conditions of the breast that the danger lurks. For believing they must represent these conditions, they go unrecognized, until the time. of golden opportunity has passed for a reasonable hope of a cure. Furthermore, although we are assured of the innocence to-day of a tumor of the breast, who can say that by next month it will not be maligant? The important thing then is the diagnosis in these cases, since the treatment, namely, conservative or radical depends upon the diagnosis. Gibson has given in part the proper procedure in breast tumors that are termed borderline cases. Small stationary tumors that do not cause physical or mental disturbances in young individuals up to thirty years of age are to be regarded with suspicion, but need not be removed if there is any special reason for not so doing. However, any growth, at any age, that shows the tendency to increase in size rapidly or steadily should be removed, if for no other reason than the necessity of anticipating severer operation, proportionate to an increasing bulk. I do not wish by this to establish a sense of false security in this class of breast tumors because we must bear in mind that these tumors are or may become malignant at any period of life. Beyond thirty years of age any definite lump should be removed and subjected to a thorough microscopical examination. The treatment of tumors whose benign nature has been determined and removal is expedient, a plastic operation popularized by Warren is the one of choice. This consists mainly of the manner of making the incision, namely, beneath, at the juncture of the breast and chest wall. By this the scar is hidden from view. In those tumors in the upper quadrants and superficial, a simple incision is perhaps the easiest and best. In all operative procedures for benign growths the tumors should be removed in toto if possible, but with as little destruction of the gland tissue as is consistent with a complete removal. This is best accomplished by taking out a wedge that includes the mass. If there are multiple foci there will be less of gland tissue if several wedge-shaped incisions are made. It is ad visable at the time of removal to have a competent pathologist to make a frozen section and if the report is one of malignancy then one should proceed with the radical operation of removal of the breast with its lymphatic. This method, however, is questionable, and a final decision should not come from the pathologist until he has examined several specimens from different portions of the tumor. As to the treatment of malignant conditions of the breast, early and complete removal while the disease is still a local condition is the only positive cure that is known at present. That all cancers have a pre-cancerous stage

will admit of no argument. If the cancer could be removed at that period this would be a big step towards the complete eradication of the cancer problem. In other words, the time to treat a cancer is before it becomes a cancer. We have learned our lesson in appendicitis, obstruction and other acute abdominal conditions as to the necessity of early operation, and it is to be hoped regarding cancer, that the same truth will be molded into some standardized procedure by the profession and this in turn be accepted by the laity. One might question this as being ultraradical, but since it is the only safe and sure procedure at present and, until some other means less radical with as positive results are advanced it is the only sane and sensible course to pursue. No one can deny that if this is carried out conscientiously that there is small doubt that the deaths from cancer would be materially decreased. As to the operative procedure, an incision is devised to suit the individual case, that will seem to give the best chance of the closure of the wound after removal of the diseased area. The axilla should be first cleaned out for the following

reasons:

(1). Lymphatics may be so involved that further operative procedure would be futile. The sooner this is known the better.

(2). Blood vessels may be tied at their origin, thus preventing shock and hemorrhages.

(3). The danger is eliminated or largely so of expressing or distributing cancer cells into the adjacent structures.

(4). Functional use of the arm will be better by beginning at the axilla because greater precision is insured.

At

The incisions should not extend beyond the axillary folds as the scar may interfere with free movement of the arm. After the axilla has been thoroughly cleaned, this is followed by the removal of the breast, including the There is hope that some pectoral muscles. agent will be discovered or some means devised by which the mutilating radical operation for this condition may be avoided. the present time radium seems to hold the stage and there is some hope that it will prove a most efficacious means in combatting this disease. Abbe, in a recent article. speaks very encouragingly of his use of radium during the past ten years. He does not advise, however, its use only in those cases after the operative period. He also advises the use of it as a prophylactic measure following operation.

INTESTINAL CATARRH."

By O. P. GOODWIN, Pleasureville.

A catarrhal inflammation of the whole or part of the intestinal tract. It is an infection or intoxication produced by hot weather, sudden changes of temperature, improper or decomposing food or milk, over eating, impure water, or water not accustomed to. Secondary, from gastritis, infectious diseases, portal engorgement.

Predisposing causes. Age, children and aged being more liable to the disease. Unsanitary surroundings, especially in hot weather. Symptoms: Diarrhea, colicy abdominal pains, gaseous distension of abdomen, rumbling and gurgling noises, vomiting, elevation of temperature, furred tongue.

