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+Project Gutenberg (https://www.gutenberg.org) public repository for
+eBook #52874 (https://www.gutenberg.org/ebooks/52874)
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-The Project Gutenberg EBook of The Cleveland Medical Gazette, Vol. I. No.
-3., January 1886, by A. R. Baker and S. W. Kelley and Various
-
-This eBook is for the use of anyone anywhere in the United States and most
-other parts of the world at no cost and with almost no restrictions
-whatsoever.  You may copy it, give it away or re-use it under the terms of
-the Project Gutenberg License included with this eBook or online at
-www.gutenberg.org.  If you are not located in the United States, you'll have
-to check the laws of the country where you are located before using this ebook.
-
-
-
-Title: The Cleveland Medical Gazette, Vol. I. No. 3., January 1886
-
-Author: A. R. Baker
-        S. W. Kelley
-        Various
-
-Release Date: August 22, 2016 [EBook #52874]
-
-Language: English
-
-Character set encoding: UTF-8
-
-*** START OF THIS PROJECT GUTENBERG EBOOK THE CLEVELAND MEDICAL ***
-
-
-
-
-Produced by Richard Tonsing, The Online Distributed
-Proofreading Team at http://www.pgdp.net (This file was
-produced from images generously made available by The
-Internet Archive)
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-
-
-                     THE Cleveland Medical Gazette
-
- _VOL. I._                  _JANUARY, 1886._                    _No. 3._
-
-
-
-
-                           ORIGINAL ARTICLES.
-
-
-
-
-                         A HISTORY OF MEDICINE.
-
-                        BY JOHN BENNITT, M. D.,
-
-    Professor of Principles and Practice of Medicine in the Medical
-     Department of the Western Reserve University, Cleveland, Ohio.
-
-
-It may not be inappropriate to give in your journal a brief sketch of
-the history of medicine, by the consideration of which we may come to a
-better appreciation of our present standpoint as medical men. We may
-also the better understand how much we, as medical men, and the world at
-large, are indebted to the methodical, plodding workers of the past in
-the field of inquiry pertaining to the nature and cure of disease. Such
-review may have the effect of stimulating medical men to more careful
-observation and the recording the results of observations that they may
-be given to others for mutual benefit.
-
-Science may be defined as “classified knowledge.” But all our knowledge
-is based on experience and observation. Medical science, like other
-sciences, taking the definition of Sir John Herschel, is “the knowledge
-of many, orderly and methodically digested and arranged so as to become
-attainable by one.”
-
-In all cases art and observation precede and beget science, and give
-origin to its gradual construction. But soon science, so built up,
-begins to reflect new light upon its parents—observation and art—helps
-them onward, expands the range of vision, corrects their errors,
-improves their methods and suggests new ones. The stars were mapped out
-and counted by the shepherds watching their flocks by night, long before
-astronomy assumed any scientific form.
-
-From the earliest ages the pains and disorders of the human body must
-have arrested men's anxious attention and claimed their succor. The
-facts observed, both as to hurts and diseases, and as to their attempted
-remedying, were handed down by tradition or by record from generation to
-generation in continually increasing abundance, and out of the repeated
-survey and comparison of these has grown the recognition of certain laws
-of events and rules of action, which together constitute “medical
-science.”
-
-There is good reason for the belief that Egypt was the country in which
-the _art_ of medicine, as well as the other arts of civilized life, was
-first cultivated with any degree of success, the offices of the priest
-and the physician being probably combined in the same person. In the
-writings of Moses there are various allusions to the practice of
-medicine amongst the Jews, especially with reference to the diagnosis
-and treatment of leprosy. The priests were the physicians, and their
-treatment mainly aimed at promoting cleanliness and preventing
-contagion. The same practice is approved by the light of latest science.
-
-Chiron, the Centaur, is said to have introduced the art of medicine
-amongst the Greeks, but the early history of the _art_ is entirely
-legendary. Æsculapius appears in Homer as an excellent physician of
-_human_ origin; in the later legends he becomes the god of the healing
-art. His genealogy is obscure and altogether fabulous. He, however, soon
-surpassed his teacher, Chiron, and succeeded so far as to restore the
-dead to life (as the story goes). This offended Hades, who began to fear
-that his realm would not be sufficiently peopled; complained to Zeus
-(Jove) of the innovation, and Jove slew Æsculapius by a flash of
-lightning. After this he was deified by the gratitude of mankind, and
-was especially worshiped at Epidaurus, where a temple and a grove were
-consecrated to him. His statue in this temple was formed of gold and
-ivory, and represents him as a god seated on a throne, and holding in
-one hand a staff with a snake coiled around it, the other hand resting
-on the head of a snake; a dog, as an emblem of watchfulness, at his feet
-(an intimation very appropriate for the medical profession). The
-Asclepiades, the followers of Æsculapius, inherited and kept the secrets
-of the healing art; or, assuming that Æsculapius was merely a divine
-symbol, the Asclepiades must be regarded as a medical, priestly caste,
-who preserved as mysteries the doctrine of medicine. The members of the
-caste were bound by an oath—the Hippocratis jusjurandum—not to divulge
-the secrets of their profession.
-
-In Rome, in the year 292 B. C., a pestilence (probably malarial fever)
-prevailed. The Sibyline books directed that Æsculapius (statue!) must be
-brought from Epidaurus. Accordingly, an embassy was sent to this place,
-and when they had made their request, a snake crept out of the temple
-into the ship. Regarding this as the god Æsculapius, they sailed to
-Italy, and as they entered the Tiber the snake sprang out upon an
-island, where afterwards a temple was erected to Æsculapius and a
-company of priests appointed to take charge of the service and practice
-the art of medicine. The name Æsculapius, then, is only an impersonation
-of medicine in the remote ages, or early ages of Grecian history.
-
-Hippocrates is the first writer of medicine whose works have come down
-to us with anything like authority other than fable. Indeed, he was the
-most celebrated physician of antiquity. He was the son of Heracleides,
-also a physician, and belonged to the family of the Asclepiades, said to
-be about eighteen generations from Æsculapius. His mother was said to be
-descended from Hercules.
-
-Hippocrates was born in the island of Cos (more anciently Meropis), an
-island of the Grecian archipelago of about one hundred square miles,
-probably about the year 460 B. C. Instructed in medicine by his father
-and other contemporary medical men, he traveled in various parts of
-Greece and Asia minor. He finally settled and practiced his profession
-at Cos, but died in Thessaly at the age of one hundred and four years
-(B. C. 357). Little is known of his personal history, other than that he
-was highly esteemed as a physician and an author, and that he raised the
-reputation of the medical school of Cos to a high degree. His works were
-studied and quoted by Plato. He was famous in his own time, and his
-works, some sixty in number, have in them many things that are not
-unworthy of consideration even after the lapse of twenty-two hundred
-years. Many of the works ascribed to Hippocrates are _not_ well
-authenticated.
-
-He divided the causes of diseases into two principal classes—the first
-consisting of the influence of seasons, climates, water, situations,
-etc.; the second of more personal causes, such as the food and exercise
-of the individual patient. His belief in the influence which different
-climates exert on the human constitution is very strongly expressed. He
-ascribes to this influence both the conformation of the body and the
-disposition of the mind, and hence accounts for the difference between
-the hardy Greek and the Asiatic.
-
-The four humors of the body (blood, phlegm, yellow bile and black bile)
-were regarded by him as the primary seats of disease; health was the
-result of the due combination (or crasis) of these humors, and illness
-was the consequence of a disturbance of this crasis. When a disease was
-progressing favorably these humors underwent a certain change (coction),
-which was the sign of returning health, as preparing the way for the
-expulsion of morbid matters, or crisis, these crises having a tendency
-to occur at definite periods, which were hence called critical days.
-
-His treatment of disease was cautious and what we now term expectant,
-_i. e._, it consisted chiefly, often solely, in attention to diet and
-regimen; and he was sometimes reproached with letting his patients die
-by doing nothing to keep them alive.
-
-His works written in Greek were at an early period translated into
-Arabic. They were first printed in Latin in 1525, at Rome. A complete
-edition in Greek bears a date a year later.
-
-Several editions in Latin and other languages have appeared from time to
-time. An English translation of 'The Genuine Works of Hippocrates,' was
-published by the Sydenham society in 1848, in 2 vols., by Dr. Adams. The
-advance which Hippocrates made in the practice of medicine was so great
-that no attempts were made for some centuries to improve upon his views
-and precepts. His sons, Thessalus and Draco, and his son-in-law,
-Polybius, are regarded as the founders of the medical sect which was
-called the Hippocratean or Dogmatic school, because it professed to set
-out with certain theoretical principles, which were derived from the
-generalization of facts and observations, and to make these principles
-the basis of practice. The next epoch in the history of medicine is the
-establishment of the school at Alexandria, which was effected by the
-munificence of the Ptolemies, about B. C. 300. Indeed the whole race of
-Ptolemies (from Ptolemy I. to Ptolemy VII. B. C. 323 to 117) seem to
-have been patrons of learning and learned men. (Less so Ptolemy VIII. to
-XIII., B. C. 117 to 43. Ptolemy II., Philadelphius, was born in Cos
-about 150 years after Hippocrates.) It was by the patronage of these
-kings of Egypt that learning flourished in Alexandria during their
-reign.
-
-In some of them this seems to have been the only redeeming feature of
-their character. Otherwise vicious, cruel, bloodthirsty in an extreme
-degree, they uniformly encouraged learning and learned men. (It seems to
-have been a hereditary trait.) Amongst the most famous of the medical
-professors of the School of Alexandria are Erasistratus and Herophilus.
-
-The former of these was a pupil of Chrysippus, and probably imbibed from
-his master his prejudice against bleeding and against the use of active
-remedies, preferring to trust mainly to diet and to the _vis medicatrix
-naturae_.
-
-Herophilus, born in Chalcedon, in Bythinia, flourished in the latter
-part of the fourth and the beginning of the third century B. C., and
-settled in Alexandria, especially was distinguished by his devotion to
-the study of anatomy. He is said to have pursued this to such an extent
-as to have dissected criminals alive. Several names which he gave to
-different parts of the body are still in use, as the torcular Herophili,
-calamus scriptorius, and duodenum. He located the seat of the soul in
-the ventricles of the brain. Only a few fragments remain of what he
-wrote.
-
-About this time the Empirics formed themselves into a distinct sect and
-became the declared opponents of the Dogmatists. The controversy really
-consisted in the question, “How far we are to suffer theory to influence
-over practice.” While the Dogmatists, or as they were sometimes styled,
-the Rationalists, asserted that before attempting to treat any disease
-we ought to make ourselves fully acquainted with the structure and
-functions of the body generally, with the operation of medicinal agents
-upon it, and with the changes which it undergoes when under the
-operation of any morbid cause, the Empirics, on the contrary, contended
-that this knowledge is impossible to be obtained and if possible is not
-necessary; that our sole guide must be experience and that if we step
-beyond this, either as learned from our own observations or that of
-others on whose testimony we can rely, we are always liable to fall into
-dangerous and often fatal errors. According to Celsus, the founder of
-the Empirics was Serapion, who was said to be a pupil of Herophilus. At
-this period, and for some centuries later, all physicians were included
-in one or the other of these rival sects, and from the evidence of
-history the two sects or schools were about equal. From Phiny, who wrote
-about the middle and sixth, seventh and eighth decades of the first
-century, we learn that medicine was introduced into Rome at a later
-period than the other arts and sciences.
-
-The first person who seems to have made it a distinct profession,
-separate from priestcraft, was Archagathus, a Peloponnesian, who settled
-at Rome about B. C. 200. His treatment of his patients was so severe and
-unsuccessful that he was finally banished, and no other mention is made
-of a physician at Rome for about a century, when Asclepiades of
-Bythinia, acquired a great reputation. His popularity depended upon his
-allowing his patients a liberal use of wine, and of their favorite
-dishes, and in all respects consulting their inclinations and flattering
-their prejudices; and hence it is easy to understand the eminence at
-which he arrived, for we see even in our own time men building up great
-reputations by similar practices.
-
-This man with a long name—Archagathus—was succeeded by his pupil,
-Themison of Laodicea, the founder of a sect called Methodics, who
-adopted a middle course between the Dogmatists and Empirics. During the
-greater part of the first two centuries of our era the Methodics were
-the preponderating medical sect, and they included in their ranks C.
-Aurelianus, some of whose writings have come down to us.
-
-They soon broke into various sects of which the chief were the
-Pneumatics, represented by Aretaeus of Cappadocia, whose works are still
-extant; and the Eclectics, who claimed as do the Eclectics of to-day, to
-select the best from all the other systems and to reject the hurtful.
-The most remarkable writer of this age is Celsus (about A. D.), whose
-work (De Medicina) gives a sketch of the history of medicine up to that
-time and the state in which it then was. He is remarkable in being the
-first _native_ Roman physician whose name has come down to us.
-
-Dioscorides of Cilicia flourished about the end of the first century. He
-accompanied the Roman army in their campaign through many countries and
-gathered a great store of information and observations on plants. In his
-great work 'De Materia Medica,' he treats of all the then known
-medicinal substances and their properties, real or reputed, on the
-principles of the so-called humoral pathology. Two other works are
-ascribed to him but their genuineness is questionable. For fifteen
-centuries the authority of Dioscorides, in botany and materia medica,
-was undisputed, and still holds among the Turks and Moors.
-
-                          [_To be Continued._]
-
-
-
-
-              REPORT OF A CASE OF EXTRA-UTERINE PREGNANCY.
-
-                 BY H. J. LEE, M. D., CLEVELAND, OHIO.
-
-
-The following case came under my care during my term of service in the
-wards of Charity Hospital in this city. Mrs. D., age thirty-five,
-married, one child two years of age, was admitted to the hospital July
-14, 1885, with the following history: She had always enjoyed good
-health, and there was no history of uterine disease. She menstruated
-about the first of April, 1885, did not menstruate in May, and supposed
-herself pregnant, as she had always been regular before, and during the
-latter part of May she had considerable nausea and other symptoms of
-pregnancy. About the first of June, while in church, she was taken with
-a severe hemorrhage. She was taken home and a physician called, who
-examined her and decided from the symptoms and history that she had had
-a miscarriage. There was very little hemorrhage after she arrived home,
-in fact very little at any subsequent time, but she did not recover
-well, had some pains in the abdomen, and she said had some fever all the
-time. Not getting on well, as she and her friends thought, it was
-decided to change physicians, which was done. The second physician
-concurred in the diagnosis of the first, and treated her evidently on
-the expectant plan, as any one would be compelled to do, owing to the
-difficulty of making a correct diagnosis at such an early stage. After a
-time, there being no improvement, she decided to go to the hospital. On
-admission she was quite emaciated and had an anaemic appearance; her
-temperature was about 99° to 100° in the morning and 100° to 102° in the
-evening. There was considerable tenderness in the right iliac region,
-extending into the hypogastric region. Uterus was not felt to be at all
-enlarged, but the os was patulous. There was an enlargement to the right
-of the uterus. This could be felt both externally and through the
-vagina; was of an irregular outline, and quite tense and tender upon
-pressure. A sound was introduced into the uterus and passed in about
-three inches and was deflected to the left quite perceptibly. It did not
-appear quite certain that there was nothing in the uterus, and in view
-of the history of the case it seemed justifiable to explore the cavity.
-Accordingly a good sized sponge tent was introduced and allowed to
-remain twenty-four hours, when it was removed and the uterine cavity
-explored with purely negative results. The patient had now been under
-observation over a week, and attempts made to improve her general
-condition with tonics and nutritious diet, but without success. Her
-temperature continued about 101° most of the time. A positive diagnosis
-had not been made, though it seemed that about everything could be
-excluded except extra-uterine pregnancy. At this juncture Dr. W. J.
-Scott was asked to see the patient. He did so and made a very careful
-examination, and gave it as his opinion the case was one of
-extra-uterine pregnancy. The next day Dr. Dudley P. Allen was called in
-consultation with Dr. Scott and myself. Dr. Allen's examination was
-careful and exhaustive, and at its close he gave it as his opinion that
-while there were some obscure points, the most probable conclusion was
-that the case was one of extra-uterine fœtation.
-
-Having all arrived at this conclusion, independently of each other, it
-was agreed that as there was some obscurity in the case, and also that
-in the event of there being a fœtus outside of the uterus it had now
-advanced to about the fourth month of gestation; consequently the most
-favorable time for the employment of the electric current had passed. In
-view of these facts, and also of the fact that exploratory incisions are
-attended with comparatively little danger, it was decided to make an
-exploratory incision and determine what was the condition of things. If
-a fœtus was found remove it if possible. If the trouble was something
-that could not be removed, the incision could be closed and the patient
-probably in no wise injured. Dr. Allen was asked to operate, and on the
-sixth of August the operation was performed. There were present, Dr.
-Allen, Dr. Scott, Dr. Millikin and the house staff. The anæsthetic was
-administered, and before commencing the operation an aspirator needle of
-good size was introduced into the tumor through the vagina. Upon
-exhausting the air no fluid was obtained, but upon partially withdrawing
-the needle about a drachm of clear serum was obtained, which was thought
-to be peritoneal fluid. It was then decided to proceed with the
-operation. An incision was made about an inch above and parallel to
-Poupart's ligament, commencing at the anterior superior spinous process
-of the ilium, and terminating at the outer margin of the rectus muscle.
-
-On opening the abdomen an adherent mass was found closely attached to
-the coecum. Strong bands also passed from the mass toward the symphysis
-pubis. In order to reach the mass more fully, and also the annexes of
-the uterus, the adhesions to the pubis were divided between ligatures.
-This having been done, it was still found to be impossible to detach the
-intestines which were closely adherent to the coecum, and nothing
-abnormal could be found in connection with the uterus. Failing to
-discover the cause of the adhesions about the coecum from the abdominal
-cavity, it was thought this might be accomplished by separating the
-peritoneum from the iliac fossa, and reaching the coecum from the outer
-and posterior side. This separation was continued until it could be
-carried no further without great danger of wounding the external iliac
-vessels, which were exposed for several inches. Although nothing further
-than a closely adherent mass of intestines had been found, an attempt to
-separate which had been carried to the limit of safety, and the cause of
-the malady had not been demonstrated with entire satisfaction, it was
-deemed best to close the abdominal incision, which was accordingly done.
-
-The subsequent history of the cure was as favorable as could be desired.
-The wound united very readily. The temperature never rose above 103°,
-and was only at that point for a few hours; most of the time was 100° to
-101.5°. Two weeks after the operation temperature was normal, a point it
-had not reached since her admission, and probably not for some time
-previous.
-
-Patient was examined September 8; the tumor was found to be considerably
-diminished in size, and tenderness almost entirely disappeared. She had
-apparently gained in weight, and expressed herself as feeling well. She
-was discharged from the hospital September 9. On the tenth of October
-she again presented herself, according to agreement, and was examined by
-Dr. Scott, Dr. Allen and myself. The tumor had entirely disappeared,
-only a slight thickening of the tissues remaining, the uterus had
-resumed its normal position, and the patient, to all appearances, was as
-well as ever.
-
-I have reported this case as one of extra-uterine pregnancy, and yet it
-will be seen by the report that the existence of that condition was not
-demonstrated at the operation, but it seems to me that the history of
-the case, both prior and subsequent to the operation, demonstrates
-pretty conclusively that it could be nothing else. Both the gentlemen
-who saw the case before operation were of the opinion that everything
-could be excluded except a collection of fluid, disease of the coecum
-and extra-uterine pregnancy, and to my mind (and the gentlemen who were
-called in consultation have expressed themselves in the same manner) the
-operation and the result of it excludes everything except the last
-mentioned condition. It may be said that in the treatment of the case
-less severe measures should first have been tried; that the electric
-current should have been employed before resorting to an operation. This
-subject was fully discussed, and the decision against the employment of
-electricity was unanimous, from the fact that the most favorable time
-for its employment had passed and the time had arrived when any further
-delay was dangerous. Then the danger from an exploratory incision is so
-small that it seemed to be more than counterbalanced by the knowledge
-that would be obtained by it. If an exploratory incision was made we
-would then be better able to tell what we had to deal with, and would
-also be in a position to deal with whatever was found in the most
-effectual manner, and it was thought that the most certain means of cure
-should be employed first and the patient not be subjected to the danger
-of delay in order that less certain methods might first be tried; also
-the high temperature seemed to render any delay more dangerous. The
-incision described was employed because it seemed that the tumor could
-be more easily reached and removed by means of it than by means of the
-central one. When, however, the mass was reached it was found to be so
-firmly attached to the cœcum by strong adhesions that it was absolutely
-immoveable. Under these circumstances it was decided that it would be
-unwise to attempt its removal, consequently the wound was closed and the
-operation desisted from. The subsequent history was all that could be
-desired, or could, under any circumstances, have been expected.
-
-I think the most probable explanation of the disappearance of the tumor
-is this: The case was one of extra-uterine pregnancy of the abdominal
-variety, the ovum became attached to the peritoneum and a connective
-tissue proliferation was set up which surrounded it with a vascular
-sack, the walls of which kept pace with the growth of the ovum, and as
-they extended into the abdominal cavity formed adhesions to the cœcum,
-intestines, and other parts in the vicinity. During the operation these
-adhesions were ligated and divided, and in consequence the nutrition of
-the ovum was entirely cut off, and death and absorption was the result.
-
-Since writing the report of this case the patient has been seen and
-examined. She seems to be in perfect health, and says she never felt
-better. There is not a vestige of the tumor remaining, except two or
-three small indurated spots that can be felt through the vagina.
-
-
-
-
-                        STAMMERING, STUTTERING.
-
-               BY PROF. G. DELON, LATE OF PARIS, FRANCE.
-
-
-Here is an universal and very strange infirmity, impeding speech, the
-origin of which must be anterior to the formation of languages.
-Hippocrates, the “Père de la Médecine,” Galen and Aristotle attributed
-it to an abnormal moisture of the brain and tongue and to a defective
-construction of the tongue, and their theories have been revived by
-modern writers. We find in Aristotle a double definition that stammering
-is an inability of articulating a certain letter, and stuttering an
-inability of joining one syllable to another. Notwithstanding the
-difference between the causes, the characteristics and the effects of
-both defects, several languages have but one word to express it; in
-French, for instance, “Bégaiement” means either stammering or
-stuttering. American dictionaries give the same definition for both; and
-in common talk no distinction is made, all stoppages in speech being
-called indiscriminately stammering or stuttering.
-
-Speech being a combination of separate sounds produced by the expired
-air, it is certain that the first condition required for natural and
-correct speech is an undisturbed and normal action of the breathing
-apparatus.
-
-The movements performed by the respiratory organs for the modification
-of the currents of air being produced by muscles owing their activity to
-nerves—motor and sensory—and the vocal organs being, like all parts of
-the organism, provided with nerves, it becomes evident that a general
-excitation of the nervous system, or any unusual excitement of the
-motor-nerves in action, will affect the muscles, cause irritation and
-create disturbances in inspiration, expiration and speech.
-
-Normal inspiration is produced by a regular contraction of the
-diaphragm, and expiration is due to the elasticity of the tissue of the
-lungs. A spasmodic inspiration, during which a prolonged contracted
-spasm of the diaphragm takes place, produces stammering; such a
-convulsive contraction of the diaphragm can take place without
-attempting to speak, but any attempt to utter sounds during the spasm
-will result in stammering. At the end of the spasm, the air is then
-quickly expelled from the lungs. I have noticed stammering children that
-I have treated subject to frequent attacks of hiccough; in hiccough the
-expiration is quiet: an irritation of the nerves of the diaphragm brings
-about, with a violent inspiration, an attenuated convulsive contraction
-of the diaphragm, as in stammering.
-
-In stuttering which is characterized by the presence of some spasm, in
-all articulations, labial, lingual, dental and guttural, although
-respiration is irregular and the respiratory organs do not work well,
-the inability to form and join the sounds comes from other sources than
-a spasmodic contraction of the diaphragm.
