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diff --git a/old/53325-0.txt b/old/53325-0.txt deleted file mode 100644 index 3850f81..0000000 --- a/old/53325-0.txt +++ /dev/null @@ -1,2240 +0,0 @@ -The Project Gutenberg EBook of The Cleveland Medical Gazette, Vol. 1, No. -5, March 1886, by A. R. Baker, S. W. Kelley, and Others - -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. 1, No. 5, March 1886 - -Author: A. R. Baker, S. W. Kelley, and Others - -Release Date: October 19, 2016 [EBook #53325] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK CLEVELAND MEDICAL GAZETTE *** - - - - -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) - - - - - - -[Illustration] - - DESCRIPTION OF PLATE. - - Powers used. Figs. 7 and 9, Gundlach’s objective, III, ocular III, - magn. about 175 diam. All the rest Gundlach’s - objective V, ocular III, magn. about 500 diam. - - Fig. 1. Part of alveolus, submaxillary cat, compressed - Carmine. - - _m._ Nuclei of memb. propr. - - _g._ Nuclei of gland cells. - - Fig. 2. Part of alveolus submaxillary cat; membr. propr. torn - Carmine. - - _n._ Nuclei of membr. prop. either rolled up or seen - edgewise. - - _m._ Similar nucleus flattened out. - - Fig. 3. Nucleus of membr. propr. - - _a._ Viewed edgewise. - - _c._ Viewed from surface. - - _b._ Viewed in position between both. - - Fig. 4. Group of gland cells with nucleus and portion of - membr. propr. resembling a connective tissue - corpuscle with processes. - - Figs. 5 and 6. Fragments of membrana propria with nuclei. Cat. - - Fig. 7. Nerve trunk with branches, accompanying a small duct. - Carmine. In the main trunk the individual fibrils - cannot be distinguished. Aniline blue might have - made them distinct. - - Fig 8. Small nerve trunk containing two naked fibrils in - sheath. Aniline blue. - - Fig. 9. Single naked nerve fibril found passing on to an - alveolus. It seemed to pass on to the capillary - figured but a small break, where the fibre might - have been torn, or where from the underlying cells - it could not be distinguished—allows doubt if the - fibre seen along-side of the capillary is the - continuation of the fibre. Carmine and aniline blue. - - Figs. 10 and 11. Capillaries with nerve fibrils accompanying the same. - Carmine and aniline blue. - ------------------------------------------------------------------------- - -[Illustration] - - - - - THE - Cleveland Medical Gazette - - _VOL. I._ _MARCH, 1886._ _No. 5._ - - - - - ORIGINAL ARTICLES. - - -TWO DISPUTED POINTS IN THE HISTOLOGY OF THE SUBMAXILLARY GLAND. MEMBRANA - PROPRIA—NERVE-ENDINGS (WITH PLATE.)[1] - - BY CHR. SIHLER, M. D., PH. D., CLEVELAND, OHIO. - - Formerly Fellow of the Johns Hopkins University. - -The submaxillary gland is of importance not only for its own sake, but -because its anatomical connections and situation are such that it can be -subjected to physiological experiment, and a number of important results -have been reached which I may discuss at some future time. - -Footnote 1: - - Read before the Cuyahoga County Medical Society, January 7, 1886. - -The results of my work are not only contradictory to the authorities in -histology, but also do not harmonize with the requirements of prevailing -physiological theories. Bringing this before you does not mean that I -ask you to accept either facts or conclusions. I am fully aware of the -difficulty of such work, the doubtfulness of the facts and the liability -to error in the conclusion. But it is just possible that some of the -younger members may fare as I did—have not all their time occupied by -practice—and if I enlist the interest of any in this most important -region I shall feel happy. - -A number of years have passed since I undertook this question, and the -work on the nerve-endings on muscle, which I had the pleasure to -communicate to this society a few months ago, was undertaken more as a -study, to make myself familiar with analogous structures, than that I -expected to find anything new. - - - METHOD. - -In the investigations on the nerve-endings I used the submaxillary of -the half-grown cat, the calf, the ox and the puppy. The method followed -was in the main that of Beale. In the case of the cat I injected the -whole animal from the aorta with Turnbull’s blue, dissected out the -gland, duct, and the nerves entering it. After breaking up the gland -into pieces by aid of a needle, from the size of a bean to a pea, I -placed it in a dish with a light cover, containing Beale’s carmine -(carmine dissolved in ammonia and glycerine). I am in the habit of using -a stronger solution than Beale’s. I suspect that the carmine I used in -some of these stainings was adulterated with eosin, and that possibly -this may have been of advantage. In some of my stainings I used a fluid -prepared from cochineal; used ammonia in dissolving the coloring matter, -and then added carmine besides. It is of the utmost importance to have -no excess of ammonia present, otherwise the staining will be slow and -imperfect. I have been staining with this method for years, yet I cannot -say why the results differ so much. Some time ago I stained a frog for -the nerve-endings in muscle and obtained the most beautiful results, but -in the number of stainings I have made since (trying to follow the same -method) I have not been by far as successful as then. In breaking up the -gland I do not always separate all the pieces, but try to remove the -connective tissue holding together the small lobules with the dull end -of a needle, and then throw the coherent mass into the stain. In this -way I procured a very perfectly injected and beautifully stained -submaxillary of a half-grown cat, from which I made a number of valuable -specimens. The material may remain in the staining fluid for weeks, and -may be examined every two or three days to note how the staining is -advancing. When the masses stained are large, or the whole gland is -subjected to staining, of course the outer parts are more deeply stained -than the inner ones, but it is at times convenient to have material of -different depths of staining. After the process has continued long -enough—the nuclei at least should be very distinctly colored—the -material is transferred into a fluid containing glycerine five parts, -water and alcohol each two parts, acetic acid one part. Here it may -remain about twenty-four hours, and finally it is to be preserved in a -similar mixture containing but a trace of acetic acid. I hold acetic -acid of varying strength diluted with glycerine in high esteem in such -investigation. It does two things, removes the superfluous stain and -softens and clears up the connective tissue. Thus treated, the material -is ready for examination. - -The tissues thus prepared may be hardened in alcohol and sections cut, -but this will not aid much in the investigation of the questions that -interest us. For this purpose teasing and compression with the cover -glass are mainly to be relied upon. It is to be commended to isolate one -of the little lobules the gland is composed of, because thus we -certainly have ready for examination all the elements making up the -gland. The little root which connects the lobule with the rest of the -gland will consist of the duct, vessel and nerves supplying the lobule. -Such a lobule is broken up with needles and by compression between -slides. All these manipulations are to be carried on in glycerine. When -the fragments are small enough they are examined with lower powers. The -ducts in well injected specimens can be recognized by the rich supply of -vessels, the nerve-trunks by the arrangement of the nuclei. - -After examining larger fragments with lower powers, smaller ones are -selected, subjected to pressure with cover glass, and examined with -higher powers. By compression with cover glass, pushing from side to -side, one can isolate almost any structure. One can also then make sure -whether a fine fibre is really in connection with any other structure, -or only lying above or beneath the same. - -The staining with the carmine will generally not attack the fine nerve -fibres. To show these up I have used aniline blue dissolved in water. By -these means I have brought out very plainly the nerve fibres, in nerve -trunks, of considerable size, as well as those along vessels. I took the -material prepared as described, broke up a little piece in fragments of -the size of mustard seeds, and left them twelve hours in the blue fluid -in a watch glass. Glycerine, if necessary, slightly acidulated, will -remove the superfluous stain. I was very much pleased with the action of -the aniline blue. - -Notwithstanding its physiological importance there is among the -authorities as yet no uniformity of opinion on the histology of this -gland, save that it belongs to the racemose glands, and is made up of -epithelial cells. - -The question whether there is present a special membrana propria, -enveloping the glandular epithelium, as Pflüger teaches, or a network of -partly coalesced connective tissue cells, as Kölliker supposes, may not -seem very important, but certainly such points must be cleared up before -such questions as to how the nerves end can satisfactorily be answered. - -This question, the importance of which will be admitted by all, is also -a disputed one. In Stricker’s handbook Pflüger has, in the article on -the submaxillary gland, given a detailed account of the mode of -nerve-ending in this gland. According to his investigations it is of -various kinds. - -(1.) The medullary fibre approaches an alveolus penetrates this -membrane, the axis cylinder breaks up into innumerable fine fibres, and -these pass into the body of the gland cell. (2) Or the nerve passes into -a pale cell provided with numerous processes, which in their turn form -connections with the secreting cells. - -These results of Pflüger have, however, not been accepted by all -investigators. Thus Kölliker says on this question: - -“The investigations on the nerve-endings in the salivary glands are -evidently far from being concluded, nevertheless so much can be gathered -from the work done that the nerve fibres are in more intimate relations -with the glandular elements than has been surmised heretofore. What -these relations may be I cannot say, for notwithstanding a very careful -investigation of this gland it has not been possible for me to reach -views definite and not open to doubt, although frequently enough I have -seen fibres and threads of various kinds apparently come in contact with -salivary cells. Further, regarding the drawings and descriptions of -Pflüger, I must confess, having at the same time nothing but the highest -esteem of this investigator, as well as of the care and accuracy he -employed in this question, that these do not seem altogether convincing -to me.” - - - MEMBRANA PROPRIA. - -I find that the gland cells are enclosed by a membrane (agreeing -altogether with Pflüger) which I look upon as decidedly homogeneous -(histologically speaking, of course), not showing any structure; by no -means being merely a reticulum of connective tissue corpuscles, as -Kölliker suggests. - -Further: This membrane is provided with nuclei of an oval form -(generally), reminding me of the nuclei supplying the nerve sheaths. - -Finally: This membrana propria sends out from the alveolar walls, -processes, ensheathing—how complete I cannot say—the gland cells. I -cannot otherwise explain the glistening lines, which we see in examining -sections VI extending from the alveolar wall between the cells, -resembling altogether the sections of the alveolar walls. To investigate -this matter more accurately, I have stained sections with carmine, also -with log-wood, and have found that the alveolar wall and these lines -stain the same way. Further breaking up such a section by manipulation -with cover-glass, one can obtain fragments of these processes, thus -demonstrating that these lines are not merely optical illusions. - -The nuclei of this membrana propria are situated on its inner surface -and could be distinguished in the gland of