of the want of co-operation on the part of the members of the largest District Society in the State in furnishing material for his report, having received but three communications for his use, one from Dr. Love, of Montclair, whose excellent and terse notes are commended to the attention of the Society, a case of surgical disease from Dr. Pierson, Jr., to be noticed hereafter, and history of a case of varix by Dr. Holden.

Dr. Halsey, of Gloucester, reports that his district has been distinguished by an unusual degree of health up to the middle of January, since which time pneumonia has prevailed over all the county. In one locality only did it assume a severe form; there the mortality was great, as also an epidemic of scarlet fever under homeopathic treatment, where 35 to 40 per ct. of all the cases were fatal. In the town of Woodbury scarlatina has prevailed in a mild form.

Dr. Miller, of Hudsm County, reports the ratio of sickness and mortality to the population to have been less than for many preceding years. In Jersey City the autumn brought with it dysentery in mild form, and the winter, fevers of a remittent and typhoid type, the latter in many instances severe and fatal. Scarlet fever was very rife during the winter months-a few cases were of a malignant character, resisting treatment and proving fatal within forty-eight hours. Dr. Varick relied in his treatment upon the alkaline bi-sulphites, inunction with lard, and support. He reports but two fatal cases out of a larger number treated than in any previous season. Pneumonia and bronchitis were extremely prevalent during the last of the winter and early spring, with few or no fatal cases.

In Hudson City, fevers in the remittent and intermittent form have been common throughout the year. It is, as Dr. Culver remarks, the ever prevalent fever of the whole county. Scarlet fever and measles were also quite prevalent. In August a few cases of cholera asphyxia appeared, and during the latter part of the month and early in September an epidemic of choleraic dysen

tery occurred. A case reported by Dr. Culver, with his observations upon the cause of the epidemic, is appended to the report from Hudson County, and is commended to notice. Pneumonia and and other forms of congestive lung disease were prevalent during the latter part of January, invading the city suddenly. This form of disease is not usual in this locality.

In the northern part of the county measles, scarlatina and pneu. monia prevailed to a great extent, no age being exempt. Dr. Talson speaks of the value of the wet sheet in scarlatina, finding to be both a sedative and diaphoretic.

From Hunterdon County, the Secretary of the District Society, Dr. George H. Larison, writes that the general health has been in advance of former years. The diseases which have exhibited an epidemic tendency are enteric fever in August and September, and pneumonia in adult cases in February and March, mostly severe and protracted in its course, but with a favorable issue.

Mercer County-The reporter, Dr. Phillips, notices no disease of an epidemic nature, and a general state of health, attributed by him, in some degree, to the general attention on the part of the boards of health and the people generally to sanitary laws, in anticipation of the invasion of epidemic cholera.

In Middlesex County, Dr. Hunt notices a decreased prevalence of miasmatic fevers. An epidemic of pertussis was wide spread throughout the county in 1866, and had not subsided at the date of the last report. Measles have been largely epidemic in Woodbridge and Piscataway during January and February. Few families escaped; the type was mild, as also was the treatment. The Dr. remarks that the habit of pouring down hot teas in the early stage of the disease to the extent in which it is practiced in domestic treatment, is not desirable. A hot draught at night with a foot bath, and cold drinks during the day while the fever is high, will suffice generally to do all we can toward "bringing the disease out."

For Monmouth District, Dr. A. A. Howell reports no epidemic

disease, and general good health during the year. He says that pulmonary tuberculosis appears to be on the increase, and deaths from the disease, are, in his belief, much more frequent than they were twenty-five years ago. In Manalapan, Dr. Deshler states that at no previous time has he seen so many cases of pneumonia. Recovery from the attacks was usually rapid and complete.

Dr. Van Riper, for Passaic District, notices erysipelas as occurring during the winter, not of a virulent character, mostly confined to the face. In children it was general. He treated these cases with the bi-sulphate of soda internally administered, and externally as a lotion. Scarlatina has appeared in a sporadic form throughout the whole year-cases generally mild and but few fatal. Diphtheria occurred in isolated cases, usually mild and not attended with the tumefaction of the tissues of the neck, which so distinguished it in its earlier history. A case of the disease attended with tetanus, is noticed by the reporter. Exemption from bowel affections, either by adults or children, has been decidedly marked, they usually prevailing in this district during the summer and early fall months.

