were performed upon two hundred children, using the undiluted, old tuberculin. In the "Medical Review of Reviews" his article is abstracted in brief. From this we learn that harmful results, particularly fever, did not follow in any instance. Among the cases tested 5 per cent. yielded a positive reaction, in all of which cases tuberculosis could be positively demonstrated. He concludes that when an infant fails to react after two such tests made at intervals of about two weeks, it is safe to assume with quite a degree of certainty that tuberculosis is not present. This assumption, he claims, has been confirmed by autopsy findings in many cases.

PERSONAL AND GENERAL ITEMS

Dr. Walter A. Jillson, class of 1905, B. U. S. M., has retired from practice in Gardner, Mass., and is about to enter upon service at the Flower Hospital in New York City.

At the annual meeting of the Trustees of Boston University, held at the University building on Monday afternoon, January 10, Dr. Charles Leeds of Chelsea was re-elected a trustee for a term of five years. Dr. Leeds was also elected a member of the Executive Committee on the Medical School.

I Dr. Nathaniel R. Perkins was elected a member of the Visiting Committee of the Medical School for the term ending in 1913.

Dr. Samuel E. Fletcher has recently been elected mayor of the city of Chicopee, Massachusetts, where he has been in active practice since his graduation from Boston University School of Medicine in 1892.

Dr. Robert Rice, a graduate of Hahnemann of Philadelphia, has located at 330 Washington Street, Haverhill.

Dr. Agnes C. Patterson, class of 1900, B. U. S. M., is at Calhoun, Alabama.

Dr. Spencer D. Whiting, B. U. S. M., class of 1905, has been taking some post-graduate work in Boston preparatory to returning to his practice in Nome, Alaska. Dr. Whiting speaks with enthusiasm of life in Alaska.

Owing to ill health, Dr. William F. Wesselhoeft has been obliged to give up temporarily his practice and his lectures at the Medical School, and has gone to Jamaica for the rest and change which he needs. The Gazette extends its heartiest good wishes for a speedy return to full health and strength. During Dr. Wesselhoeft's absence Dr. DeWitt G. Wilcox will substitute for him in the lecture course on Surgery to the Junior class of Boston University School of Medicine.

Applications will be received for two interneships in Hahnemann Hospital, Scranton, Pa. The term is one year, beginning July 1, 1910. For information address H. F. Heilner, M.D., Burr Building, Scranton, Pa.

Dr. E. E. Goodwin of Brockton, class of '99, B. U. S. M., has removed his office to the Central Hospital, 223 North Main Street, where he will continue in general practice, with facilities for caring for medical, surgical and maternity cases.

Dr. Hovey L. Shepherd, formerly professor of Materia Medica in Boston University, and a graduate of the class of '95 of the Medical School, has located in the O. T. Johnson building, Los Angeles, California, having removed there from Winchester, Mass., for the benefit of his little son's health. Dr. Shepherd's former practice in Winchester has been taken by Dr. H. F. Simon, class of 1904, B. U. S. M.

A competitive examination for interneship at the National Homeopathic Hospital, Washington, D. C., will be held at noon on Saturday, March 3. For information address Dr. George C. Birdsall, secretary of the staff, 1330 Massachusetts Avenue, Washington, D. C.

The "Critique" appears this year in a completely new dress and one that is most becoming. We have for long held this journal in high esteem, although not always agreeing with all of the contents. We realize, however, that each individual has a right to his own opinions and can but admire those who strenuously uphold such opinions even in the light of much criticism. It seems probable that the editor of this journal is best fitted to fill the position, heretofore unoccupied, of the late Dr. Frank Kraft in so far as originality and personality of journalistic work lies.

We extend to the "Critique" our most cordial greetings, and trust that it may ever be as ardent an advocate of the right as it sees it, as it has been in the past.

The Rockefeller Institute of Medical Research at New York is the recipient of a bronze bust of Louis Pasteur from the Pasteur Institute of Paris. This gift has been made as a recognition of the valuable assistance rendered by the American Institute during the recent epidemic of cerebro-spinal meningitis that occurred in France.

