numerous to mention, the element of cost enters. This is a considerable item to the large clinics and to the medical departments of the steamship companies.A preparation for pediculi which is not in extensive use at present and is effective and cheap is an ointment containing 25 per cent of xylene in a base of hydrous wool fat and petrolatum, equal parts. Sutton 1 calls attention to the effectiveness of xylene against pediculosis capitis in his textbook on diseases of the skin. If applied undiluted it is too irritating ; mixed as directed it produces fer a few minutes a mild warmth and tingling sensation of the skin. This is relieved by rubbing, which is desirable to get the ointment well spread over the skin and around the bases of the hairs. The patients are instructed to apply the ointment from the axillae to the ankles twice daily for at least five days. It is necessary to continue treatment for several days to insure the destruction of the hatching nits. These hatch in from four to seven days. This treatment has proved successful at this hospital. It is 51 per cent cheaper per pound than the mild mercurial ointment, is cleaner to handle, and has not caused any cases of dermatitis.Accessory or supernumerary lobes of the lungs are usually unimportant from a pathologic point of view. Either lung may have one or two extra lobes or rudimentary fissures; the extra lobes when present are usually small but may be quite large. They are generally located posteriorly, near the hilus, and have a broad or sessile base. Occasionally, as in our case, they are located anteriorly and are pedunculated, in which event they usually arise from the free margin of a standard type of lobe.Rudimentary fissures are sometimes seen; one happened to be present in our case, both abnormalities being in the left upper lobe.The remarkable feature of our case was made possible by the simultaneous presence of a hydrothorax. The accessory lobe had floated in the hydrothorax and because of respiratory movements had made two and one-half turns from left to right. This had resulted in a high degree of passive congestion just short of gangrene.REPORT OF CASE W. W., a man, aged 70, entered the hospital, Feb. 26, 1929, because of cough of three weeks' duration ; shortness of breath at various intervals for eight years, and swelling of the ankles, particularly during the past year. All his symptoms had been aggravated by a severe cold two years before. He had had gonorrheal arthritis thirty-two years before.On examination the blood pressure was 120 systolic ; the pulse 80, and the temperature 98.4 F. The head and neck were normal.The chest was of the broad type. Expansion was equal and adequate. In the lungs there was dulness over the bases with absence of breath sounds. Breath sounds over the upper portion of the lungs were harsh with many wheezing râles. There was no cardiac thrill. Slight bulging of the precordium was noted. The dulness of the heart was greatly increased, merging with the dulness at the base of the lungs. A heaving apex beat wa...

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