the cat, mentioned above, not -only by their more oval, oblong or elliptical form, from the more -roundish nuclei of the gland cells, but just as plainly by the lighter -red or pinkish staining which they take on the nuclei of the gland cells -being stained a deeper red. - -Compressing very small fragments of gland-substance (always of course in -glycerine), by means of the cover-glass, beating and pushing it from -side to side, thus bursting the alveolus and tearing the membrane and -isolating it from the contained gland cells, one can prepare for -examination greater or smaller pieces of this membrane. There are by -such means obtainable fragments with all sorts of processes and fringes, -short and long, many and few, which undoubtedly may remind one of -“connective tissue cells.” (See fig. 4.) More convincing than these are -membraneous pieces, which may be obtained of various sizes. (See figs. -5, 6.) I have a drawing of such a fragment, which, if enlarged as figs. -1 and 2, would cover over one-quarter of the page, and to which a number -of nuclei, more than six, are attached. As a rule, this membrane will, -by the manipulations with the cover-glass, not be spread out, but rather -folded up, huddled together inclosing some of the gland cells, forming -an indescribable nest. - -I do not know if it will be necessary to mention in this connection that -I consider these nuclei identical with the half-moon cells of Gianuzzi, -and cannot help expressing my surprise at the physiological importance -assigned to them; for they have been considered playing the role of -mother cells, giving origin to glandular epithelium formed to take the -place of cells used up in the process of secretion. The dark staining, -which in section they seem to assume as well as the semilunar form, will -be discussed later. Of course I look upon these nuclei as belonging to -flat epithelial cells, as we find them lining nerve sheaths, and serous -membranes, and consider them of the same physiological importance as the -nuclei of such endothelial cells. A similar ensheathing membrane, or -membrana propria, I find in the ducts; but here I have not been able to -distinguish processes passing in between the cells. If present they must -be exceedingly delicate, for it is not difficult to press out groups of -cells from the ducts so that empty pieces (short ones of course) of such -can be examined. - -While the membrana propria of the ducts can be separated rather easily -from the inclosed cells, it is different from the surrounding network of -capillaries. It seems impossible to remove the capillaries from the -duct-walls; while, in the gland-structure proper, among the alveoli, the -separation of the capillary from an alveolus, can with little difficulty -often be accomplished, so that a piece of capillary can be examined -without any other structures lying above or beneath it. - - - BLOODVESSELS. - -It was somewhat surprising to me, and not a little interesting, to find -that the ducts have a decidedly richer blood supply than the gland -substance proper, the meshes of the capillaries covering the ducts very -closely indeed. - -I will also call attention to the fact that, along the terminal portions -of the ducts, no arteries or veins can be seen; and what is still more -important, no free nerve-fibres can be discovered. Following the ducts -outwards, as these attain larger dimensions, and especially where they -give off side branches, we find arteries and veins accompanying them, -and there will also be found along-side of them fine nerve-branches. So -much is certain, that in that region, where arteries and veins are not -to be seen, there are also no separate nerve twigs, and that here the -union or coalescence of nerve and tissue which the nerves are to -influence must have taken place. If one considers the fine meshes of the -capillary network enveloping the ducts, and keeps in mind the abundance -of nuclei belonging to the capillary, the membrana propria and the duct -cells proper, he can imagine how difficult it must be to follow the -course of the nerves through and among all these structures. That it has -been impossible for me to separate capillary and membrana propria, has -been mentioned. - - - NERVES. - -If one were to ask the physiologist: What do you expect us to find in -our anatomical investigations on the nerve-endings in the submaxillary -gland, he would undoubtedly answer: “You will find an arrangement -analogous, if not similar, to that in the striped muscle; the -nerve-fibre will be seen to approach the alveolus, penetrate its -covering, and the protoplasm of the nerve and the gland-cell will be -found to come in contact, if not to coalesce.” And that is what has been -found by Pflüger. - -It has been my endeavor for some time to find something similar to the -descriptions of Pflüger, but so far in vain, although many an alveolus -has been carefully examined, flattened out and slowly crushed, so that -each nucleus could be diagnosed, but never have I found anything which -would remind me of the drawings by Pflüger in Stricker’s ‘Histological -Handbook.’ - -In this matter I reasoned thus: If there are any such structures as -specialized nerve-endings present in the glandular elements, we might -look for an analogy either to the striped muscle fibres or to the -capillaries, in both of which nerve-endings are known to be present. In -the former case we have the so-called end-plate—the nerve fibre ends in -a multi-nucleated mass—but as the muscle fibre, standing for a number of -cells, is so different a structure from the gland-cells, we might, with -greater probability, expect some such arrangement as we see on the -capillaries. Here we see fine fibrils, provided with nuclei, exceeding -the fibres two to four times in thickness, entwining the capillary, thus -coming in contact with each of the cells composing the capillary wall. -In the (submaxillary) gland there are similar structures to be -influenced; at least in the capillary as well as in the gland, we have -cells lying side by side to be influenced by nerves—hence we might -expect similar structures. - -Although the books in general have very little to say about the nerve -supply of the capillaries, yet it is a fact, and can well be -demonstrated, _e. g._, in the frog’s muscle, that such is the -arrangement. As a rule, the fibril cannot so readily be detected, but -the nuclei belonging to it are not difficult to recognize. A still more -convenient and instructive locality is the base of the frog’s mouth, -where everything is one plane, and where the nerve fibres can be -followed to their ultimate ramifications. - -Let us now see what evidence of nerve-endings we find in or on the -alveoli of the gland, examining one, or more accurately, a part of one -(the round eminence). We shall see what fig. 1 presents. We see there -two sets of nuclei; one kind oval, longish, stained lighter than the -rest, of a pink hue (fig. 1, _m_), and these a further examination will -demonstrate to be the nuclei belonging to the membrana propria, which -have also been described before. Besides these nuclei, fewer in number, -there is another kind, making up the bulk of the nuclei, more rounded in -form (fig. 1, _g_), and of a deep-red color, which, in their turn, will -prove to be the nuclei of the gland-cells; and these two are the only -elements or structures that I have been able to demonstrate in a -glandular alveolus. - -At one time I thought I had found in or on the alveoli the evidence of a -network of fine nerves. Quite frequently one can observe longish, even -spindle-shaped, often deeply stained, nuclei, which resemble very much -those belonging to the fine nerve fibres. (Fig. 2, _n_, such nuclei are -figured.) But so far, whenever I examined such a spindle-shaped nucleus -more carefully, I found that it proved to be one of the nuclei belonging -to the membrana propria, already described, and the form, as well as its -dark color, was due to the fact that it had been examined edgewise. If, -by manipulation, such a nucleus was turned over and compressed to -present a flat surface, it would have an oval outline and be of a -light-red color. Fig. 3 (_a_, _b_, _c_), shows the same nucleus as it -appeared when seen edgewise, when seen from the flat and when seen in a -position midway between these. Thus is also to be explained the -demilune: If the section would strike a nucleus so that it would be seen -only edgewise—especially if the membrana propria has a chance to roll up -slightly—we should then have a deeply stained body, somewhat -half-moon-shaped, the demilunes of the books. - -So far, nothing but the nuclei have been mentioned, and the observation -might very appropriately be made, that there might exist some -exceedingly fine and delicate nerve fibrils without nuclei. Such a -system of structures would, of course, be almost impossible to -demonstrate with any degree of certainty. I have not, of course, -sufficient reason to deny such an arrangement, and would not consider it -improbable if we had not, in the capillaries of the frog’s muscle (and -other structures) evidence certainly not in favor of such an assumption. -The fine nerve fibrils supplying the capillaries are richly supplied -with nuclei, although the cells which build up the walls of the -capillary are by far more insignificant elements than the secreting -cells of the gland. Certain it is that as yet there is no evidence of -the existence of such fine non-nucleated fibrils, arranged either in the -form of a network or a bundle of fine branches. - -The examination of the alveoli not leading to any results as to -nerve-endings—no structures being discovered there that might be called -nervous—I attacked the problem from the other side. I took up the nerve -trunks accompanying the ducts, and tried how far I could follow their -divisions and branches, and can say that I have spent a great deal of -time on this point. In speakings of the bloodvessels, the fact was -mentioned that, where arteries and veins of any size run along-side of -the duct, these are accompanied by nerve branches, _i. e._, bundles of -nerve fibres, inclosed in a sheath, and these—at least in the cat, the -calf and the ox—are made up (excepting, possibly, the very large trunks) -of fine nerve fibres. Thicker or medullary nerves I have not been able -to discover, even in branches of considerable size, consisting of, say -six or eight fibres, and giving off smaller twigs containing one to -three fibres. Fig. 7 shows such a nerve-trunk with side branches; -neither in the main stem nor in the offshoots are there any medullary -nerves discoverable. - -If this observation is correct, we see that what has to be traced -further, is not the more easily recognized medullary fibre, but -exceedingly fine fibrils carrying in certain intervals nuclei, the only -distinguishing feature. It will be admitted also (first) that it must be -a matter of considerable difficulty to follow such indifferent looking -structures, as delicate fibres. And (secondly), one cannot expect to -find medullary nerves approach the alveoli, penetrate the membrane, come -in connection with the secretory cells, etc., etc, as has been done by -Pflüger. If the question should be asked how far I have been able to -follow these nerves, I should say: Small twigs consisting of one to -three fine fibrils, enclosed in a sheath branch off from a trunk, not -much larger, and apply themselves to the membrana propria of the duct; -their sheaths in all probability coalescing with that membrane. Here -they have been seen to apply themselves to some bloodvessel and are now -lost out of sight, being hid by all the many structures mentioned above, -the nuclei of membrane, capillary, duct cells, and the fibre cannot so -readily be distinguished from the membrana propria of the duct upon -which it rests. But I do not wish to be understood that because the -nerves have been lost out of sight, along-side of vessels, that they -have their “ending” there, inasmuch as the network of bloodvessels is -such a close