that had antitoxin at least twelve hours before being operated upon was twelve, of whom nine recovered; at the time of operation or within twelve hours preceding it, twenty-eight, nineteen of whom recovered; three to eight hours after, five, three of these proving fatal. The complications were marked septic infection in fifteen cases, nephritis in two, and bronchopneumonia in five. Death was caused in eleven instances by sepsis; in two, by bronchopneumonia; in two, by sudden plugging of the tube by loosened membrane; and in four from exhaustion.

The writer's conclusions are that it matters but little, what may be the sex, age or condition of the patient at the time the intubation is done, but to have the prognosis good, it is absolutely imperative that a large dose of antitoxin must be given within forty-eight hours of the inception of the disease and that at least ordinarily intelligent nursing be bestowed upon the little patient.

DISCUSSION.

Dr. Loomis.-If cases are taken early enough there is little danger from the operation per se.

Dr. Swasey. In this paper is any distinction made between pseudo-membraneous croup and diphtheria? Formerly in these two diseases the result was uniform— all died. Since the use of antitoxin results have been better. He had one case of undoubted laryngeal stenosis. The child evidently could not live until morning but with the use of antitoxin it became better and convalesced. How can we ascribe to intubation alone the credit of the cure, when both the serum and the tube are used? We generally give the credit to the former. Intubation since the introduction of antitoxin, is becoming obsolete.

Dr. Wright.--In most of the cases a bacterial examination was made and in all but one Klebs-Loeffler bacilli were found.

Dr. Abrams wanted to know how many cases Dr. Wright had had in a year. He has a nice intubationset and would like a chance to use it. There has not been

a case of intubation in Hartford since antitoxin was introduced. He has seen six cases, all of which would have been fatal without antitoxin, all of which recovered with it. He would like to ask Dr. Wright how many cases he has had in a year.

Dr. Beckwith congratulated Dr. Wright on his success. If one can become familiar with the instrument he will get good results. If one can only relieve the terribly distressing dyspnea it is accomplishing much. It must be allowed that the doctor's deductions are correct. It would seem that there is not that irritation in the larynx which produces bronchopneumonia. We ought to be thankful to Dr. Wright for his paper.

Dr. Durell Shepard.-Dr. Wright has intubated a number of cases for him and the relief of the dyspnea was great, the greatest relief to a patient imaginable. If it was one of his own children he would have intubation done in preference to tracheotomy.

Dr. Wright said that he had not intubated every case. Since he first used antitoxin he has had one hundred and ten cases of laryngeal stenosis. The only ones intubated were the worst. Many in the room can certify as to the necessity of intubation. Of fifty or more who were not intubated, six or seven died. He has done many who were perfectly hopeless at the time. Like other physicians who do a good deal of a certain kind of work, he has devised a change in the O'Dwyer instrument. This is to facilitate the grasping and the distending of the tube.

MUSHROOMS AND MUSHROOM POISONING.

G. N. LAWSON, M.D.,

MIDDLE HADDAM.

Interest in the study of our edible fungi has been growing rapidly for several years, due largely to the inspiring articles and book of our late artist-naturalist, William Hamilton Gibson. This popular interest, like most good things, has its advantages and its dangers, and both should be thoroughly understood by our profession.

Every year thousands of pounds of nourishing food go to waste in our fields and woods, which might be made available if the people had a knowledge of our wild mushrooms. For centuries the Chinese have made the fungi an important article of diet, and in Europe they are extensively used, more than thirty tons being sold in Rome each year. In this country comparatively few people are familiar with the edible species which are found growing wild, and the very high prices at which cultivated mushrooms are sold prohibit their use by any but the more wealthy people.

The nourishing qualities of mushrooms are unquestionable, for although like most vegetables, they contain eighty or ninety per cent. of water, the dry substance contains twenty to fifty per cent. of protein.

Thus chemically they more resemble meat than vegetable substance and on this account decay rapidly and should be eaten only when perfectly fresh and should be used with the same moderation as animal food.

In this State we probably have about seventy-five species of mushrooms which are known to be valuable for food. Of these I have eaten about twenty species. Besides these there are five hundred or six hundred

others, many of them known to be injurious when eaten, but by far the largest number are yet untested. The number of species which are known to contain a deadly. poison is three or four, but there are many others which would cause sickness if eaten, as they are bitter, emetic, cathartic, indigestible, or in some other way distasteful to the digestive organs.

The question now arises, how shall we distinguish the edible kinds from the poisonous. Various rules have been suggested, but all are misleading and worse than useless. Two of the most common of these fallacious rules are that a mushroom is safe if it peels easily and that all poisonous mushrooms will discolor a silver spoon while they are being cooked. The only safe way is to know each species which we would eat as we would know an esculent vegetable from a poisonous weed-by its specific characteristics. There are two ways to study mushrooms. One is to take every new species to an expert, find out its name and nature, and make yourself familiar with its appearance. Experts are, unfortu nately, not always at hand, so most of us will have to resort to the second method and get our knowledge with the help of books. Here a new difficulty confronts us. Most of the literature on American mushrooms is scattered through various publications and Agricultural reports. Mr. Charles H. Peck, State Botanist of New York, who is one of the best authorities on American fungi, tells me that he is preparing the way for a treatise on the mushrooms of America, but that the attempt to write such a work now would seem rather premature, as twenty-five or thirty new species turn up each year in New York alone.

The books which I should recommend are the following, and they might be obtained and read in the order I give them:

Gibson's "Our Edible Toadstools and Mushrooms," Harper Bros., $7.50.

Report of Charles H. Peck, State Botanist of New York, for 1895, published by James B. Lyon, Albany, N. Y.

Underwood's "Suggestions to Collectors of Fleshy Fungi," Cambridge Botanical Supply Co., Cambridge, Mass., twenty-five cents.

Peck's "Boleti of the United States," Cambridge Botanical Supply Co., forty cents.

Then if one wishes to go into the more scientific study of the subject, the best book for the further identification of species is Masse's "British Fungus Flora," four volumes at $2.00 a volume, McMillan. The parts may be had separately and those specially valuable are the first three volumes.

Lists of mushroom literature may be obtained from the Cambridge Botanical Supply Co.

There are mycological societies in Boston and New York for the study and testing of mushrooms.

MUSHROOM POISONING.

There are two classes of mushrooms, which I will name as the irritating and the deadly. The first class is poisonous because its members are irritating to the digestive tract. These fungi usually have a bitter, peppery or other unpleasant taste or are tough and therefore indigestible. Common examples of this class of fungi are russula emetica, lactarius piperatus and boletus felleus.

The treatment for a case of poisoning from eating mushrooms of this class is to give an emetic and to meet any indications that may arise.

A good formula is olive oil and whiskey, equal parts, to be given p. r. n. Vinegar and whiskey has also been

recommended.

A certain time elapses between the eating of a poisonous fungus and the manifestations of symptoms of