be kept saturated with vapor from a kettle containing lime and turpentine, at a temperature of 65 to 70 F. One of the most difficult features of the after-treatment is feeding the patient, and I find most children refuse to take nourishment by the method recommended by Casselberry. Some refuse food altogether and should be nourished by the rectum. An unlimited amount of tact is required to get the -co-operation of the child. It should be made to lie on its side with the head hanging slightly over the edge of the bed and a certain position is had in which food can be taken with comfort. Frozen milk and cracked ice can be best swallowed and should be allowed if the child is sthenic; otherwise milk and soft cooked eggs should be given. Whenever the child has a paroxysm of coughing, the head should be elevated. The throat should be sprayed only to correct fetor, as the child should be annoyed as little as possible and no medicines should be given by the mouth.

The same procedure is required for removing as introducing the tube and is more difficult.

CONCLUSIONS.

1. Numerous statistics prove that antitoxin has lessened the mortality of diphtheria one-half.

2. The remedy is never toxic in its effects, and never causes or increases albuminuria if properly used, and does not interfere with the use of other remedies.

3. The dose of antitoxin in laryngeal cases should be from 1500 to 4000 units, according to the age and condition of the patient.

4. In weak anemic and albuminuric cases its administration should be more guarded, as the restraining effect on the kidneys in Case. No. 3, was due to a faulty administration.

subjected to intubation, lessening the absorption of toxins, and renders an early removal of the tube safe.

6. Antitoxin has a favorable effect on the mixed infections, as in Case 5.

7. From a personal observation of three successful out of five tracheotomies and five consecutive successful intubations for croup, my preference is for intubation, except in rare cases.

DISCUSSION ON DR. HARBIN'S PAPER.

Dr. James T. Ross of Macon: I did not expect to say anything, but I have been very much interested in Dr. Harbin's paper because it has fallen to my lot on several occasions to use the same procedure he recommends, and I want to say this much about antitoxin: I feel that it is not generally enough used. Several years ago I had the misfortune of seeing a niece of mine die that I afterwards thought might have been saved by the use of antitoxin. I did not use it then, because so many adverse criticisms appeared in our medical journals. In many instances reports would read something like this: A man had three cases of diphtheria, all presumably doing very well; he had administered antitoxin, and in less than an hour or two hours he was called to see the patients, and found one dead, and another dying, and with great effort the third patient was saved. I am satisfied in my mind that it was not due to the antitoxin; it was simply one of those paroxysms that comes on when the diphtheritic membrane perfectly occludes the trachea and the patient dies from suffocation, as is so often the case. I feel that there is nothing to be feared in the administration of antitoxin. I remember one case I had that was either membranous croup, as we call it, or it was subglottic infiltration, I do not know which. It was a child, three years of age, and in that case I used 7500 units of antitoxin, and the child wore a tube for several days. This case was successful. I have several patients living after the use of the tube, and I think the shortest time I have ever removed the tube and left it out was seven days. The longest time I ever had to watch the tube carefully was six weeks. During this time the child on several occasions was seized with paroxyms, and we thought it would die before we could replace it. If I remember rightly, the doctor did not speak of the indications concerning when the tube should be removed. Many authors lay down as among the indications for removing the tube a stopping or filling up of the tube, and the absence of certain signs. If you will bear on the child's chest and abdomen, so that you can watch the movements of the chest, you can easily tell that the patient has labored breathing, and I do not wait any longer. I do not wait for the child to become cyanotic before introducing the tube, and I have often seen these little patients go to sleep shortly after the introduction of the tube. I prefer intubation to tracheotomy, and personally I have never seen a case that got well after tracheotomy, but I have seen quite a number recover after intubation.

Dr. Harbin (closing the discussion): I have nothing to say except to refer to one point, and that is the indications for removing the tube. It seems to me, the best indications for removing the tube are when the expectoration becomes less purulent and becomes more frothy and scant, and, at the same time, when you notice it is streaked with a little blood, which shows that the membrane is pretty well absorbed. I have found that condition a practical indication for the removal of the tube.

THE NECESSITY OF A STATE PEDIATRIC SOCIETY.

BY OLIVER B. BUSH, M. D., COLQUIT, GA.

The subject of which I am now about to speak is one of the utmost importance and one which has been but little agitated in this part of the United States among the medical profession; the object of this paper is to impress upon the profession the great importance of studying and treating the diseases of children above all others.

It is of great importance for several reasons; because the class of individuals here referred to are so important, not only because they are human beings and sufferers in common with all mankind, but far more so because they are the most helpless; and still more so because they are the angels of the fireside and the hope of the country.

Am I exaggerating when I call them the angels of the fireside? No.

Mr. President, what is home without a baby? After the labors of the day are over and we wend our way homeward at night: the babe with its outstretched arms and its lovely prattle is the first to engage our attention, and while in health is the delight of all, but on the contrary, when we walk in and find the little darling sick, imagine the agony and suspense of that father who loves the little fellow so dearly. Why, there is no sacrifice he would not make for the relief of that babe. The doctor, of course, is the first person thought of after the good motherly neighbors have been consulted, and now imagine the suspense of the poor doctor when he is called in and the patient unable to give him a single symptom. Of course he appeals to the mother who in a disconnected and unsatisfactory manner proceeds (as best she can) to give the history of the case.

The diseases of children are as varied as those of the adult and at all times more difficult of diagnosis; especially is this so with the young practitioner, and, it is not infrequently the case that he (especially in the remote parts of the State) would like to read and have discussed before the Association, a paper bearing on some disease of childhood, yet he does not do so, because he fears there would be so little interest taken in this class of practice that he would hardly have time to read the paper, much less have discussions on it. According to the By-Laws of this Association we only have three days in which to read and discuss the various subjects (relating mostly to adults) and hearing reports of committees; and there is not time enough to devote to the discussion of diseases of children.

Therefore, Mr. President, is it not advisable that a society for the consideration of this class of diseases alone, be organized, or, if this is not practical, to extend the time of this Association and a special section be inaugurated to consider this class of diseases?

Now when we take into consideration the vast number of diseases that child is heir to, and the limited time we have in this Association to discuss them in, and learn each others' views relative to their treatment, we are more impressed with the great importance of a society for the consideration of this special class of practice.

There is not a practitioner in this whole country who will not testify with me that our facilities for studying the diseases of children in our colleges are too meager, and that the chances to become familiar with them are only from