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C IN C IN N AT I, J. A. N. U A R Y 6, 1872. No. 1.
# iès. ſº "HITTA}<ER, M. D. tº Aº Aº Editor, S U R (G 1 cas. C E. H. N. H. C.
. .” - - No. 101 West Ninth Street, Cincinnati.
* * * + £º. OF &
º -
; : . . . . . Assºgra TE EDIroRs. . *: ; " ..
- **w. pºsós, M. B. THAD. A. REAMy, M. D. P R o F. W. W. D. A w so N.
P. S. Conser, M. D. C. D. PALMER, M. D. º: &
W. W. SEELY. M. B. SAMUEL NICKLEs, M. D. At the Good Samaritan Hospital.
CHAs. KEKRNs, M. D. JNo. LACLEvKLAND, M. D.
• Roberts BARºoijdºw, M. D.
w. w: săEEy, M. p., - - - - - - TREASUREE.
Irreducible Hernia. Stricture of the Urctiira—Frog-
No. 118 West Seventh Street, Cincinnati. tatic Stricture.
2 * .4 C LU B R A TES." * # * ~ *
& &ºm=== GENTLEMEN : tº .*.
This patient, Ulrich Schuck with this large serotal
3. 4 Copies to one address $ 7.00 * * * * *
* . ** &&. ... [hernia represent to you more as a matter of citriosity
* -º *2 £4. & 4 }.s o, and pathological interest, than for any surgical treat-
C O N T E N 7" S.
*===s* Page.
& Rºſtºl Ali, A.R.THC. I.ES
Surgical Clinic of Prof. W. W. Dawson, Irreducible Hernia, stric- Sº &º
3 tute ºf Urºtatic stricture. * E * * * * | tº . •º
Belladonna for Arrest ºf Mamalary Secretion by Thad A. § 2;
º /
* & º
x * Jºã --~~ § š § 2.
#ºsaury, M.D... 4. ñº i.
*śd Wººds ºthe Stomach by J. Q. A. Hudson, M.D........,54 § { %
* ...? ** 3. & 3. * i. ‘... ... …” * * -- *- $ $ %
ºngºsure ºrthering byw. W*Seely, M.D.....…................7 §
is ºf . * f #. Jº- ** { 3. §:
ºº: , ; & ‘. -* * $* isſ
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, -, * * >. skáš. <> - Sºſ ENTIFIC NOTEs º § §
- . *— --" " | " Nº
-Physiºlºgy ºf Virsºaºrècious Disease..... $8 §
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tion to 'Skada—Cholera—the Berlin Battle—English Animal * § # 3 #. º:
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—É -ºf ºn Eclipse— * ; :# 3 *% ;
-- ºr - ºngº Eclipse—The Title of Doctor..................8-9 à $. c
sº -—-* . #. 3r : º º
, sº : . CIFNiCA}, MIEMORANDA tº
** §,
3rºnic Injections of Morphia—Hernia Puncture—Morphia
... . . .
fº.
# t *:: * iº- #.
ºsºbiealſy in Erysipelas 9–12
*.*, * & S * * º
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...tro.ºadsrs of the clinic....
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*----- Isº *
Now is the time to subscribe for THE CLINrc. With
, sº 4. •ºr
the presenat number begins a new volume. As difficul- ==
s-º-º-º- . . . E
ties have been experienced in securing tack numbers ###
&
-
*
we advise thºs wº intend to subscribe to do so at once.
* * *** g &- **** iºt &
Every physician ought to take the CLIN1c, becauseTap ment. The time for surgical interference, if indeed
CITNIC is, in sh # tº º treatment by the knife is ever justifiable in such cases
is, in short, an exponent of modern medicine. *as long passed; we may, however, derive some useful
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2 - -
[JAN. 6, 1872.
T IHI IE C T , T IN I. C.
sº
lessons in the management of hernia. He is 64 years of
age. The tumor which you see extending from the
pubes to knees is a double scrotal hernia—reducible on
the right, irreducible on the left side. The left hernia
is of 27 years standing, and occurred while he was
engaged at some hard labor in a tan yard. The rup-
ture on the right side happºned 5 years later. The
great mass of this tumor is made by the protrusion on
the left side, and this is irreducible; the right hernia,
the reducible is not larger than the patient's fist. The
penis, by the weight of the tumor dragging the skin
from above downwards is entirely obscured. When he
wishes to urinate he reduces the right hernia, this,
pushing the skin upwards exposes the penis. The size
of the scrotum is immense—measuring 13 inches in
length and 27 inches in circumference. Dr. Gross re-
ports a case 12 inches in length and nearly 2 feet in cir-
cumference. Strange as it may seem this man, with
this fearful encumbrance, makes a living by peddling.
He suffers as do all persons with large irreducible herniae
from disorders of digestion, colicky pains and constipa-
tion of bowels. He finds most comfort in a fluid diet.
Why is this hermia irreducible 7 First, from adhesions
between the sac and its contents; second, from hyper-
trophy of the protruded viscera, this is peculiarly true
of the omentum ; third, from a contracted condition of
the peritoneal cavity. *
Could this have been prevented ? The answer to this
question suggests some points of vital interest to us in
the treatment of hernia in its early days. A scrotal
hernia which is at first reducible may at låst become
irreducible by neglect, by allowing it to remain without
the abdomen. The ring contracts without strangulating,
the protruded parts become inflamed, plastic matter
unites them to each other, and to the sac. The
lesson which I would impress upon you and which
you should impress on your patients is immediate and
permanent reduction and the early application of the
truss in these cases, by the judicious use of these
measures you may cure your patient, but if do not, you
will most assuredly save him from the fearful calamity
which has befallen this poor man. *
What can you do for a case of irreducible hernia before
it has attained great size? It is said that some cases,
even old ones have been cured by long confinement to
bed, low diet and free purgation; but you will find
few persons who will submit to this course, especially
when you cannot give them positive assurance of
relief. Is the knife justifiable 2 Under some cir-
cumstances I think it is. The following case will
illustrate my meaning. In 1864 David Turner
aged 15, entered the Commercial Hospital with an
irreducible scrotal hernia, complicated with hydro-
cele. The hernia was congenital, but had been
irreducible but for two months. The scrotum was
about six inches in length and three inches in diameter,
and was daily increasing. He was an intelligent lad
and was willing to take the hazard of an operation
hº-
rather than the encumbrance of what promised to be; * *
and that very soon, an immense serotal tumor. I
opened the sac found the hernia omental, returned it
after breaking up the adhesions, and in one month he
left the hospital entirely well. &
Stricture—Prostatic Stricture.
I present to you at this meeting two cases of stricture
of the urethra. They are both permanent strictures, you
all know well the classification of strictures, the spas-
modic and the permanent; the former is insignificant—
as simple as an ordinary cramp or muscular spasm, and
hardly deserves to be placed along with the latter which
is an impairment most painful to the patient and most
difficult to the surgeon. Indeed I know of no non-malig-
nant disease of more grave import than permanent
stricture.
What is stricture ? I think the definition of
Sir Charles Bellis a good and correct one, he looked upon
the urethra as a closed canal the sides of which fall
together except when called into use. Now in stricture,
this canal as he says has “lost its power of dilating.” Of
these permanent obstructions I propose to speak to-day.
What form do these obstructions assume? First you
have linear stricture, seldom seen, it is a mere membra-
nous screen stretched across the channel—thin, filmy,
easily broken down; the first introduction of a sound
usually dissipates it. Occasionally it takes the crescen-
tic shape and encroaches upon but one side of the
canal.
Second, what is called the “bridle stricture” some-
times presents itself. This kind of stricture seems
to me to be more often in the imagination of the surgeon
than in reality. It is described in your books
as consisting of a number of bands thrown across
the urethra, and most authorities as if to relieve
themselves, suggest that these bands are but the result
of “false passages” made by the injudiscious use of the
sound. For myself, I cannot say that I have found
them either as the result of disease or as following
a violent and reckless use of instruments.
Third, annular strictnre, this variety of urethral ob-
struction is a limited, a closely defined stricture, as if a
cord was thrown around the canal, contracting it and
diminishing its dilating ability. This obstruction is
rare, and when found is easily managed.
Fourth, the tortuous stricture. This is the leading,
the most difficult to manage and, unfortunately, the
most frequent form of obstruction of the urethra. The
plastic matter thrown out beneath the mucus mem-
brane (never upon it except in those questionable in-
stances of diphtheretic deposite) abridges the canal—first
here, then there, until the calliber and dilating
capacity of the tube is so encroached upon that “dilata-
tion” complete, satisfactory to the patient, is lost, and
the precess of micturition is accompanied with straining
and pain, the intensity of the pain and the violence of
*.
JAN. 6, 1872.]
the straining depending on the extent and unyielding
quality of the stricture.
In what part of the urethra are strictures most fre-
quently found? Sir Henry Thompson after examining
a large number of cases and specimens comes to the con-
clusion that the contraction is most commonly found in
the posterior part of the spongy portion of the urethra.
Liston, depending on measurement instead of the more
reliable guide, i. e., the anatomical relations of the
canal, contended that the most frequent seat of stricture
was about four inches from the meatus. The membra-
nous portion of the urethra—that between the bulb
and the apex of the prostate has been according to the ex-
perience of some most frequently affected. Sometimes the
whole canal is contracted—such an instance I will show
you to-day. Is the prostatic portion of the urethra ever
affected by stricture? Sir Henry Thompson says that
no specimen of prostatic stricture is to be found in the
museums of Paris, London or Edinburg; hence he ques-
tions its existence. Leroy D'Etiolles, however, affirms
its occurrence and refers to a specimen of it in his own
collection. Ricord believed also in stricture of the pros-
tatic urethra. Sir Henry in his learned work on stric-
tures says, “at present, therefore, the existence of pros-
tatic stricture appears to rest on the observations of
Leroy D'Etiolles and Ricord. Its excessive rarity to
say the least is at all events demonstrated.” I certainly
have seen two cases of prostatic stricture during the
past summer, and one of them I will present to you,
to-day. The first was a patient from a neighboring
state. An examination showed a stricture occupying
about one inch and a half of the posterior portion of the
Spongyurethra. The contraction was so great that a
No. 2 bougie was introduced with difficulty. The dila-
tation of this stricture developed the fact that the
membranous portion was largely expanded, and the
prostatic portion contracted. After long and repeated
efforts the prostatic stricture yielded.
The patient now before you consulted me last May
for a stricture in the posterior part of the Spongy por-
tion. I succeeded in dilating it until a No. 10 bougie
could be introduced with ease. He passed a fair stream
of water for some time, but gradually the stream began
to diminish in size, and micturition was attended with
pain and straining. He returned to the city and on
examination I found the obstruction in the prostatic
Portion. A No. 10 could still be introduced with ease
to the apex of the prostrate, but was there arrested.
With No. 3 I could enter but could not pass through
the prostatic urethra. In attempting to withdraw the
instrument it was held with great firmness by the stric-
ture. I could not have been mistaken in the seat of
the contraction for with my finger in the recºurm i could
feel the instrument in the canal surrounded by the
gland. After daily trials for a week I succeeded for the
first time this morning in passing the instrument through
the stricture into the bladder. By gradual dilatation
I expect te cure the stricture here involving the pros-
TIEI IET: C T , IIINTIC . - 3
tatic just as I did that situated in the spongy portion.
The next patient, Martin, whom I present you has
had stricture for ten years, and has two urinary fistulae.
He voids his water in great suffering, most of it finding
its way through the fistulae, but little passes by the
urethra. The meatus is contracted and I find it impos-
sible to introduce a No. 3 bougie. I now try No. 2 and
succeed in introducing it about two inches. No. 1 pass-
es as you see along the canal until I reach almost the
termination of the spongy portion of the urethra, at this
point this small instrument meets with obstruction, it
may be caught in a fold of the mucous membrane, I
withdraw it, and again, as I advance it, the obstruction
appears at the same point. I use as you observe the
slightest force in advancing the instrument. I cannot
impress too strongly upon you the importance of great
gentleness and delicacy in introducing an instrument
into the urethra under all circumstances and especially
when you have its capacity abridged and are using a small
bougie. But little force is required to thrust such an
instrument through the mucous membrane; the bad
results of such an accident are easily foretold. The
gravity of this case is apparent to you, the stricture
involves the whole of the urethra to the bulb and may
extend even beyond it. -
Whāt are the effects of stricture? You generally find
the canal behind the stricture dilated. The bladder is
usually contracted and its walls, the muscular portion,
thickened. A case is reported in which the vesical walls
looked as thick and strong as the walls of the left ven-
tricle of the heart. Sometimes these vesical muscles
under great straining give way at one or more points,
sacs and pockets form, the rupture of these cause urinary
infiltration and this is followed by consequences the
most disastrous. The kidneys and ureters suffer; in old
cases you are likely to have degeneration of the former
and dilatation of the latter. When a breach occurs in
the urethra behind the stricture, perineal abscesses form
and leave behind them perineal, urinary fistulae. This
has been the case in the patient before you. The rup-
ture of the urethra under constant straining allowed the
urine to pass into the cellular tissue, abscesses formed
and these, when opened, left adventitious urinal tracts.
If you could see the violent exertions of this poor man
when he is passing his water you would understand why
in such cases the whole detrusor urinae apparatus is en-
larged and strengthened for the purpose of forcing the
urine through the lessened canal. -
What is the treatment of stricture? Three methods
are resorted to, viz: gradual dilatation, forcible rup-
ture and urethrotomy.
It is said that any stricture which allows the escape
| of urine however small the quantity can be passed with
a bougie and that dilatation under such circumstances
complete and perfect, is practicable. This proposition
is generally, but not always true. You may have a
stricture that is so hard, so unyielding that it cannot be
overcome by gradual dilatation. Again, you may have
4 TIEEE THE C T , T N T C .
[JAN. 6, 1872.
a stricture which yields temporarily to the introduction
of sounds until a large size is admitted, and yet in
twenty-four or forty-eight hours of rest, the whole ad-
vantage gained is lost. Prof. Syme has reported such
cases. Under these circumstances you must either re-
sort to rupture or internal or external urethrotomy.
For rupture or forcible dilatation of stricture a variety
of instruments have been invented. The instrument
of Mr. Holt, which I show you has been received with
much favor and the best results have followed its use. It
consists of two plates joined together, having the shape
of a catheter. When the instrument has passed the
constricted point a staff is inserted between the plates
and forced down to and through the stricture. The
dilator which I now hold in my hand is of French man-
ufacture and is still more simple. There is a staff about
the size of a No. 3 bougie—this is introduced and upon
it slides an olive shaped body, this latter, wedge-like in
action, is forced through the stricture. Still more nu-
merous are the instruments invented for internal
urethrotomy. The best which I have seen is Maison-
neuve's, it is simple in construction and easy of manage-
ment. A No. 2 steel bougie is grooved on its concavity,
into this grove a staff is fitted carrying a blade with its
cutting edge in front. It is arranged so that the incision
may be from below upwards or from side to side,
Experience shows that there are certain forms of
stricture which cannot be overcome by gradual dilata-
tion, and it is in these intractable cases that rupture or
incisions are resorted to. Each surgeon has and is
wedded to a favorite plan. One always resorts to rup-
ture, another sees no virtue in breaking up a stricture
in this way and always resorts to internal urethrotomy,
whilst Syme, after doing most to enforce the axiom that
all strictures are permeable and all permeable strictures
can be dilated, arrived at the conclusion later in life
that there were certain forms of urethral obstruction
that could only be treated successfully by perineal sec-
tion or external urethrotomy. He gives two classes of
these cases. 1st. Cases in which the urethra is so irrit-
able that the introduction of an instrument instead of
alleviating, aggravates the suffering. 2d. Cases in
which dilatation is rendered useless by the contractile
tendency of the stricture. With all due defference to
the authority of this distinguished surgeon I think there
is another class of cases in which external incision is
still more appropriate. I refer to those cases in which
we have urinary fistulae. My patient, Martin, belongs
to this class. You may dilate his stricture, but the
fistulae remain; by external urethrotomy you relieve
the stricture, you open a new track for the urine, the
fistulae close. Prof. Syme lays down the rule that
permeability is an indispensable pre-requisite to the per-
formance of external division, and yet, in his earlier life,
on one occasion he introduced his grooved sound down
to a stricture which he could not pass, opened the
urethra in front of the contraction and then guided the
instrument through and cut upon it. This operation
has been repeatedly performed without the aid of the
grooved staff, and often the very best results have
followed.
I will be able with this patient in a few days to intro-
duce the instrument of Syme; upon this I will divide
the stricture, and whilst the urine is flowing through
the incision the adventitious urinary tracts will close.
In concluding my remarks on this subject I would
suggest the following rules for your guidance.
1st. Dilatation, for all uncomplicated strictures which
can be passed by a sound. -
2d. Internal Urethrotomy for all strictures complicated
with great irritability of the urethra or obstinate con-
tractile tendency—those cases in fact for which Syme
recommends perineal section.
3d. Eaternal Urethrotomy or Perimeal Section for all
strictures associated with urinary fistulae.
—-º-º-º-
BE LILAIDONN A IFOR AIRREST ©IF
MMANIMA RY SECRETHON.
BY
THAD. A. REAMY, M. D.
Mastitis is no trivial affair; and mammary abseess is
a calamity which every conscientious obstetrician will
spare no pains in averting from his parturient patients.
When the child is still-born, or dies soon after delivery,
or from any cause cannot be put to the mother's breast,
any means which will arrest the mammary secretion is
at once a desideratum.
Belladonna, if properly employed, generally proves
itself an agent competent to such a result.
The testimony of the profession, however, upon this
point, is quite conflicting. I need not stop to quote the
authorities pro, or con. They are well known to be
pretty equally divided, as to numbers and credibility.
Each founding his opinions upon clinical experience.
My own testimony is authorized by observation of 22
cases in private practice; running over a period of 15
years. In 20 cases Suceess was perfect. That is, no
amount of Secretion occurred which gave rise to any
trouble. In Several cases no milk was secreted at all.
In two cases the remedy seemed to exert no influence
whatever. The milk tubes being fully distended within
the usual time; in one of them intense inflammation su-
pervened followed by abscess. It is but fair to state,
however, that in this case the breast which suffered, had
endured a similar experience at a former period, and,
from the consequent changes of structure, had not re-
covered. In my judgment three important items enter
largely into the question of success or failure with the
remedy, viz: Time when employed; Preparation of the
drug; Manner of application.
1st, Time. The application should be commenced within
a few hours after delivery. Usually from forty to seventy
hours intervene between delivery and full establish-
JAN. 6, 1872.]
ment of milk secretion. During this entire time the
remedy should be applied, as it is far easier to arrest
the secretion in its incipiency than when under full
headway; to prevent the filling of the lacteal vessels,
than to dispose of their contents, and the coincident
pain and inflammation, after they are already filled.
The plausibility of this proposition seems to me
sufficiently manifest without argument. But is enforced
by the views, now most generally received, by those
who have faith in the antigalactic powers of belladonna,
as to its modus operandi. I refer to the explanation first
given by Mr. Richard Hughes. Succinctly put by
Stille as follows:
“Belladonna both excites the sympathetic nerve and
depresses the cerebro-spinal influence; wherefore its
application to the breast diminishes both its secreting
power and the supply of the material on which that
power is exercised.” The same doctrine is well
expressed in the following quotation which I make from
my friend, Dr. F. P. Anderson of this city.
“Belladonna being a powerful excitant of the un-
striped muscular fibre, it diminishes the afflux of blood
through contraction of the arterial and glandular tunics.
Hence it does not act as a direct astringent, but as a
stimulant neurotic and as indicated by counteracting
the inhibitory influence of the vagus, it addresses itself
to the sympathetic system. Its efficacy in constipation
may be attributed to such an agency. -
“In studying the effects of belladonna in iritis, we
observe two important facts: First, that its external
application may have a local effect only; when a weak
solution is applied about the eye or to the conjunctiva,
the drug expends its energy in the neighboring tract,
and the phenomena following are confined to the eye
treated. - -
“Secondly, that in dilating the pupil and diminishing
ocular tension—by relieving engorgement through exci-
tation of the vaSO-motors—it operates specifically on the
sympathetic nerves.
Thus, when the drug is applied to the mammary
region during the period of secretion, this localized and
peculiar influence controls the greater supply of blood
directed to the gland.”
Second, as to Preparation. An aqueous solution of
the alcoholic extract, say fifty grains to the ounce, is
preferable to either the fluid extract or an ointment
—for the simple reason that it is more readily absorbed.
Third, as to mode of Application. Let it be applied
with the open hand of the nurse over the entire
gland, or still better, let strips of muslin saturated with
the solution be applied and covered over with oil silk.
Let all friction be scrupulously avoided as tending pow-
erfully to excite secretion in the gland. -
Finally, and for the same reason, let the breasts not
be emptied of colostrum or of any milk which may have
been secreted. Keep pups, pumps and nurses mouths
away. No injunction, made will be more difficult to
enforce than this, nurses will insist that “a part of the
T E H C T.I.N.I. c.
5
milk at least must be abstracted. The breast. must dry
up by degrees,” and yet, who does not know that for
every drachm of milk drawn, six drachms will be
secreted as a consequence of the abstraction.
I may be excused for insisting with my professional
brethren who may wish'to give the remedy a fair trial ;
that if on the second or third day, as may often occur,
there should be some general fever accompanied with
more or less pain and fullness of the breasts, no alarm
need be suffered; do not be driven to abandon the treat-
ment, all those symptoms will subside in a few hours.
In this connection I am informed by my collegue, Prof.
Jas. T. Whittaker, who was for six months a pupil in
the Vienna Gen’l Hospital, that it is the uniform prac-
tice in that institution upon the intervention of the
first symptoms of inflammation in a mammary gland,
to wet nurse the child, and thus remove every source
of irritation. And he saw no cases of mammary abscess
in any ward of that immense charity. I am gratified
thus to have attested by the experience of extended
hospital practice, the truth of principles which I had
Settled upon as the result of personal observation in
private practice. I have spoken only of belladonna for
arrest of Secretion in cases where desired. In a future
article I shall give my experience with it, in the man-
agement of inflamed and painful breasts where lactation
was permitted to go on.
- — ——º-o-º-––. --
RUPTURE AND wounds or THE stomLACH.
BY
J. Q. A. HUDSON, M. D.
*msº
[Read before the Meigs and Mason Academy of Medicine, Dec. 21, '71.]
The almost total fatality of any injury of the stomach
with solution of continuity of its coats, is such that our
medical literature presents but a meagre record of cases
of this lesion. This arises not only from the fact of but
few recoveries having been known, but also from the
fact that death usually rapidly takes place; leaving no
items of interest in their history worthy of record.
There is, generally, simply the stomach lesion, shock,
and death in a short period, a few hours at the furthest.
Rupture of the stomach without external violence, is
extremely rare; while perforation from disease, though
rare, is comparatively more frequent. I find the two
following cases recorded of rupture without external
violence.
“Doctor d’Beauclair relates a case of a lying-in wo.
man, who died on the fifth day after delivery, with all
the usual symptoms of peritonitis. Thirty hours after
her decease, the body was opened, and a laceration was
found, four inches in length, in the lesser curvature of
the stomach. The edges of the laceration were highly
inflamed, and in a state of gangrene” (Atm. Med. Record,
April, 1828, p. 419).
6
[JAN. 6, 1872.
TIH. H. C. LINTI c.
“In April, 1828, a man aged thirty-four years, was
brought into St. Bartholomews Hospital, complaining of
severe pain in the abdomen. Ten hours afterwards, he
was seized with violent vomiting; the pain ceased;
the vomiting also ceased; he died in five hours more,
The posterior surface of the stomach was found lacerated,
to the extent of three inches; and the contents of the
stomach had escaped through the aperture; the mucous
membrane was reddened, there was no thickening, ulcera-
tion or any apparent disease of the stomach” (Taylor's
Med. Juris., 1861, p. 282). -
Rupture of the stomach from external violence is usu-
ally accompanied by lesions of other abdominal organs.
It is probably always fatal, the patient generally not
surviving the shock.
Mr. Poland relates three fatal cases of this injury. In
one, death took place in three hours; in five hours in
the second; and at the end of five days in the third;
quoted from Guy's Hospital Reports (see Rankin's Ab-
stract, July, 1858, p. 189). -
There are no positive symptoms determining the ex-
istence of this lesion, but it may be suspected, if the
force producing the injury was received upon the upper
part of the abdomen, and there is severe abdominal pain,
great shock, and vomiting of blood. Haematemesis is
thought to be an unmistakable symptom of rupture,
and it probably generally is, if occurring in connection
with the accident received, with the other accompanying
symptoms; yet, haematemesis sometimes occurred in
rupture or wound of the upper portion of the small in-
testines. Haematemesis might also be supposed to arise
from injury to the mucous coat without rupture, but I
find no cases to support such a supposition.
There would be a greater liability to the occurrence
of rupture, if the violence were received when the stom-
ach was full, as, after a meal, and the danger of effusion
would of course be greater, as effusion generally in this
condition arises. It is well known that effusion into
the cavity of the peritoneum, is the great source of
danger, in all injuries involving the continuity of struc-
ture of the abdominal organs. When it occurs, the
shock is intensified, and peritoneal inflammation is a cer-
tainty, if the patient rallies and reaction is established.
In rupture of the stomach the abdominal parietes are
usually intact, or at least the integument remains
whole, while in wounds of this organ the abdominal wall
is also involved. The fatality in wounds is probably
not so great as in rupture, yet in the former, recoveries
are rare. We find a few instances of recoveries from
wounds of the stomach, but I can find none, in which
all the symptoms were present that are believed to indi-
cate rupture. Cases of recoveries are found from exten-
sive wound of the stomach. The protrusion of this organ
through the wound in the abdominal wall, and the ef.
fusion of the gastric contents externally, may be consid-
ered favorable circumstances, when occurring at the
time of the injury.
The force required to produce rupture, without solution
of continuity in the parietes, must be great, producing
other internal injury and increasing the severity of the
shock; while in wounds the force is less and it is spent
chiefly upon the part directly wounded. ... •
If there be no protrusion of the stomach, the existence
of the external wound favors the escape of the gastric
contents externally, and, if the stomach and abdominal
wounds are by accident or otherwise maintained in
apposition until surgical aid is rendered the probability
of internal effusion is lessened. Effusion into the peri-
toneal cavity does, however, often occur.
Death in these cases may result suddenly from shock
at the moment of injury. These cases may be classed
with those in which death arises from blows on the epi-
gastrium of which Prof. Gross gives an instance (see
Sys, of Surg. 3d Ed., p. 598).
The following is a case of sudden death from a gun-
shot wound.
A policeman was shot by a pistol bullet in attempting
to arrest a robber “He almost instantly expired.” On
post-mortem the only injury found, is given. “There
was an aperture with blackened edges, of the size of a
shilling, an inch below the juncture of oesophagus with
the stomach on its posterior surface; and another cor-
responding aperture on the anterior surface of the
stomach, also at the cardiac end, but lower than the
aperture on the posterior surface. No important
blood Wºssel was wounded.” (See Am. Journ. Med. Sci.,
Cct., 1842, p. 487.)
The proportionate number of recoveries to deaths in
stomach wounds is very small.
The ratio as given by Percy referred to by Jno. Watson,
is undoubtedly too high. Watson says: “Injuries of
this sort are, unquestionably, among the severest and
most alarming; but their proportion of deaths to re-
coveries is perhaps fully estimated by Percy, who calcu-
lates that out of twenty cases only four recover.” (See
Am. Journ. Med. Sci., Oct., 1844, p. 326.) Hamilton,
(Mil. Surg., 1865, p. 358,) places the rate much lower,
and is probably nearer the truth. He says: “The
fatality of these accidents is even much greater than in
similar wounds of the intestines. Probably not one in
fifty recovers; perhaps not one in a hundred.”
All authors agree as to the great mortality; but in
the absence of statistics nothing definite as to the pro-
portion of recoveries to deaths can be known.
The rarity of the report of cases of wounds of the
stomach in military practice, is another proof of the
mortality; since it is probable that nearly all thus
wounded die on the battle field. I can find but one
case of recovery from wound of the stomach occurring
during the late war. There may be other cases reported,
since my material for reference is not extensive.
On post-mortem after wounds of the stomach, there is
usually found a greater or less amount of foreign matter
in the peritoneal cavity; such as blood, chyme, un-
digested food, etc.; the existence or not of peritonitis
depending upon the time of death in relation to such.
JAN. 6, 1872.]
TIEEE E CIT, IIST.I. C. 7
If death occur during the period of shock, but little in-
flammation will be found; if the period of reaction has
been some time passed, evidences of peritoneal inflam-
mation will be more marked. *
Notwithstanding the oft repeated statement that
there is no peritoneal cavity as such, and that by the
action of the muscles and atmospheric pressure, the
cavity can not exist strictly speaking, yet, the contents
of the stomach under certain circumstances (as well as
those of the intestines,) and the contents of the blood
vessels do get into the peritoneal cavity; the cavity
being filled as much after the effusion as before. The
abdominal contents are the same, there is simply a
change of position or relation. Although the equable
pressure of the abdominal parietes, keeping the viscera
in close apposition, is a favorable condition to prevent
effusion, yet is too often inefficient, as repeated post-
mortems in wounds of the stomach and intestines have
abundantly shown.
The probability is, that Gross is nearer the truth than
was Franro' or Jno. Belt, or B. Cooper, when he states
that in the majority of cases of wounds penetrating the
stomach or intestines there is effusion into the peritoneal
cavity.
The circumstances that favor absence of effusion are
as follows: º
1. The concurrent protrusion of the wounded pºrt at
the time the wound is received. The effusion is then
external, and the surgeon can command the wound to
prevent to a great extent, if not wholly, future effusion
into the cavity.
2. Apposition of the wound in the tube, with the
wound in the abdominal wall. If this apposition exists,
and is maintained, the contents of the tube escape inter-
nally if at all.
3. A quiescent state of the body and of the bowels im-
mediately after and following the injury.
4. An empty condition of the wounded part of the
tube at the time of the accident. The symptoms
denoting wound of the stomach are the same, (though ||
sometimes less in degree,) as those of rupture.
There are symptoms of shock shown by pallor, faint-
ness, weak and frequent pulse, excessive pain in the
abdomen, nausea and vomiting; and sometimes vomit-
ing of blood. Haematemesis is considered as diagnostic;
but it is often absent. The stomach may be wounded
at a point including one of its principal blood vessels, or
it may be wounded where no important blood vessel is
included. So that although this symptom is valuable
when present, with tolerable certainty denoting wound
of the stomach, its absence is of no value to show that it
is not wounded. Where the wound in the stomach
cannot certainly be known by inspection, the situation
and direction of the wound, the extent of penetration
of the instrument may aid in the diagnosis. Symptoms
of shock are not invariably present as in many of the
cases of necrosis where the stomach was known to be
wounded shock was slight or entirely absent. The same
remark applies to nausea and vomiting.
The symptoms indicating unfavorable prognosis are
excessive shock, especially if of long duration ; vomit-
ing of blood, especially if this should continue; as its
persistency will point to the wound of some important
blood vessel; a full state of the stomach when wounded,
as this condition favors effusion; and after the reaction
is established the supervention of peritonitis; especially
if it is supposed to be caused by, or connected with,
effusion into the peritoneal cavity. Before entering
upon the treatment of wounds of the stomach I will
present a summary of the cases of recovery so far as I
have been able to collect them from the literature at
my disposal. We may possibly be able to deduce some
conclusions from them in regard to treatment.
[To be continued.]
—sº-º-º-
A Case of Congenital Fissure of the Lids.
BY
W. W. SEELY, M. D. *
sº-sº
From the Transactions of the American Ophthalmological Society
of July, 1871, just published.
Freaks in embryological development are interesting
as curiosities, and instructive when studied in connec-
tion with the normal growth.
The case I have met with presented abnormalities in
both lids, and also in the ball.
Beginning at the outer angle and following the lower
lid toward the inner angle, we found the development
perfect for about three-fourths of the length of the nor-
mal lid. Then, by a pretty steep angle of declension,
the lid terminated with a channel, through which the
tears flowed upon the cheek. The remaining fourth of
the lid was found as a piece of skin, of an irregular, in-
verted V-shape, closely attached to the globe, extending
to near the sclero-corneal junction.
The upper lid extended, with perfect development,
to a point corresponding to the beginning of the defect
in the lower. Here there was a slight notch; then the
free margin was continued on to the inner angle, but
without cilicilia, or Meibomian glands, so far as I could
discover. There were, also, no cilicilia on the angle ofter-
mination in the lower lid, none upon the fold of skin
attached to the globe. Nor we terhere any Meibomian
glands in this attached portion, and no cartilage. There
was likewise no trace of the inferior canaliculus.
Dr. Wecker has given a description of a case of con-
genital fissure of the lid (see Arch. für Ophthal, und
Otol., vol. i.), and has referred to nine others. -
So far as I can discover, the case I have described is
peculiar in this, that there was a very large portion of
skin attached to the globe. This portion, however, did
not fill up the defect when the lids were closed, for a
space was still left between the lid proper and the ad-
herent portion. With the exception of this adhering
part, the eyeball was perfect.
T H E CITISTI c.
[JAN. 6, 1872.
I have seen one case of slight notching of the upper
lid, occurring in a child affected with a single harelip.
Also a dermoid tumor about the sclero-corneal junction,
without any coloboma of the lids.
The child whose case I have described had a suspicion
of defect in the upper lip, and also of the alveolar pro-
cess. The lip seemed to be thinned in front of each
nostril, the fact becoming quite apparent when the child
cried and the lip was stretched, -
According to Kölliker (see “Entwickelungs Geschichte
des Menschen und der Höheren Thiere”), we have the
sclerotic and cornea appearing in the latter part of the
second and first part of the third months. The eyelids
begin, as small folds of skin, about the first of the third
month; come into contact and unite in the fourth.
It would seem, according to the pointing of some of
these cases of defects, that, along with the formation of
the lids, there must also take place a histological trans-
formation of the skin covering the eyeball, into two
layers of mucous membrane; the one, the palpebral,
the other, the ocular conjunctiva,
Continuing our reasoning with this view, we are of
course forced to regard these colobomata as simply ar-
rests of histological transformation. -
As regards the operative interference, I would simply
add that the first step was to free the movements of the
ball, which of course were very much restricted by the
cuticular attachment. To accomplish this, I dissected
the attached portion loose, down to the level with the
cul-de-sac, and snipped it off. Then, by loosening the
conjunctiva a little, and making two incisions along the
cul-de-sac, on either side, it was readily brought together
over the denuded spot and held by two sutures.
Two weeks later, I prepared the parts, denuding them
up to the inner angle, also the lid, and, by making an
incision horizontal to its free margin, carried it forward
and fastened it. - - -
It fitted nicely, and remained three days, when the
mother brought the child in, saying she had torn the
parts loose. Subsequent attempts failed to keep them
together, -
—º-e—º-
scLENTIFIC NoTEs.
General Physiology of Virus and of
Infectious Diseases.
BY
M. CHEAUVEAU, Prof. Physiology at Lyons,
Conclusions of an exhaustive memoir presented during the Cours
Publics, from the Gazette Hebdom, Nov. 17, 1871,
We have now finished, gentlemen, this investigation
of the ultimate causes of infectious diseases. We may
recapitulate now in the determination of the necessary
distinctions in rendering our subject accurate and pre-
C159, * -
Among contagious diseases there is a large category
properly called parasitic, due to the presence of animals
or vegetables which multiply by direct alternate gen-
eration; maladies in which the animals or vegetables
act only by the local irritations and destructions which
they induce. In these maladies if the parasites be very
small or of nature but little aggressive or if they do not
attack organs of great importance, their presence may
be compatible with an almost perfect state of health.
When they exist in reverse conditions they may be
fatal. Examples: The trichina muscularis, the psoro-
sperm of the silk worm, the hepatic douve, etc. Properly
considered, these must be admitted in the category of
infectious diseases, - -
Another division of contagious affectious of parasitic
nature forms the class of septic or septicoid diseases,
which in the existing state of our knowledge are to be
considered as produced by the rapid multiplication in
the blood of organic ferments whose action is to induce
a kind of poisoning of the nutritive fluids in greater or
less degree according to the character of the poison, the
condition of the individual, etc. These affections may
complicate infectious diseases proper but should not be
confounded with them. * * *
Finally, a last class of contagious diseases comprises
the infectious diseases proper, our subject of study: dis-
eases whose symptoms do not correspond to those caused
by direct action of parasite ferments. * * *
In these diseases the entity of the contagium does not
reside in the fluid elements of the juices containing the
poisonous elements. This is absolutely determined.
The plasma or the serum in which the granular ele-
ments float is perfectly inert when deprived of these
granules. The granules alone are the exclusive agents
of infection.
In regard to the origin and development of these
agents we may say that the ultimate cause of the infec-
tion resident in these minute masses of protoplasm is
derived from the contact of germs themselves already
infectious and capable of inducing similar properties
in the bodies with which they come in contact,
—sº-9—sº--—
MEDICAL NEws.
SKoDA has just received another ovation in Vienna,
CHOLERA persists in Turkey. According to the
Vienna Medical Press Dec. 10, the victims of the past
week alone number 277. -
THE BERLIN BATTLE-From a recent letter we
learn that a doctor's quarrel of magnificent proportions
is now raging in Berlin. The signal for the fight was
the appointment of Frerichs as Lehenrt's successor to
the position of Director of the Science Deputation, a
body created in 1817. Profs. Langenbeck, Martin and
Virchow have interviewed the minister of instruction,
and highly explosive paper missiles have bsen discharged
on all sides, Virchow's open declaration that Frerichs
JAN. 6, 1872.]
TEEE CITINI c.
was not the proper person to fill such a position has |.
created a profound sensation. In comment upon this
statement the Vienna Medical Press remarks that
“Such an expression from Virchow could only depend
on facts, and these facts meet with confirmation when
we reflect that Frerichs has done nothing in science,
little or nothing in literature, for a very long time
indeed, notwithstanding his various positions and his
earlier labors. It is very well known that Frerichs has
never been dearly loved as consulting physician, but
there must be other reasons for this strong opposition
against him which will be disclosed, no doubt, with
time. ... • . . . . - *
PHYSIOLOGICAL LABORATORY FOR ANIMALS.—A hos-
pital is just opened in South London for the study of
the diseases of the domestic quadrupeds and birds. A
certain Mr. Brown of Dublin has endowed the hospital
with £30,000. Eccentric as this expenditure might
seem to be at first sight a moments reflection will re-
veal the great value of such an institution in the new
light it will cast upon the pathology of the diseases of
man with whom the lower animals have so many af.
fections in common. The direction of the hospital has
been entrusted to the distinguished Burdon Sanderson
of University College, and he has called to his assis-
tance Dr. Klein of Brücke's laboratory in Vienna.
DANGERS OF AN ECLIPSE,--The following edict was
actually published in 1699, by the Elector of Darmstadt,
in view of the approach of a total eclipse of the sun :
“His Highness having been informed that on Wed-
mesday morning next, at ten o'clock, a very dangerous
eclipse will take place, orders that on the day previous,
and a few days afterwards, all cattle be kept housed, and
to this end ample fodder be provided; the doors and win-
dows of the stalls to be carefully secured, the drinking
wells to be covered up, the cellars and garrets guarded,
so that the atmosphere may not obtain lodgment, and
thus produce infection, because such eclipses frequent-
ly occasion whooping cough, epilepsy, paralysis, fever,
and other diseases, against which every precation
should be observed.”—Scientific American. -
THE TITLE OF “DOCTOR,”—The title of “Doctor” was
invented in the twelfth century. Irnerius, a learned
professor of law at the University of Bologna, induced
the Emperor Lothaire II., whose chancellor he was, to
create the title, and he himself was the first recipient of
it. He was made doctor of laws by that University.
Subsequently the title was borrowed by the Faculty of
Theology, and first conferred by the University of Paris
on Peter. Lombard. William Gordenio was the first
person upon whom the title of Doctor of Medicine was
bestowed; he received it from the College of Asti, in
1329,-N. Y. Med. Gaz. ".
SMALL-Pox in BERLIN.—The present epidemic of
Small-Pox in Berlin has already reached enormous pro-
portions. Up to Dec. 10,9000 persons had been attacked,
CLINICAL MEMORANDA. .*.
1HYPopFRMIC INJECTION OF MORPHIA.—Mr. J. P.
Sleightholme gives(The Practitioner, July, 1871) the re-
sults of his experience with this mode of medication de-
rived from two thousand injections of morphia while
house physician to the Manchester Royal Infirmary.
He says that with one exception, he never saw any im-
mediate ill-effects from it, and only in one case, any great
evil result from its prolonged use. He seldom found it
necessary to increase the dose beyond one-fourth of a
grain. In conclusion; he says, “that when hypodermic
injections of morphia were used with intention of re-
lieving pain, they almost invariably succeeded in doing
So, no matter how severe the pain might be; that when
sleep was prevented by severe pain, the pain was re-
lieved and sleep generally followed; but that when sleep-
lessness depended upon or was accompanied by great ex-
citement or delirium—as in mania, delirum tremens,
acute chorea, &c.—the injections not only frequently
failed to produce sleep, but were often followed by in-
creased excitement and delirium.”—American Journ. of
the Medical Sciences. -
“Hernia puncture, a New and Easy Mode of Treat-
ing Straugulated Hernia. Purancture for Abdom-
imal Tympanites. Puncture of the Bladder for Re-
tention and Infiltration of Urine.”
The following discussion in the French Academy the
report of which we find in the Edinburgh Medical Journal
for December, 1871 is exceedingly interesting, and
peculiarly so to us from the fact that in our neighbor-
ing city, Louisville, three cases have been reported
wherein the “New and Easy Method” has been resorted
to, and with somewhat of success. These cases occurred
in the practice of Drs. David Cummings and Douglas
Morton, and have been reported in the Richmond and
Louisville Medical Journal, by Dr. Morton. (See that
journal for Sept. and Dec., 1871.)
“Case of Strangulated Hernia, in which the intestine was
punctured and air withdrawn, with remarks and discussion.
–M. Dolbeau reports the following case:—B., aet. 59,
entered hospital for the treatment of an aggravated con-
dition of disease of the heart. He also had a reducible
hernia. This, some days after admission, without any
Special reason, became painful, and the patient soon
showed all the classic symptoms of strangulated hernia,
and was sent to the surgical wards of M. Dolbeau. The
heart symptoms were by this time very urgent and
alarming. This hernia was as large as a turkey's egg,
in scrotum and in inguinal region, painful, hard, and
resonant to precussion.
10
[JAN. 6, 1872.
TEEE CI.I.INTI c.
“The patient seemed so weak that M. Dolbeau thought
it useless to operate, but next day (the fifth since any
facal evacuations had been obtained) the patient was a
little better, so that M. Dolbeau thought of trying
puncture and tapping of the intestines. Two punctures
were made by the smallest needle of M. Dieulafoy's in-
strument, the first obtained only some reddish fluid
mixed with fæces; the second also a quantity of fluid.
The tumor was diminished in size, and taxis succeeded
in reducing more than half of it into the abdomen; the
remaining half was not painful, and seemed omentum
only. Faradization of the abdominal muscles was then
used, and in four hours a stool was obtained, which was
soon followed by a second. The patient unluckily died
of his heart-disease in the evening. An examination of
the body showed that the hernia had been reduced, and
that the puncture of the intestine had not caused any
communication with the peritoneal cavity. The portion
of intestine was removed and inflated with air; not a
single bubble of air escaped, and the intestine remained
distended. -
“M. Boinet remarked that he had never performed the
operation of puncture for hernia, but had often done it in
abdominal tympanitis, even five or six times in one
month on the same individnal. He had never seen any
harm result from the punctures, which were quite inno-
cent if performed with a sufficiently fine needle. Air
and fluid can escape without causing effusion into the
peritoneum, as the little aperture is at once closed by
the contraction of the walls of the intestine.
“M. Lábbé thought M. Dolbeau's communication very
interesting. M. Dieulafoy's instrument was better
suited than any other needle or trocar. He had done
it in a case of peritonitis after ovariotomy, and there
was no peritoneal effusion. He had on another occasion
made a different use of the needle. A patient had re-
tention of urine, and an enormous infiltration of urine
in the perineum. The catheter could not be passed, but
by the syringe the water was completely drawn from
the bladder. After death the puncture was found to
leave no trace of its presence, nor to have caused any
escape of urine.
“M. Tarnier referred to a paper he had published, in
which he had recorded several cases of intestinal strangu-
lation treated by puncture of the intestine.
“M. Giraldes referred to a sealed packet which he had
some time before deposited with the president, in which
a series of observations on puncture of the intestine in
strangulated hernia were recorded. He had often done
it, both in children and adults.
“M. Blot had punctured the intestine with a flat
needle so long ago as 1855, in a case in which caesarian
section had been performed, and peritonitis with disten-
tion had occurred, and a lump of intestine had protruded.
This could not be returned from its size till punctured.
The patient died next day. Yet no trace whatever of
effusion into the peritoneum from the needle-wounds
could be found. It is possible to puncture the intestine
with a fine instrument without any danger of effusion
into the peritoneum. '. -
“M. Verneuil had never performed the operation, and
had some doubt of its efficacy on physiologico-pathologi-
cal grounds. The intestine in these cases is paralyzed
as well as strangulated, and the puncture would not
have any effect in remedying the paralysis. The sub-
ject gives an opportunity of mentioning a method of
the taxis in which compression of the neck of the sac is
added to the ordinary pressure on the hernial tumor
itself with great advantage.
“M. Trelat related two cases of hernia he had recently
operated on with success after eleven and fifteen days
of strangulation respectively. How to account for such
an unexpected result?. His opinion was, that in these
cases the patients had not really suffered from strangu-
lated hernia, but from hernia in which adhesions be-
tween the bowel and omentum had caused an arrest on
the course of the faeces. Gosselin, in his Lectures on
Hernia, describes adhesions, but thinks that they are
rarely causes of accidents, as they are almost always
soft, and merely the result of the peritonitis which
accompanies the strangulation. In my two cases the
intestine did not show the ring which generally is caused
by the neck of the sac, but had adhesions which caused
me to separate bowel from omentum by a careful and
delicate dissection. The adhesions bled when separated
in the first case so as to require perchloride of iron, and
the second to resist even that styptic, and to require the
use of the hot iron to several bleeding points.
“M. Lábbé thought M. Trelat’s cases most important,
and he agreed with him in his pathology. He had
operated with success in a female of 82, in Whom he
had to dissect many adhesions between intestine and
omentum, which bled so much as to require perchloride
of iron. He described another case in which symptoms
of strangulation had gone on to a fatal issue, with-
out the existence of real strangulation, but only the
presence of adhesion between bowel and omentum.
“M. Giraldes had lately seen a case of hernia in which
the intestine had been strangulated in a sac of omentum.
Had this been reduced en masse the patient would have
been unrelieved. This condition had been recognized
and well described by English surgeons.
“M. Liegeois described a case in which he had opened
a cavity from which gas with a faecal odor escaped, so
that every one thought it was intestine, and the edges
of it were stitched to the wound. The vomiting con-
tinued, no faces escaped, and a future operation showed
that the bowel had not been opened at all, but that it
was gangrenous from being tightly strangulated by the
cribriform fascia. -
“M. Despres mentioned a case of hernia in which Boyer
had opened skin, sac, omentum and bowel at once, they
being all thin and adherent. Without destroying the
adhesions or reducing the hernia he stitched up the
wound, and the patient got well. The accident which
M. Liegeois described had happened to many good
surgeons. Gazette des Hôpitaua, Nos. 73, 75.”
JAN. 6, 1872.]
TIEEE E CIT, I N T C.
11
Puncturing the walls for pneumatosis has been per-
formed so frequently of late and with such success that
it is now established as a legitimate measure. Fonssa-
groes has reported almost one hundred cases collected
from his own and from the experience of others. This
city furnishes several cases in which it has given great
relief. “Hernia puncture” as Dr. Morton calls the
operation for the relief of a strangulated bowel is hardly
yet upon its trial—but few cases have been treated by
this method. M. Tarnier it will be seen refers to a
paper of his in which are “recorded several cases of in-
testimal strangulation treated by puncture of the intes-
time” but he gives no data of the success of the treat-
ment. M. Giraldes is equally unsatisfactory in his
mere reference to his sealed package in which is recorded
his experience,
M. Huguier, however, has invented an instrument
to prevent the escape of gas and feces into the peritoneal
cavity, and with this instrument he has successfully
treated strangulated hernia. -
No notice is taken of this treatment in either of the
three fresh surgical works now on the table before us,
viz: Grant's Science and practice of Surgery, Spence's
Lectures on Surgery and Ashhurst's Principles and
Practice of Surgery; the first and the last bearing, re-
spectively, dates September, 1871 and November, 1871.
It would seem from the silence of these three works that
M. Tarnier's paper on “Hernia puncture,” has not had
a very extensive circulation.
The first case given by Dr. Morton was operated on
by Dr. David Cummings, in November, 1869. The
patient was a negro boy with a large strangulated
scrotal hernia. “The instrument employed by Dr.
Cummings was a hollow needle, made for applying
sutures in vesico-vaginal fistula. Immediately on in-
troducing this instrument, the gas which distended the
bowel, gushed out, relaxing the walls of the loop and
rendering reduction a matter of the utmost ease. The
patient was up on the next day, and suffered no bad re-
sults from the operation.” -
In the second case, (an old hernia that became strang-
ulated during a fit of coughing) Dr. Morton used “the
nozzle of a hypodermic syringe.” He drew off some
flatus, and with the syringe pumped out some fluid;
but could not succeed in reduction. During an hour's
absence (in which he was making arrangements for
herniotomy) spontaneous return of the bowel occurred.
Dr. Morton reports this case to show that no bad effects
follow the puncture of the bowel.
The third case we infer was successful. Dr. Morton
used a small trocar and canula, and had an erysipelartous
inflammation following the puncture, which he attrib-
uted to the escape of fluid into the subcutaneous cellular
tissue. To prevent this he advises a canula needle
tapering from heel to point. -
, Equally suggestive is the case reported by M. Lābbé,
in which he with the smallest needle of Diénlafoy's in:
strument relieved a dsstended bladder. After the death
of the patient no trace of the puncture was left.
sion, and pain of the inflamed skin.
MoRPHIA HYPODERMICALLY IN ERYSIPELAS.—In
the Deutsche Klinik, No. 39, is a paper from the pen of
Professor Estlander, of Helsingfors, upon “The Subcu-
taneous Injection of Morphia in Traumatic Erysipelas.”
He states that he employed this injection originally in
his clinical practice, in combination with the so-called
abortive treatment (chiefly by means of tincture of
iodine), mainly with the view of relieving the heat, ten-
It was soon found,
however, that the morphia must have exerted other ef-
fects also, so quickly was the course of the disease mit-
igated. It was therefore used in a series of cases as the
sole local remedy, and the conviction became establish-
ed that it must have exerted a direct influence on the
inflammatory process, diminishing its intensity and ar-
resting its progress. When the limits between the in-
flamed and healthy portions of the skin are not very
clearly defined, and the process manifests itself in the
form of large red spots gradually approaching each other
if we inject near the affected parts we usually find next
day that the erysipelas has not extended farther, or has
done so only to an insignificant extent. In cases in
which the limits of the reddened and swollen skin are
well marked, if we make some injections in its vicinity,
we may find that the inflammatory process, which
during the preceding twenty-four hours had made con-
siderable progress, is sometimes at once arrested, but
more frequently it continues in a diminished degree,
gradually yielding in the course of a few days to a con-
tinuation of the treatment.
In the worst cases of erysipelas ambulans, as in the se-
vere epidemic form, or where a peculiar disposition of
the individual prevails, the morphia exerts as little effect
as any other of the so-termed abortive remedies. In es-
timating how far the results depend upon the peculiar
nature of the erysipelas itself, and how much they are
ascribable to the injections, Professor Estlander has un-
dertaken many comparative trials, and he could relate
many cases in which, while a rapid improvement fol-
lowed the use of morphia, other cases treated at the
same time, either expectantly or by means of other rem-
edies, were much slower in their progress. Still, he is
too well aware of the capricious character of erysipe-
las to venture to deliver any categorical judgment upon
the subject. But a five-years' experience has convinced
him that these injections constitute a better mode of
treating erysipelas than many other means.
For the injections, two grains of the cholorate or
acetate of morphia are dissolved in a drachm of water;
and as Luer's syringe holds about a quarter of a drachm
of which a quarter or a half is injected, it follows that
the dose varies from one-eight to one-quarter of a grain.
As, so far from the erysipelas ever appearing at the
small puncture-wounds, these and their immediate vicin-
ity are always respected by it, the dose may be distribu-
ted over different º of the healthy skin, at a distance
of one or two inches from the limits of the inflamma-
tion. Usually the injection is made only once in twen-
ty-four hours.
12
[JAN. 6, 1872.
TH. H. cI, IISTI c.
Professor Estlander has no intention of proposing this
as an exclusive method of treating erysipelas, believing,
on the contrary, that one of its advantages is that it ad-
mits of the simultaneous use of other means. He has
tried, indeed, all the various other remedies which have
been recommended, and regards the tincture of iodine as
the best of these. As soon as from shivering and the
appearance of the wound erysipelas seems threatening,
he administers an emetic, a means which he believes is
nowadays too much neglected, and one which he be-
lieves conduces to moderation of the disease. The mor-
phia is next injected, either as the sole means or in con-
junction with a daily painting with iodine, employing
afterward wadding and compression by a roller where
practicable. Ipecacuanha with phosphoric or sulphuric
acid may afterwards be administered. The sesquichlor-
ide of iron, once regarded as a specific, is of no real
utility.—Times and Gaz., Dec., 9 '71. -
—- sº-º-º-
HoME NEws.
LECTURES were regularly resumed in the College on
Thursday morning last. The long pull on the home
stretch commences.
THE hospitality of the Good Samaritan was thoroughly
tested last week on the occasion of a visit to the institu-
tion by a large number of the most prominent eitizens
of our city. The entertainment is said to have been
the affair of the season.
DURING the past year 2,752 patients have been register-
ed and treated at the Dispensary of the Medical College
of Ohio.
THE most complete and elegant electrical apparatus
in the U. S. is now being fitted up in the Good Samar-
itan Hospital. Constant and Induced Currents,Galvano-
Cautery, all manner of machinery in the electric art is
ordered without regard to expense. The electric cham-
ber with all its appliances is a gift—the private munifi-
cence of a citizen of Cincinnati.
THE medical sensation of the week has been the
Lawler will case now being argued in our courts before
Judge Cox. The question concerns the validity of a
will made by Mr. Lawler in advanced life when the
contestants claim, degenerative changes were present in
marked degree, as evidenced by the post-mortem exami-
nation as well as by collateral testimony. The lawyers
on both sides refresh themselves after the severe labor
of the day with light reading on medical subjects, more
particularly with the latest novels on the anatomy,
physiology and pathology of the brain Any points of
general interest elicited will duly appear in The Clinic.
TO THE REALDERS OF ** THE cLIN1c.”
The termination of the first volune is a suitable occa-
sion to review our work for the past six months, and to
indicate our plans for the future. We think we may
claim for THE CLINIC that it differs from other medical
journals of the United States in its strictly practical
character. The original contributions which have
appeared in its pages have had the aim to afford some
definite information to our readers, and have been as
free as possible, we think, from that prominent defect of
journalistic literature, the publication of papers pre-
pared by their authors for the gratification merely of
the cacoethes scribendi. Whatever excellence the original
articles of the first volume may have possessed will
certainly be sustained by the contributions of the
future, some of which are promised us by the most dis-
tinguished writers of the country. In this original de-
partment it is proposed hereafter as heretofore, to dis-
cuss the questions of the hour. Our pages will always
be open to fair and candid criticism upon medical ques-
tions, but merely personal controversies will under no
circumstances be admitted. The department of selec-
tions will contain as heretofore the cream of foreign
literature. Our readers must have observed, me may
| remark in this connection, that THE CLINIC usually
anticipates all other journals of the United States in the
publication of the discoveries and improvements in
medical science. Hitherto our selections have been
made chiefly from German, French and English sources:
our facilities in this regard are now materially increased,
and hereafter the medical literature of the other
languages of Continental Enrope will be laid under
contribution. Our readers may depend upon it that
THE CLINIC will keep them en rapport with modern
medicine. As a large subscription list will enable us to
carry out these objects more perfectly we hope our
friends will interest themselves to increase the circulation
of THE CLINIC.
State Medical Society.
The following Special Committees are to report at the ensuing meeting
in Portsmouth, on the second Tuesday of June, 1872,
Uterine Therapeutics—H. J. Herrick, Cleveland;
Ovariotomy—A. Dunlap, Springfield; Eye and Ear Sur-
gery—W. W. Seely, Cincinnati; Vaccination—W. B.
Davis, Cincinnati; Nervous Transmission—S. S. Scoville;
Generation—J. T. Whittaker, Cincinnati; Puerperal
Convulsions—J. Pomerine, Cincinnati; Pathology of the
Blood—W. P. Thornton, Cincinnati; Therapeutics of
Mineral Springs—G. E. Walton, Cincinnati; Therapeu-
tics of Electricity—R. Bartholow, Cincinnati; New Rem-
edies—E. R. Lang, Portsmouth; Gynaecology—C. D.
Palmer, Cincinnati; Chronic Diseases of the Lungs—
Wm. Carson, Cincinnati; Hernia Cerebri—P. S. Conner,
Cincinnati; Obstetric Records—J. Helmick, Cleveland;
Castration—W. C. Hall, Fayetteville; Electrolysis—W.
H. Mussey, Cincinnati; Cholera Infantum—A. J. Miles,
Cincinnati; Amputations—T. H. Kearney, Cincinnati;
Belladonna—J. A. Little, Deleware, Ohio; Diseases of
the Larynac—R. Wirth, Cincinnati; Uterine Diseases—
E. B. Stevens, Cincinnati; Diseases of Skin—C. O.
Wright, Cincinnati; Surgical Diseases of Women—T. A.
Reamy, Cincinnati; Medical Chemistry—J. B. Hough,
Ridgeville; Puerperal Insanity—R. Gundry, Dayton ;
Prevailing Diseases throughout the State—J. R. Black,
Newark; Inflammations of the Chest—J. A. Murphy,
Cincinnati; Semiological Value of Yellow Elastic Tissue
in Sputum—A. T. Keyt, Cincinnati; Relation of the
Mental to Man's Physical Forces—A. B. Jones, Ports-
mouth ; Asylums for Epileptics—W. J. Conklin, Byron
Station, W. L. Peck, R. ºnary ; Pschycology—J. W.
Hadlock, Cincinnati,
DIVIDED MEDICINES,
The Divided Medicine Com’y,
CINCINNAT1, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEw AND ExCEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general. .
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE.
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities. ---
But not only SolubLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of Drvſped MEDICINES. “... .
& This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; : #. sh, io, and even lobo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. .
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For samples, Price Lists, and Agencies, address
The Divided Medicine Co.,
- IECX 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
: - - •. & * Walnut Hills, Cincinnati, O.
MR. FREDERICK KRAUs: - CINGINNATI, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: . w -
SULPH:MORPFIII........ % grain in each square ARSEN:ACID 1 &
ſº º::::...º.º.”--------------------- . * *A*. * * * * * * * * * * * * * * * * * * * * * * * * c e a e s a e e -20 te
- . + Čºrts ºf...ſº & © . & 4 qū - CALOMISL..............................}4 grain in each square.
COPPER........................ % § { • Zºº
y RESPECTFULLY You Bs,
E. S. WAYNE, Analytic Chemist.