The St. Louis Children's Hospital, an institution under exclusively homœopathic control, is reported to be the recipient of a gift of $128,000. The money wili be used for the erection of a new hospital as a memorial to the late Mrs. Liggett.

GIFT TO THE LOWELL GENERAL HOSPITAL.-An additional sum of $50,000 has been given by Mr. F. A. Ayer, formerly of Lowell, now of New York, for the maintenance of the Lowell General Hospital. This makes a total of over $200,000 which the Hospital has received from this source.

A METCHNIKOFF LABORATORY.-The "Medical Times" states that the Municipal Council of St. Petersburg has decided to name its newly installed laboratory after the eminent biologist, Metchnikoff, a Russian by birth, a Frenchman by adoption.

BEQUESTS OF THE BOYD WILL.-According to the will of the late George William Boyd, who died about five years ago, a number of New England institutions receive bequests. Among these are the Massachusetts Homœopathic Hospital, $2,000, and the Roxbury Homœopathic Dispensary, $1,000.

QUEEN OF BELGIUM A PHYSICIAN.-It is interesting to note that the new Queen of Belgium has pursued for a number of years the study of medicine, having completed her course for her medical degree at Leipzig a short time before her marriage to the present king.

She was the daughter of the late Duke Karl Theodor of Bavaria who died recently. Prior to her accession to the throne she continued to take an active part in the medical work of Brussells, particularly in connection with tuberculosis.

STATE REGISTRATION OF NURSES.-According to a recent law in Pennsylvania suitable persons may now be approved by a special board and allowed to use the title "registered nurse" or its abbreviation, R. N. The board also authorizes a pin to be used by such persons when desired.

ALCOHOL AND IMMUNITY.-In the November "Lancet" is an interesting paper by Parkinson upon the demonstrable relation between alcohol and immunity. Among other things he states that alcohol in small quantities has no action upon phagocytic activity. That small quantities when injected into rabbits may temporarily increase immunity; that a large dose of alcohol very materially lowers the degree of resistance for at least twenty-four hours. That the continuous use of moderate doses causes a decrease in immunity, and that the reactions to vaccines in rabbits given alcohol is much less noticeable than in normal rabbits.

HOSPITAL APPOINTMENTS FOR 1910.-The following is the series of appointments for the medical and surgical services at the Massachusetts Homœopathic Hospital for the current year:

Medical.-First quarter, Dr. F. B. Percy; second quarter, Dr. J. P. Sutherland; third quarter, Dr. E. E. Allen; fourth quarter, Dr. H. E. Spalding.

Surgical.-First quarter, chiefs, Dr. W. S. Smith, Dr. W. F. Wesselhoeft; first assistants, Dr. R. C. Wiggin, Dr. H. D. Boyd; second assistants, Dr. R. F. Souther, Dr. H. J. Lee.

Examining surgeon, Dr. W. K. S. Thomas.

Surgeons to out-patients, Dr. Clarence Crane, Dr. F. R. Sedgley. Second quarter, chiefs, Dr. J. B. Bell, Dr. W. F. Wesselhoeft; first assistants, Dr. Clarence Crane, Dr. J. E. Briggs; second assistants, Dr. Thomas, Dr. Sedgley.

Examining surgeon, Dr. Souther.

Surgeons to out-patients, Dr. R. C. Wiggin, Dr. H. J. Lee.

Third quarter, chiefs, Dr. T. E. Chandler, Dr. C. T. Howard; first assistants, Dr. Wiggin, Dr. Boyd; second assistants, Dr. Souther, Dr. Lee. Examining surgeon, Dr. Sedgley.

Surgeons to out-patients, Dr. Jones, Dr. Briggs.

Fourth quarter, chiefs, Dr. Packard, Dr. Briggs; first assistants, Dr. Crane, Dr. Briggs; second assistants, Dr. Sedgley, Dr. Thomas.

Examining surgeon, Dr. Lee.

Surgeons to out-patients, Dr. Powers, Dr. Souther.

BY GEORGE E. MAY, M.D., NEWTON CENTRE, MASS.

