The impulses, according to the author, must be transmitted to the brain by different paths. In examining temperature sensation it has been ascertained that there are also cold spots and warm spots-they are minute, constant areas where minimal stimuli arouse the sensation of heat and cold when the same stimuli would not arouse such sensation in the intermediate spaces. When thermal irritants are applied, as a rule only one kind responds. It is impossible to give temperature limits so that one could say just when the cold spots or warm spots would be stimulated. Some stimuli act upon both the warm and the cold spots. Mechanical, electrical, and at times thermal, stimuli do so. With temperatures between 45° and 50° C. one is generally sure to stimulate the cold spots as well as the warm. The author has termed this the paradoxical cold sensation. A simple experiment is here given which illustrates the specific nature of the cutaneous, afferent nerve fibers: "By means of a small lens the sunlight is concentrated on a part of the skin where the warm and cold spots have been determined beforehand. By bringing the focus to a warm spot the sensation of warmth is produced; on a cold spot the sensation of cold. In the intermediate spaces the concentrated light is either felt as painful or is not felt at all, according to its intensity. The touch spots never respond, being not accessible to any kind of thermal stimulus."

The author believes then, that the cutaneous nerve supply is a fourfold one, and it has been estimated that there are on the skin of the trunk and limbs about 30,000 warm spots, 250,000 cold spots, and 500,000 touch spots. It has been found difficult to estimate the number of spots where pain is felt with maximal intensity. The objection has been raised that a warm, a cold, a blunt or a sharp instrument passed over the skin is everywhere recognized in its proper qualities, and that the sensation seems a continuous one throughout. The author explains this by saying that all sensory organs possess what he terms the "irradiation of stimuli." There are two kinds of irradiation, a physical and a physiologic. Physical irradiation consists in the spreading of the irritation over a larger number of terminal organs than the nature of the stimulus itself would seem to demand. This spreading is caused by certain physical qualities of the tissue or part conducting the stimulus to the terminal organ. And it has been found that unless special precautions are taken thermal and mechanical stimuli are apt to irritate more than one terminal organ. Physiologic irradiation is demonstrated by showing that when the points of a pair of compasses are set on the skin, these points are not discriminated as separate if the distance (which varies in different parts) is reduced to a certain liminal value. This observation was first made by E. H. Weber. It was found that this liminal distance could be reduced by applying the two stimuli not simultaneously but successively. And the author also determined by this method that two neighboring touch spots could be ascertained, but one could not judge of their relative positions. Simultaneous stimulation facilitates the spread of irritation, and the localization of a given stimulus and the intensity with which it is felt depends

not only on the physical properties of the stimulus' and the number and quality of the terminal organs engaged, but also on the conditions existing in the central nervous system.

The observations of Head on the results of nerve injury are next referred to, and they have established the correctness of the view that in speaking of the perception of pressure that distinction must be made between light pressure, or touch, and deep pressure.

In discussing certain parts of Head's work where he endeavors to explain why there are under certain conditions imperfect sensations of heat, cold, and pain, by formulating the view that there is present a certain system of nerves which he calls " protopathic." These nerves regenerate according to Head, more quickly than the "Epicritic" nerves, their sensations are strong, vary little in intensity and their sense of localization is ill developed. The author disagrees with this view. He believes that in regard to the perception of intensity and locality of a stimulus, certain qualities of the central nervous system, such as summation, irradiation, etc., play an important rôle. Further, when a cutaneous nerve is severed the atrophy of its distal end, of its terminal organs, and probably of the skin is not the sole effect, but there occurs at the same time marked changes in the corresponding spinal ganglia and their posterior roots. The experiments of George Kaeter and H. K. Anderson are mentioned as evidence of the changes to be found in the spinal ganglia under such circumstances.

He assumes that as a result of the degenerative processes in the spinal ganglia following nerve injuries the connections of the neurons are loosened and stronger stimuli are needed to awaken sensations than normally, and also that the irritation is almost constant as regards intensity and irradiation, which means that summation and localization are very imperfect. It is known that certain drugs also act in this way. The writer then states that since all the points elicited by Head can be explained "by reference to certain well established physiologic and pharmacologic data," that it seems unnecessary to suggest a hypothesis which is not supported by existing physiologic and psychologic data. The author concludes by stating that his own explanation is more or less hypothetical, but that it is consistent with all recorded observations up to the present time. Finally he believes that physiology must be aided by clinical observation in discovering the functions of the nervous system. FITZGERALD.