-
-Stammering proper, when organic, might be called stammering of the
-diaphragm, and that distinction would be quite logical, as other organs
-wholly unconnected with speech show that peculiarity of being affected
-with stammering.
-
-The influence exercised on the voice and speech by the respiratory
-mechanism is so considerable that a variety of theories on respiration
-have been advanced and discussed by physicians and specialists, not only
-with reference to speech impediments but specially for singing,
-elocution, acting and public speaking, and also in reference to general
-health. Writers and professors advocating exclusively so-called
-diaphragmatic, or costal, or abdominal respiration, are incorrect and
-perfectly deceived. The diaphragm, the ribs, and the muscles of the
-abdomen must all do more or less their special work, in order to carry
-on a normal and healthy respiratory act. An eminent physician, Dr. Ed.
-Fournié of Paris, says: “He who respires exclusively by one or the other
-of these alone (diaphragm, ribs or abdomen) must be indeed a sick man.”
-Costal or side-breathing is due to the elevation and depression of the
-ribs simultaneously with the contraction of the diaphragm. Abdominal
-breathing, the method taught to singers, is performed by the pressure of
-the abdominal muscles upon the anterior and lateral walls of the
-abdomen, forcing up the diaphragm, and thus expiring almost completely
-the air in the lungs.
-
-Medical and scientific investigations concerning speech defects have
-been as considerable as it is contradictory. The observations of
-prominent doctors and specialists, some of them being afflicted
-themselves, have in the most argumentative thesis attributed
-stammering-stuttering to numerous and varied causes, the enumeration of
-which has a real historical and pathological interest:
-
-Faulty action of the tongue, disorders of tongue-muscles, spasms of the
-glottis and epiglottis, troubles located in the larynx and in the
-hyoid-bone, abnormal depth of the palate, affections of the muscles of
-the lower jaw, spasm of the lips, abnormal dryness or moisture, or
-lesion of brain, nerves, muscles or tongue, nervous affection,
-intermittent necrosis, general debility or weakness, chorea, incomplete
-cerebral action, imperfect will-power, want of harmony between thought
-and speech, imitation and habit.—Such is the nomenclature of the
-principal ingenious theories exposed and upheld by those who have made a
-study or a business of the cure of speech defects. But some mistaken
-innovators, not satisfied with theories and investigations, gave to
-their ideas an experimental form. Forty and forty-five years ago a
-surgical craze, originating in Germany as a pretended cure of speech
-defects, was raging all over Europe. Stammerers and stutterers suffered
-a variety of operations, the horizontal section of the tongue, the
-division of the lingual muscles, the division of the genio-hyo-glossi
-muscles, the cutting of the tonsils and uvula, etc. Such suppression and
-mutilation of the vocal organs could not bring any cure, as it was
-proved, and some patients having died, the operating craze was put to an
-end forever. Since that it is by more gentle means that all attempts
-have been made to cure impediments of speech. The unfortunate stutterer
-has no longer to dread the misemployed zeal of surgical operators, and
-now it is even his own fault when he allows himself to fall into the
-hands of ignorant charlatans.
-
-Without lessening the value of former discoveries, I will say that the
-specialist of to-day must disagree with the most eminent authors and the
-most prominent works on that question, including Velpeau, Amussat,
-Becquerel, Lenbuscher, Bèclard, Bristowe, etc., and arrive at the
-conclusion that their testimony was one-sided, being confined to their
-own or few cases, and limited to mere theory and speculation. For the
-treatment of vices of speech, with the indispensable knowledge, long and
-practical experience alone will instruct what is the right method to
-pursue. The various theories on the nature and causes of that infirmity,
-and the enumeration of the different responsible organs may be, at the
-same time, partly false and partially true; but they have proved
-powerless to cure or relieve.
-
-In all varieties and forms of stammering-stuttering all the vocal organs
-can be blamed, and have, in each case, to be reformed and improved. In
-the majority of cases we find some traces of the organic peculiarities
-aimed at by authors, even if their influence is doubtful. Respiratory
-trouble is at the bottom of every case. The internal organs, and the
-tongue, the lips and jaws are to some extent in an abnormal condition,
-and suffer a convulsive spasm; they have to be treated, strengthened and
-made flexible. The nerve-function of the organs of speech is also
-disturbed. We notice in the majority of cases, to a certain degree,
-organic weakness, nervousness, lack of will-power, and above all,
-disregard of all natural rules and ignorance of the use and natural
-functions of the organs of speech.
-
-As to prognosis, I will say that all stoppages in speech, accompanied by
-spasms, sometimes hardly perceptible, and which are not the result of
-paralysis or lesion, may be classified as stammering-stuttering, and can
-always be cured, whatever may be their origin or cause, or their
-intensity, and that it is only a question of time and perseverance even
-for the most stubborn cases.
-
-The treatment of stammering-stuttering, which does not comport any
-operation nor drugs, is purely educational. It consists in remedying the
-defect and teaching properly the science of speech. Still, I think, that
-in many cases a strict attention ought to be paid to hygienic measures;
-some medical care and prescription would help the patient and the
-instructor. In the actual condition of things no regular practicing
-physician can afford to devote his ability and time to the treatment of
-speech defects. But doctors have to study the infirmity, to know that it
-can be cured, that it is an interesting and complex disease, in the
-treatment of which the progress of medical science can bring a
-revolution. Physicians the world over having wholly neglected to
-consider that question, the result has been to leave it in the hands of
-incompetent persons. In principle the question of speech impediments
-cannot be separated from medicine. Physicians cannot ignore an infirmity
-in which the organism itself is undoubtedly involved, at times in a very
-intricate manner and to a considerable extent. Every true physician
-feels that he has a sacred mission—to alleviate suffering; the tortures
-of a large class of people partially deprived of the faculty of speech
-are well worth his care and attention. Medical students ought to be
-provided with the means of becoming versed in an affection offering such
-a large field for study and work, where so much light is needed, and
-where the prospects of discovery and improvement from a scientific and
-medical standpoint are so legitimate. The family physician, often
-consulted, will do good work in advising his clients to try and get rid
-of such a terrible affliction, to be cured without delay, and in
-preventing them from falling into the hands of quacks.
-
-
-
-
-                             HOMELY FACTS.
-
-                      BY F. STEWART, CLEVELAND, O.
-
-
-Not long ago as a bottle was placed upon the counter of a pharmacist to
-be refilled, its inner walls were observed to be richly decorated with
-the active principles of the compound. A witch-hazel doctor standing by
-declared the decorated walls to be the secret of the patient's recovery,
-but upon inquiry it was found that the patient was no better. Still they
-had decided to try another bottle, and the apothecary was not the one to
-object. The investigation was carried no farther, but if it had been the
-same old story of _incompatibles_ would have been retold. To the aqueous
-solutions containing oleoresinous tinctures or extracts (such as
-cannabis indica, guaiac, benzoin, lupulin, ginger, myrrh, cubeb,
-eucalyptus, sumbul, and many others) a sufficient quantity of carbonate
-or calcined magnesia should be added. A few grains (say three to twenty)
-to the prescribed dose will suffice for a good suspension, and will be
-found in most cases unobjectionable of course in an acid mixture.
-
-There are many conflicting reports of this class of medicines, owing to
-unscientific prescribing as well as unreliable preparations. The
-activity of this class of medicines demands nothing short of strong
-alcohol for their extraction. Yet many weak and worthless preparations
-may be found in the market. If the unscientific observers would look
-more to the quality of their goods, these conflicting reports would
-begin to subside.
-
-A physician once told an apothecary that he prescribed fluid extracts
-because he found them more reliable than the tinctures. This was not
-true, and could not be proven. Upon investigation it was found that his
-prescribed dose of fluid extract of digitalis was equivalent to
-fifty-five drops of the tincture, a dose larger than he intended to
-prescribe. With such science the witch-hazel doctor will ride a high
-horse, and come in on the home stretch with flying colors. No singer can
-sing well who sings too many songs, and no beginner will prescribe well
-who prescribes too many medicines. This song has been sung much but not
-half enough, for it is not borne in mind. Many fail with a remedy simply
-because they have failed to master it.
-
-Mastering the few is said to be the key to success, and the writer
-believes it, for he has seen it proven. An eminent physician from New
-York was once called in consultation to a western city. His prescription
-was mercury iodide, potassium iodide, and infus. gentian. He stated (and
-the other physician said, “I see”) that the only object of the potassium
-was to dissolve the mercury iodide. But potassium's great affinity for
-iodide accepted it, at once dropped the free mercury to the bottom,
-likely to be taken all at the last dose, equal to fifteen or twenty
-grains of blue pill. He had failed to master this remedy.
-
-The witch-hazel doctor could not declare this time that the untaken
-medicine saved the patient's life, for he died before taking it. But he
-could smile at the prescription appropriately, were none of his own to
-be found on file.
-
-Another phase of fashion reminds one of the old saying “distance lends
-enchantment;” for there is just as good sense in going to New Brunswick
-to have a boil lanced as there is in bringing syrup hypophosphates from
-that place.
-
-The present pharmacopœia contains a splendid formula for this syrup—one,
-too, with which phosphoric acid, quinine and strychnine are perfectly
-compatible. A pharmacist that will not exert himself to furnish the very
-best article for a physician's prescription is not entitled to the
-physician's respect. But for a physician to expect a pharmacist to send
-all over town for some foreign preparation that might, in almost all
-cases, be better made at home, affords a weapon to retard medical
-science and advance the nostrum manufacturer. The more scientific
-physicians well know and admit that a good pharmacist can better judge
-of a compound than a physician, who seldom stops to test it, but
-prescribes it a few times and, in many cases, never thinks of it again,
-or, perhaps, not until he presents his bill and finds the patient's
-money all gone for semi-proprietary medicines that cost from fifty to
-one hundred per cent. more than would have paid for better compounds.
-Physicians will only have to examine these medicines after they have
-stood a year or two, and in many cases a much less time, to see the
-force of this argument.
-
-Among these nostrums are found numerous preparations we could mention,
-including many emulsions, elixirs, etc. It is comforting to see the
-better class of physicians giving these nostrums a “wide berth.” Others
-will follow their example if they investigate and master their remedies.
-
-Having no time to continue this rehearsal, I close with a _plea for more
-science, more investigation_, that we may not have to send to Buffalo
-for syrups of Dover powder or farther east, west or south for nostrums,
-but master the remedies we have, saving to the physician and patient
-from fifty to one hundred per cent., thus mitigating the popular cry of
-the high price of medicine. There should be a table of incompatibles in
-every medical college as prominent as the multiplication table in the
-schools, or pharmacists should be allowed more freedom to prepare
-medicines properly, instead of being held to the letter.
-
-The writer should not complain, for he has been liberally treated by the
-profession in this respect; but he does not feel at liberty to add
-magnesia to a mixture unless so ordered. A pharmacist did this at one
-time in a tar-and-water mixture, gaining great praise from the
-physician. (Making the tar quite thin with a little alcohol, then
-absorbing the whole with magnesia, and emulsifying by adding the water
-gradually.)
-
-
-
-
-                       BREUS' OBSTETRIC FORCEPS.
-
-                        BY C. B. PARKER, M. D.,
-
-   Professor of Physiology and Lecturer on Gynæcology in the Medical
-        Department of Western Reserve University, Cleveland, O.
-
-
-The accompanying wood-cuts represent the forceps recently introduced to
-the profession by Dr. Breus, formerly first assistant in the clinic of
-Prof. Carl Braun, Von Fernwald, in Vienna.[1]
-
-Footnote 1:
-
-  Archiv für Gynäcologie XX Band 2 Heft.
-
-It is the simplest in construction of the so-called axis traction
-forceps, and is specially designed for the extraction of the head
-presenting high above the pelvic brim. In size, shape, curves, handles,
-lock, etc., it is an exact model of the J. Y. Simpson forceps—the
-favorite instrument of the Vienna school.
-
-[Illustration: Fig. 1.]
-
-Unlike the ordinary forceps, however, it is constructed with a
-hinge-joint (_a_ Fig. 2) at the angle of the fenestrum with the shaft,
-which permits of a movement of the blades through an arc of about 40°.
-An elbow on the lower margin of the blade arrests the further movement
-in the downward direction, and a prolongation of the upper fenestrum of
-the blade, in the form of an arm (_b_), is continued backward parallel
-to the shafts. This arm turns at an angle of 100° in front of the lock
-and terminates in an eye, through which the split pin seen at the side
-of the instrument passes. The pin fits loosely in the eyes and
-restricts, while still permitting considerable latitude of movement to
-the blades. At the suggestion of several gentlemen to whom the
-instrument was shown, the shaft has been lengthened nearly one inch. In
-other respects the forceps is an exact counterpart of those now used in
-the lying-in department of the General Hospital in Vienna.
-
-[Illustration: Fig. 2.]
-
-The principal advantages secured by these forceps are:
-
-1. That they are best adapted to draw in the pelvic axis.
-
-This was the special claim set up by Aveling for his Sigmoid forceps.
-Tarnier also, in introducing his axis traction forceps to the profession
-in 1877 (for an account of which see _British Medical Journal_, May 26,
-1878), proves by means of diagrams and figures that, “in pulling on the
-classical forceps, it is impossible to make the traction exactly in the
-line of the pelvic curve,” and that two forces are actually exerted—one
-in the direction of the inferior straight, and the other at right angles
-to this in the direction of the pubes, while the head tends downward in
-the pelvic curve—the resultant of these two forces. This “vicious
-pressure” upon the pubes represents not only so much force lost, but
-also tends to injure the maternal soft parts, and can only be overcome
-by using the axis traction forceps. As the head descends, the pelvic
-curves of the blades become less and less, until, as the head arrives on
-the floor of the pelvis, the forceps are nearly straight. At the moment
-the head sweeps over the perineum the blades are still further
-deflected, until they form an angle with the shafts, as shown in the
-dotted lines of Fig. 1, thus forming the perineal curve of Herman's,
-Aveling's and Tarnier's forceps.
-
-2. These forceps give the greatest permissible freedom of movement to
-the head during traction.
-
-By the loose connection of the blades each possess a degree of
-independent movement, but always in a plane parallel to the other, so
-that the head may rotate during traction. The carrying out of this
-important principle is the chief advantage of this instrument over all
-other axis traction forceps.
-
-3. An index is supplied by the arms and pin, which serves to indicate
-the advance and position of the head.
-
-The application of Breus' forceps is in no wise more difficult than that
-of the ordinary instrument. Having disinfected, warmed and lubricated
-the blades, and the patient being prepared by an irrigation of a
-solution of bichloride, one part in 2,000, and placed in the lithotomy
-position, the handle of the left blade is taken up by the thumb and
-three fingers of the left hand (as one would hold a fiddle bow), the
-index finger pressing the projecting arm firmly against the shaft, as
-the thumb of the right hand guides the blade forward in the groove
-between the index and middle fingers introduced into the vagina. The
-right blade is then introduced in a similar manner and locked, and the
-pin inserted in the eyes of the projecting arms. The traction is made
-upon the handles in the axis of the brim, without changing its direction
-until the head presses on the perineum. Prof. Braun prefers, at this
-point, to remove the forceps and complete the delivery in the ordinary
-way.
-
-The same precautions are necessary in using the axis traction as the
-ordinary forceps. Especially must it be remembered that, as the force is
-exerted directly in the axis of the pelvic curve, and none being lost,
-much less is required, and generally the force of one hand is quite
-sufficient. To avoid too great compression of the head, the compressing
-force should be removed by opening the lock in the interval of each
-traction.
-
-Breus' forceps, after being tested successfully in all possible
-difficult cases—in many where the operator had failed with the ordinary
-forceps, as I myself have seen—is now recognized as the instrument best
-adapted to those cases where the head presents high above the pelvic
-brim.
-
-
-
-
-                            CORRESPONDENCE.
-
-
-
-
-                            BALTIMORE NOTES.
-
-                   BY SPENCER M. FREE, A. M., M. D.,
-
-     Professor of Diseases of Children in the Baltimore Polyclinic,
-                             Baltimore, Md.
-
-
-It is said of Baltimore that socially it is different from other large
-cities in the _freedom_ as well as the cordiality with which it extends
-its hospitality. The business men and their clerks are polite and
-attentive. They do not display the trait, so common in the metropolis,
-of incognizance—even to rudeness—if one chances to be on a tour of
-inspection instead of purchase. The impression is at once made, and very
-forcibly, that a Baltimorean has plenty of time, that he is not hurried.
-He will stop on the street and direct a discomfited stranger, and has
-been frequently known to turn aside from his duties and accompany the
-lost one to where he could take care of himself. This is a natural
-element in the entire populace, and is very prominent in the medical
-profession. A stranger is welcomed so heartily that he feels at home
-immediately, and can settle down among friends.
-
-It occurs to me that this easy-going feeling has had much to do in
-keeping our city from occupying the prominent position in education and
-authorship that her opportunities, and conditions in general, would lead
-us to expect. I am glad to say that she is arousing from her lethargy,
-and recently her pen has been busy. Several works have emanated from the
-profession here which have attracted much attention, and have been quite
-extensively read. Notably among them is a 'Text-book of Hygiene,' by Dr.
-Rohe, and 'The Physician Himself,' by Dr. Cathell, which has reached a
-fifth edition and a sale of over fifteen thousand copies. I should like
-to say, concerning these two works, that no physician, especially if he
-be under thirty-five years of age, should be without them. Two other
-works, 'A Manual on Nervous Diseases,' by Dr. A. B. Arnold, an old,
-experienced and able teacher, and one on 'Practical Chemistry,' by Dr.
-Simon, have been much studied and commented upon. They are limited to
-special subjects and will not naturally obtain a large class of readers.
-These, like the long-delayed blade of corn, which pushes its emerald tip
-heavenward and bears upon its face the sparkling matin dew, give promise
-of a fertile soil and of abundant fruitage.
-
-At the last meeting of the Medical and Surgical Society—which we had the
-pleasure of attending—there was an interesting discussion on cerebral
-troubles of syphilitic origin. A number of cases were related. The
-various symptoms of these maladies are familiar to your readers. The
-treatment which was successful in all but one of the cases here
-reported, was mercury and iodide of potassium. The plan preferred for
-the administration of mercury is by inunction. All the debaters insisted
-upon the full constitutional effects of the drugs. As one gentleman put
-it, “the system must be saturated before a cure is assured.”
-
-I might mention among the symptoms, that those manifested by the eye
-were not regarded as reliable. In one case the only manifestation was a
-persistent and severe supra-orbital and occipital neuralgia, and for
-some time the man was in consequence wrongly treated.
-
-One physician noted _insomnia_ as a distinct and always present symptom.
-Also as a point of differential diagnosis between the convulsions of
-epilepsy and those of local lesion of the brain, that in the former
-there is no _consciousness_ of having a convulsion, while in the latter
-such consciousness is very clear, at least at the beginning of the
-spasm.
-
-A case of pelvic peritonitis of the chronic form, reported by the
-president of the society, elicited much discussion, especially upon the
-subject of exploratory abdominal incision as a means of diagnosis. He
-noticed that the younger surgeons favored the operation, but the older
-ones were more conservative.
-
-A member reported one of those peculiarly (excruciatingly, I ought to
-say) interesting cases of labor, in which, by _great_ exertion on his
-part, and the assistance of two physicians and three (I think is the
-number) midwifes or old ladies, he managed “to save the old man,” though
-the other parties concerned passed on into the mysterious future. (The
-society is expected to laugh a good deal just here, and of course we
-expect the readers to do the same.)
-
-At a recent meeting of the Baltimore Medical Association a member
-related the following experience: In a family of three children, the
-oldest, who had scarlatina four years ago, contracted diphtheria; in a
-few days a younger one became ill with the same disease, but accompanied
-in forty-eight hours with a distinct eruption of scarlatina. A few days
-later the youngest was stricken with scarlatina, but had no symptom of
-the diphtheritic trouble.
-
-The report brought out the thought of most of the members present. The
-two questions of “the identity of pseudomembranous croup and
-diphtheria,” and of “diphtheria a local or a constitutional disease”
-were again argued, and, as usual, no opinions were changed. Like the
-Scotchman, each was willing to be convinced, but he could not find any
-one able to convince him. Two points were fully agreed upon, namely,
-that the presence of membrane in the fauces, and of sequellæ, are not of
-importance in diagnosis; also that nearly all of the cases in which the
-posterior nares becomes seriously implicated are fatal. One gentleman
-advanced the opinion, supported by “statistics” (as accommodating a
-friend as “facts”), that when the submaxillary glands were enlarged in
-this disease recovery took place; when they were _not_ enlarged, death
-occurred. The doctor did not say that death occurred at once or within a
-few days, so we shall be charitable and suppose that he meant sometime
-during the succeeding hundred years.
-
-Notes of two very interesting cases of myelitis, followed by spastic
-paraplegia, were read and discussed. The author made special mention of
-the exaggerated tendon-reflex being always present in disease of the
-lateral tract of the cord, and that this symptom is diagnostic—if
-hysteria be first excluded. He also noted in these cases that the
-condition of the muscles of the posterior portion of the legs (lower)
-was very tense, producing an impression on grasping them similar to that
-noticed on grasping a piece of iron. Neither of these men were able to
-place the heel upon the floor when standing erect. No amount of effort
-on their part could enable them to accomplish it. Neither of them were
-improved by the use of the iodides.
-
-
-
-
-                          NOTES AND COMMENTS.
-
-If “K.” will send name, we will take pleasure in publishing his article
-in our next number.
-
-                  *       *       *       *       *
-
-White physicians in Oriental countries are asked almost daily whether
-they cannot prescribe for suffering women without seeing them. Oriental
-women, debarred by social custom from consulting male physicians, are
-the victims of great and unnecessary suffering. They are thus shut off
-from the aid of western medical skill, though they know its value and
-are desirous of availing themselves of it. The movement in China and
-Japan to introduce female physicians from Europe and America is
-conferring great benefit upon the women of those countries and making
-brilliant opportunities for skilled women who go there. The hospital for
-women recently opened at Shanghai, under the charge of American women,
-is already filled with patients. An association has also been formed in
-India for training native nurses.
-
-                  *       *       *       *       *
-
-The new college building of the Medical Department of the Western
-Reserve University is being pushed rapidly to completion. The stone-work
-is done and the roof is now being placed in position. When once
-inclosed, work upon the interior can proceed regardless of the weather.
-It is thought that it will be so far completed as to be used for
-commencement exercises the last week in February.
-
-                  *       *       *       *       *
-
-Four cases of trichiniasis were reported to the health officer of
-Cleveland, December 23d. All were members of one family and had partaken
-of the same uncooked ham. The physician reporting the cases, Dr. J. F.
-Armstrong, had his suspicions aroused by the symptoms presented, and at
-once examined the suspected meat. His fears were confirmed by finding
-trichinæ spirolis in the remaining portions of the ham, and his
-observations were verified by the health officer. None of those affected
-are as yet seriously ill. It appears necessary to sound a constant
-warning against eating uncooked pork.
-
-                  *       *       *       *       *
-
-“_No Children Allowed._”—The “Solid Comfort” will answer for the
-occasion to designate an elegant apartment house opened about two years
-ago in a suburb of Boston. It was finished with all modern conveniences
-and inconveniences. There were electric bells in a row at the door, so
-that the afternoon caller could ring up nine different and peaceful maid
-servants before getting into communication with the family she came to
-see; there were fire escapes and telephones, and elevators and speaking
-tubes; and, in all probability, safety valves and submarine cables. But
-the crowning joy of all was the fact that no children were allowed
-within its walls. It was built for the accommodation of childless
-couples, and to ten childless couples were the suites let. How great was
-the quiet and calm of that sheltered retreat, until one ill-starred
-morning, when the cry of an infant, shrilly and piteously, broke the
-stillness! Horror and indignation upon the part of nine guiltless
-couples! And yet, so weak is humanity, that before the end of the second
-year there were children in seven of the ten families. The childless
-young couples were childless no more; and when the owner of the building
-complained to his friends of the unfair treatment he had received at the
-hands of his tenants, they all laughed in his face and advised him to
-let his apartments to bachelors.—_Sanitarian for November, 1885._
-
-
-
-
-                     The Cleveland Medical Gazette.
