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laid down by the books is useless, and the administration of turpeth mineral, which has been so highly recommended, has seemed only to produce a prostration which has hastened death. Tracheotomy in an ordinary private house in this region offers small chance for success.

Cerebro-spinal meningitis has prevailed at several different periods in the Northwest during the last sixteen years; sometimes being confined to special districts, but generally affecting, to a greater or less extent, wide areas. At such times its peculiar epidemic influence, like that of diphtheria, has changed and aggravated nearly every other form of disease.

It has always appeared in the early spring, and generally has disappeared with the first warm weather. Children have been most affected by it, and males apparently oftener than females.

The invasion has generally been rapid; a sudden and alarming loss of strength, patient feeling tired, with headache, sighing respiration, and an irregular pulse. Vomiting usually, and great thirst; soon followed by sore throat, swelling of face, and stiffness of neck. Delirium nearly always present, and often a semi-comatose condition.

The disease is often several weeks in duration. With us it has been very fatal, yet many cases recover under a stimulating treatment. It has been noticed that the pretty free use of opium is almost always necessary, and that it it beneficial in the end.

The deafness which always accompanies this disease has too often remained after recovery; and it is believed that this is the great cause of so large an increase of our deaf-mute population. The applications for admission to the deaf and dumb asylums are much more frequent than the natural increase of population would account for.

It is not known that any case of hydrophobia has ever occurred in Minnesota ; and the occurrence of rabies among the dogs and wild animals, which has been so common the past five years on the plains of Kansas and Nebraska, has never been known in this region.

Traumatic tetanus occurs occasionally, and is always fatal.

Although the heat in the middle of a summer day is intense, sun-stroke rarely occurs, and when it does, is readily relieved. It here always occurs in the daytime.

During the warm months diarrhoea and dysentery prevail to a considerable extent. They are usually of a mild form and easily

VOL. XXVI.-25

controlled. Epidemic dysentery appears only at rare intervals, but is occasionally quite severe. It is, however, not often a cause of death.

Epidemic cholera has never prevailed in this State. Sporadic cases of genuine cholera have been known to occur; and each time that cholera has been epidemic in St. Louis, a number of cases of that disease have been landed at the different river towns, by passing boats, yet in very few instances has it exhibited any tendency to spread, and then only to a limited extent. So far as this region is concerned, the evidence is altogether against the contagiousness of cholera.

The summer complaints of children are among the most certain diseases we see. They vary in type each year, sometimes being gastro-enteritic, or simple enteritic; another time entero-colitic; or too often cholera infantum.

Beginning after the latter part of June, and nearly always by the middle of July, these diseases prostrate large numbers of infants and small children; and very often they prove fatal. It has been noticed that when we have hot days, with cool nights, the children are most affected; and some of our best physicians think hot dry weather most likely to produce these diseases, yet, it is certain, some of our worst epidemics have appeared when frequent showers made the season delightful.

The children in the larger towns seem no more liable than those in the open country, and it is true that infants having good sur. roundings and intelligent care are nearly as often affected as any others. It is also true that at times a change of residence will do wonders toward the cure. A change of location often, from the town to the country, or from a close valley to the open prairie, will revive the most hopeless case, without material change in diet or treatment.

During some warm seasons there will be no genuine cases of cholera infantum, and only very slight gastric or enteric troubles; but nearly every summer, we see more or less nursing and teething infants, between the ages of eight and twenty months, die of what appears true cholera. An infant apparently well at bedtime, will rouse its parents in the night by its restlessness and vomiting. It will appear very hungry, taking milk or water with avidity, and almost immediately ejecting it; watery passages will come from the bowels. The babe will seem in pain, and have a scared look. Nothing will quiet it, but, throwing itself from side to side, it will

cry out sharply, and gradually grow weaker. In about twelve hours the eyes will be sunken, the fontanelles depressed, and all hope gone. Without regard to care or condition the child is struck as by a blow, and no treatment yet recommended will avail to prevent a fatal termination.

Diseases of the urinary organs are not very common with us, and they are rarely a cause of death, yet two of the most formidable of those troubles are met with so often, it is deemed necessary to mention them. They are renal calculi and albuminuria.

Whether from the general use of limestone water or from some other cause, calculi very often form in the kidneys, and attacks of renal colic generally follow. It is remarkable how few of those small calculi are retained in the bladder long enough to cause serious trouble.

Stone in the bladder is rarely seen.

Acute albuminuria as a sequel of scarlatina, measles, rheumatism, or syphilis; or resulting from exposure to a cold rain, or too long continued chilling of the feet, is frequently seen; and too often being neglected it becomes chronic. Even when chronic in its character, it is found that judicious treatment will long keep the patient in comparative comfort. Many physicians in this region are now satisfied that the water from the springs at Wakesha, Wisconsin. is of decided advantage in the treatment of this disease.

Skin diseases are oftener seen, and many of them are very obstinate. They are much more troublesome in winter than in summer.

The diseases mentioned above embrace about all that are seen with any frequency in this region.

The climate acts beneficially, no doubt, in the cure of all depressing morbid conditions, and this is especially noticeable in the excellent recoveries from syphilis, frost-bite, etc. It is certain, also, that it greatly aids recovery after wounds and surgical operations. On the other hand, it often over-stimulates the active thinker or worker of this section, and leads him to indiscretions which speedily tell on the brain ; resulting often in cerebral hyperæmia, nervous dyspepsia, partial paralysis, etc.

April 30, 1875.

PARTIAL REPORT OF COMMITTEE ON VENTILATION.

LANSING, May 1, 1875. U. I. BOWDITCH, M.D.,

Chairman of Section on State Medicine and Public Hygiene. SIR : I regret to inform you that, as Chairman of Committee on Ventilation, I have not been able to prepare any report. My time has been so occupied with work for our State Board of Health, that I have found it impossible to perform work in other fields. I exceedingly regret this, for I am deeply interested in the effort to improve the sanitary condition of our public schools.

Drs. Stuart and O'Sullivan have contributed valuable articles, which I inclose to you, to be presented to the Section.

Very respectfully,

R. C. KEDZIE, Chairman of Committee on Ventilation.

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Wixona, Minn., April 7, 1875. DEAR SIR : Shortly after receiving information of my appointment as a member of the Committee on Ventilation, of which you are chairman, I sent circulars to various persons in this State, whom I had reason to believe were giving attention to the subject of ventilation, and a few of whom, with myself, were experimenting in that direction. Among the latter is Dr. Hewitt, Secretary of the State Board of Health. One of his letters, pertaining more to the subject of ventilating school buildings than dwellings, I herewith inclose for your consideration; it now being too late for me to assist you in the report, were you to assign me any portion of the subject to work up.

Yours truly,

A. B. STUART.

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