The normal spleen in the adult is about five inches long, three or four inches in breadth, one and one-half inches in thickness, and weighs on the average about seven ounces.

The spleen is supposed to manufacture white blood corpuscles, and this manufacturing reaches a pronounced activity when the organ is hypertrophied, as in leucocythæmia. The spleen from its power to dilate, serves as a reservoir of blood for the portal system, especially for the blood vessels of the stomach. Many of the purin bodies are found in the spleen, as xanthin, hypoxanthin, and uric acid.

According to Schiff and Herzen, the spleen may have much to do with the formation of trypsin, since addition of splenic infusion or of splenic venous blood activates the pancreatic extract, this being due to an internal secretion of the spleen.

Enlargement of the spleen, of rapid development and moderate extent, is a pertinent physical sign in various acute infections, of which the following are typical examples: malarial fever, relapsing fever, typhoid fever, typhus fever, sepsis, acute miliary tuberculosis, erysipelas, diphtheria, variola, scarletina, pneumonia, cerebrospinal fever and acute atrophy of the liver. Of most of the primary anemias this is also true-lymphatic leukemia, Banti's disease, and pernicious anemia. Syphilis, rickets and pancreatic cirrhosis serve to illustrate chronic diseases of which moderate splenic enlargement is symptomatic.

Genuine primary tumors are extremely rare, but secondary carcinoma and secondary sarcoma are fairly common. Primary tuberculosis is rare, but secondary manifestations have been occasionally observed.

*Read before the Massachusetts Surgical and Gynecological Society, Decen.. ber 8, 1909.

Ectopy of the spleen, or wandering spleen, in the majority of cases is associated with, and is, indeed, a part of that condition of general prolapse of all the viscera which is known as enteroptosis.

The spleen may be injured by itself or along with other viscera, the most common injury being from contusion, which may produce rupture and hemorrhage. The organ is so friable that it may literally burst under a slight force. Rupture is especially likely to occur after those infectious diseases which cause its enlargement.

Chronic tumor of the spleen, in certain instances, may be justly attributed to one of the several causes heretofore mentioned, being a part of a constitutional dyscrasia. Quite apart from these factors, however, not a few cases of chronic splenic enlargement exist in which the clinical history and all the concomitant conditions throw absolutely no light on the origin of the tumor. Nor are pathologists prepared to classify these enlarged spleens except under the general term of chronic indurative splenitis. It seems most probable, however, that the inception of the process is to be sought in some past infectious disease. Not a few cases are undoubtedly due to a latent malarial infection, as an enlarged spleen is very common in persons who reside in or emigrate to malarial regions, who give no other history of any malarial symptoms.

Wounds of the spleen from gunshot or stabs are very apt to be fatal within a short period of time unless prompt interference is at hand. Splenotomy, or the removal of portions of the spleen, has been done with a moderate degree of success for injuries involving fragmentary portions of the organ, but as a rule splenectomy, or the entire removal of the viscus, seems to be the operation of choice and should be undertaken at once in all traumatic conditions of the organ.

The removal of the spleen in splenomyelogenous leukemia is, according to most writers, contraindicated. In the early period of splenic surgery, splenectomy was repeatedly performed in the hope of eradicating the disease. In 1894, Vulpius and Ceci collected twenty-eight cases of splenectomy in leukemia with twenty-five deaths immediately after the operation. Of the three cases that survived the operation one lived thirteen days, another eight months, while the third is reported as having been cured. A total of about forty-nine splenectomies in leukemia have been reported with six recoveries and forty-three deaths, with a mortality of 87.7 per cent. Hemorrhage and shock are the chief factors in the mortality of this operation. In addition, our present conception of the bone. marrow changes in this disease seems to demonstrate the futility of splenectomy to stay the progress of this malady.

In the idiopathically enlarged spleen the indications for removal are not at all absolute. It is principally justified as a prophylactic measure, as an otherwise trivial traumatism may seriously jeopardize the patient's life by the serious susceptibility of the enlarged spleen to rupture. Prior to 1908 there have been collected