to have the alkaline treatment. Discharged from medical ward cured of his rheumatism on the 25th of April.

CASE. IV.-Sophia H housemaid; age 23 Applied for admission March 31st, suffering with rheumatic fever complicated with endocarditis. Has been subject to rheumatism for eight years. Ordered the alkaline treatment. Was discharged cured April 13th.

CASE V.-Mary R――, age 22; domestic. Was admitted on the 17th of April, with fever and pains in joints. Says she has been sick for two weeks. Her joints are much swollen, and very red and painful. Ordered alkaline treatment. The following morning urine alkaline. Discharged well May 7th.

CASE. VI.-Ellen H- -, age 35; cook. admitted March 1st suffering with rheumatism, the chronic variety. She was put alternately upon the wine colchicum, dov. pulv. and quinine, and alkaline treatment. The latter remedy benefitted her the most. rheumatism yielded slowly. She was discharged well April 15th.

The

CASE. VII.-Mary McK- age 35; admitted April 24, with rheumatic fever, and pains in hands and knees. Has been subject to rheumatism for several years. Discharged well May 2nd.

Ordered the alkalies.

Surgical Items.

By J. B. HOUGH, M. D., Ridgeville, Ohio.

Sponge Tents.-Knowing the fact that absolute or strong alcohol will quickly set the fibres of common sponge, after having been moulded or compressed into any given size or shape, I was led to the following quick and easy method of preparing sponge tents, tampons, etc:

The sponge is first thoroughly moistened with water and pressed as dry as the strength of the hand will permit; then having formed it into the desired shape and size by the hand, or by pressing into a quill or any other tube or mould it is immers ed into the alcohol. If the spirit is sufficiently strong, (90 to 100

pr ct) the sponge is immediately set into the given shape, which it retains perfectly after the pressure or mould is removed. It is then hard, firm and inflexible and may be trimmed to a sharp point or any other desired shape.

To restore it to its former size and shape it is only necessary to moisten it with a few drops of water. The alcohol sets the sponge perfectly, whether the amount of compression be much or little, so that the degree of dilatation, attainable by the use of tents thus prepared, will of course, depend upon the size after moulding and the degree of pressure used. As this process of preparation works perfectly and without delay its advantages are obvious.

Specular Ear-forceps.-The difficulty often experienced in removing foreign bodies from the ear without injury to the organ or unnecessary pain to the subject suggested, the idea of a light, slender forceps having for its jaws the longitudinal halves of an ear-speculum, prolonged into mandibles of sufficient length to reach the tympanum. The instrument must be bent so that the hand shall not intervene between the eye and the object. The great satisfaction and convenience experienced in using an improvised forceps of this kind leads me to believe that instrument makers would confer a favor upon themselves and the profession by supplying us with a convenience that would soon create its own demand.

Fatal case of tetanus resulting from the removal of ten teeth from the upper jaw while under the influence of the nitrous oxide gas.

By H. K. STEELE, M. D., Dayton, Ohio.

John E. P—, age 19 of strong constitution, robust and in full health, on the 1st of March last, while under the influence of nitrous oxide gas, administered by a dentist, had ten of the upper teeth removed, for the purpose of having a full artificial set inserted.

He felt some of the pain of the operation, but was well able to endure it and recovered apparently from its effects, and continued at his occupation, that of farming. On the 7th of March a twitching of the lower lid of the right eye, with a tendency in it to "draw down" was observed by himself and friends. On the 8th he applied to the dentist for relief, who made an external ap

plication of chlorform, deeming that sufficient. The left eye, however, became similarly affected, and other symptoms were gradually manifested until the 14th, at which time I first saw him (the distance from th city, 7 miles, being probably, a reason why I was not sooner called.) There was then inability to separate the jaws more than three-quarters of an inch, a spastic contration of the masseter. There was retraction of the angles of the mouth, and an occasional clonic spasm of the muscles of the abdomen.

Under the influence of a cathartic, with full doses of belladonna and bromide of potassa and ice-bags to the spine; two or three hours sleep was obtained that night, without, however, relaxation of the jaws, or entire subsidence of the abdominal spasm. On the morning of the 15th there was a perceptible exaggeration of the symptoms, the spasms of the abdominal muscles at times being very painful, deglutition performed with some difficulty; a drop of water falling on the chin or running down the neck, producing the spasms in their full force.