-
-
-              _A MONTHLY JOURNAL OF MEDICINE AND SURGERY._
-
-                    ONE DOLLAR PER ANNUM IN ADVANCE.
-
-  All letters and communications should be addressed to the CLEVELAND
-         MEDICAL GAZETTE, No. 5 Euclid Avenue, CLEVELAND, OHIO.
-
- A. R. BAKER, M. D., _Editor_. S. W. KELLEY, M. D., _Associate Editor_.
-
-
-
-
-                               EDITORIAL.
-
-
-Original communications, reports of cases and local news of general
-medical interest are solicited.
-
-All communications should be accompanied by the name of the writer, not
-necessarily for publication.
-
-Our subscription price remains at one dollar per annum in advance. Vol.
-I begins with November, 1885. Subscriptions can begin at any time.
-
-Remittances when made by postal order or registered letter, are at the
-risk of the publishers.
-
-
-                         THE FASHIONABLE HOBBY.
-
-It is reported that a Dr. Sax, of France, has discovered in all forms of
-beverages containing alcohol a “bacillus potumaniæ;” and it is claimed
-that this bacillus multiplies in the system of the drinker and
-circulates in his blood, and that when he gets delirium tremens he is
-not the subject of hallucinations but sees the reptilian forms that are
-inhabiting his own brain and optic apparatus.
-
-While the microscopists and various ologists are discussing this, we
-will tell a story of a certain worthy practitioner of our acquaintance.
-The doctor's hobby was malaria. If a person came in with a headache it
-was “malarial headache;” backache, “malarial backache;” legs ache,
-“malaria.” One day a man came in with his arm hanging helpless. Our
-friend promptly began about malaria. The man said he had heard of
-break-bone fever, but that he had fallen off a street car and didn't
-think this was a malarial fracture.
-
-Some of the best fellows we know ride hobbies, but let those who now
-bestride the bacillus beware where the creature carries them.
-
-
-                             OLEOMARGARINE.
-
-The subject of artificial butter continues to agitate the public mind
-and stomach. There are involved a few plain principles which, if
-applied, will elucidate the whole matter.
-
-Good glycerine can be made from dogs or horse fat, sugar from rags; sea
-water or the most impure lake or river water can be changed to _azua
-pura_ by distillation; good suet or tallow can be so treated as to make
-a nutritious and harmless article of diet. Now, if old grease can be so
-manipulated and modified as to give a pure and edible result, cheaper
-than old-fashioned butter, the latter will have to go out of fashion.
-
-In that case, wrong would lie only in selling the article for what it is
-not, and not in the fact of its being also injurious to the user. Just
-as in many synthetically manufactured wines and cigars, which are not
-chemically essentially different from the article they imitate, but are
-fraudulent because they are sold as imported or genuine, which they are
-not.
-
-If the goods are good, let them be sold for what they really are; and if
-the old-fashioned butter is higher priced, let those of us who like pay
-the difference for our fastidiousness. The manufacturers of the new
-butter should expend their efforts and their money in perfecting their
-process, so as to give an innocent and useful food, and in proving that
-it is so, instead of opposing the action of the Board of Health. The
-verdict of the health authorities should be regarded as final by every
-individual of the public, and until the new article is pronounced at
-least harmless, no one should think of using or handling it any more
-than they would measly pork or spoilt fish.
-
-
-                      MEDICAL DEFENCE ASSOCIATION.
-
-We have selected a few recent cases of suits for malpractice with the
-object of calling the attention of physicians to the importance of
-adopting some plan looking toward the suppression of quackery and the
-protection of professional rights when assailed by hostile influences.
-
-“In April, 1884, Dr. Graves of Petaluma, California, was called to see
-Mrs. Winters, the wife of a laborer whose family he had attended
-gratuitously for nearly sixteen years. He found that the woman, who was
-fifty-eight years of age, had fallen from a height and injured her
-ankle. The limb was very much swollen, so as to interfere with
-examination, but no crepitus could be elicited, neither was there any
-displacement, or shortening; and as the swelling continued, the limb was
-placed in position and wrapped loosely in cloth saturated with anodyne
-lotions. The patient, we are told, received every attention from Dr.
-Graves, but there was left finally some stiffening of the joint and a
-very slight inversion of the foot. No complaints were made until a new
-doctor arrived in the town, who told the patient the limb had been badly
-treated and advised her to sue for malpractice. The case was examined by
-ten of the chief surgeons in the State, including Drs. Lane, McLean,
-Morse and Dennis, all of whom said that there might have been a sprain
-or an incomplete fracture of the external malleolus, but that the ends
-of the bones were in perfect apposition and never had been separated,
-and that the stiffening was probably due to inflammatory adhesions. Two
-other doctors, one of whom being he who advised the suit, testified that
-there was shortening of the limb, and that the lower fragment of the
-tibia had been driven up and behind the fibula. One of these would-be
-surgeons, Dr. Wells, is nearly eighty years of age, and had not read a
-work on surgery for thirty years; the other, Dr. Ivancovich, confessed
-he had no special experience in surgery. Their incompetence may be
-judged from the way they measured the patient's limb in court. This was
-done by taking a carpenter's rigid rectangular rule, and measuring the
-limb as she maintained the upright position. The result was that in the
-opinion of nine jurymen the testimony of two unknown, inexperienced
-general practitioners out-weighed that of ten specialists in surgery,
-all of whom possess a national reputation, so that a verdict was
-returned in favor of the plaintiff, awarding her eight thousand dollars
-damages.”
-
-“Some three years ago Dr. Purdy, a well-known and esteemed physician,
-gave notice to the health department of New York City, in accordance
-with a regulation of the sanitary code which makes it the duty of
-physicians to notify this department of cases of infectious diseases,
-that in his opinion a young woman who was under his treatment was
-suffering with smallpox. The department sent one of its medical officers
-to investigate the case. The diagnosis made by Dr. Purdy was then
-confirmed and by the authority of the board of health the patient was
-transferred to the smallpox hospital. After a day or two the patient was
-discharged. This patient immediately brought suit against Dr. Purdy for
-$10,000 damages, on the ground of injury to her business and of the
-false diagnosis upon the part of her medical attendance. The jury which
-tried this case gave a verdict of $500 against the defendant. The
-singular injustice of this verdict resides in the fact that damages
-should have been brought against Dr. Purdy, when, in point of fact, the
-injury to the plaintiff was inflicted by the health department, which
-not only affirmed the diagnosis of the attending physician, but caused
-the removal of the patient to be made to the smallpox hospital. It
-appears that Dr. Purdy's sole error in the case was in informing the
-health authorities of the possible existence of smallpox. In the
-discharge of a duty imposed upon him by a city ordinance he has been
-subjected to the expense and annoyance of a legal case, and has been
-mulcted by a jury to the extent of $500.”
-
-“Another suit of a blackmailing character has been brought against Dr.
-E. Williams and partners of Cincinnati, O. According to the Cincinnati
-_Medical News_, the charge was that they had permitted a small scale of
-iron, that had entered the eye of a boy, to remain, by which he
-eventually became blind—the sound eye becoming affected through sympathy
-with the injured one and losing the power of vision. It was proven on
-trial that the boy had visited the office of Dr. Williams but twice, and
-then had ceased calling because he was informed that, to preserve the
-sound eye and be saved from blindness, he must consent to have the eye
-that had been destroyed removed from its socket, to which his parents
-would not consent. For several months after declining the services of
-Dr. Williams and associates, he spent his time in going the rounds of
-the specialists of diseases of the eye, putting his case in charge, at
-different times, of both regular and homœopathic physicians. Every
-ophthalmologist by whom he was treated informed him that the only way by
-which he could avoid becoming blind was to have the injured eye removed.
-Finally, after losing sight in both eyes, he brought suit. The medical
-testimony, we are told, was uniformly in favor of Dr. Williams, but the
-jury disagreed.”
-
-“The Boston correspondent of _The Northwestern Lancet_ writes: 'Dr. A.,
-a reputable practitioner living in a New England city, attended Mr. B.
-for a fractured thigh. The case did well, and the patient recovered
-without deformity. No measurements were recorded by the attending
-surgeon, but he was able to swear that the result was to him perfectly
-satisfactory. A year or two later the patient entered suit against Dr.
-A. for malpractice, and exhibited a leg considerably shortened and
-deformed. A jury at once found a verdict for the plaintiff, and awarded
-damages in some six or seven thousand dollars, a sum which seriously
-crippled the physician. He devoted his energies thereafter to
-discovering what he believed to be a fraud, and finally obtained
-evidence that B. had, subsequently to his recovery under A.'s
-attendance, again fractured the same thigh while in the Adirondack
-wilderness, and had, on that occasion, had no surgical attendance
-whatever. The physician was able to recover his money, but was at the
-expense of his detectives' and lawyers' fees, to say nothing of years of
-anxiety and of damage to his professional reputation.'”
-
-The case of Drs. Reed and Ford of Norwalk, Ohio, will be remembered by
-many Cleveland physicians. Miss Pierce, a comely young lady, sustained a
-Colles fracture, and was attended by Drs. Reed and Ford. Suit was
-brought twice in county court and dismissed because plaintiff did not
-desire to try the case. A few days before the case was outlawed, suit
-was brought in the United States Court at Cleveland. Many physicians
-were called on both sides, and the testimony of all the physicians, with
-probably one exception, was that the treatment was good and the result
-better than is usual with such fractures. Flexion extension, pronation
-and supination were perfect. She had, however, the power, when the arm
-was midway between pronation and supination, of bending the wrist toward
-the radius, and by making the head of the ulna prominent she was able to
-make an apparent deformity. Her case, then, was her ability to make an
-apparent deformity by twisting her wrist. (She could do the same with
-the unfractured wrist.) She was a good-looking woman, and therefore
-entitled to sympathy. She followed up the case persistently for six
-years, therefore there must be some merit in the case. The doctors all
-testified against her, so there was a combination of the doctors which
-must not be countenanced. Upon this strong case twelve intelligent
-jurors awarded thirteen hundred dollars damages. The judge subsequently
-reduced this to five hundred. Is it any wonder, when such things can be
-done in the State of Ohio, in the name of justice, that physicians like
-old Dr. Kirtland refused to attend cases of fracture under any
-circumstances? or that it is not unusual to hear surgeons of recognized
-ability say they dare not possess property for fear of suits for
-damages?
-
-Frequently physicians are accused of malpractice, and rather than
-undergo the expense and inconvenience of a suit they will submit to an
-extortion of money; or if a suit is lost in court through prejudice,
-unjust decisions, inability to secure good council or other unavoidable
-cause, rather than undertake to carry the case to a higher court, the
-physician will pay the damages, and thus establish a precedent which
-renders every physician under similar circumstances liable to a suit for
-damages. It is always observed whenever a large amount of damages is
-collected from a physician, numerous other suits on all sorts of cases
-are commenced. Such a condition of affairs ought not to exist.
-Physicians can not expect legislators to look after their interests
-until their grievances are made known. The testimony of physicians as
-individuals will not carry enough weight to accomplish anything. Moves
-have been made in this direction through the County and State societies
-and failed first, because the members of the societies are divided among
-themselves, second, because they represent only a fractional portion of
-the profession. Out of the thousands of physicians practicing in Ohio
-there are only about seven hundred members of the State society.
-
-We believe the object of county, state and national medical societies
-are intended for purely scientific work, and the less of medical
-politics brought into them the better. But when there is some definite
-end to be accomplished, some gross wrong to be righted, some persecuted
-physician defended, there ought to be some organization including
-physicians of all schools, independent of the medical societies as now
-organized. When a physician is sued for damages, if his case is worthy
-of being defended, the entire profession ought to lend him their moral
-as well as financial support, and this could be rendered in no way
-better than by means of some organization similar to the Medical Defense
-Association of England.
-
-
-               PRELIMINARY EDUCATION OF MEDICAL STUDENTS.
-
-Dr. John J. King, secretary of Trumbull County, O., Medical Society, saw
-our article in the last number of the GAZETTE, in which we urged the
-necessity of an elevation of the standard of preliminary education of
-medical students, and sends us the following resolutions which were
-unanimously adopted by the Trumbull County Medical Society, January 31,
-1884, and Drs. Julian Harmon, J. R. Woods and T. H. Stewart appointed
-medical examiners. The requirements are about the same as adopted by the
-Pennsylvania State Society at their annual meeting in Norristown, Pa.,
-May, 1883:
-
-TO REGULATE THE STUDY OF MEDICINE.
-
-  RESOLVED, I.—That this Medical Society shall annually elect a board
-    of medical examiners, to consist of three members, whose duty
-    shall be to examine applicants for admission to the study of
-    medicine.
-
-  RESOLVED, II.—All applicants for admission as students of medicine
-    under the tuition of members of this society shall present
-    themselves before the board of medical examiners and
-    satisfactorily pass examination in the following requirements:
-
-   “I.— A written statement, previously prepared, setting forth the
-          candidate's course of study.
-
-   II.— An essay.
-
-  III.— Writing from dictation.
-
-   IV.— Spelling—Oral and Written.
-
-    V.— Reading.
-
-   VI.— Geography—Descriptive, Physical.
-
-  VII.— Political Economy.
-
- VIII.— History—Ancient, Modern.
-
-   IX.— Geology.
-
-    X.— Botany.
-
-   XI.— Chemistry.
-
-  XII.— Natural Philosophy.
-
- XIII.— Mathematics—   Arithmetic complete;
-
-                       Algebra, through quadratic equations;
-
-                       Geometry, through plane geometry.
-
-  XIV.— Languages—     English, standard school edition of English
-                         Grammar;
-
-                       Latin, Cæsar's Com., 4; Virgil, 4; Cicero's
-                         Orations, 2.
-
-                       Greek, the Reader; Gospels; Xenophon's Anabasis,
-                         2.”
-
-  Candidates for examination may elect in French, Keetle's Collegiate
-    Course in French, Composition, Translation and Reading, and
-    Lacomb's History of the French People, instead of Cæsar's Com.,
-    Virgil and Cicero's Orations; and in German, Whitney's German
-    Grammar, Composition, Translation and Reading, Schiller's Willheim
-    Tell and Goethe's Faust, but such elementary knowledge of Latin
-    and Greek will be required as to enable the candidate to
-    intelligently comprehend the etymology of medical terms derived
-    therefrom.
-
-  RESOLVED, III.—No member of this society shall receive any person as
-    a student of medicine unless he present a favorable certificate
-    from the board of medical examiners.
-
-  RESOLVED, IV.—The time of study required by members of this society
-    shall be five (5) years, including lectures.
-
-  RESOLVED, V.—Members of this society shall recommend their students
-    to attend only such medical colleges as either require an
-    examination for admission similar to the one required by this
-    society, or make the full three-years' graded course of study
-    obligatory for graduation therefrom, and otherwise endeavor to
-    elevate the standard of medical education.
-
-  RESOLVED, VI.—That this society requests the Ohio State Medical
-    society to adopt the foregoing schedule of requirements and to use
-    its influence to secure legislation making the same obligatory
-    upon persons entering their names as students of medicine in the
-    State of Ohio.
-
-  RESOLVED, VII.—That these resolutions be printed and a copy sent to
-    each medical society in this State with the request that they
-    early report their action thereon.
-
-                  *       *       *       *       *
-
-“Pioneer Medicine on the Western Reserve” is the title of a series of
-articles which began in the November (1885) number of the Magazine of
-Western History (Williams & Co., Cleveland). They are written by Dr.
-Dudley P. Allen, which insures a warm interest in the subject as well as
-a capable handling of it. The series is historical and biographical, and
-the publisher promises several portraits before the last chapter in
-March or April. Probably none of the Magazine's various serials will be
-of more interest to the public, as well as to medical men generally. In
-the opening chapters we enjoyed the author's skillful joining into
-readable continuity of the broken facts that have been gathered from so
-long ago.
-
-
-
-
-                          SOCIETY PROCEEDINGS.
-
-
-
-
-           PROCEEDINGS OF NORTH CENTRAL OHIO MEDICAL SOCIETY.
-
-                      TWENTIETH QUARTERLY SESSION.
-
-
-                                        GALION, OHIO, December 18, 1885.
-
-The president, Dr. MITCHELL of Mansfield, called the meeting to order,
-and owing to the number of papers to be presented and the brief time for
-the session, ordered the omission of reading of minutes of last meeting
-and all miscellaneous business. E. H. Hyatt of Delaware, was first
-called, and excused on the ground that he could not do justice to his
-subject, “The Use and Abuse of Alcohol from a Professional Standpoint,”
-in so short a time.
-
-Dr. R. HARVEY REED of Mansfield, the appointed lecturer, read a paper on
-Anæsthetics, in which he gave a brief review of the different general
-and local anæsthetics in use and the different compounds of the same.
-
-He referred to the elaborate experiments of Dr. Watson of Jersey City,
-which showed the following mortality on rabbits:
-
- Sulphuric ether,                                                  16.66
- Chloroform,                                                       62.50
- Bromide of ethyl,                                                 50.00
- Alcohol, chloroform and ether,                                    75.00
- Alcohol, chloroform and ethyl,                                    66.66
-
-And on dogs:
-
- Sulphuric ether,                                                  00.00
- Chloroform,                                                       00.00
- Bromide of ethyl,                                                100.00
- Alcohol, chloroform and ether,                                    60.00
- Alcohol, chloroform and ethyl,                                    80.00
-
-In these experiments the doctor found it necessary to resort to
-artificial respiration on dogs as follows:
-
- Sulphuric ether,                                                   None
-                                                                      at
-                                                                    all.
-
- Chloroform,                                                           2
-                                                                  times.
-
- Alcohol, chloroform and ether,                                        3
-                                                                  times.
-
- Alcohol, chloroform and ethyl,                                        5
-                                                                  times.
-
-The author referred to a number of experiments he had made on frogs, in
-which vivisection was made, and the heart exposed and chloroform applied
-direct, from which they died in from ten to twenty minutes, and when
-bromide of ethyl was used in fifteen to thirty minutes, but when ether
-was used, and even much freer than either of the others, they did not
-die at all.
-
-In repeated experiments, he said, he had found the use of electricity
-unreliable in resuscitating the heart under these circumstances.
-
-After referring to the mortality reports which showed 405 deaths from
-chloroform against seventeen from ether, he said: “I feel that every
-time I use chloroform as an anæsthetic I am trifling with a dangerous
-compound, and that it will only require time and perseverance in its use
-until I will share the fate of many others, whose misfortunes ought to
-be a timely warning to us against its dangerous effects; and if not
-heeded an accident will be all the more inexcusable.”
-
-He condemned the use of so-called “vitalized air” as being an uncertain
-and unstable compound: being one of the nitro-oxygen series mixed with
-chloroform, its effects were uncertain and often very injurious, which,
-he said, “should be reason enough to deter any conscientious physician
-from using it or even recommending it.”
-
-For administering anæsthetics the author recommended a clean folded
-towel as being more preferable than anything else, as it was just as
-efficient and decidedly better from a sanitary standpoint.
-
-He recommended watching the pulse closely while administering
-chloroform, and the respirations when ether was administered, lest in
-the former the cardiac ganglia become affected and suddenly arrest the
-heart's action, or in the latter the nerve cells of the medulla from its
-toxic effects abruptly interfere with the breathing.
-
-In closing the author said: “From the brief review of the anæsthetics
-most familiar to the profession from a practical standpoint we have
-arrived at the following conclusions:”
-
-_First_—Of all general anæsthetics known pure sulphuric ether stands at
-the head for safety, efficiency and every day practical use.
-
-_Second_—Hydrochlorate of cocaine stands at the head of all known local
-anæsthetics.
-
-_Third_—Ethidene promises to rival ether and merits a more general and
-extended trial.
-
-_Fourth_—No surgeon should give any anæsthetics without being prepared
-to resuscitate the patient on the shortest possible notice if necessary,
-among which preparations nitrite of amyl stands preëminent.
-
-_Fifth_—No person should be entrusted with the administration of any
-anæsthetic who is not thoroughly familiar with its physiological action
-and practical administration.
-
-_Sixth_—The indiscriminate use of anæsthetics should be strenuously
-guarded against, and especially the practice of leaving such dangerous
-compounds in the hands of the laity to be given _ad libitum_ whenever
-they may deem it necessary.
-
-_Seventh_—The judicious use of anæsthetics under all necessary
-circumstances should never be omitted, for when properly used by skilled
-hands they are a glorious haven of peace in the midst of a stormy sea.
-
-DR. J. CAMPBELL of Galion reported a case of embolism, in which the
-diagnosis was uncertain, the symptoms grave and the disturbance of the
-circulation extremely severe, distinguished physicians differing widely
-as to the pathological conditions, and the autopsy revealed adhesions of
-the right lung and of the pericardum. Left lung compressed, left heart
-hypetrophied and stenosis of aortic orifice. On motion the case was
-referred to the committee on publication, and Drs. Hackendorn, Ridgway
-and Mitchell, who had seen the patient, were requested to give their
-views.
-
-DR. N. B. RIDGWAY reported a case of laceration of perinæum with
-operation within an hour, with complete success, on which remarks were
-made by Drs. Reed, Larimore and Kelley.
-
-DR. KELLEY presented a clinical case of blindness in right eye of a
-girl, from the concussion of a snow ball striking the arch of the orbit.
-
-The society adjourned to meet in Mansfield March 25, 1886.
-
-                                                J. F. MARKEL, Secretary.
-
-
-                THE AMERICAN PUBLIC HEALTH ASSOCIATION.
-
-       ANNUAL MEETING HELD AT WASHINGTON, D. C., DEC. 8-12, 1885.
-
-        [By G. C. Ashmun, M. D., Health Officer, Cleveland, O.]
-
-In the summer of 1873 a few gentlemen met at Long Branch, New Jersey,
-and organized as the “American Public Health Association.” At that time
-there were but few state boards of health, and local boards were not
-generally efficient; and it was one of the chief objects of the American
-Public Health Association to aid in the establishment of health and
-sanitary organizations throughout the country. Prominent among the
-original members of the association were gentlemen from the Mississippi
-valley. For a long time the cities and towns of that valley had suffered
-from visitations of yellow fever, and men had become somewhat
-enlightened by the good results obtained from the course pursued by
-certain officers during the war. Especially was this true in New
-Orleans, and the question was fairly raised whether local conditions
-were not responsible for the disastrous outbreaks which had occurred so
-frequently.
-
-From 1873 to the present time, there have been annual meetings of the
-association, with a greatly enlarged membership. A large result of the
-efforts of the association and its members is seen in the national,
-state and local boards of health, and other sanitary organizations
-throughout the country. But three of the states are now without state
-organizations. The recent meeting in Washington was its “thirteenth
-annual,” and was as well attended and its members as enthusiastic as at
-any. The members were “welcomed” on behalf the medical fraternity of
-Washington by the venerable Dr. J. M. Toner, and by the district
-authorities through the President of the Board of Commissioners, Judge
-Edmonds. These remarks were followed by the usual address by the
-president of the association, Dr. Reeves of West Virginia.
-
-The chief point, perhaps, of Dr. Reeves' address, and the one calling
-out most expressions of approval, was the arraignment of Congress for
-its failure to provide means for the support of the National Board of
-Health. He cited the liberality shown to care for domestic animals, the
-fisheries, the Indians, and, indeed, almost every conceivable object,
-but Congress was unwilling to grant even a sum sufficient for gathering
-and publishing the reports from local boards. He expressed a strong
-feeling against the attempt to have the work for which the National
-Board was created to perform, done by the Marine Hospital Service.
-
-A large part of the time of the meetings was taken up in hearing reports
-from committees appointed at the meeting in St. Louis, 1884. Among these
-reports were some of great interest. Prof. Sargent, of Harvard, gave a
-report upon “School Hygiene in American Schools and Colleges,” and this
-was enlarged by a paper from Dr. Hartwell, of John Hopkins University,
-on “The German System of Physical Education.” At this meeting prizes
-were to be awarded, in accordance with the wish of Mr. Lomb, of Baush &
-Lomb, Rochester. The subjects were:
-
-1. “Healthy homes and food for the working classes.”
