tion with Dr. J. S. Carpenter and Assist. Surgeon H. R. Sillyman, U.S. Army. On lifting the skull-cap, some ecchymosed spots were found upon the brain just under the seat of fracture of the os frontis. That bone was fractured in a radiated manner, without depression, excepting at the extreme corner of the outermost fragment, where probably a half inch of the fragment was pushed below the natural level. The depth of depression was perhaps one-eighth of an inch. The brain was congested to the extent of possibility. The ventricles were full of fluid. On examining the floor of the skull, it was found that the temporal bone was badly fractured in its petrous portion. The sphenoid was separated from its connection with the left temporal, and the impression of a number of disconnected fragments communicated to the finger. One of these was lifted out by a person present, while he was verifying the examination. In reviewing this case, several points of interest may be remarked. 1. As to Diagnosis.-The hemorrhage from the left ear indicated, of course, fracture of the base of the cranium. This was announced to the friends, and an unfavorable issue stated probable. At the same time, the diagnosis between compression and concussion had to be made. Entire consciousness was restored within five hours after the accident had been received. The pulse was regular and frequent. No stertor occurred, and no symptoms of compression. could be found, except that the pupil of one eye was somewhat more dilated than the other. It was therefore concluded that compression did not exist, and that the depression of the forehead was chiefly (if not entirely) dependent upon the outer table of the os frontis being driven in upon the inner. It was supposed that the fracture was a fissured one of the internal table, and that there was no great effusion of blood beneath it. 2. As to Treatment.-It is evident that, upon the preceding diagnosis, treatment could be only palliative, sustaining, and expectant. No operative procedures could be deemed for a moment desirable or expedient. For, plainly, if fracture of the basis cranii were diagnosed, trephining could afford no remedy, even had compression been believed to exist. But as six days passed by without symptoms usually attendant on compression being manifested, there was no excuse for any surgical interference. The erysipelas intervening on the scalp was readily met and subdued by local means; the restlessness was treated by sedatives to the nervous system; the strength husbanded by appropriate nourishment throughout; and the fatal event (due to effusion and pressure on the base of the brain) was attempted vainly to be stayed by watery purgation, blisters, and arterial sedatives. The temptation in such a case would be to useless surgery. The antidote is a clear and sure diagnosis. There is one point worthy of notice, and that is the long period (six days) before effusion and compression occurred. It would be interesting to know why the irritation from the broken fragments was not earlier carried to a fatal extent, or whether the treatment employed had any effect in prolonging the period of consciousness. OFFICERS AND MEMBERS. President.-JAMES S. CARPENTER, M.D. Corresponding Secretary.-JOHN G. KOEHLER, M. D. Drs. W. T. BEACH, Jos. W. BIRD, D. W. BLAND, GEO. W. BROWN, T. B. CASTLE, MEMBERS. Drs. THEO. A. HELWIG, E. HUNTZINGER, J. G. KOEHLER, J. C. McWILLIAMS, C. T. PALMER, G. L. REAGAN, B. F. SHANNON, JACOB F. TREichler. OFFICERS AND MEMBERS OF THE SUSQUEHANNA COUNTY MEDICAL SOCIETY. President.-Dr. C. C. HALSEY. Vice-President.-Dr. C. C. EDWARDS. Secretary. Dr. E. L. GARDNER. Treasurer.-Dr. WM. L. RICHARDSON. Delegates to the Medical Society of the State of Pennsylvania.— Drs. C. C. EDWARDS, J. W. COBB. Delegates to American Medical Association.-Drs. L. A. SMITH, WM. L. RICHARDSON. OFFICERS AND MEMBERS OF THE VENANGO COUNTY MEDICAL SOCIETY. President.-B. GILLETT. Vice-President.-S. G. SNOWDEN. Secretary.-W. S. WELSH. Treasurer.-W. L. WHANN. Censors.-S. G. SNOWDEN, J. R. AETER, D. C. GALBRAITH. Delegates.-B. GILLETT, ROBERT CRAWFORD. Drs. J. R. AETER, L. E. BAUMAN, ROBERT CRAWFORD, J. M. DILL, T. M. EGBERT, D. C. GALBRAITH, MEMBERS. Drs. B. GILLETT, S. S. PORTER, W. L. WHANN. OFFICERS AND MEMBERS OF THE WASHINGTON COUNTY MEDICAL SOCIETY. President.-Dr. THADDEUS DODD, Amity. Censors. Dr. BOYD EMORY, Dunningsville. Dr. J. R. WILSON, Washington. Dr. A. M. REA, West Middleton. Delegates to the American Medical Association.-Drs. THOMAS MCKENNAN, STEPHEN L. BLACHLY, JAMES G. DICKSON, J. W. ALEX ANDER. Alternates.-Drs. H. D. ENOCHS, Jos. H. LITTLE, N. P. MORRISON, D. S. EAGLESON. Drs. J. W. ALEXANDER, MEMBERS. DAVID ANDErson, H. S. CHALFANT, M. H. CLARK, JAMES G. DICKSON, THAD. DODD, ELIAS F. DODD, S. T. DODD, GEO. A. DOUGherty, D. S. EAGLESON, BOYD EMORY, H. D. ENOCHS, STEPHEN E. HILL, Drs. WM. KING, Jos. H. LITTLE, N. P. MORRISON, T. H. PHILIPS, A. M. REA, T. R. STORER, S. S. STROUSE, |