cent; excluding the cases moribund at the time of injection or dying within twenty-four hours, it was 8.8 per cent. (8) The most striking improvement was seen in the cases injected during the first three days Of 4,120 cases the mortality was 7.3 per cent; excluding cases moribund at the time of injection or dying within twenty-four hours, it was 4.8 per cent. (9) The mortality of 1,448 cases injected on or after the fourth day was 27 per cent. (10) The most convincing argument, and to the minds of the committee an absolutely unanswerable one, in favor of serum therapy is found in the results obtained in the 1,256 laryngeal cases (membranous croup.) In one-half of these recovery took place without operation, in a large proportion of which the symptoms of stenosis were severe. Of the 533 cases in which intubation was performed the mortality was 25.9 per cent., or less than half as great as has even been reported by any other method of treatment. (11) The proportion of cases of broncho-pneumonia-5.9 per cent.— is very small and in striking contrast to results published from hospital sources. (12) As against the two or three instances in which the serum is believed to have acted unfavorably upon the heart might be cited a large number in which there was a distinct improvement in the heart's action after the serum was injected. (13) There is very little, if any, evidence to show that nephritis was caused in any case by the injection of serum. The number of cases of genuine nephritis is remarkably small, the deaths from that source numbering but fifteen. (14) The effect of the serum on the nervous system is less marked than upon any other part of the body; paralytic sequelæ being recorded in 9 7 per cent. of the cases, the reports going to show that the protection afforded by the serum is not great unless injections are made very early. L. EMMETT HOLT, M. D., ACTION OF THE SOCIETY.-At the close of its presentation, the Society voted to accept the report of the committee, and, after a full discussion, it was decided to embody its conclusions in the following resolutions : (1) Dosage. For a child over two years old, the dosage of antitoxin should be in all laryngeal cases with stenosis, and in all other severe cases, 1,500 to 2,000 units for the first injection, to be repeated in from eighteen to twenty-four hours if there is no improvement; a third dose after a similar interval if necessary. For severe cases in children under two years and for mild cases over that age the initial dose should be 1,000 units, to be repeated as above if necessary; a second dose is not usually required. The dosage should always be estimated in antitoxin units and not of the amount of serum. (2) Quality of Antitoxin. The most concentrated strength of an absolutely reliable preparation. (3) Time of Administration. Antitoxin should be administered as early as possible on a clinical diagnosis, not waiting for a bacteriological culture. However late the first observation is made, an injection should be given unless the progress of the case is favorable and satisfactory. The Collins Hospital Buildings for the Great State Institution to be Erected Near Buffalo.-Eight years ago an act was passed by the Legislature empowering the Erie County Board of Supervisors to select a site and proceed with the erection of a County homoeopathic hospital for the insane. The Hon. William P. Letchworth lent his influential aid to the scheme, and men of prominence in the medical profession assisted in its promotion. The promoters had for their primary object the establishment of a hospital on the cottage plan, wherein patients or their friends whose faith was pinned to homeopathic treatment would be enabled to secure it. On the Board of Supervisors at that time was Fred. J. Blackmon, and with commendable energy he determined that if there was to be a new hospital building in Erie County it should be located in his town, the Town of Collins. Finally the site was selected, the committee of selection recommending the purchase of the Taylor Brothers' stock farm, and Supervisor Blackmon's efforts were rewarded. The farm consists of 500 acres, lying between the Collins station of the Erie Railway and Gowanda, about 30 miles southwest of Buffalo. 46 Having succeeded so well, the homoeopathic profession throughout the State turned their guns towards the Legislature, and in 1894 the State bought the farm from Erie County, and passed an act creating the Collins State Homœopathic Hospital to afford to the homoeopathic medical profession, and to its adherents, a hospital, and the securing to them the care and treatment of their insane upon homoeopathic principles of medicine." In the establishment of this institution its promoters have been opposed at every turn. Even the State Lunacy Commission fought it up to the last session of the Legislature, but the claims of the homœopathic school were finally admitted, and last winter the board of managers received a grant of an additional $100,000 with which to erect preliminary buildings The plans were immediately prepared, and they have been approved by the State Commission and State architect, leaving nothing more to be done but to award the contracts and build as far as the appropriation will permit. A picture in the Buffalo Express shows the general character of the first group of new buildings. Provision is made therein for the accommodation of 120 patients. The plan, however, is to build comfortable cottages of attractive design, distributed about the site in harmonious and convenient arrangement, the object being ultimately to have accommodations for at least 1,500 of the State insane. The new buildings will be situated