F. E. SUIR 7, E. S. WAYNE
TT. THC. Suire & Co.,
WHOLESALE DRUGGIST's,
INAL A. INT TJ ET AL C T TU TER, I INT G-
£Hemists AND FHARM aceutists,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
sex.x:cºexex, ox{UGs ANYO Ivocoxc)(N)es,
cºrvo, CA), AºA)3A%us,
TEST5, MEDICAL, GLASS WARE, &c., &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
| “,
Made in accordance with the U. S. P. and other recognized authori-
ties.
E"INFC ANTD EAERIHC CEDEMICA LS,
Of the popular class of preparations known as
II, T, IIXIIIHR, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c.
AGENTS FOR BULLOCK & CRENSHAW'S
Sugar-coated Pills and Granules.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.
*N
tiºi
7
JAMEs Fosſºr, Jr., & co.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
game. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in.
struments. Those in want of any of the acknowledged good aids of
Yision to imperfect eyes, will always find the best and largest stock of
Lenses, Spectacles, and the best models procurable, with pains.
taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopic objects
and *rºcopº Apparatus, Magnifiers and Readers in
great variety. edical Batteries, Barometers, Thermo-
meters, Hygrometers, Urimometers and Rain Gauges,
of the most approved construction always on hand. All orders promptly
and accurately filled,
JAS. FOSTER, JR. deali
F. S. SHACKLEFORD, } *** * JAs. Foster, J.R. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TXIPR). S.INT-TM A-TE,SIET’S
-º-N
ºs--
No. 758 BRoadw AY, New York
I HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAYRE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M.D., Surgeon to the
Massachusetts General Hospital,
BEG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of 'Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Oure Truss Offices of S. N. MARSH & CO., No. 2 Vesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
OPPOSITE THE HIGH STEEPLE,




William Autenrieth,
No. 71 WEST sIXTH stre+ET,
Bºwiń walnut in WWE,
sº
CINCINNATI, OHIO,
MANUFACTURER OF AND DEALER IN
III, III III, III.
Abdominal Supporters, Trusses,
CLUB-FOOT SHOES,
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
Metalie and Rubber Syringes,
Stomach Pumps, Etc.,
stockINGs Fort waſticose veins.
Special attention given to the fitting of Apparatus for Deformities.
Bºy Agent for DR. L. A. BABCOCK'S
silver uterine Supporter,
-ALSO-
DR. AHL's POROUS FELT SPLINTs,
•-ALSO-
D A. Y. * S S L T, IN T S
-AND-
s. W. Elliott’s Saddle-bags!
Flºrial Instruments,
EXCETSXOR ELECTRO-MIAGENETIC MACEOINE5
AND
GALVANIC BATTERIESs
The Medical Profession is solicited to examine the valuable im-
provements in electrical Instruments, Patented February 18t, 1870,
manufactured by the GALVANO-FARADIC M'F'G CO. The recent re-
searches of European Scientists in Therapeutical Electricity have at-
tracted the attention of the most intelligent Physicians. Few can now
dispense with Electrical Machines, although formerly abandoned, ow-
ing to their inefficiency and inconvenience. These inconveniences are
now abviated. Our instruments meet all the requirements of advanced
science. They are the most elegant, powerful and cheapest ever offered.
Combined simplicity, range of effects, and facillity of use. Always ready,
require no preliminary preparation or assistance, no skill or experience
and will remain in operation an indefinite period. They produce the
primary and secondary currents—the former in unequalled force. By a
mere movement, either can be obtained without changing the Elec-
trodes. THE FORK is a peculiarity by which the rapidity of the
shocks can be increased or diminished at pleasure-a therapeutical ne-
cessity. On examination, other important improvements will be ap-
parent. There are
FOUR SIZES
of the Excelsior Electro-Magnetic or Faradic Machines: No. 1, small for
family use, $10; No. 2, medium, for ordinary use, $15; No. 3, large,
for professional purposes, $20; No. 4, Double Cell, of great power, $30;
There are three sizes of the Excelsior Galvanic Batteries: Eight Cells.
$20; Sixteen Cells, $36; Thirty-two Cells, $60. Surgical Batteries, for
Coutreization, of any size ordered.
© THE RHEon Egos, or cuRRENT GUIDE,
Patented February 1st, 1870, is an entirely new contribution to Science,
by which total interruption, alternate connection and interruption,
of inversion or the polarity of the current, is obtained by a
mere pressure of the finger. We also manufacture Carbon or
Gilt Steel Point Electrodes; Eye, Ear, Phrenic Nerve
Electrodes; Catheters for Urethra and Uterus;
Electric Scourges, Foot Plate, Tin or Carbon, Wires with or without
Trocars. for resolution of Tumors, Tongue Plates, Rubber
tubing, Battery fluid, &c. &c. Please call and ex-
amine, or send for Circular to
The Galvano-Faradic M'f'g Co.,
No. 167 East Thirty-fourth St., Cor. Third Av. New York,
OPINION OF PROF. DOREMUS.
College of the City of New York, cor. of Lexington Avenue and 23d
Street, New York, November 7, 1870.
J have carefully examined your new Electro-Magnetic Machine,
with its valuable and ingenious improvements. I consider the In-
8t?"ttºment the most complete, the most varied in its applications,
and most convenient I have ever seen.
R. O.G.D.E.W DOR EMU.S.
Late and Important Improvement.—Patent applied for. The Ex-
celsior Machine Rendered Portable.
Can now be carried around by city or sountry Physicians, charged and
ready for use, without the posibility of spilling the Battery Fluid.
ROBT CLARKE & Co.
~ PUBLISHERS,
|||}|{&\ſill;
Call the attention of the Medical Profession
to their Externsive Stock of
&nglish, 31ſtrican aud french
wrozcºz moors.
Paying particular attention to this branch of
their business, they are enabled to execute all
orders on the shortest notice, and at the most |
reasonable rates. Their facilities for the impor-
tation of FOREIGN BOOKS, THE PROCEED-
INGS OF SOCIETIES and HOSPITAL RE-
PORTS are unsurpassed, and any orders en-
trusted to their care will be filled promptly, and
at the lowest rates.
Subscriptions received for FOREIGN and
AMERICAN PERIODICALS.
All the New Publications received as soon
as issued. -
Letters of Inquiry will receive our prompt
and full attention.
Catalogues furnished gratis on application.
ROBERT CLARKE & Co.,
lºwhilºlº, mºulilº;
PRINTERS AND BLANK BOOK MANUFACTURERS,
2eaders in Zaze,_Medical, Zheological,
School, azed.2/?scellaneous Zooks,
G & TVVest
CINCINNATI, O.
Fourth street,
J. Taft. w. TAFT.
Editor Dental Register
J. & W. Taft,
TENTIST's
17 WEST FOURTH STREET, .
CINCIN NATI, O.
#:
Registers
§
ºxº
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,
arosTER’s,
Are furnished to Officers, and Soldiers on Government
account. • * -
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMEs A. FOsTER,
911 (Shestnut Street, Philadelphia, Pa. No. 60 West
Fourtin street. Cincimamati, Ohio, or 172 Jef-
ferson Avenue, Detroit, Mich.



HE C
LINI C.
PUBLISHED EVERY SATURDAY.
T E R MIS-$2.00 a. Year, Invariably in Advance. All Communic
ations relating to Publications must be addressed to the Editor :
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
Vol. 2. C IN C IN N A TI,
J A N U A R Y 13,
1872. No. 2.
*, **
**
*śs. T. whitra KER, M. D.
No. 101 West Ninth Street, Cincinnati.
- - - Editor.
...A-SSOCI-A-TIE EIDITOR.S.
W. W. D.Awson, M. D. ThAD. A. REAMy, M. D.
P. S. ConneR, M. D. C. D. PALMER, M. D.
*W. W. SEELY. M. D. SAMUEL NickLEs, M. D.
ºHAs. KEARNs, M. D. JNo. L. CLEVELAND, M. D.
• * Roberts BARTHollow, M. D.
M A F P& T VVAIN'S
- NIHEVV E O OIP3C
IS NOVV READY FOR CA NVASSEPS.
It contains over 600 pages of reading matter, with 250
engravings, designed crpressly for this work, by the best
artists in the country. A gents now at work upon it are
meeting with unparalleled success. Agents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re.
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 Elan Street, Cincinnati, O.
W. W. SEELY, M. D., - - - - - - Theasunes.
& No. 118 West Seventh Street, Cincinnati. .
C L U B R A T E S.
4 Copies to one address * * * * * * * * * * * $ 7.00
6 4 & 6& 10.00
12 & & & & 18.00
C O N T E N T S.
W ºssºmsº Page
The Clinic Lamp Bracket, by F. P. Anderson, M. D
tº e º $ tº e º 'º º tº g g g º 'º º tº º tº $ 1 tº ſº tº $ tº I3
Rupture and Wounds of the stomach by J. Q. A. Hudson, M. D........14
LECTURE &
Clinical, on Liver Cirrhosis by Prof. Duchek of Vienna, (From the
Vienna Med. Press, Dec. 3, 1871.).............................................. 17
screNTIFIC Notes
* Iron, the Coloring Matter of Nature—Extra-Uterine retation-
The Development of Myopia........... ....................................... 19-20
MEE}}|{CALL NEWS
The Liberal Professions—Medical Fees in Italy—A College for Si-
beria—On Embalming—Suicide by Morphia Hypodermically—
Death of Dubois--Oppolzer's Successor—Cholera—Strasburg
School—Small-Pox—University of Warsaw—Jewish Medicine—
Books and Pamphlets Received
CHAINHCA L. NIEMIORAN HDA
• * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Yºrgotin, Hypodermically in Haemoptysis—Bromide of Iron—Suc-
cessful Method of Treating Dysmemorrhea and Sterility—Com-
pressed Air in Hooping Cough—The Diseases of Alaska............ 22-24
HOAIF; NEWS .................. a * * * * * * * g e • - - - - - - - - - - - - - - - - * * * * * * * * 24
The spring Course of 1872.......................................... 24
oRrginAr; Artirer:Es: - - - -, };
§ºn
spesign:sº
º
Editor Dental Register
J. & W. TAFT,
TDTEINTTISTS
117 WEST FOURTH STREET,
CHN CIN N ATI, O.
wº a nº
Begisters
Now is the time to subscribe for THE CLINIC. The
new volume is just commencing. With this number is
forwarded the table of contents of volume first, hitherto
delayed in press. A glance over it will reveal the fact
that all the news, inventions and discoveries of the year
have been duly and fully recorded. Can you afford to
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,
be without THE CLINIC”





















cº, ITT, e-
- 28
Carriage Manufacturer,
NOS. 9 and 11 East Sixth Street, bet. Main & Sycamore.
I MARE NOTHING BUT
F/RS7 Czz SS. Wºo ºf A',
, Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of
LIGHT FAMILY CARRIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to -
PHYSE&HANS” {jSE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen's
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
Physicians in the city and neighborhood.









CAMIA Rao
MANUFACTURING COMPANY,
MANUFACTURERS AND IMPORTERS OF
AND
Window Shades,
37 West Fovazz Sragaz,
CINCINNXTI, O.
UNI) ERWEAR
GENTLEMEN.
Handling much larger quantities of fine and
valuable Underwear than any other firm in the
West, we are enabled to purchase at closer fig-
ures. We are therefore prepared to offer extra
inducements to consumers.
IHOSIEERY,
FULL LINES OF THE BEST ALWAYS ON HAND.
SHIRTS MADE TO ORDER.
WILSON BROS,
Pike's opera House, Cineinnati; 931 wabash Ave-
*e, and 88 West Washington street, Chicago,
|
E. De ALIBRO & BRO.
IMPORTERS AND MANUFACTURER8 OF
FOREIGN and DOMESTIC WOODS
In veneers, Boards and Plank,
|frºnt-Maº','!-Biſſani ºil-Biiſi'i.
The only house in the Western country that saws Spanish and Mexi-
can Cedar for Cigar-Box Makers We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 West Second Street,
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI,
colò RF cºe co-
Fashionable Hatters,
IMPORTERS AND MANUFACTURERS OF
#,ABERs' Fürs,
92 WEST FOTTERTEL ST.
Opposite Post Office,
CINCININ ATI.
*Special Inducements to Medical Men.
BASCOM & CARPENTER,
Stationers, Printers
-AND->
Blank Book Manufacturers,
13e VINE stre+SEr,
&\\\\\\\\\\\\e


Wm. Wilson McGrew,
wo, ºr rasr rovara scºrer.
PIKE's OPERA HOUSE BUILDING,
In porter and Dealer
. . —“I N.--— -
Diamond and Gold Jewelry,
Watches for Ladies and Gentlemen, .
Sterling Silver Tableware, -
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
Marble Statuary,
FAN cºr Coons,
G E N E R A LLY. .

O D O Fº I L E S S A. IN ID PA I, A. T A E L E •
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portland, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market. .
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
- . - tº:
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Itachitic Affections, in
Chronic Rheumalism, &c. -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent. -
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

F. E. SUIR F. E. S. WAYNE
F. E. Suire & Co.,
WHOLESALE DRUGGESTs,
IN/[ _AL INT TJ ET AL C T TJ TER, IT INT G-
£Hemists AN ID f'HARMACEutists,
CINCINNATI, OHIO,
Have constantly on hand a full assortment of
sye), EcºEYO YO33 UGS ANOO WXXºoxc)(N)es,
cxxxenxxcAx. AxºeAx}A^egs,
• TESTS, MEDICAL, GLASS WARE, &c., &o.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and . Proximate Principles of Plants,
Made in accordance with the U. S. P. and other recognized authori-
ties.
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An excellent Chalybeate and tonic, Wine of Iron, &c
AGENTS FOR BULLOCK & CRENSHAW'S
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º
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Special attention paid to orders for Fine Microscopic Objects
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S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
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&P) TRUSSES. &
No. 758 BROADWAY, NEw York
I HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LIEWIS A. SAY RE, M. D.
* - Surgeon, Bellevue Hospital.
Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital, *
BEG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the modi-
cal profession generally. WILLARD PARIKER, MI. D.
Professor of Surgery, New York City
From Prof. Willard
Dr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West l'ourth St.,
between Main and Walnut, Cincinnati. -
OPPOSITE THE HIGH STEEPLE,















JAN. 13, 1872.]
T H E C H., H. N. H. C. L. A M P B R A C K E T -
BY
F. P. ANDERSON, M. D.
Lecturer at the Good Samaritan Hospital,
The ordinary stands for the attachment of larynggo-
scopic apparatus have such limited movements, that
we are compelled to have our patients in a variety of
attitudes and in constrained positions before satisfactory
relations can be established with the mirror. Moreover,
they are utterly useless for the examination of other
than the buccal and aural cavities. -
Mr. W. H. Meredith, of this city, has designed and
constructed for me an admirable contrivance for employ-
ing the reflector whenever artificial light may be re-
quired,
To an upright stand, terminating in a globe, is at-
tached a shaft made in the form of a clamp, each end of
which is fitted with a socket; the lower one receiving
the ball of the stand, the upper containing a ball at the
extremity of a shorter shaft. This second shaft and
bulb are made of three pieces, held together at the outer
end by the collar of a clamp that steadies a vertical rod
for the lamp; they are hollow, and passing through is
a rod extending from the clamp of the lamp-supporter
into the bulb, where the base of a cone-shaped head
rests against a rubber ball, and the shoulder fits
against corresponding inclines in the shaft.
The rod to which the reflector is attached is swung
by a ball and socket, and the vertical position main-
THE CL.INI c.
13
tained by a weight below. When the long shaft or
clamp is brought together with the hand screw, the
rod in the second shaft is drawn back by the inclines
pressing on the conical head, and the frame is held in
any position desired. Thus, we have three universal
joints under the control of one clamp.
==
#º
*::::
*: -
4. Wº:
tº:
The Tobold reflector and mirror may be used not
only for the usual purposes, but also for the ex-
amination of the vagina, rectum, and with the endoscope
attached as in the second cut, the urethra and bladder.
As the light may be thrown at any angle, this ap-
paratus would prove Servicable in operations neces-
Sarily undertaken at night, and in surgery of the
uterus. - -
I prefer the light from good kerosine oil to Cincinnati
gas, but the student lamps can be replaced by an Ar-
gand burner easily. .
—=º-e-ºº--—
THE AGE OF PLANTS.—The following statement by
M. Tandon exhibit the age to which certain plants may
attain: Palm 200-300 years, Elm 355, Cypress 388 years,
Chestnut 626 years, Cedars 800 years, Nut Trees 900
years, Linden 1076 years, Fir 1200 years, Oak 1400 years,
Taxas 2880 years, the Mammoth of California(37 feet di-
ameter, 450 feet high) 5000 years, Dracana Draco 7000
years. The Nestor of these trees was measured by
Humboldt(74 ft. at the base)in 1799 on the island Ten-
eriffe. As is well known it fell in the storm of Jan. 2,
1868. The Wellington trees may attain to the age of
3000 years and over. *



