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meagre labors conducted under extreme difficulties, (without state or financial aid, that is, when these were most needed) particularly during the applications and experiments of the last two years. The future of serotherapy in tuberculosis is, in my mind, very bright and very promising. The first and second stages have been benefited under unfavorable circumstances, by only slightly immunized serum. Consequently, it is only fair to reason that with more strongly immunized serum, such as is now ready to use, (I have only a limited quantity) much better and quicker results can be obtained, particularly if better hygiene and dietetic conditions obtain. Theoretically it would seem that if by the use of this serum constitutionally the tuberculous processes may be arrested in a given case, injections directly into the pulmonary cavities, where these exist, or the excision of a rib or two and the use of the tubercle antitoxine directiy into the wound, or perhaps some other direct antiseptic medication, would prove practicable and useful to save life. It would seem, too, that such cases as hip-joint disease, which, according to statistics, are more successfully treated by the expectant therapy than active operation, could be safely operated after the arrest of the tuberculous process; for, as Koenig has pointed out, it is the operation that disseminates the bacilli in such cases, so many of which terminate fatally after the usual surgical interference and the usual after treatment. And so in all surgical cases of tuberculosis, whether it invades the bones, the joints, the skin, the tendons or other organs, or several of them, if the serum will, by some means, stay the microbes, as I have every reason to believe it will, there is ground for hope on its introduction to therapeutics.

Besides the use in the treatment of tuberculosis, we have, of course, to consider the means of protection of those exposed, by the practice of periodical injections of antitubercle serum, which will render the susceptible immune, for a while, at least. As a prophylactic, the serum should prove very useful in the preservation of families tainted by inheritance, or exposed to the germs from their birth.

In closing allow me to summarize the opinions arrived at after my few years of investigation and observations and the recent incomplete practical tests of my colleagues and myself.

A. Sero-therapy in tuberculosis is efficacious.

B. Blood serum of horses is naturally feebly antagonistic to the germs of tuberculosis, but in its natural state it is too slow, and it takes quantities too enormous for use in treatment.

C. Horse blood serum may be rendered strongly antagonistic to this germ by the proper treatment of the animals with properly prepared and tested toxines of the right character. But the serum thus obtained should

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never be used without previous tests as to its degree of immunity, and its purity from a microbic and chemic standpoint.

D. A horse properly treated three months may yield serum with immunizing power that will probably prove sufficient to arrest consumption in the first stages, in three or four months, and sometimes in less time; and in the second stage in four to six months.

E. Discrimination should be made in the selectioh of cases, and judg ment exercised to exclude from the favorable class all those seriously com plicated bacteriologically, certain cases otherwise pathologically complicated, and other patients which practice alone will suggest.

F. In as much at hospitals for consumptives are sadly needed any way, the success has already been sufficient to warrant the hope that, in the near future, such institutions will be built on modern principles of hygiene, for the exclusive treatment of tuberculosis. The sero-therapy, with the adjunct treatments, promises better success than we had grounds to hope for before. However, I do not present the new treatment as a specific, or a cure; I merely report progress in our investigations. Had I been able financially, and had 1 control of a hospital, I would not have reported for six months more.

TECHNIQUE.

As to the technical features of the preparation of the anti-tubercle serum I have little to say at present. The profession realizes that success with the serum therapy depends on accurate and delicate labaratory experimental manipulations, which few are fully equipped to undertake. The preparation of the toxines, the measurement of their potency, the dosage for the realization of immunity, and finally, the innoculations of immune animals and the subsequent tests of the purity, the therapeutic value, of the serum extracted, and a hundred little details of moment, are all questions of great importance, which necessarily involve special training. Commercialism might, at any moment, by some failure or accident, throw discredit on the new treatment, were I to explain in full the detalls of procedure in the production of the agent, before I have completed my researches to a point where we may show a larger number of improved cases and greater benefits. we have only a limited quantity of serum on hand--not enough to offer to the profession-having under treatment some thirty cases, whom we have promised and wish to inject for some time to come. The production of the serum is costly and, above all, it takes months to get the best material. I have reason to believe, however, that we have found the key to shorten materially the time which was found necessary to strongly immunize the horses now in use.