one that the nerves cannot but help coming in contact with -them. Fig. 8 shows such a fine nerve-trunk. By the aid of aniline blue -the fine fibrils have been made quite plain. Such fine fibrils can by -the same means be demonstrated in much larger trunks, as shown in fig. -7, and it can be shown that even such large trunks consist of nothing -but these fine fibrils. - -I have also seen, exceptionally however, fine nerve twigs run into the -alveoli directly, but the nerves here were of the same nature as the -ones described going to the duct. Fig. 9 shows a fine fibril passing on -to an alveolus and running probably on to a vessel; the nerve fibre -resting upon gland cells, also stained, could not with absolute -certainty be traced to the vessel. There is a small break shown in the -drawing. - -As intimated, especially if the cells of the duct are still _in situ_, -it is impossible to follow the fine nerve-fibres any further. By -pressing out the cells from the ducts, one can obtain portion of the -duct, with the capillaries belonging to them, but they are short pieces, -and the nerve fibril is not easily discoverable. - -But there remains one fact to be mentioned, which may throw light on the -question, as to how the nerves end and which in my opinion might and -does clear up the difficulty. - -Examining the capillaries supplying the gland alveoli, one is able to -find nuclei, not belonging to the capillaries themselves. This statement -can be made for two reasons. In the first place, the majority of these -nuclei have not the form of the nuclei of the capillary, and in the -second place these nuclei are situated on the outside of the capillary -wall. Whoever has examined the capillaries of the frog’s muscle knows -that just such or the same nuclei belong to nerve-fibres, supplying the -capillary wall. In the mammal of course these nuclei are smaller and not -so conspicuous, nor can we procure pieces of capilliary of any length -(the structures under examination here, not being in one plane.) Thus we -cannot expect to have matters so plain here and easy of demonstration. -After finding these nuclei, it was of course my desire to find if they -were united by fibres. It must in this matter be kept in mind, that if -there are such fibres present to which these nuclei belong, these may be -expected to be in the most intimate relation with the capilliary wall, -if one is to influence the other—and therefore not of ready and easy -demonstration. - -I have, however, succeeded in showing in a number of instances that such -fibres exist. Figs. 10 and 11 show such a fibre uniting several nuclei. -The shortness of these fragments makes a more perfect demonstration -almost impossible. - -If this observation is correct, we find on the capillaries the same -(only finer) fibres provided with nuclei, which we have lost out of -sight following the branching out of the nerves. - -There is also some evidence of fine fibres in the membrana propria of -the ducts, inasmuch as we find here nuclei along-side of the -capillaries, these not being the nuclei of the membrane, but resembling -altogether the nuclei of the nerve fibres. - -Again, as stated above, I have not been able to find any such evidence -of nerves in connection with the gland cells themselves. In case, -however, such an arrangement or something similar existed, why should it -have been impossible for me to find evidences of such as well here on -the gland cells as on the capillaries; and should they not be more -readily found in the gland than in the capillary, inasmuch as we have -larger structures to deal with here in the gland. - -The conclusion then regarding the nerve-endings to which my work has led -me are these: - -There were no special nerve-endings found in connection with the gland -cells themselves. _We find, however, upon the capillaries evidence of -the same kind of fine nucleated fibrils, which we find to be present in -the fine nerve twigs_, as far as we can follow them in their course -towards their final distribution. To explain the action of nerves on the -process of secretion we would have to assume either that the nerves -accompanying the capillaries also influence the gland cells, or that the -glands are stimulated to activity by some changes in the condition of -the capillary wall furnishing a greater amount of oxygen and nutritive -fluids. - -The results are partly negative, partly positive. The latter I wish to -emphasize, believing it worthy of attention, as it may throw light on -the physiology of the capillary wall, which seems to be altogether too -much neglected. The negative I have offered, knowing well enough that -such negative results must be accepted as final with much hesitation. - -To any one feeling inclined to undertake investigation on this gland, I -would make a few suggestions: - - (1) Make sections through gland hardened in bichromate of potash, - or alcohol, and stain with staining fluids. - - (2) Compare in material prepared as above described, the vascular - supply of duct and gland substance proper. - - (3) Compare gland and duct cells. - - (4) Find the nuclei of the membrana propria and compare the same - with the nuclei of the gland cells. - - (5) See if you can examine the same nucleus from different sides. - Do you think that the demilune of books and the nucleus of the - membrana propria might be the same thing? - - (6) Prepare pieces of the membrana propria covering the alveoli. - What is your opinion—is there a membrane or only a reticulum of - connective tissue cells? - - (7) Prepare pieces of membrana propria of duct. - - (8) Can you find the nuclei of the duct, and other nuclei on the - exterior of the capillaries? - - (9) Can you find pieces of capillaries belonging to the alveoli, - and do you find any nuclei on them? - - (10) Examine the wall of the duct in injected and uninjected - material, both stained. - - (11) Follow the bloodvessels—can you find nerves on the walls of - arteries? - - (12) Of what structure do you find the root of a little lobule to - consist? - - (13) How do the nerve trunks differ from the fibrous envelope - holding together all these structures? - - (14) Differentiate between the nuclei of the nerve fibres and the - nuclei of the nerve sheath. - - (15) Examine nerve branches of various thicknesses—what do you - find the nature of the nerve fibres to be? Do not forget the - aniline blue and try other staining fluids. - - (16) Can you find evidence in the alveoli of other structures - besides capillary, membrana propria and salivary cells? - - (17) How far have you succeeded in following the fine nerve twigs? - - (18) By all means try different methods, different tissue, and - compare the results. See what you can discover by simply teasing - material treated with Muller’s fluid, and other stained and - treated as I have described. - - (19) Follow the course of the arteries, and note where the larger - vessels pass into the capillaries. - - - 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. - - [_Continued from page 103._] - -But the contributions to medicine of all his predecessors dwarf into -insignificance when compared to those of Galen—who lived and wrote in -the middle of the second century—and whose writings were ultimate -authority, until they were attacked and publicly burned in the 16th -century by the arch-quack Paracelsus. Galen, although born in Pergamus, -in Mysia and living there, was called by the Emperors M. Aurelius, and -L. Verus to attend them in the northeastern frontier of Italy, and was -for a considerable period of time physician to the emperor, spending a -considerable portion of the last half of his life at Rome. He died in -Sicily in 201 aet 71 (?) There are ascribed to him 83 treatises on -medicine about which there is no question as to their genuineness, 19 -that are questionable, 45 undoubtedly spurious, 19 fragments, 15 -commentaries on Hippocrates’ works. Besides these, he wrote a great -number of works (not all on medicine) whose titles only are preserved, -so that altogether it is believed that the number of distinct treatises -cannot have been less than 500. These were, on (1) Anatomy and -Physiology, (2) Dietetics and Hygiene, (3) Pathology, (4) Semiology and -Diagnosis, (5) Materia Medica and Pharmacy, (6) Therapeutics including -Surgery, (7) Commentaries on Hippocrates, (8) Philosophical and -Miscellaneous. Most of these works are still extant in Greek (in which -they were originally written). They have been translated into many -modern languages. His works on anatomy and physiology are most valuable. -But it is not certain that he ever dissected human bodies. His knowledge -he derived from dissecting apes, bears, goats, etc., and his knowledge -of physiology from experiments on these animals. His pathology was -speculative. - -In diagnosis and prognosis he laid great stress upon the pulse, on which -subject he may be considered as the first and greatest authority, for -subsequent writers adopted his system without alteration. He placed -great confidence in the doctrine of “critical days,” which he believed -to be influenced by the moon. - -In materia medica he was not considered as good authority as -Dioscorides. He was prone to making prescriptions containing many -ingredients, some of which were entirely _inert_. He seems to have -placed more faith in amulets than in medicine, and is supposed to be the -author of the anodyne necklace, which was for a long time famous in -England. He was an allopathist in his notions, _i. e._, he believed that -disease is something contrary to nature, and is to be overcome by that -which is contrary to the disease itself. At the same time he taught that -nature is to be preserved by that which has relations to nature, in -accord. Hence his two indications, “Overcome Disease,” “Sustain Nature.” - -Before this time, as already intimated, the medical profession was -divided into several sects, who were always disputing with one another. -After him, all these sects seem to have merged into his followers. The -subsequent Greek and Roman medical writers were compilers from his -writings, and being translated into Arabic, Galen’s works became -authority in the East as well as in Europe, and continued to be so for -fourteen hundred years. In 1559, Dr. Geynes was cited before the college -of physicians for impugning the infallibility of Galen. On his -acknowledgment of his error and humble recantation, signed with his own -hand, he was received into the college. - -The great mass of Galen’s _works_, together with modern improvements and -researches, have now in great measure consigned them to neglect, but his -_fame_ can only perish with the science itself. As in the case of -Hippocrates, his immeasurable superiority over his contemporaries seems -to have acted as a check to all attempts at further improvement. - -The first names of any renown that occur subsequent to Galen are those -of Oribasius, Alexander of Tralles, Ætius and Paulus Egineta, who -flourished between the fourth and seventh centuries. They were all -jealous Galenists, and those of their writings which are still extant -are, for the most part, compilations from the predecessors, especially -from their great master, Galen. - -The writings of Paulus seem to be the last of any written in the Greek -language, which had been the language of medical science for more than a -thousand years. At about this time the Arabian school was beginning to -rise into notice. The earliest Arabian writers on medicine of whom we -have any notice or certain account, is Ahrum, who was contemporary with -Paulus. The most celebrated physicians of this school were Rhazes, (who -flourished in the ninth century, and was the first to describe -small-pox) and Avicenna who flourished early in the eleventh century, -and whose ‘Canon Medicina’ may be regarded as a cyclopaedia of all that -was known of medicine at that time (as well as collateral sciences). -This was a compilation from Greek writers, whose writings had been -translated into Arabic, (for Avicenna was not a Greek scholar