-
-2. “The sanitary conditions and necessities of school-houses and school
-life.”
-
-3. On “Disinfection and individual prophylaxis against infectious
-diseases.”
-
-4. On “Preventable causes of disease, injury, and death in American
-manufactories and workshops, and the best means and appliances for
-preventing and avoiding them.”
-
-These prizes were in cash, and amounted to five hundred dollars each,
-the decision resting with a separate committee for each. Without taking
-more space, it may be said that these meetings are usually attended by
-about three hundred members, from all parts of the country. Canada sends
-representatives, and the meeting in 1886 is to be held in Toronto. Very
-diverse opinions are developed, and sharp discussions are the order. All
-shades of medical and lay topics and views are brought out, but all meet
-on the common ground of desire for improvement in health. The medical
-officers of the army and navy are always well represented by such men as
-Drs. Billings, Sternberg, Gihon, Turner and others, while Hon. Erastus
-Brooks of New York is a layman whose views have been and still are
-relied upon as representing a philanthropic sentiment which can be found
-in all communities.
-
-
-  CUYAHOGA COUNTY MEDICAL SOCIETY—ADJOURNED MEETING, OCTOBER 15^{TH.}
-
-
-                 REPORTED BY L. B. TUCKERMAN, COR. SEC.
-
-DR. HIMES presided.
-
-DR. POWELL gave a verbal report on the progress of obstetrics and
-diseases of children as follows:
-
-
-                              OBSTETRICS.
-
-In the department of obstetric literature, 'Barnes' Obstetrics' had just
-been published by Lea. It was encyclopædic in its character. Lusk had
-issued a new edition with several chapters added. Parvin's book was now
-in press, and is also issued by Lea. In the department of diseases of
-children, Eustace Smith's work is invaluable as regards symptomatology
-and clinical history, but is not so good in therapeutics. Goodhart's
-work, edited by Starr, is also of value.
-
-Axis traction forceps are coming more and more into favor, Lusk's
-modification of Sarnier's forceps being used. Simpson's axis traction
-forceps is also much used in this country and in Germany. The form used
-by Dr. Lusk's assistant and in use in Karl Braun's maternite in Vienna,
-with a hinge jaw where the blade joins the shaft and traction handles,
-allows more motion of the head and has a number of other advantages.
-
-Electricity is coming more and more in vogue as an oxystocic. It seems
-to hasten labor without increasing pain. Its use to destroy the life of
-the fœtus in fallopian pregnancy is more common in this country than in
-Europe.
-
-In the past two years Lawson Tait has operated five times for ruptured
-fœtal cyst, with four recoveries. There are no other cases on record so
-far as known to the reporter. The present tendency of professional
-opinion is to favor an immediate operation.
-
-Intra-uterine injections are not so freely used as formerly, and are
-restricted to cases where there is actual retention of putrid material
-in the uterine cavity, with fever. Bichloride of mercury is gaining
-ground as the antiseptic par excellence.
-
-Cocaine has been tried to relieve the pain during dilation of the os,
-but has not proved a success. It is, however, a success in relieving
-certain cases of obstinate vomiting of pregnancy, and also the pain of
-fissured nipples.
-
-Hicks' bimanual method of treating placenta previa is gaining ground.
-
-In connection with post partum fever, a larger number of cases of
-diphtheritic complications is noted than formerly.
-
-
-                         DISEASES OF CHILDREN.
-
-Crede claimed to be able to prevent ophthalmia neonatorum by instilling
-into each eye at birth two drops of a two per cent. solution of nitrate
-of silver.
-
-Cassels of Berlin, after an exhaustive investigation, claims that no
-remedies are so reliable in _pertussis_ as belladonna and quinia.
-
-In the treatment of _diphtheria_, Tr. Ferri and Potass. Chloras seem to
-stand as high as ever in the opinion of the profession. Calomel, which
-also has its admirers, seems to have lost no ground, as well as the use
-of the steam atomizer.
-
-DR. ALLEN presented a dermoid cyst of the left ovary, removed that
-forenoon from a nullipara aged twenty-seven. Six hours after the
-operation the patient's temperature was 99.6° Fahr., and there had been
-but little vomiting.
-
-DR. SIHLER showed a gall stone found at the autopsy of a woman
-forty-eight years old, whose symptoms had not been those which are usual
-in fatal cases of obstruction of the gall duct. There had been no
-jaundice, no bile in the urine and no previous attacks of pain. She
-complained one morning of sore throat, and was given one-eighth of a
-grain of morphia. In the evening there was pain in the stomach and the
-morphia was discontinued. This was on Saturday. By Sunday or Monday the
-pain had become located along the border of the liver. On Tuesday the
-free edge of the liver could be felt, and the temperature had risen to
-102° or 103°, pain and vomiting having also become very severe. The next
-week pain was less and swelling less, and in two weeks all symptoms were
-gone. She never before had symptoms of colic. Two weeks later, after she
-had been asleep about three hours, she had another attack. The next day
-the temperature rose again, and there was a larger region of
-sensitiveness than before. On Tuesday the fever subsided. On Wednesday
-collapse and vomiting ensued, ending in death. The autopsy disclosed
-adhesions of the liver, omentum and colon, an effusion of bile in the
-tissues, and this gall stone was found in the gall bladder.
-
-DR. ALLEN mentioned a case that he had seen in Keith's Clinic in
-Edinburgh, where an operation was undertaken for ovarian cyst, but when
-on opening the abdomen the tumor was found to be the gall bladder so
-enlarged as to fill the whole lower part of the abdomen.
-
-DR. SIHLER said that in his case the gall bladder was not so very much
-enlarged.
-
-DR. TUCKERMAN reported a case where a gall stone the size of a pigeon's
-egg was found post mortem, but which during life could sometimes be felt
-through the abdominal wall and sometimes not, and which gave rise to a
-bruit so distinct as to warrant a strong suspicion of aneurysm.
-
-DR. VANCE stated that according to his observation the passage of a gall
-stone into the intestine by ulceration was a common cause of intestinal
-obstruction. He also called attention to the value of the symptom of
-itching as pointing to the gall bladder as the seat of the difficulty.
-
-DR. LINHART reported a post mortem in a case of typhoid fever where
-eighty-five small stones were found in the gall bladder. The bladder was
-but little distended.
-
-
-
-
-                               NEW BOOKS.
-
-
-  'TRAITE PRATIQUE DES MALADIES DE LA PEAU; DIAGNOSTIC ET TRAITEMENT.'
-  Par M. Le Docteur E. Guibot, Medecin De L' Hopital Saint Louis,
-  Paris, etc.
-
-This, the fourth work which the author has written on dermatology, is
-intended to present, in a clear and concise way, a resumé of the more
-voluminous books which have preceded it. Unfortunately the dermatology
-of to-day, as it appears in the English language, is drawn largely from
-the precepts of the Vienna school. In fact, since the little volume of
-Robert Liveing, which appeared in London about eight years ago, there
-has been no truly English or American treatise on the subject; although
-books on diseases of the skin have appeared in quick succession, they
-have been vague echoes from the _Krankenhaus in Wien._ Do not think from
-this that I undervalue the original work done by the great teachers of
-local dermatology, for they have taken vast strides in the advancement
-of the science, but other lines of thought and investigation are needed
-to broaden the scope of the earnest student. The work before me, as its
-name implies, is a practical treatise on diseases of the skin, of about
-four hundred pages, with especial attention to diagnosis and treatment.
-To facilitate the former, the author has grouped cutaneous maladies
-which are alike in nature into what he calls _Diatheses_, of which the
-syphilitic, scrofulous, herpetic, cancerous and the congestive are dwelt
-upon. In differentiating the scrofulous from the syphilitic diatheses,
-the author says: “In the third stage of syphilis, as we have said, the
-work of destruction starts from within, attacking first the deeper
-structures, as the periostium cartilage and bone, whereas scrofula
-pursues the same destructive course inversely; that is to say, from the
-superficial to the deep parts. This consideration, upon which we cannot
-insist too strongly, is of the greatest importance in diagnosis. For
-example, if syphilis attacks the nose, the part first involved is the
-mucous membrane of the nasal fosæ, then the nasal bones and cartilages,
-which may become completely destroyed before the process subsides,
-leaving the nose flattened but the skin intact. In scrofula the work of
-disorganization begins in the superficial parts—the skin—and not until
-the part involved is completely destroyed does it proceed to those which
-are deeper, viz., the cartilage and bone. Again, it may be seen that the
-destruction is more complete in scrofula than in syphilis. This is
-especially true of the skin, for syphilis has at least a respect for
-this organ, which scrofula has not.”
-
-After establishing, as he says, “the principles upon which the
-scrofulous diathesis is founded,” he proceeds to enumerate the different
-_scrofulides_ of the skin as follows: 1, Erythematous; 2, Phlegmonous;
-3, Pustulo-crustaciæ; 4, Tuburcular; 5, Rupiform; 6, Ulcero-gumatous.
-
-THE HERPETIC DIATHESES.—“The distinctive feature of prime import in
-herpetic lesions (_herpidites_) is their duration. In the two diathesis
-we have just considered we have said that the _scrofulides_ are
-continuous in their duration; they present no interruption, no
-intermittance; whereas the _syphilides_ are essentially intermittent;
-they disappear spontaneously, or under the influence of treatment, and
-reappear without regularity or periodicity. Their intervals of latency
-are variable, often regulated by the change of season, especially liable
-to reappear in the springtime, and sometimes after many years of
-complete immunity.
-
-“The _herpidites_ combine in their evolution the two characters of
-intermittency and chronicity. At their commencement they are
-intermittent; in the second stage, which occurs after a certain though
-variable period, they assume the character of chronicity.” The author
-further divides the _herpidites_ into benign and malignant. Under the
-former are included herpes, impetigo, lichen, eczema and psoriasis; the
-latter includes pemphigus, cachectic rupia and prurigo senilis
-formicans. The cancerous and the congestive diatheses follow, after
-which the exanthemata and the cachectic diseases of the skin.
-
-SYMPTOMATIC AFFECTIONS OF THE SKIN, arising from pathological,
-physiological and psychological disturbances are probably of more
-interest than any other group, because here one finds so many things not
-even mentioned in most works on dermatology, and because this class of
-affections seems destined more and more to be a common inherent of
-American life.
-
-“These diseases, which are called diseases of the skin, are not so in
-reality. They belong more or less to the entire organism, revealing
-themselves upon the external integument with visible and palpable
-peculiarities which enable us to form an opinion as to their true
-nature. Considering the subject from this point of view, dermatology is
-therefore one of the most important branches of pathology; it is the
-torch which throws light on many morbid conditions which otherwise would
-remain obscure, vague and unsettled. But dermatology is more than this;
-it is the index, the external manifestation of disturbances which may be
-physiological or pathological, superficially or deeply seated. It is
-still more, for it is the visible expression of certain psychological
-emotions and moral states which are reflected upon the skin, there to be
-interpreted by the observing student.” This part of the work ends with a
-chapter on dermatoses of local origin, which includes parasitic
-affections.
-
-The book concludes by taking up the treatment of the different diseases
-one by one. In the treatment of syphilis the author says: “The
-preparation of mercury to which we give the preference is the proto
-iodide. It is less dangerous, more soluable in the stomach and more
-easily assimilated. It should never be given to exceed three
-centigrammes a day.”
-
-Time forbids further details. I will simply say the book is a good one,
-and will well repay careful study. Arrangements have been made with the
-author and his publishers to translate the work into English.
-
-                                                          W. T. CORLETT.
-
-                  *       *       *       *       *
-
-“OFFICIAL FORMULÆ OF AMERICAN HOSPITALS” is the title of a 16-mo manual
-of 238 pages, published by the _Medical World_ of Philadelphia. It
-contains the formulæ of some twenty-nine American hospitals, collected
-and arranged by C. F. Taylor, M. D. Price $1.00.
-
-                  *       *       *       *       *
-
-“ORGANIC MATERIA MEDICA AND THERAPEUTICS,” in accordance with the sixth
-revision of the United States Pharmacopœia. By James Young Simpson, M.
-D., of Orange, New Jersey. Book of 337 pages, well printed and very
-neatly bound. Published by J. H. Vail & Co., New York.
-
-
-                         THE ASTRONOMIC DOCTOR.
-
-By request we take pleasure in reprinting this poem from the CLEVELAND
-MEDICAL GAZETTE of April, 1860. A modest country practitioner discovered
-a planet. The medical and scientific world prepared to give him a public
-dinner at the “Hotel du Louvre.” But word was sent from the modest
-doctor he would rather “stay at home in his wooden shoes” (it is his own
-expression).
-
-                                   I.
-
-                 To grace the brow of savans
-                   Astronomy has twined the crown,
-                 The trumpet sounds their giant deeds,
-                   And celebrates their high renown.
-                 But from the shrouded face of night
-                   A doctor draws the veil, and first
-                 Upon his modest, upturned sight,
-                   The splendors of a planet burst.
-
-                                  II.
-
-               His country rounds he still pursues,
-                 The storm he bears, and winter's cold;
-               Nor does his simple heart refuse
-                 Creation's wonders to behold,
-               But Lescarbault with lifted eyes,
-                 And hand upon his earnest heart,
-               Slow walks, to view the stars, but flies,
-                 Relief from suffering to impart.
-
-                                  III.
-
-                 Upon the doctor's humble life
-                   Simplicity her graces sheds,
-                 From grandeur far, and envious strife,
-                   Goodness to diligence he weds.
-                 His coat of serge he wears content,
-                   Nor e'er for gilded splendor sighs,
-                 But when he scans the firmament
-                   He sees his “star of honor” rise.
-
-                                  IV.
-
-               On history's page enshrine his fame,
-                 Yet other glories claim our song;
-               Friends, collegues, share another's name!
-                 To Laennec too our toasts belong,
-               An echo to his ear betrays
-                 The seat of misery's hidden dart—
-               'Tis well on stony worlds to gaze—
-                 'Tis nobler far to read the heart.
-
-The above verses were written by Dr. Piory, one of the celebrated
-physicians of Paris, and were sung by Dr. Mayne at the annual dinner of
-the Medical Society of the Arrondisement of the Elysee. For the elegant
-and faithful translation which we have given, we are indebted to the
-kindness of a very accomplished young friend.
-
-
-
-
-                          TRANSCRIBER'S NOTES
-
-
- 1. Corrected nevrosis to necrosis (or might be neurosis) on p. 110.
- 2. Silently corrected typographical errors.
- 3. Retained anachronistic and non-standard spellings as printed.
- 4. Enclosed italics font in _underscores_.
- 5. Superscripts are denoted by a carat before a single superscript
-    character or a series of superscripted characters enclosed in curly
-    braces, e.g. M^r. or M^{ister}.
-
-
-
-
-
-End of the Project Gutenberg EBook of The Cleveland Medical Gazette, Vol. I.
-No. 3., January 1886, by A. R. Baker and S. W. Kelley and Various
-
-*** END OF THIS PROJECT GUTENBERG EBOOK THE CLEVELAND MEDICAL ***
-
-***** This file should be named 52874-0.txt or 52874-0.zip *****
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-<pre>
-
-The Project Gutenberg EBook of The Cleveland Medical Gazette, Vol. I. No.
-3., January 1886, by A. R. Baker and S. W. Kelley and Various
-
-This eBook is for the use of anyone anywhere in the United States and most
-other parts of the world at no cost and with almost no restrictions
-whatsoever.  You may copy it, give it away or re-use it under the terms of
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-www.gutenberg.org.  If you are not located in the United States, you'll have
-to check the laws of the country where you are located before using this ebook.
-
-
-
-Title: The Cleveland Medical Gazette, Vol. I. No. 3., January 1886
-
-Author: A. R. Baker
-        S. W. Kelley
-        Various
-
-Release Date: August 22, 2016 [EBook #52874]
-
-Language: English
-
-Character set encoding: UTF-8
-
-*** START OF THIS PROJECT GUTENBERG EBOOK THE CLEVELAND MEDICAL ***
-
-
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-Produced by Richard Tonsing, The Online Distributed
-Proofreading Team at http://www.pgdp.net (This file was
-produced from images generously made available by The
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-</pre>
-
-
-<div class='tnotes covernote'>
-
-<p class='c000'><strong>Transcriber's Note:</strong></p>
-
-<p class='c000'>The cover image was created by the transcriber and is placed in the public domain.</p>
-
-</div>
-
-<div>
-  <span class='pageno' id='Page_97'>97</span>
-  <h1 class='c001'><span class='xlarge'>THE</span> Cleveland Medical Gazette</h1>
-</div>
-
-<table class='table0' summary=''>
-<colgroup>
-<col width='33%' />
-<col width='33%' />
-<col width='33%' />
-</colgroup>
-  <tr>
-    <td class='c002'><em>VOL. I.</em></td>
-    <td class='c003'><em>JANUARY, 1886.</em></td>
-    <td class='c004'><em>No. 3.</em></td>
-  </tr>
-</table>
-
-<div class='chapter'>
-  <h2 class='c005'>ORIGINAL ARTICLES.</h2>
-</div>
-
-<h3 class='c001'>A HISTORY OF MEDICINE.</h3>
-
-<div class='nf-center-c1'>
-<div class='nf-center c006'>
-    <div>BY JOHN BENNITT, M. D.,</div>
-    <div class='c006'>Professor of Principles and Practice of Medicine in the Medical Department of the Western Reserve University, Cleveland, Ohio.</div>
-  </div>
-</div>
-
-<p class='c007'>It may not be inappropriate to give in your journal a brief
-sketch of the history of medicine, by the consideration of which
-we may come to a better appreciation of our present standpoint
-as medical men. We may also the better understand how
-much we, as medical men, and the world at large, are indebted
-to the methodical, plodding workers of the past in the field of
-inquiry pertaining to the nature and cure of disease. Such
-review may have the effect of stimulating medical men to more
-careful observation and the recording the results of observations
-that they may be given to others for mutual benefit.</p>
-
-<p class='c000'>Science may be defined as “classified knowledge.” But all
-our knowledge is based on experience and observation. Medical
-science, like other sciences, taking the definition of Sir
-John Herschel, is “the knowledge of many, orderly and
-<span class='pageno' id='Page_98'>98</span>methodically digested and arranged so as to become attainable
-by one.”</p>
-
-<p class='c000'>In all cases art and observation precede and beget science,
-and give origin to its gradual construction. But soon science,
-so built up, begins to reflect new light upon its parents—observation
-and art—helps them onward, expands the range of
-vision, corrects their errors, improves their methods and suggests
-new ones. The stars were mapped out and counted by
-the shepherds watching their flocks by night, long before
-astronomy assumed any scientific form.</p>
-
-<p class='c000'>From the earliest ages the pains and disorders of the human
-body must have arrested men's anxious attention and claimed
-their succor. The facts observed, both as to hurts and diseases,
-and as to their attempted remedying, were handed down by
-tradition or by record from generation to generation in continually
-increasing abundance, and out of the repeated survey and
-comparison of these has grown the recognition of certain laws
-of events and rules of action, which together constitute “medical
-science.”</p>
-
-<p class='c000'>There is good reason for the belief that Egypt was the
-country in which the <em>art</em> of medicine, as well as the other arts
-of civilized life, was first cultivated with any degree of success,
-the offices of the priest and the physician being probably combined
-in the same person. In the writings of Moses there are
-various allusions to the practice of medicine amongst the Jews,
-especially with reference to the diagnosis and treatment of leprosy.
-The priests were the physicians, and their treatment
-mainly aimed at promoting cleanliness and preventing contagion.
-The same practice is approved by the light of latest
-science.</p>
-
-<p class='c000'>Chiron, the Centaur, is said to have introduced the art of
-medicine amongst the Greeks, but the early history of the <em>art</em>
-is entirely legendary. Æsculapius appears in Homer as an
-excellent physician of <em>human</em> origin; in the later legends he
-becomes the god of the healing art. His genealogy is obscure
-and altogether fabulous. He, however, soon surpassed his
-teacher, Chiron, and succeeded so far as to restore the dead to
-life (as the story goes). This offended Hades, who began to
-<span class='pageno' id='Page_99'>99</span>fear that his realm would not be sufficiently peopled; complained
-to Zeus (Jove) of the innovation, and Jove slew Æsculapius
-by a flash of lightning. After this he was deified by the
-gratitude of mankind, and was especially worshiped at Epidaurus,
-where a temple and a grove were consecrated to him. His
-statue in this temple was formed of gold and ivory, and represents
-him as a god seated on a throne, and holding in one hand
-a staff with a snake coiled around it, the other hand resting on
-the head of a snake; a dog, as an emblem of watchfulness, at
-his feet (an intimation very appropriate for the medical profession).
-The Asclepiades, the followers of Æsculapius, inherited
-and kept the secrets of the healing art; or, assuming that
-Æsculapius was merely a divine symbol, the Asclepiades must
-be regarded as a medical, priestly caste, who preserved as mysteries
-the doctrine of medicine. The members of the caste
-were bound by an oath—the Hippocratis jusjurandum—not to
-divulge the secrets of their profession.</p>
-
-<p class='c000'>In Rome, in the year 292 B. C., a pestilence (probably malarial
-fever) prevailed. The Sibyline books directed that Æsculapius
-(statue!) must be brought from Epidaurus. Accordingly,
-an embassy was sent to this place, and when they had made
-their request, a snake crept out of the temple into the ship.
-Regarding this as the god Æsculapius, they sailed to Italy, and
-as they entered the Tiber the snake sprang out upon an island,
-where afterwards a temple was erected to Æsculapius and a
-company of priests appointed to take charge of the service and
-practice the art of medicine. The name Æsculapius, then, is
-only an impersonation of medicine in the remote ages, or early
-ages of Grecian history.</p>
-
-<p class='c000'>Hippocrates is the first writer of medicine whose works have
-come down to us with anything like authority other than fable.
-Indeed, he was the most celebrated physician of antiquity. He
-was the son of Heracleides, also a physician, and belonged to
-the family of the Asclepiades, said to be about eighteen generations
-from Æsculapius. His mother was said to be descended
-from Hercules.</p>
-
-<p class='c000'>Hippocrates was born in the island of Cos (more anciently
-Meropis), an island of the Grecian archipelago of about one
-<span class='pageno' id='Page_100'>100</span>hundred square miles, probably about the year 460 B. C. Instructed
-in medicine by his father and other contemporary medical
-men, he traveled in various parts of Greece and Asia minor.
-He finally settled and practiced his profession at Cos, but died
-in Thessaly at the age of one hundred and four years (B. C.
-357). Little is known of his personal history, other than that
-he was highly esteemed as a physician and an author, and that
-he raised the reputation of the medical school of Cos to a high
-degree. His works were studied and quoted by Plato. He
-was famous in his own time, and his works, some sixty in number,
-have in them many things that are not unworthy of consideration
-even after the lapse of twenty-two hundred years.