Discharges at first consist of fecal matter, followed by watery irritating fluid, the stools varying from three or four to ten or more, increased by taking food. The stools present a yellowish brown or greenish color, very offensive, in advanced cases dysenteric in character, painful tenesmus, stools small contain blood and mucus, loss of appetite, thirst present.

Physical Examination. On inspection tympanitic distension, tongue dry and furred. Palpitation, considerable tenderness, fluctuation if much fluid present.

Percussion. Tympanitic resonance varying with tension of bowel. Severe forms have loss of flesh, weakness, high temperature, headache, prostration, general disturbance of health.

It is important to localize the disease, whether it be duodenum, ileum, colon or rectum.

In duodenum constipation often present in place of diarrhea with colon not affected. Usually gastritis, with nausea, vomiting, gastric pain coexists. Small intestine-absence of much diarrhoea, presence of colicky pain, rumbling, distention of area of small intestine, stools contain undigested food, bile and small masses of mucus.

Colon. Considerable pain, diarrhea, tenderness over colon, soup-like stools, mucus in large masses indicate that the trouble is in the colon.

Rectum. Large quantities of mucus and pus, painful tenesmus indicate inflammation of rectum.

Prognosis. In uncomplicated cases favorable, occurring in extreme ages and delicate subjects often endangers life. Duration three or four to ten or more days. Treatment. In mild cases due to errors in diet a mild purgative, restricted diet is all that is required. Rest in bed, calomel followed by saline to clean *Read before the Henry County Medical Society.

out the intestines, salol, pepsin with a little phenol to quiet gastric complications. If stools are watery and odorless and colon empty, salol, bismuth and opium to control pain. pain. When stools dark, considerable odor, mucus and blood zinc phenolsulphonate, bismuth subgallate with copper arsenite. Colon irrigation once or twice daily, enemas of

starch water and laudanum.

Food should be given at regular intervals, milk, eggs, cocoa, soups, predigested foods, beef juices when appetite reduced. If constipation, fruit juices may be allowed. Tonics. Iron, arsenic, strychnine, cascara to move bowels.

COUNTY SOCIETY REPORTS

Boone The Boone County Medical Society met at Union, Wednesday evening, October 21st, with O. E. Senour. Those present were Drs. Langdale, McKim, Jones, Cofield, Phinney, and Hafer of Cincinnati, Dr. Furnish of Covington, Drs. Slater and McChord of Ludlow, Drs. Slater and Blackerby of Erlanger, Drs. Menefee and Foreman of Walton, Dr. Grant of Florence, Dr. Hays of Bllittsville, and Senour of Union.

After a lunch was served the meeting was called to order by President B. K. Menefee.

C. C. Jones, of Cincinnati, read a paper on "The Treatment of Ear, Nose and Throat During the Acute Infections." This was a very practical and instructive paper and was thoroughly discussed by several present.

H. H. Hays read a paper on "Whooping Cough" which was also very practical and enjoyed by all present and brought forth good discussions.

After a very enjoyable social session the meeting adjourned to meet at Walton with Dr. Menefee on the third Wednesday in November at 7 P. M.

O. E. SENOUR, Secretary.

Bell The Cumberland Valley Medical Society met with the Bell County Medical Society on October 9th, 1914. The following doctors were present: J. H. Parker, U. G. Brummett, J. T. Evans, Jacob Shultz, O. P. Nuckols, F. B. Burton, J. W. Parker, T. H. Curd, C. A. Moss, Edward Wilson, C. K. Broshear, J. P. Edmunds, C. F. Clayton, L. L. Bobertson, J. G. Foley, and Dr. Craig.

Chas. F. Clayton read a very instructive paper on "Vaccines and Serums' which was thoroughly appreciated by all present and the discussion in which all present took part brought out some very interesting points in the use of vaccines and

serums.

J. G. Foley made a talk on public health and

told us some of the many things the Bell County Board of Health is doing.

Lewis J. Jones not being able to attend sent in an excellent paper on "Chole-cystitis," which was read and discussed.

There being no further business the meeting was adjourned.

C. A. MOSS, Secretary.

Bullitt The Bullitt County Medical Society met at the courthouse in Shepherdsville, at 10 A. M., October 26, 1914. The forenoon was taken up by case reports and general discussions, all present participating.

The Delegate to the State Meting reported that he was unable to reach Newport on account of an accident on the way. However, other members who had been at the meeting, reported some points of the Newport meeting and same was discussed.

