when new buildings were under construction. The operation was delayed for, several months while the throat department was being finished. When the surgical quarters became available only four out of forty waiting children required operation. Sutcliffe has observed similar improvement at the Sea Bathing Infirmary at Margate in the health of children waiting for operations which subsequently proved needless. Danischevsky, the honorary secretary of the Russian Committee on Rheumatism, also writes2: " Infection [wvith us] is now considered as a function of three variables, the microorganism, the macro-organism, and the environment." It is well known that many French authorities are inclined to dissociate from true rheumatism all acute infective conditions.The use of vaccines must follow the accepted doctrine on infection. Treatment by preparations of gold is still in an experimental stage. Strasser of Vienna and others advocate a "simultaneous therapy " of arthritis by a combination of remedies. This practice is opposed by other authorities, because of the difficulty of interpreting the reactions which are produced. They hold that 'in the use of physical remedies, especially baths, the daily 'reaction is-a necessary guide to treatment. The simultaneous use of vaccines or of gold inevitably blurs the picture and deprives the practitioner of essential guidance in conducting the cure. Conclusion'The knowledge of chronic rheumatism has been clarified and extended in recent years, and new suppositions are leading to new knowledge. More reliance is now placed on physical medicine, both for the prevention and for the relief of chronic rheumatism. Many observers have been impressed by the disturbances in the peripheral circulation, the systemic vaso-constriction and curtailment of blood flow in the arterioles and capillary bed, by the failure of the normal reaction to cold, especially when muscular activity is in abeyance, and by the consequent slow invasion of chill. What is the remedy of choice to deal with the invasion of eold on the surface of the body? Interesting new evidence of the effect of external heat in removing stiffness and pain and other effects of exposure to cold, fatigue, and occupational trauma is forthcoming from pithead baths.The same processes seem to be at work in articular and in non-articular forms of chronic rheumatism. Consequently, the methods of treatment applicable to arthritis also apply to sciatica, lumbago, and fibrositis. To this entire category of chronic painful diseases the distinctive generic name of rheumatism has iLways been given, and this older and limited connotation of the name has been confirmed by recent knowledge.The The occurrence of death in cases of undulant fever is unusual, and a fatal termination as a result of endocarditis would appear to be very rare. This is true of infection both by Brucella melitensis and by Brucella abortus. The earliest record we can find of the former is that of Hughes,' who in 1897 described four cases of undulant fever in which the heart was aff...

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