not being able to take the proper care of himself. He was entirely cured after the fifth injection and has had no return of the discharge or symptoms. Syphilis had been acquired a few months before the gonorrhea was "contracted. He received oil of sandalwood internally and urethral injections of argyrol. In no instance was a patient made worse by the injections, except that in a few cases there was a slight increase in the discharge during the negative phase when the initial dose was too large.

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... Almost invariably, in cases in which the gonococcus was without doubt the cause, there was improvement which lasted from three to seven days after the injection. My best results have been obtained with doses varying from five to fifty million gonococci. In acute gonorrhea the initial dose should not exceed five or ten million, but may be repeated somewhat earlier than when larger amounts are given. The injections were made in the subcutaneous tissue of the buttock, as here the minimum amount of pain is produced. It is well to begin with fifteen million in chronic cases and gradually increase the amount at subsequent injections according to the reaction produced. Usually the succeeding injections should be administered before the improvement of the previous one has entirely disappeared. This varies from five to eight days. In most cases the vaccine treatment was supplemented with urethral irrigations and injections, prostatic massage when indicated, and suitable internal medication. From five to eight injections were required for the average case, but more in cases in which recrudescences occurred. I will describe briefly the histories of two patients with the infection so deeply seated that invariably such cases are difficult to cure by the usual methods. History.-Dr. X., one of my first patients, came to me on account of a persistent and recurrent prostatitis. I had been treating him in an irregular manner for about eighteen months; the urethra would clear up entirely at times, not a thread being present in the urine, but the prostate could not be freed from pus. Alcoholic or sexual indulgence would nearly always bring back the urethral discharge in which gonococci could be demonstrated. The vaccine treatment was instituted and continued with local urethral treatment, prostatic massage and internal medication as previously given. He claims that much more benefit was received from the treatment after the injections of bacterin than had been obtained from the same treatment before these injections were given. After eight hypodermic injections of vaccine he seemed entirely cured and has had no further relapses in spite of alcoholic and venereal excesses. History.-Mr. Y., aged 26, was referred to me on account of a gonorrheal urethro-cysto-prostatitis of ten years' standing, with constant recrudescences. Malarial infection was almost as deeply seated as the gonococcal infection. The attacks of malaria always brought on the discharge and but for presence of the gonococci he would have thought it due entirely to the malaria. Considerable improvement followed the first injection. The discharge and bladder symptoms disappeared after the third injection and the prostatic enlargement was greatly reduced, while after the fifth injection all of the trouble seemed entirely cured and the urethral shreds had disappeared. Not feeling sure, however, that latent infection might not still be present three more injections of vaccine were given. As far as I can judge now, the patient is well. The prostatic secretion is practically normal, both in quantity and quality. Sexual intercourse was indulged in April 6, without my permission, and was not followed by any return of the trouble. These cases were selected as they represent a type of conditions which we find most difficult to cure permanently. Several others belong to this class, but most of the others thus treated were milder in character and responded equally well or even more satisfactorily to the bacterin therapy. When used judiciously I feel sure that by appropriate administration of vaccines we have a valuable adjunct in the treatment of gonorrheal conditions. On Oct. 23, 1901 the Dutch ship Nederland dropped anchor in San Francisco Bay and her master sought the out-patient office of the U. S. Marine Hospital in that port. Here he told one of the tales of sea horrors which officers of this service must listen to, as long as owners are covetous and navigation laws are insufficient. A tale not of brutality of man to man, this, but of a long voyage, poor provisions, scant water, and finally out of the mysterious deep, this strange sickness which made strong men weak even to death. There had been no sickness on the voyage from Hamburg, though the "beans were bad" and water ran low. So the master made port at Santa Rosalia, Lower California, and with refilled tanks put out to sea. A few days later the men noticed a great weariness and weakness in the legs. They could not go aloft and no persuasion could make them move quickly. Then the dragging legs began to swell and the weariness to increase. This ran from man to man, one dying "from ruptures which came." Finally the mate was stricken, and the master by tremendous effort brought his crippled crew and short-handed ship to port at last. Now he had his mate and seven seamen to be treated, pending final disposition at the hands of the Dutch government. So to the hospital came a message to send both ambulances for eight cases of beri-beri, and as I was serving there as interne these cases came under my observation, from their coming ashore in a ship's boat until their final discharge, December 14, at the request of the Dutch government. I had never questioned .the diagnosis which seemed so apparent at the time, until this year, when I read a book on "The Cause and Prevention of Beri-beri" by W. L. Braddon, an officer of the Malay States government. As his book is an emphatic advocacy of the rice theory, and as he recognizes a ship disease resembling beri-beri, I wish to review these cases in the light of his observations, aiming to place them in the proper category. The first thing noticed in these men was the gait of those who were able to walk. It was with feet wide apart, plunging and yet with a hesitancy about commencing each step. It appeared to be a combination of the ataxic and steppage gaits. In all the cases the temperature ran a nearly normal course, the respiration averaged 20 and the pulse ran between 90 and 100. The urine of all the cases was free from albumin and sugar. The following is a synopsis of each case on examination: Case 1.-H. K. (Permit 247), age 20. Onset.-Four weeks before admission, with pain in back and head, swelling of legs, nausea, but no vomiting. Physical Examination.-Legs and feet edematous, dyspnea and palpitation of the heart on slight exertion. Pain and tenderness on pressure along course of nerves of legs and feet. Diminished power in muscles of legs, areas of anesthesia on