After a good meal at the O'Brien House, the society reconvened as an open meeting at 1:30 P. M. Notices had previously been sent out and a very nice crowd was ▲ hand. Senator J. R. Zimmerman made the address of welcome, Dr. G. C. Hall, of Louisville, made an address on the subject, "The Necessity of Regular School Inspection." Dr. Hall used charts and illustrations and it was very interesting and helpful to all.

Judge E. A. Funk, spoke as one of the County Health Officers, upon the sanitary conditions of the county in general. He took up the past, present and future conditions as he saw it, and his talk was both instructive and entertaining. The other two Health Officers, Drs. Geo. Kirk and S. W. Bates, made brief addresses.

C. Z. Aud was to make an address but could not be present.

Others who tok part in the discussion were: J. W. Dodds, Bardstown Junction; R. I. Kerr, Belomnt; S. H. Ridgway, Shepherdsville; Arthur Bates, Beuchel; W. W. Hill, and Jas. S. Lutz, both of Louisville; Prof. Ora Roby, Superintendent of County Schools; Mr. Lindsey Ridgway, County Clerk; Robert Smith and Mrs. R. L. Troutwine, all of Shephersville.

The entire meeting was a very pleasant one and we hope shall arcuse the entire county before its influence shall die out. We expect to hold another meeting next spring and continue the good work of educating and improving our county along the lines of health and sanitation.

R. I. KERR, Secretary.

Carlisle The Carlisle County Medical Society met at Bardwell. December 1st, 1914, in the Odd Fellows and Masonic Hall, with the following members present: President J. G. Dunn, W. Z. Jackson and R. T. Hocker, of Arlington; H. A. Gilliam, Milburn; W. L. Mosby, H. T. Crouch, G. W. Payne and T. J. Marshall. of Bardwell; W. I. Poole, of Berkley and D. S. Robertson, of Cun

ningham. The last two named becoming members at the meeting.

W. Z. Jackson read a paper on "Pott's Fracture." He gave a complete picture of the fracture and its treatment

G. W. Payne opened the discussion by going into the anatomy of the fracture. Mosby, Crouch and Marshall also discussed the paper, Jackson closing.

W. I. Poole read a very able and brief paper on "Treatment of Pneumonia." He insists on fresh air and proper nourishment in the management of his cases, using drugs as indicated.

Discussion by Drs. Crouch, Mosby, Hocker, Gilliam, Payne and Marshall. Nearly all use carbonate of creosote in the treatment.

H. A. Gilliam stated he hadn't lost a case of pneumonia under 3 or over 60 years, in his practice within the last five years.

J. F. Dunn read a paper on "Epidemic Sore Throat." He is in the midst of an epidemic of this kind now. He asked that the paper be discussed. The essayist thinks that his cases are tonsilitis, while others in near localities had been having an epidemic of diphtheria. Mosby, in discussing the paper agreed with the essayist that a great majority was tonsilitis, while Payne and Marshall argued that more than likely a large per cent. were diphtheria. Crouch, Jackson, Poole, Hocker and Gilliam also discussed the pa

per.

The following officers were elected for the next year: President, H. A. Gilliam; Vice President, W. I. Poole; Secretary, T. J. Marshall; Treasurer, G. W. Payne; Censor, D. S. Robertson.

The Society adjourned to meet in Arlington the first Tuesday in March.

T. J. MARSHALL, Secretary.

Christian-The Christian County Medical Society met in regular session, Tuesday, November 17th, in Hopkinsville, with the President presiding.

The members present were, Drs. Watts, Rozzell, Gaither, Jackson, Reynolds, Keith, Beazley. Rice, Lacy, Southall, Backus, Gates, Sargent, Caudle, Rudd, Lovin, and Sandbach.

E. L. Gates reported a case of "Infantile Paralysis in a Three-Months-Old Child." Discussed by Drs. Bell, Sargent, Caudle and Keith. Dr. Keith asked what position should the physician take in reporting a case of infantile paralysis?

Andrew Sargent read a very interesting and well prepared paper on "Spondylotherapy." He prefaced his paper with a short history of "Spondylotherapy" and how he became interested in the subject. He referred freely to noted authorities on the subject and after Dr. Caudle offered himself as a subject he demonstrated his method of lowering and raising the pulse rate. The essayist proved himself master of his subject and was the means of bringing out one of the most interesting discussions of the year, of which Drs.

Reynolds, Keith,Rozzel, Rudd, Backus and Sandbach took part.