14
[JAN. 13, 1872.
TIEEE IED CT I INTI C.
RU PTURE AND WOUNDS OF THE STOMACH.
BY
J. Q. A. HUDSON, M. D.
[Read before the Meigs and Mason Academy of Medicine, Dec. 21, ’71.]
Continued from No. 1.
CASE 1. A trooper attempting suicide shot himself
with a pistol, the ball passing through from the epigas-
trium, in front, and lodging in the loins, where it was
extracted. Fluids passed from the stomach through
the posterior opening. Symptoms of shock were slight.
Vomiting is not mentioned as being present. The an-
terior opening soon closed up, and in six weeks the man
recovered (see Am. Journ. Med. Sci., Aug., 1830, p. 528).
CASE 2. This is the case of Alexis St. Marton, so well
known throughout the world. I will give the descrip-
tion of the accident in the words of Joseph Lovell, M.D.,
who attended the case.
“The charge, consisting of powder and duck shot, was
received in his left side, at a distance of not more than
a yard from the muzzle of the piece. It entered pos-
teriorly and in an oblique direction forward and inward;
carrying away the integuments and muscles to the size
of a man's hand; fracturing and entirely blowing off
the anterior half of the sixth rib; fracturing the fifth;
lacerating the lower portion of the left lung and
diaphragm and perforating the stomach.
“I saw him in 25 or 30 minutes after the accident,
and, on examination, found a portion of the lung as
large as a turkey's egg protruding through the external
wound, lacerated and burnt, and immediately below
this another protrusion, which, on further inspection,
proved to be the stomach, lacerated through all its
coats, and pouring out the food he had taken at break-
fast through an orifice large enough to admit my fore
finger.” Without quoting the narrator further, all that
it is necessary to add is, that, by appropriate treatment,
and after a tedious separation of pieces of broken ribs
and of cartilages and extensive sloughings of the soft
parts, in one year from the date of the accident the man
recovered with an external opening communicating with
the stomach, which Dr. Lovell describes as follows:—
“The perforation was about the size of a shilling, with
its edges firmly attached to the pleura and intercostal
muscles, and the food and drinks continually exuded
unless prevented by plug, compress and bandage.”
In this case there were no symptoms of shock, no
nausea or vomiting, and no blood passed out of the ori-
fice in the stomach.
A few months subsequent to his recovery a valve
gradually formed by protrusion of the coats of the stom
ach, that prevented the egress of the contents, but which
ç »uld easily be pushed inwards (see Am. Med. Recorder,
Jan., 1825, p. 14 and Beaumont's Eageriments, 1833,
p. 17).
CASE 3. By Benjamin Travers. A woman aged 53,
in a fit of despondency, attempted suicide after the
Chinese style. Wound transverse, below the umbilicus,
three inches long. Part of large curvature of the stom-
ach, the arch of the colon, and the entire large omentum
protruded and strangulated in the wound. Omentum
was found partially detached from the stomach, and on
the stomach a peritoneal graze half an inch in length,
and at another point a perforation of all the coats, ad-
mitting the head of a large probe. Pulse 102 and irreg-
ular, very faint and exhausted, disposition to hiccough.
The perforation in the stomach was encircled by a fine
silk ligature, the ends cut off close, and all the parts
returned into the abdomen. The external wound was
closed with the quill suture. Antiphlogistic treatment
pursued as needed and the woman was well in two
months (see Med. Chir. Review, April, 1826, p. 547).
CASE 4. The following case exibits a parade of ig-
norant rashness on the part of the surgeon, and the pow-
er of nature over his misguided practice, aſid the acci-
dent, that seemed combined to thrwart her efforts. The
patient was an Indiah. The surgeon was called six
days after the Indian was stabbed; during which time
the Indian had walked thirty miles. “There was a wound
four inches long, a little below and to the left of the
Scrobiculus cordis. Protruding from the wound there
presented a tumor, which, upon first view, I thought to
be a portion of the bowels, but upon further inspection,
I discovered that it was most probably omentum.” As
there was some evidence of sphacelus a ligature was ap-
plied to the whole of the protruded mass. This brought
on incessant vomiting, small rapid pulse, cold and
clammy skin, indicating the necessity of removing the
ligature. These symptoms should have intimated cau-
tion on the part of the surgeon, but timidity and caution
were not his forte. Since the ligature would not succeed,
he imagined that the knife would. He says, “I carefully
separated the already dead parts of the tumor from that
which was not in a state of gangrene. In doing so, I
had to remove a portion of the stomach. The stomach
was secured by ligature, and confined within the lips of
the external wound. The wound was stitched and
dressed with adhesion plaster.” Symptoms of shock
followed, from which he rallied, and in twenty-two days
the Indian was well, there being a “firm adhesion of the
stomach along the lips of the external wound” (see Am.
Journ. of Med. Sci., May, 1839, p. 261).
CASE 5. A negro escaping from servitude, gave a back
lick with a large knife while running and struck his
pursuer, wounding him in the stomach. “The wound
was about two inches below the ensiform cartilage and
nearly three inches long externally. The stomach was
opened by a wound more than two inches long. The
dinner which the man had just taken before the accident'
consisting of bacon, cabbage and cider, was partly dis-
charged through the cut, and part of it escaped into the
iº-
JAN. 13, 1872.]
T TH. H. cf.INTI c.
15
peritoneal cavity.” The external wound was sown up
by an old Soldier, but the stitches were removed by the
physician (Dr. Archer) on his first visit, two days after
the accident. An abscess in right groin was opened
during the subsequent treatment which discharged
cabbage, etc. No statement given in regard to symp-
toms of shock nor as to haematemisis. The man recover-
ed, time required not given (see Am. Journ. Med. Sci.,
Oct., 1844, p. 327). -
CASE 6. A Prussian peasant, endeavored to excite
vomiting by pushing a knife down his throat, which he
accidentally swallowed. . The account does not say
whether the knife was open or shut. The knife was
afterwards removed by Daniel Schroaben, by an incision
to the left of the epigastrum. External opening two
inches in length, dimensions of the wound in the stom-
ach not stated, but it was probably small. The knife
extracted was found to be nearly two inches long. No
sutures were made in the stomach. The internal wound
was closed by five pig sutures. “No serious symptoms
ensued, and the patient soon got well” (see Am. Journ.
of Med. Sci., Oct., 1844, p. 330). -
CASE 7. A Prussian woman, swallowed a knife seven
inches long which she was using to excite vomiting.
Eleven days afterwards the knife was removed by gar-
trotomy by a Dr. Hubner. “He found that the blade
had already pierced through the stomach and had ex-
cited slight suppuration around it.” No serious symp-
toms are mentioned as having occurred, and no mention
is made of sutures. “Her recovery was prompt” (see
Am. Journ, of Med. Sci., Oct., 1844, pp. 330, 331).
CASE 8. “A young fellow of Sprague, out of mere
sport,” says Crollius, “swallowed a knife nine inches
long, the point of which presented a little above the
fundus of the stomach towards the left side, and the
handle towards the spine. Two months afterwards it
was successfully extracted from the stomach by Florian
Mathis, first surgeon to the emperor.” No mention i
made of any bad symptoms occurring; of shock or hem-
orrhage, nor is any mention made of the use of sutures.
(see Am. Journ. of Med. Sci., Oct., 1844, p. 330).
CASE 9. A negro boy, six years of age, fell on a pair
of sharp shears making a flap-like wound in the integu-
ment near the left hypochondrium, through which the
stomach protruded, exhibiting a wound in it three-fourths
of an inch in length, which was discharging the contents
of the stomach. The stomach was treated at the
wounded part with a single stitch of fine silk. “The
wound of the stomach was brought exactly opposite the
integumentary wound and gently retained within its
verge. A single stitch, patent lint with cold water and
a bandage completed the dressing.”
The only bad symptom mentioned is nausea and vom-
iting while handling and returning the protruded stom-
ach. Haematemesis is not mentioned. The boy recov-
ered; time not stated (see Am. Journ, of Med. Sci., Jan.,
1852, p. 285). *
A case of wound of the stomach with recovery is re-
haematermisis.
attended to, that he felt well.
ported in Am. Journ. of Med. Sci. for July, 1855, p. 273,
but the symptoms detailed do not satisfy my mind that
the stomach was wounded, consequently I shall not
quote it. -
CASE 10. G. H. Bowers, Private, 8th Ills. Cavalry
wounded near Frederic, M. D., Sept. 13, 1862, “by a
musket ball, which entered two inches above the um-
bilicus, an inch to the left of the lienea alba, and made
its exit beneath the tenth rib, three inches to the left of
the spinous process of the tenth dorsal vertebraf. Im-
mediately after he was shot he vomited blood copiously
until syncope supervened. Haematemisis recurred fre-
quently for seven days, and blood passed at stool. Acute
peritonitis ensued. Liquid taken into the stomach
passed freely through the anterior wound.” In eight
months the parts were restored to their natural function,
but the body was bent forward by intra-abdominal ad-
hesions (Circular No. 6 S. G. O., Nov. 1, 1865, p. 25).
CASE 11. Giovanni Nieto was wounded with a knife
in the epigastrum accidentally. The wound was a little
over an inch in extent in the parietes of the abdomen,
being a little to the right of the linea alba between the
umbilicus and ensiform cartilage; through which had
passed a portion of a meal he had partaken of about two
hours before the accident. A portion of the omentum
of about four fingers breadth protruded. The omentum
having been cleansed and returned, the parietal wound
was closed by the twisted suture, over which a compress
was applied. There were no symptoms of shock and no
“He declared after his wound had been
On the fifty-fifth day
Nieto was completely well” (see Am. Journ. of Med. Sci.
July, 1871, p. 272).
CASE 12. The following statement of this case is all
that I have access to relating to it. It is from Ham-
ilton’s Mil. Surg., 1865, p. 361. Hamilton refers to the
Am. Med. Times, April 4, 1863, for a full account of it.
Hamilton says, “Dr. Peters relates in the same paper a
case of punctured wound of the stomach, which came
under his notice in New Mexico; the wound having
been inflicted with a cheese knife. In this case, the
man recovered in a short time without surgical inter-
ference.”
In this list of cases we have three of gunshot wounds
and nine of wounds by cutting instruments, of which,
in three cases the wound in the stomach was made by
the surgeon for the extraction of foreign bodies. No
sutures to the stomach were used in the gunshot wounds.
Of the nine cases of wounds by cutting instruments
sutures are stated to have been used in three cases. In
one case of cxtraction of foreign body it is stated that
no suture was used for the gastric wound. No mention
is made of suture to the stomach in the other two cases
of extraction of foreign bodies, and it is probable that
none were used. In three cases of, incised wounds
sutures were used. In one a single stitch; in another a
small perforation was enclosed by a ligature; and in the
third a ligature applied to the opening made by carelessly
&:
16
[JAN. 18, 1872.
TIEEE CI.INI c.
cutting a part of the stomach away when removing
gangrenous omentum.
As regards the use of sutures applied to incised wounds
of the stomach, there is little doubt of their necessity
and usefulness in certain cases. We have, however,
but very little instruction in our text books upon this
point; indeed many of them make no mention of incised
stomach wounds whatever. -
Hamilton, in his Military Surgery 2865, makes no
reference to incised wounds or their treatment, except
by inference in his remarks on the case already quoted.
Erichsen, in the last edition of his Surgery, does not
refer to incised wounds of the stomach. The following
writers are wholly silent on this subject: S. Cooper,
The Prac. of Surg., 1846; B. Cooper, First Lines, 1885;
John Hunter, Principles of Surg., Am. Ed., 1839;
Malgaigne, Oper. Surg., Am. Ed. 1851; Wm. Ferguson,
Prac. Surg., 1853. There is no allusion to either rup-
ture or wounds of the stomach, in Braithwaite from the
commencement to the present time. Dorsey, in his
Elements of Surgery, V. I. p. 104, says, “When a
wound can be seen, a number of Stitches proportioned
to its extent must be used, the ligature cut off close, and
the parts returned.” Collis says, (Lectures on Surgery,
Am. Ed., 1845, p. 133,) “All you can do is, in wounds
of the stomach, to keep the patient on the smallest
quantity possible of food; and make him observe the
utmost quiet.” Gross, (System of Surgery, 2nd Ed.,
v. II. p. 597,) says, “Wounds of the stomach must be
closed by suture, and afterwards managed with especial
reference to the prevention of undue inflammation.”
A little further on he says, “Where gastroraphy has
been neglected, or rendered impracticable, etc., but he
does not give the conditions which render it imprac-
ticable.
In the Medico Chirurgical—Review, July, 1847, is a
review of G. J. Guthrie's work “On Wounds and In-
juries of the Abdomen and Pelvis.” On page 90 the
reviewer gives in his own (the reviewer's) words Mr.
G.'s method of treating wounds of the stomach.
“If the wound is small, it must be treated by the
continuous suture, first that of the intestines; and if
the external aperture through which its contents are
effused is too small to admit of the wound in the organ
being sewn up, it should be enlarged. This is, however,
only a suggestion for the prevention of certain death;
Mr. Guthrie never having put it into force yet”
Druitt, (Surgery, 1860, p. 463) mentions only the
treatment of wounds of the stomach in connection with
protrusion, and directs that the wound be sewn up and
the parts returned.
These meagre statements by surgeons who make any
reference to the treatment of wounds of the stomach,
and the silence of the majority of writers, are but the
necessary result of want of experience and observation
by reason of the great fatality of these accidents.
y Death supervenes too rapidly to apply any treat-
ment. The following rules in regard to the treatment
sº
of incised wounds of the stomach, are offered as probably
a fair representation of the treatment according to the
barren authority we can find.
1st. When the wounded part is protruded, or if it is
easily accessible through the parietal wound, it should
be treated with suture according to its extent. For a
puncture or a perforating wound, its simple inclosure
with a small ligature on the external surface is all that
is required, if it is thought necessary to apply any
suture. These small wounds (if 3 of an inch or less)
will probably do well without suture or ligature if the
stomach is and be kept empty. If the cut is of larger
extent, the interrupted suture, or Gelys suture, or
Lemberts suture, is probably preferable to the continued
Suture.
If it is known that the stomach is full, or partially so,
more care should be used to secure an even coaptation
of the edges of the wound, and the stitches should be
nearer each other, not more than 1-6 of an inch apart.
Some surgeons in wounds of great extent are partial to
the continued suture as it is supposed to secure a more
perfect adaptation of the parts, and is more easily applied.
The kind of suture employed, is, perhaps not so import-
ant as the skillful application of it, Securing a nice
coaptation of the serous surfaces.
2nd. After the application of the suture, if practicable,
the stomach wound should be kept within the lips of the
parietal wound, or near to it since if effusion occurs there
may be opportunity for external egress, and since the
inflammatory action in the parts favor adhesion and
consequent prevention of effusion.
3rd. The wound in a protruded stomach might be in
such a part of it that apposition of the parietal wound
with the former could not be maintained after
a return of the parts. In such cases the surgeon is com-
pelled after sewing up the wound to return the protru-
sion and trust to nature.
4th. When we apprehend from the attending symp-
toms that the stomach is wounded, but from the small-
ness of the wound, we cannot apply the suture, and if
there be no evidences of effusion into the peritoneal
cavity, the case is to be treated by other means to be
given further on, and no attempt is to be made by enlarg-
ing the external wound to Secure by suture the wound in
the stomach. •
5th. In all cases where the stomach wound cannot be
reached and no effusion eacists, the external wound should
be closed by suture and adhesive strips, compresses and
bandages applied to aid in Securing as far may be an
immobility of the parts.
6th. In cases where there is an effusion in the neigh-
borhood of the wound the external wound if it has been
closed should be opened, and by position and moderate
compression an attempt be made to cause an escape
externally of the foreign matters. Should this fail, the
external opening should be enlarged, and the matters
allowed to escape, and if after enlarging the external
wound and allowing the escape of the effusion the stom-
JAN, 18, 1872.]
ach wound can be reached, it should be secured by
Suture.
7th. What is to be done in cases of effusion into the gen-
eral peritoneal cavity? These cases must be rare, since
with the stomach wound and the effusion, death will
usually soon follow ; but that such cases may occur
and recover, case 5 treated by Dr. Archer proves.
Many, probably most surgeons would abandon these
cases to nature and to certain death ; yet would it not
be preferable for the surgeon to follow G. J. Guthrie's
plan before referred to, viz., to enlarge the external
wound and secure if possible the wound in the stomach
by suture, and then aid in the removal of the effusion
by injecting a weak, tepid solution of chloride of sodium
into the peritoneal cavity, as was successfully done by
Peaslee in a case of double ovariotomy? (See Am.
Journ. of Med. Sci., July, 1864, p. 48.)
It is undoubtedly true that there is a difference in
this membrane (the peritoneum) in different individuals
as to its sensitiveness to morbid impressions, from the con-
tact of foreign bodies; and when the system does not
yield rapidly to the malign influences of the effusion it
would appear proper that the surgeon should aid nature
by removing the existing effusion and prevent its con-
tinuance by securing the wound in the stomach. This
plan of treatment is merely presented as a plausible one
and seems to the writer to be the only reasonable
course to pursue. t
It may be urged against this plan that the evidences
of effusion into the peritoneal cavity are sometimes un-
certain. True, yet in cases when the Surgeon can
make a positive diagnosis, must he abandon the only
probable means of hope 2
The general treatment of wounds of the stomach may
be stated in brief, to be ; absolute rest of body, in a posi-
tion to fully relax the abdominal muscles, absolute ab-
stinence from food for several days; using nutritive in-
jections if withholding food by the stomach is long re-
quired, as was done in the case of H. Martin. The use
of ice or ice-cold applications to the parietal wound, the
very limited allowance of ice or ice water to allay
thirst. Opium to allay pain and inflammation, con-
joined with liberal, general, and especially local blood-
letting as circumstances demand. Enemas may be used
to secure alvine evacuations if necessary. When food
is resumed by the mouth, it should be given in a com-
Centrated liquid form, and in Small quantities, such as
beef essence, milk, etc., etc.
—sº-o-º--
TIT FOR TAT—The following between General Syester
and Dr. Warren from the Wharton trial now in progress
at Annapolis;
While this subject was under discussion, Attorney
Seneral Syester remarked to witness: “A doctor ought
to be able to give an opinion of a disease withont making
mistakes!”
Witness—They are as capable as lawyers.
Attorney General—Doctor's mistakes are buried six
feet inder ground. A lawyer's are not.
Witness—But they are sometimes hung on a tree.
T IEC IH C T , IIST I C -
17
IL H W E R C H R R H 49 S H S .
A CIinical Łecture by Prof.; Duichek, Vienna.
[From the Wiener Med. Presse, Dec. 3, 1871.]
We learn from his history that our patient has been
in the habit of imbibing freely of beer. For some time
he has been ill, or better said perhaps, has felt that he
has become weak and feebler. For the past six or
seven weeks there has been vomiting every morning
after coughing and retching in the throat, vomiting
besides of mucus, of a fluid of sour taste. Associate
with this anorexia occurred and gastric symptoms of
other nature, and then SWelling of the lower abdomen,
swelling which is significant, and which shall closer en-
gage us. The first glance at our patient teaches us that
we have to deal with a malady which extends its im-
press over the whole body, and that we shall find changes
in the abdomen which have exercised a slowly ad-
vancing influence upon nutrition and the general health.
Our patient shows marked bony development but the
subcutaneous tissue is poor in fat, the skin is lax, flabby
and paler than matural; the back of the hand is very
pale; only on the uncovered surfaces is the healthy
tinge apparent. There is no oadema of the lower ex-
tremities. He can walk, there are no cephalic symp-
toms. His tongue is somewhat, yet not markedly,
coated white; neck and chest show the usual relations.
The left nipple is somewhat higher than the right, an
evidence that the right chest is narrower than the left.
The thoracic arch is rather prominent. This may not
be regarded, however, as the result of the abdominal
swelling, for the abdomen is soft and yielding, and in no
case does enlargement or dilatation of the lower thorax
occur from this cause. Respiration is easy, symmetrical.
Easy it is to see, however, that respiration is not the
same as in a healthy man. In health there is a marked
elevation of the anterior abdominal wall during in-
spiration, a consequence of the descent of the diaphragm
—the upper portion of the chest remaining comparatively
quiet. In the female sex the diaphragm is less active,
its descent is not so marked, on the other hand, there
is greater motion of the upper ribs; plainer this
becomes in disease. Just such a manifestation is pres-
ent in our case, for a simple mechanical reason. In all
diseases which distend the lower abdomen, marked
ascites, meteorism, etc., the descensus diaphragmatis is
hemmed; it cannot sink to its usual position without
overcomingstronghindrances, and in such cases vicarious
costal respiration is observed: in man it signifies mechan-
ical obstruction to diaphragmatic descent. Such an
obstruction is present in the case before you. Our pa-
tient breathes more with his upper ribs because the
descent of the diaphragm is hindered. When ascites is "
|
marked, any descent of the diaphargm ean scarcely be
18
[JAN. 13, 1872.
__ TIEEE THE C T , T N T C -
*
demonstrated, percussion sounds are full as high as the
fourth rib. The fifth intercostal space resounds with
the tympanites of the stomach. Heart dullness reaches
to the sixth rib, a little lower perhaps than noamal.
Externally, cardiac dullness extends to its normal
bounds, internally, up to the sternum is perfectly clear
sound, distinct dullness at the left sternal border. The
relations of cardiac dullness, therefore, are almost normal.
To the right, mammary line, fifth rib, but light dullness
is perceptible; above the sound is clear. Dullness,
thus, is higher on the right than usual. Plainly this
dullness depends upon the liver. At the xyphoid pro-
cess there is dullness corresponding to the thickness of
the left lobe of...the liver. When this is voluminous,
even though the stomach be distended, the sound is
still dull, when thinner, the dullness is less marked.
Further to the left the sound of the stomach is manifest,
perfectly clearly the dullness and clarity separate. The
hepatic dullness may not be traced further to the left
on account of the gastric sound, plainly because the
liver lobe has increased in thickness. The lower border
of the liver has its usual place, but its upper border is
higher because of the higher diaphragm. Palpation in
the hepatic region teaches us nothing concerning the
liver; this region is empty, offering but little resistance,
such as intestinal convolutions might yield. Towards
or at the close of the recti muscles this resistance in-
creases, so that we can say that the liver has not essen-
tially increased in volume. It lies a little higher and
we might conclude because it is a centimeter or two
higher that it is somewhat larger but not much weight
may be placed upon so little difference.
If we examine the second important organ of the ab-
domen, the spleen, we find the sound clear to the sev-
enth rib, dull from the seventh to the tenth. Anteriorly
it reaches in its broad diameter sharp up to the
border of the ribs. Palpable is it not. This is, perhaps,
because the tension of the abdominal parietes is very
great so that the finger can only sink to a centimeter's
depth. We demonstrate thus, in addition to the
described condition of the liver, a marked enlargement
of the spleen.
Now, then, our first question is whence and since
when is this enlargement? Tumor from intermittent
ſever is not his history. This is, truly, its most frequent
cause of which we shall speak anon.
There is anothſ r cause of splenic enlargement; it is the
presence of amyloid degeneration with like disease of the
liver and kidneys, a sequel often enough, of precedent
syphilis. So often, indeed, that it was formerly believed
that amyloid degeneration only occurred in the case of
syphilis, a view which is by no means correct. It may
be present, this degeneration, probably in consequence
of the destruction of the elements of the organ in other
diverse conditions, may occur in intermittent fever.
After a protracted intermittent, a permanent spleen
tumor remains: amyloid degeneration then often affects
it; presenting itself, thus, as a residium of the disease.
We discover in our patient a demarcation line in the
linea alba between the clear and dull sound. To the
right and left the dull sound is limited by a horizontal
line. We change the position of the patient, still we
have the lowest part dull, distinctly marked again from
tympanites above by a horizontal line. The parts now
highest, before dull, yield now the clear sound. The
Sounds have been changed thms with the change of the
patient's posture, showing a free fluid in the abdominal
cavity. It has sought the deepest part of the cavity
and is separate from the tympanites of the swimming
intestines above by a horizontal surface. A small quan-
tity of fluid in the abdominal cavity sinks into the pel-
Wis and is only demonstrable when it has risen above
the pelvic intestines and is manifest to percussion.
To resume, then, we have before us a condition im-
plying a chronic disease. We observe general emacia-
tion and debility. We have seen that the liver is a
little though not markedly higher than normal; below
it maintains the usual position. There is therefore
slight enlargement rather than slight diminution in its
size. The left lobe extends less far to the left than
usual; its limiting border is detectible at the linea alba
So that we must consider the left lobe to be rather thin-
ner than normal. . Further we found the spleen enlarged,
and finally free fluid is present in the abdominal cavity.
From these tracings we have to decipher the disease
before us. Because we have found so little wrong with
the liver we may not depart from this organ in our dis-
cussion for I shall exhibit to you later that we are able
to draw definite conclusions as to the constitution of the
liver from this complexity of symptons present. To
this end we must refer to other manifestations, the most
striking of which is the free fluid in the abdominal
cavity. Det us inquire, now, how may such an accu-
mulation, in general, occur 2 That the fluid here is not
encysted, the change of position proves. This must
first be clear because there are various kinds of free
fluids in the abdominal cavity. An encysted tumor
with considerable dullness would notºfurnish to per-
cussion a level surface. This is of greatestimportance in
the diagnosis of female abdominal disease because with
them diseases of the sexual organs, ovarian cysts, uterine
tumors, are so frequent. All tumors of considerable
size may be distinguished from free fluids in the major-
ity of cases by the fact that their limiting borders show
to percussion a convex line. Tumors, too, as you may
well undsrstand, are not so freely movable. There is
one disease, however, whose differential diagnosis in this
regard will give you trouble. It is chronic peritonitis.
This is usually associate with neoplasms, tubercle, etc.,
and there is not only fluid effusion present, but also new
formations, false membranes occasioning adhesions be-
tween the intestines, abdominal walls and other organs.
Flnids of this origin do not change place in the same
m.anner on rapid change of position of patient. It flows
between the adherent intestines and even this change
occurs slowly and imperfectly, correspondingly mystify-
JAN. 18, 1872.]
T H E c T, TTNTI c.
19
ing the sonnds of percussion. If, then, the fluid may
not he moved in toto, the supposition that pathological
adhesions are present is justifiable. Of course this alone
would not determine the disease, but it would establish
the fact of adhesions and previous and concurrent in-
flammatory lesions and then the question would arise
what is the nature of the inflammatory process. The
present case precludes such an iuſlammation: we have
here to deal with a hydrops formed in the serous cavity;
the tissues concerned having been changed only in the
lightest degree—our case is hydrops ascites. Every
hydrops naturally implies a stasis in the veins concerned
or in the lymph vessels. Our first suspicion would
point to venous stasis, and in this region as no other
venous system could produce such a lesion, to the vena
portae. We believe, then, that the circulation in this
system is hemmed, either its trunk or in its branches in
the liver, Always when ascites alone is present our
first suspicion is directed to this vessel. Before going
further we should mention that just such an ascites in
connection with oedema of the feet may occur in Brights
disease, with pulmonary oedema in bronchial catarrh
and in heart disease. The question then arises is this
ascites but a partial manifest of a general dropsy, is
there, in other words, some disease present which may
be regarded as the cause of general dropsy. In our case
the present condition precludes such an idea. There is
no trace of hydrops in the lower extremities. Possibly
oedema was there and has since disappeared. Patients
not infrequently present with the statement that they
were dropsical in the feet but it has since vanished and
is now confined simply to the abdomen. In such cases
such changes have been effected in the peritoneum, per-
manent thickening perhaps, as to have interferred
with its reabsorption of the fluid effused. Here an ac-
curate history is the great desideratum. In our case it
is definitely determined that Oºdema of the extremities
never “did exist. There has been at no time, then, a
lesion causative of general dropsy. Heart diseases,
kidney diseases, thus, are excluded.
- [To be continued.]
—º-e—cº-
SCIENTIFIC NOTES.
IRON, THE COLORING MATTER OF NATURE.-And
last of all: A nobler color than all these—the noblest
color ever seen on this earth—one which belongs to a
strength greater than that of the Egyptian granite, and
to a beauty greater than that of the sun set or the rose
—is still mysteriously connected with the presence of
this dark iron. I believe it is not ascertained on what
the crimson of the blood actually depends; but the
color is connected, of course, with its vitality, and that
Vitality with the existence of iron as one of its substan-
tial elements. &
Is it not strange to find this stern and strong metal
mingled so delicately in our human life that we cannot
- evº, º Without its help?—Ruskin—The Two Paths
EXTRA-UTERINE FOETATION.—A case of extra-uterine
foetation was reciently admitted into the Vienna Hos-
pital. "When the patient was dying, it was determined
to make an effort to save the child. The Caesarean op-
eration was performed, and the child gasped once or
twice, but did not show further signs of life. The child
was found quite free in the peritoneal cavity” and the
post-mortem examination revealed the fact that the im-
pregnated ovum had dropped into the fold of Douglas,
and attached itself to the peritonéum. The umbilical
cord was found surrounding the uterus in several coils,
while it is supposed that the child escaped from the
membranes two or three months ago. The Fallopian
tube was so much spread out as to be undistinguishable
as to its distal termination. The parts will be subjected
to a careful examination, in order to see how far the pla-
centa became formed, and the vascular supply acquired
from parts not originally destined for the purpose. As
evidencing the innate power of its support and growth
in the impregnated ovum, without the aid of the organ
specially furnished for its reception and growth, the case
is one of no ordinary interest.
EIN BEITRAG Zur Entwickelungs-Geschichte der
Myopie, gestützt auf die Untersuchung der Augen von
4358 Schülern u. Schülerinnen.
A contribution to the development of Myopia, based on
the examination of the eyes of 4,358 Scholars, girls and
boys.
We extract simply some of the prominent points from
this interesting article (to be found in Graefe's Archiv.,
vol. xvii, part i).
The pupils were in seven Russian gymnasia where
the ages ranged from 10 to 21; One progymnasium,
four German Schools, for boys and girls, with ages from
8 to 20, and a normal School for educating teachers with
ages from 17 to 24.
Myopes - - - tº- 1,317=30.2 per ct.
Frnmetropes - - º - 1,132=26. ( &
Hypermetropes - º * - 1,889-–43.3 “
Amblyopes - - -> --> 20= 0.5 “
Total - - 4,358 100 per ct.
Among 3,266 boys, there were
Myopes tº t- º º 1,017=31.1 per ct.
Emmetropes - - º - 867–26.5 “
Hypermetropes - - - 1,360=42. { {
Amblyopes - - tº- tº- 13= 0.4 “
*=s*
Total - s 3,266 100 per ct.
Among 1,092 girls, there were
Myopes gº * - º 300=27.5 per ct.
Emmetropes - - * - 265 – 24.2 “
Hypermetropes - º * 520–47.7 “
Amblyopes - - - - = 0.6 “
Total - - 1,092 100 per ct.
20
[JAN. 13, 1872.
T TE-ITE] . CT I I INT I C -
Among 2,534 pupils of the Russian Gymnasia there
Were
Myopes - - - - 866=842 per ct
Emmetropes - * * * - 654=25.8 “
Hypermetropes - - - 1,003=39.5 “
Amblyopes - - - - , 11= 0.5 “
Total - . 2,534 100 per ct.
And among 1,824 pupils of the German Schools there
Were *
Myopes - - - - 451=24.7 per ct.
Emmetropes - * gº - 478–26.2 “
Hypermetropes - - - 886=48.6 “
Amblyopes - * tºp * > 9– 0.5 “
Total - - 1,824 100 per ct.
The large per centage of hypermetropes will be ob-
served, and the author concludes that between the ages
of 6–7, still more hypermetropes will be found. In the
lower classes he found two-thirds of the children with
H.; in the upper, one-third. Hence, he regards the
normal refraction of young uninjured eyes hyperme-
tropes. The so-called emmetropia or even myopia be-
ing an exceptional condition for this eye. -
In regard to the use of concave glasses, he says, their
use while the refraction is undergoing changes, has of
itself an injurious effect upon such eyes and he regards
it a misfortune to be obliged to prescribe them for
young myopes.
He is inclined to modify the opinion usually So
strongly expressed, that a highly myopic eye is a dis-
eased eye. Undoubtedly, as he states, many highly
myopic patients with excellent vision are never seen by
the ophthalmologist; only those presenting subjective
disturbances. He claims that the increase of myopes in
the classes of more years study show that it is the occu-
pation with all its attendant circumstances, that pro-
duces this condition. -
Myopia occurring in an hypermetropic or emmetropic
eyeball, is due to the lengthening of its axis, and the
author feels sure that the chief cause lies in the badly
constructed school desks, and insufficient and bad light.
––– mºs-o-º-
MIMEDICAH, NEWS.
THE LIBERAL PROFESSIONS.—While I allow, that
peculiar and important advantages arise from the ap-
propriate studies of the three liberal professions, I must
confess, that in crudition and Science, and in habits of
deep and comprehensive thinking, the pre-eminence,
in some degree, must be assignod to physicians.—Parr.
MEDICAL FEES IN ITALY.—The question whether it
was advisable to have a fixed tariff of medical fees,
either general or local, was discussed at the recent meet-
ing of the Italian Medical Association. The decision
was, by a not very remarkable majority, in the negative
in both cases.
A COLLEGE FOR SIBERIA.—A quarter of a million
dollars has been placed in the hands of Minister Tolstoi
to form a University in Siberia.
ON EMBALMING-The art of embalming, as is well
known, is very old; even the ancient Egyptians had
introduced the practice from Ethiopia, a country
abounding in various gums, which served them to pre-
serve the remains of their relatives. The transparency
of these substances had induced some travelers to assert
that the bobies were embalmed in glass, like insects
in amber.
posed the absurdity of such a report, since it is more
than probable that glass was Scarcely, if at all, known
amongst them.
wax, and the Scythians Sewed them up in skins.
De Pau and many other writers have ex-
The Persians enveloped their dead in
The operators were the priests, who persuaded the
multitude that the immortal part of our being was re-
tained within its earthly house so long as the corporal
form could be preserved entire, and a belief in the
transmigration of souls naturally led to the desire of re-
taining them as long as it was possible in their former
bodies; and the words of Virgil—“animamque sepul-
chro, condimus”—would seem to warrant this belief
amongst the ancients.
The operator, or “incisor,” as he was called, appears
to have been considerered a degraded being; for
Diodorous tells us that, after the operation, he was pur-
sued by the relations of the defunct, and pelted with
stones, as having polluted the remains of the dead.
As to remunoration, Diodorus Siculus states that the
first class embalming cost a silver talent, the second
twenty minae, and the third scarely anything.
Rymer’s “Foedera,” vol. i. p. 1001, will be found a letter
from the Keeper of the King's Wardrobe to Sir Ralph
de Stoke, Clerk of the Great Wardrobe, stating that
Richard de Montpelier is going to London on account
of the king's (Edward I.) illness, and desires that every
In
facility may be afforded him to procure and make up
the medicines. “Propter Infirmitatem Domini Regis per
ordinationum Magister Nicolaus de Tyawick” (sic).
Richard de Montpelier's account for this illness and
subsequently the embalming the king amounted to £134
16s. 4d., a considerable sum in those days. Amongst
other curious items we find:—
£. S. d.
Pro Emplastris Cironeis - - - - 4 0 0
Item pro Terebintine destillato - - - 0 40 0
Item pro uno Emplastro pro Collo Regis
cum Ladano et Ambras Orientalis - - 0 60 0
Item pro vi. Malis Granates - - - - 0 60 0
Item pro sex unciis de Balsamo ad Corpus
Domini Regis unguendes - gº - 13 0 0
Item pro pulveri aromatice de Aloeis Thuris
Myrrhae ad ponendem in Corpord Regis 4 0 0
Item pro Musco uncia iiij. ad Ponendem in -
Membris Regis (a) - - ſº - 0 60 o
A curious fact with relation to the embalming of .
JAN. ,131872.]
TIEEE THE CIT I I INTI C.
21
Edward I. will prove that Master Nicolas of Tynwycke
(who, the king said “was, more learned and fit to have
the care of his health than any one in the realm”),
Master Peter, the Surgeon, and Richard of Montpelier,
the Espicer (or apothecary), did their duty well, for
about fifty years ago the tomb of Edward I. was opened
and the body found entire. A zealous antiquarian,
Sir J. Ayscough, was induced to taste the “pickle”
or fluid in which the royal body was preserved, and
even then, more than 500 years after the embalmment,
it showed traces of the spices used, and of which we
have just given the charges and accounts.
In modern times we find that Edmond Phillips had
£40 4s. 8d. for embalming the body of Thomas Sutton,
the benevolent founder of the Charterhouse. In the
case of George II, the two Sergeant-Surgeons had £1228s.
9d. each for “opening and embalming,” and the apoth-
ecary £152 for “a fine double cerecloth and a due
quantity of rich perfumed powders.”—Times and Gaz.,
Dec. 9, 271.
SUICIDE BY MORPHIA HYPODERMICALLY.--Dr. Stan-
ton of Pensylvania met his death by an overdose of
Morphia, one grain, self administrated on himself for
the relief of an erysipeloid inflamation following a post-
mortem. “Every remedy and appliance known to sci-
ence were promptly used for his relief but without
avail.”
“Thus perished one of the brightëst ornaments of the
Medical profession—a victim to his professional devo-
tion and to the remedy he had so often successfully
used to relieve the suffering of his fellow-men.”—Ea-
change.
DEATH OF DUBOIS-M. Paul Dnbois, Prof. of Mid-
wifery in Paris and one of the most eminent obstetric
authorities in France died on Nov. 29, at the advanced
age of 76. He had held his professorship for 25 years.
OPPOLZER's SUCCESSOR-Prof. Bamberger is finally ap-
pointed by the new minister of Austria to fill Oppolzers
place. Further intrigues are over. The home talent
party is defeated and dead. There is general jubilee.
CHOLERA-This pestilence has never persisted with
Such obstinacy. Last month 379 fell victims in Con-
stantinople in a single week. In Austria and Galicia it
prevails still in all the old places of attack. In thir-
teen places from which reports have been received 179
persons have been attacked; of these 154 died.
STRASBOURG—The medical faculty is reorganized.
Sixty students are already enrolled.
SMALL-Pox—Our epidemic is slowly abating. Deaths
average but five to six daily. As usual towards the
close of every epidemic the type of the disease is consid-
erably modified. Cases of confluent small-pox are rari-
ties. - -: -
THE UNIVERSITY OF WARSAw.—The Russification of
the Warsaw University is now complete. All the
Polish Professors have been removed.
JEWISH MEDICINE.—We have observed in a religious
contemporary devoted to the conversion of the Jewish
race (the Scattered Nation), Sóme papers by one of our
fraternity, Mr. Gaskoin, on “Medicine as Practiced by
the Jews.” The September number contains an article
under the heading “The Foundation of the University
of Coadova,” which has an original stamp, and which
sets things in a new and as yet unconsidered light. We
hope to see these papers continued. From the Decem-
ber number of the same publication, we are ſain to bor-
row a few “Talmudic Gleanings.” These passages are
of an extremely biting character, and serve to show the
priestly race of yore in strong antagonism to our art:
a “Talmudic Gleanings.
“14. A Doctor that heals for nothing, his cure is worth
nothing—Bava Kama, fol. 85, i.
“15. Most donkey drivers are wicked, most camel
drivers are worthy, most sailors are pious, but the best
of Doctors are for hell.—Kidushin, fol. 82, i.—Note.—
A Doctor, says a certain writer, has the advantage over
the Angel of Death. The latter kills gratis, but the
former is paid for it. -
“16. Seven have no portion in the world to come—the
legal writer, the scribe, the best of Doctors, etc.—Avoth.
Drö. Nathan, c. 36. e
“17. When a patient says, I am in need of (certain
food), and the Doctor says he is not in need of it, the
patient is rather to be listened to ; for(Prov. xiv., 10).
the heart knoweth its own bitterness.-Yoma, fol. 83, c. 1.
“18. If there be no Israelitish Doctor in the city, but
there are in it a Samaritan Doctor and a Gentile Doctor,
the latter may circumcise (a Jewish child), but not the
former.—Avodah Zarah, fol. 26, c. 2.
“19. Physician, heal thy lameness.—fol. 23, c. 2.--
Times and Gaz. Dec. 16 '71.
We commend unto these theological Savages the fol-
lowing:
“The skill of the physician shall lift up his head; and
in the sight of great men he shall be in admiration.”—
Eccles. awarvi. 3.
——º-e—º---
Boolºs and Pamphlets. Received.
A TREATISE on HUMAN PHYSIOLOGY, ETC., by
John C. Dalton, M. D. Fifth Edition Revised and En-
larged, Philadelphia, Henry C. Lea, 1871. -
A TEXT BOOK on PATHOLOGICAL HISTOLOGY, by Dr.
Edward Rindfleisch. Translated by Wm. C. Kloman,
M. D., and F. T. Miles M. D., Philedelphia, Lindsay and
Blakiston 1875.
ESSENTIALS of PRACTICAL MEDICINE, by Henry
Hartshorne, M. D. Third Edition Philadelphia, 1871
Henry C. Lea $2.40.
MEDICAL OFFICE ** PUPILAGE, by John D. Jackson,
M. D., Danville Ky,
22 T IEEE TER C
T I I INT T C - [JAN. 13, 1872.
VACCINATION and its PROTECTIVE POWER in WEST
VIRGINIA. A report to the Governer Nov. 8, 1870 by
John C. Hupp, M. D., State Vaccine Agent, Wheeling,
1871.
THE RELATION of EPILEPSY to INSANITY and JU-
RISPRUDENCE, by W. J. Conklin, M. D., Ohio State So-
ciety Paper. -
THE CLINICAL THERMoMETER, by Z. C. McElroy,
M.D., Zanesville, Ohio. Reprint from Med. World, Oct.,
1871.
FourTH ANNUAL REPORT of the PUBLIC LIBRARY
of CINCINNATI.
THE MUTUAL RELATION of the MEDICAL PROFESSION,
ITS PRESS and the CoMMUNITY, by Dr. Storer Jr. Re-
print from Gynaecolog Journal, 1871.
ADDRESS, Introductory to the 12 Regular Session of
the Miami Medical college, by B. F. Richardson, M.D.,
Cincinnati, 1871. *
ON CHRONIC HYPERTROPHY of the LIPS, by R. W.
Taylor, M. D. Reprint from Med. World, N. Y. 1871.
THE PHYSICIANs' DAILY PoCKETRECORD comprising
a visiting list, many useful memoranda, tables, etc., by S.
W. Bulter M. D. Philadelphia 1871 is the most complete,
and at the same time, compact affair of the kind we
remember to have seen. This is the only kind of vade
mecum or compendium that should be allowed to be
published.
—sº-o-º-
C LINHC AL MEMORANIDA.
on the Therapeutical Value of the Hypodermic
Injection of Ergotin in Haemoptysis.
RY
C. CURRIE RITCHIE, M. D.
Physician to the Hulme Dispensary, Manchester,
Experimental research has conclusively shown that
ergot contracts the minute arteries, and by So doing in-
creases the blood-pressure. A simple experiment will
as Dr. Meadows has shown, be sufficient to establish the
former of these propositions: thus, if a single grain of
ergotin in solution be injected subcutaneously into the
web of a frog's foot previously extended under a micro-
scope, in a few minutes the circulation will be seen to
become much quicker, then it will stop for a few sec-
onds and oscillate in a spasmodic, jerking manner; after
about half an hour, the blood-current will gradually
return to its normal even, steady flow. The Well-known
experiments of Brown-Séquard afford additional evi-
dence on this point. He found that in the dog the Ves:
sels of the pia mater contracted during its administration,
just as with belladonna, but that ergot acted more pow-
erfully on the cord than belladonna: both of these
agents diminish the reflex power of the cord. The Bec-
ond proposition, that the blood-pressure is increased,
receives interesting corroboration from the recent re-
Searches, chiefly with the haemadynamometer, of Dr.
Ch. L. Holmes, published in the Archives de Physiologie,
No. 3, for 1870. He finds that “ergot contracts the
minute vessels by an action. on their muscular walls,”
and “that this contraction augments the blood-pressure
in the large vessels;” it is, moreover, found that pre-
vious division of the vaso-motor nerves does not prevent
the narrowing of the minute vessels, and that this
diminution of calibre is also produced in the minute
vessels of the lungs, causing a temporary diminution in
the pressure of the systemic arteries. This last result
has a direct bearing on the whole subject of pulmonary
hemorrhages; and as it seemed to Dr. Holmes to be ca-
pable of a scientific explanation, he performed numerous
experiments in order to test its accuracy. Thus, he
surmised that the effect might be due simply to the Sud-
den introduction into the interior of the heart of a for-
eign body, and accordingly he substituted other substan-
ces for the ergot which he had injected into the jugular
vein of a dog; but whereas the injection of ergot was
with great rapidity followed by sudden diminution of
the blood-pressure, which remained depressed for several
seconds and then reached a higher level than before the
injection, no such result followed the injection of the
other substances. This sudden primary descent of the
pressure-curve occurred after ergot-injection, even when
it was introduced at a distance from the heart, and
when the cardiac nerves had been divided previous to
the injection; so that Dr. Holmes is led to the con-.
clusion that the occurrence is due to contraction of the
pulmonary vessels, “impeding or even preventing the
passage of blood into the left heart, and so diminishing
the flow into the arteries and lowering their tension.”
Such considerations as these lead us to hope that
renewed and extended investigation by those who have
the opportunity of inquiring into the therapeutical ac-
tions of the ergot of rye may assign this powerful agent
its true place in our Materia Medica.
An interesting paper published by Von Langenbeck
in the Berliner Klinische Wochenschrift, No. 12, 1869, p.
117. “On the Hypodermic Injection of Ergot in Ane-
urism,” contains the first account I can find of its ad-
ministration by this method. He argued that, as ergot
induced contraction of the smooth muscular fibres it
would be a powerful agent in producing haemostasis,
Two cases of aneurism, one in the right supra-clavicular
fossa and the other of the right radial artery, were suc-
cessfully treated by this means. Dr. Dutoit of Bern
(Langenbeck's Arch. Bd. xii. No. 3), and others have
successfully repeated this method of dealing with aneu-
rism. In some editorial remarks appended to the med-
ical periscope of the Elinburgh Medical Journal for July,
1870, a case is quoted where a patient who had bled to
thirty-six ounces from the lungs, within a few minutes,
had his hemorrhage completely checked in three min-
utes by the subcutaneous injection of five grains of
JAN. 13, 1872.]
T EE THE C T , T TNT I C .
23
ergotin; and Dr. Allan Jamieson records a case in the
British Medical Journal for June 3, 1871, in which the
same treatment was successfully adopted in a slighter
case. The last case attracted my attention to this mode
of treatment, and I have since adopted it in eight cases,
the particulars of which are now offered as data for
judging of its value. The ergotin used was obtained
form Messrs. T. and H. Smith, of Edinburgh, and a
solution of five grains in ten minims of distilled water
was employed, except in Case VIII, in which unusual
irritation was produced by it; I therefore substituted a
solution (prepared according to Langenbeck's formula)
of three grains of ergotin, in equal parts of glycerine
and rectified spirit, which produced very little irrita-
tion. -
[The Cases in detail follow. The remedy proved suc-
cessful in every instance].—The Practitioner, Dec., '71.
BROMIDE OF IRON.—This remedy is advocated by Dr.
N. H. Norris, of Beloit, Wis. (North Western Med, and
Surg. Journal), as nearly a specific in involuntary emis-
sions and spermatorrhoea. He has administered it three
times daily, an hour before or after meals, in doses of
three to five grains, rubbed up in a little syrup.
Prof. Namais (Practitioner) states that this remedy
corrects defective formation of blood, and quiets nervous
excitation, and produces the combined effects of iron
and the bromides. He regards bromide of iron as being
in many instances a therapeutic agent of Superior value
in epilepsy even to the bromide of potassium.—Med.
Record. -
—º-o-º-
A Successful Method of Treating Certain Cases of
Dysmemorrhoea and Sterility.
BY
PROTHEROE SMITH, M. D.
Senior Physiclan to the Hospital for Women, London.
The plan which I then pursue is, first to prepare the
patient by a purgative dose, and by abstinence from
local excitement, and from alcoholic drinks, or much
animal food, When hyperaemia exists, I scarify laterally
the labia uteri repeatedly at the commissures of the
labia, by which the vascularity of the organ is reduced
and the shape of the ostincae, when constricted, is im’
proved. After accustoming the uterine canal to bear a
metal bougie, which should be repeatedly and daily in-
troduced, and increased in size until that of a No. 10
catheter can be borne without any pain, then the uter-
ine dilator may safely be employed. It will be seen
that this instrument consists of two short blades, two
inches and a half long, the inner being continuous with
the sliding shaft, with which it is nearly at a right angle,
having at its proximate end a screw worked by a nut
So as to mark precisely, by an index on the handle, the
extent of dilatation employed. This should be used at
first cautiously about every second day, always ceasing
to screw as soon as pain is experienced. This is imme-
diately relieved by a turn or two of the screw the
reverse way.
It will be found, in a short time, that the uterus be-
comes accustomed to the dilatation, when it may be
employed to a greater extent; and in the course of a
few days or weeks, as the case may be, a forced dilata-
tion to the extent of an inch or an inch and a half may
be used with impunity. After this it will only be nec-
essary to use the dilator daily for two or three days, and
afterwards at longer intervals, to keep the parts open
till they permanently heal in the state of distention
effected by the operation.
Time would fail me, were I to attempt to illustrate
these remarks by a review of all the cases in which I
have employed this mode of treatment. It must here
suffice to remark, I have seen this practice followed by
complete successin many instances, from amongst which
I would quote the following extreme, but successful
cases of dysmenorrhoea and sterility, treated by forcible
extension and incision of the labia uteri.
CASE I. A lady, aged 41, after sixteen years of mar-
ried life without pregnancy, has since given birth to
| two children.
CASE II. A lady, aged 37, her husband hemiplegic
from his youth, married thirteen years without family,
and now has a living child.
CASE III. A patient, aged 39, married twelve years,
and barren, became the mother of a living child.
CASE IV. The wife of a clergyman, aged 28, having
been sterile for six years after marriage, was delivered
of a living child. -
CASE W. A resident in a distant colony, married fif.
teen years, and barren, aged 38, became pregnant, but
miscarried, in consequence of over-exertion at the sec-
ond month of utero-gestation. -
CASE VI. A delicate lady, aged 29, married nine
years, but never pregnant, became so, and had a living
child, followed by a second two years after.
I select these few cases from a large number, because
in all there existed more or less dysmenorrhoeal symp-
toms, and three of them were complicated by consider-
able structural disease, which had first to be removed
before the plan of treatment I now advocate was
adopted.
In this paper I have endeavored, as far as possible, to
confine my observations to facts capable of demonstra-
tion; and I hope the experience of other members of
this Association may confirm my own conclusion that
forcible distension of the constricted os internum and
incision of the OS externum only, in the manner de-
scribed, in cases of obstructive dysmenorrhoea and ster-
ility, is preferable to the operation by the hysterotome.
The former is attended with less risk; and, with this
impunity, it offers greater success, with the further ad-
vantage of leaving the uterine tissue, excepting at its
extreme mouth, without lesion.—Brit. Med. Journ.,
Dec. 16, ’71. -
24
[JAN. 18, 1872.
T TH THE C T , T NTT C.
CoMPRESSED AIR IN WHoop1Ng Cough.-No treat-
ment has hitherto been found materially to shorten the
disease. * * * * * * Now, however, the efforts of
compressed airis stated by M. Fend to be a valuable meth-
od of treatment. It was first recommended by M. Ber-
tin and then by Dr. Sandahl of Stockholm, who reports
no less than 102 cases rapidly cured by this means. M.
Fend has also tried it and obtained extremely favorable
results.-The Practitioner, Dec., '71.
THE DISEASES OF ALASKA.—Dr. W. T. Wythe (Pac-
ific Medical and Surgical Journal), in his “Medical
Notes on Alaska,” states that bronchitis is never
absent there; catarrh is seen at every change of the
weather. Pneumonia often occurs, and in sporadic
cases assumes a typhoid type. Rheumatism is very
obstinate, and occurs very often, aud generally takes
%
the articular form. Tuberculous diseases are very
common among both natives and whites. Phthisis
pulmonalis runs a fearfully rapid course. Eczema is
often seen, but yields readily to treatment. Syphilis
is slowly but Surely killing all the natives of the north-
west coast. Rheumatism, bronchitis, and scurvy are
the prevailing diseases.
lower portion of the radius often happen from accidents
peculiar to the country, viz., trapping and rowing. Va-
Tranverse fractures of the
riola has never reached Alaska.
—º-e'-º'-
HOMIE NEWS.
IF VIRCHow is really in earnest about leaving Berlin
(which we don't believe) in search of more democratic
institutions let him come to Cincinnati. Brown—
Sequard's fate in Boston need not alarm him. Cincin-
nati is sounder on the home talent question and Sister
Anthony will give him a place at once.
THEORY vs. PRACTICE.--When Vallandigham lay
dying of a gun-shot wound in the abdomen the adven-
turous Marion (Sims) sent out a telegram to his attend-
ing surgeons, merely suggestive, you know, to cut down
upon and ligate the bleeding vessels. “Many were the
wounded at Sedam which might have been saved in
this way” but were’nt on account of the timidity of the
French surgeons. -
Now what we want to know is this; When Mr. Fisk
lay dying by the same accident at the Grand Central,
New York, why did’nt the fearless Marion volunteer to
go down into his bowels and tie up all the bleeding
vessels and intestines and save his country this precious
life 7
Medical College of Ohio.
S P R J N G C 0 U R S E ,
*
The regular eight weeks course of practical instruc- .
tion for the Spring of 1872 commences May 15. Un-
usual advantages are offered this year in the fact that
the course will be conducted by the entire faculty of the
College.
The course will embrace the following topics:
Clinical Medicine—Bartholow.
Surgery—Dawson. ... " -
Anatomy Brain and Nervous System—Gobrecht.
Operative Surgery—Conner.
« Obstetrics—Reamy.
“ Ophthalmology—Seely.
Female Pelvic Surgery—Palmer.
Urinalysis—Nickles. -
Physical Diagnosis—Cleveland.
Fractures and Dislocations—Kearns.
Microscropy—Whittaker. -
Prof. Graham will deliver occasional lectures on Clin-
ical Medicine and Diseases of the Chest during the pro
gress of the Course. -
The design of the Course is to present instruction in
a thoroughly practical manner. Physical Diagnosis is
to be demonstrated in the hospital wards; Operative
Surgery, Operative Obstetrics, and Operative Ophthalmol-
ogy, on the cadaver. . -
The Dissecting Room will be under the supervision of
Dr. where abundant material will be provided.
Special attention will be paid to the chemical and mi-
| croscopical analysis of morbid urine. -
In order to render this course the most practical pos-
sible, an opportunity will be afforded each individual of
the class to make the various examinations and opera-
tions on the living and dead subjects. Wednesday and
Saturday afternoons will be devoted as heretofore to
Medical and Surgical Clinics at the Good Samaritan
Hospital: Two Daily Clinics will be regularly held in
Cincinnati Hóspital, throughout the entire course; and
a Daily Clinic will be held at the Dispensary of the
Medical College of Ohio.
One hour each evening will be devoted to Recitations
on Anatomy, Physiology, Practice, Surgery, Obstetrics,
and Materia Medica.
The eminently practical nature of this course, and its
shortness of duration, together with the great clinical
advantages presented in Cincinnati, can but commend
themselves favorably to the practitioner as well as the
student. -
FEES FOR THE ENTIRE CourSE, $10
As this Course does not count towards graduation,
being cosidered supplemental to the regular winter
course, graduates of the College are not required to
matriculate. The matriculation of non-graduates is
deducted from the fees of the ensuing winter session.
William Autenrieth,
No. 71 wrest sixth sTEREET,
BETWERN WAINUT AND WINE,
cincinnati, ohio, .
III ſummºl. In
Abdominal Supporters, Trusses,
GLUBFOOT SHOES, -
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
* -
&
Metalie and ERubber syringes,
stomach Pumps, Etc.
STOCKINGS FOR WABDCOSE WEINS,
special attention given to the fitting of Apparatus for Deformities.
Mº Agent for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
. ~. -ALSO– -
DR. AHL SPOROUS FELT SPLINTs,
–ALSO–
T) A. Y. * S S T T, T N T S
–AND–
| tracted the attention of the most intelligent Physicians.
- parent.
W. Elliott's saddle-bags
Flºrial Instrument.
ExCEISIOR ELECTRO-MAGNETIC MACHINEs
AND .
GALVANIC BATTERIES.
The Medical Profession is solicited to examine the valuable ſm-
provements in electrical Instruments, Patented February 1st, 1870,
manufactured by the GALVANO-FARADIC M’F’G CO. The recent re-
searches of European Scientists in Therapeutical Electricity have at-
Few can now
dispense with Electrical Machines, although formerly abandoned, ow-
ing to their inefficiency and inconvenience. These inconveniences are
now abviated. Our instruments meet all the requirements of advanced
science. They are the most elegant, powerful and cheapest ever offered.
Combined simplicity, range of effects, and facillity of use. Always ready,
require no preliminary preparation or assistance, no skill or experience
and will remain in operation an indeffinite period. They produce the
primary and secondary currents—the former in unequalled force. By a
mere movement, either can be obtained without changing the Elec-
trodes. THE FORIK is a peculiarity by which the rapidity of the
shocks can be increased or diminished at pleasure—a therapeutical ne-
cessity. On examination, other important improvements will be ap-
There are
FOUR SIZES
of the Excelsior Electro-Magnetic or Faradic Machines: No. 1, small for
family use, $10; No. 2, medium, for ordinary use, $15; No. 3, large,
| for professional purposes, $20; No. 4, Double Cell, of great power, $30;
There are three sizes of the Excelsior Galwanic Batteries: Eight Cells.
$20; Sixteen Cells, $36; Thirty-two Cells, $60. Surgical Batteries, for
Coutreization, of any size ordered.
© THE RHEodeGos, or CURRENT GUIDE,
Patented February 1st, 1870, is an entirely new contribution to Science,
|by which total interruption, alternate connection and interruption,
of inversion or the polarity of the current, is obtained by a
mere pressure of the finger. We also manufacture Carbon or
Gilt Steel Point Electrodes; Eye, Ear, Phrenic Nerve
Electrodes; Catheters for Urethra and Uterus;
Electric Scourges, Foot Plate, Tin or Carbon, Wires with or without
Trocars. for resolution of Tumors, Tongue Plates, Rubber
tubing, Battery fluid, &c. &c. Please call and ex-
amine, or send for Circular to
The Galvano-Faradio M'fg Co.,
No. 167 East. Thirty-fourth St, Cor. Third Av. New York,
OPINION OF PROF. DOREMUS.
College of the City of New York, cor. of Lexington Avenue and 23d
Street, New York, November 7, 1870.
I have carefully examined your new Electro-Magnetic Machine,
with its valuable and ingenious improvements. I consider the In-
stººlment the most complete, the most carded in its applications,
a.º.d most convenient I have ever seen.
R. O G D ENT DOR E.Jſ U.S.
Late and Important Improvement.—Patent applied for. The Ex-
celsior Machine Rendered Portable.
Can now be carried around by city or sountry Physicians, charged and
ready for use, without the posibility of spilling the Battery Fluid.