himself). -Avenzoar, and Averrhoes flourished in the twelfth century. The last was -a celebrated philosopher as well as physician. The works of Hippocrates -and Galen, which, together with the works of Aristotle, Plato and -Euclid, were translated into Arabic in the ninth century, formed the -basis of their medical knowledge; but the Arabian physicians did good -service to medicine, introducing new articles from the East into -European materia medica, as for example, rhubarb, cassia, senna, -camphor, and in making known what may be termed the first elements of -pharmaceutical chemistry, such as a knowledge of distillation, and of -the means of obtaining various metallic oxides and salts. - -Upon the decline of the Saracenic universities in Spain, which was about -the time of the death of Averrhoes, the only medical knowledge that -remained was to be found in Italy, where the School of Salerno acquired -considerable celebrity, which it maintained for some time, till it was -gradually eclipsed by the rising fame of other medical schools at -Bologna—where Mondino or Mundinus de Leozza publicly dissected two human -bodies in 1315. - -Contemporary with Mondini, lived Gilbert, the first English writer on -medicine who acquired any repute; and the next century gave birth to -Linacre, who after studying at Oxford spent a considerable time at -Bologna, Florence, Rome, Venice and Padua, and subsequently became the -founder of the London College of Physicians. It was in this fifteenth -century that the sect of chemical physicians arose, who claimed that all -the phenomena of the living body could be explained by the same chemical -laws as those that rule inorganic matters. Although the illustrations -and proofs which they adduced were completely unsatisfactory, yet the -tendency at the present time is in the same direction, since chemistry -and physiology are better known. - -This seems to be a period prolific of new diseases. In the thirteenth, -fourteenth and fifteenth centuries we hear most of leprosy, and of the -visitation of the plague in Europe. Whooping-cough and scurvy were never -described by any writer anterior to the fifteenth century. Syphilis was -first recognized in Italy in the fifteenth century, from which country -it spread rapidly over the whole of Europe. - -In the sixteenth century the study of human anatomy may be said to have -been fairly established by the zeal and labors of Vesalius, and in this -and the succeeding centuries we meet with the names of many physicians -whose anatomical and physiological investigations tended either directly -or indirectly to advance the science of medicine. This was the epoch of -Eustachius, Fallopius, Asellius, Harvey, Rudbeck, Bartholini, Malpighi, -Glisson, Sylvius, Willis, Bellini, etc., names preserved in anatomy. - -Chemistry was now being separated from alchemy, and advancing to a -science, and a combination formed between its principles and those of -physiology, which gave rise to a new sect of chemical physicians, quite -distinct from the sect represented two centuries before by Paracelsus. -The chemical school was succeeded by the mathematical school, of which -Borelli, Sauvages, Heill, Jurin, Mead and Freind were amongst the most -celebrated. While at the same time the old Galenists were fast -disappearing. To the rival sects of this period must be added the -Vitalists, which originated with Von Helmont, and with some -modifications was adopted by Stahl and Hoffman. The greatest physician -of the seventeenth century was, however, Sydenham, who, though inclining -to the chemical school, did not allow his speculative opinions regarding -the nature of disease to interfere with a careful consideration of the -indications for treatment, as derived from the symptoms, and from -experience. - -Boerhaave, a Dutch physician and philosopher, occupied special -prominence in last part of the seventeenth and the early part of the -eighteenth centuries. He engaged in the practice of medicine at Leyden -in 1693, and became professor of theory and practice of medicine in the -university of that city in 1701. He was erudite, exact, simple and -eloquent, and hence as a lecturer very popular. He specially advocated -simplicity in practice of medicine. Professor of botany was added to his -duties in 1709. He wrote a treatise in 1703 (in Latin) advocating -mechanical and chemical hypotheses in medicine. In 1708 his institutes -of medicine extended his reputation; and in 1709 appeared his famous -‘Aphorisms’ on the diagnosis and cure of disease. In this was a well -defined classification of diseases, including their causes, nature and -treatment, which was adopted by his contemporaries. He was distinguished -as a botanist and chemist. He published a description of plants at -Leyden in 1710, and became professor of chemistry in 1718 in addition to -his other duties. He made chemistry popular by presenting it in a clear -and attractive style, in his lectures and in his ‘Elements of Chemistry’ -(1724). - -On account of his attack of gout he was constrained to give up the -teaching of botany and chemistry in 1727. He was elected a Fellow of the -Royal Society of London in 1730. His fame extended over the world. A -Chinese mandarin hearing of his fame addressed a letter to Boerhaave, -physician in Europe, which reached him in due time. His practice was -lucrative, and he spent money freely in the interest of science and -benevolence, yet such was his success that it is said that at his death -(in 1738) he left an estate of nearly a million dollars. - -Cullen, who was born in 1710 and died in 1790, was undoubtedly the -greatest medical man of his age. It is especially interesting to read -the biographies of such men as Cullen and of Hunter his contemporary, -and of Jenner of the last half of the eighteenth century, and of John -Brown the quack—though much quoted. - -The present century may be considered as the epoch of physiological -experiment and clinical observation. The efficient laborers of the last -eighty years in the field of medicine have been so numerous that it -would be impossible to notice at this time even those deemed most -celebrated, while it would be invidious to attempt such a selection. - -In this time our materia medica has received a large number of most -important additions, amongst which may be noticed, morphia, quinia, -strychnia, iodine and the iodides, bromides, cyanohydric acid, cod-liver -oil, chloroform, chloral, nitrite, amyl and a long list of preparations -from the vegetable kingdom and from the hydrocarbon series. - -The physical diagnosis of disease has been facilitated to an extent far -beyond what the most sanguine physician of the last century could have -deemed possible, by the discovery and practical application of the -stethoscope, the pleximeter, the speculum in various forms, the -ophthalmoscope, the laryngoscope and the thermometer; while chemistry -and the microscopy have been applied successfully to the investigation -of the various excretions, and especially of the urine, bile, and in the -study of digestion where the process could be observed in its various -stages in the person of Alexis St. Martin. - -But the field for the medical historian broadens immensely and can best -be appreciated by study of a catalogue of medical books and periodicals -of the present century. - - - CASE OF HYSTERICAL BLINDNESS. - - BY D. B. SMITH, M. D. - - Professor of Diseases of the Eye and Ear in the Medical Department of - Western - Reserve University. - -On the fourth day of June I was called to see Miss C. R., aged nineteen -years, a clerk, who told me that she had gone to bed the night before -perfectly well, and that when she awoke in the morning she found herself -totally blind, and had remained so up to the time of my visit, about -eleven o’clock. This blindness she said had come on without the least -pain or bad feeling, and the eyes were not in the least degree -uncomfortable, nor had they been during the morning. No cause on the -part of the patient could be assigned for the attack, and nothing of the -kind had ever happened to any member of the family before. The external -examination gave not the slightest evidence of any disease of the -eyeballs or lids. The conjunctiva was perfectly normal, as were also the -cornea iris and pupil. The ophthalmoscope revealed a perfectly healthy -retina and optic nerve and clear media. The tension of the eyeball was -normal. There was not the least constitutional disturbance, if we except -a marked nervousness caused by the fear that she would be permanently -blind. The patient declared most positively that she could not see the -lamp even when held close to the eyes. From the fact that the pupils -were perfectly normal and moveable under the influence of light, and -that the patient put out her hand to shake hands with me in a way that I -felt she could not do if she did not see, I diagnosed a case of -hysterical blindness. It was more than a simulated blindness, for all -the anxiety and mental distress of actual blindness were present; and I -am satisfied the patient was honest in her belief that she could not -see. The ordinary remedies for hysteria were given and were taken -faithfully and regularly, and although for several days she took large -doses of the bromide, valerianate of ammonia, hyoscyamus, assafœtida, -and kindred drugs, there was not the slightest improvement in her -vision. These remedies were continued from the fourth to the fourteenth -without any perceptible effect. After ten days I began to give her -tonics instead, and although she took the elixir cinchona with dilute -hydrochloric acid, tincture of nux vomica, quinine, iron oxid of zinc, -and finally stimulants, there was no improvement and the patient said -she remained in total darkness. This tonic course was continued up to -the twenty-ninth, and had been followed out thoroughly for two full -weeks without effect. - -During the nearly four weeks treatment the patient said that when the -eyes were shut she could discern the position of the lighted lamp, but -when the eyes were open she could not see the lamp or the slightest -object, or even tell daylight from darkness. At various intervals during -this time her pastor visited her and offered her his most heartfelt -sympathy. Her friends were becoming exceedingly anxious least the sight -would never return, although I could assure them that there was not the -least danger of permanent blindness. I became satisfied at this time -that medication was not going to dispel this peculiar attack of hysteria -and that it would need something besides medicine to produce such an -impression upon her mind that she could overcome it, so I told her that -I was going to do something the next day that would surely make her see -before night, and that she should be of good cheer for her sight would -return very soon. The next morning I went down about nine o’clock armed -with my ophthalmoscope, my case of trial glasses and my Hearteloup’s -artificial leech. The patient seemed to be quite confident that she -would soon see, and was very hopeful as to the result of what was to be -done. I looked into the eyes with my ophthalmoscope, and then applied -the cylinder of the artificial leech to the temples without scarifying -and used considerable traction, first on one side and then on the other, -having previously told her not to open the eyes until I told her to do -so. In about half an hour I told her to open the eyes gradually so as -not to let the light in too suddenly and then tell me what she could -see. The instant she opened them she said I can see the light and the -position of the window. I then told her to close the eyes again and I -reapplied the cylinder and commenced the suction as before. By this time -the temples had become red and so sensitive that she now complained of -some pain when the cylinder was reapplied. After twenty minutes she was -told to open the eyes again and she said she could see objects about the -room distinctly. She was then tried with large letters but she said she -could