-Many of the works ascribed to Hippocrates are <em>not</em> well
-authenticated.</p>
-
-<p class='c000'>He divided the causes of diseases into two principal classes—the
-first consisting of the influence of seasons, climates, water,
-situations, etc.; the second of more personal causes, such as
-the food and exercise of the individual patient. His belief in
-the influence which different climates exert on the human constitution
-is very strongly expressed. He ascribes to this influence
-both the conformation of the body and the disposition of
-the mind, and hence accounts for the difference between the
-hardy Greek and the Asiatic.</p>
-
-<p class='c000'>The four humors of the body (blood, phlegm, yellow bile
-and black bile) were regarded by him as the primary seats of
-disease; health was the result of the due combination (or
-crasis) of these humors, and illness was the consequence of a
-disturbance of this crasis. When a disease was progressing
-favorably these humors underwent a certain change (coction),
-which was the sign of returning health, as preparing the way
-for the expulsion of morbid matters, or crisis, these crises having
-a tendency to occur at definite periods, which were hence
-called critical days.</p>
-
-<p class='c000'>His treatment of disease was cautious and what we now
-term expectant, <em>i. e.</em>, it consisted chiefly, often solely, in attention
-to diet and regimen; and he was sometimes reproached
-with letting his patients die by doing nothing to keep them
-alive.</p>
-
-<p class='c000'><span class='pageno' id='Page_101'>101</span>His works written in Greek were at an early period translated
-into Arabic. They were first printed in Latin in 1525,
-at Rome. A complete edition in Greek bears a date a year
-later.</p>
-
-<p class='c000'>Several editions in Latin and other languages have appeared
-from time to time. An English translation of 'The Genuine
-Works of Hippocrates,' was published by the Sydenham society
-in 1848, in 2 vols., by Dr. Adams. The advance which
-Hippocrates made in the practice of medicine was so great that
-no attempts were made for some centuries to improve upon
-his views and precepts. His sons, Thessalus and Draco, and
-his son-in-law, Polybius, are regarded as the founders of the
-medical sect which was called the Hippocratean or Dogmatic
-school, because it professed to set out with certain theoretical
-principles, which were derived from the generalization of facts
-and observations, and to make these principles the basis of
-practice. The next epoch in the history of medicine is the establishment
-of the school at Alexandria, which was effected by
-the munificence of the Ptolemies, about B. C. 300. Indeed the
-whole race of Ptolemies (from Ptolemy I. to Ptolemy VII. B.
-C. 323 to 117) seem to have been patrons of learning and
-learned men. (Less so Ptolemy VIII. to XIII., B. C. 117 to
-43. Ptolemy II., Philadelphius, was born in Cos about 150
-years after Hippocrates.) It was by the patronage of these
-kings of Egypt that learning flourished in Alexandria during
-their reign.</p>
-
-<p class='c000'>In some of them this seems to have been the only redeeming
-feature of their character. Otherwise vicious, cruel, bloodthirsty
-in an extreme degree, they uniformly encouraged learning and
-learned men. (It seems to have been a hereditary trait.)
-Amongst the most famous of the medical professors of the
-School of Alexandria are Erasistratus and Herophilus.</p>
-
-<p class='c000'>The former of these was a pupil of Chrysippus, and probably
-imbibed from his master his prejudice against bleeding and
-against the use of active remedies, preferring to trust mainly to
-diet and to the <i><span lang="la" xml:lang="la">vis medicatrix naturae</span></i>.</p>
-
-<p class='c000'>Herophilus, born in Chalcedon, in Bythinia, flourished in the
-latter part of the fourth and the beginning of the third century
-<span class='pageno' id='Page_102'>102</span>B. C., and settled in Alexandria, especially was distinguished
-by his devotion to the study of anatomy. He is said to have
-pursued this to such an extent as to have dissected criminals
-alive. Several names which he gave to different parts of the
-body are still in use, as the torcular Herophili, calamus scriptorius,
-and duodenum. He located the seat of the soul in the
-ventricles of the brain. Only a few fragments remain of what
-he wrote.</p>
-
-<p class='c000'>About this time the Empirics formed themselves into a distinct
-sect and became the declared opponents of the Dogmatists.
-The controversy really consisted in the question, “How
-far we are to suffer theory to influence over practice.” While
-the Dogmatists, or as they were sometimes styled, the Rationalists,
-asserted that before attempting to treat any disease we
-ought to make ourselves fully acquainted with the structure and
-functions of the body generally, with the operation of medicinal
-agents upon it, and with the changes which it undergoes
-when under the operation of any morbid cause, the Empirics,
-on the contrary, contended that this knowledge is impossible
-to be obtained and if possible is not necessary; that our
-sole guide must be experience and that if we step beyond this,
-either as learned from our own observations or that of others
-on whose testimony we can rely, we are always liable to fall into
-dangerous and often fatal errors. According to Celsus, the
-founder of the Empirics was Serapion, who was said to be a
-pupil of Herophilus. At this period, and for some centuries
-later, all physicians were included in one or the other of these
-rival sects, and from the evidence of history the two sects or
-schools were about equal. From Phiny, who wrote about the
-middle and sixth, seventh and eighth decades of the first century,
-we learn that medicine was introduced into Rome at a
-later period than the other arts and sciences.</p>
-
-<p class='c000'>The first person who seems to have made it a distinct profession,
-separate from priestcraft, was Archagathus, a Peloponnesian,
-who settled at Rome about B. C. 200. His treatment
-of his patients was so severe and unsuccessful that he was finally
-banished, and no other mention is made of a physician at Rome
-for about a century, when Asclepiades of Bythinia, acquired a
-<span class='pageno' id='Page_103'>103</span>great reputation. His popularity depended upon his allowing
-his patients a liberal use of wine, and of their favorite dishes, and
-in all respects consulting their inclinations and flattering their
-prejudices; and hence it is easy to understand the eminence at
-which he arrived, for we see even in our own time men building
-up great reputations by similar practices.</p>
-
-<p class='c000'>This man with a long name—Archagathus—was succeeded by
-his pupil, Themison of Laodicea, the founder of a sect called
-Methodics, who adopted a middle course between the Dogmatists
-and Empirics. During the greater part of the first two
-centuries of our era the Methodics were the preponderating
-medical sect, and they included in their ranks C. Aurelianus,
-some of whose writings have come down to us.</p>
-
-<p class='c000'>They soon broke into various sects of which the chief were
-the Pneumatics, represented by Aretaeus of Cappadocia, whose
-works are still extant; and the Eclectics, who claimed
-as do the Eclectics of to-day, to select the best from
-all the other systems and to reject the hurtful. The
-most remarkable writer of this age is Celsus (about A. D.),
-whose work (De Medicina) gives a sketch of the history of
-medicine up to that time and the state in which it then was.
-He is remarkable in being the first <em>native</em> Roman physician
-whose name has come down to us.</p>
-
-<p class='c000'>Dioscorides of Cilicia flourished about the end of the first
-century. He accompanied the Roman army in their campaign
-through many countries and gathered a great store of information
-and observations on plants. In his great work 'De Materia
-Medica,' he treats of all the then known medicinal substances
-and their properties, real or reputed, on the principles of the so-called
-humoral pathology. Two other works are ascribed to
-him but their genuineness is questionable. For fifteen centuries
-the authority of Dioscorides, in botany and materia medica,
-was undisputed, and still holds among the Turks and Moors.</p>
-
-<div class='nf-center-c1'>
-  <div class='nf-center'>
-    <div>[<em>To be Continued.</em>]</div>
-  </div>
-</div>
-
-<div>
-  <span class='pageno' id='Page_104'>104</span>
-  <h3 class='c001'>REPORT OF A CASE OF EXTRA-UTERINE PREGNANCY.</h3>
-</div>
-
-<div class='nf-center-c1'>
-<div class='nf-center c006'>
-    <div>BY H. J. LEE, M. D., CLEVELAND, OHIO.</div>
-  </div>
-</div>
-
-<p class='c007'>The following case came under my care during my term of
-service in the wards of Charity Hospital in this city. Mrs. D.,
-age thirty-five, married, one child two years of age, was
-admitted to the hospital July 14, 1885, with the following history:
-She had always enjoyed good health, and there was no
-history of uterine disease. She menstruated about the first of
-April, 1885, did not menstruate in May, and supposed herself
-pregnant, as she had always been regular before, and during the
-latter part of May she had considerable nausea and other
-symptoms of pregnancy. About the first of June, while in
-church, she was taken with a severe hemorrhage. She was
-taken home and a physician called, who examined her and
-decided from the symptoms and history that she had had a
-miscarriage. There was very little hemorrhage after she
-arrived home, in fact very little at any subsequent time, but
-she did not recover well, had some pains in the abdomen, and
-she said had some fever all the time. Not getting on well, as
-she and her friends thought, it was decided to change physicians,
-which was done. The second physician concurred in the
-diagnosis of the first, and treated her evidently on the expectant
-plan, as any one would be compelled to do, owing to the
-difficulty of making a correct diagnosis at such an early stage.
-After a time, there being no improvement, she decided to go
-to the hospital. On admission she was quite emaciated and
-had an anaemic appearance; her temperature was about 99° to
-100° in the morning and 100° to 102° in the evening. There
-was considerable tenderness in the right iliac region, extending
-into the hypogastric region. Uterus was not felt to be at all
-enlarged, but the os was patulous. There was an enlargement
-to the right of the uterus. This could be felt both externally
-and through the vagina; was of an irregular outline, and quite
-tense and tender upon pressure. A sound was introduced
-into the uterus and passed in about three inches and was
-deflected to the left quite perceptibly. It did not appear quite
-<span class='pageno' id='Page_105'>105</span>certain that there was nothing in the uterus, and in view of the
-history of the case it seemed justifiable to explore the cavity.
-Accordingly a good sized sponge tent was introduced and
-allowed to remain twenty-four hours, when it was removed and
-the uterine cavity explored with purely negative results. The
-patient had now been under observation over a week, and
-attempts made to improve her general condition with tonics
-and nutritious diet, but without success. Her temperature continued
-about 101° most of the time. A positive diagnosis had
-not been made, though it seemed that about everything could
-be excluded except extra-uterine pregnancy. At this juncture
-Dr. W. J. Scott was asked to see the patient. He did so and
-made a very careful examination, and gave it as his opinion
-the case was one of extra-uterine pregnancy. The next day
-Dr. Dudley P. Allen was called in consultation with Dr. Scott
-and myself. Dr. Allen's examination was careful and exhaustive,
-and at its close he gave it as his opinion that while there
-were some obscure points, the most probable conclusion was
-that the case was one of extra-uterine fœtation.</p>
-
-<p class='c000'>Having all arrived at this conclusion, independently of
-each other, it was agreed that as there was some obscurity in
-the case, and also that in the event of there being a fœtus outside
-of the uterus it had now advanced to about the fourth
-month of gestation; consequently the most favorable time for
-the employment of the electric current had passed. In view
-of these facts, and also of the fact that exploratory incisions are
-attended with comparatively little danger, it was decided to
-make an exploratory incision and determine what was the condition
-of things. If a fœtus was found remove it if possible.
-If the trouble was something that could not be removed, the
-incision could be closed and the patient probably in no wise
-injured. Dr. Allen was asked to operate, and on the sixth of
-August the operation was performed. There were present,
-Dr. Allen, Dr. Scott, Dr. Millikin and the house staff. The
-anæsthetic was administered, and before commencing the
-operation an aspirator needle of good size was introduced into
-the tumor through the vagina. Upon exhausting the air no
-fluid was obtained, but upon partially withdrawing the needle
-<span class='pageno' id='Page_106'>106</span>about a drachm of clear serum was obtained, which was
-thought to be peritoneal fluid. It was then decided to proceed
-with the operation. An incision was made about an inch
-above and parallel to Poupart's ligament, commencing at the
-anterior superior spinous process of the ilium, and terminating
-at the outer margin of the rectus muscle.</p>
-
-<p class='c000'>On opening the abdomen an adherent mass was found closely
-attached to the coecum. Strong bands also passed from the
-mass toward the symphysis pubis. In order to reach the mass
-more fully, and also the annexes of the uterus, the adhesions to
-the pubis were divided between ligatures. This having been
-done, it was still found to be impossible to detach the intestines
-which were closely adherent to the coecum, and nothing abnormal
-could be found in connection with the uterus. Failing to
-discover the cause of the adhesions about the coecum from the
-abdominal cavity, it was thought this might be accomplished
-by separating the peritoneum from the iliac fossa, and reaching
-the coecum from the outer and posterior side. This separation
-was continued until it could be carried no further without great
-danger of wounding the external iliac vessels, which were
-exposed for several inches. Although nothing further than a
-closely adherent mass of intestines had been found, an attempt
-to separate which had been carried to the limit of safety, and
-the cause of the malady had not been demonstrated with entire
-satisfaction, it was deemed best to close the abdominal incision,
-which was accordingly done.</p>
-
-<p class='c000'>The subsequent history of the cure was as favorable as could
-be desired. The wound united very readily. The temperature
-never rose above 103°, and was only at that point for a few
-hours; most of the time was 100° to 101.5°. Two weeks after
-the operation temperature was normal, a point it had not
-reached since her admission, and probably not for some time
-previous.</p>
-
-<p class='c000'>Patient was examined September 8; the tumor was found to
-be considerably diminished in size, and tenderness almost entirely
-disappeared. She had apparently gained in weight, and
-expressed herself as feeling well. She was discharged from the
-hospital September 9. On the tenth of October she again presented
-<span class='pageno' id='Page_107'>107</span>herself, according to agreement, and was examined by
-Dr. Scott, Dr. Allen and myself. The tumor had entirely disappeared,
-only a slight thickening of the tissues remaining, the
-uterus had resumed its normal position, and the patient, to all
-appearances, was as well as ever.</p>
-
-<p class='c000'>I have reported this case as one of extra-uterine pregnancy,
-and yet it will be seen by the report that the existence of that
-condition was not demonstrated at the operation, but it seems
-to me that the history of the case, both prior and subsequent
-to the operation, demonstrates pretty conclusively that it could
-be nothing else. Both the gentlemen who saw the case before
-operation were of the opinion that everything could be excluded
-except a collection of fluid, disease of the coecum and extra-uterine
-pregnancy, and to my mind (and the gentlemen who
-were called in consultation have expressed themselves in the
-same manner) the operation and the result of it excludes everything
-except the last mentioned condition. It may be said that
-in the treatment of the case less severe measures should first
-have been tried; that the electric current should have been
-employed before resorting to an operation. This subject was
-fully discussed, and the decision against the employment of
-electricity was unanimous, from the fact that the most favorable
-time for its employment had passed and the time had arrived
-when any further delay was dangerous. Then the danger from
-an exploratory incision is so small that it seemed to be more
-than counterbalanced by the knowledge that would be obtained
-by it. If an exploratory incision was made we would then be
-better able to tell what we had to deal with, and would also be
-in a position to deal with whatever was found in the most
-effectual manner, and it was thought that the most certain
-means of cure should be employed first and the patient not be
-subjected to the danger of delay in order that less certain
-methods might first be tried; also the high temperature seemed
-to render any delay more dangerous. The incision described
-was employed because it seemed that the tumor could be more
-easily reached and removed by means of it than by means of
-the central one. When, however, the mass was reached it was
-found to be so firmly attached to the cœcum by strong adhesions
-<span class='pageno' id='Page_108'>108</span>that it was absolutely immoveable. Under these circumstances
-it was decided that it would be unwise to attempt its
-removal, consequently the wound was closed and the operation
-desisted from. The subsequent history was all that could be
-desired, or could, under any circumstances, have been expected.</p>
-
-<p class='c000'>I think the most probable explanation of the disappearance
-of the tumor is this: The case was one of extra-uterine pregnancy
-of the abdominal variety, the ovum became attached to
-the peritoneum and a connective tissue proliferation was set
-up which surrounded it with a vascular sack, the walls of which
-kept pace with the growth of the ovum, and as they extended
-into the abdominal cavity formed adhesions to the cœcum,
-intestines, and other parts in the vicinity. During the operation
-these adhesions were ligated and divided, and in consequence
-the nutrition of the ovum was entirely cut off, and
-death and absorption was the result.</p>
-
-<p class='c000'>Since writing the report of this case the patient has been
-seen and examined. She seems to be in perfect health, and
-says she never felt better. There is not a vestige of the
-tumor remaining, except two or three small indurated spots
-that can be felt through the vagina.</p>
-
-<h3 class='c001'>STAMMERING, STUTTERING.</h3>
-
-<div class='nf-center-c1'>
-<div class='nf-center c006'>
-    <div><span class='sc'>By Prof. G. Delon, late of Paris, France.</span></div>
-  </div>
-</div>
-
-<p class='c007'>Here is an universal and very strange infirmity, impeding
-speech, the origin of which must be anterior to the formation
-of languages. Hippocrates, the “<span lang="fr" xml:lang="fr">Père de la Médecine</span>,” Galen
-and Aristotle attributed it to an abnormal moisture of the brain
-and tongue and to a defective construction of the tongue, and
-their theories have been revived by modern writers. We find
-in Aristotle a double definition that stammering is an inability
-of articulating a certain letter, and stuttering an inability of
-joining one syllable to another. Notwithstanding the difference
-between the causes, the characteristics and the effects of both
-defects, several languages have but one word to express it; in
-<span class='pageno' id='Page_109'>109</span>French, for instance, “<span lang="fr" xml:lang="fr">Bégaiement</span>” means either stammering
-or stuttering. American dictionaries give the same definition
-for both; and in common talk no distinction is made,
-all stoppages in speech being called indiscriminately stammering
-or stuttering.</p>
-
-<p class='c000'>Speech being a combination of separate sounds produced by
-the expired air, it is certain that the first condition required for
-natural and correct speech is an undisturbed and normal action
-of the breathing apparatus.</p>
-
-<p class='c000'>The movements performed by the respiratory organs for the
-modification of the currents of air being produced by muscles
-owing their activity to nerves—motor and sensory—and the
-vocal organs being, like all parts of the organism, provided
-with nerves, it becomes evident that a general excitation of the
-nervous system, or any unusual excitement of the motor-nerves
-in action, will affect the muscles, cause irritation and create disturbances
-in inspiration, expiration and speech.</p>
-
-<p class='c000'>Normal inspiration is produced by a regular contraction of
-the diaphragm, and expiration is due to the elasticity of
-the tissue of the lungs. A spasmodic inspiration, during
-which a prolonged contracted spasm of the diaphragm takes
-place, produces stammering; such a convulsive contraction of
-the diaphragm can take place without attempting to speak,
-but any attempt to utter sounds during the spasm will result
-in stammering. At the end of the spasm, the air is then
-quickly expelled from the lungs. I have noticed stammering children
-that I have treated subject to frequent attacks of hiccough;
-in hiccough the expiration is quiet: an irritation of the nerves
-of the diaphragm brings about, with a violent inspiration, an
-attenuated convulsive contraction of the diaphragm, as in stammering.</p>
-
-<p class='c000'>In stuttering which is characterized by the presence of some
-spasm, in all articulations, labial, lingual, dental and guttural,
-although respiration is irregular and the respiratory organs do
-not work well, the inability to form and join the sounds
-comes from other sources than a spasmodic contraction of the
-diaphragm.</p>
-
-<p class='c000'>Stammering proper, when organic, might be called stammering
-<span class='pageno' id='Page_110'>110</span>of the diaphragm, and that distinction would be quite logical,
-as other organs wholly unconnected with speech show that
-peculiarity of being affected with stammering.</p>
-
-<p class='c000'>The influence exercised on the voice and speech by the respiratory
-mechanism is so considerable that a variety of theories
-on respiration have been advanced and discussed by physicians
-and specialists, not only with reference to speech impediments
-but specially for singing, elocution, acting and public speaking,
-and also in reference to general health. Writers and professors
-advocating exclusively so-called diaphragmatic, or costal, or
-abdominal respiration, are incorrect and perfectly deceived.
-The diaphragm, the ribs, and the muscles of the abdomen must
-all do more or less their special work, in order to carry on a
-normal and healthy respiratory act. An eminent physician,
-Dr. Ed. Fournié of Paris, says: “He who respires exclusively
-by one or the other of these alone (diaphragm, ribs or abdomen)
-must be indeed a sick man.” Costal or side-breathing is due to
-the elevation and depression of the ribs simultaneously with the
-contraction of the diaphragm. Abdominal breathing, the
-method taught to singers, is performed by the pressure of the
-abdominal muscles upon the anterior and lateral walls of the abdomen,
-forcing up the diaphragm, and thus expiring almost
-completely the air in the lungs.</p>
-
-<p class='c000'>Medical and scientific investigations concerning speech defects
-have been as considerable as it is contradictory. The observations
-of prominent doctors and specialists, some of them being
-afflicted themselves, have in the most argumentative thesis attributed
-stammering-stuttering to numerous and varied causes,
-the enumeration of which has a real historical and pathological
-interest:</p>
-
-<p class='c000'>Faulty action of the tongue, disorders of tongue-muscles,
-spasms of the glottis and epiglottis, troubles located in the
-larynx and in the hyoid-bone, abnormal depth of the palate,
-affections of the muscles of the lower jaw, spasm of the lips, abnormal
-dryness or moisture, or lesion of brain, nerves, muscles
-or tongue, nervous affection, intermittent necrosis<a id='p110'></a>, general
-debility or weakness, chorea, incomplete cerebral action, imperfect
-will-power, want of harmony between thought and
-<span class='pageno' id='Page_111'>111</span>speech, imitation and habit.—Such is the nomenclature of the
-principal ingenious theories exposed and upheld by those who
-have made a study or a business of the cure of speech defects.
-But some mistaken innovators, not satisfied with theories and investigations,
-gave to their ideas an experimental form. Forty
-and forty-five years ago a surgical craze, originating in Germany
-as a pretended cure of speech defects, was raging all over
-Europe. Stammerers and stutterers suffered a variety of operations,
-the horizontal section of the tongue, the division of the
-lingual muscles, the division of the genio-hyo-glossi muscles,
-the cutting of the tonsils and uvula, etc. Such suppression and
-mutilation of the vocal organs could not bring any cure, as it
-was proved, and some patients having died, the operating craze
-was put to an end forever. Since that it is by more gentle
-means that all attempts have been made to cure impediments
-of speech. The unfortunate stutterer has no longer to dread
-the misemployed zeal of surgical operators, and now it is even
-his own fault when he allows himself to fall into the hands of
-ignorant charlatans.</p>
-
-<p class='c000'>Without lessening the value of former discoveries, I will say
-that the specialist of to-day must disagree with the most eminent
-authors and the most prominent works on that question, including
-Velpeau, Amussat, Becquerel, Lenbuscher, Bèclard, Bristowe,
-etc., and arrive at the conclusion that their testimony was
-one-sided, being confined to their own or few cases, and limited
-to mere theory and speculation. For the treatment of vices of
-speech, with the indispensable knowledge, long and practical
-experience alone will instruct what is the right method to
-pursue. The various theories on the nature and causes of that
-infirmity, and the enumeration of the different responsible
-organs may be, at the same time, partly false and partially true;
-but they have proved powerless to cure or relieve.</p>
-
-<p class='c000'>In all varieties and forms of stammering-stuttering all the
-vocal organs can be blamed, and have, in each case, to be reformed
-and improved. In the majority of cases we find some
-traces of the organic peculiarities aimed at by authors, even if
-their influence is doubtful. Respiratory trouble is at the bottom
-of every case. The internal organs, and the tongue, the
-<span class='pageno' id='Page_112'>112</span>lips and jaws are to some extent in an abnormal condition, and
-suffer a convulsive spasm; they have to be treated, strengthened
-and made flexible. The nerve-function of the organs of
-speech is also disturbed. We notice in the majority of cases,
-to a certain degree, organic weakness, nervousness, lack of
-will-power, and above all, disregard of all natural rules and
-ignorance of the use and natural functions of the organs of
-speech.</p>
-
-<p class='c000'>As to prognosis, I will say that all stoppages in speech,
-accompanied by spasms, sometimes hardly perceptible, and
-which are not the result of paralysis or lesion, may be classified
-as stammering-stuttering, and can always be cured, whatever
-may be their origin or cause, or their intensity, and that it is
-only a question of time and perseverance even for the most
-stubborn cases.</p>
-
-<p class='c000'>The treatment of stammering-stuttering, which does not
-comport any operation nor drugs, is purely educational. It
-consists in remedying the defect and teaching properly the
-science of speech. Still, I think, that in many cases a strict
-attention ought to be paid to hygienic measures; some medical
-care and prescription would help the patient and the instructor.
-In the actual condition of things no regular practicing
-physician can afford to devote his ability and time to the treatment
-of speech defects. But doctors have to study the
-infirmity, to know that it can be cured, that it is an interesting
-and complex disease, in the treatment of which the progress of
-medical science can bring a revolution. Physicians the world
-over having wholly neglected to consider that question, the
-result has been to leave it in the hands of incompetent persons.
