Had seen some cases in which diptheretic complications occurred, in these he had employed iodine in a vaporized form. Had no faith in preventive influence of belladonna, although he knew that there were still some who believed in its efficacy, and had recently seen it again advanced by physicians of some note.

Dr. HARRINGTON asked if scarlatina had been observed in nursing children.

Dr. WYCKOFF replied in the affirmative, and that he had seen nursing children take it first in family, which was contrary to former experience.

Dr. SHAW could date back thirty-three years when an extensive epidemic occurred in Chautaqua county, although he had in the course of his practice seen a large number of cases-could add nothing new.

Dr. LYNDE-Had seen several epidemics. The mode of origin and communication was wholly inexplicable. In Springville, Erie county, he had observed a very severe epidemic. He read a brief resumé of his views.

Dr. HARRINGTON said Aitken affirmed that the disease was three times as fatal in the city as in the country, and in certain localities of his practice he had observed this to be the case; he had observed many more fatal cases in crowded neighborhoods. Had seen one case where a female was attacked in a few days after confinement; had used ice in many cases with very pleasant results to his patients.

Dr. ELLIOTT said that he agreed with the former speakers.

Dr. WHITE called upon the Ex-Health Physician, Dr. O'Brien, and the present incumbent, Dr. Chace, for remarks,

Dr. O'BRIEN could offer nothing in addition to what had been said concerning the character of the disease. The mortality last year was about 630. In December it was 66, in January about 69.

The disease was not confined to this locality alone, but was prevalent in Syracuse, Rochester, Lockport and the surrounding towns in this vicinity. The spread of the disease was aided by those in whose families it was present. Thought that more stringent measures should be employed to prevent communication between the sick and the well.

Keepers of stores and other places liable to be frequented by children, should be compelled to close their places of business when connected with their dwelling on the appearance of scarlatina. The regulations in regard to funerals should be as stringent as in small pox.

Dr. CHACE stated that the Board of Health had been backward in making any regulations from the fact that they lacked a unanimous expression of the profession. He would like very much to have a definite statement by this Association.

Dr. WHITE remarked that he was pleased to observe the entire unanimity existing in the expression of the views of the Association, and would offer the following proposition as expressing in a condensed form the opinion of the members: 1. The terms scarlet fever and scarlatina are synonomous. and are applied to one and the same disease.

2. Scarlet fever is prevailing in the city at present as an epidemic, but it is not unprecedented in severity.

3. It is communicable and can be carried in clothing.

4. Under such circumstances in all individuals who are made susceptible by the epidemic influence, it is developed by individual contact, although occasionally it may arise de nevo.

The

5. Patients should be isolated from the commencement of the attack until the full period of desquamation is passed. period of incubation is not well settled.

6. Hygienic care in the sick room is of great importance, including ventilation, cleanliness of person and clothing, good food, etc. 7. The secretions of the body should be immediately disinfected. 8. After the termination of a case the room which the patient has occupied should be thoroughly disinfected, ventilated and cleaned.

9. The use of belladonna or other so called preventative medication, is of no value. Keeping the individual in a condition conductive to perfect health is the best means of preventing or mitigating the disease. Impure air, uncleanly and crowded apartments, are liable to add to its severity.

10. Treatment is to be pursued upon general principles. Each individual case is to be treated as the symptoms present themselves. So-called specifics are wholly valueless.

11. It seldom attacks the same person the second time.

12. Great care should be exercised in avoiding undue exposure for sometime subsequent to convalescence, as troublesome and often dangerous sequelæ are apt to follow.

On motion of Dr. SAMO, seconded by Dr. WYCKOFF, this summary was unanimously adopted, and the Secretary instructed to prepare copies for the public press.

The propositions for membership of Drs. Willoughby and Bielby were received, and, under the rules, were laid over for one month.

On motion, the Society adjourned.