Appointments, Resignations, Etc.

BACHELDER, DR. F. S., appointed Assistant Physician Eastern Michigan Asylum, at Pontiac, Mich., October, 1906.

BEEBE, DR. ARTHUR H., Assistant Physician, Illinois Asylum for the Incurable Insane, appointed April 10, 1906. Graduate 1905, University of Illinois, Medical Depart

ment.

BRADLEY, DR. ISABEL A., formerly in charge of the Pathological Laboratory of the Columbus State Hospital at Columbus, O., resigned to take up medical work in the wards.

BRUNDAGE, DR. HOWARD, formerly Interne at Columbus State Hospital at Columbus, O., promoted to be Assistant Physician, July 15, 1906.

BRUNK, DR. R. C., First Assistant Physician at Central State Hospital at Petersburg, Va., resigned.

CALHOUN, DR. ARTHUR P., of the Eastern Washington Hospital for the Insane at Medical Lake, Wash., appointed Superintendent of the Western Washington Hospital for the Insane at Fort Steilacoom, Wash.

CAREY, DR. HENRY B., Assistant Physician, Michigan Asylum at Kalamazoo, Mich., resigned August 20, 1906, to accept the chair of Materia Medica and PharmaIcology at the University of California.

CLARK, DR. ASA, Superintendent of Stockton State Hospital, Stockton, Cal., resigned to take charge of a private sanitarium in Stockton.

CLARK, DR. FRED. P., appointed Superintendent of Stockton State Hospital at Stockton, Cal.

CONRAD, DR. CHARLES E., Medical Interne at Manhattan State Hospital at Ward's Island, N. Y., resigned May 1, 1906, to accept a position in a general hospital. CORBUS, DR. JOHN C., formerly Superintendent of Illinois Eastern Hospital for the Insane at Hospital, Ill., resigned.

CRANE, DR. JOHN D., Clinical Assistant at Binghamton State Hospital at Binghamton, N. Y., promoted to be Medical Interne at Manhattan State Hospital at Ward's Island, N. Y., July 7, 1906.

DOLLEAR, DR. ALBERT H., appointed Assistant Physician at Illinois Western Hospital for the Insane at Watertown, Ill.

DUNN, DR. CLARA, Assistant Physician, Illinois Asylum for the Incurable Insane, appointed July 15, 1906, and transferred to the Illinois Northern Hospital for the Insane September 28, 1906.

DUNN, DR. MABEL, Second Assistant Physician at the Nebraska Hospital for the Insane at Lincoln, Neb., resigned July 16, 1906, to enter private practice. EMERSON, DR. ADELE RUSSELL, of Massachusetts, appointed Assistant Physician at Northern Indiana Hospital for the Insane at Logansport, Ind.

EWING, DR. HALLE L., Assistant Physician at the Hospital for the Insane at Hastings, Neb., appointed Second Assistant Physician at the Nebraska Hospital for the Insane at Lincoln, Neb., Aug. 16, 1906.

FERGUSON, DR. RAY, appointed Superintendent at Territorial Asylum for the Insane at Phoenix, Arizona.

GARVIN, DR. ALBERT H., Medical Interne at Hanhattan State Hospital at Ward's
Island, N. Y., promoted to be Junior Physician, April 21, 1906, and resigned
June 5, 1906, to accept a position at Ray Brook Hospital for Tuberculosis.
GARVIN, DR. WILLIAM C., JR., Junior Physician at Manhattan State Hospital at
Ward's Island, N. Y., resigned July 12, 1906, to enter private practice.
GILLETTE, DR. PHILLIP F., appointed Assistant Physician at Illinois Hospital for the
Incurable Insane at Bartonville, Ill.