At this point, the program being completed, Dr. Keith stated that the Metcalfe Committee was ready to report. The Chair appointed Dr. Keith the Chairman of the Committee to bring Mr. Metcalf, our esteemed friend, before the society. When Dr. Keith entered the room with Mr. Metcalfe, Dr. H. C. Beazley, as spokesman for the society, presented a handsome chest of silver to Mr. Metcalfe in the following words:

"Mr. President: We have with us to-day a gentleman whose acts of kindness, hospitality and whose genial personality have endeared him to each and every member of the Christian County Medical Society.

"In innumerable ways Mr. T. L. Metcalfe has abundantly proven himself to be a genuine friend of the doctors, and not only to the physicians, but like Ben Adhem; he is the friend of man. Our town, our county, our country needs more men like him.

We stand to-day as citizens of the greatest country on earth and as we stand in view of the monuments of a past civilization, confronting the problems, the carnage and the strife of the present age; we are more disposed than ever to regard America as the field where the ideal and the actual combining their forces, will produce a higher and nobler civilization, than the human race has ever attained. In order to accomplish this, we must have a nation of men--real men, unselfish and unafraid.

"Each of us should be eager to make the history of our nation great, not by military exploits, except to maintain our honor, but by the higher triumphs of art and peace.

"Free men like free states, united by a common brotherhood should rival each other in the glorious task of advancing human liberty.

"The kindly, unselfish and public-spirited life of Mr. Metcalfe is an example to us of what a true citizen of a community should be.

"We reciprocate your friendship Mr. Metcalfe, and we wish to assure you that we esteem the spirt of altruism which has prompted you in the extension to us of so many expressions of favor.

"It gives me great pleasure, to present to you, in the name of the society, this token of our appreciation of your kindness to us. At the same time we wish you to know that neither the words nor the gift can express all that we cherish for you in our hearts."

W. S. SANDBACH, Secretary.

Christian-The Christian County Medical Society met in regular session in the City Court Room, Hopkinsville, Tuesday December 15th, at 1:30 P. M., with the following members present: H. W. Watts, President; W. E. Reynolds, T. W. Perkins, J. R. Paine, T. D. Rudd, M. W. Rozzell, J. B. Jackson, F. M. Brown, J. P. Keith, H. C.

Beazley, O. L. Barnes, J. H. Rice, Andrew Sargent, J. W. Harned, J. L. Barker, Austin Bell, J. G. Gaither, D. H. Erkiletian, F. H. Bassett and W. S. Sandbach.

The minutes of the last meeting were read and adopted and the Secretary made his annual report as follows: Out of 50 active physicians in the county, 44 are members of the society, with an average attendance of 23. With 12 meetings. One member present at every meeting six at eleven meetings and four who had never been present during the year. There has been read twelve papers, 37 case reports and 16 clinical

cases.

This being the annual meeting for the election of officers for the ensuing year the President called the election, which resulted as follows:

President, E. L. Gates, of Herndon; Vice-President J. R. Paine, of Pembroke; Secretary-Treasurer, W. S. Sandbach of Casky; Censor, Austin Bell, of Hopkinsville; Delegate to State Meeting, Drs. Sandbach and Keith.

Moved by Dr. Barker, seconded and passed that the society pay the Secretary's expenses to the State Medical Association.

Our retiring President, H. W. Watts, in a few well chosen words, reviewing the work done the present year and the President-Elect, E. L. Gates, outlining the work for the coming year, completed the program for this meeting.

The enthusiasm ran high through the entire meeting and the prospects are bright for a larger better and a more progressive society this year than ever before.

W. S. SANDBACH, Secretary.

In discussing the paper P. D. Gilliam said: "I think if statistics of cancer were kept we would hesitate to operate. How do we know that it is not a general disease with a local manifestation? We are dependant on our resistant power.''

O. W. Rash said, I want to change; I now think that diseased tonsils should be removed. I think they cause rheumatism. I do not think cancer of the uterus is ever cured.

I. J. Hoover said: I think we cure cancer with the knife. Do we know when to do this? No, but I think we should remove it at the earliest opportunity. I believe a complete hysterectomy will cure cancer of the uterus. All canerous conditions can be cured by the knife, if done at the right time."

W. F. Stirman said: "I am sure cancer, in the beginning is local, and if you can remove it in

time, you can cure it. We must not wait for vaccines, but use the knowledge we have and act; I have 17 women alive now, on whom I removed cancer of the breast. The last one five years ago, I have more than that many dead. 1.never remove an epithelioma of the lip that I do not cure it. The time to attack a cancer is when you see it, if it is operable. I believe the operation for uterine cancer is the most hopeless, because that region is, very rich in lymphatics, and all are infected. I think it is hopeless to operate for uterine cancer in patients over 50 years of age."

