The new hospital accommodations in Greenwich are all that could be desired.

Danbury physicians report a successful year with no changes of note in the hospital line.

The new Charities Building is open in Bridgeport with all departments busy.

Stamford reports a new nurses' home adjoining the present property. The building and land were presented to the Stamford Hospital by Mr. and Mrs. C. O. Miller of that city. A fine new piano was presented to the nurses by the members of the Stamford Medical Society.

To summarize, the year has been one of progress along medical lines and of greater harmony among the medical men of Fairfield County.

Respectfully submitted,

F. H. BARNES,

Acting Councilor.

(b) Hartford County, Walter R. Steiner, Councilor. Mr. President and Gentlemen of the House of Delegates:

The Hartford County Medical Association has had an uneventful year. The war played sad havoc with our membership, as many were away and the duties of those remaining at home made well-attended meetings impossible. In the fall the influenza epidemic compelled us to omit the usual October meeting. The spring gathering, however, had a good representation of our members present, and we enjoyed hearing three papers from those who had been in service in the Medical Officers' Reserve Corps. During the dinner at our spring session, Dr. W. D. Mackenzie spoke on the League of Nations, and Dr. W. F. Verdi of New Haven told us about some of his experiences in France.

We have lost during the year three members, Doctors Lewis, McSweeney, and Ryan. Their obituaries will appear in the coming transactions so they will receive no extended notice here. We now have 242 members, including the three new members who were elected at our spring meeting.

The New Britain Hospital is happy as being the recipient of about $1,000,000 from the late Darius Miller of that city. The

other hospitals in the county have continued their efficient work, although frequently poorly manned during the war, and often cramped by lack of funds.

Respectfully submitted,

WALTER R. STEINER,

Councilor.

(c) Litchfield County, Elias Pratt, Councilor.

Mr. President and Gentlemen of the House of Delegates: Nothing of special note has occurred in the activities of the Society during the past year. Owing to the work the members were doing on the draft boards and the epidemic of influenza there was no scientific programme at the semi-annual meeting in October. The annual meeting in April was of especial interest. Our President made us a visit and Drs. Turkington, Adams, and Woodward gave us a very interesting and entertaining account of their experiences in the service of the United States. Drs. Turkington and Adams pictured camp life from the humorist's as well as the physician's point of view, while Dr. Woodward gave us a very graphic description of front line service in the British Army during the drive in the later months of the

war.

We lost by death one member, Dr. W. W. Wellington, of Terryville. He was in active practice for many years although not a very faithful attendant at the meetings of the Society.

The number present at our meetings is not as large as could be desired, still the Society is in a prosperous condition and harmony prevails among the members.

Respectfully submitted,

ELIAS PRATT,

Councilor.

(d) Middlesex County, Dr. George N. Lawson, Councilor.

Mr. President and Gentlemen of the House of Delegates:

The present membership of the Middlesex County Medical Association is an even 50.

With the exception of New London County, which held its semi-annual meeting in connection with that of the State Society, our county was the first and perhaps the only one to hold a semiannual meeting. On account of the epidemic of influenza we did not get together at the regular time in October but we met on the evening of January 13th and after a short business meeting and a good supper we listened to a paper by Dr. Lyman on tuberculosis.

The general topic at our annual meeting in April was War Developments in Medicine and Surgery.

The Central Medical Association has held interesting monthly meetings throughout the year, devoting one to a symposium on the subject of influenza and two or three to stories of war work by some of our members who had returned from that service. Out of the thirteen physicians of Middlesex County who have been away in war service four have returned and others are expected back soon. It is proposed to hold a little later in the spring a reception and to give a banquet in their honor.

Since my last report a municipal bacteriological laboratory has been established in Middletown under the able supervision of Dr. Jessie Fisher.

Last summer a movement was started to raise money and build a much-needed additional wing to the Middlesex Hospital, but it was found that the difficulties of securing a contractor and obtaining the structural material and the high cost of building made it seem wise to postpone the undertaking.