DIVIDED MEDICINES,
The Divided Medicine Com’y,
CINCINNATI, OHIO.
{
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExCEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUS, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several squares must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. -
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities.
But not only SolubLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. Ǻ - - "y
sº. This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; : *, *, *, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. - -
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH OF TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calis with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days. -
For samples, Price Lists, and Agencies, address
Medicine CQs
IECX 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
MR. FREDERICK KRAUs: - CINCINNAT1, February 15, 1871.
*:3 Dear Sir–The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: - -
SULPII:M0ſ: PPI II....................... % grain in each square. ARSFN:ACID.......................... 1-20 grain in each square.
4 4 CH IN INI ....................... 1. & 4 tº ſº. {{ CALOMEL.............................. 34 “ $ 4 46
• * COPPER ........................% ( &
Respectfully Youes, ’’
E. S. WAYNE, Analytic Chemist.

List of Pharmaceutical Preparations,
MANUFACTURED BY
Jozy Wºyazºr & Bºozººn,
F.E.I.T.A.D.E.L.F.E.C.I.A.
-º.
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
- ELIXIR OF GENTIAN FERRATED,
ELIXIRVALERIANATE OF AMMONIA,
(Goddard’s Formula,)
--- - ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK, -
- ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Hron,
BITTER WINE OF IRON,
Citrate of Hron and Peruvian Bark,
—º-
- FERRATED CORDIALELIXIE,
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK, . - -
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
r TASTELESS COD LIVER OIL,
TASTELESSCODLIVER OIL. FERRATED,
BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA, wine OF PEPSIN
SYRUPSUPERPHOSPHATE OF IRON, EPSIN,
- ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRA BRAVA.
* * STUIPIEPOSITOTERIES.
Rectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
&are, and of every variety of combination. Lists sent on application. * *
SPONGE TENTS.—For the Urethra, of every size and style, made of finest quality of sponge.
—-
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GooD s AMARITAN HOSPITAL.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
ided with all the necessary ap-
of sixth and Lock streets. It is handsomely furnished throughout, and is prov
with commanding views, surround the whole house, and wide
pointments of a First-class Hospital. Porticoes,
entilation which is so essential to health and comfort.
halls and abundant windows secure that full and free v
Service is furnished by the
sts.TERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford. - {
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each .
Professor presiding over his own cspecial department. Patients may, however, select from the regular profession
of the city any physician of their choice. - -
esents extra inducements to Invalids throughout the State as a safe and
The GOOD SAMARITAN HOSPITAL pr
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment. -
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
service.
Băș" Address,
SISTEER ANTHON.Y., - 4
Hospital of the Good Samaritan,
corner of Siaoth and Look, Sts., Cincinnati. Ohio-























































































ROBT CLARKE & Co.
PUBLISHERS,
millºilº
N0, 65 WEST FOURTH STREET,
Call the attention of the Medical Profession
to their Extensive Stock Of
(ºuglish, Āmerican and freuth
MELPIC-11, B00A.S.
Paying particular attention to this branch of
their business, they are enabled to execute all
orders on the shortest notice, and at the most
reasonable rates. Their facilities for the impor-
tation of FOREIGN BOOKS, THE PROCEED-
INGS OF SOCIETIES and HOSPITAL RE-
PORTS are unsurpassed, and any orders en-
trusted to their care will be filled promptly, and
at the lowest rates.
Fos"TER’s
* IEP A TIENT
Are furnished to Officers and Soldiers on Government
a CCount.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any dthers now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb—why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMEs A. FOsTER.
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 17.2 Jef-
ferson Aves, ue, Detroit, Mich.
SAML. P. THOMAS
Subscriptions received for. FOREIGN and mºs
AMERICAN PERIOD1CALS.
All the New Publications received as soon
as issued.
Letters of Inquiry will receive our prompt
and full attention. -
Catalogues ſurnished gratis on application.
ROBERT CLARKE & CO.,
Whilºlºmºnºlin
PRINTERS AND BLANK BOOK MANUFACTURERS,
2eaders in Zaze. Medica?, ZZeological
School, azed.//sce//azzeous Zooãs,
G5 West Elourth Street,
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ID E A LEF IN
English, French and Scotch
G O O. Dºs,
34 West Fourth Street,
CA.Ye.Z.º.º.º. Zºz.


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CINCINNATI.
IET A C U L T Y.
J A M E S G R A H A M, M. D., DE AN,
Professor of the Theory and Practice of IMC edicine and Clinical JMC edicine.
w. W. DAWSON, M.D.,
Professor of Principles and Practice of Surgery and Clinical Surgery
C. D. PALMER, M.D.,
Professor of Medical and Surgical Diseases of Women.
T. A. REAMY, M.D.,
Professor of Obstetrics and Diseases of Children.
JOHN L. CLEVELAND, M.D.,
Demonstrator of Anatomy.
CHARLES KEARNS, M.D.,
Assistant to the Chair of Surgery.
ROBERTS BARTHOLOW, M.D.,
Professor of Materia Medica and Therapeutics.
W. H. GOBRECHT, M.D.,
Professor of Anatomy.
P. S. CONNER, M.D.,
Professor of Surgical Anatomy.
W. W. SEELY, M.D.,
Professor of Diseases of the Eye and Ear.
SAMUEL NICKLY'S, M.D.,
Professor of Physics and Medical Chemistry
J A M HD S T . W H ITT A. Ex H. F. , -
Professor of Physiology and Secretary of the Faculty.
Janitor, College Building, Sixth St., bet. Vine and Raea,
*
T. Louis BRows, Prosector of Anatomy.






CLI
«s-ºs-ºs-
PUBLISHED EVERY SATURDAY.
T ERM s—$2.00 a
Year, Invariably in Adyance. All Communications relating to Publigations must be addressed to the Editor:
All Communicatións relating to Business, Subscriptions, Advertisements,"etc., to the Treasurer.
Vol. 2, ... . & IN CIN N ATI, J
4 - > . .
JAS. T. VVRITTAKER, M. D. - - -
No. 101 West Ninth street, Cincinnati.
Assocz.A.T.E. ºr rºofs. -
W. W. D.Awson, M. D. THAD. A. REAMy, M. D.
P. S. Conner, M. D. C. D. PALMER, M. D.
W. W. SEELY, M. D. SAMUEI, NICKLEs, M. D.
CHAs. KEARNs, M.D. Jno. L. CLEVELAND, M. D.
- RobăRTs BARTHorow, M. D.
Editor.
W. W. SEELY, M. D., - - - - - - - TREASURER.
No. 118 West Seventh street, Cincinnati. -
club R AT Es.
4 Copies to one address......... ~~~~ ......# 7.00
{} * @ € $ I0.00
I 2 .84 “. ......... 18,00
C O N T E N T S.
— - Page.
º origiNAL ARTICLEs
Medical Electricity and Medical Electrical Apparatus, by Roberts
Bartholow, M. D. • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 25
l{*moval of a Uterine Polypoid Tumor, by A. Guthrie, MI. D............. 26
Čaronic Dysentery, Treatment by Chlorate of Potash, by E. Z.
Shackleton, M. D.............. * . . . . . . . . . . “…...................................... 27
LECTURE .
“linicaſ, on iñér Cirrhosis by Prof. Düchek of vienna, (From the
Wiener Med. Presse, Dec. 10 and 17, 1871).................................. 27
- SCIENTIFIC NOTES
The Pathology of Hydrophobia—Parasites of Small-Pox—Prize in
Electricity “....................................... 20–30
MEDICAL NEWs **
The Actonian Prize–Novel Method of Inducing sleep—Medical
Counsellors—The Palm to the True Victors—Testimony to an
Italian Physician—The 44th Congress of German Physicians
and Physicists............. i * t - º g º º q & s > g º º v c q x ç ç w g º & e º is tº $ tº º 30-32
correspond ENCE / . . .
},etter from Mr. Stanton—An Explanation........ " \º. ........92
REviews ...'
Neuralgia and the Diseases that simulate it, * ºf F. E. Anstie,
M. D.—Reoprt of the Commissioner of Pensions to the Secty.
of Interior for 1871,...............
a * * tº tº e º is a º ºs s
CLINICAL MEMIoIRANDA
Ergot in Dysentery—New Treatment of Hydrocele, etc.—Vaccina-
tion Papers—Quinine in Trachoma–Gonorrhea Treated by
Water—A New Treatment of Spleen Tumors—Sulphurous
a tº a tº e º g º º a tº ſº ºr e º 'º º q is a s is tº it
*
Acid in Contused Wounds—Cause of Infectious Diseases......33-35
HOME News..... * * * * * * * * * * * * * * * * * * * * * * * * * * * * g º ſº e º a e g º g g g g g is ..............36
The Gºod Samaritan Hospital................... .................36
****
Now is the time to subscribe for THE CLINIC. The new
Volume is just commencing. Over one hundred new sub-
*ribers are already entered this month. Back numbers
*e disappearing fast,
* * * ***...----->
...........32-33 .
{T}
&J e
A N U A R Y 20, 1872. No.
coars are co-
Fashionable Hatters
IMPORTERS AND MANUFACTUREIts or
ŁABHES” Fººs,
92 wrest FOURTH st'.
Opposite Post Office,
CINCININATI.
& Special Inducerments to Medical Men.
* -
pg|ART Still MA
!- ºb ES GNERS ASP.
J. TAFT, W. T.A.F.T.
Editor Dental Register
J. & W. TAFT,
TXTEINTTISTS
17 WEST FOURTH STREET,
CINCINNATI, O.
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,












- * ,
*
Hills&SH
No. 65 WEST FOURTH STREET,
Call the attention of the Medical Profession
to their Extensive Stock of
&nglish, American and french
wrorcºr moors.
Paying particular attention to this branch of .
their business, they are enabled to execute all ||
- º
‘. . Jºe
~ . - - - *
< . -
v. & - - - - - -
- - *, * , 4.
. ^ i.
- ^. • - , , . ~ * : * * * *
*. . . . . . . • * : .
w S, - - * . ."
* - -
- -
- * - * - #: “y” . -
- -- -- • # , , , , . . . . * - - -
-- - || - g
| | |, ...' º . . . ; ; ; .
:-- , . . * : us i . . .
... ', . : * : ***
- - - : '.' .
. . . . . . ‘. . . . . . . . . . . . .
. : || || || ||
. : ºr * , - m.
BMWERN WINt nu VINE,
MANUFACTURER OF AND DEALER IN
Abdominal Supporters, Trusses,
GLUBFOOT SHOEs,
orders on the shortest notice, and at the most| . . . .
reasonable rates. Their facilities for the impor- |
tation of FOREIGN BOOKS, THE PROCEED-
INGS OF SOCIETIES and HOSPITAL RE-|
PORTS are unsurpassed, and any orders en- |
trusted to their care will be filled promptly, and
at the lowest rates.
Subscriptions received for FOREIGN and
AMERICAN PERIODICALS.
All the New Publications received as soon |
as issued.
Letters of Inquiry Will receive our prompt
and full attention. - - -.
Catalogues furnished gratis on application.
RobHRT CLARKE & Co.,
whilºlº, mºtiºn
PRINTERS AND BLANK BOOK MANUFACTURERS,
Zealez’s a Zºº...?/edica/, ZŽeological,
.Sc/oo/, and .7//sce//azzeozzy Zooſs,
655 West Fourth str. eet, -
Keeps constantly on hand a full variety of -
Metalic and Rubber syriages,
stomach Pumps, Etc.
‘stockings Fon warticose veins,
“-º-
Special attention, given to th eff tting of-App aratus for. Deformities. -
—ALso— • ‘’ -
DR AHL's PORöUS FELT, SPLINTs,
—A LSO– . . . . . . . . . . . . . . *
, - . . . . . . . . . . . . . . . . . . . . .”. . . . . . .
- . . .” • * : * ~ * ~ * > . - - ---
- - - - - ... • “. -
- . . A. ' *:S , , ºf Tº T : T.: Tººr rri c
ve £--> \- .2 - - - - ~\sº . . . ~ * S. 3 ºz. . . | 1 || tº .. .. | Nºs
—AND—
CINCINNATI, O.
º -
• i * . . . . . . - .* ... " - -- ~. • . . . . . ºr . * . . . . . * -
1 . . ; - '-º'- ~f *** - º - *S*. * * . . . i -> * : - * > , - . 23 - . . . . * * , - - . . * * : -
$s... Yºſer ºilić tºº...ºſité *-i- ºr
- t • . - - ... - - -> - .* * * - - - - * .
, - . - . . . . . . f. , ' ' ', . . . . . . . . . . ...-a, - ". . . . . .







List of Pharmaceutical Preparations,
won.w mºrezºn 4 anorman,
F.H.I.E.A.D.E.I.P.E.C.I.A.
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIRVALERIANATE OF AMMONIA,
(Goddard’s Formula,)
. . ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Irons, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK, -
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER winE OFIRON,
Citrate of Iron and Peruvian Hark,
- ," FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH, &
• ‘ ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK,
- * FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH, -
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
- .* BEEF, IRON AND WINE,
Extract of Reef, Citrate of From a had sherry Winne.
ELIXIRVALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUP SUPERPHOSPHATE OF IRON. OF PEPSIN,
" . - - ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRA BRAVA.
stſ E*E*Oslº DOERIEs.
Reetum, Vaginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination, Lists sent on application. *
SPONGE TENTS,--For the Urethra, of every size and style, made of finest quality of sponge,
-*- *S*_º ſº ſº
- - -- **
Wm. Wilson McGrew,
.Wo. 77 Wasz. Fourzºn, Sznarr,
PIKE's OPERA HOUSE BUILDING,
Importer and Dealer

'-º'-wºº, I N Wºrwººeee- -
Diamond and Gold Jewelry, sº
Watches for Ladies and Gentlemen,
Sterling Silver Tableware,
Bronzes, Antique and Modern,
Marble and Bronze Clocks,
Marble Statuary,

FAN cºr Coons,
GENER ALLY.
Carriage Manufacturer,
Nos. 9 and 11 East Sixth Street, bet. Main & Sycamore.
I MARE NOTHING BUT
czar'ss ºro w A'.
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur
passed. Of -
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety ºf light elegant designs of different cost and finish. In vehicles especially
adapted to •º-
PHYSE&#AAS” （SE.
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen’s
buggies, road and, trotting wagons, and
racing work of every description, has long





-------- - - - -** * -- ~-
F. E. Suutº. E. S. WAYNE
T. E. Suire & Co.,
WHOLESALE DRUGGDSTS,
IM. A. N. U E A CT UER IN G.
gh exists A. N. D PHARM Aceutists,
CITYCIN NATſ, OHIO,
Have constantly on hand a full assortment of
S EX, X: Cºſ’)S)O X}}{3 O G, S ANYO meoworses,
cxxxºny)(CAX, AX'X'A}{A}^0 S,
rests. Medical glass ware sº, sº,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
ties.
FINR, ANTD FRAEH, CHEMICALS.
Of the popular class ºf preparation3 known as
H. LIXII ER, s,
We manuſactiſe a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and loſic, Wine of Iron, &c
AGENTS FOR BULLOCK & CRENSHAW'S
Sugar-coated Pills and Granules.
Y
Price Lists of preparatious and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the good" sold by us generally.
Made in accordance with the U. S. P. and other recognized authori-
i
{
TR.s.IN.INMARSH's
º, "tº
º
JAMEs Fostºn, J.R., & Co.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
same. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in.
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best” and largest stock of
Lenases, Spectacles; and the best models procurable, with pains-
} taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopic Objects
and Microscopic Apparatus, Magnifiers and Readers in
great variety.' Medical:Batteries, Earometers, Thermo-
meters, Hygrometers, Urinomieters and ſtain Gauges.
of the most approved construction always on hand. All orders promptly
and accurately filled. ' ' ' ' ' ' . . . . . . .
JAS. FOSTER, JR.
F. S. Säääki ºpp, ; ** JAs. FostER, JR. & co.
S.W. Cor. Fifth & Race Sts., Cincinnati, 0.
§2) TRUSSES. c992
. No. 758. BROADWAY, NSW. Yoak
HAWE, been in the habit of applying and recommeriding the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. I.EWIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
BEG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hornia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, MI. D.
Professor of Surgery, New York City
*
Dr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & CO., No. 2 Vesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
OPPOSITE THE HIGH STEEPIE,