not see to read them, but could see the black objects. Told her -glasses would help her and placed a No. 72 convex spherical glass before -the eyes when she could see Jaeger No. 20, then told her she needed -other glasses and replaced the No. 72. She now saw to read No. 16. I -continued taking off and putting on this same No. 72, with good effect -and whenever she came to a standstill in reading reapplied the cylinder -with uniform benefit until finally after two hours constant work she -could read Jaeger No. 1. During all this day she was able to see -distinctly. The next day she was again unable to read but a short -repetition of the same course brought her vision back again. There was -no return of the blindness after that except occasionally for a short -time at intervals of two or three days. - -In the course of ten days all trace of the difficulty had passed by and -since has never returned. This case was diagnosed as one of genuine -hysteria and not one of simulating blindness or malingering, and is -reported as the most marked case I have ever had illustrating the effect -of hokus pokusing (to call it by a mild name) which produced such a -strong mental impression that the patient lost sight of her own peculiar -mental condition, and by which a perfect cure was effected. - -To her the blindness was real, and her friends feel that a remarkable -cure has been performed. Such a blindness can occur in any nervous -hysterical patient, while simulated blindness usually occurs in those -who wish to avoid service in the army or navy, or in the case of lazy -young people who do not wish to study at school or college, and in those -who have received a slight injury and wish to make it appear more -serious for the sake of obtaining large damages, either from private -individuals or corporations. - -For its detection there are several methods which are usually sufficient -to give us positive proof that the blindness is not real. Von Graefe -placed a number eight or ten prism in front of the eye, with the base -upwards, downwards or sidewise, and if strabismus is present before the -removal of the prism there is binocular vision. - -Juler places spectacles with an opaque glass in front of the good eye, -when, if the patient can read, he must see with both eyes; or he places -concave 20 before the good eye, when if the patient can read fine print -he must see it with the other eye. - -Juval places a ruler before the eye so as to cover part of the page to -be read, when, if one eye is blind, not all the page can be read. - -Mittendorf puts atropine in the good eye, when if the patient can read -fine print he is not blind with the other eye. - -Wells places a prism in front of the supposed blind eye, and notices -whether the apis of vision of that eye changes when the prism is -removed. - -Bull bandages the good eye and places a prism in front of the other eye, -and holds a lighted candle before the eye, and if the eye turns as the -prism is turned, the eye is not blind. - -The test with Snellens or other colored letters is also a good one. A -word with alternate red and bluish green letters is painted on glass and -placed in the window, and the patient is asked to read the letters. If a -bluish green glass is held in front of the good eye, he will see only -the green letters unless he can see with the other eye, for all but the -red rays in the red letters are cut off in the transparency in the -window, and the green glass cuts the red off, leaving those letters a -perfect blank to the well eye. - -Kugel places various colored glasses before each eye and then places an -opaque glass in front of the sound eye, and a transparent glass of the -same color before the other one, and if the patient sees the object, he -is simulating blindness. - -Herring has the patient look through a tube large enough to cover both -eyes, and then suspends a small ball in front of the tube and drops -small objects near this ball, and if the patient can tell whether the -balls are dropped in front of or behind the suspended ball, he must see -with both eyes. - -Lawrence recommends the stereoscope for detecting binocular vision, and -places in a covered stereoscope a picture each side of which is -different, and yet such as to make a single picture when both sides are -seen. A clock dial, for example, with figures in one side only or -figures with complemental colors, such that with both eyes the object -would appear differently colored from what it would when seen with -either eye separately. The distance apart of two objects held up in -front of both eyes can be readily told by the patient if he sees with -both eyes, no matter how the objects are held with relation to each -other. But if there is vision with one eye only, the patient can tell -the distant apart with accuracy only when the objects are both held at -the same distance from the eye, but not when one is held considerably in -front of the other. - -One who sees with one eye only always thinks he is nearer to the object -than he really is when reaching out for that object. It is always more -difficult for him to pour from a pitcher into a cup or glass if held a -little distance below it, hence the blind in one eye usually place the -nose of the pitcher in contact with the glass before pouring. The old -parlor trick of placing two pins in the wall and putting a cent on them -and directing the patient to stand across the room and then walk over to -the cent and knock it off with the outstretched finger without hitting -the pins, may be made use of as a test in simulated blindness, for with -one eye the patient always falls short of the mark the first time the -experiment is tried. The most simple method of detecting simulated -blindness in one eye is by noticing the movement of the pupil under the -influence of light. If an eye is blind, the light has little or no -effect upon it when the other eye is closed. The pupil is usually -dilated. It may be well to mention here that atropine dilatation is -generally wider than that due to amaurosis, and also that a cone of -light from a strong convex glass thrown upon the sound eye will contract -the pupil of the blind eye if the dilatation is not due to atropine. -Simulated blindness in both eyes is not likely to be seen, and then the -condition of the pupil is of great value in detecting it, and is one of -the best guides in connection with the ophthalmoscopic observation. - - - A CASE OF DOUBLE UTERUS AND VAGINA. - - BY S. W. KELLEY, M. D., CLEVELAND, O. - -Miss H. E., aged 20, American of Irish parentage: dark brunette, short -in stature but apparently quite handsomely formed, and ruddy with -health. She has never been sick in her life. Has menstruated normally -since her fifteenth year, though scantily during the past year. She -feared she had been injured a few days previously by the overturning of -a chair upon which she was standing, as she had since felt pain and -uneasiness in the lower pelvic and pubic region, for which she sought -advice. - -Upon examination I found no injury worthy of record, but the -malformation here described. Cases of this anomaly have been recorded -from time to time, being always of interest to the teratologist, -occasionally requiring attention on account of interference with the -marital relation or parturition, and being referred to in every -discussion on superfœtation. - -The external genitalia are well developed. No hymen, nor any remains of -one. I have no reason to doubt her virginity. An inch within the -introitus vaginæ the finger met a narrowing into which only its tip -would pass. Searching to the left another smaller opening was -discovered, the two being separated by a strong membrane. Returning to -the right or larger passage, was able by careful dilatation for ten or -fifteen minutes to insert three-fourths of the length of the index -finger and encounter another narrowing, which being patiently overcome, -the first joint of the finger found more room and examined uterine -cervix and the external os, which is linear antero posteriorly. The neck -projects about half an inch into the vagina. The lips are thin, of -normal density. Withdrawing the finger and finding the smaller opening, -could succeed in penetrating only about an inch. Observed a third, -smallest opening in the left vaginal wall, between the ostium vaginæ and -the second opening described. - -[Illustration] - -The patient would consent to no interference that could possibly cause -even temporary disability for daily housework and care of an invalid -mother, but agreed to return daily for a few days. After dilating -without anæsthesia fifteen to twenty minutes daily for four days, could -pass two fingers or a Fergusson speculum one and one-eighth inches into -the right passage, and could pass one finger readily, or speculum -seven-eighths of an inch in diameter into the left passage. The septum -between the two passages is placed antero posteriorly. It is about an -eighth of an inch thick, and has the appearance of any other portion of -the vaginal wall. It begins an inch within the introitus, and extends to -the uterus, making a right and left vagina of normal length. The third, -smallest passage, admits a sound and extends upward an inch in the left -lateral vaginal wall and ends in a blind extremity. - -The right vagina discloses an uterine os three-eighths inch in length -antero posteriorly, the anterior end of the slit inclined toward the -median line. The sound passes readily a distance of one and -three-eighths inches, entering in a direction upward and inward half -that length, and then turning upward and outward. The sound moves freely -in the cavity, and the lining membrane evidently contains folds. -Secretion of the cervix free. - -On the left side the os uteri is smaller, the opening not exceeding a -quarter inch, the length being laterally. The lips are in a pouting -shape, the anterior, especially, having quite a fold above it. The sound -enters freely nearly an inch in a direction upward, outward and slightly -backward; lining membrane apparently folded. Very little secretion. By -introducing two fingers of the left hand, palm upward, the index into -the right vagina and the second finger into the left, the two uterine -mouths can be examined simultaneously, and this gives a very vivid -impression of the condition. As to the shape of the whole uterus very -little can be determined by bimanual examination, the vaginal walls -being so tense and abdominal thick. By the rectum the uterus can be felt -flat and wide, but no bi-lobing is apparent. - -The young lady could not be persuaded to permit an examination during -menstruation to determine whether the flow took place on both sides. - - - MEDICAL SOCIETIES—THEIR BENEFITS TO US AND OUR DUTIES TO THEM. - - BY DR. WILLIAM FORSTER, RETIRING PRESIDENT VENANGO COUNTY MEDICAL - SOCIETY, PENNSYLVANIA. - -Though at best societies in their present form are not very old, medical -associations, differing somewhat in their organization and aim, are as -old as the science of medicine itself. Even in the fabulous ages it had -its heroes, and some rose to the height of deification. In earlier ages -those who practiced medicine were looked upon as inspired. They, in -addition to belonging to a profession, constituted a class or caste. In -some Asiatic nations, and among some of our Indian tribes, it is very -much the same at present. - -One must belong to the caste, or be able to trace his descent from it, -as a necessary qualification to practice medicine. - -This is the earliest form of a medical society, and though it may not -possess many progressive elements, it has elements of strength. - -What few investigations it did make, it kept. Its peculiar organization -and position fitted it for being a good conservator; and when the star -of empire took its western course, the tide of medical knowledge stored -up and held sacred and secret in Asia, Egypt and Greece, flowed out and -was diffused over five continents. - -Hippocrates, about twenty-five hundred years ago, took the light