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ART. III.-Clinical Remarks upon Surgical Cases occurring in the Buffalo Hospital of the Sisters of Charity. By Prof. Julius F. Miner, M. D. Reported by W. W. MINER, M. D.

CASE XVI.-Angular Curvature.-The diseased condition which is the origin of the deformity noticeable in the back of this child, is known as angular curve or Pott's disease of the spine. The deformity is in the upper part of the dorsal region, and is unfavorably located as far as treatment is concerned. It cannot be perfectly restored, and you should not be persuaded otherwise. Writers on this subject have claimed more than facts will warrant. Apparatus has been recommended, which is constructed with a hinge, placed opposite the angle of the spine, and the design of it is to force a restoration of the vertebrae to their normal position, the obliteration of the angular deformity. It attempts too much. The deformity is not capable of being perfectly removed, if any essential change has taken place in the vertebral substance. There is here also a degree of paralysis of the lower extremities; it has been noticeable for a month or two. Such condition is quite a frequent accompaniment in the course of the disease. It was formerly supposed that this paralysis arises from pressure upon the spinal cord by the displaced vertebrae. It is now known that it is due to an inflammatory condition of the cord, or of its membranes, rather than to direct pressure upon the nerve substance. It generally disappears in due time, and that while the curve has

been in no degree restored, and it rarely leaves any permanent ill effects. I had a patient with disease of the spine at the General Hospital some time ago, who was paralyzed for a whole year, but is now actively employed in a grocery story in this city.

An abscess is sometimes formed in connection with the diseased structures, and the pus formed may burrow in various directions, depending upon the location of the spinal disease and the anatomical character of the adjacent soft parts. It accordingly may find escape in the lumbar or cervical regions, or may follow the psoas muscles and open externally at a point quite remote from the main source of trouble. The generally entertained opinion of physicians is that spinal disease is of scrofulous or tuberculous origin. This opinion has long been held, and is not questioned by the majority of practitioners. The patients may present a large, tumid abdomen, pale face, thin muscles, anemic condition, and later, may have cough and consumption, but it seems to me that the tuberculous disease that may develop is not the primal source of the disease of the spine. If this is of itself tuberculous in character, one would expect that death would sooner or later be the result of spinal disease. I have for ten or fifteen years watched these cases to see if they were fatal, and have not found the first instance of this kind that would confirm the theory of tubercular origin. I am of the opinion that the disease is not tubercular or scrofulous in character, but that it is of the ordinary character presented by disease of joints and bones.

Though not susceptible of perfect restoration, the cases are greatly amenable to treatment. Local support is required, to relieve pressure and steady the natural movements; it will prevent farther progress of the deformity. Physicians all over the country are prescribing cod liver oil, iodide of potassium, etc., for this affection, and think that they are then doing well enough. These are good remedies to be sure, but they are not curative of the real trouble. It is doing next to nothing to give these patients medicines alone and tell them to take their chances. Care in treatment, local support, recumbency, rest, cod liver oil, iodides, tonic remedies, out door air, and all that the patient can eat, are necessary in the treatment of this disease. Any good physician can

order or contrive appliances that will generally mitigate and relieve the case he may have. The idea is to relieve the pressure that naturally comes upon the structures which have become involved in disease, and are no longer fit for their natural use.

An apparatus such as I show you, of firm material with a padded covering is made, having a stiff back, moulded to the peculiar shape of the spine, in the case for which it is intended, provided at its lower part with pelvic band that may be approximated closely to the pelvis and thus form a basis of support, while by means of arm pieces of elastic material projecting in like manner above, support may be given the shoulders or head, which will very greatly remove the weight of the upper portion of the body from the opposed surfaces of diseased vertebræ.

This relief of weight and pressure is a very valuable remedial agent, will generally prevent progress of disease and deformity, and greatly relieve the patient. We need not say much about bringing the parts back to their natural position and removing the deformity; it is quackery, I think, to talk thus and propagate such views. Many things have been written that I do not believe were done, or at least results are frequently to be inferred from