-In principle the question of speech impediments cannot be
-separated from medicine. Physicians cannot ignore an infirmity
-in which the organism itself is undoubtedly involved, at times
-in a very intricate manner and to a considerable extent. Every
-true physician feels that he has a sacred mission—to alleviate
-suffering; the tortures of a large class of people partially deprived
-of the faculty of speech are well worth his care and
-attention. Medical students ought to be provided with the
-means of becoming versed in an affection offering such a large
-<span class='pageno' id='Page_113'>113</span>field for study and work, where so much light is needed, and
-where the prospects of discovery and improvement from a
-scientific and medical standpoint are so legitimate. The family
-physician, often consulted, will do good work in advising his
-clients to try and get rid of such a terrible affliction, to be cured
-without delay, and in preventing them from falling into the
-hands of quacks.</p>
-
-<h3 class='c001'>HOMELY FACTS.</h3>
-
-<div class='nf-center-c1'>
-<div class='nf-center c006'>
-    <div>BY F. STEWART, CLEVELAND, O.</div>
-  </div>
-</div>
-
-<p class='c007'>Not long ago as a bottle was placed upon the counter of a
-pharmacist to be refilled, its inner walls were observed to be
-richly decorated with the active principles of the compound.
-A witch-hazel doctor standing by declared the decorated walls
-to be the secret of the patient's recovery, but upon inquiry it
-was found that the patient was no better. Still they had
-decided to try another bottle, and the apothecary was not the
-one to object. The investigation was carried no farther, but if
-it had been the same old story of <em>incompatibles</em> would have been
-retold. To the aqueous solutions containing oleoresinous
-tinctures or extracts (such as cannabis indica, guaiac, benzoin,
-lupulin, ginger, myrrh, cubeb, eucalyptus, sumbul, and many
-others) a sufficient quantity of carbonate or calcined magnesia
-should be added. A few grains (say three to twenty) to the
-prescribed dose will suffice for a good suspension, and will be
-found in most cases unobjectionable of course in an acid mixture.</p>
-
-<p class='c000'>There are many conflicting reports of this class of medicines,
-owing to unscientific prescribing as well as unreliable preparations.
-The activity of this class of medicines demands nothing
-short of strong alcohol for their extraction. Yet many weak
-and worthless preparations may be found in the market. If the
-unscientific observers would look more to the quality of their
-goods, these conflicting reports would begin to subside.</p>
-
-<p class='c000'>A physician once told an apothecary that he prescribed fluid
-<span class='pageno' id='Page_114'>114</span>extracts because he found them more reliable than the tinctures.
-This was not true, and could not be proven. Upon
-investigation it was found that his prescribed dose of fluid
-extract of digitalis was equivalent to fifty-five drops of the
-tincture, a dose larger than he intended to prescribe. With
-such science the witch-hazel doctor will ride a high horse, and
-come in on the home stretch with flying colors. No singer
-can sing well who sings too many songs, and no beginner will
-prescribe well who prescribes too many medicines. This song
-has been sung much but not half enough, for it is not borne
-in mind. Many fail with a remedy simply because they have
-failed to master it.</p>
-
-<p class='c000'>Mastering the few is said to be the key to success, and the
-writer believes it, for he has seen it proven. An eminent physician
-from New York was once called in consultation to a
-western city. His prescription was mercury iodide, potassium
-iodide, and infus. gentian. He stated (and the other physician
-said, “I see”) that the only object of the potassium was to dissolve
-the mercury iodide. But potassium's great affinity for
-iodide accepted it, at once dropped the free mercury to the
-bottom, likely to be taken all at the last dose, equal to fifteen
-or twenty grains of blue pill. He had failed to master this
-remedy.</p>
-
-<p class='c000'>The witch-hazel doctor could not declare this time that the
-untaken medicine saved the patient's life, for he died before
-taking it. But he could smile at the prescription appropriately,
-were none of his own to be found on file.</p>
-
-<p class='c000'>Another phase of fashion reminds one of the old saying
-“distance lends enchantment;” for there is just as good
-sense in going to New Brunswick to have a boil lanced as there
-is in bringing syrup hypophosphates from that place.</p>
-
-<p class='c000'>The present pharmacopœia contains a splendid formula for
-this syrup—one, too, with which phosphoric acid, quinine and
-strychnine are perfectly compatible. A pharmacist that will
-not exert himself to furnish the very best article for a physician's
-prescription is not entitled to the physician's respect.
-But for a physician to expect a pharmacist to send all over town
-for some foreign preparation that might, in almost all cases, be
-<span class='pageno' id='Page_115'>115</span>better made at home, affords a weapon to retard medical science
-and advance the nostrum manufacturer. The more scientific
-physicians well know and admit that a good pharmacist can
-better judge of a compound than a physician, who seldom
-stops to test it, but prescribes it a few times and, in many
-cases, never thinks of it again, or, perhaps, not until he presents
-his bill and finds the patient's money all gone for semi-proprietary
-medicines that cost from fifty to one hundred per
-cent. more than would have paid for better compounds. Physicians
-will only have to examine these medicines after they
-have stood a year or two, and in many cases a much less time,
-to see the force of this argument.</p>
-
-<p class='c000'>Among these nostrums are found numerous preparations we
-could mention, including many emulsions, elixirs, etc. It is
-comforting to see the better class of physicians giving these
-nostrums a “wide berth.” Others will follow their example if
-they investigate and master their remedies.</p>
-
-<p class='c000'>Having no time to continue this rehearsal, I close with a <em>plea
-for more science, more investigation</em>, that we may not have to
-send to Buffalo for syrups of Dover powder or farther east, west or
-south for nostrums, but master the remedies we have, saving
-to the physician and patient from fifty to one hundred per cent.,
-thus mitigating the popular cry of the high price of medicine.
-There should be a table of incompatibles in every medical college
-as prominent as the multiplication table in the schools, or
-pharmacists should be allowed more freedom to prepare medicines
-properly, instead of being held to the letter.</p>
-
-<p class='c000'>The writer should not complain, for he has been liberally
-treated by the profession in this respect; but he does not feel
-at liberty to add magnesia to a mixture unless so ordered. A
-pharmacist did this at one time in a tar-and-water mixture,
-gaining great praise from the physician. (Making the tar quite
-thin with a little alcohol, then absorbing the whole with magnesia,
-and emulsifying by adding the water gradually.)</p>
-
-<div>
-  <span class='pageno' id='Page_116'>116</span>
-  <h3 class='c001'>BREUS' OBSTETRIC FORCEPS.</h3>
-</div>
-
-<div class='nf-center-c1'>
-<div class='nf-center c006'>
-    <div>BY C. B. PARKER, M. D.,</div>
-    <div class='c006'>Professor of Physiology and Lecturer on Gynæcology in the Medical Department of Western Reserve University, Cleveland, O.</div>
-  </div>
-</div>
-
-<p class='c007'>The accompanying wood-cuts represent the forceps recently
-introduced to the profession by Dr. Breus, formerly first assistant
-in the clinic of Prof. Carl Braun, Von Fernwald, in Vienna.<a id='r1' /><a href='#f1' class='c008'><sup>[1]</sup></a></p>
-
-<div class='footnote' id='f1'>
-<p class='c000'><span class='label'><a href='#r1'>1</a>.&nbsp;&nbsp;</span>Archiv für Gynäcologie XX Band 2 Heft.</p>
-</div>
-
-<p class='c000'>It is the simplest in construction of the so-called axis traction
-forceps, and is specially designed for the extraction of the
-head presenting high above the pelvic brim. In size, shape,
-curves, handles, lock, etc., it is an exact model of the J. Y.
-Simpson forceps—the favorite instrument of the Vienna school.</p>
-
-<div  class='figcenter id001'>
-<img src='images/i020.jpg' alt='' class='ig001' />
-<div class='ic001'>
-<p>Fig. 1.</p>
-</div>
-</div>
-
-<p class='c000'>Unlike the ordinary forceps, however, it is constructed with a
-hinge-joint (<em>a</em> Fig. 2) at the angle of the fenestrum with the shaft,
-which permits of a movement of the blades through an arc of
-about 40°. An elbow on the lower margin of the blade arrests
-the further movement in the downward direction, and a prolongation
-of the upper fenestrum of the blade, in the form of
-an arm (<em>b</em>), is continued backward parallel to the shafts. This
-arm turns at an angle of 100° in front of the lock and terminates
-in an eye, through which the split pin seen at the side of the
-<span class='pageno' id='Page_117'>117</span>instrument passes. The pin fits loosely in the eyes and restricts,
-while still permitting considerable latitude of movement to the
-blades. At the suggestion of several gentlemen to whom the
-instrument was shown, the shaft has been lengthened nearly
-one inch. In other respects the forceps is an exact counterpart
-of those now used in the lying-in department of the General
-Hospital in Vienna.</p>
-
-<div  class='figcenter id001'>
-<img src='images/i021.jpg' alt='' class='ig001' />
-<div class='ic001'>
-<p>Fig. 2.</p>
-</div>
-</div>
-
-<p class='c000'>The principal advantages secured by these forceps are:</p>
-
-<p class='c000'>1. That they are best adapted to draw in the pelvic axis.</p>
-
-<p class='c000'>This was the special claim set up by Aveling for his Sigmoid
-forceps. Tarnier also, in introducing his axis traction forceps
-to the profession in 1877 (for an account of which see <cite>British
-Medical Journal</cite>, May 26, 1878), proves by means of diagrams
-and figures that, “in pulling on the classical forceps, it is impossible
-to make the traction exactly in the line of the pelvic
-curve,” and that two forces are actually exerted—one in the
-direction of the inferior straight, and the other at right angles
-to this in the direction of the pubes, while the head tends
-downward in the pelvic curve—the resultant of these two
-forces. This “vicious pressure” upon the pubes represents
-not only so much force lost, but also tends to injure the maternal
-soft parts, and can only be overcome by using the axis traction
-forceps. As the head descends, the pelvic curves of the
-blades become less and less, until, as the head arrives on the floor
-<span class='pageno' id='Page_118'>118</span>of the pelvis, the forceps are nearly straight. At the moment
-the head sweeps over the perineum the blades are still further
-deflected, until they form an angle with the shafts, as shown in
-the dotted lines of Fig. 1, thus forming the perineal curve of
-Herman's, Aveling's and Tarnier's forceps.</p>
-
-<p class='c000'>2. These forceps give the greatest permissible freedom of
-movement to the head during traction.</p>
-
-<p class='c000'>By the loose connection of the blades each possess a degree
-of independent movement, but always in a plane parallel to the
-other, so that the head may rotate during traction. The carrying
-out of this important principle is the chief advantage of
-this instrument over all other axis traction forceps.</p>
-
-<p class='c000'>3. An index is supplied by the arms and pin, which serves
-to indicate the advance and position of the head.</p>
-
-<p class='c000'>The application of Breus' forceps is in no wise more difficult
-than that of the ordinary instrument. Having disinfected,
-warmed and lubricated the blades, and the patient being prepared
-by an irrigation of a solution of bichloride, one part in 2,000,
-and placed in the lithotomy position, the handle of the left
-blade is taken up by the thumb and three fingers of the left
-hand (as one would hold a fiddle bow), the index finger pressing
-the projecting arm firmly against the shaft, as the thumb of
-the right hand guides the blade forward in the groove between
-the index and middle fingers introduced into the vagina. The
-right blade is then introduced in a similar manner and locked,
-and the pin inserted in the eyes of the projecting arms. The
-traction is made upon the handles in the axis of the brim, without
-changing its direction until the head presses on the perineum.
-Prof. Braun prefers, at this point, to remove the forceps
-and complete the delivery in the ordinary way.</p>
-
-<p class='c000'>The same precautions are necessary in using the axis traction
-as the ordinary forceps. Especially must it be remembered
-that, as the force is exerted directly in the axis of the pelvic
-curve, and none being lost, much less is required, and generally
-the force of one hand is quite sufficient. To avoid too great
-compression of the head, the compressing force should be removed
-by opening the lock in the interval of each traction.</p>
-
-<p class='c000'>Breus' forceps, after being tested successfully in all possible
-<span class='pageno' id='Page_119'>119</span>difficult cases—in many where the operator had failed with the
-ordinary forceps, as I myself have seen—is now recognized as
-the instrument best adapted to those cases where the head presents
-high above the pelvic brim.</p>
-
-<div class='chapter'>
-  <h2 class='c005'>CORRESPONDENCE.</h2>
-</div>
-
-<h3 class='c001'>BALTIMORE NOTES.</h3>
-
-<div class='nf-center-c1'>
-<div class='nf-center c006'>
-    <div>BY SPENCER M. FREE, A. M., M. D.,</div>
-    <div class='c006'>Professor of Diseases of Children in the Baltimore Polyclinic, Baltimore, Md.</div>
-  </div>
-</div>
-
-<p class='c007'>It is said of Baltimore that socially it is different from other
-large cities in the <em>freedom</em> as well as the cordiality with which
-it extends its hospitality. The business men and their clerks
-are polite and attentive. They do not display the trait, so common
-in the metropolis, of incognizance—even to rudeness—if
-one chances to be on a tour of inspection instead of purchase.
-The impression is at once made, and very forcibly, that a Baltimorean
-has plenty of time, that he is not hurried. He will
-stop on the street and direct a discomfited stranger, and has
-been frequently known to turn aside from his duties and accompany
-the lost one to where he could take care of himself.
-This is a natural element in the entire populace, and is very
-prominent in the medical profession. A stranger is welcomed
-so heartily that he feels at home immediately, and can settle
-down among friends.</p>
-
-<p class='c000'>It occurs to me that this easy-going feeling has had much to
-do in keeping our city from occupying the prominent position
-in education and authorship that her opportunities, and conditions
-in general, would lead us to expect. I am glad to say
-that she is arousing from her lethargy, and recently her pen
-has been busy. Several works have emanated from the profession
-here which have attracted much attention, and have been
-quite extensively read. Notably among them is a 'Text-book
-of Hygiene,' by Dr. Rohe, and 'The Physician Himself,' by
-<span class='pageno' id='Page_120'>120</span>Dr. Cathell, which has reached a fifth edition and a sale of
-over fifteen thousand copies. I should like to say, concerning
-these two works, that no physician, especially if he be under
-thirty-five years of age, should be without them. Two other
-works, 'A Manual on Nervous Diseases,' by Dr. A. B. Arnold,
-an old, experienced and able teacher, and one on 'Practical
-Chemistry,' by Dr. Simon, have been much studied and commented
-upon. They are limited to special subjects and will not
-naturally obtain a large class of readers. These, like the long-delayed
-blade of corn, which pushes its emerald tip heavenward
-and bears upon its face the sparkling matin dew, give promise
-of a fertile soil and of abundant fruitage.</p>
-
-<p class='c000'>At the last meeting of the Medical and Surgical Society—which
-we had the pleasure of attending—there was an interesting
-discussion on cerebral troubles of syphilitic origin. A
-number of cases were related. The various symptoms of these
-maladies are familiar to your readers. The treatment which
-was successful in all but one of the cases here reported, was
-mercury and iodide of potassium. The plan preferred for the
-administration of mercury is by inunction. All the debaters
-insisted upon the full constitutional effects of the drugs. As
-one gentleman put it, “the system must be saturated before a
-cure is assured.”</p>
-
-<p class='c000'>I might mention among the symptoms, that those manifested
-by the eye were not regarded as reliable. In one case the only
-manifestation was a persistent and severe supra-orbital and occipital
-neuralgia, and for some time the man was in consequence
-wrongly treated.</p>
-
-<p class='c000'>One physician noted <em>insomnia</em> as a distinct and always present
-symptom. Also as a point of differential diagnosis between
-the convulsions of epilepsy and those of local lesion of the
-brain, that in the former there is no <em>consciousness</em> of having a
-convulsion, while in the latter such consciousness is very clear,
-at least at the beginning of the spasm.</p>
-
-<p class='c000'>A case of pelvic peritonitis of the chronic form, reported by
-the president of the society, elicited much discussion, especially
-upon the subject of exploratory abdominal incision as a means
-<span class='pageno' id='Page_121'>121</span>of diagnosis. He noticed that the younger surgeons favored
-the operation, but the older ones were more conservative.</p>
-
-<p class='c000'>A member reported one of those peculiarly (excruciatingly,
-I ought to say) interesting cases of labor, in which, by <em>great</em>
-exertion on his part, and the assistance of two physicians and
-three (I think is the number) midwifes or old ladies, he managed
-“to save the old man,” though the other parties concerned
-passed on into the mysterious future. (The society is
-expected to laugh a good deal just here, and of course we
-expect the readers to do the same.)</p>
-
-<p class='c000'>At a recent meeting of the Baltimore Medical Association a
-member related the following experience: In a family of three
-children, the oldest, who had scarlatina four years ago, contracted
-diphtheria; in a few days a younger one became ill with
-the same disease, but accompanied in forty-eight hours with a
-distinct eruption of scarlatina. A few days later the youngest
-was stricken with scarlatina, but had no symptom of the diphtheritic
-trouble.</p>
-
-<p class='c000'>The report brought out the thought of most of the members
-present. The two questions of “the identity of pseudomembranous
-croup and diphtheria,” and of “diphtheria a local or a
-constitutional disease” were again argued, and, as usual, no
-opinions were changed. Like the Scotchman, each was willing
-to be convinced, but he could not find any one able to convince
-him. Two points were fully agreed upon, namely, that the
-presence of membrane in the fauces, and of sequellæ, are not
-of importance in diagnosis; also that nearly all of the cases in
-which the posterior nares becomes seriously implicated are
-fatal. One gentleman advanced the opinion, supported by
-“statistics” (as accommodating a friend as “facts”), that
-when the submaxillary glands were enlarged in this disease
-recovery took place; when they were <em>not</em> enlarged, death
-occurred. The doctor did not say that death occurred at once or
-within a few days, so we shall be charitable and suppose that
-he meant sometime during the succeeding hundred years.</p>
-
-<p class='c000'>Notes of two very interesting cases of myelitis, followed by
-spastic paraplegia, were read and discussed. The author made
-special mention of the exaggerated tendon-reflex being always
-<span class='pageno' id='Page_122'>122</span>present in disease of the lateral tract of the cord, and that this
-symptom is diagnostic—if hysteria be first excluded. He also
-noted in these cases that the condition of the muscles of the
-posterior portion of the legs (lower) was very tense, producing
-an impression on grasping them similar to that noticed on
-grasping a piece of iron. Neither of these men were able to
-place the heel upon the floor when standing erect. No amount
-of effort on their part could enable them to accomplish it.
-Neither of them were improved by the use of the iodides.</p>
-
-<div class='chapter'>
-  <h2 class='c005'>NOTES AND COMMENTS.</h2>
-</div>
-
-<p class='c007'>If “K.” will send name, we will take pleasure in publishing
-his article in our next number.</p>
-
-<hr class='c009' />
-
-<p class='c000'>White physicians in Oriental countries are asked almost daily
-whether they cannot prescribe for suffering women without seeing
-them. Oriental women, debarred by social custom from
-consulting male physicians, are the victims of great and unnecessary
-suffering. They are thus shut off from the aid of western
-medical skill, though they know its value and are desirous
-of availing themselves of it. The movement in China and
-Japan to introduce female physicians from Europe and America
-is conferring great benefit upon the women of those countries and
-making brilliant opportunities for skilled women who go there.
-The hospital for women recently opened at Shanghai, under the
-charge of American women, is already filled with patients.
-An association has also been formed in India for training native
-nurses.</p>
-
-<hr class='c009' />
-
-<p class='c000'>The new college building of the Medical Department of the
-Western Reserve University is being pushed rapidly to completion.
-The stone-work is done and the roof is now being
-placed in position. When once inclosed, work upon the interior
-can proceed regardless of the weather. It is thought that
-<span class='pageno' id='Page_123'>123</span>it will be so far completed as to be used for commencement
-exercises the last week in February.</p>
-
-<hr class='c009' />
-
-<p class='c000'>Four cases of trichiniasis were reported to the health officer
-of Cleveland, December 23d. All were members of one family
-and had partaken of the same uncooked ham. The physician
-reporting the cases, Dr. J. F. Armstrong, had his suspicions
-aroused by the symptoms presented, and at once examined the
-suspected meat. His fears were confirmed by finding trichinæ
-spirolis in the remaining portions of the ham, and his observations
-were verified by the health officer. None of those
-affected are as yet seriously ill. It appears necessary to sound
-a constant warning against eating uncooked pork.</p>
-
-<hr class='c009' />
-
-<p class='c000'>“<em>No Children Allowed.</em>”—The “Solid Comfort” will answer
-for the occasion to designate an elegant apartment house
-opened about two years ago in a suburb of Boston. It was
-finished with all modern conveniences and inconveniences.
-There were electric bells in a row at the door, so that the afternoon
-caller could ring up nine different and peaceful maid servants
-before getting into communication with the family she
-came to see; there were fire escapes and telephones, and elevators
-and speaking tubes; and, in all probability, safety valves
-and submarine cables. But the crowning joy of all was the
-fact that no children were allowed within its walls. It was built
-for the accommodation of childless couples, and to ten childless
-couples were the suites let. How great was the quiet and calm
-of that sheltered retreat, until one ill-starred morning, when
-the cry of an infant, shrilly and piteously, broke the stillness!
-Horror and indignation upon the part of nine guiltless couples!
-And yet, so weak is humanity, that before the end of the
-second year there were children in seven of the ten families.
