal of the tonsils has been followed by a complete and entire cessation of the rheumatic symptoms. However, we may have rheumatism in children without tonsillar involvement and, moreover, the rheumatism may not manifest itself in any way except by an endocarditis.

Likewise some skin diseases, erythema, eczema, etc., are of undoubted rheumatic origin. Night terrors and sleeplessness are sometimes offshoots also, as well as migraine and gastralgia.

There is one condition upon which I wish to lay particular stress, and that is chorea. The majority of cases are but the manifestations of rheumatism. Uniformly you have the growing pains, tonsillitis and anemia. The danger in chorea is the often accompanying endocarditis.

There is a difference of opinion as to the percentage of chorea cases that are rheumatic, but undoubtedly the great majority are engrafted upon that diathesis. The treatment is largely hygienic, avoiding as far as possible all conditions that have a tendency to aggravate and cause rheumatism. In regard to diet, the consensus of opinion is that "rheumatic children do much better upon a diet composed largely of nitrogenous food and that the sugars and starches should be restricted in amount. given in all cases" (Holt).

Milk should be freely

particular condition in Those usually indicated

The remedies given should meet the which the rheumatism manifests itself. are the same as in adult life. Thus we have for the more acute cases sodium salicylate, oil of wintergreen, salicin and salol. Alkalies are indicated particularly in those cases where there is a hyperacidity of the urine.

But subacute cases are often little or not at all influenced by the salicylates and the alkalies, and here we have to depend on the use of general tonics, as iron and cod liver oil.

In order to protect the heart during a rheumatic attack absolute rest and an equable temperature for the patient must be insisted on and procured.

For the chorea of rheumatic origin we have the salicylates and cimicifuga racemosa, of which give the fluid extract, ten to fifteen drops in water, three times daily. While in the non-rheumatic cases of chorea we have arsenic-Fowler's solution-the most valuable remedy we possess.

But let us remember that always, when a child has growing pains, tonsillitis, anemia and functional nervous disorders, we have a case of rheumatism and that its heart is in danger.

NORTHWEST MEDICINE

CLARENCE A. SMITH, A. B., M. D.

Editor in Chief.

JAMES B. EAGLESON, M. D.
Managing Editor.

Published Monthly by the Washington Medical Library Association. BOARD OF TRUSTEES

C. W. SHARPLES, M. D., President.

E. E. HEG, M. D.;

H. M. READ, M. D., Secretary.
G. H. RANDELL, M. D.;

W. S. DURAND, M. D. (of Everett). Editorial and Business Office

Marion Building, Seattle, Wash.

Subscription Price, $2.50 per annum in advance. Single Copies, 25 Cents. Foreign Countries, $3.00 per annum.

Entered March 14, 1903, at Seattle, Wash., as Second Class Matter, under Act of Congress of March 3, 1879.

VOL. III.

JUNE, 1905.

THE JULY MEETING IN PORTLAND.

NO. 6

The Lewis and Clark Fair has been formally opened by President Roosevelt pressing the button. It is said to be the most complete fair at the time of opening that has yet been prepared. While the physicians of the whole country will inspect this with pleasure and satisfaction, Portland will be their Mecca by virtue of the great gathering of their fellows from all corners of the land. Whatever question may exist as to the number of medical visitors. from distant states, it is certain the Pacific Coast will be represented in large numbers. From our enquiries on the subject it would appear that the whole profession from the Puget Sound country has planned to be present. This is as it should be since this will be the first occasion for attending a meeting of the A. M. A. on the part of most of them and it will be many years before it meets again at their doors. The Washington physicians are especially interested in the success of this meeting and gratified at the completeness of the Portland arrangements in view of the general scepticism expressed two years ago as to the ability of any city of the Pacific Northwest to entertain and provide for this great meeting. We wish to express our appreciation of the special invitation to partake of Portland hospitality, recently extended to their Northern neighbors. When the A. M. A. shall meet in Seattle, after a period of ten years, we shall aim to reciprocate in like manner and extend the glad hand to our Portland brethren.

