the same loving and yet regretful spirit that you are showing toward Dr. Osler today.

In the name and in behalf of the Medical and Chirurgical Faculty of Maryland I accept this portrait, but what are we to do with it, where shall we place it? A few years ago I went into the hall of the Faculty on Eutaw street. The pictures of some of the men who have been an honor and an ornament to the profession here in Maryland and have sent the fame of American medicine throughout the world are in that hall. I found them not hanging upon the walls, but carefully taken down, so that the rain, which was coming in through the roof, and the dampness in the walls might not injure them. Those men, men and women of Baltimore and Maryland, attended you or your fathers and mothers from the hour of birth until they ceased to work. They have eased your pains or those of many dear to you, they have guarded you from disease and brought back to your cheeks the bloom of health, and they have closed the eyes of your loved ones in death. They deserve a better memorial than has yet been raised to their memories, a better and safer place in which to place their portraits.

They and those who came after them have built up, have accumulated a most valuable medical library, which is placed in the same building, a building which today, tonight, any time, may go up in flames. It may be, probably is, insured, but no money can replace some of those books. That library is used by the profession of Baltimore and Maryland, not for its own selfish purposes, not from the desire to gather knowledge for its own sake, but for your good, my hearers. It is your library in a very wide sense, used for your benefit, and valuable, and alone valuable, as and because it is so used.

Some months ago a committee was formed to solicit subscriptions toward a fund to place those portraits and that library in a fireproof building—a building which would afford also a meeting place for the various medical societies of the city and this State organization, a building which would be an ornament to the city and the pride of the profession.

This movement had its origin in a desire to mark in some way our appreciation of Dr. Osler's services to this Faculty, services which have been of inestimable value in building up the library and in fostering in the profession that "unity, peace and concord" which has formed the topic of his farewell address.

No testimonial I know would be more acceptable to him than to be told that out of a desire to show our affection for him, our appreciation of his work for the profession and his contributions to scientific medicine, this building, which has been one of the cherished hopes of his life, had at last been erected.

Many generous subscriptions have been made, many members of the profession have subscribed more, I know, than they really could afford, but much remains to be done, and it is to you, for whose benefit, after all, citizens of Maryland and Baltimore, the library exists and these societies have been organized, it is to you that we look to complete the sum needed.

I feel sure many of you will feel gratified to have an opportunity to this

express your affection for some family physician, either now living or gone to his reward, and to show your appreciation of the life Dr. Osler has lived and the work he has done here in Maryland for you and for medical science We ask you, in the words of another, soliciting aid for a public purpose, to determine what you think you can subscribe, and then-to double it.

As for this picture, we will cherish it as we will cherish in our hearts and exemplify in our professional lives these last words of our most beloved friend and associate.

Society Reports.

THE JOHNS HOPKINS HOSPITAL MEDICAL

SOCIETY.

MEETING HELD MAY 15, 1905.

Clinical Features of Thyroid Hypertrophy.-Dr. Halsted said that one or more of the symptoms usually known as "exophthalmic goiter" might occur with various pathological conditions in the thyroid. Cysts, adenomata, carcinomata, and even "normal" thyroids had given such symptoms. No sharp line, indeed, could be drawn between perfectly normal people and those with extreme hypertrophy. The well-known symptom-complex is sometimes present without hypertrophy of the gland. The condition is more frequent in females (4.6 to 1), though late in life the proportion is smaller. The prognosis is bad, and it is doubtful if complete recovery has ever occurred. Twenty-five per cent. of all the patients die within a short time, and the rest remain in a state of labile equilibrium. Acute cases occur; one, reported in Nothnagel, appeared in two days and disappeared in eight. The mild form of the disease has been particularly studied by the French, but all observers have noticed that there is no sharp line of demarcation between normal patients and those with mild goiter. In the cystic cases there has usually been no hypertrophy of the non-cystic portions of the thyroid. In the Johns Hopkins Hospital there have been 46 cases of goiter with symptoms operated upon. The majority of these were mild, but a few were severe. There was one death in the series, and in this case nearly three-fourths of the gland was removed. At present non-operative treatment is being tried, and the x-ray is being used instead. The influence of this agent has been marked in certain of the reported cases, but it is not prompt.