o) sºlubot You
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soluld on 1 Jo alou.A out do uoſº Iod u Kluo Juul os pauſing
oq ūuo SAoSI ou I, sočut ºujºt ºu utoqn 5uſtumn Kq
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26 THE CLINI c. [JAN. 20, 1872.
Same, with Hydrostat attached - 23 00 | During each paroxysm of pain the tumor gradually
No. 2–sixteen Cells, for General Use - - 3500 descended, and at length during one of unusual severity, -
With Hydrostate - - - - 40 00 on the 18th, it was partially expelled from the uterine
No. 3.-Thirty-two Cells, of Double Strength i cavity.
where increased power is necessary, At 4 A. M. of the 19th she had another.paroxysm of
and for Electrolysis - - - 60 00 pain, followed by excessive loss of blood which was with
With Hydrostate - - - - 7000 difficulty restrained. At 10 A. M., assisted by Drs.
The additional cost of the “Commutator,” if ordered Keables and Wilkin of this place, I applied a silk liga-
for each of those Batteries, is $3.00. ture with Gooche's double canulas. Just as the liga-
For a portable Battery this arrangement is the best ture had encircled the neck of the polypus, a copious
that has hitherto been proposed. No Portable Battery, gush of blood occurred, which was inmediately arrested
however, can work as satisfactorially as the permanent | by tightening it and again occurred upon relaxing it.
arrangements described in a previous number of THE |The ligature now was drawn tight and firmly secured.
CLIN1c. For permanent use the cups of Siemens and |The patient being much exhausted from loss of blood,
Halske, and the regulator of the Galvano-Faradic Com- etc., was ordered two teaspoonſuls of brandy with one
pany seem to us to be the most desirable. grain of opium to be repeated if necessary.
--—--→–- A portion of the tumor having already sloughed, it
now became doubly necessary to use every precaution
to prevent Septicamia; accordingly she was ordered to
RY : inject, per vaginam, Sol. Carbolic Acid (grs. xv to aqua
Oiss) overy four hours. She slept some through the
night, had no recurrence of pain, but the stomach was
very irritable and would not tolerate quinine or any
form of iron. -
I was called April 8th, 1870, to see Mrs. R. act 34, On the morning of the 21st, the foctor was intolerable,
who was suffering excruciating agony from violent and with a view of lessening the chances of blood-
throes resembling labor pains, except that they were poisoning 1 ordered, Carbolic Aeid, grs. xv, Alum Wa-
more continuous; she was bathed in perspiration and |ter Osº, to be injected, per vaginam, every two hours,
tossing herself from side to side in bed. Upon inquiry hoping that the astringency of the alum by corrugating
I found that she had suffered more or less at her catame- the tissues would, to a certain extent, prevent absorp-
nial periods for three years, but much more so during tion of the poison. . . The ligature was tightened each
the last year, which had also been attended with con- alternate day. She had no recurrence of hemorrhage,
siderable loss of blood. The catamenia resumed regu- but had occasional attacks of diarrhoea, which were
larly, and continued from six to eight days; during the kept in abeyance with Bismuth and Opium, Huxham's
interim she was quite free from pain, but was much Tincture, Brandy and a nourishing diet: these were con-
annoyed by leucorrhea. She had been married fifteen tinued until the 31st, when making gentle taction on the
years but never been pregnant, her general health was canula it came away. The tumor was so large that it
considerably impaired; appetite poor, bowels regular. Was removed from the vagina with considerable diffi-
No organic disease of thoracic or abdominal organs. culty. It was pyriform in shape and fully as large as a
Ordered Morph. Sulph., gr. at once to be repeated pint cup, and when laid open had the appearance of a
overy half hour till the pain abated. On making a solid mass of flesh interspersed with fibrous tissue.
digital examination per vaginam, I found the os Subsequent to this, she improved quite rapidly and
somewhat dilated, soft and patulous, and a small tumor was able to sit up in ten days and was quite well in a
presenting itself just within, seemingly as large as an month. • .
egg. On the 9th she had another severe paroxysm of She menstruated regularly and without any abnor-
pain accompanied by copious hemorrhage, for which mal trouble, on the 4th of the following July, the
she was ordered Acetate of Lead and Opium. menses recurring every two weeks for three months,
After the menstrual period had passed I made a specu- after which they became regular every month and have
lar examination and found the tumor just within the continued so up to the present time (Nov. 23d, 1871).
uterine neck; it having receded farther into the uterine | When conversing with her yesterday, she told me
cavity on the cessation of pain. After explaining to that she had no more Pain during her “periods” now
Mrs. R., the real nature of her case and the necessary than when she was 15 years of age. The pedicle of the
opcration, I prescribed some iron and quinine and tumor Was remarkably large and must have been almost
awaited the next menstrual epoch, which returned on an inch and a half in diameter; which partially accounts
the 8th of May accompanied by a repetition, in an for º length of time the ligature was in cutting its
aggravated form, of all the former symptoms; the hem- wº #pal points connected with the case are:
orrhage only being controlled by frequent vaginal injec- || 1st. The immediate cessation of hemorrhage on tight-
tions of alum-wator. ening the ligature. -
Removal of it [terine Polypoid 'ſ'ku naaor.
.A. ( ; UTHR1ſ., Mſ. D.
Pella, lowa,
JAN. 20, 1872.]
TIEI IET: C T , IIST I C .
27
2d. The magnitude of the tumor.
3d. The largeness of its pedicle. -
4th. The possiple influence which the alum-water
may have had in preventing absorption of putrid
matter. -
This case is reported in the hope that it might be of
some value to those who are compiling statistics of
“Uterine Tumors and Neoplasms.”
--—-—e-e—e------ -- - - - -
c H R o N I C D Y s E N T E R Y .
some Further Testimony in favor of the Employ-
ment of Chlor. Potash in Chronic Dysentery.
- BY -
E. Z. SHACKLETON, M. D.
The successful employment of Potass. Chlor. in the
treatment of Chronic Dysentery, reported by my friend
Dr. A. B. Isham, of Walnut Hills, Ohio, in the The
Clinic of Nov. 24, prompts me to add my testimony as
to the efficacy of this medicine.
Case 1. Mrs. A., German, aged 29, well nourished,
was attacked July 11th with dysenteric stools, bloody
and frequent. Some tenesmus and tormina. Treated
herself with domestic remedies until July 22, when I
was called to attend her. Found upon examination
, the disease had passed into the chronic form.
Stools frequent and Small, presenting a purulent ap-
pearance, flakes of lymph, etc. *Tenesmus and tormina
greatly increased. Abdohen full, tender upon pressure,
Prescribed -
JR.
Ol. Ricini 3ss.
Ol. Terebinth.
Tr. Opii aa, gtt. a.
TM. To be taken at once.
This caused evacuations of scybala smeared with a
muco-purulent material. -
Having had good results from the administration of
Pot. Chlor. in several previous cases, I determined to
resort to it at once; accordingly, I prescribed Pot. Chlor.
ten grs. every 4 hours; together with 1-5 gr. Morph-
Sulph. sufficiently often to ensure freedom from pain.
Saw patient again on 23, when she expressed herself as
feeling much better. Stools not so frequent, tenesmus
and tormina not so great. This treatment was persevered
in, -except as pain became less, when less morph. was giv-
en until wholly stopped on the 25th. Aug. 1st she was
dismissed cured; discharges having become healthy in
appearance, abdominal pains absent, etc. From
this time she rapidly gained strength.
Case 2. Fred. K. also a German and well nour-
ished, age 55, Called to attend this man July 23, found
he had been suffering with dysentery four days, stools
frequent, small and bloody; lower bowels full. Gave
full dose of Mag. Sulph. to carry away offending accu-
mulations, and deplete inflamed mucous surface;
operated promptly and fully. Patient not improved,
gave Opium and Plumbi Acet., formentations to abdomen;
also injections of Tr. Opii in thin starch water to re-
lieve tenesmus, which it did to some extent; treatment
continued until 26th, patient no better. Then changed
to the Ipecac treatment, 3 gr. Morphia to quiet stom-
ach, and in ten or fifteen minutes gave 20 gr. dose of
Ipecac which was tolerated, gave this every 4 hours;
continued this until 30th, discharges less frequent, but
present a purulent appearance. Patient considerably
debilitated. Stopped Ipecac and substituted Pot. Chlor.
gr. x every 3 hours, Morphia sufficiently often to
ensure rest. Continued treatment until Aug. 7th,
when patient came to my office saying he was perfectly
well. -
Of course this prompt benefit could not be obtained
did we not commence treatment soon after the assump-
tion of the chronic form , extensive ulcerations would
not so readily yield.
St. MARYs, OHIo, Jan. 1, 1872.
--------—-º-º-º--------- - -
I, I ºf E R (; I R. R. H. O S H S .
A Clinical Lecture by Prof. Houchek, Viennina.
[From the Wiener Med. Presse, Dec.,10 and 17 1871.;
('onfinited from No. 2,
Let us turn our attention now to the local origin of
the disease. In the inflammations mentioned transuda-
tions occur from the vessels themselves, from those
parts, namely, where the inflammatory process has
developed. That we have here before us an inflamma-
tory lesion is improbable from the fact that the fluid in
the abdominal cavity is free. Further we have estab-
lished the fact that the spleen tumor present is not re-
ferable to former disease which may have left it as a
residuum. Finally this is not in harmony with an
idiopathic peritonitis, wherefore we need not delay over
the presumption of such an inflammation. Other facts
assist us. If we direct our whole attention to the vena
porta we may establish all the symptoms, develop
them, indeed, therefrom. Stasis in the portal vein—
I speak of its trunk or its chief branches—must necessa-
rily occasion disturbances in the circulation of its
various branches. If the trunk of the portal vein, the
collecting canal of all its branches, be subjected to com-
pression, the whole mass of blood is forced back upon
the mesenteric, splenic, gastric, etc., veins. The best
example of this is furnished in simple portal thrombosis
wherein the roots of the vein are distended in high
degree, the splenic vein thus is engorged with blood, in
28
[JAN. 20, 1872.
TEEE CI.INI c.
the substance of this organ as well, and the spleen with
this increased volume presents itself thus as a tumor.
It is not yet definitely determined whether this result
is a simple phenomenon of stasis or whether there is not
also associate with it alterations of tissue. Patholog-
ically, we know that the spleen often enlarges rapidly,
assuming a great increase in its volume. Spleen tumors
are often encountered of such size as to extend two or
three inches below the border of the ribs. Hard and
firm they seem in consequence of the great distension of
the capsule from the proliferation of the spleen substance
which continually occurs. A second and much more
frequently observed stasis presents itself in the roots of !
the numberless vessels which go to and from the
mesenteric vein. These are vessels which ramify in the
peritoneum, in the mesentery, upon the surface of the
intestines, in the substance of the intestine itself, vessels
which reach the liver through the mesenteric veins and
through it finally the gentre of the circulation. A |
stasis developed here must become evident in the intes-
tine and the peritoneum. The exudation mentioned
must then occur in the peritoneum very early and the
same effects ensue as in the feet after ligation of the
crural vein. When pressure is exerted upon the
mesentery, ascites develops, as a further consequence,
stasis in the intestinal vessels, transudations into the
interior of the intestines, diarrhea, and if the process be
rapidly developed, as is the case in portal thrombosis,
the extremely distended vessels are ruptured and hem-
orrhage occurs. In regard to these intestinal hemor
rhages, however, I must remark that they occur from
many internal causes. When ascites and spleen tumor
are absent in such cases, the diagnosis may not be estab-
lished. There are cases marked by has matemesis where
the cause of the hemorrhage may not be assigned. The
Yemae gastricte which empty into the Yenal splenicae
may induce, in consequence of stasis in the Yena porta,
stasis in the vessels of the stomach and though this may
not lead to any marked exudation of fluid, it may and
does not infrequently lead to hemorrhage. All this,
however, is not symptomatic of granulated or cirrhotic
liver, not symptomatic of any liver diseaso necessarily,
symptomatic simply of stasis of the portal vein.
The same manifestations are present when the portal
vein is subjected to compression, when a thrombus is
formed in its interior or extends into its branches, when,
finally, there is such disease in the liver as to occlude
the caliber of the numberless branches of its final rami-
fication. *
We are thus far, then, in our disease as to be able to
diagnosticate some impediment to the cireulation of the
portal vein ; that we may state, moreover, that this dis-
turbance has its seat at various points, that it is in the
trunk of the vessel or in its branches, because we find
present ascites and tumor of the spleen. In further
diagnosis we have now to regard at what point of the
vena porta the obstruction must exist to evince the
lesions present. It would lead us, to-day, too far from
our purpose were we to discuss all the possibilities of
such cases. We confine ourselves, therefore, to the most
essential. Here belong, then, diseases which concern
the branches of the portal vein and which extend thence
to its trunk, diseases of the peritoneum and intestine.
I need only remind you in the present case, that the
history points to no such affections. There has been
in our patient no previous dysentery, no intestinal dis-
ease of any kind. He has slowly passed from a condi-
tion of perfect health into that manifest before us, Our
examination reveals no disturbing element, as tum.or
from the pressure of which upon the short trunk of the
vessel between the liver and duodenum these symptoms
might ensue. We could establish nothing in this whole
region other than the described condition of the liver.
From the absence, then, of any extrinsic compression
upon the portal trunk or branches we are cast back
upon the liver. - - -
How, now, may these disturbances in the portal circu-
lation occur 7 Lesions may very early, as is readily
understood, affect the branches into which the portal
vein breaks up. When the chief of these branches are
compressed, stasis must ensue. These cases are rare.
It is possible that cicatrices following inflammations
tumors, neoplasms in the liver may compress the portal
branches. One of the diseases that furnishes most
abundant new formations is carcinoma. But this dis-
ease show this most remarkable peculiarity; it causes
these portal disturbances in only the rarest cases.
Ascites, it is true, does often occur, but the stasis is
never 80 great as to induce an increase in the volume of -
the spleen. On the contrary, we find quite early a
marked reduction in its size, so that it is present but as
a seeming appendix which must be sought after to be
fonmd. This is because its tissue, under the metamo-
photic changes of the new formation, becomes atrophied.
It is attacked, with marasmus. We encounter the
cause of these portal disturbances seldom, then, in the
chief branches of the vein. We find the most frequent
cause of the lesion to be connective tissue exuberations
in the substance of the liver. One form of this affection
is present in the well known granulated liver, liver cir-
rhosis. Bessdes this there are various atrophic condi-
tions which lead to connective tissue proliferation
though only to moderate degree. Thus in the simple
form of atrophy consequent upon that fatty degenera-
tion which is caused by protracted hyperaemia, in simple
hyperoemia, in heart disease of some years duration, we
find the liver firmer and more solid, granulated lightly,
too upon its surface. The connective tissue increases
in volume, the liver becomes harder and firmer and
these circumstances exercise, then, an influence upon
the portal branches. The most fruitful source of con-
nective proliferations is furnished by simple inflamma-
tory processes, hepatitis, thus, a disease which is, how-
ever, extremely rare in our climate and syphilis of the
liver, an affection which produces, in those parts where
retrograde change has commenced, opaque, whitish,
JAN. 20, 1872.]
THE CLINI c.
29
shiny cicatricial tissue either in linear or rounded form
or in bridles with branching processes. -
This cicatricial formation in the liver is, according to
late investigations, not so very rare, and the masses of
connective tissue often encountered in the liver with
whose genesis we were quite unacquainted ten or twelve
years ago, we have learned in the last few years to re-
gard of syphilitic origin. The amount of stasis in syph-
ilis of the liver must depend upon the amount and dis-
tribution of the lesions peculiar to the disease. Such a
mass in the right lobe would only affect a small number
of portal branches, only an insignificant stasis, thus,
would ensue, and this would be compensated for in
other unaffected vessels.
I have seen cases in life which have been marked by
all the symptoms of liver cirrhosis, wherein a more
thorough examination has revealed numberless cicatrices
of syphilitic processes elsewhere in the body; treated,
then, as cases of syphilis, cure has resulted. Syphilis is,
then, a fruitful source of connective tissue proliferation
and of stasis in the portal circulation.
But the most frequent cause of these phenomena is
liver cirrhosis. We understand by this a disease processin
which there is symmetrical new formation of connective
tissue. Of this, there are at most, but two varieties.
The liver is permeated with masses of connective tissue,
in a sense, new and foreign to it. It encroaches upon
the interspaces for the portal branches which are com-
pressed. The circulation in this vein is more and more
interfered with until full stasis is brought about with the
consequences present in the case before us. We have
here a case of hydrops ascites not referable to changes
in the mesenteric veins or in the portal trunk, as also a
spleen tumor inexplicable on any other assumption.
Our case implies a central impediment, in all proba-
bility situate in the liver. The only other tenable
theory would be a compression exerted between the
liver and the vena cava an accident of such extreme
rarity that it may be safely left out of account. Hay-
ing established this we may now inquire what are the
symptoms which atrophy of the liver presents. It
should be first remarked that the influence of this dis-
ease is different in different cases and at different times,
so different, indeed, that many distinguish between a
preliminary stage and a stage of attack. The liver is
sometimes found large or moderately enlarged so that
it is palpable beneath the border of the ribs; with this
increase of size are present the symptoms of liver cir-
rhosis, but on post-mortem the granular surface is want-
ing. Masses of connective tissues are evident, unsy-
mentrically arranged, without cicatrices, without granu-
lation on the free surface or on the surface of section.
It may be maintained that this is the preliminary stage
Which may remain for a long time, not being attended
With atrophy of the parenchyma. I may add, too, that
We encounter cases wherein the process induces marked
*ites, marasmus and death without any atrophy of
* gland. Many have claimed this as a particular
kind of cirrhosis in which the liver becomes enlarged
and hardened from the rich proliferation of connective
tissue in its interior. But it is as rational to maintain
that this is but a preliminary stage and that in conse-
quence of the rapid changes in the nutrition induced
there has not been time sufficient for retrograde change
and consequent atrophy: that when the process is more
protracted this atrophy always ensues.
Hitherto we have only been able to state that there
must be stasis in the whole portal circulation for the
production of these symptoms. Whether this stasis,
however, be due to connective tissue proliferation is
still sub judice. If a case be marked by liver enlarge-
ment with a distinct border, other causes leading to
stasis, particularly, liver syphilis, hyperamia from heart
disease and other causes being excluded—or on the oth-
er hand, if a case be marked by liver decrease, its border
not being palpable at the moment of deepest diaphrag-
matic descent, the diagnosis is more Secure. I may re-
mark to you that the condition described in the books
you will seldom encounter. The deductions of phantasy
from the autopsies of exquisite cases are seldom realized
in life. The fingers can not penetrate in palpation
much more than one-quarter of an inch: elevations of
an inch in hight may thus exist and escape detection.
Granulations are flat and low, and may but very seldom
be recognized by touch. I believe that in many cases
in which they have been recognized, they have been
products of syphilis. I remember to have treated a
case of syphilis in a woman at the Josephinium hos-
pital, where numbers of granulations of half an inch in
hight were plain to the touch.
To resume now in conclusion for to-day, we may ac-
cept a case to be cirrhosis of the liver in all probability,
where there is stasis of the portal system, when this
stasis is inexplicable by other diseases, and where,
further, splenic enlargement is present. Should there
be associate with this a small liver and hob-mailed to
the touch, the diagnosis is fixed. Confirmed, it is still
further by a history of the abuse of spirituous drinks.
—-tº-º-º--------
SCIENTIFIC NOTES.
'The Pathology of My drop in obia.
An Abstract from the Prager Wiertejarschrift, No. xxiii, 1871.
-*
The symptoms just portrayed are regarded by many
physicians and authors as characteristic of a specific
inoculation from the bite of a rabid animal. But there
are many eminent authorities who refuse to regard
hydrophobia in man as a specific disease, and who deny,
indeed, the possibility of human infection.
Prof. Bruckmüller states in his interesting essay on
hydrophobia, that all the symptoms claimed for hydro-
phobia, according to his most abundant and varied ex-
perience, occur in the most different disease processes;
i)
* }
: - **—
, t -
.*, tº -- … . . * * *---
pneumonia, brain cancer, diseases of the prostate, etc.;
further, there is no single pathological characteristic
of hydrophobia found universally in all bodies dead of
this disease: every lesion present may occur in other
diseases. Hydrophobia, therefore, is no specific disease,
but only under certain circumstances a prominent symp-
Concerning its contagion, Bruckmüller maintains there
are more facts against it than in its favor. Firstly, the
symptoms of hydrophobia in man are very different
from those in dogs, the most marked symptom of the
disease in dogs, e. g., the desire to bite, is absent in
man. Hydrophobia presents the most marked analogy
to traumatic tetanus, may, indeed, only be distinguished
from it by the cause of the latter. His conclusion is,
therefore, that hydrophobia in man, when induced by
the bite of a dog is nothing else than tetanus. Observe
the statistics of dogs bitten by a mad dog, this is a strong
fact against contagion. According to Hartwig, but 6 in
137 are affected ; the rest remain healthy. Inoculation
imparts the disease in about 15 per cent of cases. In
many cases entirely different diseases follow inoculation,
typhoid fever, catarrhal processes, lung inflammations,
Inoculations with blood are totally without effect. |
Gºtc.
Lorinser, also in Vienna, in his extremely interesting
work on this disease, demonstrates the untenability of
the prevailing doctrine of the contagion of hydrophobia.
The transmission of a specific contagion from the dog to
man, belongs, he claims, to the region of fables. There
are no characteristic symptoms of this disease; what do
exist prove only that the dog is sick and inclined to bite.
Pathological sections exibit no characteristic lesion.
Hence, Lorinser maintains that what has been called
hydrophobia is not a definite disease, but is only a symp-
tom of many and very different affections, -
Concerning the disease, now, known as hydrophobia of
man, the author is of the opinion that it is mistaken for
convulsions, tetanus (perhaps from trauma, as well from
cold, mental emotions, cycesses, all, however, in no con-
nection with madness), hysteria, cramps, etc. Certain
it is, that persons bitten by dogs, do sometimes in conse-
quence either of wound, severe caustics applied, intense
anxiety or of extraneous causes, become attacked with
tetanic symptoms. In support of this are arrayed the
following facts:
1. Hydrophobia sometimes originates without any
cause whatever, without a previous bite, scratch or lick
from a raging animal. - -
2. Among the great number bitten it is only seldom |
that one is attacked with hydrophobia, Sladtburgen
treated 12 persons bitten by a mad dog. But one be-
came sick; he recovered. Cramer states that of 100
bitten in Hamburg, in 1852-3, only one died of hydro-
phobia. -
3. In many cases, º occurs months or years
after the witt: ; how may this be explained 2
processes which present no analogy to hydrophobia, as |
(same as in trismus and
| water.
tom of the most diverse diseases (a view already expressed|
by Köchlin). It is, then, to be regarded as a secondary
manifestation, often induced by external influences.
T C - [JAN. 20, 1872.
4. The course of the so-called hydrophobia as well as
the lesions in the dead body differ not in the least from
the symptoms and pathology of tetanus. Cries of pain
are regarded as barks, convulsive twitchings of the
mouth for attempts to bite; difficulty of swallowing
osophageal cramp) for fear of
* .
33
w
º:
5. The course of diseases known to be induced in the
body by the transmission of poisons from the lower
animals, presents not the least resemblance to hydro-
phobia. -
Supported by all these facts, the author comes to the
conclusion that hydrophobia in man is not an effect of
animal poisoning; it is not a specific disease; it is noth-
ing else than a neurosis. (trismus, tetanus) which may
supervene upon trauma, occur as well from many
other causes.
PARASITES OF SMALL-Pox,-Weigert found in the
corium of sections of the skin in small-pox vesicles or
sacs of 0.01-0.02 mm. diameter which he with Reckling-
hausen considers as lymph vessels whose contents ex-
hibit the characteristics of bacterians as described by
Recklinghausen. He found them only in hemorrhagic
cases and in localities in the vicinity of the efflorescences
of the disease; he does not believe, however, that they
are peculiar to small-pox. In what relation they do
stand to this disease he is not yet able to state.—Cen-
tralbl.f. Med. Wissen, No. 39, 71. .
PRIZE IN ELECTRICITY-By a decree, dated April 18,
1866, of the Minister of Public Instruction in France, a
prize of 50,000fr, (2,000l.)was offered for the most useful
application of the Voltiac Pile, the period for competi-
tion to expire in April 1871. From a report of the
minutes presented by the President of the Republic, it
appears that candidates are few in number, and that in
the opinion of the 8&vants to whom the memoirs were
submitted, none is of sufficient merit to have earned the
prize. By a decree of the 29th of November, the com-
petition is now extended for another period of five years,
to terminate on November 29, 1876,
MEDICAL NEws.
THE ACTONIAN PRIZE.-The next Actonian Prize or
prizes offered by the Royal Institution, will be awarded
*
ſ
| in the year 1872 to an essay or essays illustrative of the
wisdom and beneficence of the Almighty. The subject
is “The Theory of the Evolution of Living Things.” The
prize fund is two hundred guineas, and it will be awar-
ded as a single prize, or in sums of not less than one
hundred guineas each, or withheld altogether, as the
managers in their judgment shall think proper. Com-
petitors for the prize are requested to send their essays
to the Royal Institution, Albemarle Street, on or before
June 30th, 1872, addressed to the Secretary, and the
adjudication will be made by the managers in Decem-
ber, 1872. - " . .


JAN. 20, 1872.]
TEEE C LINI. C. - 3]
A NOVEL METHOD OF PRODUCING SLEEP IN IN- |
FANTs.--Dr. Curren, writing in the Dublin Quarterly
Journal of Med. Sci., of the Medical History of the Him-
alayas, speaks ot a curious way which the woman of the
country have of quieting their children when obliged to
leave them. When a mother goes into a field to work,
or is otherwise unable to take her child with her, she
selects some sheltered spot near a stream, in which she
places some straw for a bed for her infant, and then di-
rects, by means of a piece of split bamboo, a current of
water, of from one to two or three inches in diameter on
its uncovered occiput and temples. This produces a
soporific effect, which generally lasts as long as the water
continues to flow. The sleep is said to be very soothing,
and children who have been much subjected to its in-
fluence are known to have been unusually free from the
annoyances incidental to the period of dentition.
MEDICAL COUNSELLORS.–Jas. Paget, D. C. L., F. R.
.S. S., (Lancet), in a clinical lecture on “Dissection
Wounds,” in connection with his late illness, remarked
that Sir William Lawrence used to say that he had not
known any one to recover on whose case more than
seven had consulted. Our art has improved. He had
the happiness of being attended by nine: Dr. Burrows,
Sir William Jenner, Dr. Gull, Dr. Andrew, Dr. Gee,
Mr. Caesar Hawkins, Mr. Savory, Mr. Thomas Smith,
and Mr. Karkeek.
lors was safety.
THE PALM To THE TRUE VICTORS.—“The Prince
lives, and every day gives us assurance that
the great danger is over. But surely those who
have undergone trials only inferior to those of the snf-
ferer himself are not to be forgotten. If the nation re-
joices and is thankful, it ought not to be forgotten what
it owes to the skill and science, to the devotion and Self-
sacrifice, in every sense entire and complete, of the
physicians. Sir William Jenner would be the first to
extol the exertions of the colleague who has earned from
all at Sandringham what he values probably only second
to the approbation of his conscience, the deepest grati-
tude. In Dr. Gull were combined energy that never
tired, watchfulness that never flagged-nursing so tender,
ministry so minute, that in his functions he seemed to
combine the duties of physician, dresser, dispenser, Valet,
nurse—now arguing with the sick man in his delirum
So, Softly and pleasantly that the parched lips open to
take the scanty nourishment on which depended the re-
serves of strength for the deadly fight when all else failed,
now lifting the wasted body from bed to bed, now wash-
ing the worn frame with vinegar, with ever-ready eye
and ear and finger to mark any change and phase, to
Watch face and heart and pulse, and passing at times
twelve or fourteen hours at that bedside. Ánd when
that Was over, or while it was going on—what a task for
... |-to soothe with kindest and yet not too
to º .* yº †: was º great tº bºº,
confidence. †h.”. ºair; . É. to justify
ings I hear, and it is only just that
º º be known, for very certain it is that from
º of Whom they are said not one word of the truth like
s
would ever come.”—Dond. Corr. N. Y. Daily.
He says, in this multitude of counsel-
+-
TESTIMONY To AN ITALIAN DISTRICT PHYSICIAN.—
The municipality of Castiglion d'Orcia has presented
Dr. Comparina, district medical officer of Campiglia,
medical works to the valne of 140 lire(£5:12), in rec-
ognition of the zeal and devotion with which he has per-
formed his duties, L’Imparziale regards this as a rsre
instance of public generosity, and hopes that the exam-
ple may be frequently followed. -
-————-º-e -º-
The 44th Congress of the German society of
Physicists and Physicians. Rostock.
Sept. 18-24. 1871.
Certainly the most enthusiastic, perhaps the most
profitable session ever held by this learned body has
that proven which assembled for the first time
under a united Germany. Most instructive papers were
presented in every department of science. We have
space but to notice a few of the most prominent from
the section on internal medicine. The next congress
assembles at Leipsic the place where the Society was
founded half a century ago. Prof. Leyden, (Königs-
berg) read a paper on the peculiar character of the ex-
pectoration in bronchial asthma. It is scanty, -1
drachm in 24 hours, grayish-white, and transtucent. It
contains masses of fine fibrils and flocculi of considerable
tenacity and usually a light gray color. These fibrils
and flocculi are derived from the finest bronchioles and
are composed of mucous corpuscles in retrograde change,
dry and granular, with a mass of elongated, octahedral
crystals visible under the microscope at 300-600 diame-
ters. These crystals are imbedded in a basis substance
consisting of cells in retrograde, granular, metamorphosis.
Between these cells, granular masses are encountered
in molecular motion. Similar crystals are observed
in dry catarrh, croupous bronchitis with asthmatic com-
plications, mucous tumors, leucocythaemic blood, and
in the spinal cord. They are quite brittle, colorless,
easily soluble in warm water, alkalies, and dilute acids,
Prof. L., is inclined to accept the view that this peculiar
secretion mechanically, perhaps also chemically, excites
in the smaller bronchi an irritation in the vagus termin-
ations in the bronchial mucous membrane with reflex
contraction of their muscles, and thus the symptoms of
nervous bronchial asthma are produced. An experi-
mental proof cannot yet be furnished. Matters thrown
into the air passages of animals never penetrate to the
finest bronchi. In regard to therapy the remedies in
highest repute are chloral hydrate, opium, ipecac,
iodide of potash and inhalations of alkaline fluids.
Prof. Waldenburg (Berlin,) demonstrated his
Cesophagoscope and a quicksilver manometer. By means
of the first the lateral walls of the upper part of the
Oesophagus may be brought into view. The manometer
which is connected with the mouth by means of a sac
is designed for measuring the force of inspiration. It is
32
[JAN. 20, 1872,
TIH. H. cI.TISTI c.
of high importance in a diagnostic point of view in that
unlike the spirometer it does not take into account the
force exercised by the muscles. Inspiration and expira-
tion moreover are separately measured and may thus
be compared. º: 3:
Prof. Liebreich (Berlin) on crotonchloralhydrat as a
narcotic. [Chemistry omitted.] In animals this agent
brings about anaesthesia of the head, under continued
action, of the rest of the body; in the second stage there
is absence of reflex excitability in consequence of affec-
tion of the spinal cord; in the third, under-large doses,
death follows by paralysis of the medulla oblongata.
Animals may, however, still be maintained alive by
means of artificial respiration since the action of the
heart is not at all affected. Chloral, on the other hand,
finally induces paralysis of the heart. It would seem
from its action that dichlorallyle is formed in the body
and this is analogus in its effect to aethylidenchloride.
Experiments on man demonstrate that the brain may
be brought into profound narcosis by crotonchloralhy-
drat without interfering with the functions of the rest
of the body, while with chloral a corresponding amount
of brain narcosis is attended with general anaesthesia
and dangerous reduction of the hearts activity. * *
Prof. Binz (Bonn); On the effects of quinine on
haemoglobin. According to former experiments fresh
blood of warm blooded animals, which have received
quinine in doses this side of fatality, shows distinctly
diminished reaction to the stimulus of oxygen. By new
experiments, by means of the direct action of quinine on
haemoglobin and fresh blood, B. has demonstrated that
haemoglobin dissolved in a dilute solution of quinine,
remains protected against decomposition and oxygena-
tion for a long time while the protecting solution
becomes of a bluish-red color and of disagreeable odor.
–Schmidf's Jahrbücher, Dec. 1, ’71.
-—º-e-º--- ~~
("@IRRESPONIDEN (‘E.
CINCINNATI, ()., Jan. 16, ’72.
EDS. CLINIC :
In THE CLINIC of January 13th under the head of
“Medical News” is an item speaking of the death of my
brother Dr. Stanton, of Pennsylvania, as “Suicide by
Morphia Hypodermically,” and stating that the dose
taken was one grain.
The dose taken was but little, if any, more than half
a grain, and the case was not suicide. No one who
knew my brother has the slightest suspicion that the
case was one of suicide, in fact those who were cognizant
of the circumstances knew that it was not.
Will you please make these corrections in the The
Clinic and oblige
Yours Truly,
William Stanton,
It E VIE W S .
NEURALGIA AND THE DISEASES THAT SIMULATE
It. By Francis E. Anstie, M. D. For sale by Robert
Clarke & Co. -
We have been promised this book for some time
through the London Practitioner, and now welcome it
to our library.
The author professes to put forward “substantially a
new view” on the subject of neuralgia, which was briefly
mentioned in his article in Reynold’s “System of Medi-
cine,” three years ago. The subject is presented under
the following divisions. Clinical history—Complieations
of Neuralgia—Pathology and Etiology of Neuralgia—
Diagnosis and Prognosis—Treatment. This completes
part I. - - - -
Part II is devoted to the diseases that resemble neu-
ralgia—Myalgia—Spinal Irritation—The Pains of Hy-
pochondriasis—Pains of Locomotor Ataxy—Pains of
Cerebral Abscess—Pains of Alcoholism.
Chap. I. Clinical history is very instructive, and is
highly satisfactory, but it encroaches somewhat upon
the chapters devoted to pathology, etiology and treat-
ment. The characteristic feature of the book is devel-
oped in the chapter devoted to pathology and etiology,
viz., the theory that all neuralgia is of centric origin.
He hopes to be able “to convince most readers, that the
essential seat of every true neuralgia, is the posterior
root of the spinal nerve in which the pain is felt, and
that the essential condition of the tissue of that nerve
root, is atrophy, which is usually non-inflammatory in
origin.” This theory is maintained by a consideration
of the etiology of neuralgia and the kindred neuroses,
clinical observations, hypotheses, etc. Showing how
peripheral irritation may produce centric degeneration .
and centric degeneration pain. The chapter is rich in
research and suggestion, but we fail to come to the same
conclusion with the author and prefer, until some
further advance is made in the pathology of the disease
the “inhibition theory” of Handfield Jones. It does
not appear but that a trophic degeneration of the cord,
would be as plausible an explanation as a degeneration
of the posterior root. The chapter devoted to treatment
is in pleasant contrast to the majority of monographs
and systems of practice that we meet with, whose prin-
cipal strength is given to the etiology, symptomatology,
pathology, etc., while the treatment of the disease in
hand is merely briefly mentioned. Treatment here is
as thoroughly discussed as the size of the book will
admit, and fully represents the most enlightened and
approved methods. The part devoted to the examina-
tion of diseases resembling neuralgia closes this truly
interesting and instructive votume.
The fact that the author has been a-sufferer from the
painful disease of which he treats, for years past, will
lend to the book the increased charm of personal ex-
perience, by one who was capable of noting and reason-
ing from what he felt.
JAN. 20, 1872.]
.. TIH. H. C.L.INI c.
REPORT of THE COMMISSIONER OF PENSIONs to the
Secretary of the Interior for the yearending June 3, '71.
—Upon examination of this interesting report, (sent to
“THE CLINIC” with compliments of T. B. Hood, M.D.,
Chief of Medical Divison Pension Bureau,) we find that
on the 30th of June last there were on the rolls 207,495
pensioners of all classes, receiving in the aggregate
$33,077,383 63. Nearly 100,000 men of average not ex-
ceeding 35 years were in receipt of invalid pensions on
the 1st October,
a price was peace secured. The tabulation of the several
classes of injuries and diseases and their relative propor-
tions has been admirably done, and will make the re-
port of much value for future reference. The more.
strictly business details of the operations of the Bureau
will not so particularly interest the medical men of the
country. The remarks on examinations and medical
examiners are at once true and worthy of most careful
consideration. That the affairs of the Bureau may be
so administered as to do justice to the Government and
the disabled, there must be competence and honesty
on the part of those medical men upon whose reports of
existing disability the Department at Washington must
base its estimate of the propriety of allowing pensions
and in what grade ; and upon each judgment of these
examiners, payments for a period of ten years are made.
When so much expenditure of money is to be made it
behooves the U. S. Government to select and retain first
class examining surgeons, and to do their work properly,
compensation must be made for the services rendered. It
is to be hoped that the suggestions of the Hon. Commssion-
er of Pensions on this subject may be duly heeded by
Congress. So too, as there must be an examination at
Washington of these reports of medical examiners
scattered over the whole country, such examination must
be made by a thoroughly educated and specially trained
chief of the Medical Division of the Bureau Prudence
and economy alike dictate the formal recognition of such
officer in the Bureau, making him second only to the
Commissioner himself, and the paying him such liberal
salary as will secure the right man for the place. Judg-
ing from the report before us we think the country
fortunate in having in this Pension Bereau such men as
the present. Commissioner and Chief of the Medical
l)ivision. -
- - ----——sº- © -º---- - - - - - . .
C J, INIC AI, WIEMORAN ID.V.
on the Employment of Ergot in Dysentery.
Paris Academy of Medicine, Séance. Oct. 10, 71.
This note is presented to the Academy by Prof. Gub-
ler in the name of M. Luton, Prof. of the clinic at the
Ecole preparatoire at Reims, -
During the epidemic of dysentery which prevailed in
Reims towards the close of last summer and which has
What an army of sufferers—At what
33
not yet entirely disappeared, I employed against this
malady with varying success, most of the anti-dysenteric
agents reported most efficacious.
Our epidemic became severe, recovery ceased to be
the rule. The action of medicines was not evident; the
most of those attacked, particularly among the aged,
succumbed to the disease. It seemed to me then time
to seek for some new method of medication which might
furnish results more satisfactory and more rapid. There
came then under my treatment a female affected with
both memorrhagia and dysentery. This gave me an op-
portunity of trying the ergot of rye, whose employment
is so efficacious against one of these diseases. Both af.
fections were favorably influenced by this remedy at
once, and after a few doses constipation was produced.
which lasted at least four or five days.
This attempt was repeated soon upon cases of simple
dysentery. It always acted kindly in a very short time,
amelioration soon occurring, afterwards complete re-
covery. I gave the ergot in powder, three grammes
[45 gr.] per day in divided doses of 50 ctgr. I have
likewise prescribed ergotine in pilule or solution in cor-
responding doses with the same advantage.
Two or three days suffice ordinarily for complete cure.
In grave cases of course longer time is required.
Ergot does not attack the hemorrhagic element of
dysentery only, but the malady in its entirety, the mu-
cous secretions, tenes)nus, the colics, the fever are as
well made to experience its good effects, and this in the
first few hours of treatment. In one case marked by
grave symptoms, as algidity, the reaction was as prompt
as emergetic. The patient, an aged female, had taken
only six grammes of ergot in two days and recovered
completely. The number of patients treated in this
way has not been large nor has the use of the drug been
very extensive; but I believe I am justified to-day in
signalizing public attention to this method of treatment,
marked as it is by the rapidity of its effects and by the
constancy of its action. I am prompted, therefore, with
the intent of giving to these facts the widest possible
publicity to address the Academy in this manner.—Bull
de Therap., Nov. 30, 71.
NEW TREATMENT OF CYSTS AND HYDROCELE.-M.
Munod communicates the following to the Paris Sur-
gical Society. The immediate cause of cysts and of se-
rous accumulation in normal cavities lies in the pre-
dominance of Secretion over absorption: treatment
should be directed to the restoration of the equilibrium.
Three years ago I was consulted by an individual with
a voluminous goitre. I diagnostrated cyst of the thy.
roid gland. By way of confirmation I made an explor.
ation with a fine trocar when an amber colored fluid
escaped ; when the cyst had again filled itself anew I
practised the following operation; by the aid of a hy-
drocele trocar I drew off a coffee cup [French] of seros-
ity and injected an equal quantity of alcohol at 40 deg.
Fifteen days thereafter I repeated the operation. In one
month resolution was complete. No recurrence has
-
34
[JAN. 20, 1872.
TIH. H. cI, IISTIC.
tion for a hydrocele. I removed a very little of the
serum and injected one gramme of alcohol. Eight days
thereafter the tumor had diminished. I now made a
second operation ; fifteen days after it, a third.
tient has been perfectly well for six months. In another
amber liquid and injected one gramme of alcohol at 40
deg. This patient like the others resumed his occupa-
tion immediately after the operation. Some days after,
I made a second operation when the tumor entirely
disappeared. Finally in a third instance, my own in-
dividual case, a hydrocele formed the size of a hens egg.
I made the puncture and the injection. On the same
day I walked at least an hour. The liquid has dimin-
ished considerably but has not entirely disappeared.
By the proceedure of my employment the vaginal tu-
mic is not destroyed but is restored to its normal condi-
tion. I believe this treatment will be found valuable in
hydrorachitis, ovarian cysts, hydrarthrosis, etc.—Bull. de
Therap., Nov. 30, 71.
VACCINATION-PAPERS.—Small-pox having entered
our hitherto healthy town, there has been a great de-
mand for vaccination; and I have, at times, found
difficulty in keeping up a regular supply of lymph. To
meet this, I have devised a new method of lymph pres-
ervation; it is most portable, and very certain in its
effect. Taking asheet of common sized (i. e., cream-laid)
note paper, I paint it with fresh lymph taken from the
vesicle with a fine camel-hair pencil. The lymph soon
dries; and the paper is ready for use. When required,
a minute piece may be cut out or torn off the sheet, and,
after having been slightly breathed upon, should be
stuck upon the freshened surface. If the paper be re-
quired to be kept for any length of time, it should after
being charged, be covered with a thin coating of white
of egg. Isinglass will not do, as it cracks when dried—
Preston—Brit. Med. Journ., Dec. 23, '71.
QUININE IN TRACHOMA.—In the treatment of granu-
lar pannus associate with blepharospasm, Bader (Guy's
Hospital), has seen rapid and favorable results from the
external application of sulphate of quinine. The anti-
septic value of this preparation induced him to try it in
granular lids, on the theory of the possible parasitic ori-
gin of this disease. As much as could be held on the
point of a small knife blade, is dusted upon the inner
surface of the lower lid with a camel's hair pencil. The
secretion is somewhat increased thereby, but photopho-
bia and corneal affections quickly diminish and the
granulations speedily become smaller.—Berlin Klin.,
Wochusehr., Dec. 4, '71.
GONORRHEATREATED BY WATER.—A few weeks ago
THE CLINIC contained a notice of the successful treat-
ment of this disease by simple injections of water. Strong
confirmation of the efficacy of this simple method is
furnished in the following note. Dr. Castex (military
service) recommends in this disease thirty injections of
manifested in three years. A patient claimed my atten-
My pa-
fresh water per day. By this means the duration is
shortened and the intercurrence of complications pre-
vented. In no instance did haematuria, cystitis or orchitis
occur. In no case were painful erections observed.
|Castex treated in this way 312 patients mostly attacked
|within 9 days.
case of voluminous hydrocele I drew off a soup cup of
These were treated altogether 4475 days
an average of 14 days each. The same ratio was ob-
served in 33 cases treated later in like manner. All
these patients left the hospital perfectly cured having
been kept each 2 days after recovery under observation.
Of these 16 returned, however, with a recurrence of the
disease.—Rec. de mem. de med, 3, axiv.
----------—sº- e-º-------- - - , ,
A New Treatment of Spleen Tumors.
-- BY
FR. CHvosTEK, M. D., Vienna.
An Abstract from Schmidt's Jahrbücher, Dec. 1. ‘71.
The first attempt to faradise the spleen in the living
subject was made by Ziemssen, who was of the opinion,
however, that it was only in cases of pathological and
considerable increase in volume that this organ could
be reached by the electric current. His method was
to place one pole on the inner surface and one on the
outer surface of the gland. He did not demonstrate any
reduction of volume. He used moist electrodes—a
method unsuited for excitation of deep seated organs,
because only so little current penetrates beneath the
surface. Chvostek attempted to reach the enlarged or-
gan in a reflex way, by excitation, namely, of its vaso-
motor and trophic nerves. To effect this, he faradises
the integument of the splenic region with two pencils,
by means of the Secondary current of an induction
apparatus. - - -
From the 16 cases detailed it results that by the
method of faradisation cited, a marked influence upon
the spleen tumor of intermittents may be effected,
indeed, he was successful in most cases in inducing
resolution of the organ, not only in acute, but also in
chronic cases. The reduction effected in mediately
after each session (two minutes) was lost to some degree
in the intervals, yet the organ never regained its pre-
vious size. Every succeeding session reduced the tumor
somewhat. % *S* % .
Of the individual cases detailed, the second is of spec-
ial interest on account of the great volume of the tumor
and on account of the great reduction effected in the
first session of but two minutes duration. His reviewer
states that, since the first publication of Chvostek’s ex-
periments, he has had the opportunity of repeating them
in a series sf cases, eight in all, and that he can confirm
the results from his own experience. In acute tumors
(four intermittent, two typhoid spleens) he was able to
effect a marked reduction in volume very soon after the
sessions. In his chronic cases the application remains
without effect, even after ten minutes session, * *
JAN. 13, 1872.]
Quite lately he succeeded in bringing about a marked
reduction in a leucaemic spleen tumor by Chwostek's
method in the case of a man 33 years of age, whose en-
tire left abdominal cavity was filled by an immense
spleen. The blood in this case showed a marked increase
of white corpuscles even after months of treatment with
iron and quinine. The treatment first mentioned greatly
improved his general health and diminished the propor-
tion of white corpuscles in the blood. “In the last tem
weeks there was no further reduction in the volume of
the spleen. It extended upwards to the lower border
of the sixth rib, protruded beyond the thoracic arch
some 9 centr. and broadened out in the axillary line to
11 centr, diameter. I now commenced electrical excita-
tion of the splenic region. From the very first session
reduction commenced and continued up to the sixth
(most marked, however, after the first), when no further
diminution could be effected, probably on account of
such organic changes as to place it beyond the power of
any therapeutic agent. Microscopical examination of
the blood showed no difference, before and after elec-
tricity, in the quantity or proportion of white cor-
puscles.
SULPHURous ACID LOTION IN THE TREATMENT of
CONTUSED WOUNDS.—Dr. John Balfour states that an
extended experience has given him great faith in this
application. It gives almost instant relief from pain,
controls and greatly restrains suppurative action, and,
where possible, secures primary union perhaps as effi-
ciently as carbolic acid. The lotion is of the strength
of one in twelve; a thin rag (the thinner the better)
should be laid over the wound, and kept constantly wet
for the first thirty-six to forty-eight hours. When cold
becomes less agreeable, the lotion is used tepid, the rag
being wetted every twelve hours and covered with gut-
ta percha. Where primary union is taking place, about
the third or fourth day, a dressing of zinc ointment is to
be substituted for the washing: this allows the skin to
heal. When suppuration is established, a zinc lotion
may be used after a week or ten days, and the cure
Wrought out on ordinary principles. Dr. Balfour
records the following, amongst other cases:—S. B., a
lad between eleveſ, and twelve years of age, on the 8th
of June, in company with some other boys, was amus-
ing himself with gunpowder; a “peeoge” (or devil) hung
fire, and he poured some powder on it from the flask.
This of course exploded, and tore open the metacarpal
Space between the thumb and forefinger of the right
hand. The metacarpal bone of the thumb was fractured,
and both wrists scorched. A mass of the short flexors
of the thumb was forced out of the wound, contused,
torn, and blackened. As this muscular substance was
much injured and could not be returned without using
undue force, a good deal of it was cut off; the wound
Was Washed out with the sulphurous acid lotion, covered
with **ag wet with the same, and the fracture was kept
1Il position by tying the thumb to the forefinger. Had
à fair night's rest; the wrists (not complained of yester-
T H E CI I IN.I.C.
a tº gº
Jú)
day) now painful and beginning to vesicate; dressed
with carbolic acid and oil. Everything went on well,
the burns on the wrists healed kindly, suppuration was
most moderate, cicatrization rapid and perfect. Dr.
Balfour lately passed the boy into a public work, with
a thumb very little, if at all, the worse for the accident.
—Edinburgh Medical and Surgical Journal, Nor., '71.
CAUSE OF INFECTIOUS DISEASEs.--Dr. Balfour also
showed, Med. Chir. Soc. Edinburgh, a piece of lead soil-
pipe which had been inserted into an iron pipe just
below the seat of a water-closet. The iron had been
corroded, and a way of escape thus made for the poison-
ous sewer gases into the house. This specimen had been
removed from a house in which two fatal cases of diph-
theria had occurred last summer; and Dr. Balfour stated
that in his experience some such source of gaseous
leakage had been invariably found, when sought for, in
every house where diphtheria, typhoid fever, and other
allied disorders had prevailed.—Edin. Med. Journ.,
Dec., '71.
-——º-º-º--- - - - -
Hoyitº NEws. .
REMOVAL.--Dr. A. Schwagmeier to 650 Elm Street.
THE specimen of a most remarkable case of intestinal
invagination was forwarded to this city by Dr. Shackle-
ton of St. Marys, Ohio, and was made the subject of a
pathological lecture at the Good Samaritan on Saturday
last. The subject will be worked up for THE CLIN1c as
soon as a full history of the case can be obtained.
THE number of patients registered and treated at the
College Dispensary thus far this month is 158,
T)R. CONNER's paper on the Excision of the Ganglion
It is
noticed in the last number of Virchow's Jahresher, der
of Meckel continues to attract foreign attention.
Gesammt. Med.
DR. UNZICKER's paper on the use of Polygonum
Hydropiper in Amenorrhea is noticed in the last num-
ber of the British Medical Journal.
Vaccisarios chPAPER THAN SHAvisa-iſ
there is any one fact calculated to make a man
believe that he dwells among Hottentots in the midst
of a howling wilderness it is the following action of the
Board of Health of this city as reported in the Gazette
of January 10th.
“Mr. Thomas presented a resolution to pay the dis.
trict physicians $25 each for services in Vaccinating
children in the public schools.
“Mayor Davis moved to amend by paying them ten
cents per capita for pupils vaccinated, Lost, and the
original resolution was them adopted.”
Shortly after reading this magnanimous procedure
we chanced to meet one of the district physicians, and
upon inquiry learned that he had been compelled to
examine both arms of 2600 children, 400 of whom he
had vaccinated. In several districts, the labor was
even greater than this. The time required for the ex:
aminations and vaccinations was three weeks. For this
he was awarded $25. Scarcely one, we venture to
state, but lost more than that every week in the time
necessarily consumed. Six cents for protecting the
life of each individual from this fearful scourge, to say
nothing of checking the spread of the epidemic over
the city, to the mansions of the Royal Board itself as
well. As we have no desire to practice medicine in
families where the value of medical service is thus ap-
preciated we do not hesitate to enter indignant protest
against this shameful prostitution of our science. The
Board of Health, we are happy to state, constitutes but
a very insignificant part of the population of Cincinnati. - - - . . . . . -- - - - - - ---
*. - . . . Deformity, 1. Concealed Nipple, 1. Unbilical Ulcera-
(orrection—The Spring Course of 1872 commences' . . . . . . . • & . • ?
March 15th instead of May 15th as erroneously stated in
our last issue.
—e-e—e-- - - - - - ----- -----
'A'ine Gºod samaritan Hospital.
º
THE following statistics show the work done in this
excellent institution. * .. . . . .
Whole number of patients admitted
since Oct., 1866,
Of these were discharged cured
- 4,070
212
104
º
or relieved,
1)ied,
Remaining lec. 31, 1871, -
* * - -
Of the 212 deaths, 63 were due to consuumption, aud
!) were from serious injury, the patients living but a |
few hours after reaching the hospital.
Including the deaths from all causes, it will be per-
ceived that the ratio of deaths is somewhat less than
5 per centum, a mortality rate which ranks this Hos-
pital with the most successful in the world. , ,
Of the whole number of patients admitted, 1,373 were
wholly provided for at the expense of the institution;
from its own resources, without aid from public taxa-
tion. There were cared for as pay patients 3,018; but
many of these paid Small sums which did not reimburse
the hospital for the outlay on their behalf. It is true
many of these paid liberally; otherwise, so many of the
maintained at the public expense.
|Chorea, 3. Hysteria, 2.
| tirpation Nail, 5.
| absolutely indigent poor could. not have been provided
It will be perceived them, from these figures, that the
Good Samaritan H
ſospital has dispensed a noble charity
Without being a burden on the tax-paying public, it
has cared for the poor who in the City Hospital are
*
The great opportunities for medical instruction, such
|an institution affords are best appreciated by the selec-
tion of a few of the most prominent cases from the diff.
erent departments of medicine as presented to the clinical,
class during the past three months.
as tº
*
Aphtha, 1.
Medical Cases—Locomotor Ataxia,
Atropia Poisoning, 1. Epilepsy,
• . . . Hematuria, 1. Rheumatism,
5. Endocarditis, 2. Hydrophobia, 1. Pneumothorax,
1. Pleurisy with Effusion, 1. Dysentery, 4, Phthisis,8.
Obstetrical, etc., Cases.—Puerperal Mania, 1. Foetal
tion, 1. Lochial Suppression, 1. Endometritis, 1. Mām-
mary Abscess, 1. Amenorrhea, 1. Molar Pregnancy, 1.
Puerperal Fever, J.
Eye Cases and Operations.—[ritis, 8. Paracentesis, 5.
Iridectomy, 3. Cataract Operation, 1. Operation for
Malposition Punctum, 1; for Epiphora, 5. Acute Gran-
ulations, 4; Chronic, 5. Acute Keratitis, 2; Chronic, 8.
Abscess Cornea, 1. Opacities Cornea, 6. Staphyloma,
3. Operation for Strabismus, 2. Suppurative Keratitis,
2. Operation for Trichiasis, 6. Excision Eye-ball, 1. .
Surgical Cases and Operations—Encephaloid Mam-
Morbus Coxae, 2. Removal of part of lower jaw for
* . ~ : - ; *
|Exostosis, 1. Bronchocele, 2. Amputation of Fingers,
| 1; of Leg, 1; of Arm, 1. Operation for Hemorrhoids, 3;
for Anal Fissure, 1. Fracture Inf. Maxilla, 2. Intra-
Capsular Fracture Femur, 1. Fracture Tibia, 2. Dis-
location Ulna backwards with Fracture Coronoid Pro-
cess, 1. Abscess Tibia, 1. Epithelial Grafting, 3. Con-
genital Hernia, 1; Scrotal, 2; Irreducible, 2; Inguinal,
1. Lipoma, 1. Operation for Talipes Equinus, 1. En-
tero-Vaginal Fistula, (Congenital) 1. Recto-Vaginal
Fistula, I. Gunshot wound, Foot, 1. Periostitis Tibiae,
1. Hypertrophy Labia Majora, 1. Hydrocele, 5. Ex-
Venereal, etc., Disease.—Syphilis, Primary, 5; Sec-
ondary, 10; Tertiary, 6. Orchitis, 2. Lupus, 1. Peri-
ostitis, 3. Operation for Urethral Stricture by Ureth-
rotome, 3; by Dilatation, 5. Circumcision, 2. Gon-
orrhea, 8. Gleet, 3. Sarcocele, 1, Varieocele, 2.
In the Pathological Department six autopsies have
been held before the class. All the clinical lectures
have been abundantly illustrated with specimens.