RECEPTION OF A. M. A. DELEGATES IN SEATTLE AND TACOMA.

The medical profession of Seattle and Tacoma plan to receive the Eastern visitors, when passing through their cities to or from Portland, and to offer them the best attractions available. It is announced that special trains from New York, Chicago, St. Paul, the Missouri and the Mississippi valleys will reach these cities, July 8, 9 and 10. These will be met by committees and, whether their stop be long or short, the visitors will find something to fill each hour. In Seattle the medical headquarters will be in the new and elegantly furnished Elks Hall, on the fourteenth floor of the Alaska Building, where suitable entertainment will be prepared. Special cars will be provided to carry all who wish to see the features of the city. Boats will be engaged for rides on the Sound or Lake Washington, if preferred. It is assumed that our Eastern friends will, at this time, choose to devote the hours at their disposal to the beauties and development of the Puget Sound country rather than to social functions. After the Portland meeting it is planned to receive the visitors more at leisure who shall return by the Northern routes. Receptions and visits to local points of interest will be prepared. The physicians of Tacoma will receive and entertain the visitors along similar lines. It is expected that attractions of sufficient interest will be presented that they will be persuaded in the future to return to the Northwest.

BRITISH COLUMBIA MEDICAL ASSOCIATION.

The annual meeting of this neighboring association will be held in Vancouver, B. C., July 18-20. Coming immediately after the A. M. A. meeting, visitors from the East who return home via the Canadian route, will find this an opportune time to meet the brethren across the border, after spending the few intervening days in the state of Washington. It is stated that the well-known British Columbia welcome will be extended to all who attend and past experience has shown that the hospitality from that region is of the highest order. We trust the profession of the Northwest will not forget this among the other attractive medical meetings of the month of July.

MEDICAL OBITUARIES,

The fact is repeatedly illustrated that the life and activity of one individual cuts but a small figure in that of a large and growing community. The leading physicians of today are a memory to

morrow and forgotten by the next generation. Recently Dr. Jacobi, of New York, delivered an address on the life of Dr. Kracowicz, whom he termed "the leading American physician born in Europe." Being forced to leave Germany for his activity in the revolution of 1848, he settled in New York and soon became one of the most distinguished surgeons of his day as well as a leading spirit in the civic life of his adopted city. He died but thirty years ago and yet, as Dr. Jacobi states, scarcely one of his audience, in all probability, had ever heard of him before. We may all anticipate a similar fate. At the same time it is true that no class of men has a greater influence for good in any city than the medical and they, if any citizens, deserve to be held in the memories of their successors. To this end a local medical journal can devote its pages to no better purpose than presenting the characteristics and incidents in the lives of the deceased physicians in the field reached by it, thus serving to place them on permanent record. NORTHWEST MEDICINE desires to serve such a purpose in the Northwest and to this end, will always be pleased to publish obituaries received, of departed members of the profession, together with half-tones of their accompanying photographs.

PRACTICE OF MEDICINE IN SEATTLE SIXTEEN

YEARS AGO.

The cut on the opposite page shows the office of the editors of this journal during the summer of 1889, following the Seattle fire of June 6. It illustrates the office accommodations that prevailed for several months during that strenuous period and which served for a large proportion of the medical profession. The contrast is striking, compared with the facilities of the present day. This, however, possessed its advantages. There was never complaint of the lack of fresh air. No time was lost in closing for the night, this duty being accomplished when the tent flag was dropped. Besides, the liberality of the owners was manifest in thus offering the opportunity for a free night's lodging to any wayfarer who might be hunting a bed. How much pleasure of life would be lost were we deprived of the recollection of the happy experiences of the past!

ALLUMNI ASSOCIATION OF UNIV. OF PA.

The annual reunion of the Pacific Northwest Alumni Association of the University of Pennsylvania will be held at the University Club, Portland, Oregon, Saturday evening July 15, 1905. All members of the Association are earnestly requested to be present, and all visiting University of Pennsylvania graduates who expect to be in Portland at that time are most cordially invited to meet with us.

CHARLES E. MCCLURE, Secretary.
Seattle, Wash.