from -under a bushel. About three hundred years later the great Alexandrian -school or society—for it was a society as well as a school—trimmed the -light and set it higher, but it was so obscured and encompassed with -exclusiveness and secrecy as to be a long time in reaching the masses. - -The first societies in Germany, France and Great Britain were in -connection with their institutions of learning, as they were at an -earlier period in Egypt and Greece. In Rome we have reason to believe -that they were more independent, as the physicians used a society seal -as a label for their medicine. Truly independent society organization -and work is comparatively of our own day. Even in the early part of the -present century, British authority was the London, Edinburgh and Dublin -colleges. - -In our own country, previous to the organization of the American Medical -Association, about thirty-six years ago, there was very little system in -society work. That organization marks a new era in society usefulness. -From it sprung the International Medical Congress, making a unit of -medical investigation and progress of the world. We point with pride to -Philadelphia as the city in which the association was organized, and to -the able and determined stand our State has ever taken in sustaining and -strengthening it. It has been a power for good to American medicine. It -has elevated and is elevating the standard of our American medical -colleges. - -The progress in society organization, work and usefulness in the last -thirty-six years is greater than in all American medical history -previous to that time. We had then a few isolated independent medical -societies without unity and without influence. We have at present a -society in almost every county, a State society in every State, all -united in an association and wielding an influence national and world -wide. - -Great as the benefit has been to the profession at large, it has been -greater still to the individual practitioner. It has been to him a -post-graduate school. - -In our societies A. meets B., B., C. and C., D. They compare their -investigations, experiences and theories, and each is benefited. - -Our society enables us to know one another better. It is a true saying -that, “no man is as good as his best deed nor as bad as his worst.” Our -meeting in society aids us in striking the balance and makes us more -united, by forming and cementing friendships. They discourage quackery, -empiricism and everything that is professionally low and mean. They -encourage and stimulate purity, nobility and rectitude. They are a -strength to us medically and medico-legally. All that is necessary on -our part to secure us these benefits and many more which might be -enumerated, is to do our duty to our county, State and national -societies. I will now present to you what I believe to constitute at -least part of that duty. - -_First._ Punctuality and regularity in attendance. This increases our -interest and gives the society strength. - -_Second._ Support with our intellect. We may not all have an equal -number of talents, but he that has five should use them, and he that has -one should use it, and the use of that one may be just what the society -needs at the time. - -If we have anything we think good in theory or practice, or any -interesting case, let us report to our society. - -I believe everything presented should be in writing, for very few -physicians are good extemporaneous speakers, and all members should have -such notice of the subject of all papers to be read before the society -as will give them time to prepare for intelligent discussion; for unless -a man has a clear idea of his subject he is liable to wander off into a -labyrinth of side issues. - -When appointed for a paper, we should have it ready and be on hand to -read it. We should have more papers published, and to better prepare -them for publication, each society should have an editor and a -publication committee, with ability and power to revise, correct and -publish papers and reports of the society. - -_Third._ We should support our society with our influence. All have an -influence, and there is no neutral ground. It must be for or against. - -Never was there a time when there was more need of the support of the -good men in the profession. The code of medical ethics has been -attacked. The American Medical association has been attacked. - -An attempt has been made to make the one obnoxious and destroy the -harmony and usefulness of the other. - -_Fourth._ We should be prompt in paying our dues and all other necessary -demands that may be made on us by our society. Negligence—for it is -seldom or never inability—on our part may not only embarrass the -society, but tend to destroy our interest in it. - -I have a great regard for the Venango County Medical Society. It was the -first society I joined after graduating, over twenty years ago, and I -have always highly prized the friendships herein formed. - -Death has taken some from us, good men and true, but I am pleased to see -that we are also adding to our number so many young men, and growing in -strength. Let us each do our part to keep up this growth, so that when -we are weighed in the balance we may not be found wanting. - -I thank you for your kind aid and forbearance throughout the year. May -our society live long and prosper. - - - - - 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. - - - THE LATE DR. ALFRED C. POST. - -One of the old land marks of the medical profession is gone! Few men are -privileged to continue in actual practice fifty-seven years! Thousands -have heard him lecture, seen him operate and read his published papers. -He was indeed a remarkable man. At the age of eighty he continued to -operate with the freshness of youth. As a lecturer he was terse—direct -to the point; as a writer he was lucid and clear; as an operator he was -steady, bold and self-reliant; as a man he was a Christian. - -If there was one thing more than another more prominent in his -well-rounded character, it was his devotion to duty. He was a man of -fine religious faith, devout in his behavior and an excellent theologian -and Biblical scholar. The two things he is said to have most enjoyed -were a surgical operation and a prayer meeting. He was a consistent -member of the Presbyterian church, and his example of earnest, unselfish -devotion to duty can not help but leave an influence for good which will -last long after his brilliant surgical operations are forgotten. - -Dr. Post was born in New York city in 1805, graduated from Columbia -College in 1822, became a medical student in the office of Dr. Wright -Post, his uncle, an eminent surgeon of a former generation. He graduated -from the College of Physicians and Surgeons in 1827. After spending two -years in the medical schools and hospitals of Paris, Berlin and -Edinburgh, he commenced active practice of his profession in New York -city, which he continued until the week before his death. He was one of -the founders of the Medical Department of the University of New York, -taking the chair of surgery and pathological anatomy, and at the time of -his death was president of the medical faculty and emeritus professor of -the clinical surgery in that institution. His funeral took place -Wednesday, February 10, and the Church of the Covenant, of which Dr. -Post was a member, was crowded with professional and other friends of -the dead man. - - - ALUMNI ASSOCIATION OF THE MEDICAL DEPARTMENT OF THE WESTERN RESERVE - UNIVERSITY. - -The annual meeting of the Alumni Association will be held at 2 o’clock, -P. M., Wednesday, March 3, in the amphitheatre of the City Hospital -corner of Erie and Lake streets. - -Dr. E. D. Burton of Collamer, Ohio, will be the orator of the occasion, -and Prof. Proctor Thayer, the elected poet. - -The president, Prof. G. C. E. Weber, will also deliver an address. - -The subjects for discussion are: First, Cholera, the leading speakers -being Doctors Thayer, Lowman and Kelley. Second, Diphtheria, its -Aetiology and Treatment, with Dr. Knowlton of Brecksville, and Dr. Orwig -of Cleveland, as leading speakers. The annual election of officers will -be held, and other important business transacted. - -The Hon. S. E. Williamson will deliver an address to the graduating -class in the evening. The graduating exercises will be held in the First -Methodist Church, corner of Euclid avenue and Erie street. There will -afterwards be a reception and banquet at the Hollenden. - - - THE WESTERN PENNSYLVANIA MEDICAL COLLEGE. - -The Western Pennsylvania Medical College has been organized and -liberally endowed, and will soon assume possession of its new building -on Sixth street, Pittsburgh, Pennsylvania. The course of lectures will -not begin, however, until October. The faculty will be composed of the -following well-known, earnest and hard-working practitioners: Professor -of Anatomy, Dr. Heckelman; Professor of Physiology, Dr. Allen; Professor -of the Principles of Surgery, Dr. Murdock; Professor of the Practice of -Surgery, Dr. McCann; Professor of the Principles of Medicine, Dr. -Shively; Professor of Clinical Medicine, Dr. Lane; Professor of -Chemistry, Dr. Blank; Professor of Materia Medica, Dr. Gallagher; -Professor of Obstetrics, Dr. Duff; Professor of Gynæcology, Dr. Asdale; -Lecturer on Dermatology, Dr. Dunn; Lecturer on Nervous Diseases, Dr. -Ayers; Lecturer on Orthopædic Surgery, Dr. King; Lecturer on -Genito-Urinary Diseases, Dr. Thomas. - - - - - SOCIETY PROCEEDINGS. - - - PROCEEDINGS OF THE NORTHEASTERN UNION MEDICAL SOCIETY. - - SIXTIETH QUARTERLY SESSION, HELD AT AKRON, OHIO, TUESDAY, FEBRUARY 2, - 1886. - -The president, DR. J. E. DOUGHERTY, in the chair. - -DR. BAUER, of the Committee on Obituaries, was instructed to prepare a -fitting memorial to be read at the next meeting upon the death of Dr. J. -C. Ferguson of Mogadore. - -DR. PIERSON read a history of a clinical case. The clinical committee, -consisting of Drs. Hitchcock, Bauer and Rowe, after examination, -reported the case to be one of chronic pleuritis with adhesions and -effusion, and recommended alterative treatment. - -DR. FISHER read a report of a case of puerperal convulsions, in which -venesection had been resorted to with favorable results. - -In the discussion which followed, DR. SHIVELY said he did not believe in -blood-letting, but would rely upon _drastic cathartics_ and anæsthetics. - -DR. WRIGHT, in a practice of fifty years, had employed blood-letting in -a few cases with good results. - -DR. EVERHARD had seen several cases, and favored the use of anæsthetics, -but objected to the use of morphine on the ground of the supposed uræmic -pathology of puerperal convulsions. - -DR. HOWARD thought Dr. Fisher’s treatment of the case good, and believed -emphatically in blood-letting, and also in the use of arterial -sedatives, such as verat., vir., etc. - -DR. T. C. MILLER believed in thorough narcosis, giving morphine -hypodermically until the effects were noticeable on the respiration. -Anæsthetics are good, but can not be given continuously. The physician -giving the anæsthetic, when the convulsions cease will not crowd the -anæsthetic, and almost before he is aware of it the convulsions will -return. We have much to learn about the pathology of puerperal -convulsions. The speaker does not believe it to be uræmic. All of his -cases in which he gave narcotics thoroughly from the first recovered; -cases in which he used blood-letting died. - -DR. VANCE believed that the treatment advised by Dr. Miller would result -disastrously in many cases, and spoke at some length, showing that the -latest authorities believed the true pathology of the trouble to be -uræmic. - -DR. PIXLEY asked, after hearing so many opinions from so many -distinguished speakers: “What is Dr. Pixley going to do to-night if he -meets a case of puerperal convulsions? One speaker swears, if you bleed, -your patient will die; another swears, if you don’t bleed, your patient -will die; a third says, you must give opium; another says, you must