DIVIDED MEDICINES,
[he Divided Medicine Com’y,
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExCEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUS, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUAREs must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MoR.E. . . -
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities. . . . . . . .
But not only SoluRIE, but also INSoLUBLE MEDICAMENTs, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINEs. gº Y
§ This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
! l * @ &
; , , h, ś, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. * * -
Besides the peculiarity of THESE MEDICINES, that they are Not LIABLE TO SPOIL BY ANY LENGTH OF TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste. - -
... Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days. - -
For Samples, Price Lists, and Agencies, address -
* - ls. . -- - -- . - . -
The lieſne UQ's
EOx 2ess,
Or FRFDERICK KRAUS, Chemist and Druggist,
- Walnut Hills, Cincinnati, O. -
MR. FREDERICK KRAUs: * CINCINNAT), l'ebruary 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz:
SULPH:MORPHII............~% grain in each square. ARSEN:ACID...... * * * * * * * * * * * * * * * * * * *..l-30 grain in each, square. -
“ CHIN.INI ....................... I 4 * { { {{ CALOMEL..............................}4 “ $ $ * { *
{ 0. COPPER .......................}% . {t 4 \ ºr
Respºgtrully Yours,
E. S. WAYNE, Analytic Chemist


MARVIN's
COD LIVEER, CII,
*
O' D C R LEs s AN ID PALATAB LE.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERS & BARTLETT, of Portland, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market. -
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency.
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Serofula, in Rachitic Affections, in
Chronic Rheumatism, &c." - - -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers .
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent. - . -
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated. .
The Messrs. MARVIs, in order to devote their personal attention exclusively to the manufac.
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

{?
!"
|||||||}|| ||||P. ſ
16 × 13.4 S T 34 TH-ST., N E / Yo RK,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANU FACTU Reſts of PowTABLE
ELECTRO-MAGNETIC MACHINES, a
- * .." " - - . º -
Portable Galvanic Batteries,
('outinuous Current, Stölner's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
| Mill-III: Millſ;
For Iſospitals and General Practitioners,
For Bye, Ear, Larynx, Nose, Uterus, Vagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Elec.
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
EXTRA (Ts rºſto M THE OPINIONS OF THE MOST
FIH IN ENT MEMBERS OF THIS PROFESSION.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Nothing cAN
l:XCEED THE EFFICIENCY AND CON V FN (ENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.” -
We are authorized by Prof. Hammºnd to announce eta-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
provel and re-modified Instruments made by our Company.
MEREDITH CLYM ER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider their
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:– “In meat-
ness, compactness asid efficacy, they can not be excelled.”
ALFRED C. GARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.” -
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;
ALLEN MAYNARD, M. D., Cleveland, 0.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
w
D E A LE F I N
English, French and Scotch
{3} { } { } HD's,
34 West Fourth Street,
czycz.vx's ra.
- * *-*-- - - - - - - - ----------, - -
Are furnished to Officers and Soldiers on Govern Irer, tº
8. CCOUlt1t.
I claim to have colnbined such improvements in Alt'ſ 1-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Linbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–Why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. EOSTEER,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 17.2 Jet.
ferson Avenue, JPetrºit. $iich,


ſº #
|
jº | 8
º # |; .
|#|ºilº
injurier; d
ºf minuſ;inglli
º |
H||
ºr-tara º ºse
Good sa M.ARIt AN HOSPITAL.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished through9% and is provided with all the necessary ap-
pointments of a First-class Hospital. Porticoes, with commanding views, surround the whole house, and wide
hails and abundant windows secure that full and ſtee ventilation which is so essential to health and comfort.
Service is furnished by the
sist ERs or CHARITY,
Under the Superintendence of the well-known sistER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The (;OOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, ºr in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment. *
Rooms vary in price, according to the ºutructer of appointments necessary and service required, ranging, iº
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
gºş Address, th
SISTER ANTHON.Y,
Hospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnaté. Ohio,




3.
- - * *
". * : - * . * ºr sº -
- - - r ..: ' '
- - *
Is Now READY FORCA NvAssFRs.
It contains over 600 pages of reading matter, with 250
engravings, designed expressly for this work, by the best
artists in the country. Agents now at work upon, it are
meeting with unparalleled success. Agents at Circleville, . . .
O., reports 25 orders in, 2 days; one at Louisville, Ky., . .
reports 175 orders in 8 days; one at Middletown, Conn., |
: ------- ~~... •...vº ---
CAMARGO
MANUFACTURING COMPANY.
MANUFACTUREIts AND IMPORTERs of
reports 200 orders, in 12 days; one at Cincinnati, O., re: jºi ... '
ports 250 in 12 days. Early applicants secure
territory. For circulars; terms, &c., address
…”
101 Elm street, cineinnati, o,
‘. . . . . ... º. . .
9, . . -
a- *
. . . . . . . ."
, ; * x *
ºrna - i.e. z. r -
- - - * : * - r º - -
- ... ſº ſº ºff; * * * * * , } 7%g (ºf
* ſº." Aºi * ſº tº Hº). º »).
* ºf -º-, --, --- sº sº. --, *s
Blank Book Manufacturers,
1:so v1N -ris Exºr,
|
sº sº.
T. D. A. LBRO & BRO.
1 M.Põ R'l'F.RS AND MANUFACTURERs OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
intãº-Mºº-Biºaiti-kiºi.
The only. lieuse in the western country that saws Spanish and Mexi:
ran Cedar for Cigar-Box Makers We import our own wood direct, and
"" in sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 west second street,
Wenzer Milº. 507, 509, 541, 513 & 515 W. Sixth St., CINCINNATI.
32 West Fovara screer,
CISC(NSXTI, ().
H. H. BRENEMAN, Proprietor,
R
FO R
GENTLEMEN.
Handling much larger quantities of fine and
valuable Underwear than any other firm in the
West, we are enabled to purchase at closer fig-
ures. We are therefore prepared to ofter extra
inducements to consumers.
HO's HR CRY,
FULL LINES OF THE BEST ALWAYS ON HAND..
SHIRTS MADE TO ORDER.
wilson BROS,
Pike's opera House, Cincinnati: 981 Wabash Awe-
atue, and SS West Washington street. Chieing is.





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CINCINNATI.
ROBERTS BARTHOLOW, M.D.,
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| | | | | | |
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-º-º-º-º-º-º- * ------.p.
- **- •
FA C U L T Y. - . . . .
J AM ES G R A H A M, M. D., DEAN,
Professor of the Theory and Practice of Medicine and Clinical Medicine.
Professor of Materia Medica and Therapeutics.
W. H. GOBRECEIT, M.D.,
Professor of Anatomy.
P. S. CONNER, M.D.,
Professor of Surgical Anatomy.
W. W. SEELY, M.D.,
Professor of Diseases of the Eye and Ea
SAMUEL NICKLES, M.D.,
Professor of Physics and Medical Chemist
.J. A. N4. IC S
~ ---
T. LOUIS BROWN, Prosector of Anatomy.
-*-*------------------------------------
7".
ry
" I " .
W. W. DAWSON, M.D.,
Professor of Principles and Practice of Surgery and Clinical Surgery
C. D. PALMER, M.D., .
Professor of Medical and Surgical Diseases of Women.
T. A. REAMY, M.D.,
Professor of Obstetrics and Diseases of Children.
JOHN L. CLEVELAND, M.D.,
Demonstrator of Anatomy.
CHARLES KEARNS, M.D.,
Assistant to the Chair of Surgery.
VV H. I. T. "J. A. LX R. J.R. .
I” “) ſº “so I of JP) ysiology &nd Secretary of tin & Rºc 1 ty.
Janitor, College Building, Sirth S., bel. Vine and Race.
Pym'ed and Published by Noit Riº & M Unity, Medical College of Ohio Building, Cincinnati,

























PUBLISHED EVERY SATURDAY.
If M S-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
, . . . “All Communications relating to Business, Subscriptions, Adyertisements, etc., to the Treasurer. <
Vol. 2. C IN C IN N AT I, J A N U A R Y 27, 1872. No. 4.
JAS. T. whittaker, M. D. - - - Editor.
No. 101 West Ninth Street, Cincinnati.
-A-SSO’CIA-ºri; Eºdrº CER.S.
W. W. D.Awson, M. D. ... Thad. A. ReAMy, M. D.
P. S. Conn ER, M. D. C. D. PALMER, M. D.
W. W. SEELY, M. D. SAMUEL Nickles, M. D.
CHAs. KEARNs, M. D.
- Rod ERTs BARTHollow, M. D.
W. W. SEELY, M. D., TREAsukes,
No. 118 West Seventh street, Cincinnati. :
-y-
club RATEs.
4 Copiés to ône address.
JNo. L. CLEvel,AND, M.-D.
Fashionable Hatters,
- 1uPontens AND MANUFACTURElis of
"EAnths' rugs,
* *
|92 wrisT FOURTH ST.
Opposite Post Office,
CINCINNAT).
sarspeeial inducements to Medical Men.
• *
#.
.*. **
is sess sº $ 7.00
6 & & & & -- 10,00
12 44 “. ...... * 18.00
C O N T E N T S. *
} -: Tage
* 3.
origiNAL.ARTICLEs.
º Intestinal Invagination; by Jasºr, whittaker, M. *~~~~~gº
Rupture of the bladder, by P. Gardner, M.D ...”
Fistula for Cystitis, a Reply to a New Critic, by A. T. Keyt, M. D....40
Translation
Still Birth, An Abstract of a Review of Schultze’s Treatise (from
the Archiv f. Gynaecologie, Vol. II. Sect. 3, 1871.)........................ 43
screNTIFIC NoTEs.
Influence of Light on Sugar—Diabetes and the Fourth Wentricle of
T-e-s-s-s-s-s-s
s KoºBI. *Till.Man i
- Bºś AS §
NGRAVER
-Sºlº WEST FOURTH SH sº
SoNYWOOD
US CINCINNATI. Oiſo,
* * * * * *
J. TAFT, W. TAFT.
Editor Dental Register
I. A w. Tart.
IDENTIsTs
117 WEST FOURTH STREET,
~ - , -
CINCINNATI, O.
the Brain 43
MEDICAL NEWs
Med. Service in the Navy—The Pest in Persia—Honors Recipro-
cated—Small-Pox in Germany.................................. * * * * * * * * * * * *44-45
COLR RESPON D, ENCE
Letter from Dr. Trush, Vienna, on Vaccination—Letter from Dr.
Whiting, Another Misinterpretation....... 45-46
CLINICAL MEMORANDA
Removal of Morbid Growths in Larynx by Section of the Cartilages
—Bullet Explorers—Iodides of Ammonium and Sodium in
Syphilis 46–48
48
The Spring Course of 1872
*-* * * = <= * = a- =
Now is the time to subscribe for THE CLINIC. The new
Volume is just commencing. Over 150 new subscribers
are already entered this month. Back numbers are dis-
appearing fast. .
the pental
R egister,
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,

















ROBT CLARKE & Co.
William Autenrieth,
PUBLISHERS,
}|||}|S&Willº
N0, 65 WEST FOURTH STREET,
*
Call the attention of the Medical Profession
to their Extensive Stock of
&nglish, 3merican and freuth
JMAEA/CºA, AE(90AES,
Paying particular attention to this branch of
their business, they are enabled to execute all
orders on the shortest notice, and at the most
reasonable rates. Their facilities for the impor-
tation of FOREIGN BOOKS, THE PROCEED-
INGS OF SOCIETIES and HOSPITAL RE-
PORTS are unsurpassed, and any orders en-
trusted to their care will be filled promptly, and
at the lowest rates.
Subscriptions received for FOREIGN and
AMERICAN PERIOD1CALS.
All the New Publications received as soon
as issued.
Letters of Inquiry will receive our prompt
and full attention.
Catalogues furnished gratis on application.
ROBERT CLARKE & Co.,
Whilºlºmºnºliº
PRINTERS AND BLANK BOOK MANUFACTURERS,
22eaders in Zazy, Medica?, Z/ºeočoytcal,
School, azed./esce//azzeozºs Zºoo/s,
Q55 West Fourth Street,
CINCINNATI, O.
No. 71 WEST SIXTH STREET,
BKTWEEN WALAUT-Aîb WINE,
CINCINNATi, OHO,
MANUFACTURER OF AND DEALER IN
|||}|| || || || ||||||||}
Abdominal Supporters, Trusses,
GLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Koeps constantly on hand a full variety of
Metalic and Eubber syringes,
Stomach Pumps, Etc.
STOCKINGS FOR WARDCQSE WEBNS,
Special attention given to the fitting of Apparatus for Deformities.
B& Agent for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
-AIMSO-
DR. AHL's POROUS FELT SPLINTS,
-ALSO-
T) A. Y. * S S B L T N T S
-AND-
S. W. Elliott’s Saddle-bags
List of Pharmaceutical Preparations,
worry wreza e amozwan,
PHILADELPHIA
ELIX, PHOS, IRON, QUININE AND STRYCHNIA,
- . . . . . ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA, -
- (Goddard's Formula,) *
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSFHATE OF IRON,
Iron, with Phiosphorous and Calisaya,
FERRATED ELIXIE OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
CCMFCUND SyFUP OF HYPOPHOSPHITES, . . ~ *
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Coimposed of the Phosphates of Lime, Soda, Potassa and Iron,.
BITTER WINE OF IRON,
citrate of Iron and Peruvian Bark,
- FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
wiNE OF WILD CHERRY BARK,
. . . . . FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH, - -
ºf . . . . . . TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED, -
... . . . . . . . . . . BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIRVALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUPSUPERPHOSPHATE OF IRON, ----,
& . . . . . . . . . . . ___ ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRABRAVA.
stſ PPOs.ITORIEs.
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Dear Sir—The specimens of your “Divided Medicines,” handed to me for analysis, I have carefully
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8ULPH:MO RPPIII....................... % grain in each square. ARSEN: A CID.......................... 1-20 grain in each square.
tº ſº CIT IN.INI ....................... 1 § { § { { % CALOMEL.............................. % 6 & 6 & * {
“. COPPEſt ........................}% dº
RespecTFULLY YoURs,
E. S. WAYNE, Analytic Chemist.