on a bluff and will command a fine view of the surrounding country. Sewers are now being dug to the Cattaraugus Creek, a mile away, and during August the contracts were let and the masonry and work begun. The plans for the new hospital were drawn by Architect Aug. A. Esenwein of Buffalo. They provide for a preliminary group including the administration building, medical office and library and one half of the reception cottage. The administration building will be built of red brick and Medina stone, and will be a substantial and attractive structure. It will be 90x102 feet in dimensions and three stories high. On the first floor will be reception rooms, parlors, offices for the superintendent, supervisor and medical staff, and dining-room and kitchen. The second floor is divided into sitting-room, library, board-room, two suites of apartments for the families of the superintendent and the supervisor, and single bedrooms for the medical staff. The third floor is arranged in single sleeping rooms for the attendants until separate quarters are built elsewhere for them. Baths and all other modern conveniences are provided in the administration and all other buildings in the group. In the rear of the administration building, and connected therewith by by a corridor 40 feet long, is a building containing the medical office, medical library, dispensary and large recreation or sun rooms for patients under close observation. Three other corridors radiate from the medical office, one leading to the general dining hall, kitchen, laundry and power-house; and the others to the reception cottages for male and female patients. Of the cottages only one will be built this fall. It will be 200 feet long and 144 feet deep, and will have ample accommodations for 120 patients. In harmony with the rest of the group the reception cottage will be constructed of red brick with stone trimmings. It will be two stories high, and will be devoted entirely to the uses of the patients. There will be long corridors on the first floor in which they may walk about to their hearts' content, and comfortably furnished parlors and sitting rooms in which they may rest or lounge. The same plan is utilized for the second floor excepting that the corridors are turned into dormitories and the other rooms into attractive bedrooms. Twelve single rooms on each floor are reserved for patients under special treatment, and on each floor, also, is a hospital ward to contain 12 or 14 beds each, and an adjoining surgery and bath-room. There is besides, a separate dining room for the inmates of the reception hospital. Detached from the reception hospital and connected therewith by a corridor will be a building to be known as the water wing" It is in realty a general bath-room for the patients, and one will be connected with each of the detached cottages as they are built. That in connection with the first building will be 22x 52 feet in dimensions and two stories high, and will be fireproof with mosaic floors, tiled walls and approved sanitary arrangements. The preliminary group will be ready for reception of patients by the middle of next summer when work will begin on the power-house so that the buildings may be properly heated when the cold weather arrives. On the completion of the power-house work will begin on the other reception cottage which is planned to flank the administration building on the opposite side. The detached cottages will follow year by year until the entire scheme is carried out and the Collins State Hospital is made the best example of the cottage system for the care of lunatic patients in this country. The plans for the cottages are now in the hands of the State Lunacy Commission. While they are of different design architecturally, the idea of airy, sunny, bright day rooms is carried out in each, and great care has been exercised in preparing a general system of perfect sanitation. Although the buildings are necessarily plain, the Commission allowing only an average expenditure of $550 per patient in the erection of a hospital accommodation, the buildings and cottages promise to form a very effective group. A cottage will be built at a considerable distance from the others for chronic and turbulent insane, and the male and female patients will be strictly isolated. The first Board of Managers was appointed in 1894 and continued in office until the present time, although under an act passed at the last session of the Legislature and which came into force on July 1st, the present Board of three was legislated out of existence preparatory to the appointment of a Board of seven members, uniform in number with the Boards of all other State hospitals. The new Board must be appointed by the end of next December. In the mean time the old Board is pushing the work of sewer construction and is preparing in other ways for the erection of the first portion of the first group of the new buildings. The Board as at present constituted, consists of Dr. Wiliiam T. Helmuth, New York, president; Dr. Asa S. Couch, Fredonia, secretary; and Fred. J. Blackmon, treasurer. These will in all probability, be included in the new Board. Homœopathic Medical Society of Chicago.-The first meeting of this society for the season of 1896-97 will be held at 8 o'clock P. M., Thursday, September 17th, at the Auditorium Hotel, Chicago. During the early part of the winter, papers will be read according to the following: PROGRAM: September 17. First Meeting. Essayist :-Sheldon Leavitt, M. D... Subject:-"The Obstetrical Forceps. Dr. Leavitt will take up thesubject from the clinical side. 1. Some attention will be given the instrument itself—its design, its best form, etc. 2. The different modesof application, including the different positions and presentations. 