D. M. Griffith said: "I had twelve cases of rheumatism and cured them by removing the tonsils, some of them had abscesses. In three cases the tonsils seemed normal, but when cut into they were found filled with cheesy material, and when removed the diseased joints got well. Rheumatism is not a disease, but a result. John Murphy said, '75 per cent. of the cases of rheumatism that come to him were the result of tonsilitis, and were cured by removing the tonsils. He always sends his rheumatic patients to a throat specialist. I have lost all cases with cancer of the nose, because the tissues there are so rich in lymphatics. I think Mayo says he cures 70 per cent of cancers, I heard him say if they come to him in time he could cure cancer in any part of the body."

W. F. Stirman: "Dr. W. D. Gross did a great harm in teaching that cancer was a local manifestation of a systemic affection. For a long time all surgeons followed his teaching."

J. H. Thorpe read a paper on "Eye Strain." The doctor was called away and his paper was not discussed.

W. L. Tyler read a paper on "Rest in the Prevention and Treatment of Disease."

A general discussion followed.

J. J. RODMAN, Secretary.

Daviess The Daviess County Medical Society met in annual session December 15th at the City Hall, Owensboro, with the President, J. M. Stuart presiding and thirty-seven members present.

After the minutes of the previous meeting were read, the Secretary-Treasurer made report. Seventy had paid their dues during the year. One hundred and two dollars was in the treasury. Our Councilor, Cyrus Graham, was present and gave us a good and encouraging talk.

D. M. Griffith reported a case of tracheotomy to recover a lost tooth. He got it but it was so badly decayed could not use it. This case was discussed by several.

This being the annual meeting, the following officers were elected to serve for next year: President, C. DeWeese, Fordsville; Vice President, George L. Barr, Secretary-Treasurer, J. J. Rodman; Delegate, C. H. Todd; Censor, O. W. Rash, Owensboro;.

Adjourned for dinner, which was furnished by the Owensboro Medical Society. It was thoroughly discussed by all present.

At the afternoon session J. T. Dixon read a paper on "What is Rheumatism?" which was discussed by several.

The temperature was ten below zero and our former president, J. W. Ellis, was not able to be with us. By a rising vote we sent him words of good cheer with hopes that he would be with us at our next meeting. J. J. RODMAN, Secretary.

Greenup The Grenup County Medical Society met at Fullerton, on November 5, 1914, at the Davis Hotel.

Members present, E. R. Fitch, C. E. Vidt, H. T. Morris, A. S. Brady, A. J. Bryson, M. W. Meadows, and A. P. Hunt.

E. R. Fitch read a paper on the Differential Diagnosis of Pregnancy," which was appreciated by all members present.

M. W. Meadows read a paper on "Nocturnal Enuresis," which was very instructive.

A. S. Brady reported a case of Hyperemesis, after which he opened the discussion on the papers followed by Vidt, Bryson, Morris, Hunt, and in closing by Fitch and Meadows.

The officers were elected for the year 1915, as follows:

President, C. E. Vidt; Vice-President, E. R. Fitch; Secretary-Treasurer, A. P. Hunt; Censor for Three Year Term, H. T. Morris; Two Year Term A. J. Bryson.

After the meeting a special dinner was served at the Davis Hotel which was appreciated by all present.

The next meeting will be at Russell, on December 3, 1914. A. P. HUNT, Secretary.

Henderson-The Henderson County Medical Society met in regular annual session with W. A. Poole presiding and Albert S. Denton, of Robards, acting secretary. The following physicians were in attendance: J. E. Ridley, Robards; E. N. Powell, Corydon; H. S. Zernow, Corydon; Thos. Sellars, Hebbardsville; W. A. Quinn, H. C. Clay, of Anthoston; J. H. Letcher, J. C. Moseley, M. C. Dunn, Silas Griffin, W. C. Galloway, D. O. Hancock, E. L. Busby, of Zion; W. V. Neel, J. W. Stone, Cyrus Graham, Peyton Ligon and W. M. Floyd.

In honor of Archibald Dixon's fiftieth anniversary of his wedding he was elected president of the association for the coming year, and Dr. Letcher was elected vice-president. Both physicians have been president of the county society and the State Association. Their election broke a precedent in the choice of young men and they were elected as an expression of the honor and esteem in which they are held by the county society, and in acknowledgement of their eminent services to the county profession.

Dr. Peyton Ligon was unanimously elected secretary. Drs. Stone, Moseley, Bushby and Powell