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two of the cases is suggestive of diatetic errors. Little weight ought to be attach- ed to this fact owing to the extra-ordinary prevalence of cirrhotic conditions- of the internal organs, more particularly of the liver, spleen, and kidneys in Chinese, compared with the relative rareness of hepatic abscess.

An interesting point, also, is that two of these cases occurred in females one in a female child aged about 3 years, the other aged about 10 years. These cases are in direct opposition to the generally accepted facts in regard to the frequency of the occurrence of hepatic abscess in the different sexes and as regards age. As SCHEUBE has it "reports from all countries coincide in stating that the female sex enjoys remarkable immunity from liver abscess" and again "liver abscess rarely attacks children."

In my two cases, it will be noted that in the case of No. 4 acute catarrhal pneu- monia was present and was returned as the cause of death; in case No. 5, the cause of death was acute fibrinous pneumonia. It was only after a complete post- mortem examination had been performed that the existence of such a pathological

condition in the liver was ascertained.

Whether the reports from different sources as to the occurrence of hepatic abscess in children of both sexes are founded on clinical observation alone or upon the results obtained by pathological investigation, I have found impossible to determine; but what is obvious from these cases is, that had no post-mortem examination been held, Cases Nos. 4 and 5 would have passed as death from a respiratory disease. In each of these cases, the appearance presented by the liver was typical. In neither was Dysentery present and the bacteriological exam- ination was negative.

Again, the distinction generally made in regard to the number of abscesses present, i.e., the solitary large abscess and the multiple small abscesses, would appear from my cases to be of little value. In case No. 1 a large solitary abscess was found, but sur- rounding this large cavity, were numerous small abscess foci. These appeared to the naked eye to have no connection with the larger focus. A similar state of affairs was observed in Case No. 4. In Case No. 5, where numerous abscesses were pre- sent, I found it difficult to determine which might be regarded as the large abscess and which the multiple small abscesses. It would appear that with careful post- mortem evidence at one's disposal, such a differentiation of hepatic abscess woult in a great measure collapse.

Endocarditis.

From a perusal of the accompanying table it is evident that during the past year quite an interesting series of cases of acute endocarditis have come under my observation. Owing to the fact that within recent years a considerable amount of attention has been directed to this subject, particularly in regard to its bacteriology, special care was taken to examine each case with the hope of determining what micro-organisms were accountable for the production of the disease and also the extent and nature of the pathological changes produced by these micro-organisms. With one exception all the cases occurred in adults and as frequently amongst males as females. So far as the frequency with which the valves were affected it will be seen that the mitral was involved as often as the aortic and further the inflammatory process in several of the cases was not limited to the valves themselves but extended to the lining walls of the adjacent cavities.

It is unnecessary to sketch, further than is indicated in the table, the sequence of events which apparently took place in each case. The appearances resembled those fully described in any text-book on pathology.

With regard to the bacteriological investigation, however, there is much of interest. Amongst the six cases tabulated, appears one labelled as due to the Micro- coccus Gonorrhæœ. A case of this nature must appeal to all those interesting themselves in infectious diseases. Further it is important in regard to the infective nature of the micro-organism itself. A few years ago the Micrococcus Gonorrhææ- was almost entirely associated with infective urethritis. To-day, however, with a more complete knowledge of the micro-organism and the effect which it may call forth in the human body, our ideas have altered considerably. litherto the gonococcus has been generally regarded as an organism which limits itself to mucous membranes and only under exceptional circumstances penetrates into the deeper lying connective tissue structures. Many proofs, however, have been forthcoming establishing the possibility of the micro-organisins reaching the lymph channels. or the blood vessels and thereby being transported to other parts of the body, and