The Pathology of Exophthalmic Goiter.-No sharp line, said Dr. MacCallum, could be drawn between the microscopic picture presented by a normal thyroid and the thyroid of a patient with exophthalmic goiter. Aside from the changes in the thyroid itself, there may be in this disease general lymphatic hyperplasia, affecting the thymus, the glands of the neck, and the lymphatic follicles in the thyroid itself. Changes in the body musculature, in the corpus restiforme, and in the sympathetic ganglia were also described. In the thyroid itself the most recent papers on the subject, from

the clinics of Mikulicz and Kocher, state that there is no definite or constant pathological change, but a study of the 28 cases seen at the Johns Hopkins Hospital leads to the conclusion that exophthalmic goiter does present a constant pathological picture, that this picture varies greatly in degree, that the change is sometimes focal rather than diffuse, and that for this reason it may be quite overlooked. The change seen is similar to that produced experimentally by Halsted in his work on dogs. This consisted in an increase in the size of the alveoli, an increase in height of the lining cells, and a heaping up of the alveolar walls into folds. In some cases growth of the stroma took place into the parenchyma with the formation of diverticula. The colloid material might be well preserved, but often it was much diminished in quantity, and had the appearance of granular or thin fluid material. In the small alveoli it might be wanting. Retraction of the colloid so often observed was probably due to the action of fixatives. Sometimes the epithelial cells were five or six times as high as they were broad. The so-called "colloid" cells (high and thin, with deep-staining nucleus and faint pink-staining protoplasm) could be seen in the specimens, as well as the "Schmelz epithel," composed of degenerated cells, which might be lifted free from the base on which they originally lay, and lie quite loose in an alveolus. The connective tissue was increased in amount, making the specimen firm and dense. The glands were very vascular and grayish in color. The parathyroids, which have so often been blamed for the symptoms of exophthalmic goiter, were found normal by Dr. MacCallum in the nine cases examined. One or two showed some sclerosis.

These pathological changes were much like the ones produced experimentally by Dr. Halsted. It seems probable that exophthalmic goiter is due to a hypersecretion by the thyroid, but the cause of an increase in secretion beyond the amount needed by the economy is not clear, and the disease is really without ultimate explanation. Overman has pointed to the fact that certain cases follow influenza, streptococcus sore throat, etc., and infection may be the cause of the disease. A constant focal change in thyroid, varying in degree, together with normal parathyroids, are the essential pathological features of the disease.

Dr. Bloodgood referred to the recent good results reported by Abbe from the use of radium in exophthalmic goiter.

Book Reviews.

Receipt is acknowledged of the following books:

THE DISEASES OF SOCIETY. By G. Frank Lydston, M.D. Philadelphia: J. B. Lippincott Company.

LIFE INSURANCE EXAMINATION. By B. Symonds, A.M., M.D. New York: G. P..Putnam & Sons.

INTERNATIONAL CLINICS. By A. O. J. Kelly, A.M., M.D. Philadelphia: J. B. Lippincott Company.

INFLUENCE OF FOOD PRESERVATION AND ARTIFICIAL COLORS ON DIGESTION AND HEALTH. By J. M. Wiley, M.D. Washington: Government Printing Office.

THE OPHTHALMIC YEARBOOK. By Edward Jackson, A.M., M.D. The Herrick Book & Stationery Co.

GYNECOLOGY: MEDICAL AND SURGICAL OUTLINES FOR STUDENTS AND PRACTITIONERS. By Henry J. Garrigues, A.M., M.D. Philadelphia: J. B. Lippincott Company.

PROGRESSIVE MEDICINE. By H. A. Hare, M.D. Philadelphia: Lea Bros. & Co. THE URINE AND FECES IN DIAGNOSIS. By Otto Hensel, Ph.G., M.D., and Richard Weil, A.M., M.D., and S. E Jelliffe, M.D, Ph.D. Philadelphia: Lea Bros. & Co.

NORMAL HISTOLOGY AND MICROSCOPICAL ANATOMY. By Jeremiah S. Ferguson, M.Sc., M.D. New York: D. Appleton & Co.

THE EYE, MIND, Energy, and MATTER. By Chalmers Prentice, M.D. Published by the author.

THE OPEN-AIR TREATMENT OF PULMONARY TUBERCULOSIS. By F. W. Burton Fanning, M.D. Chicago: W. T. Keener.

MANUAL OF PSYCHIATRY. By J. Rogues de Fursac, M.D. Authorized translation from the French by A. J. Rosanoff, M.D. New York: J. Wiley & Sons.