In Sussex County, as reported by Dr. Miller, the only distinguishing disease during the year has been measles, which has proved itself to have been the most virulent and extensive epidemic known to the oldest practitioners of the county. A damp and chilly atmosphere in November, in which the sun's rays were obscured for a month, became a predisposing cause to diseases of the air passages, which were followed by an invasion of the epidemic. The usual catarrhal irritation announced the prodroma, and frequently continued two or three weeks before the eruption made its appearance; this was accompanied by tumefaction of the head and face, simulating erysipelas, and attended with severe dyspnoea-bronchitis and pneumonia were its frequent companions, sthenic in character. Dr. Ryerson, of Newton, in a note to the reporter, says: "I have never before, in twenty-five years of professional experience, seen a fatal case of measles. There is not

a practitioner in full business in the county who has not lost one or more patients. I have lost four, all children, which is probably one in forty-five or fifty. One practitioner had among his fatal cases a mother and two children. The number of adults attacked has been large. Very many of them claim to have had the disease before." The Dr. further remarks that he believes that the great majority of the fatal cases followed the ill-timed use of the popular heating regimen and medication, or by otherwise irritating the skin and mucous membrane just prior to the eruption.

In Warren County, which is contiguous to Sussex, the same epidemic prevailed, equally. complicated and fatal. In addition to the measles, pneumonia has been of frequent occurrence. Intermittent and remittent fevers, formerly very prevalent in this district, are for the last few years seldom met with. In their stead, has come an alarming frequency of cases of acute and chronic phthisis, seeming to have their origin, as remarked by Dr. Johnson, in the debility remaining after recurrent attacks. of subacute inflammation of both gastric and bronchial mucous membranes; pathological conditions much more frequently noticed since 1864.

A review of the sanitary condition of the State, discovers the fact that an unusual prevalence of health in the State at large, has been associated with a more than ordinary degree of disease, affecting in different forms the respiratory apparatus. Pneumonia quite generally, and measles and phthisis to a more limited extent, form the staple of the most of the reports reviewed by the Committee. The former disease has not in past years been generally recognized. Pleurisies and pneumonias are more frequently associated with the rarefied air of the more elevated regions of the of the country. The weather of the past winter has assimilated that of such districts. From December to the middle of March, the temperature was low to a very uniform degree. The ground was frozen throughout the winter, and was generally covered by snow. The dampness and fogs of the more temperate days, were rendered uncomfortable and severe in their influences by a freezing

temperature. It has been noticed that a sudden endemic of pneumonia occurred in Hudson City. Dr. Culver, in looking for its possible cause, records the fact, that the weather was damp and foggy, with fine rain or falling mist, and cold enough to freeze the mist as it fell, the ground being glazed everywhere with ice. Such facts are worthy of record. We may recognize their coincidence, while their secret relative influence is as yet beyond our knowledge.

We notice some of the new remedial agents to which our attention has been called in the reports. Apocynum Cannabinum has proved very efficient in the hands of the medical men in Cumberland County, in the cure of dropsy; sometimes by the use of the powder in ten grain doses, and sometimes in decoction 3 ss. to Ojss, reduced to Oj. Those who have administered it commend its properties as a diuretic of uncommon efficiency, and recommend it to the notice of the profession.

The bromides in their varied applications have received due notice. The more matured experience in their use, fails to give them the high place in the confidence of practitioners which has been claimed for them. Their effects are very variable. In many cases their quieting influence is undoubted. Cerebral congestion either of an active or passive kind is often relieved, but further experience seems to be necessary to measure their true value in such cases. Two cases of laryngismas stridulus were successfully treated by Dr. Varick, who administered the remedy together with tinct. iod. externally applied. These cases had resisted other treatment for a considerable time before being seen by him. It is admitted that they do not cure epilepsy, though they will unquestionably mitigate and lessen the frequency of the attacks, almost entirely suspending them, while the remedy is being administered. It seems also to afford decided relief in many cases of hooping cough, relieving spasm and allaying the temporary head symptoms so apt to arise in severe cases. As remarked by Dr. Hunt: "though it is not a panacea, it has uses which will