it is this bacteria which causes the disease. He endeavored to isolate it directly from the fluids of the mouth, but was only successful in finding it once in twenty-five cases. Another interesting point in his investigations was the finding of two other microorganisms in the lungs and in the blood in great quantities ; but which he considers as perfectly innocuous. He tried injecting large numbers into the trachea, but failed to produce any or only very slight inflammation in the lungs. The

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... was a round micrococcus, somewhat above the medium size which grew on gelatine, without liquifying it, in the . form of white colonies only raised a little above the surface. The second was a moving elliptical coccus, similar in appearance to the pathogenic one, but which reduced the gelatine fluid less quickly and the colonies of which were not so darkly granular. The above facts are of importance, as it is here clearly shown that the very abundant presence of bacteria in connection with a pathological process is far from a proof of their causal relation. These must be regarded as having developed secondarily to the pneumonia, and have thence entered the blood, while the disease was excited by another which remained in the lungs. EPITHELIOMA IN A PHTHISICAL CAVITY. The following rare case is reported by Friedlander : -6 A man died who clinically presented the features of phthisis with pleurisy on the left side. Upon opening the lungs there was found in one of the cavities at the apex of the left a tumor attached to the walls by a broad base. From this point it tapered to a sort of pedicle, which lay in the bronchus connecting with the cavity7, and enlarged again to a rounded end the size of a joint of the finger. This nearly filled the lumen of the branch in which it was, but yet was freely movable. The pearly gray medullary aspect of the growth suggested at once the diagnosis of cancer, and the, microscope showed it, to be a true epithelioma. The stroma was everywhere firm, and only moderately vascular, and infiltrated in only a slight degree with round cells. In the meshes formed by this were imbedded anastomosing cords of cells, of varying breadth. The cells within these were mostly polygonal, with serrated edges and surfaces. Here and there they were scale-like, without nuclei, reacting like the horny layer of the skin, and imbricated like an onion. In short, the typical picture which is found in epithelioma of the lip, tongue, oesophagus, etc. Nowhere else in the body was anything found which could stand in the light of a primary or secondary growth to this. Therefore this must be regarded as the unusual occurrence of an epithelial tumor proceeding from an ulcerating tuberculous surface. It seems almost at first sight as if this could not be explained in accordance with the generally accepted theory, which supposes that such growths can only start from preexisting epithelium. But the author recalls an observation of Griffini, who found in defects of the trachea and bronchi, especially those caused by7 tuberculous ulcération, that a layer of stratified pavement epithelium had been developed there. And Ziegler has also « Fortschritte der Medicin. Vol. 3, p. 307. noticed flat epithelium on the edges of syphilitic ulcers of the air passages. On the wall itself of a cavity, so far as is known, epithelium has not been found, but this is not impossible, and it might be supposed to creep in from that lining the bronchus and become modified. In subacute and chronic bronchitis (with the development of granulation tissue in and about the bronchial walls) Friedlander himself has noticed an atypical growth of the cells of the living coat by which buds and tongue-like processes of epithelium were found in the bronchial wall and its surrounding. These have the closest resemblance to cancer, but that they should ever form a true new growth must be a very rare occurrence.