INTERNATIONAL CLINICS. By A. O. J. Kelly, M.D. Philadelphia: J. B. Lippincott Company.

OPERATIVE SURGERY. By Joseph D. Bryant, M.D. Vols. I and II. New York: D. Appleton & Co.

THE JOHNS HOPKINS HOSPITAL REPORTS. By J. M. Flint. Vol. XII. Baltimore: Johns Hopkins Press.

ACUTE CONTAGIOUS DISEASES. By William M. Welch, M.D., and J. F. Schamberg, A.M., M.D. Philadelphia: Lea Bros. & Co.

A MANUAL OF PRACTICAL HYGIENE FOR STUDENTS, PHYSICIANS, AND MEDICAL OFFICERS. By Charles Harrington, M.D. Philadelphia: Lea Bros. & Co.

PRACTICAL DIETETICS, WITH REFERENCE TO DIET IN DISEASES. By Alida Francis Pattie. Third edition. New York: A. F. Pattie.

EQUANIMITAS AND OTHER ADDRESSES. By William Osler. Philadelphia: P. Blakiston's Son & Co.

THE DIAGNOSIS OF DISEASES OF WOMEN. A Treatise for Students and Practitioners. By Palmer Findley, B.L., M.D. Philadelphia: Lea Bros. & Co.

HEALTH AND DISEASES IN RELATION TO MARRIAGE AND THE MARRIED STATE. By Prof. De H. Senator and M. L. Skaminer, M.D. Vol. II. Rebman & Co.

TRANSACTIONS OF THE AMERICAN PEDIATRIC SOCIETY. Sixteenth Session, held at Detroit, Mich. Edited by L. Edford La Fetra.

PROGRESSIVE MEDICINE. By Hobart Amory Hare, M.D., assisted by H. R. M. Landis, M.D. Philadelphia: Lea Bros. & Co.

By Louis A.

A PRACTICAL TREATISE ON FRACTURES AND DISLOCATIONS.
Stimson, B.A., M.D., LL.D. Philadelphia: Lea Bros. & Co.

ADDRESSES AND OTHER PAPERS. By William W. Keen, LL.D. Philadelphia,
New York and London: W. B. Saunders & Co.

PSYCHIATRY. By Stewart Paton, M.D.

Company.

Philadelphia: J. B. Lippincott

THE PHARMACOPEIA OF THE UNITED STATES. By Authority of the United States Pharmacopeial Convention. Philadelphia: P. Blakiston's Son & Co.

A TEXTBOOK OF PHYSIOLOGY. By Winfield S. Hall, Ph.D., M.D., Leipzig. Philadelphia: Lea Bros. & Co.

INTERNATIONAL CLINICS. By A. O. J. Kelly, M.D. Vol. II. Philadelphia: J. B. Lippincott Company.

THE URINE AND FECES IN DIAGNOSIS. By Otto Hensel, Ph.C., M.D., and Richard Weil, A.M., M.D., in collaboration with Smith Ely Jelliffe, M.D., Ph.D. Philadelphia and New York: Lea Bros. & Co. 1905. In this work the portion devoted to urinary analysis offers nothing especially new, although the subject-matter is arranged very conveniently and systematically. The portion devoted to the methods of the examination of the feces, however, is especially valuable, because of the fact that this branch of physical diagnosis is so much neglected. Not the least valuable portion of this section is a discussion of the intestinal bacteria, based largely on Ford's valuable investigations on the subject. B.

THE yellow-fever situation in New Orleans appears more favorable at present. About 1200 cases have been reported since the discovery of the outbreak, and the mortality has been about 15 per cent. The work of screening and oiling cisterns has been vigorously prosecuted, and several prominent citizens have been penalized for neglect to comply with the regulations on this subject. A good many cases of yellow fever have been concealed from the authorities. In one instance a prominent family did not call a physician for fear that he would report the illness of a daughter of the house. The death of the young woman brought the facts to light. The health authorities were for a time seriously hindered in their work by the activity of Dr. R. B. Leach, a homeopathic physician from St. Paul, who claimed that people could be immunized against yellow fever by small daily doses of arsenic. This absurd proposition interested a good many people, and, of course, the newspapers gave space to Dr. Leach and his followers. Fortunately, this misguided man was not clever enough to keep alive the agitation which he started.