-The childless young couples were childless no more; and when
-the owner of the building complained to his friends of the
-unfair treatment he had received at the hands of his tenants,
-they all laughed in his face and advised him to let his apartments
-to bachelors.—<em>Sanitarian for November, 1885.</em></p>
-
-<div><span class='pageno' id='Page_124'>124</span></div>
-<div class='ph1'>
-
-<div class='nf-center-c1'>
-<div class='nf-center c010'>
-    <div>The Cleveland Medical Gazette.</div>
-  </div>
-</div>
-
-</div>
-
-<div class='nf-center-c1'>
-<div class='nf-center c011'>
-    <div><em>A MONTHLY JOURNAL OF MEDICINE AND SURGERY.</em></div>
-    <div class='c006'><span class='sc'>One Dollar per Annum in Advance.</span></div>
-    <div class='c006'>All letters and communications should be addressed to the <span class='sc'>Cleveland Medical Gazette</span>, No. 5 Euclid Avenue, <span class='sc'>Cleveland, Ohio</span>.</div>
-  </div>
-</div>
-
-<table class='table1' summary=''>
-<colgroup>
-<col width='41%' />
-<col width='58%' />
-</colgroup>
-  <tr>
-    <td class='c002'>A. R. BAKER, M. D., <em>Editor</em>.</td>
-    <td class='c004'>S. W. KELLEY, M. D., <em>Associate Editor</em>.</td>
-  </tr>
-</table>
-
-<div class='chapter'>
-  <h2 class='c005'>EDITORIAL.</h2>
-</div>
-
-<p class='c007'>Original communications, reports of cases and local news
-of general medical interest are solicited.</p>
-
-<p class='c000'>All communications should be accompanied by the name of
-the writer, not necessarily for publication.</p>
-
-<p class='c000'>Our subscription price remains at one dollar per annum in
-advance. Vol. I begins with November, 1885. Subscriptions
-can begin at any time.</p>
-
-<p class='c000'>Remittances when made by postal order or registered letter,
-are at the risk of the publishers.</p>
-
-<h3 class='c012'>THE FASHIONABLE HOBBY.</h3>
-
-<p class='c013'>It is reported that a Dr. Sax, of France, has discovered in
-all forms of beverages containing alcohol a “bacillus potumaniæ;”
-and it is claimed that this bacillus multiplies in the
-system of the drinker and circulates in his blood, and that when
-he gets delirium tremens he is not the subject of hallucinations
-but sees the reptilian forms that are inhabiting his own brain
-and optic apparatus.</p>
-
-<p class='c000'>While the microscopists and various ologists are discussing
-this, we will tell a story of a certain worthy practitioner of our
-acquaintance. The doctor's hobby was malaria. If a person
-<span class='pageno' id='Page_125'>125</span>came in with a headache it was “malarial headache;” backache,
-“malarial backache;” legs ache, “malaria.” One day
-a man came in with his arm hanging helpless. Our friend
-promptly began about malaria. The man said he had heard
-of break-bone fever, but that he had fallen off a street car and
-didn't think this was a malarial fracture.</p>
-
-<p class='c000'>Some of the best fellows we know ride hobbies, but let those
-who now bestride the bacillus beware where the creature carries
-them.</p>
-
-<h3 class='c012'>OLEOMARGARINE.</h3>
-
-<p class='c013'>The subject of artificial butter continues to agitate the public
-mind and stomach. There are involved a few plain principles
-which, if applied, will elucidate the whole matter.</p>
-
-<p class='c000'>Good glycerine can be made from dogs or horse fat, sugar
-from rags; sea water or the most impure lake or river water
-can be changed to <i><span lang="la" xml:lang="la">azua pura</span></i> by distillation; good suet or tallow
-can be so treated as to make a nutritious and harmless
-article of diet. Now, if old grease can be so manipulated and
-modified as to give a pure and edible result, cheaper than old-fashioned
-butter, the latter will have to go out of fashion.</p>
-
-<p class='c000'>In that case, wrong would lie only in selling the article for
-what it is not, and not in the fact of its being also injurious to
-the user. Just as in many synthetically manufactured wines
-and cigars, which are not chemically essentially different from
-the article they imitate, but are fraudulent because they are
-sold as imported or genuine, which they are not.</p>
-
-<p class='c000'>If the goods are good, let them be sold for what they really
-are; and if the old-fashioned butter is higher priced, let those
-of us who like pay the difference for our fastidiousness. The
-manufacturers of the new butter should expend their efforts
-and their money in perfecting their process, so as to give an
-innocent and useful food, and in proving that it is so, instead
-of opposing the action of the Board of Health. The verdict
-of the health authorities should be regarded as final by every
-individual of the public, and until the new article is pronounced
-at least harmless, no one should think of using or handling it
-any more than they would measly pork or spoilt fish.</p>
-
-<div>
-  <span class='pageno' id='Page_126'>126</span>
-  <h3 class='c012'>MEDICAL DEFENCE ASSOCIATION.</h3>
-</div>
-
-<p class='c013'>We have selected a few recent cases of suits for malpractice
-with the object of calling the attention of physicians to the
-importance of adopting some plan looking toward the suppression
-of quackery and the protection of professional rights when
-assailed by hostile influences.</p>
-
-<p class='c000'>“In April, 1884, Dr. Graves of Petaluma, California, was
-called to see Mrs. Winters, the wife of a laborer whose family
-he had attended gratuitously for nearly sixteen years. He
-found that the woman, who was fifty-eight years of age, had
-fallen from a height and injured her ankle. The limb was very
-much swollen, so as to interfere with examination, but no
-crepitus could be elicited, neither was there any displacement,
-or shortening; and as the swelling continued, the limb was
-placed in position and wrapped loosely in cloth saturated with
-anodyne lotions. The patient, we are told, received every
-attention from Dr. Graves, but there was left finally some stiffening
-of the joint and a very slight inversion of the foot. No
-complaints were made until a new doctor arrived in the
-town, who told the patient the limb had been badly
-treated and advised her to sue for malpractice. The case
-was examined by ten of the chief surgeons in the
-State, including Drs. Lane, McLean, Morse and Dennis,
-all of whom said that there might have been a sprain or an
-incomplete fracture of the external malleolus, but that the ends
-of the bones were in perfect apposition and never had been
-separated, and that the stiffening was probably due to inflammatory
-adhesions. Two other doctors, one of whom being he
-who advised the suit, testified that there was shortening of the
-limb, and that the lower fragment of the tibia had been driven
-up and behind the fibula. One of these would-be surgeons,
-Dr. Wells, is nearly eighty years of age, and had not read a
-work on surgery for thirty years; the other, Dr. Ivancovich,
-confessed he had no special experience in surgery. Their
-incompetence may be judged from the way they measured the
-patient's limb in court. This was done by taking a carpenter's
-rigid rectangular rule, and measuring the limb as she maintained
-<span class='pageno' id='Page_127'>127</span>the upright position. The result was that in the opinion of
-nine jurymen the testimony of two unknown, inexperienced
-general practitioners out-weighed that of ten specialists in
-surgery, all of whom possess a national reputation, so that a
-verdict was returned in favor of the plaintiff, awarding her eight
-thousand dollars damages.”</p>
-
-<p class='c000'>“Some three years ago Dr. Purdy, a well-known and
-esteemed physician, gave notice to the health department of
-New York City, in accordance with a regulation of the sanitary
-code which makes it the duty of physicians to notify this
-department of cases of infectious diseases, that in his opinion
-a young woman who was under his treatment was suffering
-with smallpox. The department sent one of its medical
-officers to investigate the case. The diagnosis made by Dr.
-Purdy was then confirmed and by the authority of the board
-of health the patient was transferred to the smallpox hospital.
-After a day or two the patient was discharged. This patient
-immediately brought suit against Dr. Purdy for $10,000 damages,
-on the ground of injury to her business and of the false
-diagnosis upon the part of her medical attendance. The jury
-which tried this case gave a verdict of $500 against the defendant.
-The singular injustice of this verdict resides in the
-fact that damages should have been brought against Dr.
-Purdy, when, in point of fact, the injury to the plaintiff was
-inflicted by the health department, which not only affirmed the
-diagnosis of the attending physician, but caused the removal
-of the patient to be made to the smallpox hospital. It appears
-that Dr. Purdy's sole error in the case was in informing the
-health authorities of the possible existence of smallpox. In
-the discharge of a duty imposed upon him by a city ordinance
-he has been subjected to the expense and annoyance of a
-legal case, and has been mulcted by a jury to the extent of
-$500.”</p>
-
-<p class='c000'>“Another suit of a blackmailing character has been brought
-against Dr. E. Williams and partners of Cincinnati, O. According
-to the Cincinnati <cite>Medical News</cite>, the charge was that
-they had permitted a small scale of iron, that had entered the
-eye of a boy, to remain, by which he eventually became blind—the
-<span class='pageno' id='Page_128'>128</span>sound eye becoming affected through sympathy with the
-injured one and losing the power of vision. It was proven on
-trial that the boy had visited the office of Dr. Williams but
-twice, and then had ceased calling because he was informed
-that, to preserve the sound eye and be saved from blindness,
-he must consent to have the eye that had been destroyed removed
-from its socket, to which his parents would not consent.
-For several months after declining the services of Dr. Williams
-and associates, he spent his time in going the rounds of the
-specialists of diseases of the eye, putting his case in charge, at
-different times, of both regular and homœopathic physicians.
-Every ophthalmologist by whom he was treated informed him
-that the only way by which he could avoid becoming blind was
-to have the injured eye removed. Finally, after losing sight in
-both eyes, he brought suit. The medical testimony, we are
-told, was uniformly in favor of Dr. Williams, but the jury
-disagreed.”</p>
-
-<p class='c000'>“The Boston correspondent of <cite>The Northwestern Lancet</cite>
-writes: 'Dr. A., a reputable practitioner living in a New England
-city, attended Mr. B. for a fractured thigh. The case did
-well, and the patient recovered without deformity. No measurements
-were recorded by the attending surgeon, but he was
-able to swear that the result was to him perfectly satisfactory.
-A year or two later the patient entered suit against Dr. A. for
-malpractice, and exhibited a leg considerably shortened and
-deformed. A jury at once found a verdict for the plaintiff, and
-awarded damages in some six or seven thousand dollars, a sum
-which seriously crippled the physician. He devoted his energies
-thereafter to discovering what he believed to be a fraud,
-and finally obtained evidence that B. had, subsequently to his
-recovery under A.'s attendance, again fractured the same thigh
-while in the Adirondack wilderness, and had, on that occasion,
-had no surgical attendance whatever. The physician was able
-to recover his money, but was at the expense of his detectives'
-and lawyers' fees, to say nothing of years of anxiety and of
-damage to his professional reputation.'”</p>
-
-<p class='c000'>The case of Drs. Reed and Ford of Norwalk, Ohio, will be
-remembered by many Cleveland physicians. Miss Pierce, a
-<span class='pageno' id='Page_129'>129</span>comely young lady, sustained a Colles fracture, and was attended
-by Drs. Reed and Ford. Suit was brought twice in county
-court and dismissed because plaintiff did not desire to
-try the case. A few days before the case was outlawed, suit
-was brought in the United States Court at Cleveland. Many
-physicians were called on both sides, and the testimony of all
-the physicians, with probably one exception, was that the
-treatment was good and the result better than is usual with
-such fractures. Flexion extension, pronation and supination
-were perfect. She had, however, the power, when the arm was
-midway between pronation and supination, of bending the
-wrist toward the radius, and by making the head of the ulna
-prominent she was able to make an apparent deformity. Her
-case, then, was her ability to make an apparent deformity by
-twisting her wrist. (She could do the same with the unfractured
-wrist.) She was a good-looking woman, and therefore
-entitled to sympathy. She followed up the case persistently
-for six years, therefore there must be some merit in the case.
-The doctors all testified against her, so there was a combination
-of the doctors which must not be countenanced. Upon this
-strong case twelve intelligent jurors awarded thirteen hundred
-dollars damages. The judge subsequently reduced this to five
-hundred. Is it any wonder, when such things can be done in
-the State of Ohio, in the name of justice, that physicians like
-old Dr. Kirtland refused to attend cases of fracture under any
-circumstances? or that it is not unusual to hear surgeons
-of recognized ability say they dare not possess property for fear
-of suits for damages?</p>
-
-<p class='c000'>Frequently physicians are accused of malpractice, and rather
-than undergo the expense and inconvenience of a suit they will
-submit to an extortion of money; or if a suit is lost in court
-through prejudice, unjust decisions, inability to secure good
-council or other unavoidable cause, rather than undertake to
-carry the case to a higher court, the physician will pay the
-damages, and thus establish a precedent which renders every
-physician under similar circumstances liable to a suit for
-damages. It is always observed whenever a large amount of
-damages is collected from a physician, numerous other suits on
-<span class='pageno' id='Page_130'>130</span>all sorts of cases are commenced. Such a condition of affairs
-ought not to exist. Physicians can not expect legislators to
-look after their interests until their grievances are made known.
-The testimony of physicians as individuals will not carry enough
-weight to accomplish anything. Moves have been made in
-this direction through the County and State societies and failed
-first, because the members of the societies are divided among
-themselves, second, because they represent only a fractional
-portion of the profession. Out of the thousands of physicians
-practicing in Ohio there are only about seven hundred members
-of the State society.</p>
-
-<p class='c000'>We believe the object of county, state and national medical
-societies are intended for purely scientific work, and the less
-of medical politics brought into them the better. But when
-there is some definite end to be accomplished, some gross
-wrong to be righted, some persecuted physician defended, there
-ought to be some organization including physicians of all
-schools, independent of the medical societies as now organized.
-When a physician is sued for damages, if his case is worthy
-of being defended, the entire profession ought to lend him their
-moral as well as financial support, and this could be rendered
-in no way better than by means of some organization similar to
-the Medical Defense Association of England.</p>
-
-<h3 class='c012'>PRELIMINARY EDUCATION OF MEDICAL STUDENTS.</h3>
-
-<p class='c013'>Dr. John J. King, secretary of Trumbull County, O., Medical
-Society, saw our article in the last number of the <span class='sc'>Gazette</span>,
-in which we urged the necessity of an elevation of the standard
-of preliminary education of medical students, and sends us the
-following resolutions which were unanimously adopted by the
-Trumbull County Medical Society, January 31, 1884, and Drs.
-Julian Harmon, J. R. Woods and T. H. Stewart appointed
-medical examiners. The requirements are about the same as
-<span class='pageno' id='Page_131'>131</span>adopted by the Pennsylvania State Society at their annual
-meeting in Norristown, Pa., May, 1883:</p>
-
-<p class='c000'>TO REGULATE THE STUDY OF MEDICINE.</p>
-
-<p class='c014'><span class='sc'>Resolved, I.</span>—That this Medical Society shall annually elect a
-board of medical examiners, to consist of three members,
-whose duty shall be to examine applicants for admission
-to the study of medicine.</p>
-
-<p class='c014'><span class='sc'>Resolved, II.</span>—All applicants for admission as students of
-medicine under the tuition of members of this society
-shall present themselves before the board of medical
-examiners and satisfactorily pass examination in the following
-requirements:</p>
-
-<table class='table1' summary=''>
-<colgroup>
-<col width='8%' />
-<col width='20%' />
-<col width='71%' />
-</colgroup>
-  <tr>
-    <td class='c015'>“I.—</td>
-    <td class='c016' colspan='2'>A written statement, previously prepared, setting forth the candidate's course of study.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>II.—</td>
-    <td class='c016' colspan='2'>An essay.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>III.—</td>
-    <td class='c016' colspan='2'>Writing from dictation.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>IV.—</td>
-    <td class='c016' colspan='2'>Spelling—Oral and Written.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>V.—</td>
-    <td class='c016' colspan='2'>Reading.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>VI.—</td>
-    <td class='c016' colspan='2'>Geography—Descriptive, Physical.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>VII.—</td>
-    <td class='c016' colspan='2'>Political Economy.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>VIII.—</td>
-    <td class='c016' colspan='2'>History—Ancient, Modern.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>IX.—</td>
-    <td class='c016' colspan='2'>Geology.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>X.—</td>
-    <td class='c016' colspan='2'>Botany.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>XI.—</td>
-    <td class='c016' colspan='2'>Chemistry.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>XII.—</td>
-    <td class='c016' colspan='2'>Natural Philosophy.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>XIII.—</td>
-    <td class='c016'>Mathematics—</td>
-    <td class='c017'>Arithmetic complete;</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>&nbsp;</td>
-    <td class='c016'>&nbsp;</td>
-    <td class='c017'>Algebra, through quadratic equations;</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>&nbsp;</td>
-    <td class='c016'>&nbsp;</td>
-    <td class='c017'>Geometry, through plane geometry.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>XIV.—</td>
-    <td class='c016'>Languages—</td>
-    <td class='c017'>English, standard school edition of English Grammar;</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>&nbsp;</td>
-    <td class='c016'>&nbsp;</td>
-    <td class='c017'>Latin, Cæsar's Com., 4; Virgil, 4; Cicero's Orations, 2.</td>
-  </tr>
-  <tr><td>&nbsp;</td></tr>
-  <tr>
-    <td class='c015'>&nbsp;</td>
-    <td class='c016'>&nbsp;</td>
-    <td class='c017'>Greek, the Reader; Gospels; Xenophon's Anabasis, 2.”</td>
-  </tr>
-</table>
-
-<p class='c014'>Candidates for examination may elect in French, Keetle's Collegiate
-Course in French, Composition, Translation and
-Reading, and Lacomb's History of the French People,
-<span class='pageno' id='Page_132'>132</span>instead of Cæsar's Com., Virgil and Cicero's Orations; and
-in German, Whitney's German Grammar, Composition,
-Translation and Reading, Schiller's Willheim Tell and
-Goethe's Faust, but such elementary knowledge of Latin
-and Greek will be required as to enable the candidate to
-intelligently comprehend the etymology of medical terms
-derived therefrom.</p>
-
-<p class='c014'><span class='sc'>Resolved, III.</span>—No member of this society shall receive any
-person as a student of medicine unless he present a favorable
-certificate from the board of medical examiners.</p>
-
-<p class='c014'><span class='sc'>Resolved, IV.</span>—The time of study required by members of
-this society shall be five (5) years, including lectures.</p>
-
-<p class='c014'><span class='sc'>Resolved, V.</span>—Members of this society shall recommend their
-students to attend only such medical colleges as either
-require an examination for admission similar to the one
-required by this society, or make the full three-years'
-graded course of study obligatory for graduation therefrom,
-and otherwise endeavor to elevate the standard of
-medical education.</p>
-
-<p class='c014'><span class='sc'>Resolved, VI.</span>—That this society requests the Ohio State
-Medical society to adopt the foregoing schedule of requirements
-and to use its influence to secure legislation making
-the same obligatory upon persons entering their names as
-students of medicine in the State of Ohio.</p>
-
-<p class='c014'><span class='sc'>Resolved, VII.</span>—That these resolutions be printed and a copy
-sent to each medical society in this State with the request
-that they early report their action thereon.</p>
-
-<hr class='c009' />
-
-<p class='c000'>“Pioneer Medicine on the Western Reserve” is the title of
-a series of articles which began in the November (1885) number
-of the Magazine of Western History (Williams &amp; Co.,
-Cleveland). They are written by Dr. Dudley P. Allen, which
-insures a warm interest in the subject as well as a capable handling
-of it. The series is historical and biographical, and the
-publisher promises several portraits before the last chapter in
-March or April. Probably none of the Magazine's various
-serials will be of more interest to the public, as well as to medical
-men generally. In the opening chapters we enjoyed the
-author's skillful joining into readable continuity of the broken
-facts that have been gathered from so long ago.</p>
-
-<div class='chapter'>
-  <span class='pageno' id='Page_133'>133</span>
-  <h2 class='c005'>SOCIETY PROCEEDINGS.</h2>
-</div>
-
-<h3 class='c001'>PROCEEDINGS OF NORTH CENTRAL OHIO MEDICAL SOCIETY.</h3>
-
-<div class='nf-center-c1'>
-<div class='nf-center c006'>
-    <div>TWENTIETH QUARTERLY SESSION.</div>
-  </div>
-</div>
-
-<div class='lg-container-r c011'>
-  <div class='linegroup'>
-    <div class='group'>
-      <div class='line'><span class='sc'>Galion, Ohio</span>, December 18, 1885.</div>
-    </div>
-  </div>
-</div>
-
-<p class='c000'>The president, Dr. <span class='sc'>Mitchell</span> of Mansfield, called the meeting
-to order, and owing to the number of papers to be presented
-and the brief time for the session, ordered the omission of
-reading of minutes of last meeting and all miscellaneous business.
-E. H. Hyatt of Delaware, was first called, and excused
-on the ground that he could not do justice to his subject, “The
-Use and Abuse of Alcohol from a Professional Standpoint,”
-in so short a time.</p>
-
-<p class='c000'>Dr. <span class='sc'>R. Harvey Reed</span> of Mansfield, the appointed lecturer,
-read a paper on Anæsthetics, in which he gave a brief review
-of the different general and local anæsthetics in use and the
-different compounds of the same.</p>
-
-<p class='c000'>He referred to the elaborate experiments of Dr. Watson of
-Jersey City, which showed the following mortality on rabbits:</p>
-
-<table class='table1' summary=''>
-<colgroup>
-<col width='91%' />
-<col width='8%' />
-</colgroup>
-  <tr>
-    <td class='c016'>Sulphuric ether,</td>
-    <td class='c004'>16.66</td>
-  </tr>
-  <tr>
-    <td class='c016'>Chloroform,</td>
-    <td class='c004'>62.50</td>
-  </tr>
-  <tr>
-    <td class='c016'>Bromide of ethyl,</td>
-    <td class='c004'>50.00</td>
-  </tr>
-  <tr>
-    <td class='c016'>Alcohol, chloroform and ether,</td>
-    <td class='c004'>75.00</td>
-  </tr>
-  <tr>
-    <td class='c016'>Alcohol, chloroform and ethyl,</td>
-    <td class='c004'>66.66</td>
-  </tr>
-</table>
-
-<p class='c000'>And on dogs:</p>
-<table class='table1' summary=''>
-<colgroup>
-<col width='91%' />
-<col width='8%' />
-</colgroup>
-  <tr>
-    <td class='c016'>Sulphuric ether,</td>
-    <td class='c004'>00.00</td>
-  </tr>
-  <tr>
-    <td class='c016'>Chloroform,</td>
-    <td class='c004'>00.00</td>
-  </tr>
-  <tr>
-    <td class='c016'>Bromide of ethyl,</td>
-    <td class='c004'>100.00</td>
-  </tr>
-  <tr>
-    <td class='c016'>Alcohol, chloroform and ether,</td>
-    <td class='c004'>60.00</td>
-  </tr>
-  <tr>
-    <td class='c016'>Alcohol, chloroform and ethyl,</td>
-    <td class='c004'>80.00</td>
-  </tr>
-</table>
-
-<p class='c000'>In these experiments the doctor found it necessary to resort
-to artificial respiration on dogs as follows:</p>
-
-<table class='table1' summary=''>
-<colgroup>
-<col width='91%' />
-<col width='8%' />
-</colgroup>
-  <tr>
-    <td class='c016'>Sulphuric ether,</td>
-    <td class='c004'>None at all.</td>
-  </tr>
-  <tr>
-    <td class='c016'>Chloroform,</td>
-    <td class='c004'>2 times.</td>
-  </tr>
-  <tr>
-    <td class='c016'><span class='pageno' id='Page_134'>134</span>Alcohol, chloroform and ether,</td>
-    <td class='c004'>3 times.</td>
-  </tr>
-  <tr>
-    <td class='c016'>Alcohol, chloroform and ethyl,</td>
-    <td class='c004'>5 times.</td>
-  </tr>
-</table>
-
-<p class='c000'>The author referred to a number of experiments he had made
-on frogs, in which vivisection was made, and the heart exposed
-and chloroform applied direct, from which they died in from
-ten to twenty minutes, and when bromide of ethyl was used in
-fifteen to thirty minutes, but when ether was used, and even
-much freer than either of the others, they did not die at all.</p>
-
-<p class='c000'>In repeated experiments, he said, he had found the use of
-electricity unreliable in resuscitating the heart under these circumstances.</p>
-
-<p class='c000'>After referring to the mortality reports which showed 405
-deaths from chloroform against seventeen from ether, he said:
-“I feel that every time I use chloroform as an anæsthetic I am
-trifling with a dangerous compound, and that it will only require
-time and perseverance in its use until I will share the fate
-of many others, whose misfortunes ought to be a timely warning
-to us against its dangerous effects; and if not heeded an
-accident will be all the more inexcusable.”</p>
-
-<p class='c000'>He condemned the use of so-called “vitalized air” as being
-an uncertain and unstable compound: being one of the nitro-oxygen
-series mixed with chloroform, its effects were uncertain
-and often very injurious, which, he said, “should be
-reason enough to deter any conscientious physician from using
-it or even recommending it.”</p>
-
-<p class='c000'>For administering anæsthetics the author recommended a
-clean folded towel as being more preferable than anything else,
-as it was just as efficient and decidedly better from a sanitary
-standpoint.</p>
-
-<p class='c000'>He recommended watching the pulse closely while administering
-chloroform, and the respirations when ether was administered,
-lest in the former the cardiac ganglia become affected
-and suddenly arrest the heart's action, or in the latter the nerve
-cells of the medulla from its toxic effects abruptly interfere
-with the breathing.</p>
-
-<p class='c000'>In closing the author said: “From the brief review of the
-anæsthetics most familiar to the profession from a practical
-<span class='pageno' id='Page_135'>135</span>standpoint we have arrived at the following conclusions:”</p>
-
-<p class='c000'><em>First</em>—Of all general anæsthetics known pure sulphuric ether
-stands at the head for safety, efficiency and every day practical
-use.</p>
-
-<p class='c000'><em>Second</em>—Hydrochlorate of cocaine stands at the head of all
-known local anæsthetics.</p>
-
-<p class='c000'><em>Third</em>—Ethidene promises to rival ether and merits a more
-general and extended trial.</p>
-
-<p class='c000'><em>Fourth</em>—No surgeon should give any anæsthetics without
-being prepared to resuscitate the patient on the shortest possible
-notice if necessary, among which preparations nitrite of
-amyl stands preëminent.</p>
-
-<p class='c000'><em>Fifth</em>—No person should be entrusted with the administration
-of any anæsthetic who is not thoroughly familiar with its physiological
-action and practical administration.</p>
-
-<p class='c000'><em>Sixth</em>—The indiscriminate use of anæsthetics should be strenuously
-guarded against, and especially the practice of leaving
-such dangerous compounds in the hands of the laity to be given
-<i><span lang="la" xml:lang="la">ad libitum</span></i> whenever they may deem it necessary.</p>
-
-<p class='c000'><em>Seventh</em>—The judicious use of anæsthetics under all necessary
-circumstances should never be omitted, for when properly used
-by skilled hands they are a glorious haven of peace in the midst
-of a stormy sea.</p>
-
-<p class='c000'><span class='sc'>Dr. J. Campbell</span> of Galion reported a case of embolism, in
-which the diagnosis was uncertain, the symptoms grave and
-the disturbance of the circulation extremely severe, distinguished
-physicians differing widely as to the pathological conditions,
-and the autopsy revealed adhesions of the right lung
-and of the pericardum. Left lung compressed, left heart hypetrophied
-and stenosis of aortic orifice. On motion the case
-was referred to the committee on publication, and Drs. Hackendorn,
-Ridgway and Mitchell, who had seen the patient, were
-requested to give their views.</p>
-
-<p class='c000'><span class='sc'>Dr. N. B. Ridgway</span> reported a case of laceration of perinæum
-with operation within an hour, with complete success, on which
-remarks were made by Drs. Reed, Larimore and Kelley.</p>
-
-<p class='c000'><span class='sc'>Dr. Kelley</span> presented a clinical case of blindness in right eye
-<span class='pageno' id='Page_136'>136</span>of a girl, from the concussion of a snow ball striking the arch
-of the orbit.</p>
-
-<p class='c000'>The society adjourned to meet in Mansfield March 25, 1886.</p>
-
-<div class='lg-container-r'>
-  <div class='linegroup'>
-    <div class='group'>
-      <div class='line'><span class='sc'>J. F. Markel</span>, Secretary.</div>
-    </div>
-  </div>
-</div>
-
-<h3 class='c012'>THE AMERICAN PUBLIC HEALTH ASSOCIATION.</h3>
-
-<div class='nf-center-c1'>
-<div class='nf-center c006'>
-    <div>ANNUAL MEETING HELD AT WASHINGTON, D. C., DEC. 8-12, 1885.</div>
-    <div class='c006'>[By G. C. Ashmun, M. D., Health Officer, Cleveland, O.]</div>
-  </div>
-</div>
-
-<p class='c000'>In the summer of 1873 a few gentlemen met at Long Branch,
-New Jersey, and organized as the “American Public Health
-Association.” At that time there were but few state boards
-of health, and local boards were not generally efficient; and it
-was one of the chief objects of the American Public Health
-Association to aid in the establishment of health and sanitary
-organizations throughout the country. Prominent among the
-original members of the association were gentlemen from the
-Mississippi valley. For a long time the cities and towns of that
-valley had suffered from visitations of yellow fever, and men
-had become somewhat enlightened by the good results obtained
-from the course pursued by certain officers during the war.