Chlorform by inhalation moderated the pain and gave temporary comfort. Atropia was substituted for the belladonna and cannabis indica for the potas. bromide with morphine to be given at night.

March 16th,-Had slept two hours during the night after taking the morphine; but a continuance of it did not maintain relief. This morning the disease is aggravated. He can not remain in bed, and occasionally has to be raised to a standing posi tion, the spasms affecting all the muscles of the body, that of the extensors predominating.

From this time onward the disease increased in severity. The thoracic muscles; those controlling respiration being more affected than the others. There was at no time opisthotonos or emprosthotonos, but the body was powerfully extended to a straight position. He was not able to remain in bed during the last two days, and it was only whilst there was relaxation of the spasms that he could sit in a chair, the rest of the time he was held on his feet, and required the windows and doors to be kept open, which in the very inclement weather, was of course an aggravation to his disease and precluded all hopes of affording him relief. He died on the 19th almost in a standing position, having just sunk down

exhausted by the violence of a spasm. The treatment may be summed up as follows:

Ice-bags to spine; morphine; chlorform by inhalation; cannabis indica; potass brom; belladonna; atropia; extract callabar bean by hypodermic injection grain in solution and 1 grain per ore.

The remedies affording the most relief are in the order which they are named.

Chloroform for the last two days affected the respiration dangerously. The hypodermic application of calabar bean was not in the least beneficial.

Dr. Jno. Davis, of Dayton, saw the case with me the last three days.

Medical Societies.

AMERICAN MEDICAL ASSOCIATION.

Twentieth Annual Meeting. Held in the City of New Orleans, May 4, 5, 6, and 7th.

FIRST DAY-TUESDAY, MAY 4, 1869.

THE Association convened at Mechanics' Institute, New Orleans, La., on Tuesday. May 4, 1869, and was called to order by the President, W. O. Baldwin, M. D., of Alabama, at 11 o'clock, the appointed hour.

The opening prayer was offered by the Rev. Mr. Gallagher, of Trinity Church.

Dr. T. G. Richardson, Chairman of the Committee of Arrangements, gave an address of hearty welcome to the delegates, and detailed the plan of business of the Association. No change of hour was deemed expedient. The following gentlemen were invited to seats on the platform: Drs. H. F. Askew, of Delaware; N. S. Davis, of Illinois; and Alden March, of N. Y., Ex-Presidents of the Association; and Drs. Warren Stone, and A. Lopez, of New Orleans. Drs. Taney, Legare, Anfoux, Tebault, and Barnes, of New Orleans, and McFarland, of Mississippi, were elected members by invitation

ADDRESS BY THE PRESIDENT.

Dr. W. O. Baldwin, the President, then delivered the following address:

GENTLEMEN OF THE AMERICAN MEDICAL ASSOCIATION: I congratulate you on the return of an occasion which permits us to renew that fraternity of intellect no less than that sympathy of feeling by which our life and vocation as physicians are beautifled and enobled. Of no profession are the inspired words more true than ours, that we are "members one of another." The ideal of our profession is that of complete and thorough oneness. What is scientific truth for one is scientific truth for all. We have a common estate in the facts, aims, and purposes that belong to the science of medicine; and hence we do a wise work when we acknowledge the exalted unity of the medical profession by this annual assemblage.

The nature of this occasion reconciles me, in some degree, to the task which I now have to perform. When I remember that the position I now occupy was first filled by the distinguished Chapman, and that the succeding anniversaries have been presided over by men whose genius had shed not only light, but lustre, on the annals of our profession, I feel that nothing but the inspiration which breathes through affections, kindled into life by this Association, could sustain me under the sense of incompetency for the duties to which your kindness has called. Relying on the same spirit which prompted you to confer on me the highest distinction within the gift of the medical profession of America, and hoping that my deficiencies may be forgotten in the interest and magnitude of the subjects awaiting your deliberation, I proceed to discharge the duty which the custom of my predecessors has imposed upon your presiding officer.

The spirit of a profession is the true sign of its character, as it is the measure of that respect with which its talents and services are regarded. Manly sentiment, springing from broad and genial sympathics, is the soul of every profession, and if it is wanting, no skill, not even usefulness, can prevent it from sure and speedy degrad: tion. The first and last requisite of professional life is not power of intellect, however valuable that may be, nor those acquisitions of knowledge that enrich our thoughts, but that other and finer quality of generous manhood, which, as a subtle and pervading essence, enters with its healthy vigor and