not; -another says, you must give anæsthetics; another veratrum, another -cathartics.” Now, after all of this light upon the subject, he would do -as he always has done—apply cold to the head, warmth to the extremities, -maybe give a little opium, possibly bleed a little, equalize the -circulation, and deliver as soon as possible. Some of his patients will -live and some will die. - -DR. HOWARD submitted to the society, for signatures, a petition to the -State Legislature in the interests of what is known as the “Sharpe -bill,” for the creation of a State Board of Health and a State Board of -Medical Examiners. - -Adjourned to 1:30 P. M. - - - AFTERNOON SESSION. - -On motion of DR. VANCE it was decided to hold the next meeting in -Cleveland, and on motion of DR. SCOTT the Cuyahoga County Medical -Society was invited to meet with this society. - -It was also decided that, because of the session of the American Medical -Association occurring in May, the meeting of this association be held on -the first Tuesday in April. - -Drs. A. R. Baker and W. T. Corlett were appointed a committee on -arrangements for the meeting in Cleveland. - -An election of officers for the ensuing year was held, with the -following result: President, Dr. J. W. Shively of Kent; first -vice-president, Dr. A. C. Belden of Akron; second vice-president, Dr. T. -C. Miller of Massillon; recording secretary, Dr. L. S. Ebright of Akron; -corresponding secretary, Dr. A. K. Fouser of Akron; treasurer, Dr. E. W. -Howard of Akron. - -DR. DOUGHERTY at once relinquished the chair to his successor, and in so -doing begged to be excused from the customary valedictory address -because of his having lately given up the practice of medicine and being -now very busily engaged in the duties of a county office. - -DR. SHIVELY, the president-elect, after thanking the members for the -honor conferred upon him and commending the society upon its active -prosperity and scientific advancement, entered upon the duties of the -office. - -The recording secretary and treasurer submitted their annual reports, -which, on motion, were referred to the finance committee. The committee, -after making a thorough examination of the accounts of the secretary and -treasurer, reported them as correct, but at the same time recommending a -more accurate system of book-keeping in the future, as well as the -passage of a resolution providing for an annual due from each member. - -DR. MCEBRIGHT gave notice of his intention to introduce such a -resolution at the next meeting. - -DR. LOUGHEAD, the appointed essayist, read an interesting paper upon the -Metric System, reviewing the many advantages which might be gained by -its adoption by the medical profession. - -DR. D. B. SMITH read a report of a case of hysterical blindness (see -page 212 of this number), and followed with a verbal report of a very -peculiar case of exfoliation of the epidermis. - -Remarks on the cases reported were made by Dr. Corlett and others. - -DR. HITCHCOCK reported a case of malpresentation, in which, by -manipulation and the slight aid of forceps, delivery was accomplished -with safety to both mother and child. - -DR. CORLETT spoke on the method of prescribing the bromide of arsenic. -He said the most trustworthy way was the alcoholic solution, which he -had been in the habit of diluting it in the strength of one grain to -eight ounces of simple elixirs without precipitation. Care must be taken -that no water be added before the bromide of arsenic is dissolved in -alcohol. Spoke favorably of its use in the class of skin diseases known -as _nenrose cutanae_. - -DR. EBRIGHT reported the case of a man who had swallowed a silver -dollar. DR. PIXLEY told of a similar disposition of a five franc piece, -and DR. EVERHARD related a recent attempt by a lady to swallow the gauge -of a sewing machine. The three cases terminated favorably, though the -last mentioned required the aid of a surgeon. - -The chair announced the following as the standing committees for the -ensuing year: - -Admissions—Drs. D. B. Smith, E. Hitchcock, S. Pixley. - -Publication—Drs. B. B. Brashear, T. H. Phillips, H. M. Fisher. - -Finance—Drs. T. McEbright, M. M. Bauer, L. P. Proehl. - -Ethics—Drs. X. C. Scott, A. M. Sherman, E. Conn. - -Obituaries—Drs. W. C. Jacobs, N. S. Everhard, E. K. Nash. - -The appointments for the next meeting are as follows: Essayist, Dr. A. -C. Brant; alternate, Dr. W. T. Corlett. Lecturer, Dr. E. W. Howard; -alternate, Dr. B. B. Loughead. Reports of cases, Drs. McEbright, -Phillips, Peck, Vance and Starr. Topic for discussion: “Functions of the -Cerebellum,” to be opened by Dr. Brashear. - -After tendering a vote of thanks to the city council for the use of the -council chamber, and voting two dollars to the janitor of the building, -the society adjourned to meet in Cleveland on the sixth of April. - - A. K. FOUSER, _Recording Secretary_. - - - - - NEW BOOKS. - - - ‘AN ESSAY ON THE PATHOLOGY OF THE ŒSOPHAGUS.’ By John F. Knott. - Dublin: Fannin & Co. - - ‘THE OPERATIVE TREATMENT OF INTRA-THORACIC EFFUSION.’ By Norman - Porritt, L. R. C. P., Lond., M. R. C. S., Eng. London: J. & A. - Churchill. - - ‘ON THE PATHOLOGY OF BRONCHITIS, CATARRHAL PNEUMONIA, TUBERCLE, AND - ALLIED LESIONS OF THE HUMAN LUNG.’ By D. J. Hamilton. London: - Macmillan & Co. - -We can well imagine the interest with which some practitioner in a -comparatively isolated locality—in the sense of being far from some one -of the great Atlantic cities where all new medical and surgical works -are kept in stock—reads over the titles of forthcoming works in the -particular department in which he is most concerned, and the eagerness -with which he anticipates their arrival after he has gone so far as to -order them. It may be, in this catarrhal land of ours, that it is throat -and chest diseases he is studying, and that the above works excited his -interest and drew from his pocket his hard earned dollars. If so, who -can doubt that emotions of pleasure warmed his heart as he contemplated -the instruction to be gained and the information to be acquired from -their perusal? For who would dare write on the pathology of the -œsophagus, if he had nothing to say? or descant on the operative -treatment of intra-thoracic effusion, if he was not qualified by -learning and experience to speak on the subject? But, lest the doubter -be abroad in the land, look further to the vouchers of the title page or -the preface. The first work on our list is “the Essay to which was -awarded the Gold Medal of the Pathological Society at the close of the -Session, 1876-77.” The second, “the Essay to which the Medical Society -of London awarded the Fothergillian Gold Medal, 1883.” Can anything be -more satisfactory? It is true that our last work boasts no such -authoritative endorsement, but then as the author is a professor of -pathological anatomy at Aberdeen, its other imperfections—from this -standpoint—we can imagine passed by, and the book, not without -misgivings, may be ultimately ordered with the rest. - -What is the consequence? Two of the books will prove extremely -unsatisfactory, and but one will be found to fulfill in any way the -anticipations of the purchaser. The work on the œsophagus is the -production of an undergraduate—a creditable performance for a student, -but by no means the work any practitioner, not a friend of the writer, -would care to purchase. Mr. Porritt’s treatise is good to that degree -that one feels aggrieved that his friends permitted him to publish -anything until he had produced something first-class—for he is evidently -a young man of ability. Practical surgeons who have arrived at years of -maturity, not infrequently have occasion to notice that young men of -brilliant parts who enter upon the practice of that art, seem to think -they are unjustly kept in the background because no notice is taken of -their efforts to gain position in their profession by the arts of the -rhetorician or the tricks of the essayist. Nevertheless, no man can -become a surgeon, save by surgical works, or be entitled to speak as one -except he be a man of learning or experience—or both. - -After so much that is unpleasant, it is a pleasure to turn to a work of -a radically different kind. In ‘Hamilton’s Bronchitis,’ the reader will -find a treatise that is a mine of pathological lore; a work every page -of which is suggestive and instructive. It possesses the rare quality of -being interesting to an unusual degree, and its perusal will be a -substantial pleasure to all its readers. - - * * * * * - - ‘THE PHYSICIAN HIMSELF.’ By D. W. CATHELL, M. D. Fifth edition. - Baltimore: Cushings & Bailey. - -It is rather humiliating to the physician who is interested in equipping -his brain to successfully combat disease to find himself distanced by -the individual who rides into a paying practice in a fine carriage. But -we must take the world as we find it, and so long as people are judged -by what they seem and not by what they are, such books as the ‘Physician -Himself’ will be demanded. What shall we eat, and where shall we sleep, -and how shall we be clothed withal, are, like the poor, always with the -doctor. - -Dr. Cathell has succeeded quite well in showing the importance of -business tact and sagacity in promoting the welfare of the physician. He -gives rules as to the best methods to pursue toward patients both in the -office and out, so as to line the doctor’s pocket-book. He tells him how -to dress, how to walk, how to sleep and how to eat, what kind of signs -to display, gives hints as to the selection of an office, together with -suitable furniture, etc., etc. - - * * * * * - - ‘POST-MORTEM EXAMINATION.’ By Professor Rudolph Virchow. Translated - by T. P. SMITH, M. D., from the fourth German edition. - Philadelphia: P. Blackson, Son & Co. - -In this admirable little work, Prof. Virchow gives a brief account of -his early experience as Prosector in the dead-house of the Berlin -Charity Hospital, and traces under his auspices the development of a -systematic method of conducting post-mortem examinations. He also -criticises, explains and illustrates the regulations which have been -promulgated throughout Germany for the guidance of medical jurists in -performing autopsies and drawing up reports. - -He also gives three interesting cases in which the post-mortem -examinations were performed by himself, the order of sequence enjoined -by the regulations being closely adhered to. They may be taken as -examples of the way in which all post-mortem examinations for -medico-legal purposes should be conducted. It is much to be wished that -a method similar to the one which has received the high sanction of -Prof. Virchow were adopted in this country. One hundred and thirty-eight -pages, neatly bound in cloth, with a number of plates. Price $1.50. - - * * * * * - -THE SEVENTH ANNUAL REPORT (1885) OF THE OHIO STATE PHARMACEUTICAL -ASSOCIATION contains, besides the constitution and by-laws and history -of the organization, a number of interesting articles. One of them, by -S. J. Nicolay, M. D., of Hamilton, Ohio, is in reply to Query No. 1—“Do -the Various Fluid Extracts of Hydrastis Canadensis, Made Without -Alcohol, Contain all of the Active Principles of the Drug?” The writer -says that, properly, this extract “should not contain alcohol, since the -alcoholic extractive essentially contains resin, which, being an -irritant to inflamed mucous surfaces, is a detriment in a large majority -of cases to which it is otherwise applicable.” As to whether the various -fluid extracts of this drug, made without alcohol, contain _all_ the -active principles of the crude article, he concludes, after an -examination of six specimens from different manufacturers, that “each -specimen was found to contain portions of the two known -alkaloids—berberine and hydrastine—in their varying proportions.” “As to -whether these samples contained the alkaloids in as large quantities as -the respective samples of the crude drug from which they were made, was -not determined, but probably they did.” If this is true, the fluid -extract, without alcohol, will be as effective as that made with -alcohol, beside being quite miscible with water for topical application, -injections, etc., without becoming turbid and depositing resin. - -Query 24—“_What_ is the Most Effective and Pleasant Disinfectant?”