3. Conditions calling for the forceps. 4. Dangers, etc. Demonstrations with instruments will be made on the pelvis or manikin. Prints and drawings will be used for purposes of illustration. Essayist. -Charles Adams, M. D. Subject: Reckless Surgery.'' Dr. Adams' paper is a protest against the too free use of the knife-thefuror operanol;-to which many members of the profession are prone now-a-days. Clinic :-Dr. A. E. Thomas will present two cases of rare. and anomalous forms of heart disease. October 15. Second Meeting. Essayist:-John W. Streeter, M. D. Subject: Treatment of Retroversion of the Uterus." Essayist :-B.. S. Arnulphy, M. D. Subject :-"The Angina that kills." A Es December 10. Fourth Meeting. Essayist:-J. H. Buffum, M. D. Essayist:-C. Gurnee Fellows, M. D. Subjects :-To be announced. January 15. Fifth Meeting. Essayist :-E. S. Bailey, M. D. Subject:-"The Renal Insufficiencies in their Relation to the Medical Diseases of Women." Essayist :-Wm. G. Willard, M. D. Subject :"Peritoneal Tuberculosis. At the February meeting Dr. Julia Holmes Smith will read a paper on A Consideration of Some Pathological Conditions at the Time of Puberty." The other essayist for this evening has not yet been assigned. Papers will also be presented by Dr R. Ludlam, Dr. H. R. Chislett, Dr. W. W. Stafford, Dr. Howard Crutcher, and possibly one by Dr. Ch. Gatchell, on “ Incipient Phthisis, Pulmonalis; Diagnosis and Treatment." Announcement cards will be sent to all Chicago physicians two days before each meeting. CH. GATCHELL, M. D., Prest. Jos. P. COBB, M. D., Sec'y pro tem. AN OPEN LETTER TO THE HEALTH BOARD OF MISSOURI. HAHNEMANN MEDICAL COLLEGE AND HOSPITAL OF PHILADELPHIA. PHILADELPHIA, PA., July 4th, 1896. TO THE STATE BOARD OF HEALTH OF MISSOURI : GENTLEMEN :-The Faculty of this College has recently received a printed circular, without date or signature, which bears internal evidence of having been issued by your Board, and as the envelope in which it was mailed bears the representation of your seal and the name and address of your secretary, we assume it to have been sent by your authority. The circular announces itself to be a statement of the Minimum Requirements of the State Board of Health of Missouri." It appears to be rather a statement of demands made by that Board upon the medical colleges, compliance with which will save them from the punishment of being placarded as "not in good standing." Some of the "requirements'' set forth in the circular are as follows: 1. Conditions under which you will permit a medical college to admit students to its classes. 2. A list of the persons and institutions whom you have authorized to inquire into, and decide upon, the qualifications of applicants for ad mission. 3. The branches of medical science you are going to have taught in a medical college. 4. The number and duration of the college terms or sessions, the duration of time you haye ordered for certain branches to be taught, and the (graded) arrangement or consecutive order of studies you require the college to follow. 5. Your orders and rules of discipline, conduct, and management of the college: (a) As to the regularity of the students attendance; the amount or aggregate of absence for which you will permit the Faculty to make allowance. (b) As to the methods of imparting instruction which you command the teachers to adopt and pursue; the number of quizzes they must give in a specified time. (The number of lessons required in the same time is omitted, being probably considered immaterial). (c) As to the persons you will permit to conduct the final examinations, thereby prohibiting from this duty those who are by law charged with its performance. 6. Your requirements as to the sufficiency and efficiency of the corps of college teachers, and the facilities possessed by the college for imparting instruction. 7. The value you will permit the medical college Faculty to attach to a course of studies pursued in a college of Pharmacy or Dentistry. In these "requirements" and permissions, you have practically asserted your purpose to control almost every function of the Faculty of this college. You dictate to it who and what its students shall be, what shall be their qualifications and how they shall gain admission to its classes. You, in effect, forbid the Faculty to examine an applicant to ascertain his fitness for admission, and you constitute and appoint agents outside the college authorities to execute your orders and to examine applicants for admission, and you make these appointments without reference to the wishes, opinions, or rights of the Trustees or Faculty. You command the Faculty, under penalty of your displeasure; to make careful records of the acts of these, your agents, so far as these acts refer to persons admitted to the college, and to submit a copy of these records, under oath and the seal of the corporation, to your Board annually; and the idea of assigning a reason for this unheard-of requirement seems not to have occurred to you. You dictate the course of studies, the branches to be taught, the (graded) order of their presentation and the time to be devoted to each of them,-though, as yet, you have issued your orders respecting only a portion of them. You issue a mandate respecting the "mode'' in which the teachers shall carry on their work of instruction, and thus assert the prerogative of controlling and directing the educational work of the college You assume charge of the college discipline, and lay down rules for its order and government. Finally, you propose, whenever practicable,'' to dictate the |