edy-if I may be allowed to say so-creosote, has been very satisfactory, especially in this tuberculous variety in which we find indigestion, and where the phthisical part of the organ is swollen and inflamed and a large amount of mucus is thrown off and is reabsorbed, producing sepsis. There is a sluggish condition of the mucous membrane of the stomach and entire alimentary canal, and in that condition I have found beech-wood creosote given in small doses-four or five drops in distilled water with the addition of orange peel after each meal, will aid digestion and check fermentation-not only in the intestinal condition, but also the condition which led up to it. I believe that papoid given in five or six grain doses will also aid in this condition which I have mentioned, where there is an excessive secretion of mucus.

Just one more remedy,-in a class of cases which are a very great annoyance to the physician-where sleeplessness accompanies the indigestion-where your patient not only suffers during the day the troubles of the damned, but where sleep does not come to refresh or rest at night. I have been greatly relieved for the last few months only in finding a remedy that will help in these cases, the chlorals, given in five grain doses three or four times a day with perhaps a larger dose, seven or eight grains, at bed time. The insomnia is the first relief, and then the intestinal indigestion.

By following out this plan of treatment, with the aid of other remedies, I think the disease will yield.

These are suggestions only, but have been found valuable in my own experience.

I wish personally to join with you in thanking Dr. Porter for his very valuable and interesting paper."

Dr. M. R. Crain : "Mr. President and Gentlemen :I have been very much interested and instructed in listening to Dr. Porter's paper. It is very far-reaching. I think there are more people who come to see the physician with various nervous troubles that are due primarily to indigestion than anything else. Another important cause, in my opinion, is the excessive use of tobacco and particularly among men of sedentary habits.

I think very many cases called neuresthenia are intestinal indigestion. Nervous prostration is certainly not a disease. It is only loss of vitality caused by impoverished nutrition, or it is not much less than indigestion, for if a person's digestion is good he can endure a great amount of nervous strain, and certainly that is an important factor.

A far as treatment is concerned, I think muscular exercise is of primary importance. At this day when people think they can afford but little time, you must prescribe some exercise by which they can use and call into employment a great many muscles within a short space of time. Probably the old practice of horse-back riding is one of the very best. I think also that bicycle riding is excellent in this respect, as I can testify from my own experience within the past week that it calls into play a great many muscles at the same time.

Dr. Branch: How about sawing wood?

Dr. Crain: Well, the great trouble with that, I have never found anyone who particularly enjoyed it.

Dr. O. W. Sherwin: Mr. President and Gentlemen : We all know the opposition we meet with when we prescribe care in the use of foods. I have been opposed by patients who did not like to abstain from the use of fruits, as they felt that in all gastric troubles the use of fruits

seemed to relieve the present symptoms. I think we should study well in each particular case whether we should advise against the use of fruits.

He

Another thing—I saw a case of Dr. Richmond's. said he had a patient whom he would like to have me visit. He said he was not quite positive as to the nature of the trouble. There was some pain in the region of the gall bladder, and some enlargement as well. I examined it as well as I could, found a hard tumor there, but could not detect any stones, and I gave it as my opinion that it was

cancer.

About a month afterward he had Dr. Stevens see the case and operate on it. He informed me that nearly a pound of gall stones were removed. I was unable to detect anything in the nature of gall stones, but such was the result.

Dr. L. M. Greene: Mr. President and Gentlemen: In regard to Cholelithiasis, in speaking, one gentleman here recommended the free use of hydrocarbons, but I must say that my experience is directly opposed to that. In my experience, it is the heavy meat eaters who are prone to gall stones, and as reason for that, I believe Dr. Porter spoke in his paper about the use of alkalies. That, of course, is only one of the ways of taking care of the cases. In my experience it is always in heavy meat eaters that we find gall stones, and the most satisfactory result is gained by prevention of the disease.

Dr. A. T. Woodward: Mr. President and Gentlemen: I rise to thank Dr. Porter for his paper,-not because it is entirely new to ime, but because I have read Dr. Porter's books on the subjects of digestion and assimilation and have got more meat from them than from any other work

that I have ever read or looked at. He has given me more points than I have ever got from any other source.

I did not rise to attempt to add anything to this discussion for you don't want candle light after you have had the full blaze of a noon-day sun on a subject; but I wished to thank Dr. Porter personally for his most excellent paper.

Dr. Porter: Mr. President and Gentlemen: I would say that I have been very successful in the expulsion of gall stones by hydrostatic pressure, brought about by stimulating the secretion of bile to the highest possible point, and in this way exerting a pressure sufficient to carry off the stone.

In

Among therapeutic agents, I have found in my practice that it keeps the case more comfortable if we will make it a rule to use salines between the severe attacks, and add some stimulant at the time of attack to get the necessary hydrostatic pressure upon the gall stones. this way, I have succeeded in bringing away stones measuring 11⁄2 inches in length and 3/4 of an inch in width. I do not use opium. If you use opium, you will not get the hydrostatic pressure and the successful results of the other remedies. I have used to alleviate pain, exalgin, cocaine, phenacetine and salicylic acid. You can in a measure control the pain by this combination. It may be that these are all coincidents, but it seemed to me directly as a result of treatment.

Cases of Tuberculosis Treated with Tuberculin and Antiphthisin.

By L. M. Greene, M. D., Bethel, Vt.

I am aware of the fact that tuberculin as a remedial or curative agent is very unpopular at the present time; but having treated two cases successfully with it I thought it might be of some interest to the society to get a report of these cases.

The first case is one that was treated by Dr. Charles Denison of Denver at first, and subsequently by myself. Dr. Denison treated the case with tuberculin to begin with for diagnostic purposes only. She had athritis of the knee joints contracted while nursing a sister three years previously, who died of tubercular disease of the pelvis and spine. During the three years after she had contracted the disease she had been treated by various surgical measures in hospital, etc., with no good results, always being obliged to get about in a wheel chair. General reaction followed the injection of the third, sixth, seventh and ninth milligramme doses, also slight local reaction in the left lung where she had, ten or twelve years before, suffered some slight diseases. A diagnosis of tubercular disease of the knee joints was thus established.