-Especially was this true in New Orleans, and the question was
-fairly raised whether local conditions were not responsible for
-the disastrous outbreaks which had occurred so frequently.</p>
-
-<p class='c000'>From 1873 to the present time, there have been annual meetings
-of the association, with a greatly enlarged membership.
-A large result of the efforts of the association and its members
-is seen in the national, state and local boards of health, and
-other sanitary organizations throughout the country. But three
-of the states are now without state organizations. The recent
-meeting in Washington was its “thirteenth annual,” and was
-as well attended and its members as enthusiastic as at any.
-The members were “welcomed” on behalf the medical fraternity
-of Washington by the venerable Dr. J. M. Toner, and by
-the district authorities through the President of the Board of
-Commissioners, Judge Edmonds. These remarks were followed
-by the usual address by the president of the association, Dr.
-Reeves of West Virginia.</p>
-
-<p class='c000'><span class='pageno' id='Page_137'>137</span>The chief point, perhaps, of Dr. Reeves' address, and the
-one calling out most expressions of approval, was the arraignment
-of Congress for its failure to provide means for the support
-of the National Board of Health. He cited the liberality
-shown to care for domestic animals, the fisheries, the Indians,
-and, indeed, almost every conceivable object, but Congress was
-unwilling to grant even a sum sufficient for gathering and publishing
-the reports from local boards. He expressed a strong
-feeling against the attempt to have the work for which the
-National Board was created to perform, done by the Marine
-Hospital Service.</p>
-
-<p class='c000'>A large part of the time of the meetings was taken up in
-hearing reports from committees appointed at the meeting in
-St. Louis, 1884. Among these reports were some of great
-interest. Prof. Sargent, of Harvard, gave a report upon
-“School Hygiene in American Schools and Colleges,” and this
-was enlarged by a paper from Dr. Hartwell, of John Hopkins
-University, on “The German System of Physical Education.”
-At this meeting prizes were to be awarded, in accordance with
-the wish of Mr. Lomb, of Baush &amp; Lomb, Rochester. The
-subjects were:</p>
-
-<p class='c000'>1. “Healthy homes and food for the working classes.”</p>
-
-<p class='c000'>2. “The sanitary conditions and necessities of school-houses
-and school life.”</p>
-
-<p class='c000'>3. On “Disinfection and individual prophylaxis against
-infectious diseases.”</p>
-
-<p class='c000'>4. On “Preventable causes of disease, injury, and death in
-American manufactories and workshops, and the best means
-and appliances for preventing and avoiding them.”</p>
-
-<p class='c000'>These prizes were in cash, and amounted to five hundred
-dollars each, the decision resting with a separate committee for
-each. Without taking more space, it may be said that these
-meetings are usually attended by about three hundred members,
-from all parts of the country. Canada sends representatives,
-and the meeting in 1886 is to be held in Toronto. Very
-diverse opinions are developed, and sharp discussions are the
-order. All shades of medical and lay topics and views are
-brought out, but all meet on the common ground of desire for
-<span class='pageno' id='Page_138'>138</span>improvement in health. The medical officers of the army and
-navy are always well represented by such men as Drs. Billings,
-Sternberg, Gihon, Turner and others, while Hon. Erastus
-Brooks of New York is a layman whose views have been and
-still are relied upon as representing a philanthropic sentiment
-which can be found in all communities.</p>
-
-<h3 class='c012'>CUYAHOGA COUNTY MEDICAL SOCIETY—ADJOURNED MEETING, OCTOBER 15<sup>TH.</sup></h3>
-
-<h4 class='c018'>REPORTED BY L. B. TUCKERMAN, COR. SEC.</h4>
-
-<p class='c013'><span class='sc'>Dr. Himes</span> presided.</p>
-
-<p class='c000'><span class='sc'>Dr. Powell</span> gave a verbal report on the progress of obstetrics
-and diseases of children as follows:</p>
-
-<h4 class='c018'>OBSTETRICS.</h4>
-
-<p class='c013'>In the department of obstetric literature, 'Barnes' Obstetrics'
-had just been published by Lea. It was encyclopædic in its
-character. Lusk had issued a new edition with several chapters
-added. Parvin's book was now in press, and is also issued
-by Lea. In the department of diseases of children, Eustace
-Smith's work is invaluable as regards symptomatology and
-clinical history, but is not so good in therapeutics. Goodhart's
-work, edited by Starr, is also of value.</p>
-
-<p class='c000'>Axis traction forceps are coming more and more into favor,
-Lusk's modification of Sarnier's forceps being used. Simpson's
-axis traction forceps is also much used in this country and in
-Germany. The form used by Dr. Lusk's assistant and in use
-in Karl Braun's maternite in Vienna, with a hinge jaw where
-the blade joins the shaft and traction handles, allows more motion
-of the head and has a number of other advantages.</p>
-
-<p class='c000'>Electricity is coming more and more in vogue as an oxystocic.
-It seems to hasten labor without increasing pain. Its
-use to destroy the life of the fœtus in fallopian pregnancy is
-more common in this country than in Europe.</p>
-
-<p class='c000'>In the past two years Lawson Tait has operated five times
-for ruptured fœtal cyst, with four recoveries. There are no
-other cases on record so far as known to the reporter. The
-<span class='pageno' id='Page_139'>139</span>present tendency of professional opinion is to favor an immediate
-operation.</p>
-
-<p class='c000'>Intra-uterine injections are not so freely used as formerly,
-and are restricted to cases where there is actual retention of
-putrid material in the uterine cavity, with fever. Bichloride of
-mercury is gaining ground as the antiseptic par excellence.</p>
-
-<p class='c000'>Cocaine has been tried to relieve the pain during dilation
-of the os, but has not proved a success. It is, however, a success
-in relieving certain cases of obstinate vomiting of pregnancy,
-and also the pain of fissured nipples.</p>
-
-<p class='c000'>Hicks' bimanual method of treating placenta previa is gaining
-ground.</p>
-
-<p class='c000'>In connection with post partum fever, a larger number of
-cases of diphtheritic complications is noted than formerly.</p>
-
-<h4 class='c018'>DISEASES OF CHILDREN.</h4>
-
-<p class='c013'>Crede claimed to be able to prevent ophthalmia neonatorum
-by instilling into each eye at birth two drops of a two per cent.
-solution of nitrate of silver.</p>
-
-<p class='c000'>Cassels of Berlin, after an exhaustive investigation, claims
-that no remedies are so reliable in <em>pertussis</em> as belladonna and
-quinia.</p>
-
-<p class='c000'>In the treatment of <em>diphtheria</em>, Tr. Ferri and Potass.
-Chloras seem to stand as high as ever in the opinion of the
-profession. Calomel, which also has its admirers, seems to
-have lost no ground, as well as the use of the steam atomizer.</p>
-
-<p class='c000'><span class='sc'>Dr. Allen</span> presented a dermoid cyst of the left ovary,
-removed that forenoon from a nullipara aged twenty-seven.
-Six hours after the operation the patient's temperature was
-99.6° Fahr., and there had been but little vomiting.</p>
-
-<p class='c000'><span class='sc'>Dr. Sihler</span> showed a gall stone found at the autopsy of a
-woman forty-eight years old, whose symptoms had not been
-those which are usual in fatal cases of obstruction of the gall
-duct. There had been no jaundice, no bile in the urine and no
-previous attacks of pain. She complained one morning of sore
-throat, and was given one-eighth of a grain of morphia. In
-the evening there was pain in the stomach and the morphia
-was discontinued. This was on Saturday. By Sunday or
-<span class='pageno' id='Page_140'>140</span>Monday the pain had become located along the border of the
-liver. On Tuesday the free edge of the liver could be felt, and
-the temperature had risen to 102° or 103°, pain and vomiting
-having also become very severe. The next week pain was less
-and swelling less, and in two weeks all symptoms were gone.
-She never before had symptoms of colic. Two weeks later,
-after she had been asleep about three hours, she had another
-attack. The next day the temperature rose again, and there
-was a larger region of sensitiveness than before. On Tuesday
-the fever subsided. On Wednesday collapse and vomiting
-ensued, ending in death. The autopsy disclosed adhesions of
-the liver, omentum and colon, an effusion of bile in the tissues,
-and this gall stone was found in the gall bladder.</p>
-
-<p class='c000'><span class='sc'>Dr. Allen</span> mentioned a case that he had seen in Keith's
-Clinic in Edinburgh, where an operation was undertaken for
-ovarian cyst, but when on opening the abdomen the tumor was
-found to be the gall bladder so enlarged as to fill the whole
-lower part of the abdomen.</p>
-
-<p class='c000'><span class='sc'>Dr. Sihler</span> said that in his case the gall bladder was not so
-very much enlarged.</p>
-
-<p class='c000'><span class='sc'>Dr. Tuckerman</span> reported a case where a gall stone the size
-of a pigeon's egg was found post mortem, but which during
-life could sometimes be felt through the abdominal wall and
-sometimes not, and which gave rise to a bruit so distinct as to
-warrant a strong suspicion of aneurysm.</p>
-
-<p class='c000'><span class='sc'>Dr. Vance</span> stated that according to his observation the passage
-of a gall stone into the intestine by ulceration was a common
-cause of intestinal obstruction. He also called attention
-to the value of the symptom of itching as pointing to the gall
-bladder as the seat of the difficulty.</p>
-
-<p class='c000'><span class='sc'>Dr. Linhart</span> reported a post mortem in a case of typhoid
-fever where eighty-five small stones were found in the gall
-bladder. The bladder was but little distended.</p>
-
-<div class='chapter'>
-  <span class='pageno' id='Page_141'>141</span>
-  <h2 class='c005'>NEW BOOKS.</h2>
-</div>
-
-<p class='c019'>'<span class='sc'><span lang="fr" xml:lang="fr">Traite Pratique Des Maladies De La Peau; Diagnostic
-et Traitement.</span></span>' Par M. Le Docteur E. Guibot, Medecin
-De L' Hopital Saint Louis, Paris, etc.</p>
-
-<p class='c000'>This, the fourth work which the author has written on dermatology,
-is intended to present, in a clear and concise way, a
-resumé of the more voluminous books which have preceded it.
-Unfortunately the dermatology of to-day, as it appears in the
-English language, is drawn largely from the precepts of the
-Vienna school. In fact, since the little volume of Robert
-Liveing, which appeared in London about eight years ago, there
-has been no truly English or American treatise on the subject;
-although books on diseases of the skin have appeared in quick
-succession, they have been vague echoes from the <i><span lang="de" xml:lang="de">Krankenhaus
-in Wien.</span></i> Do not think from this that I undervalue the original
-work done by the great teachers of local dermatology, for they
-have taken vast strides in the advancement of the science, but
-other lines of thought and investigation are needed to broaden
-the scope of the earnest student. The work before me, as its
-name implies, is a practical treatise on diseases of the skin, of
-about four hundred pages, with especial attention to diagnosis
-and treatment. To facilitate the former, the author has
-grouped cutaneous maladies which are alike in nature into what
-he calls <em>Diatheses</em>, of which the syphilitic, scrofulous, herpetic,
-cancerous and the congestive are dwelt upon. In differentiating
-the scrofulous from the syphilitic diatheses, the author says:
-“In the third stage of syphilis, as we have said, the work of
-destruction starts from within, attacking first the deeper structures,
-as the periostium cartilage and bone, whereas scrofula
-pursues the same destructive course inversely; that is to say,
-from the superficial to the deep parts. This consideration, upon
-which we cannot insist too strongly, is of the greatest importance
-in diagnosis. For example, if syphilis attacks the nose,
-the part first involved is the mucous membrane of the nasal
-<span class='pageno' id='Page_142'>142</span>fosæ, then the nasal bones and cartilages, which may become
-completely destroyed before the process subsides, leaving the
-nose flattened but the skin intact. In scrofula the work of disorganization
-begins in the superficial parts—the skin—and not
-until the part involved is completely destroyed does it proceed
-to those which are deeper, viz., the cartilage and bone. Again,
-it may be seen that the destruction is more complete in scrofula
-than in syphilis. This is especially true of the skin, for syphilis
-has at least a respect for this organ, which scrofula has not.”</p>
-
-<p class='c000'>After establishing, as he says, “the principles upon which the
-scrofulous diathesis is founded,” he proceeds to enumerate the
-different <em>scrofulides</em> of the skin as follows: 1, Erythematous;
-2, Phlegmonous; 3, Pustulo-crustaciæ; 4, Tuburcular; 5,
-Rupiform; 6, Ulcero-gumatous.</p>
-
-<p class='c000'><span class='sc'>The herpetic diatheses.</span>—“The distinctive feature of prime
-import in herpetic lesions (<em>herpidites</em>) is their duration. In the
-two diathesis we have just considered we have said that the
-<em>scrofulides</em> are continuous in their duration; they present no interruption,
-no intermittance; whereas the <em>syphilides</em> are essentially
-intermittent; they disappear spontaneously, or under the
-influence of treatment, and reappear without regularity or
-periodicity. Their intervals of latency are variable, often regulated
-by the change of season, especially liable to reappear in
-the springtime, and sometimes after many years of complete
-immunity.</p>
-
-<p class='c000'>“The <em>herpidites</em> combine in their evolution the two characters
-of intermittency and chronicity. At their commencement they
-are intermittent; in the second stage, which occurs after a certain
-though variable period, they assume the character of
-chronicity.” The author further divides the <em>herpidites</em> into benign
-and malignant. Under the former are included herpes,
-impetigo, lichen, eczema and psoriasis; the latter includes
-pemphigus, cachectic rupia and prurigo senilis formicans. The
-cancerous and the congestive diatheses follow, after which the
-exanthemata and the cachectic diseases of the skin.</p>
-
-<p class='c000'><span class='sc'>Symptomatic affections of the skin</span>, arising from pathological,
-physiological and psychological disturbances are probably of
-more interest than any other group, because here one finds so
-<span class='pageno' id='Page_143'>143</span>many things not even mentioned in most works on dermatology,
-and because this class of affections seems destined more
-and more to be a common inherent of American life.</p>
-
-<p class='c000'>“These diseases, which are called diseases of the skin, are
-not so in reality. They belong more or less to the entire
-organism, revealing themselves upon the external integument
-with visible and palpable peculiarities which enable us to form
-an opinion as to their true nature. Considering the subject
-from this point of view, dermatology is therefore one of the
-most important branches of pathology; it is the torch which
-throws light on many morbid conditions which otherwise would
-remain obscure, vague and unsettled. But dermatology is
-more than this; it is the index, the external manifestation of
-disturbances which may be physiological or pathological, superficially
-or deeply seated. It is still more, for it is the visible
-expression of certain psychological emotions and moral states
-which are reflected upon the skin, there to be interpreted by
-the observing student.” This part of the work ends with a
-chapter on dermatoses of local origin, which includes parasitic
-affections.</p>
-
-<p class='c000'>The book concludes by taking up the treatment of the different
-diseases one by one. In the treatment of syphilis the
-author says: “The preparation of mercury to which we give
-the preference is the proto iodide. It is less dangerous, more
-soluable in the stomach and more easily assimilated. It should
-never be given to exceed three centigrammes a day.”</p>
-
-<p class='c000'>Time forbids further details. I will simply say the book is a
-good one, and will well repay careful study. Arrangements
-have been made with the author and his publishers to translate
-the work into English.</p>
-
-<div class='lg-container-r'>
-  <div class='linegroup'>
-    <div class='group'>
-      <div class='line'><span class='sc'>W. T. Corlett.</span></div>
-    </div>
-  </div>
-</div>
-
-<hr class='c009' />
-
-<p class='c000'>“<span class='sc'>Official Formulæ of American Hospitals</span>” is the title of a
-16-mo manual of 238 pages, published by the <cite>Medical World</cite>
-of Philadelphia. It contains the formulæ of some twenty-nine
-American hospitals, collected and arranged by C. F. Taylor,
-M. D. Price $1.00.</p>
-
-<hr class='c009' />
-
-<p class='c000'>“<span class='sc'>Organic Materia Medica and Therapeutics</span>,” in accordance
-with the sixth revision of the United States Pharmacopœia.
-By James Young Simpson, M. D., of Orange, New Jersey.
-Book of 337 pages, well printed and very neatly bound. Published
-by J. H. Vail &amp; Co., New York.</p>
-
-<div>
-  <span class='pageno' id='Page_144'>144</span>
-  <h3 class='c012'>THE ASTRONOMIC DOCTOR.</h3>
-</div>
-
-<p class='c013'>By request we take pleasure in reprinting this poem from
-the <span class='sc'>Cleveland Medical Gazette</span> of April, 1860. A modest
-country practitioner discovered a planet. The medical and
-scientific world prepared to give him a public dinner at the
-“Hotel du Louvre.” But word was sent from the modest
-doctor he would rather “stay at home in his wooden shoes” (it
-is his own expression).</p>
-
-<div class='nf-center-c1'>
-  <div class='nf-center'>
-    <div>I.</div>
-  </div>
-</div>
-
-<div class='lg-container-b c020'>
-  <div class='linegroup'>
-    <div class='group'>
-      <div class='line'>To grace the brow of savans</div>
-      <div class='line in2'>Astronomy has twined the crown,</div>
-      <div class='line'>The trumpet sounds their giant deeds,</div>
-      <div class='line in2'>And celebrates their high renown.</div>
-      <div class='line'>But from the shrouded face of night</div>
-      <div class='line in2'>A doctor draws the veil, and first</div>
-      <div class='line'>Upon his modest, upturned sight,</div>
-      <div class='line in2'>The splendors of a planet burst.</div>
-    </div>
-  </div>
-</div>
-
-<div class='nf-center-c1'>
-  <div class='nf-center'>
-    <div>II.</div>
-  </div>
-</div>
-
-<div class='lg-container-b c020'>
-  <div class='linegroup'>
-    <div class='group'>
-      <div class='line'>His country rounds he still pursues,</div>
-      <div class='line in2'>The storm he bears, and winter's cold;</div>
-      <div class='line'>Nor does his simple heart refuse</div>
-      <div class='line in2'>Creation's wonders to behold,</div>
-      <div class='line'>But Lescarbault with lifted eyes,</div>
-      <div class='line in2'>And hand upon his earnest heart,</div>
-      <div class='line'>Slow walks, to view the stars, but flies,</div>
-      <div class='line in2'>Relief from suffering to impart.</div>
-    </div>
-  </div>
-</div>
-
-<div class='nf-center-c1'>
-  <div class='nf-center'>
-    <div>III.</div>
-  </div>
-</div>
-
-<div class='lg-container-b c020'>
-  <div class='linegroup'>
-    <div class='group'>
-      <div class='line'>Upon the doctor's humble life</div>
-      <div class='line in2'>Simplicity her graces sheds,</div>
-      <div class='line'>From grandeur far, and envious strife,</div>
-      <div class='line in2'>Goodness to diligence he weds.</div>
-      <div class='line'>His coat of serge he wears content,</div>
-      <div class='line in2'>Nor e'er for gilded splendor sighs,</div>
-      <div class='line'>But when he scans the firmament</div>
-      <div class='line in2'>He sees his “star of honor” rise.</div>
-    </div>
-  </div>
-</div>
-
-<div class='nf-center-c1'>
-  <div class='nf-center'>
-    <div>IV.</div>
-  </div>
-</div>
-
-<div class='lg-container-b c020'>
-  <div class='linegroup'>
-    <div class='group'>
-      <div class='line'>On history's page enshrine his fame,</div>
-      <div class='line in2'>Yet other glories claim our song;</div>
-      <div class='line'>Friends, collegues, share another's name!</div>
-      <div class='line in2'>To Laennec too our toasts belong,</div>
-      <div class='line'>An echo to his ear betrays</div>
-      <div class='line in2'>The seat of misery's hidden dart—</div>
-      <div class='line'>'Tis well on stony worlds to gaze—</div>
-      <div class='line in2'>'Tis nobler far to read the heart.</div>
-    </div>
-  </div>
-</div>
-
-<p class='c000'>The above verses were written by Dr. Piory, one of the
-celebrated physicians of Paris, and were sung by Dr. Mayne
-at the annual dinner of the Medical Society of the Arrondisement
-of the Elysee. For the elegant and faithful translation
-which we have given, we are indebted to the kindness
-of a very accomplished young friend.</p>
-
-<div class='tnotes'>
-
-<div class='chapter'>
-  <h2 class='c005'>TRANSCRIBER'S NOTES</h2>
-</div>
- <ol class='ol_1 c011'>
-    <li>Corrected nevrosis to necrosis (or might be neurosis) on p. <a href='#p110'>110</a>.
-
-    </li>
-    <li>Silently corrected typographical errors.
-
-    </li>
-    <li>Retained anachronistic and non-standard spellings as printed.
-    </li>
-  </ol>
-
-</div>
-
-
-
-
-
-
-
-
-<pre>
-
-
-
-
-
-End of the Project Gutenberg EBook of The Cleveland Medical Gazette, Vol. I.
-No. 3., January 1886, by A. R. Baker and S. W. Kelley and Various
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