JAN, 27, 1872.]
O R. I. G. I N A L A R T I C L E S.
: O :
I N T E S T IN A IL IN V A G IN A TI O N .
BY
JAS. T. WHITTAKER, M. D.
Abstract of a Lecture delivered at the Good Samaritan
Hospital, Jan. 13, 1872.
GENTLEMEN :
We are doubly fortunate to-day in the specimen to
form the subject of our study: first in that it is in some
respects one of the most remarkable examples of a very
rare lesion in pathology; second in that it concerns a
part of the body whose physiology is still fresh in our
minds. It is really a subject of mutual congratulation
that so many choice specimens in pathology have pre-
sented in the limited time allotted to this department
of our science; indeed, such good fortune had not been
ours were it not for the occasional assistance of distant
friends. I mention this fact merely to acquaint you
with our obligations to Dr. Shackleton for the rare
consideration he has exhibited to all of us in placing
this specimen with the following letter in our hands.
ST. MARYs, OHIO, Jan. 8, '72.
Dear Dr.
I send you this morning by express a specimen of
invaginated bowel; it will perhaps be of some interest
to you and the class. The man from whom the speci-
men was taken was treated by my friend Dr. Stearns,
of this place. The autopsy was made this P. M., 22
hours after death by Drs. Stearns, Bradley and myself.
I will give you the history of the case as nearly as I
can. The man was 51 years of age. The friends say he
has suffered since boyhood with “cramp colic,” for the
past twenty years he has suffered very considerably, and
has during this time firmly believed there was a reptile
of some kind in his bowels. This idea of his has ex-
cited the curiosity of the whole country. In the inter-
vals between his attacks of colic he lived with a con-
siderable degree of comfort, indeed, was able to work
hard. He has always been troubled with constipation
and for many years there has been a very great amount
of gurgling, peculiar and loud in the right iliac region;
this gurgling was always exceedingly annoying to him.
His last illness was of about a week's duration; during
this illness there were unmistakable evidences of peri-
itOnitis.
* We found the abdomen very tympanitic, large quan-
tities of lymph thrown out over the peritoneal surface,
the whole bowels largely dilated; old adhesions over
T IEEE TEE C T I I INT I C .
87
all parts of the intestines, stomach adherent to liver and
small intestines; right kidney so adherent to intestines
that on removing the bowels the kidney was torn out
with them. General adhesions were so numerous that
it was very difficult to trace up the small intestines.
In moving the coecum we would get the characteristic
gurgling Sound that was so noticeable during life. You
will observe two outgrowths from the mucous surface,
what are these ? Let us have the benefit of your exam-
ination.
Part of the receiving portion of the bowel you will
perceive we cut away, an unavoidable mutilation,
which I know you will regret.
Yours Truly,
E. Z. SHACKLETON.
The most striking conditions manifest in this C3Sé a re
first, the immense size of the gut. The largest German
Sausage, the Schinkenwurst, may hardly aspire to such
dimension as this. It measures in circumference 13
inches. If all the invagination has been removed, about
12 inches of the ileum has slipped into the colon. Next
you will observe its marked discoloration, where it is
not absolutely black, it is deeply livid, only here and
there is the hue of a lighter red, nowhere of the normal
clear and shiny gray, It has lain in alcohol on its way
down to us consequently the odor of the decomposition
so evidently present is no longer perceptible. To the
touch it is resistent with a distinct doughy feel. At
one extremity just above the coecum, which we recognize
by its blind extremity, there is a protrusion of intestine
through a button-like orifice. This is plainly the
divided Small intestine as it enters the ileo-coecal valve.
We have then before us a case of intussusception or in-
vagination, volvulus it is sometimes improperly called,
of the small intestine in the large. The ileum to use a
rough illustration, is “telescoped” into the colon—and
caught there and held by firm adhesions, between the
apposing surfaces. Singular are the anatomical rela-
tions of these surfaces. If I take this piece of healthy
intestine and push one part down into the part below
it, ensheath it, in other words, or invaginate it—vagina
means a sheath—you will understand how it is that
peritoneal surfaces and mucous surfaces must always
come in contact with each other. If I now cut across
the gut as ensheathed I expose three circles all round
its circumference. The outermost is the receiving or
intussuscipient gut, the innermost is the received or
intussuscepted gut and the middle is the receding por-
tion connecting the two. .
What is the most remarkable feature of the case
before us is the enormous thickening that has occurred
in the inflammatory processes which have united the
invaginated and receding layers. As you observe the
combined wall of these two layers is quite three inches
thick. This it is which has narrowed down the calibre
of the received or interior gut so that I can barely insert
into it the end of the little finger. Of course the mesen-
38
[JAN, 27, 1872.
T H. H. cI.TISTI c.
tery of the ileum must have been dragged into the
large intestine, but it was doubtless removed in the
difficult operation of dissecting out the large intestine.
It is because the mesentery of the ensheathed is dragged
into the ensheathing intestine that these inflammatory
processes are first engendered. The mesentery carries
the blood supply; the intestine, in some cases entirely
deprived of its blood, undergoes necrosis and death, a
condition which we have learned to regard as a conserv-
ative process of nature. • .
The reason of this rare accident is difficult to under-
stand. When there is no tumor present whose weight
might have dragged down the upper portion—and all
the invaginations described are in the line of peristalsis
—or no foreign body impacted which may have acted
in the same way, we must assume a paralysis of the
lower portion of the intestine whereby it is left dilated
after the part above it has contracted. What would
tend to support this view is the fact that every increase
of the original invagination is at the expense of the re-
ceiving part of the tube. Pflüger has shown experi-
mentally that an irritation of the splanchnic nerves
does hem the action of the intestinal muscles. Once
produced, there is of course a constant tendency to its
increase upon every contraction of the receiving part of
the intestine.
This accident may occur anywhere in the intestimal
tract, small or large, most frequently, however, is it en-
countered in the large intestine particularly at the ileo-
cCecal valve as in the case before us. -
In most cases as may be readily understood it termin-
ates in death, either by the peritonitis excited or by
septicæmia from the absorption of putrid matters. Yet
cases of favorable termination are not So Very rare.
Either the invaginated intestine, then, sloughs off and
is passed per anum leaving a thick fibrinous ring at the
point of entrance, or it becomes firmly adherent to the
receiving tube leaving its calibre open. Sometimes it
sloughs but partially, then there depends at the lower
portion a fringe-like mass of mucous membrane, thicken-
ed and engorged as in the present case to resemble
neoplasms on the inner surface. In the first two cases
recovery may be perfect. In the last there is constant
intestinal difficulty left.
It is easy enough to understand how cramp colic and
constipation were constant attendants upon this case.
The constriction of the inner tube is so great, indeed,
that is wonderful that stercoraceous vomiting was not
a symptom in his history. Evidently the canal was
large enough to permit the passage of feces to extent
sufficient to prevent this complication.
The amount of thickening here, the really immense
quantity of exudative material present, clearly proves
the chronicity of the affection. In all likelihood this
condition has existed ever since childhood, of course in
much less marked degree. In course of time the tube
became narrower and narrower, fecal accumulation with
corresponding gaseous formation, as evidenced by gurg-
ling and tympanites, more and more marked, the local
became very gradually a general peritonitis, the cause
of the death which was the only relief possible to such
3. CàSG. *
The following cases collected from different sources at
hand illustrate the different varieties of this lesion
with other points of interest connected with the subject.
1.—Intussusception of portion of ileum. Passage of
intussuscepted part per anum. Recovery. Woodman,
Times and Gaz., Dec. 3, 1870. Temale, aged 41. At-
tacked with sudden violent abdominal pain and vomit-
ing. Pain localized at regio hypochond; no tumor
palpable; constipation two days. Thirteenth day pains
much more violent; spontaneous evacuation with piece
intestine belonging to ileum. Recovery in short time.
2.—Extensive invagination, Small and large intestine.
Ballard, Transact. Path. Soc. Lond, vol. viii, p. 385, in
a child 6 mos. Death 6th day. Part of ileum and
upper part of colon found in descending colon. Volvulus
palpable, per rectum, to finger, like pregnant OS uteri.
3.—External protrusion, Sydney Jones, Transact.
Path. Soc., loc. cit., p. 179. Healthy child at breast,
sudden vomiting mucus and blood, constipation. End
3d day fecal discharge, recovery. Recurrence symp-
toms after 3 weeks, stools with difficulty, End 4th
week bowel gradually protruded from rectum to length
of 6 inches. Gangrene ensued, death 9 weeks. Lower
part of ileum and coecum with appendix found invag-
inated into colon. Tube narrowed to # inch.
4.—Intussuscept, flex. Sigmoid, coli and upper part
rectum. Holmes, Transact, l.c., p. 177. Tailor, aged
40. Diarrhea alternating with constipation. Death.
End of invagination, which was 3 inches long, fringed.
Perforation upper portion, communicating with Douglas
space. 's -
5.—Invaginat, one yard Small intestine in consequence
of fibrous tumor, size of a Walnut, Springing from mes-
entery. Knauss, Würt Corr. Bl. 28, 1859, from Schmidt's
Jahrbücher.
6.—Invag. and discharge after gangrene of nearly one
yard of intestine; 10 in. ileum, whole coecum and part
of colon ascendens. Perfect recovery in 14 days. Voss,
Norsk Magazin vii, 1858, Schmidt’s Jahrb. cv, 335.
7.—Invaginat. descending colon, child, repeated hem-
orrhage, Jacobi, Schmidt’s Jahrb. cxii, p. 362.
8.—Invag, one foot small intestine in colon after in-
gestion one pound of cherries with seeds. Blandlot,
Gaz Med. de Paris. Countryman, aged 19. Intense
pain, obstimate constipation, death. No adhesions, canal
size of little finger.
9.—Invaginat. Small intestine and coecum. Grizolle,
Session Anatom. Soc., Paris. Schmidt's Jahrb., vii, 248.
Diarrhea a constant symptom in life. Death by peri-
tonitis. -
10.-Invag. colon in rectum. Lond. Med. Gaz., XY,
Oct. 25, 1834, from Schmidt’s Jahrb., vol. vii, p. 282.
Coecum and colon both invaginated, 10 mos. child.
Only with considerable difficulty could the invagination
be withdrawn.
JAN, 27, 1872.]
T TEEE THE C T , T N T C -
39
11–Invag. large part small intestine complicated
with ascites. Schmidt's Jahrb. II. p. 40, 20 cent.
ileum, coecum and ascending colon invaginated into
sigmoid flexure and rectum.
12.-Invag. caused by traction fibrous tumor in mu-
cous membrane. Holmes Surgery, iv, p. 612.
18.-Invag. 8 in. ileum with coecum and appen-
dix. Recovery 6 weeks, Holmes Surgery, l.c. p. 617.
14—Invag. and discharge 29 inches colon in child 6
years of age. Gross Surgery II. 617. This is the cel-
ebrated Dawson case. Notwithstanding the immense
loss of intestine the child made an excellent recovery.
From the same work is quoted the following “In 35
cases analyzed by Dr. William Thompson, the invagi-
nated pieces varied in length from six inches to three
feet and nearly all included the entire cylinder of the
tube along with a portion of the mesentery. The small
bowel was concerned in 22 cases and the large or the
large and small in 13. The average duration of the
disease was from four to five weeks.”
REMARKS.—The rarity of this affection is illustrated
by the fact quoted in Holmes Surgery that in 48,218
children [in whom invagination is most frequent] treat-
ed at the Hosp. for Sick Children, London, in five
years, but one death from invaginated intestine oc-
curred.
In the treatment of acute cases it is proposed to un-
fold the invagination before adhesion has occurred by the
injection of air or water. But little success, however,
has been obtained in this way. A case is reported by
Dr. Baldwin, of Florida, Am. Journ. Med. Sci., Oct., 1852,
p. 568, where a supposed invagination was relieved by
the injection, per rectum, of a large quantity of air.
Pirigoff, according to Henoch. Klinik der Unterleibs
Kr. Berlin, 1858, first proposed the operation of entero-
tomy, laparotomy or entero-laparotomy, in relief of
recent cases. According to Ulmer (loc. cit.), laparotomy
has been undertaken in 11 cases of intestinal obstruc-
tion. The operation was successful in six of these. It
is alleged to be no more dangerous than caesarian sec-
tion, lithotomy, extirpation of uterus or ovariotomy.
Knives, forks, and other foreign bodies have been re-
moved by laparo-enterotomy by Schwabe, Renault,
Gruger, Shoval, Frizac. The operation has been repeat-
edly performed as a means of prolonging life in oesoph-
ageal stricture. The difficulty of locating the lesion is
Principally theoretical. In most cases a tumor is palpa-
ble. If not, the section should be made so as to reach
the coecum where invagination is most frequent. After
section the lividity of the intestine reveals the seat of
the disease. The occurrence of stercoraceous vomiting
is a safe indication of the time for operation. This usu-
ally occurs from the 6th–9th day. Pfeiffer even went
So far as to claim that “Laparotomia est volvulo neces-
*ia.” Maissoneuve concluded his celebrated speech at
the Paris Academy on this subject as follows:– “Intes.
tinal obstruëtion, differ as they do in their nature, are
**ide of the limits of our art. The chief means of
relief is laparo-enterotomy. This operation may be at-
tempted with hope of success in all cases where no gen-
eral peritonitis or gangrene is present.” Finally, he
cites the successful case of Dr. Reali in the hospital at
Orvieto—Fror. Not. No. 182, May, 1849.
The great relief of the terrible pain of gaseous disten-
tion by puncture of the intestine is alluded to by sev-
eral authors.
In the treatment of chronic cases where adhesion and
possibly gangrene has supervened, is there no hope left.
In a case of this kind where there is such general ad-
hesion that the right kidney was torn out in the act of
dissecting away the invaginated gut there is of course
no relief but death. But if the adhesions be not so
great as in the present instance—and I find no case
where they were so universal—would it not be justifia-
ble to exsect the whole affected tract of intestine and
unite the divided ends? Certainly we know that
when a very great portion of intestine naturally sloughs
away complete recovery follows and as well we
know that several feet of intestine may be excised in
the lower animal and the divided ends united by suture
without the least, other than temporary, inconvenience
to the animal.
—º-G-sº-
Accidental Rupture of the Bladder.
BY
P. GARDNER, M. D.
Pine Grove, Ohio,
On the evening of the 16th of November I was called
to see Mr. W. R., at. 28, of mixed temperament,
nervous predominating.
On my arrival I found him in a most helpless and
pitiable condition. His story was as follows: “About
1 o'clock P. M., of that day he had mounted a hay
stack, leaving the pitch fork behind ; from some cause
his foot-hold gave way and he slid down to the bulge
of the stack where he encountered the upper end of the
fork handle which struck him in the perineum” just
anterior to the border of the sphincter, lacerating
the parts extensively, entering the pelvic canal, ruptur-
ing the bladder above its neck, passing backward pene-
trating the rectum and ascending as high as the pro-
montory of the sacrum. Here he was pinned until an
assistant came and withdrew the fork by force. The
bladder being distended at the time of the accident its
contents were discharged into the open wound and
escaped externally. I introduced a catheter through
the urethra and threw an injection through it into the
bladder; the injection was immediately thrown out
through the accidental opening. I resolved, then, at
once to avail myself of the benefits of the tube used
after lithotomy, and requested medical assistance in the
case. In due time Drs. C. D. Wall and W. W. Mills
arrived, the former administered chloroform while the
40
[JAN. 27, 1872.
T TEI IEH C T I I INTIC .
latter aided me in introducing the tube through the
wound into the bladder. The task was somewhat
difficult but we at length succeeded, and in a few min-
utes the urine commenced passing through the tube.
I may here state that I evacuated the bowels freely
before introducing the tube,and found that the opening in
the bladder and rectum communicated, and that the
faeces passed directly into the bladder. After the intro-
duction of the tube I administered tannin and opium
freely, and kept the bowels confined for six days, and
thus obviated that difficulty. I allowed the tube to
remain in the wound until the eighth day when I intro-
duced the catheter through the urethra and withdrew
the tube, plugging up the opening with lint saturated
in glycerine. Occasionally air found its way into the
bladder for a few days but I allowed the catheter to
remain until he could micturate easily then withdrew
it and a speedy recovery followed. In fifty days after
the receipt of the injury he was able to go around and
is now able to attend his business, suffering no incon-
venience from the injury. Such are the facts without
note or comment which I respectfully submit to the
profession.
———sº- ©-sº-----—
A Vindication of a Criticism on Fistula
for Cystitis.
BY
A. T. KEYT, M. D.
Being a Reply to Dr. Emmet.*
In The Clinic of December 30, is a communication
from Dr. Emmet in defense of the treatment of chronic
cystitis by vesico-vaginal fistula; avowedly called forth
by criticisms on this practice, one by myself, and one
by an anonymous correspondent, both published in
The Clinic of November 18. This communication with
all kindness and respect towards the distinguished and
gentlemanly author, I beg leave to notice. Says Dr.
Emmet, “It is evident that the objections made to the
operation, although plausibly taken, are merely theoret-
ical.” Evidently the intention of this allegation is to
destroy the force of the objections. My object was to
produce such an invºntory of evils pertaining to this
procedure as would present it in the light of its gravity.
These conditions were so plain to my mind, that I had
no thought but that as named they would be accepted.
As they are now challenged in high quarters, it becomes
eminently proper to briefly, as may be, examine the
grounds on which they stand.
I said the operation was very painful. It is a law
well recognized, that a wound inflicted upon a sensitive
part of the body will cause a sensation of pain. Under
* Dr. Keyt is justly entitled, as he claims, to reply to a new critic.
With this reply the discussion of this subject in The Clinic is definitely
concluded.-EDS, CLINIO.
this general law then, I cannot err in affirming as very
painful the operation of thrusting a trocar through the
sensitive vesical and vaginal walls, and the extension of
the wound thus made by Scissors.
Of the dangers of the operation, I instanced:
1st. Hemorrhage. This danger is deduced from ; first,
the general law, that incised wounds of vascular parts
are followed by bleeding: secondly, that this is an in-
cised wound made in very vascular parts: thirdly, the
inevitable therefore of the syllogism: fourthly, the fre-
quency of this occurrence after lithotomy operations,
so analogous to this: and fifthly, the difficulty of arrest-
ing the hemorrhage, in this situation. If these prem-
ises are good, the conclusion is just. This is a real
danger not to be diminished or ignored by pronouncing
it “merely theoretical.”
2nd. Shock. It is a perfectly rational conclusion, from
what we know of the effects of wounds upon the nervous
and vascular systems, and especially of the effects of op-
erations on the bladder, that this condition would be an
element of danger. It is produced for just what it is
worth and no more. The inference is, that the lesser
f rms of nervous disturbance, as rigors, etc., would be
quite frequent, and the graver forms constituting shock
proper, not so remote as to be justly omitted in an
estimate of the gravity of this operation.
3rd. Urinary Infiltration. This condition is appre-
hended from the situation being favorable for its occur-
rence, and from its known frequency after lithotomy,
which in vaginal lithotomy presents the same conditions,
and in the male, conditions sufficiently analogous for
just deduction. -
Here are the walls of the bladder and vagina with a
layer of loose connective tissue between them. A wound
is made through and through which of course opens up
this tissue. The urine trickles along the channel of the
wound, and as it does so, a portion settles into the
meshes thus ready prepared for it; then by gravity it
sinks to and permeates the cellular tissue of the lower
portions of the pelvis, and plausibly, by the operation
of capillarity and the law of the diffusion of liquids it
rises higher, and is more extensively and thor-
oughly diffused. If there be a question as to the
operation of these last two agencies, there can be none
as to that of the first under whose influence alone
sufficient region is invaded for most serious and ex-
tensive ravages. ' The situation as it exists is thus seen
to be favorable; nor is it essential as stated by Dr.
Emmet, that there should be an “accumulation in the
bladder;” though in the probable event of a temporary
obstruction in the vaginal portion of the wound, the
vesical portion remaining open, the opportunity of infil-
tration would be increased; for then a collection of
urine in the wound would be in steady contact with a
larger surface of cellular tissue, thus favoring a more
rapid diffusion; nor indeed is it at all presumable, that
the tube with its vesical button, if one be used, can so
accurately fit all the parts as to draw off all the urine.
JAN, 27, 1872.]
TIH. H. C. T.I.N.I. c.
41
I have been thus particular in the elucidation of this
point because I have evidently been misunderstood. I
hope now my meaning is made plain.
Again, urinary infiltration is apprehended after this
operation because it is a mostgrave and common sequence
of lithotomy. Erichsen, in his surgery, states, “diffuse
inflammation of the cellular tissue of the pelvis—is the
most frequent cause of death after lithotomy.” And
“the urine, as it escapes through the wound, sinks into
the meshes of the loose cellular tissue over which it
flows, and thus gives rise to infiltration, followed by
rapidly extending inflammation and sloughing which
speedily involves the whole of the neighboring textures.”
When authority so high speaks so well it is needless to
deduce other. If infiltration then takes place so readily
after lithotomy, it can readily take place after this op-
eration in which similar conditions and relations of
wound and cellular tissue exist. It will also be noticed,
that Mr. Erichsen’s idea is that the urine sinks into the
cellular tissue as it flows through the wound, and not
that it is forced in by a distended bladder behind an ob-
structed outlet.
4th. Inflammation and ulceration of the wound. The
wound thus made with its surfaces separated and bathed
in urine, and the contiguons cellular tissue infiltrated
with urine, must inflame and ulcerate. It is a natural
and inevitable inference that in some cases the action
would prove excessive, and result in sloughing of the
wound with the evils of this process—among which may
be mentioned a liability to secondary hemorrhage.
This fourth danger can likewise be well supported by
appealing to the results of lithotomy.
5th. Pelvic Cellulitis with its train. If the liability to
infiltration of urine is established, this condition as
surely follows, and it is even more certain, because it
may-arise, also, from inflammation extending along the
connective tissue from the wound as a starting point.
It is needless to make any presentation of the well
known gravity of this evil with its abscesses, sloughing
of tissues, pyemia, etc., etc.
6th. Peritomitis. This grave element of danger arises
in the same connections as the last.
These, then, are my objections to the primary opera-
tion with the reasons so far sustaining them. One
species of argument I well know has not been introduced:
I have offered no facts, no cases in which these evils and
dangers were actual occurrences. As yet, we have had
no full reports of cases subjected to the operation, and so
we are in ignorance as to what facts they contain. If
nothing to our purpose can be derived from these, we
gravely apprehend the future will furnish all the facts
needed, if gentlemen continue to perform the operation
and give full reports of their cases. Even in the pres-
ent showing of a limited number of cases where it has
been performed, as claimed, without serious complication
or disaster there is nothing to weigh against the conclusion
of rational deduction, that this is a dangerous operation.
When by sound reasoning a priori a procedure is made
out as hazardous it is not logical or safe to disregard the
conclusion, though the results of experience should be
for a time against it. Some illustrations of this propos-
ition arise in my mind which I proceed to give.
Some years ago, when chloroform was being intro-
duced as an anaesthetic, men reasoned about it, and con-
cluded it was unsafe. They felt quite sure that an
agent capable of such sudden, and powerful and pro-
found influence would sometimes prove fatal, others
were using it with happy effect; and reasoning from
their experience it was safe. But what of chloroform
to-day ? Let the published records of “deaths from
chloroform” answer
The structures, forces, and actions concerned in the
process of parturition are such as to suggest in connec-
tion with it the liability to uterine hemorrhage; and
yet, in my midwifery practice, there have been times
when I have had such a succession of cases in which
“the loss of blood was so trifling as to be of no conse-
quence,” that I might have concluded from the results
of my experience, that the fear of hemorrhage in these
cases was entirely theoretical. I extended my expe-
rience, and met with the fearful floodings.
Conceive of one reasoning, without reference to results,
about the Safety or danger of lithotomy. By a natural
and easy process he would arrive at the conclusion that
it would be a highly dangerous operation; and yet, in
the experience of many surgeons, this fatal operation
has been performed, for a time, in an unbroken line of
SUICCéSS.
“The late Mr. Lynn had cut 25 patients with-
out losing one, and he said that he thought he had at
last discovered the secret of performing lithotomy with
success; but, he added, that the Almighty punished
him for his presumption, for he lost the next four cases
that hg, cut.”
“Mr. Liston, during a period of six years, in which he
operated twenty-four times, lost no patient from litho-
tomy at University College Hospital; but out of the
whole thirty-seven cases which he cut during the period
of his connection with that institution, there were five
deaths; reducing the average to 1 in 7.2.”
And the operation, now on its trial, so manifestly
dangerous, from the possession of intrinsic and significant
elements of danger; from its being so closely allied in
the character and relations of its wound to lithotomy;
and hence partaking to that extent of the evils and
fatality of that operation; and again, from its being
performed on patients broken down, without recupera-
tive eſtergy, and hence more liable to suffer the evil
consequences dreaded : even this operation has been
performed a number of times without, it appears, re-
ported disaster; and on the strength of these results it
is declared by Dr. Emmet, its great American Exponent,
“attended with as little risk as any operation in minor
surgery.” If experience is extended, in this direction,
we look to future tables with a column showing the
number of cases operated on, and another the number
42
[JAN. 27, 1872.
T H E c T.I.N.I. c.
of deaths, to prove the fallacy of this limited experience,
and confirm the conclusion arrived at by sound reason,
that this is a dangerous operation.
But the evils of the method, unless in the event of
the patient's death, extend beyond the first operation.
Upon the evil of the continuous dribbling of urine, I
need not dwell; for Dr. Emmet states:—
“The only serious objection to the operation is the
inconvenience to the female from the escape of urine.”
In my first communication I offered as objections the
8wbsequent operations. It is plain that two conditions
of the opening may exist; first, a contracted condition
with tendency to closure following a minimum of in-
flammatory and ulcerative changes in the wound; and
secondly, a permanently patulous condition following
more or less sloughing of the wound. Evidently, if, in
the contracted aperture, a tube with a “button” were
retained, it would be so embraced as to necessitate an
operation for its removal. If the tube be not worn or
other means of maintaining the opening employed—and
the frequent introduction of tent or bougie would be
another evil—the fistula closes prematurely and all that
was sought is lost. The plan must then be abandoned
or the patient subjected to another operation. In the
other condition of permanently patulous opening, the
patient will ultimately require the operation for vesico-
vaginal fistula or be left to go through life with her dis-
tressing infirmity. This operation may indeed be “so
well known and simplified in its every step, as to be
within the scope of many surgeons all over the country.”
Nevertheless it is equally well known by many surgeons
and by all intelligent physicians, as well as keenly by
the unhappy subjects of it, that it is an operation very
tedious, very distressing, of considerable difficulty, often
extensive and very liable to failure. It is well
known, too, that the after treatment compelling con-
finement to bed in a constrained and fixed posture with
a catheter retained in the bladder and the bowels kept
constipated by opiates, is exceedingly irksome and dis-
tressing to the patient. The operation, too, has its risk,
though in a just estimate, the danger is not comparable
to that of the first, because the parts, from the rough
handling they have been subjected to, now tolerate in-
jury better; but mainly for the reason, that the walls
of the bladder and vagina have consolidated about the
fistula from the previous inflammation, thus effectually
preventing infiltration of urine. No woman in whom
this “strange and eventful” treatment is carried out to
the end, can be expected to escape this operation; which
in its simplest form is an evil of magnitude; for it is
not conceivable that the fistula would so adapt itself to
the requirement of the case as to close spontaneously
just at the time it is considered no longer needed.
The above I believe to be a simple and true statement
of the circumstances of the subsequent operations.
This is the method, involving so much of pain, and
suffering and risk, that is proposed, and to some extent,
practiced as a therapeutic resource in chronic cystitis.
Says Dr. Emmet:—“A certain number of cases of long
standing, however, exist where the walls of the bladder
have become thickened, and this hypertrophy is kept up
by the increasing effort to force out every drop of urine
as it passes into the bladder. This condition, I believe,
is incurable by any other known means than that gained
by the rest afforded after creating an artificial opening.”
There is still room for the opinion, which I think is
entertained by many in the profession, that all these
cases, curable by any means, can be successfully treated
by judicious and safe methods. The principle of rest
in the treatment of disease and injury is beautiful, most
kind and effective in its influence. It is applicable to
these cases when brought to bear on them in an easy
and natural way, and without the intervention of a
method causing unrest, perturbation and risk to life.
It is said it is not proposed to resort to this procedure
“under any circumstances until other means of relief
have failed.” I should not consider that “other means”
had been sufficiently tested until they had been tried
and re-tried, under the most favorable circumstances of
faithful, skillful attendance, and willing, obedient,
cooperative patient, taking advantage of time, and rest,
and all things; and then persevering until the patientis
relieved, or found to be hopelessly incurable: and even
in the last sad state I should expect “other means” to
afford her some amelioration.
I am willing to concede, however, that the fistula once
successfully established, the current of the urine diverted
from the urethra, and the patient no longer required to
perform urination, the sense of relief is sudden and great.
But the captivating result is purchased at too great a
price; and a patient with this disease treated by the
most faithful and favorable application of ordinary and
safe means, has, in my belief, a far better chance for
relief and continued comfortable existence than one
treated by the extraordinary and unsafe method by
fistula. Furthermore in this disease no exigency arises
justifying an extreme measure, as in the conditions jus-
tifying or calling for lithotomy, herniotomy and all the
great legitimate operations of surgery.
The conclusion of the whole matter is that the prac-
tice should be condemned; at the same time I much
regret that this is at variance with the estimate placed
upon it by some of the Great in our profession.
—º-º-º-
AN ACCIDENT IN THE LABORATORY..—On Thurs-
day, Dec. 21, a most distressing accident occurred in
the laboratory of the Josephinium at Vienna. The
Professor of Chemistry, Dr. Schneider, was busy with
some chemical investigations when a sudden explosion
took place in a glass vessel shattering it to pieces and
wounding the chemist so severely about the face as to
endanger sight in both eyes.'
JAN. 27, 1872.]
TIH. H. C.I.I.INI c.
43
S T I IL L. B I R T H [.
Its Pathology and Therapy.
An Abstract of a Review of Schultze’s (Jena) work, “Der Scheintod
der Neugebornen” (from the Archiv. für Gynaekologie, vol. II,
Sec. 3, 1871).
The author defines still birth as an intra-uterine Suffo-
cation of the living child and shows that the apoplectic
and anaemic forms have a common cause with the purely
suffocatory type, viz., interference with the placental
respiration. For while brain pressure by irritation of
the vagus causes a reduction of the pulse, anaemia by
diminishing the activity of the heart's action with con-
sequent back action upon the placental interchange
produces the same results. Brain pressure and anaemia
are the rare causes of placental disturbances; to the
same effect tend more frequently, severe pains with
short intervals, tetanus uteri, hemorrhages, syncope and
death of the mother, premature separation of the placenta
pressure on the cord, etc. The injurious effect of prem-
ature respiration depends upon diminution of pressure
in the umbilical arteries in consequence of the fullness
of the vessels of the lungs as well as upon the distension
of the right auricle, sequitur of the cava and umbilical
vein, associate with the closure of the foramen ovale.
The facts that the first acts of respiration in living
children are marked by loud rales and that the first ex-
cretions contain albumen show that these children have
inspired prematurely. When on post-mortem, foreign
substances are discovered in the trachea and bronchi,
this premature respiration is proven : yet in some cases
inspired substances may not be present; this happens
or not, as may be understood, according to the disposi-
tion of the face. In these cases there is found marked
pulmonary hyperamia, with subpleural ecchymoses, a
condition which may be referred in most instances to
futile attempts at respiration, but which may result, on
the other hand, from compression of the cord and stasis
in the aorta and ductus arteriosus. The aspired sub-
stance is liquor amnii with meconium and vernix
caseosa. In exceptional cases, also, during operations
or explorations atmospheric air may be inspired by the
foetus. In these cases the lungs are usually only partly
vesiculated. Sometimes the foetus begins, then, to cry
in utero. If the presence of inspired substances be not
recognized in the trachea and lungs of the still born at
maturity, if the lungs be not found, then, in a condition
of hyperaemia, the author concludes that death has oc-
cured by protracted Suffocation without any preceding
act of respiration. On account of the great flexibility
of the costal cartilages immature births- may execute
with open mouth acts of respiration which nevertheless
fail to carry air to the lungs [The lungs may be found
perfectly void of air, even after distinct extra-uterine
effºrts at inspiration as Schröder has recently shown.
Rev.J. Profound asphyxia and absence of rales in the
resuscitated are signs that there has been no premature
effort of respiration. The most marked grade of intra-
uterine asphyxia may occur without any previous res-
piratory effort, if interference with the placental respi-
ration slowly increases. To this class belong those cases
of still births which have lain for hours long without
... respiring, have been almost buried, indeed, when resus-
citation finally occurred. They are only explicable on
the assumption of a slow but profound reduction of the
excitability of the medulla.
Asphyxia, associate even with meconium discharge,
may be, as is well known, only transitory in the course
of labor and disappear entirely before its termination.
This is because the disturbances of circulation induced
by premature respiration have ceased with the relief of
the disturbance of the placental respiration. Should
the cause of the placental disturbance continue, the
child usually makes repeated efforts at respiration, be-
comes profoundly asphyxiated or dies. Further, it is
not of rare occurrence for the foetal heart to be markedly
retarded during the last uterine contraction and in this
case the child begins to breathe unusually late. [While
such a reduction of the heart’s activity, recognized by
anscultation, does not, therefore, call for operative inter-
ference in rapid termination of delivery, yet it teaches
us not to dally too long in the preservation of the perin-
eum, rather to hasten delivery, when necessitated, by
sufficient section of the perineum (episiotomy) Rev.]
In general, the prognosis is more favorable in cases
where asphyxia has ensued without previous respiration
than when this has previously occurred; most unfavor-
able it is when respiration has been attempted when no
air could enter the mouth on account of its position.
The author coincides with Cazeaux in recognizing
two grades of still birth ; the first, with muscular rigid-
ity and red or livid skin; the second, graver, with mus-
cular relaxation and pale skin. As Sequelae of still
births after resuscitation, are to be considered the con-
ditions engendered by the inspired substances. These
may occasion atelectases and lobular pneumonias and,
alas, only too often, subsequent death. Further, blood
extravasations are not infrequent, especially in the brain,
and from these may be derived the various muscular
contractions of advanced childhood.
The reduced excitability of the medulla, the accumu-
lation of carbonic acid gas, the absense of oxygen in the
blood, the disturbances of the circulation and the pres-
ence of inspired substances in the organs of respiration—
these are the factors with which a rational therapy has
to contend. The author now details the various meth-
ods of resuscitation usually resorted to, expresses objec-
tions to each, and finally, concludes that his own meth-
od, best, and almost simultaneously, fulfills the three
most essential indications. In the lighter grades of
asphyxia, the cord is to remain intact until the cessation
of all pulsation. This is done that the closure of the
ductus arteriosus may not be prevented by back action
of the blood in the aorta. Mechanical irritation to the
44
[JAN. 27, 1872.
T EIIH, C T.I. N. T. C.
surface, sprinkling cold water, even immersion of the
whole body in cold water, perhaps an emptying of 20-30
grm. blood from the cord are here in place. The asphyxia
of the second grade (paleskin, relaxed muscles) demands
immediate separation of the cord and induction of arti-
ficial respiration by the method of the author. This
consists in imparting to the child’s body a swinging mo-
tion; the body is bent upon itself in the lumbar region,
and then swung at first the head upwards and then the
pelvis upwards when it is gradually turned upon its
abdominal surface to effect a full expiration with expul-
sion of the inspired substances. As the body is now
returned to its first position, an act of inspiration occurs.
This swinging motion is repeated eight or ten times,
when a warm bath follows: then the body is again
swung, when a cold bath follows, and this motion and
these alternate baths are continued until the child cries
or the heart ceases to beat. Should dyspnoea occur, the
Swinging and cold baths are repeated. Should this
swinging not lead to entrance of air in immature births
upon the first trial, catheterisation of the trachea should
be performed and air should be blown into the lungs
before the motion is repeated.
—sº-o-º-
scIENTIFIC NoTEs.
INFLUENCE OF LIGHT ON SUGAR.—M. Raoult states,
in a paper read before the French Academy of Science,
that cane sugar becomes transformed into grape sugar
under the prolonged influence of light. Having dissolv-
ed 10 grammes of white sugar in 50 grammes of pure
water and boiled the solution for a few minutes, he
placed equal portions in two white glass tubes, which
were then hermetically closed. One was deposited in
a dark place, while the other was exposed to light.
Five months afterwards the tubes were opened, and the
contents of that which had been exposed to light gave
the reaction of glucose.
DIABETES AND THE FOURTH VENTRICLE OF THE
BRAIN.—In order to explain the apparently contradic-
tory results, Cyon set about investigating the way in
which the fibres of the annulus of Vieussens affect the
liver, and more especially the circulation in it.
On irritating these fibres, he found that a number of
fine white lines appeared round the lobules of the liver,
in the position occupied by the small branches of the
portal vein and hepatic artery; and these were so nu-
merous as to produce the appearance of whitish spots on
the organ, which continued while the irritation lasted,
and disappeared after it ceased. At the same time that
these spots appeared, he noticed that any cut or tear
in the liver bled less freely than before. This indicated
that contraction of the portal vein or hepatic artery, or
of both, had been occasioned by irritation of the
annulus; but, in order to make assurance doubly sure,
as well as to find out whether it was the artery or the
vein that contracted, he put a T-cannula into the hep.
atic artery, and connected it with a manometer. On
then irritating the annulus of Vieussens, the pressure
rose in the manometer as much as thirty to seventy
millimetres of mercury; while in the carotid it only rose
five to ten millimetres. To remove the last objection
which might be raised, and show conclusively that the
rise of pressure was due to contraction of the branches
of the hepatic artery in the liver, and not to any other
cause, he compressed the artery beyond the point where
the canula had been inserted, so that no change in the
calibre of its branches could have any influence on the
blood-pressure in its trunk. On again irritating the
annulus, he found that no alteration in the pressure was
produced. Division of both annuli produced, as was to
be expected, dilatation of the branches of the hepatic
artery, and fall of the blood-pressure in it. When the
portal vein was experimented on in the same manner,
the pressure only rose ten or twelve millimetres during
irritation; and he thinks this is probably due indirectly
to the change in pressure in the artery. .
These experiments completély prove that the vaso-
motor nerves of the hepatic artery are contained in the
annulus of Vieussens; that their division causes the
vessel to dilate, and at the same time produces diabetes.
The theory of Bernard, that the diabetes depends on the
dilatation, and on the consequent rapid circulation of
blood in the liver, is thus rendered in the highest degree
probable.—Brit. Med. Journ., Dec. 23, '71.
—sº-º-º-
NIIEDICAL NEWS.
MEDICAL SERVICE IN THE NAVY.—The Secretary of
the Navy has recently announced to the navy, in a
general order, No. 164, that no assistant-surgeon will be
examined for promotion until after he has served in his
official capacity “at least two years on board of a pub-
lic vessel of the United States at Sea.” This is an accor-
dance with the letter and spirit of the law, which re-
quires that the professional qualifications of candidates
shall be ascertained by suitable examination before they
are appointed assistant-surgeons. The requirement of
two years' service at sea prior to promotion, specified in
the act, is to test the personal aptitude for “life on the
ocean wave” without which a medical officer is worthless
in the naval service. Gentlemen who have been Com-
missioned three years may be examined for promotion
at the discretion of the Secretary of the Navy, provided
they have been qualified by two years' experience at sea.
At the expiration of five years' service they are legally
entitled to be examined for promotion, if qualified by
at least two years' service at Sea. -
THE PEST IN PERSIA.—Dr. Castaldi who was sent
out from Teheran to investigate the epidemic prevail-
ing in Kurdistan reports his observations to the sanitary
council Constantinople to the effect that the epidemic is
nothing less than the Asiatic pest. The disease begins
with vigor, cerebral disturbance (sopor and delirium
JAN. 27, 1872.]
and vomiting. At times immediately, at times after a
short period, boils begin to appear on the soft parts, in the
axillae, and on the neck producing violent pains. Later
the body is covered with bluish-black spots of the size
of a pea and larger. It is in high degree contagious, ex-
tending itself as in Bana from house to house. It first
appeared last winter in the village Arbanus, which was
totally depopulated. In Bana, 5,000 inhabitants, 150
cases have occurred, of these only 54 terminated fatally.
In some of the villages of Asiatic Turkey bordering on
Persia the pest has also appeared.
HoNORS RECIPROCATED.—From the Constitutionnel we
learn that it is proposed by the French government to
decorate with the ribbon of the Legion of Honor all
the German Physicians and internes who gave aid to
the wounded of the French during the late war. The
Emperor of Germany has thanked M. Thiers for this,
and will in return bestow the iron cross with the white
ribbon, upon the French Physicians and internes who
distinguished themselves by extending succor to the
German wounded. The Constitutionnel is glad that the
internes are included in the proposition, and pronounces
a eulogium upon this class for their courage, devotion,
and self-denial. The Union Médicale of October 3,
while agreeing with the Constitutionnel as to the merits
of the internes, thinks that their patriotism will in-
terfere with their wearing the iron cross or deriving
great pleasure from its possession.—Phil. Times, Jan. 15,
1872.
SMALL-Pox IN GERMANY.—The epidemic of this
disease in Vienna is rapidly increasing. The number
of deaths has not yet reached the proportions announced
in Berlin, Breslau, etc., but it is already of such extent
as to necessitate the construction of a new ward for
small-pox patients in Prof. Hebra’s department.
—-º-º-º- *
CORRESPONDEN CE.
VIENNA, AUSTRIA, December 18, 1871.
- EDs. CLINIC: -
I thought last night I should be able to write a
short article to-day on vaccination, giving reasons why
a good many physicians were opposed to it, etc. But
on looking over some of the literature on this subject
and especially syphilis vaccination, I find that it would
require several days study to enable me to state what
really has been proven and what not; time, which I
cannot just now devote to such studies. Hence I will
tell you what my ideas are on the subject and what I
know to be fact.
It is asked why are German physicians opposed to
Vaccination ? Before answering the question itself. I
find it necessary to protest against the assumption that
the German physcians en masse are opposed to this
measure, or even that a majority of them stand in any
Way, in an attitude of opposition. I am forced to this
T THE EI, C T , IISTIC .
tion must be admitted.
this city.
45
belief from what I read in German medical journals, as
well as from what I hear and see in the several hospitals
here. That a few are strenuously opposed to vaccina-
The question “why” can be
answered in a few words. It is preeminently the fear of
syphilitic contamination. A quite secondary reason may
also be the circumstance that even successful vaccina-
tion does not entirely protect every individual against
Small-pox. Is there sufficient cause to be afraid of
syphilitic contamination through vaccination ? Un-
doubtedly there is, for it is an admitted fact, that the
blood of syphilitic persons if introduced under the
cuticle of the non-syphilitic, will in a certain number
of these latter, about 25 per cent., develop the disease ;
hence, if vaccinating from arm to arm, we employ
bloody lymph we are likely to infect healthy persons;
providing, however, the person from whom such lymph
is taken was at the moment suffering from some man-
ifest form of syphilis. As a matter of course, the con-
tamination is certain to occur, if vaccination is made
from a syphilitic pustule or syphilitic Sore of any kind
or crusts from such pustules or sores. It is not proba-
ble, however, that any physician will in this manner
spread the contagion, inasmuch as such practice would
at once prove the offending party guilty of either gross
ignorance, or criminal neglect. I will not maintain
that in past years children and grown persons may not
have been thus infected, on the contrary, it seems pretty
well established that it has occurred; is however less
likely to happen in future, because much more care will
be exercised in the selection of vaccine-lymph, or crusts.
This much the opponents to vaccination have established.
But they have done more, they have spread distrust and
horror by publishing as syphilitic, many cases which, at
most, were what the dualists call chancroids, a peculiar
ulcerative process, not producing any constitutional
symptoms.
Now, is all this sufficient cause to be opposed to and
to discourage human vaccination ? Not at all. In the
first place the danger of contamination has been largely
overestimated, magnified. This is conclusively verified
in every country where vaccination is practiced. As an
instance I will simply cite the Foundling Hospital of
Here about fourteen hundred children are
vaccinated annually. The institution also furnishes
vaccine-lymph to all vaccination districts in the Aus-
trian empire, besides sending some abroad: one hun-
dred and fifty tubes having been lately sent to Cincin-
nati. The present Director of the Hospital, Dr. Fried-
inger, has held this position for seventeen years and for
two years besides was assistant in the institution.
During all this long period with this great number of
vaccinations annually, Dr. Friedinger has not, so he has
informed me, seen a single case where syphilis had been
communicated through vaccination. In one instance
he took lymph from a child which a few days later
showed unmistakable symptoms of syphilis. The vac-
cinated child was kept under observation for a year, or
46
[JAN. 27, 1872,
TIEEE THE C T , T: INTT C.
more, and no syphilis ever manifested itself. Here,
then, we have an instance where one man has performed
upwards of 25,000 vaccinations, without having seen or
learned that in any instance he had communicated
syphilis, and this too, in a city like Vienna. Dr. F.,
however, exercised great care in the selection of his
lymph sources, only strong, healthy children, free from
every syphilitic manifestation are used as Stammimpflinge
[sources]: the vesicles must bear the characteristic
marks, and be not over seven days old, counting from
the day of vaccination. All dwarfish, or abortive vesi.
cles are to be avoided, likewise, and, particularly so
those in which pus-cells have already been formed.
Nor does it seem to be a matter of indifference as to how
the operation is performed. Dr. Hobner, of Fratz,
recently reported a case in point. He vaccinated from
the same source a healthy child on both arms; on One
arm by the method of very superficial incisions, on the
other by somewhat deep punctures. On the first arm a
typical vaccinia development was the result; but on
the second, where puncture had been resorted to, in-
stead of having a dry crust at the end of the third week
an ulcerative process set in, and cicatrization did not
take place until the end of the fifth week.
The facts noted, it seems to me, go to prove that we
need have no fear of syphilitic contamination if we will
but observe the rules generally laid down for the
guidance of vaccinators, and which are none other than
those incidentally referred to as followed by Dr. Fried-
inger, viz: To use as “Stammimpflinge” [sources] only
strong, and as far as possible, healthy children ; the
lymph to be taken from none but entirely normally
developed vesicles, and not later than the seventh day,
counting of course from the day of vaccination. Any
vesicle, the contents of which are turbid, milky, or
bloody should be scrupulously avoided, for there can be
but little doubt that, in all cases where syphilis has
been carried from one to another by vaccination, the
source was just such a vesicle or pustule. The age
of the “Stammimgflinge,” should also be taken into ac-
count, it should not be less than six months, one year is
still better. One reason for this is that congenital syph-
ilis almost invariably manifests itself during the first
six months of life; by far the greatest number occur
during the first three months of life. In performing
the operation itself care should be exercised to wound
the cutis vera as little as possible; simply removing the
epidermis by scratching, etc., seems to have given the
very best results.
In regard to minor objection to vaccination ; that it
is not a perfect and permanent protection against Small-
pox, it may be stated without fear of contradiction that
a successful vaccination affords so nearly perfect protec-
tion against variola, that the failures are but an in-
finites mal per cent. Of those who subsequently suffer
from small-pox, again, but a small per cent. have to go
through severe grades of the disease; the large majority
of vaccinated Small-pox patients being light cases, coa-
sequently the rate of mortality among these is much
lower thaa among those not vaccinated.
To conclude then, I see no good and valid reasons
why anybody, least of all a physician, should be opposed
to judicious vaccination. - -
Yours Truly,
J. TRUSH.
EDS. CLINIC :
I was not a little startled on reading a paragraph in
the number of your paper of the 13th headed “SUICIDE
BY MORPHIA HYPODERMICALLY,” and a notice follow-
ing of the death of the late lamented Col. David Stan-
ton, M. D., of New Brighton, Pa. Now there is a dash
of malignity in the caption to the short article referred
to, that is perfectly inexplicable to me when I look at
the high character of the names of those who conduct
the paper, as well as the unexceptionable tone of the
entire paper itself in other respects; and "I cannot avoid
respectfully calling attention to this matter with the
hope it may be accounted for by some inadvertence.
If there was anything in the circumstance attending
the sad fate of my friend Dr. Stanton, that warrant
such an unqualified use in connection with it, of what
in modern times is almost universally regarded as an
extremely opprobious term, those whose opportunities
were excellent for knowing the facts are still in ignor-
ance of it. I trust the numerous friends of the de-
ceased gentlemen, both in and out of the profession to
which he belonged and adorned, may be relieved of the
feeling which is engendered by such a public announce-
ment as above, by the appearance of some satisfactory
explanation. . - .*
I am very Respectfully,
Yours, cte. -
* L. M. Whiting, M. D.
CANTON, O., Jan. 20, '72.
The notice of Dr. Stanton's death referred to was
clipped from the Atlanta Med, and Surg. Journal, Nov.,
1871. As Dr. Stanton was an entire stranger to the
Editors of this paper, the “dash of malignity” is nonsense.
Dr. Stanton killed himself accidentally. That is the
fact and that is the tenor of the letter in the Atlanta
Journal and the note in THE CLINIC. -
It is a matter of regret, however, that any misinter-
pretation of the statement has arisen, particularly as it
turns out that the deceased has near relatives both in
the medical and legal profession in this city.—EDs.
CLINIC,
º
—-º-e-º-
C LINICAL VIEM IORANIDA.
THE REMOVAL OF MORBID GROWTHS FROM THE
LARYNX BY SECTION OF THE CARTILAGES.—Mr.
Arthur Durham read a paper before the Royal Medical
and Chirurgical Society (Lancet, November 25), in
JAN. 27, 1872.]
47
which he related in detail five cases, in each of which
the operation had been performed in Guy's Hospital,—
in three cases by himself, in one by Mr. Bryant, and in
one by Mr. Colley. The result in four of these cases
had been eminently satisfactory, free respiration and
good voice having been regained. The remaining case
was still under treatment. Appended to the communi-
cation were more or less complete reports of all the
cases the author had been able to find on record. These
cases were thirty-two in number, and, with the five de-
tailed in his communication, gave a total of thirty-seven.
In nineteen of these the operation might be regarded as
having been completely successful, natural respiration
and voice (though in some instances not normal in tone)
having been restored. In seven partial success was ob-
tained, respiration having been restored, but the voice
lost or very seriously impaired. In four cases some
temporary relief was obtained. In three the result
might be considered negative, neither good nor harm
having been done. The reports of at least two cases
were incomplete. In two cases—and two cases only—
death resulted. In each of these, however, the im-
mediate cause was blood-poisoning. Metastatic abscesses
were found in the lungs in one case; in the other
erysipelas and gangrene occurred, and broncho-pneu-
monia and exhaustive fever ensued and led to a fatal
issue.—Phil. Times, Jan. 15,’72.
BULLET ExPLORERS.—The Improvements which
have taken place in the modern applications of electric-
ity have paved the way for more simple and yet more
sensitive bullet explorers. One of these is the invention
of Mr. De Wilde, a civil engineer, and is very compact-
ly arranged in a box of small dimensions. The electric
action is excited in a suitable cell; the electricity there
developed is increased in intensity by the invention of
a multiplying coil; an exploring probe is connected by
insulated wires with the apparatus; and the indication,
when the circuit is completed by contact of the two
points of the probe with a leaden bullet or piece of iron,
is given by the striking of a hammer against an alarm
‘bell. The bell sounds at each interruption and
renewal of contact of the points with metal. The ex-
ploring probe consists of a long slender tube of smooth
vulcanite, containing two insulated needles, the points
of which can be withdrawn within the tube, or be made
to protrude, at the pleasure of the operator. Altogether
it is an effective appliance as an exploring instrument,
owing to the strongth of the electric current developed,
and the marked manner in which the indications are
given by the sound of the bell when a bullet or other
metallic substance is met with. There is also attached
to the instrument a bullet extractor, the two arms of
which are insulated, and so arranged that, when they
are connected, in the same way as the explorer, with the
battery, they indicate the grasping of the foreign body
similarly by the sound of the bell. Unless the metal
be firmly grasped by both blades, without any other
substance intervening, the indication will not of course
be given.
Another instrument of a similar nature has been
made by Messrs. Krohne and Sesemann of London.
The indications of contact with a lodged bullet or other
metal are in this instrument afforded by the movements
of a galvanometer, and of a fine needle working upon a
dial-plate, in the same manner as is seen in the ordinary
single needle telegraph. I have experimented with both
instruments, and have found them equally effective in
their indications. Attached to the latter instrument is
not only a bullet-extractor as well as the explorer, but
also a pair of acupuncture needles' for use in cases where
metallic bodies are supposed to be lodged in soft tissues,
away from any means of approach by a wound or sinus.
A rough but sufficiently effective electric instrument
for facilitating the discovery of metallic substances
lodged in gun-shot wounds has been made in the follow-
ing way. The magnet of an ordinary pocket-compass,
which has had some turns of wire covered with thread
wound round it as an induction coil, is employed for the
electric indicator while a piece of copper sheeting, bent
round a small plate of zinc, but separated from it by
flannel padding Saturated with the usual diluted acid,
forms the voltaic pile. The exploring instrument is
formed by two insulated wires, bound together, but
with the points left free. These parts being connected,
when the circuit is completed by contact with metal,
the indication is given by movement of the magnet of
the compass-Longmore—Brit. Med. Journ., Dec. 30, 71.
– sº-º-º-
º - -
The Iodides of Ammonium and sodium
in Syphilis.
IBY
BERKELEY HILL, M. D.
Surgeon to University College Hospital,
It not unfrequently happens in cases where iodine is
required, and the patient has taken iodide of potassium
with good effect for a certain time, that this medicine
either ceases to produce any result, or is no longer toler-
ated. Faute de mieux, mercury is sometimes resorted
to ; but, as the cases are not suitable for mercury, they
generally become worse while taking it. In this diffi.
culty, the iodides of sodium and ammonium are very
useful, for they affect the body somewhat differently
from the potassic salt. They can be borne by, and pro-
duce the effect of iodine in many persons who have be-
come nauseated by the latter. They moreover contain
less alkali per weight of the Salt, and their alkali is less
deteriorating to the blood than potash. One or two
cases will illustrate my meaning. A gentleman was
brought to me by his medical adviser, with extensive
and obstimate syphilitic ulcers of the tongue and palate.
He had had several other forms of syphilis during the
nine or ten years he had been infected, and was in a
48
[JAN. 27, 1872.
TIEEI IEH C T , I INTI C.
weak and low-spirited condition. Early in the disease,
he had taken mercury and other remedies in the usual
way. Latterly, for the ulcers in his mouth, iodide of
potassium had been given in doses gradually increasing
to a scruple, and even half a drachm; but, when I was
consulted, these had ceased to check the disease, and had
produced iodism. In consequence of this, mercury and
several other drugs had been tried again without benefit.
Though his tongue was foul, his appetite, but for the
pain of eating, was good. This is important; if the di-.
gestion be deranged, it must be set right again before
iodine can have fair play. Under these circumstances,
the patient was ordered to begin with eight-grain doses
of iodide of ammonium in bitter infusion three times
daily. He bore this well, and in the course of a few
weeks his tongue and palate were nearly healed. For
complete cicatrisation it was necessary to alter the form
to iodide of sodium; and, during two years, he has been
taking this salt at short intervals to prevent the relapse
of his disease. Here is another case of syphilis appear-
ing unconquerable by either mercury or iodine, which
had been given by several medical men whom the
patient had consulted. The case was interesting from
the probability of its being one of contagion through an
infected monthly nurse “sucking the breasts.” The
child was infected at the mouth subsequently to its
mother, and the history in the mother points to con-
tagion having entered by the nipple.
patient until two years after infection; she had then
severe ulceration of the tongue and of the soft and hard
palate, and limited necrosis of the bone in the palate.
From the prescriptions which she showed me, she had
been taking scruple doses of iodide of potassium, for
some time with good effect; but, latterly, even double
doses of her medicine had only produced severe iodism
without controlling the disease. It was with some
reluctance that she consented to try iodine again; but,
after a few eight-grain doses of iodide of sodium, coupled
with frequent washing of the mouth with hyposulphite
of soda and glycerine lotion, her sufferings were so far
removed that she announced, a week afterwards, that
she could eat crusts with ease; and, in a month, except
that a morsel of necrosed bone still adhered, the mouth
was quite well. The course of this case since has been
obstinate; gummata appearing elsewhere after that in
the mouth had healed; but she still takes iodine, some-
times in one salt, sometimes in another, and occasionally
mixed with Bell’s liquid extract of Sarsaparilla. It
would be easy to multiply instances where, iodide of
potassium having lost its effect, the progress towards
recovery can still be maintained by another form of
iodine; but that is needless.-Brit. Med. Journ., Dec.
23, 1871. -
JIM FISK's brain is said to have weighed 59 ounces.
Cuvier's, notably the heaviest, weighed only 64 ounces.
Fisk’s is heavier than Simpson's, the fifth heaviest, in-
deed, recorded. It would be interesting to have the
particulars as to the number and depth of the convolu-
tions, etc. Possibly the science of bumpology might
receive some additions.
I did not see the
Medical College of Ohio. .
S P R N G C 0 U R S E ,
The regular eight weeks course of practical instruc-
tion for the Spring of 1872 commences March 15. Un-
usual advantages are offered this year in the fact that
the course will be conducted by the entire Faculty of the
College. - -
The course will embrace the following topics:
Clinical Medicine—Bartholow.
“ Surgery—Dawson.
Anatomy Brain and Nervous System—Gobrecht.
Operative Surgery—Conner.
& 4 Obstetrics—Reamy.
{{ Ophthalmology—Seely.
Female Pelvic Surgery—Palmer.
Urinalysis—Nickles. -
Physical Diagnosis—Cleveland. &
Fractures and Dislocations—Kearns.
Genito-Urin. Dis.—Anderson.
Microscropy—Whittaker.
Prof. Graham will deliver occasional lectures on Clin-
ical Medicine and Diseases of the Chest during the pro
gress of the Course. -
The design of the Course is to present instruction in
a thoroughly practical manner. Physical Diagnosis is
to be demonstrated in the hospital wards; Operative
Surgery, Operative Obstetrics, Operative Ophthalmology,
and Operative Gynaecology on the cadaver. - -
The Dissecting Room will be under the supervision of
Dr. where abundant material will be provided.
Special attention will be paid to the chemical and mi-
croscopical analysis of morbid urine.
In order to render this course the most practical pos-
sible, an opportunity will be afforded each individual of
the class to make the various examinations and opera-
tions on the living and dead subjects. Regular daily
Medical and Surgical Clinics will be held at the
Good Samaritan Hospital: Two Daily Clinics will be
regularly held in the Cincinnati Hospital, throughout the .
entire course; and a Daily Clinic will be held at the
Dispensary of the Medical College of Ohio.
One hour each evening will be devoted to Recitations
on Anatomy, Physiology, Practice, Surgery, Obstetrics,
and Materia Medica. -
The eminently practical nature of this course, and its
shortness of duration, together with the great clinical
advantages presented in Cincinnati, can but commend
themselves favorably to the practitioner as well as the
student.
FEES FOR THE ENTIRE COURSE, $10
As this Course does not count towards graduation,
being considered supplemental to the regular winter
course, graduates of the College are not required to
matriculate. The matriculation of non-graduates is
deducted from the fees of the ensuing winter session.
**
F. E. Suikº. E. S. WAYNE
F. E. suire & Co.,
wholesale DRUGGists,
TM A-IN U E A CT Uſ ER, ITN G.
£Hemists AND PHARM aceutists,
CINCINNATI, OHIO.
Have constantly on hand w full assortment of
seveereo waves Aso moeoxexses,
cxxxery)(XCA), AXºAX3A%Us,
TESTs, MEDICAL GLAss war.B. &c., &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordance with the U. S. P. and other recognized authori-
ties.
FINFE AND RAF HE CHEMICALS,
Of the popular class of preparations known as
II, T, IL& IIER, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c
AGENTS FOR BULLOCK & CRENSHAW's
Sugar-coated Pills and Granules.
)
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our |
Preparation, and the quality of the goods sold by us generally.
TER,
º; §§ " ; ºf
sº
JAMES FOs
Wººl
JR., & Co.
|Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a loug Heries of years (having been established since 1836), and in the
reorganization of their firin will endeavor to merit a continuation ºf the
same. We wish it understood by the Professiºn and the Public generally
that our invariable rule is, ſo make or import none but the best in-
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Lemases, Spectacles, and the best models procurable, with pains-
taking skill to adjust them to all contiitions of sight. at our house.
Special attention paid to orders for Fine Microscopic Objects
and Microscopic Apparatus, Magnifiers and Readers in
great variet v. Medical Batteries, Barometers, Thermo-
Rhaeters, Hygrometers, Urimometers and Rain Gauges,
of the most approved coustruction always on hand. All orders promptly
and accurately filled.
JAS, FOSTER, JR. dealing
F. S. SHACKLEFORD, ! *** ** IAs. FostER, JR. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
T)IER, S-INT-TV/I_A_IER/STEI’S
TRUSSES.
No. 758 BRoapway, NEw York
HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsli. for the last eight years, tº the ex-
clusion of all others, and have found it to give general satisfaction. eflect-
ing a radical cure, in the majority of cases, in a very fºw months.
As a Truss for the radical cure of Hermia, l think it lar prº-ferable to
any I have ever examined. LEWIS A. SAY li E, M. D.
- Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend. M. D., Surgeon to the
Massachusetts General IIospital.
B EG leave to state for the benefit of all concerned, that I have known
lºr. S. N. Marsh the last fifteen years. St I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with lais Truss, and the success he has met with in producing a Hindical
Cure of líernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with au v of the risks to the pil lient
that exist in inany of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Maish as a gentleman of honor
and integrity, and as such recommend him to the metal bºrn of the medi-
cal profession generully. Wil, LA 1RL) l’Alt 1 E.R., M. I.).
Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
Trusses, Shoulder Braces, Supporters. Elastic Stockings, SuspenRory
Bandages, Apparatus or Spinal Curvature, Club Feet, bow Legs, and all
other Physical Deformities, made and accurately fitted at the Ratlical
Cure Truss Offices of S. N. M.A RSil & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
OPPOSITE THE IIIGEI STEEPLF,








