Professor of Diseases of Children in the Baltimore Polyclinic, Baltimore, Md.

It is said of Baltimore that socially it is different from other large cities in the freedom as well as the cordiality with which it extends its hospitality. The business men and their clerks are polite and attentive. They do not display the trait, so common in the metropolis, of incognizance—even to rudeness—if one chances to be on a tour of inspection instead of purchase. The impression is at once made, and very forcibly, that a Baltimorean has plenty of time, that he is not hurried. He will stop on the street and direct a discomfited stranger, and has been frequently known to turn aside from his duties and accompany the lost one to where he could take care of himself. This is a natural element in the entire populace, and is very prominent in the medical profession. A stranger is welcomed so heartily that he feels at home immediately, and can settle down among friends.

It occurs to me that this easy-going feeling has had much to do in keeping our city from occupying the prominent position in education and authorship that her opportunities, and conditions in general, would lead us to expect. I am glad to say that she is arousing from her lethargy, and recently her pen has been busy. Several works have emanated from the profession here which have attracted much attention, and have been quite extensively read. Notably among them is a 'Text-book of Hygiene,' by Dr. Rohe, and 'The Physician Himself,' by Dr. Cathell, which has reached a fifth edition and a sale of over fifteen thousand copies. I should like to say, concerning these two works, that no physician, especially if he be under thirty-five years of age, should be without them. Two other works, 'A Manual on Nervous Diseases,' by Dr. A. B. Arnold, an old, experienced and able teacher, and one on 'Practical Chemistry,' by Dr. Simon, have been much studied and commented upon. They are limited to special subjects and will not naturally obtain a large class of readers. These, like the long-delayed blade of corn, which pushes its emerald tip heavenward and bears upon its face the sparkling matin dew, give promise of a fertile soil and of abundant fruitage.

At the last meeting of the Medical and Surgical Society—which we had the pleasure of attending—there was an interesting discussion on cerebral troubles of syphilitic origin. A number of cases were related. The various symptoms of these maladies are familiar to your readers. The treatment which was successful in all but one of the cases here reported, was mercury and iodide of potassium. The plan preferred for the administration of mercury is by inunction. All the debaters insisted upon the full constitutional effects of the drugs. As one gentleman put it, “the system must be saturated before a cure is assured.”

I might mention among the symptoms, that those manifested by the eye were not regarded as reliable. In one case the only manifestation was a persistent and severe supra-orbital and occipital neuralgia, and for some time the man was in consequence wrongly treated.

One physician noted insomnia as a distinct and always present symptom. Also as a point of differential diagnosis between the convulsions of epilepsy and those of local lesion of the brain, that in the former there is no consciousness of having a convulsion, while in the latter such consciousness is very clear, at least at the beginning of the spasm.

A case of pelvic peritonitis of the chronic form, reported by the president of the society, elicited much discussion, especially upon the subject of exploratory abdominal incision as a means of diagnosis. He noticed that the younger surgeons favored the operation, but the older ones were more conservative.

A member reported one of those peculiarly (excruciatingly, I ought to say) interesting cases of labor, in which, by great exertion on his part, and the assistance of two physicians and three (I think is the number) midwifes or old ladies, he managed “to save the old man,” though the other parties concerned passed on into the mysterious future. (The society is expected to laugh a good deal just here, and of course we expect the readers to do the same.)

At a recent meeting of the Baltimore Medical Association a member related the following experience: In a family of three children, the oldest, who had scarlatina four years ago, contracted diphtheria; in a few days a younger one became ill with the same disease, but accompanied in forty-eight hours with a distinct eruption of scarlatina. A few days later the youngest was stricken with scarlatina, but had no symptom of the diphtheritic trouble.

The report brought out the thought of most of the members present. The two questions of “the identity of pseudomembranous croup and diphtheria,” and of “diphtheria a local or a constitutional disease” were again argued, and, as usual, no opinions were changed. Like the Scotchman, each was willing to be convinced, but he could not find any one able to convince him. Two points were fully agreed upon, namely, that the presence of membrane in the fauces, and of sequellÆ, are not of importance in diagnosis; also that nearly all of the cases in which the posterior nares becomes seriously implicated are fatal. One gentleman advanced the opinion, supported by “statistics” (as accommodating a friend as “facts”), that when the submaxillary glands were enlarged in this disease recovery took place; when they were not enlarged, death occurred. The doctor did not say that death occurred at once or within a few days, so we shall be charitable and suppose that he meant sometime during the succeeding hundred years.

Notes of two very interesting cases of myelitis, followed by spastic paraplegia, were read and discussed. The author made special mention of the exaggerated tendon-reflex being always present in disease of the lateral tract of the cord, and that this symptom is diagnostic—if hysteria be first excluded. He also noted in these cases that the condition of the muscles of the posterior portion of the legs (lower) was very tense, producing an impression on grasping them similar to that noticed on grasping a piece of iron. Neither of these men were able to place the heel upon the floor when standing erect. No amount of effort on their part could enable them to accomplish it. Neither of them were improved by the use of the iodides.