GREENE, DR. JAS. L., Superintendent of the Nebraska Hospital for the Insane at Lincoln, Neb., resigned on July 16, 1906, to accept an appointment as Superintendent of the Hospital for the Insane at Kankakee, Ill.

HAY, DR. J. T., First Assistant Physician at the Nebraska Hospital for the Insane at Lincoln, Neb., promoted to be Superintendent, July 16, 1906.

HIGGINS, DR. SPENCER L., Junior Physician at Manhattan State Hospital at Ward's Island, N. Y., resigned April 10, 1906, to accept an appointment as Assistant Physician at the Soldiers Home at Bath, N. Y.

HUMMEL, DR. E. M., appointed Assistant Physician at the Insane Asylum of the State of Louisiana, at Jacksonville, La.

JENNINGS, DR. STUART S. M., appointed Third Assistant Physician at the Southern California State Hospital at Patton, Cal.

JOHNS, DR. GEO. A., appointed Assistant Physician at St. Louis Insane Asylum at St. Louis, Mo., Nov. 4, 1905.

LAKE, DR. LAFAYETTE, appointed Medical Interne at Manhattan State Hospital at Ward's Island, N. Y., July 13, 1906.

LETT, DR. EDMUND R., Medical Interne at Manhattan State Hospital at Ward's Island, N. Y., resigned April 1, 1906, to accept a position in a general hospital in New York City.

LUDLUM, DR. SEYMOUR DEW., Assistant Physician at Friend's Asylum at Frankford, Pa., resigned December, 1905.

LYPPS, DR. BERTHA M. L., appointed Assistant Physician Eastern Michigan Asylum at Pontiac, Mich., September, 1906.

MCGEORGE, DR. JAMES M., formerly Assistant Physician at Massillon State Hospital at Massillon, O., resigned.

MEDER, DR. FLORENCE, Third Assistant Physician at the Western Kentucky Hospital
for the Insane at Hopkinsville, Ky., accepted a similar position at the Eastern
Kentucky Hospital for the Insane at Lexington, Ky., September 1, 1906.
MILLS, DR. GEORGE W., of New York City, appointed Junior Assistant Physician at
Buffalo State Hospital at Buffalo, N. Y., April 21, 1906. Transferred September
15, 1906, to the Central Islip State Hospital, Central Islip, Long Island.
MONTGOMERY, DR. J. R., appointed Assistant Physician at Massillon State Hospital at
Massillon, O.

MOORE, DR. JOSEPH W., appointed Junior Physician at Manhattan State Hospital at
Ward's Island, N. Y., June 5, 1906.

MORSE, DR. MARY ELIZABETH, Assistant Physician, Eastern Michigan Asylum at Pontiac, Mich., resigned, June, 1906, to accept a position as Pathologist to New England Hospital for Women and Children, Boston.

NICHOLSON, DR. FRANK S., formerly Assistant Superintendent of the Norfolk Hospital for the Insane at Norfolk, Neb., resigned July 30, 1906.

O'DAY, DR. SYLVESTER, appointed Junior Physician at Manhattan State Hospital at Ward's Island, N. Y., June 6, 1906, after having completed his service in a general hospital in Brooklyn.

OSBORN, DR. WILLIAM S., formerly Assistant Physician at State Inebriate Hospital at Knoxville, Iowa, promoted to be Superintendent.

PARISH, DR. REBECCA, Assistant Physician at Northern Indiana Hospital for the Insane at Logansport, Ind., resigned to establish a general hospital for the Methodist Missions at Manila, P. I.

PATTERSON, DR. CHRISTOPHER J., Assistant Physician at Manhattan State Hospital at Ward's Island, N. Y., resigned May 11, 1906, to accept a position at Falkirk at Central Valley, N. Y.

PHILLIPS, DR. ARTHUR M., promoted to be Assistant Physician at Manhattan State Hospital at Ward's Island, N. Y., May 12, 1906.

PETTIT, DR. JOHN G., appointed Assistant Physician at the West Virginia Hospital for the Insane at Weston, W. Va.

PILGRIM, DR. CHARLES H., Superintendent of Hudson River State Hospital at Poughkeepsie, N. Y., appointed President of the State Commission of Lunacy.