Vista Block, Grand Avenue; and the Union Trust Building.

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Savannah, Florida & Western Railway Co's New Hospital Car.Through the courtesy of Dr. Frank H. Caldwell, Surgeon-in-chief of the above named road, we are enabled to present our readers with a series of cuts of this car. These will enable them to understand its construction much better than any article giving a description in detail.

Cut No. 1 represents the exterior of the car, which you will notice is provided with a wide door at the side for the admission of the patients, through which can be seen, in part, the furnishings of the car.

Cut No. 2 gives a view of the operating-room as seen from the bedroom, showing the operating table and other paraphernalia necessary for

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the proper equipment of this room, beyond which will be seen, through the hall a portion of the sitting-room, and to the left a bed with the head placed against the partition of the operating room, just beneath a wall-lamp.

Cut No. 3 is a view of the bed-room, showing one bed at right angles, and the other lengthwise of the car. These beds are portable and can be changed to suit the necessities of the case, or can be stowed away out of the road, as will be seen by the frame work and mattress of a third bed neatly tucked away against the left wall of the car. The bedsteads are all made of iron, and are so constructed as to be readily folded when not in use, giving additional room in the ward department of the car.

The bedding, when not in use, is stowed away in a corner closet, which does not appear in the cut. In addition to the above equipments a lavatory and water tank are here provided.

The question of a hospital car is one that has been agitated in railway circles for several years, and whilst it has met with favor in many directions yet it has been opposed in others, and the result is, that railway companies have been slow to adopt it and maintain it on their lines. Notwithstanding announcements have been made through the press, of one or two roads hav

ing decided to put on a hospital car, yet to the best of our knowledge at the present time, the Savannah, Florida & Western is the first in this country to construct, equip, and put into practical operation a car of this description. Much credit is due Dr. Caldwell for bringing about this innovation for the caring and handling of the injured and sick employes of the company. the same time the company for which he is chief surgeon, is to be congratulated for listening to his advice and putting into practical operation his suggestions, and by so doing have taken an advance step in their already elaborate arrangements for the prompt and efficient care of their sick and injured. Med. Fortnightly.

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DEPARTMENTS

PATHOLOGY AND BACTERIOLOGY.

IN CHARGE of E. B. LA FEVRE, A. M., M. D., ABILENE, KANSAS.

THE IDENTIFICATION OF THE TYPHOID FEVER BACILLUS.

ORDAN (Journal of the American Medical Association, Vol. XXIII, No. 25) very thoroughly sums up the work already done, having for its object the identification of the Eberth-Gaffky bacillus-the germ causative of typhoid disease, at the same time quoting the views of the various authorities throughout the world upon this very important and highly interesting topic, and in conclusion formulates the following ideas, which he believes indicate the prevailing opinions among those whose investigations permit them to speak with confidence:

"1. There is usually found in the spleen and other organs of an individual dying of typhoid fever, a bacillus which possesses certain definite morphologic and physiologic characteristics."

"2. This bacillus, when viewed in the light of all its characters, can be distinguished from the other members of the coli-typhoid group. No single character, however, is 'characteristic,' and nothing short of an enumeration of all the known morphologic and physiologic properties of the bacillus is a sufficient basis for diagnosis."

"3. There exists a well-nigh complete chain of varieties between the typical colon bacillus and the typical typhoid bacillus. Whether this represents ontogenetic as well as phylogenetic possibilities, is still an open question."

"4. The intermediate varieties, of which there appear to be many, resemble the typhoid organism very closely. It is still uncertain whether they are able to cause typhoid fever, or a disease resembling it, in man."

"5. The cases of alleged conversion of one 'species' or 'variety' into another do not carry conviction, and are susceptible of other interpretations than those advanced regarding them."

THE LEUCOCYTES IN CROUPOUS PNEUMONIA.

Billings (Johns Hopkins' Hospital Bulletin, November, 1894) carefully reviews the investigations of the different writers on leucocytosis in pneumonia, from its first mention by Piorry in 1839 to the present day, and also recites the results obtained from his examination of the blood of twenty-two individuals suffering from this affection.