Respectfuly submitted,

GEORGE N. LAWSON,

Councilor.

(e) New Haven County, Dr. William H. Carmalt, Councilor. Mr. President and Gentlemen of the House of Delegates:

The activities of the medical profession of New Haven County for the past year refer principally to the influenza and the war work of its members. The first has been so ably handled by Dr. Blumer in a paper read to the New Haven Medical Asso

ciation that for one out of practice, having individually no cases to treat, and seeing the disease only at arm's length in its relation. to the New Haven Hospital, it would be pure faking to attempt any description of it at first hand. Whatever I may have to say will be taken largely from the reports of the Board of Health of the City of New Haven, from Dr. Blumer's paper and references to the work of Dr. Winternitz of the Brady Laboratory of the New Haven Hospital.

Major Chester Brown's report on the war work of the profession of the state will show, without my repeating it, what the county has contributed along that line.

The first cases of influenza recognized as of the epidemic form appeared in September, 1918. They rapidly increased and continued active until April, 1919. The height of the epidemic was reached in November. It has not been possible to get reliable statistics with regard to its frequency for several reasons. In the first place reliable diagnosis could not be made: in the beginning many cases were so slight as to be taken simply for heavy colds and not reported, and later at the height of the epidemic everything affecting the upper air passages was called influenza, and physicians, working night and day, exhausted almost in mind and absolutely so in body, were quite unable to give the time, until tired nature restored itself, and then many cases were unavoidably forgotten. As you know this was the most widespread epidemic known in medical history. Though the mortality percentage, for reasons already given, could not be actually stated and may not appear so extremely high, the actual deaths were very large, as the column after column of death notices in the newspapers showed. I have heard the estimate made that one out of every sixteen of the population was affected, but I cannot vouch for its accuracy. The mortality rate is equally uncertain as to the community at large; but in the New Haven Hospital, where records were kept, out of 1,201 cases admitted between September 13, 1918, and April 1, 1919, 307 died, or 25 per cent. This very large fatality rate is of course higher than for the general population, for only the recognized and one may consider the more severe cases were admitted there. I am not saying

that doubtful cases were refused, for not one was refused, but the milder cases did not apply. The deaths were invariably due to pneumonia, in this respect agreeing with the experience of Dr. Christian of Boston, as published in the Journal of the American Medical Association, and it is conceded that if careful examinations were made the clinical signs of pneumonia were always present. Professor Winternitz's observations made in the Brady Pathological Laboratory of the New Haven Hospital and Yale Medical School are exceedingly valuable. He had been studying for the War Department of the United States Government the effects of the poisonous gases used in warfare on the mucous membranes of the air passages in causing extensive necrosis of the epithelium, and was at once impressed at the autopsies of patients dying of the influenza-pneumonia with the similar appearances of the mucous membrane there; in consequence of this widespread necrosis the entrance of the influenza bacilli, whatever they may be, to the air vesicles was facilitated producing multiple areas of broncho-pneumonia, which coalescing gave rise to the peculiar form of pneumonia noted to which the patient succumbed. I will not presume to even attempt to describe the pathological changes he found. He will in proper time and place give the result of his studies; let it suffice here for the New Haven County Councilor to report that these investigations are being made ready for publication as soon as possible and they will be pioneer contributions to medical science.

Speaking of this work in the Brady Laboratory, it may be worth while as a factor of interest to the profession, to indicate briefly the steps that are being taken looking to the development of the Medical School of Yale University through its union with the New Haven Hospital, which will realize the hopes and expressed intentions of the founders of the General Hospital Society of Connecticut as shown in various ways in the early history of the hospital.

Founded in 1826, the incorporators and charter members were, with one exception, professors in the medical institution of Yale College as the Medical School was then designated, and for many years they continued to contribute a substantial part of the