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The case in question was that of a young man, aged 27, who, while employed as a railroad brakeman, was injured Nov. 6, 1906, by a collision of the locomotive, on which he was riding, with a carload of logs. I saw the patient Dec. 4, 1906, twenty-eight days after the injury was received. During this time the patient had been treated by the company physician, with occasional consultations with the family physician. He had been told that an amputation of the leg would be the only procedure. This was asked for by his physicians on several different occasions, but was refused by both the patient's father and the patient himself. After a careful examination I found that a compound comminuted fracture of both bones existed at about the junction of the lower with the middle third of the leg. The communication on the external side was from two and

Case 1. —Colored child, aged 7; previous history negative. History. —The child had been sick for three weeks when I was called. The father stated that the child had been treated for typhoid fever during the entire time, but without any appreciable change for the better. The history was misleading in many respects. The child complained of nausea, slight headache, loss of appetite, abdominal tenderness, pain through the small of the back, as the father put it, constipation, frequent and painful micturition. The temperature was less than 100 F., pulse was somewhat accelerated. The general appearance was that of one who had suffered long and patiently. Examination. —I suggested to the mother that a more thorough examination of the child be made, to which she readily consented. In the outward appearance of the vulva there was nothing to attract special attention, except that the tissues were slightly inflamed; on pressure