PILSBURY, DR. L. B., of Lincoln, Neb., appointed Pathologist at the Nebraska Hospital for the Insane at Lincoln, Neb., July 12, 1906.

PODSTATA, DR. VACLAV H., Superintendent of Cook County Institutions at Dunning, Ill., resigned and appointed Superintendent at Illinois Northern Hospital for the Insane at Elgin, Ill., July 1, 1906.

RICHARDS, DR. JOHN S., appointed Medical Interne at Manhattan State Hospital at Ward's Island, N. Y., June 21, 1906.

RICHARDSON, DR. Wм. H., appointed Assistant Physician at St. Louis Insane Asylum at St. Louis, Mo., October 14, 1905.

RICHARDSON, DR. W. W., Assistant Physician at Columbus State Hospital at Colum. bus, O., resigned July 15, 1906, to accept an appointment in the Insane Department of the Philadelphia Hospital at Philadelphia, Pa. He is a son of the late Dr. A. B. Richardson, formerly Superintendent of the Government Hospital for the Insane, Washington, D. C.

RORICK, DR. ESTELL H., formerly Superintendent of the Athens State Hospital at Athens, O., and later Superintendent of the Ohio Institution for Feebleminded Children at Columbus, O., resigned.

SIAKIN-ROSS, DR. VIADINE, formerly Superintendent of State Insane Hospital at Yankton, S. D., resigned to enter private practice in Sioux Falls, S. D.

SIMPSON, DR. CLARENCE E., Assistant Physician Eastern Michigan Asylum at Pontiac, Mich., resigned to enter private practice, October, 1906.

Singer, Dr. H. DOUGLAS, appointed Assistant Superintendent of the Norfolk Hospital for the Insane at Norfolk, Neb., July 30, 1906.

SKOLFIELD, DR. EZRA B., Second Assistant Physician at Eastern Maine Insane Hospital at Bangor, Me., resigned to enter private practice.

SKOOG, DR. A. L., First Assistant Physician at Kansas State Hospital for Epileptics at Parsons, Kan., resigned and appointed Pathologist at Woodcroft Hospital for Mental Diseases at Pueblo, Col.

STRIPP, DR. ALBERT E., Assistant Physician, Michigan Asylum at Kalamazoo, Mich., resigned September 1, 1906, to engage in private practice.

TALBOT, DR. ROBERT S., appointed First Assistant Physician at Central State Hospital at Petersburg, Va.

Tatge, Dr. OraL, appointed Assistant Physician at Massillon State Hospital at Massillon, O.

TURNBULL, DR. E. G., appointed Second Assistant Physician at Protestant Hospital for the Insane at Montreal, Quebec.

TYSON, DR. FOREST C., appointed Second Assistant Physician at Eastern Maine Insane Hospital at Bangor, Me.

VAN ZANDT, DR. EUCLID, Superintendent of the Western Washington Hospital for the Insane at Fort Steilacoom, Wash., resigned.

VAUGHAN, DR. HARRY F., Assistant Physician at Massillon State Hospital at Massillon, O., resigned.

WARD, DR. WILLIAM H., Superintendent of the Territorial Asylum for the Insane at Phoenix, Ariz., resigned.

WATERMAN, DR. CHESTER, appointed Medical Interne at Manhattan State Hospital at Ward's Island, N. Y., May 5, 1906.

WATKINS, DR. RACHEL A., Assistant Physician, Illinois Asylum for Incurable Insane, appointed September 28, 1906. Graduate 1906, University of Illinois, Medical

Department.

WEATHERHEAD, DR. C. F., Second Assistant Physician at Protestant Hospital for the Insane at Montreal, Quebec, resigned November, 1905.

WHITMAN, DR. FRANK S., Superintendent at Northern Illinois Hospital for the Insane at Elgin, Ill., resigned June 30, 1906.

WILHITE, DR. OLE C., formerly Superintendent of State Inebriate Hospital at Knoxville, Iowa, appointed Superintendent of Cook County Institutions at Dunning, Ill., July 16, 1906.

WILSON, DR. GUSTAVE, promoted to be Second Assistant Physician at the Southern California State Hospital at Patton, Cal.