—is -answered by L. Sollman of Canton in an essay in which he treats: 1. “As -to what is that something which disinfectants are intended to -counteract.” 2. “What articles are disinfectants, and what is the way in -which they effect disinfection.” 3. “Which of them is practically -useful, and which is the most practical way of using them under various -conditions.” - -A copy of the report can be had by forwarding fifty cents to the -secretary, Lewis C. Hopp, Cleveland, O. - - - - - NOTES AND COMMENTS. - - -_The Graubuch of the General Hospital of Vienna._—From this very -interesting report for 1884 we learn the following: At the end of ‘83 -there remained in the hospital 1,672 patients; of these 1,037 were males -and 635 females. In ‘84, 23,937 patients were admitted, 14,801 males and -9,136 females. Discharged as cured, 12,532; improved, 4,485; uncured, -2,857. At the end of December, 1884, the number of patients remaining in -the hospital was 1,742. - -The maximum of sickness among males was reached in January (1,179); -among females in May (740). The minimum among males in the month of -August (842); among females in September (588). - -It is somewhat interesting to note among the victims of pulmonary -tuberculosis, the proportion furnished by various occupations. Two -hundred and four day laborers, 113 shoemakers, 90 blacksmiths, 76 -cabinetmakers, 71 turners, 30 coachmen, 19 butlers, 19 waiters, 8 -landlords, 6 musicians, 6 servants, 4 conductors, 2 janitors, 1 -stenographer, 1 chorister, 1 turnkey, etc. The proportion of deaths from -tuberculosis expressed in percentage of the whole number of deaths was -as follows: June, 5.6; April, 4.7; March, 4.4; August, 4.3; May, 4.2; -February, 4.1; January, 3.9; October, 3.6; July, 3.2; November, 2.9; -September and December, 2.8. - -The most rheumatism occurred in May (84), most typhus in September (19), -most bronchitis in March (210), the most pneumonitis in April (78), the -most catarrh of the digestive organs in July (81). - - * * * * * - -WINTER PRURIGO, says Dr. Corlett in a clinical lecture, a common and -most annoying disease of the skin in this climate, must be regarded as a -_local neurosis_. In its treatment internal medication avails but -little, excepting in severe cases where the paroxysms of itching occur -several times during the four and twenty hours, when hydrobromic acid -may be used with marked benefit. It is in local measures, however, that -we are effectually able to control it. - -At the outset of a paroxysm apply caustic potash in strength varying -from x to xxx grains to the ounce of water, to which a drachm of -glycerine may be added, after which the following should be added: - - ℞ Menthol ℨss. - Acidi carbolici ℨss. - Sodii benzoati ℨij. - Ung. aquae rosae ℥iij. - Cerae alba q. s. Misce. - -In mild cases, by omitting the caustic potash, the following lotions -will be sufficient: - - ℞ Menthol ℨj. - Alcoholis ℥ij. - Acidi carbolici ℨss. - Sodae benzoati ℥j. - Aquae rosae ℥vj. - Misce. - - * * * * * - -Dr. G. E. Paget of Cambridge is to have a K. C. B. bestowed on him, and -Dr. William Roberts of Manchester is to be knighted. Dr. Paget is Regius -Professor of Physic in the University of Cambridge, and a brother of Sir -James Paget, the eminent London surgeon. Dr. Wm. Roberts is Professor of -Clinical Medicine in the Victoria University. In neither case can the -title of “Sir” enhance the distinguished professional reputation already -enjoyed by each of these gentlemen.—_London Correspondence N. Y. Medical -Record._ - - * * * * * - -At the end of November the Curatorium of the General Polyclinic of -Vienna held its first meeting according to its new constitution. -President Bezecny and Vice-Presidents Dompropst, Marshall and -Neumann-Spallart were unanimously reëlected. The chairman, Baron -Bezecny, next greeted the new curators, and stated that the object of -the meeting was to raise a large sum of money to erect a small hospital -for emergency cases. Upon request of the chair, Prof. Schnitzler gave a -brief report of the work of the Polyclinic from January 1 to November -25, 1885. Over thirty-two thousand patients were treated. The number of -hearers, almost entirely doctors, during the semester year of ‘84-5, -reached the height of four hundred and fifty-four. Among these were one -hundred from Austria and Hungary, and almost as many out of the German -empire. Then follow from other European States—Russia, England, Sweden -and Norway, Belgium and Holland, Italy and Greece. America was -represented by more than one hundred attendants; but also Asia, Africa -and Australia furnished hearers to the Polyclinic. Prof. Schnitzler then -left the subject of the report and moved that it be made the ambition of -the Polyclinic to erect a Polyclinical hospital. This motion, after a -very brief debate, was unanimously adopted. - - * * * * * - -On account of the death of Prof. Geo. Hunert, A. M., M. D., the chair of -Theory and Practice of Medicine is vacant in the Medical Department of -Wooster University in this city. As yet a successor has not been decided -upon. - - * * * * * - -_Third Annual Meeting of the Ohio State Sanitary Association._—We regret -that the programme of this meeting, which was held in Columbus, O., Feb. -25-26, was not received in time for publication in our last number. A -number of practical papers were read, some of which we shall present to -our readers. - - * * * * * - -Drs. Scott, Ashmun and Herrick, of Cleveland, presented papers at the -meeting of the State Sanitary Association. - - * * * * * - -Dr. J. H. Gleeson of 87 Bond street met a sudden death on the evening of -February 22, at Gerling & Haber’s drug store, No. 283 St. Clair street. -It is reported that Mr. Haber handed him by mistake a couple of ounces -of a mixture of carbolic acid and glycerine, which the doctor swallowed -and expired in a few minutes. The inquest will bring out the facts. - - * * * * * - -Dr. Geo. F. Leick is in New York City, where he expects to remain -several months. - - * * * * * - -Dr. A. B. Carpenter, who has been abroad in the hospitals of London and -Berlin during the past year, has returned to Cleveland. - - * * * * * - -Dr. H. G. Sherman, owing to ill health, has gone south for the winter. - - - HOW DOES AMERICAN JOURNALISM AID THE DEVELOPMENT OF THE MEDICAL - PROFESSION? - -The New York _Medical Journal_ says that “it regards the great -distinctive service of American medical journalism as shown mainly in -its counteracting influence in removing the pedantry shown in the -medical colleges, and encouraging the expression of original thought in -young men.” Surely, it were a great thing to remove the stupidity -engendered by medical schools, and to draw forth the powers of original -thought which are dormant in the young doctor. Of the truth of this view -we have no question, nor can any editor of any experience or success -fail to have many personal experiences in this sort of work. In the very -best sense of that term, the medical editor is a teacher; and this, too, -in causing others to work for the common good. The education follows -from the efforts of the young doctor to learn something of profit or -interest to the profession, and then place this before the profession in -the most attractive shape. The medical editor, in order to make his -journal a success, is compelled to get the best work expressed in the -best way. Most of the older members of the profession have never learned -to write, and as they become burdened with the cares of a large -business, it becomes impossible for them to learn the art of writing. -Much they possess of positive value to the profession, but from the -defect of not being able to write with comfort, their knowledge dies -with them. The medical editor can get little help from them. There are a -considerable number of the members of the medical profession who could -not write a decent article, if they had any distinct ideas to put in it. -Obviously, the medical editor can do nothing with this class. But there -is another class of doctors, who have the general culture and the -brains, but are too modest to think of writing for the benefit of their -seniors. From this class the medical editor draws most of his working -colaborers. By encouragement, by personal solicitation, by aid in -matters of reference, by stimuli of ambition, of professional pride, by -appealing to the sense of his obligations to do for the general -profession that which lies in his power, many of this class are brought -into active service in medical journalism. Having encouraged to habit of -expression, the editor stimulates the habit of original research. Of -course, different individuals will be stimulated in different -directions. So, at last, the editor will have writers in every portion -of the field of the art and science of medical surgery. Hence, it comes -about that the editor sends men to work with the microscope, in the -chemical laboratory, in the pharmaceutical laboratory, in the -physiological laboratory, in the anatomical room, in the hospital, in -the dispensary, in the tomes of medical literature of every language and -of every age. In short, he has these men at work in every field -congenial to them, and such that they can reach it. - -In a very real sense, an editor is like a captain of a ship—he shows his -abilities not so much in what he does himself, as in what he can get -others to do. That there are not more really good medical journals, is -due to the fact that there are really few medical men having the power -of getting others to work in the fields leading to medical journalism. - -When a young doctor has begun to realize that he can talk to the entire -medical profession, life and study takes an entirely new aspect. The day -of small things is past, and the day of an enlarged and enlarging -manhood has come to him. One who does realize this truth will never -write a poor article for publication. The poor articles come from quite -a different sort of men. These the medical editor gradually weeds out. - -Of this direct and indirect influence upon the conduct of medical -colleges, and upon medical societies and medical publishers, writers of -medical books, and the relations of medical men, we have not time to -speak. But in all these things the medical journal is the means by which -the process of both good and bad education goes forward. Out of all -these educational processes the medical profession is slowly rising -higher in its development. - -To every young man who would make the most of his powers, we say: think, -observe, and write for the medical press constantly. It may be that one -article a year is all that any particular person can produce. It may be -that longer time will be required, but whether the time be long or -short, be sure to begin and keep up the habit of correct thinking, -constant study and correct and frequent writing.—_Detroit Lancet._ - ------------------------------------------------------------------------- - - - - - TRANSCRIBER'S NOTES - - - 1. Corrected yours to hours on p. 195. - 2. Corrected Aurelinsto Aurelius on p. 206. - 3. Silently corrected typographical errors. - 4. Retained anachronistic and non-standard spellings as printed. - 5. Enclosed italics font in _underscores_. - - - - - -End of the Project Gutenberg EBook of The Cleveland Medical Gazette, Vol. 1, -No. 5, March 1886, by A. R. Baker, S. W. Kelley, and Others - -*** END OF THIS PROJECT GUTENBERG EBOOK CLEVELAND MEDICAL GAZETTE *** - -***** This file should be named 53325-0.txt or 53325-0.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/5/3/3/2/53325/ - -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) - - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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