Oppenheim of Berlin called attention to the fact that in diseases of the glands of internal secretion, such as exophthalmic goiter, for instance, pain may precede the other symptoms for years. This can probably be referred to a diminished or increased secretion of some gland or glands, or to the production of chemically irritating materials (hormones). The same explanation may apply also to the algias (painful conditions) of the menopause, of paralysis agitans and many acroparesthosias. The

more »

... s in hysteria and neurasthenia have various origins. There are psychic forms (psychalgias) both ideogenous, as, for instance, the fear of cancer, as well as emotional; generally these two factors are united. More frequent than the pure psychalgias are forms of pain which have a physical basis (local irritations, fatigue, traction on muscles, gastro-intestinal disturbances, gout, diabetes, etc.) ; but the. hyperesthcsiii, focusing of the attention, persuasion and increased introspection of the morbidly nervous transform their slight temporary pains into permanent painful affec- tions. An essential rôle is played in these cases also by the vasomotor diathesis with its tendency to cramps of the vessels, and further the inherited transmission of pains in tho direct or transferred form. Von Frankl-llochwart of Vienna called attention to the fact that piiins of psychic origin do not recur in dreams as is the ease when they proceed from an organic basis. Dubois of Bern stated that he has been able sometimes to relieve and cure pain by his method of explanation and persuasion, even in cases of pain apparently permanently rooted for fifteen years, which had defied all other methods. On the other hand, Trimmer insisted that there is much of suggestion in the action of Dubois' method, which the latter energetically denied. The convincing of the person, persuading him to see the matter in its proper light, are the effectual elements, and the personality cooperates with it. With suggestion, as Dubois emphasized, it is necessary to instill into the patient opposing ideas. Oppenheim, in conclusion, insisted that the. method of Dubois of simple explanation and instruction is not sufficient in many cases of neurosis. MENINGITIS WITH APPARENTLY NORMAL CEREBROSPINAI, FLUID In the febrile diseases of children, Professor Förster of Breslau has frequently observed a severe clinical picture of meningitis without change in the lumbar-puncture findings. After the disappearance of the meningitic symptoms there remained a cerebellar disturbance of the gait which also after weeks and months completely disappeared. The cases were in tuberculous children. EXOPHTHALMIC GOITER IN MEN Mendel and Tobias of Berlin discussed Basedow's disease in men. Men are less frequently affected with this disease than women (in the proportion of 1:6), and in general at a later age. The thyroid may be little, if any enlarged, but the sexual functions, in contrast with women, are rather diminished; early arteriosclerosis frequently occurs as a complication and pronounced psychoses are more common in men. Internal therapy is, as a rule, sufficient. KERODIAGNO.SIS IN NEUROLOGY Golla of Breslau gave the results of Abderhalden's serodiagnosis in brain and spinul-cord diseases. The serum from fifty-eight persons with organic brain or spihal-cord disease was investigated. In a number of these, the process showed a fermentative destruction of the nerve tissues. This condition was almost constant in paralysis, in which, in contrast to other organic processes, other organs also were digested. Alcohol and Responsibility in the Academic Course The faculty of the University of Bonn have posted the following notice on the blackboard: "Among the cases of discipline coining before us for decision, we again and again have the experience thai the students present the excuse that they were drunk or so drunk that, they did not know what they were doing. Some recent instances of this impel us to give notice that we arc not accustomed to give any weight to this form of defense in general, and do not recognize drunkenness as a ground of extenuation. The students of the university fortified by a long course of training in character, must be expected to have? reached such a degree of self-control and strength of will that they do not lose control of their nense, and of (heir actions by excessive use of alcohol. If the student acts contrary to this duty, he must bear the consequences."