O
Carriage Manufacturer,
****
NOS, 9 and 11 East Sixth Street, bet. Main & Sycamore.
I MAKE NOTHING BUT
AEA ſº,S 7" CZ.Z.S.S. W. 62/PA’.
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of
LIGHT FAMILY CARRIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to • -
PHYSECHANS” USE.
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen’s
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
Piysicians in the city and heighborhood.


||||||||}|| ||||||}|| ||M||
167 EAST 34TII-ST, NEIV Yo RK,
By Special Appointment Electrical Instrument Makers tº
the New York State Hospital for Nervous Diseases,
ELECTRO-MAGNETIC MACHINES,
Portable Galwamic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871. :
These Instruments are the most Elegant, Powerful, Effica-|
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery I'luid. -
|M|| |||||—||M|| ||||||||}|
PERMANIENT BATTERIEs,
For Hospitals and General Practitioners,
IET IIECTIER, OTDIEBS.
For Bye, Ear, Larynx, Nose, Uterus, Vagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Eleo-
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use. *
Exrn Arts ritor trºm o Prwroxs or The wrosal
Elliſ I.N EN I" M.E.M. ºf EItS (/ F T'Lº ſº PIE OFESS f ON.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Not HING cAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.” -
"We are authorized by Prof. IIammond to announce en-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
M EREDITH CLY \l ER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“ I consider their
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:–“ In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. G. ARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. E.:
ALLEN MAYN A R D, M. D., Cleveland, O.; Dr. C. WANN E,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES |
KELLY, Florence, O.; Dr. JOIIN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes.
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
mauy other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
call of send FOB CIRCULAR AND PEIGE LIST.
SAML. P. THOMAS
T.A.. I
DEALER IN
English, French and Scotch
GOODs,
34 West Fourth Street,
crwczºwycz Tr.
Fosºrr:R's,
IE_A_TIENT
&
§
§§
Are furnished to Officers and Soldiers on Government
il CCOUI n t- -
I claim to have combined such improvements in ARTI.
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb – why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb—why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs — testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTER.
911 Chestnut Street, Philadelphia, Pa. No. 60 West
- Fourth street. Cincinnati, Ohio, or 172 Jef.
ferson Avenuto, Detroit, Mich






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Good sa MARITAN HOSPITAL.
The GOOD SAMARITAN HIOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
pointments of a First-class Hospital, Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the - -
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment. -
Rooms vary in price, according to the character of appointments necessary and service required, ranging, ja
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
service.
Bºy" Address,
SISTER ANTHONY, - *-*.
y
Hospital of the Good samaritan,
corner of Siacth and Lock Sts., Cincinnati, Ohio-






















































































































M A F P& T VVA. I. N'S
- N E VV TB O O IX
IS NOVV READY FOR CA N VASSERS.
It contains over 600 pages of reading matter, with 250
engravings, designed crpressly for this work, by the best
artists in the $ountry. A gents now at work upon it are
meeting with unparalleled success. A gents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reſorts 200 orders in 12 days; one at Cincinnati, O., re-
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLET ON & CO.,
161 Elm Street, Cincinnati, O.
*-
BASCOM & CARPENTER,
Printers
Sy.
Stationers,
-AND-
Blank Book Manufacturers,
136 VINE sºrrle ET,
s\ssºs
E. D. ALBRO & BRO.
IMPoirTERS AND MANUFACTURERS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
frtaint-Mikº','!-Buliiſi'ani Star-Bilº'Wit.
The only house in the Western country that saws Spanish and Mexi-
can Cedar for Cigar-Box Makers We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 West Second Street,
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI.
CAN'ſ A F&G-O
MANUFACTURING COMPANY.,
MANUFACTURERS AND IMPORTERS OF
A N D
Window Shades,
67 WºSz" Fotºzºzy Szººgz",
CINCINNXT, O,
H. H. BRENEMAN, Proprietor,
UNDER WEAR
GENTLEMEN.
Handling much larger quantities of fine and
valuable Underwear than any other firm in the
West, we are enabled to purchase at closer fig-
ures. We are therefore prepared to offer extra
inducements to consumers.
HO's IEERY,
FULL LINES OF THE BEST ALWAYS ON HAND.
SHIRTS MADE TO ORDER.
wilson BROS,
Pilke's opera House, Cincinnati; 931 Wabash Awe-
nue, and ss West Washington street, Chicago-

2.
2.
s
ź.
i
| § w "gººº
2:
i.
s
A.
2.
- - *— '' - Eºº ºr - - 21st-
Bºº. inimi; ; Riº mimim, fift.
º Fºil
i. - Sl
lºss. Sº Aº
º % º; WWAS E
:
". - I F A C U L T Y.
J A M E S G FR A H A M, M. D., DE AN,
Professor of the Theory and Practice of IMedicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., - W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., º C. D. PALMER, M.D.,
Professor of Anatomy. - Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D., T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
W. W. SEELY, M.D., JOHN L. CLEVELAND, M.D.,
Professor of Diseases of the Eye and Ear. - Demonstrator of Anatomy.
SAMUEL NICKLES, M.D., CHARLES KEARNS, M. D.,
Professor of Physics and Medical Chemistry. Assistant to the Chair of Surgery.
J A M HE S T . W H ITT A EX E. F.,
Professor of Physiology and Secretary of the Faculty.
T. Louis BRow N, Prosector of Anatomy. Janitor, College Building, Sixth St., bet. Vine and Race.
Printed and Published by Nor R1s & Mr RRY, Medical College of Ohio Building, Cincinnati,

































THE CLINIC,
PUID. LISIIIED IF VIEIRY SATUIR
T E R M. S.–$2.00 a Year, Invariably in Advance. All Communications relating to Tublications must be addressed to the Editor:
{DAY.
*
All Communications relating to Dusiness, Subscriptions, Advertisements, etc., to the Treasurer.
Vol. 2.
gº tº º Editor.
sº
JAS. T. VVH ITTA KER, M. D.
No. 101 west Ninth street, Cincinnati.
Asso~t.A.T.E. F.Torrors.
W. W. T.Aws, N., M. D. Tii Ap. A. REAMy, MI. D.
P. S. CoNNER, M. D. C. D. PALM ER, MI. D.
W. W. SEELY, M 1). SAMU Fr. Nicku,Es, M. D.
CHAs. KEARNs, Mſ D. JNo L CLEVELAND, M. D.
Rob ERts BARtholow, M. D.
C IN C IN N AT I, F E B R U A R Y 3, 1872.
W. W. SEELY, M. D. • * * ~ *, * TREAstiter.
No. 118 West Seventh street, Cincinnati.
C L U B R A T E S,
4 Copies to one address................ * * * * * * * * * * * * * * * * *s º ſº º te is is tº sº e º is sº is tº a tº $ & e º ºs $ 7.00
6 { { “ .................. 10:00
12 & & “. ...................................................... 18.00
C O N T E N T S.
- oitre+När, ARTrcies’
Some Medico-Legal Questions in the Watson-Shryock Murder Case,
by Roberts Bartholow, M.D...................................................... 49
Page,
Ophthalmist Neonatorum, by W. W. Seely, M. P.” “…&
Atropia as an Antidote to Opium, by W. L. Buechner, M. D............54
THRANSI L A' N; © N
On the Surgery of War, being an Abstract of a Review of Pirogoff's
Report on the Franco-Germanic Service (from the Allgem.
Militärärztl. Zeitung, Dec. 24, 1871.)............. tº a n e º 'º e º a tº º e º * * tº e < * * * * * * * * * * * 54
• SCIENTIFFIC NOTES
Multiple Metastatic Abscesses—Transfusion of Blood
M.I.E.[PHCAI, NEWS
American Malicine—Honors to the Physicians of the Prince—The
Rites of Found \tion Sacrifice—Circumcision of Corpses—A
Valuable Carrier Pigeon—Small Pox in Germany—ceremonial &
Purification
c1. IN 19 A1. MEM ort ANDA
A New Remedy for Small-Pox—Chloral in Gout—Charcoal in Gas-
tric and Enteric Disorders—Chloride of Ammonium in Hepatic
ſ
(:
Abscess—Electricity in Womiting of Pregnancy
HOME NEWS
* * * *mºnº amºus sº *-i- ºr sºm, ºmsºmºmº.
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recieved the paper during the past month will, if they
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Treasurer without delay. The low price at which the
paper is published renders prepayment imperative.
Regular subscribers who are minus any back numbers
of this volume have but to signify the same at the office
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co-Ars de co-
Fashionable Hatters,
#,A}}{ES” # UHS,
92 WEST FOTTER TH ST.
Opposite Post Office,
º CIN CININ ATI.
& Special Inducements to Medical Men.
J. TAFT,
Editor Dental Register
J. & W. TAFT,
TIENTISTS
117 WEST FOURTH STREET,
CIN CIN NATI,
§§§
O.
A Monthly Journal,
Wº º
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,


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M A PITALIN EIOSIPLT ALT 1.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of Sixth and Lock streets.
pointments of a First-class Hospital.
It is handsomely furnished throughout, and is provided with all the necessary ap-
Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department.
Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITA), presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week.
service.
tº Address,
SISTEER ANTHON.Y.,
This includes, of course, the diet list, and every demand of
FIospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio.



























































































ROBT CLARKE & C0. William Autenrieth,
PUBLISHERS, No. 71 WEST s][XTH sº DEREET,
Hºlºhim ...
N0, 65. WEST FOURTH STREET, MANUFACTURER OF AND DEALER IN
*:::::::::::::::::::::::"I'll III IIHITI'll III/III,
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'Paying particular attention to this branch of SPINAL APPARATUS, ETſ
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Subscriptions received for FOREIGN and |
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AMERICAN PERIODICALS. STQC(K556S FOR WABDCOSE WEUNS,
All the New Publications received as soon
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Tetters of Inquiry will receive our prompt
º 40
andful attention. •º tº a de : Gº Agent for DR. L. A. BABCOCK'S
Catalogues furnished gratis on application.
ROBERT CLARKE & Co., Silver Uterine Supperter,
lºwhººlin,hºlm, mºnºliin
PRINTERS AND BLANK BOOK MANUFACTURERS,
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2ealers in Zaze,_Medicač, Zheožogical,
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|||||||||}|| MM|| ||M||
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167. EAST 34 TLL-ST., NEW YOIRI,
By Special Appointment Electrical Instrument Makers tº
the New York State Hospital for Nervous Diseases,
MAN UFACTURERS OF PORTABLE
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These Instruments are the most Elegant, Powerful, Effica-
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instantly set to work or stopped. Will remain in operation
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Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery I'luid.
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IPERMANIENT BATTERIEs,
For Hospitals and General Practitioners,
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For Eye, Ear, Larynx, Nose, Uterus, Vagina, Bladder, Rec-
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EMI IN ENT MEM t; ERS ºu F Tºuſ: PItty FESS to N.
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A LFR E.D. C. G. ARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Simi ar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Iłoard, Bellevue IIospital;
A LEX. B. MOTT, Prof. of Surgery; A. MUR RAY, M. D.;
CHAS. E. B.I.UMENTIIA L, M. D.; E. C. SEGUIN, MI. ix.;
A LLEN MAYN A R D, M. D., Cleveland, O.; Dr. C. WANN i E,
Waynesburg, Pa.; Dr. JOI) N KlNG, Cincinnati; Dr. JAMES
KELLY, Florence, (); Dr. JO11N BECKER, Brighton, Iowa;
lor. G. It SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
b irre, Pa.; JOHN J. CALD WELL, M. D., Brooklyn, and
In any other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Llectrical Instruinent for medical purposes.
J
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
*
Can be |
DEALER IN
English, French and Scotch
GOODs,
34 West Fourth Street,
("A.W.’6”.A.W.Wº Z"A.
FOSTER’s
N
2.
Sºº "a º
ſ º
U.Nº
º
IF_A_TIENT
Willitial
Are furnished to Officers and Soldiers on Government
a CCount.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others new
in use. For the truth of this assertion, I would respect fully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs— my choice in a limb – why I
commenced to manufacture them—suggestions to those sut-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do nºt
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb. etc., etc.
All communications should be addressed to
JAMES A. FOSTETR a
911 Chestnut Streets. Philadelphin, Pa. No. 60 West
§ U)
šč.
§ tº
§ -
§ {ſ}
§ O
§ Nº.
Fourth street. Cincinnati, Ohio, or 172 Jeſ.
ferson Avenue, ixeiroit, Miche



gºssmºs 'uºmº
O' D C R L E s s A N ID PA. L.A.T A. E L E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portland, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who bad
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
ſectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Itachilic Affections, in
Chronic Rheumalism, &c. -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent. -
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
\
- JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

DIVIDED MEDICINES,
PREPARED BY
The Divided Medicine Comy,
CINCINNATI, OHIO.
- { . +. -
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExcEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUS, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several squarES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. .
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities.
But not only SolubLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. A'
2 This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
! ; ; , ºo, and even lobo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. . -- . .
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH OF TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste. • .
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For samples, Price Lists, and Agencies, address
The Divided Medicine Coe
‘p EOx: 2ess,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
MIt. FREDERICK KRAUs: CINCINNATI, renº, 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
opecified in each, viz: -
SU LP II: M () ſº PH II....................... % grain in each square. ARSEN: ACID.......................... 1-20 grain in each square.
** (; H IN INI .......................] * * * * & tº CALOMEL 34 “ “ & 4
* COPPElt ........................% & 6
ResPEctfully Yours,
E. S. WAYNE, Analytic Chemist



FEB. 3, 1872.]
O RIG IN A L A RTI C L E S.
—sº-º-º-
SOME MEDICO-H, EGAI, QUESTEONS IN THE
waTsox-shºrt YoCK MURDER CASE.
BY
Roberts BARTHoLow, M. D.
The trial of Watson for the murder of Shryock which
has recently been concluded at Evansville, Indiana,
involves some medico-legal questions of great im-
portance. During the course of this investigation, there
have occurred amongst the medical witnesses, those
marked differences of opinion with which the public
now, unfortuna'ely, are only too familiar. These un-
scemly differences result from various causes. Medical
men summoned to testify to facts, and as experts, differ
widely in their powers of observation, in their reasoning
faculties, and in their knowledge of the special questions
submitted to their decision. Actuated by a foolish
vanity, some physicians in the witness box are led to
differ on matters of fact and opinion, because in agree-
ing they would appear to be no wiser than their col-
leagues. Nothing seems to be more grateful to such
weak minds, than this mode of asserting their superiority.
Moreover, professional prejudices frequently intervene
to bias their opinions. They are sure to differ with an
opponent or a professional rival. It follows from these
facts that courts look with suspicion on expert testimony,
and lawyers make use of it to confuse, rather than en-
lighten juries. The Watson-Shryock murder case fur-
nishes us no exception to this customary conduct of
medical experts, and the acquiual of Watson, the accused,
is largely due to the confusion in which they involved
simple matters of fact.
Shryock was wounded on the 20th of October, 1871,
by a pistol ball fired by W son. The ball entered the
right lateral plane of the body in the intercostal space
between the ninth and tenth ribs. Dr. M. J. Bray, who
it appears is a Professor of Surgery in the Evansville
Medical College, was called upon to attend Shryock.
He testified that he “discovered a bullet wound in his
right side,” that “the bullet hit the ninth rib and passed
between the ninth and tenth ribs.” Notwithstanding
the strong probability that a bullet passing between the
ninth and tenth ribs would involve the liver, we find
this surgeon practising the enormity of probing the
wound. With a disregard of the consequences of such
manipulation, amazirg even in a novice, but most
prehensible in a professed surgeon we find that
he inserted a probe five or six inches into the
Wound, and traced the ball as far as he could. ,
That he really did probe this wound of the liver ap-
Pears in concurrent testimony. Dr. B. J. Day who
TIE-L IEI, C T , T INTT C.
49
attended with Dr. Bray also “probed the wound.” Dr.
Davidson, an intelligent young physician who was pres-
ent, testifies that Dr. Bray “probed the wound down-
ward and inwardly.” Any intelligent physican can
after such statements estimate at their true value, the
opinions of such an expert as Prof. Bray. It is true“he
thought none of the viscera were injured,” although
“he noticed jaundice about a week after the wound was
inflicted.” Dr. Bray and Dr. Day also testified that
Shryock had peritonitis in a few days after the in-
jury, and Dr. Day with an insight which appears
akin to “second sight” discovered two abscesses which
appeared and disappeared in a miraculous manner
under the touch of this medical magician. Notwith-
standing this, Shryock became weaker, and although Dr.
Day considered him in danger, he was placed on a steam-
boat to be transported to Cincinnati. When he arrived
on the boat Shryock appeared to a witness to be “so
weak that he might die at any moment.” It appears
further that he died en route, at the Louisville wharf
on Sunday, the 15th of December. He was interred at
the Wesleyan Cemetery near Cincinnati. The body
was exhumed on the 8th of January by authority of the
Coroner, and an autopsy was made by Dr. M. T. Carey.
Captain Hargrave, Prosecuting Attorney of Vander-
burgh County, Dr. H. M. Harvey of Evansville, Dr. R.
H. Johnson of Cincinnati, and the writer were present
at the autopsy. Notwithstanding the body of Shryock
had lain in the ground twenty days, it was quite well
preserved, and in a satisfactory condition for examina-
tion. The eyes were much sunken, and there was a
greenish-gray discoloration of the abdominal walls, but
otherwise no obvious change had occurred. “A small
oval cicatrix” in the words of Dr Carey “was found on
the right side of the chest at the lower margin of the
ninth rib, and six and a half inches to the right of the
median line of the body.” Dr. Bray, who appeared to
be extremely anxieus that none of the abdominal or-
gans should prove to be injured by the ball, in his ex-
planations to the jury, fixed the position of the wound
of entrance, much further forward toward the median
line of the body, than the situation of the cicatrix
warranted. The abdominal organs although much dis-
colored were in a satisfactory state of preservation, and
it was quite easy to discover any lesions which the en-
trance of the ball may have produced. The evidences
of general peritonitis were conclusive. The intestines
were glued together by inflammatory exudation and
numerous fibrinous bands stretched across from the
parietal to the visceral peritoneum. In separating some
of these bands attached to the descending colon, the
bowel gave way and perfectly normal feces escaped.
Dr. Carey, in his report makes the extraordinary state-
ment that this fecal matter was found external to
the descending colon, and referring to two points of per-
foration in the bowel leaves it to be inferred that this
escape of feces was ante mortem. That he intends this
inference to be made, is evident because he immediately
#50
[FEB. 3, 1872.
T H. H. C.I.I.INI c.
alludes to a collection of “about sixteen ounces of
yellow fluid having the color of feces in the right
hypochondrium.” A perforation in the intestine, due
to an ulcerative process, escape of fecal matter, and
subsequent peritomitis, would form a theory to account
for the death, and in fact this theory was made use of
by an expert called for the defense. As there was no
evidence of intestinal lesion, as the feces were not visible
until Dr. Carey used his knife to separate the adhesions,
and as the feces which then escaped were normal, the
conclusion is irresistable that it was the post-mortem dis-
section and not disease that had caused perforation of
the intestine.
The most remarkable lesion developed at the autopsy
was the sero-purulent collection in the right hypochon-
drium, alluded to above. This fluid was limited to this
situation by adhesions between the parietal and hepatic
peritoneum, and it was bounded above by the lower
concave surface of the diaphragm, and below, by the
upper convex surface of the liver. An excavation
about one-fourth of an inch in depth at the deepest
part, existed in the right lobe of the liver and formed
the lower boundary of the sero-purulent collection. A
cicatrix was discovered on this part of the liver. Dr.
Cary who seems most desirous not to state facts which
may bear an interpretation unfavorable to the accused,
mildly expresses himself as follows:
“Upon the anterior and inferior margin of the right
lobe of the liver there was an induration and a puckered
condition of the part, which looked somewhat like a
cicatrix.” He has nothing to say in regard to the re-
lation which the external wound bore to the cicatrix on
the surface of the liver, notwithstanding he was coduct-
ing a medico-legal investigation. Dr. H. M. Harvey of
Evansville, a very intelligent and accurate physician
who was present at the autopsy, testified that “the
cicatrix on the liver corresponded with the external
scar,” and this he ascertained most positively by passing
a probe through the external wound. I saw this ex-
periment made and also testified positively to the fact.
A Dr. Johnson, of Cincinnati who admitted that he
had been physician to Watson's family and was em-
ployed by Watson's brother to attend the autopsy,
testified that the external wound was not in relation to
the cicatrix on the liver—but Dr. Johnson made many
very remarkable assertions in the course of his examina-
tion. If nothing more than a cicatrix indicating injury
to the liver had been discovered, doubts might have
arisen as to cause of it, but immediately in connection
with the external cicatrix there was found a perfora-
tion extending entirely through the right lobe of the
liver. This canal was of a grayish-brown color, perfectly
distinct from the rest of the liver substance as regards
appearance, and contained within it some partly fluid
and partly solid matter. Dr. Harvey testified that this
canal was about the size of an ordinary lead pencil,
which corresponds with my own observation. The
eapert Dr. Johnson and Dr. Cary did not see this. Dr.
Johnson testified in Court that this perforation had no
existence, and Dr. Cary does not allude to it in his
report to the coroner although it was laid open and
commented on during the autopsy. Some concretions
of very recent formation were found in the gall bladder.
That these concretions were recent is evident from the
following facts: they were very irregular in outline
and very soft and friable. When several old biliary
concretions are contained in the gall bladder, they are
firmer, have smooth facets and are known, hence, as
“articulating.” The gall bladder itself undergoes
changes due to the long continued irritation of these
concretions; the mucous membrane becomes thickened,
and the organ contracts inflammatory adhesions to the
surrounding parts. These changes are slow in progress
and are not manifested by obvious objective symptoms;
hence, biliary colic is the only conclusive evidence
usually obtainable of the existence of these bodies.
(Thudicum, p. 188. Trousseau, Vol. III. p. 218.) . As
there were no lesions of the gall bladder whatever, as
the concretions were soft and friable, and as there had
been no symptoms of hepatic colic, it is clear the “gali
stones found had been formed very recently.” Indeed
there can be no doubt, that their formation was the
direct product of the changes in the constitution of the
bile wrought by the injury of the liver. The confident
Dr. Johnson, affirmed that “the presence of these gall
stones would seriously affect the health because no bile
could be received into the gall bladder”—a remark
which indicates that he is not aware that the gall
bladder is not essential, that it is only a receptacle for
the surplus bile, and that as the hepatic duct com-
municates with the common duct, the bile will continue
to flow into the intestine even when the gall bladder
is permanently occluded. But Dr. Johnson acted as
an expert whose business it was to defend the accused.
The ball which passed through the liver was found
“upon the anterior surface of the left kidney,” directly
on a line with the external wound and the perforation
through the liver. In order to avoid this import-
ant organ, the liver, Dr. Bray in his testimony
made the ball drop down into the cavity from the
rectus muscle, and Dr. Johnson caused it to be deflected
by the ninth rib and could not be induced to believe
that it had entered the abdomen at all, until it was
found on the left kidney, when he was put in the de-
plorable position of having no theory to explain its
presence. Several of the principal physicians of E ans-
ville, Dr. S. W. Thompson, Dr. J. M. Myler, and, Dr.
De Bruler examined as experts, testified that A ball
entering the right lateral plane of the body b tween
the ninth and tenth ribs, and reaching the 'eft idney,
would necessarily pass through the right bbe of the
liver. - - -
I should not fail to notice the attempt made to ex-
plain the cicatrix on the right lobe of the liver by an
assumption that it was syphilitic in origin. Evidence
was introduced at the trial to show that Shryock had
FEB. 3, 1872.]
T TED TEB C T , T TNT I C .
5}
been syphilized, but there were no external or internal
manifestations of syphiloma found at the autopsy. The
cicatrix on the liver presented none of the characters
significant of this condition and the rest of the organ
not affected by the ball in its passage, was free from
suspicion of syphiloma (Virchow, Syphilis der Leber).
As the defense also maintained a theory that Shryock
had died of phthisis and not of the gunshot wound, it is
very important to examine with some attention the
condition of the lungs. Dr. Thompson testified that
Shryock was discharged from the army in 1863 on ac-
count of consumption, but admitted that there was not
found sufficient disease of the lungs to cause death.
Even the confident Dr. Johnson admitted that, although
“the lungs were very much consolidated by calcareous
matter, consumption had nothing to do with the death.”
Dr. Carey reports that “the upper lobes of the lungs
were comparatively healthy except they contained
some cretaceous tubercles.” He states, however, that
“the lower lobes of both lungs were found in a state of
carnification and contained small tubercular cavities”——
expressions which indicate clearly enough that Dr. Carey
is not informed in regard to the recent pathological
views on these points. The “state of carnification,”
there can be no doubt, was simply pneumonia, and the
cavity which was found at the base of the right lung,
was formed in anticipation of a discharge through the
lungs of the purulent collection on the other side of the
diaphragm. It is now perfectly well known that ab-
scesses of the liver frequently discharge through the
lung, that adhesions form between the pulmonary and
diaphragmal pleura, and that an inflammatory process
is set up in the lung to make a passage way to the bron-
chi. (On this point the reader may consult any work
on the liver—Frerichs, Murchison or any modern work
on Practice. Also Rokitansky, vol. 2, p. 108).
Having thus set forth the reasons for believing that
the ball which entered Shryock's body between the
ninth and tenth ribs, wounded the liver and peritoneum,
it remains to inquire whether the lesions found were
attributable to this cause, and whether death was the
result of the injury.
On these points we find some extraordinary testimony
by witnesses to fact and by the experts. Dr. Bray
did not think the ball injured Shryock, that it
could not have gone through the thickest part of the
liver, and that death would have ensued in a few hours
if this organ had been wounded. Dr. Day did not think
the sero-purulent collection in the right hypochondrium
bore any relation to the wound; the ball may have
“aggravated” but did not cause it, and yet he admits
that the abscesses right and left in regard to which he
testified, followed the injury. Dr. Johnson testified
that a wound of the thickest part of the liver would
prove fatal by hemorrhage in from twelve to twenty-
four hours.
9" the other hand, Dr. De Bruler, who is an accom-
Plished physician, testified that a wound of the liver is
not necessarily fatal, but that “a ball passing through
the liver and lodging in the left kidney would produce
a serious injury.” Dr. H. M. Harvey, whose testimony
was a model of clearness and scientific accuracy, said
that the ball passed through the thickest part of the
liver, that the position of this organ varies somewhat
with inspiration and expiration, that a gunshot wound
of the liver may prove immediately fatal by hemorrhage
and shock, that, if the patient recover from the imme-
diate effect of the injury, he may succumb to the results
of the inflammatory process.
As it is impossible to reconcile the conflicting views
of the experts, authorities must be appealed to in order to
ascertain whose opinions are in accordance with existing
knowledge.
Are wounds of the thickest part of the liver neces-
sarily immediately fatal 2
M. Verneuil has recently reported a case in which a
revolver ball passed through the greatest diameter of the
liver, without causing death, but peritonitis did not follow
the injury. In Circular No. 3 for 1871, I find three
cases—Dr. Whitehead's, Dr. McKee's and Dr. Hassig's—
which the right lobe of the liver at its greatest diameter
was wounded, and yet recovery ensued. In these instances,
free diseharge took place from the external wound and gem-
eral peritonitis did not follow. Severe shock followed
immediately on the reception of the wound, and in Dr.
McKee's case, a condition of collapse, but the patients
emerged from this, and not being subjected to the de-
structive changes consequent on general peritonitis and
hepatitis, recovered.
Hamilton (p. 363) thus speaks of wounds of the
liver :
“When a ball has penetrated this organ, death gener-
ally ensues in a very few hours from internal hemorrhage;
and in the large majority of cases, when owing to the
more superficial course of the missile, a fatal hemorrhage
does not occur, death follows in a few days from the
supervention of inflammation both in the substance of
the liver and in the peritoneum. Occasionally, how-
ever, the patient survives a long time, or makes a com-
plete recovery.”
McLeod (p. 256), whose book is based on the expe-
rience of the Crimean war, makes the following obser-
vations: “Balls entering the liver, kidneys, or spleen,
are well known to be usually mortal, although excep-
tional cases are not rare. The collapse is generally very
severe.” If some hemorrhage, or the effusion of any of
the secretions, as bile * * * follow the injury, then
the collapse will not only be severe but continue. The
inflammation which is so certain to occur in the peritoneum
requires very careful watching, as it often sets in very slowly
and deceptively.”
Larrey (Tome II, p. 420,) speaking of wounds of the
liver, remarks that if extravasation of biliary matters
takes place in the peritoneal cavity, the wound is
necessarily fatal. He gives two instances of recovery
from gunshot injury of the liver, but in these cases, the
52
[FEB. 3, 1872.
TIE-T ED CT, T N T C.
extravasated blood and biliary matters found vent
through the external wound. Ballingall (p. 347) after
alluding to the great mortality of gunshot wounds of
the liver, thus describes a condition of things exactly
like that found in the body of Shryock: “When the
patient survives so long as to admit of an adhesion
taking place between the surface of the liver and the
abdomen contiguous to the wound, the matter which
subsequently forms is precluded from access to the ab-
dominal cavity, and the case is then assimilated to one
of abscess of the liver.” Guthrie (p. 582,) sums up in a
few sentences the results of wounds of the liver.
“Wounds and injuries of the liver whether incised or
penetrating, occurring from blows or from musket balls,
are very serious, although not necessarily fatal. Some
few persons recover altogether; some few with more or
less of permanent disability. The remainder die during
the first or inflammatory stage; or in the secondary one
which follows from the twelfth or fourteenth day after
the primary symptoms have in some measure sub-
sided.”
Hennen (p. 329,) says, “The wounds of the fixed
viscera of the abdom.en though highly dangerous are
not necessarily mortal: * * All deep wounds of the
spleen, liver, or kidney, are almost immediately fatal
from hemorrhage; some instances however occur, where
even severe injuries are survived.” Hennen gives
(p. 340) a remarkable instance of recovery in which
the ball fractured the eighth and ninth ribs and passed
through the greatest diameter of the right lobe of the
liver.
From these military authorities, the highest to
which we can refer on questions connected with gun-
shot wounds the following conclusions may be deduced:
Gunshot wounds of the liver are not necessarily
fatal.
If the patient survive the shock of the injury, he
may live a variable period of time. -
Wounds of the liver that do not prove immediately
fatal may cause death by secondary inflammation.
Abscesses connected with the liver by limiting in-
flammation, and general peritonitis are common results
of wounds of the liver,
It follows as a corollary from these conclusions that
although Shryock's wound of the liver did not immedi-
ately prove fatal, his death eventually was due to the
inflammation which ensued, and was brought about
in the mode indicated by the authorities on this sub-
ject.
Authorities referred to in the text:
TIIUDICUM.—A Treatise on Gall stones:
Chemistry, Pathology and Treatment.
London, 1863.
TROUSSEAU.—Clinique Médicale de L’Hotel Dieu de
Paris Tome 3me Paris, 1865.
VIRCHOW.--Die krankhaften Geschwälste. Zweiter
Band, Berlin, 1865.
American Journal of the Medical Sciences, January,
1872, p. 263.
Their
Churchill,
Circular No. 3, Surgeon General's Office, 1871.
HAMILTON.—Military Surgery, New York, 1865.
M. LEOD.—Surgery of the Crimean War. Churchill,
London, 1858.
LARREY.-Clinique Chirurgicale Tome. deaux. Paris,
1829. -
BALLINGALL-Outlines of Military Surgery. Fifth
Edition, Edinburgh, 1855. -
GUTHRIE.—Commentaries on the Surgery of the
War. Sixth Edition, London, 1855.
HENNEN.—Principles of Military Surgery, First Am.
Ed., Phil., I830.
—sº- e -º---
o P HT HI A L NIH A N E O N A T G R U ºf .
BY
PROF. SEELY.
A Clinical Lecture at the Dispensary of the Medical College of Ohio.
GENTLEMEN :
The first case I beg to call your attention to is this
little child, three weeks old. I open the eyelids and
you see from one eye the matter streaming out ; in the
other you might see it resting in the lower cul-de-sac.
We have before us a case of the so-called ophthalmia
neonatorum.
What is the disease?
From the physical characters certainly all would say
a purulent iuflammation of the conjunctiva.
I have already tried to impress on yºur minds some
points in differential diagnosis in ophthalmic troubles.
in these little people, while the tendency of mucous
inflammations is towards the purulent form, yet it is
by no means absolutely necessary for them all to assume
it, for we sometimes find but a catarrhal form with
only a muco-purulent discharge, and this may be slight.
A simple statement of such a fact may be sufficient to
afford some comfort when you are brought into contact
with irritated eyes in your obstetric practice. Let us
see what the symptoms are which should attract your
attention. If in from twelve hours to a week or two
after birth, you find the eyelashes matted together or
the eyes tearing a good deal, and on depressing the
lower lids the conjunctiva looks red and swollen You
have sufficient cause for suspecting the commencement
of an inflammation.
If these symptoms appear in the first three days you
*-
would be warranted in regarding them as the beginning
of what is most strictly termed ophthalmia neonatorum,
purulent conjunctivitis in new born children.
Aetiology.
Almost any irritation of so delicate a membrane
may produce a purulent inflammation, and yet there
are certain irritants to which the eyes of the new born
|are especically liable.
FEB. 3, 1872.]
TIH. H. C.L.INI c.
53
The child in its passage through the vagina comes in
contact with whatever secretions may be there, and
particles from these may be the exciting cause.
These vaginal discharges are probably the most fre-
quent cause of this disease, and the cases brought before
you have only too frequently such an origin.
I have given the mother of the child a prescription
for blenorrhagia, which she says she was suffering from
when the child was born. So in this case we probably
need look no further for a cause, as you all know the
virulence of the gonorrheal matter. Inoculation, then,
is the most fruitful source of ophthalmia neonatorum.
But do not be too ready to infer such an origin, as
carelessness in cleansing the child, and caring for it by
exposing the eyes to too bright a light, allowing the
cold air to strike, etc., may produce the character
of inflammation.
For your therapeutics it matters little what the cause
may be.
If you have formed suspicions or not, you give the
necessary precautions about the hands being clean
when the child’s eyes are attended to, and that all the
cleansing apparatus be absolutely clean and used only
for the child. In this way you protect those about and
also prevent reinoculation if the mother has gonorrhea.
Gonorrheal ophthalmia is only produced by some of the
particles of matter coming in contact with the conjunctiva,
and it is on this account that we caution, so strongly,
patients with gonorrhea against getting in any way the
matter into the eyes.
Prognosis.
The prognosis will depend on the stage in which you
see the case. Seen in the premonitory stage it is always
good, for the congestion can almost always be removed
by very simple treatment; if not seen till the eyelids
are more or less thickened, and discharging pus it is
still good; but if the cornea shows any signs of being
involved the prognosis must be guarded.
Treatment.
In the first stage a weak astringent, such as half a
grain of zinc or nitrate of silver to the oz. of water, or
even a weak solution of the sulphate of morphia
(gr. 3 aq 3i.) will suffice to relieve all the difficulty as
a rule, if uscd every two or three hours.
If the second stage has come on and there is more or
less swelling of the lids and a purulent discharge, the
indispensable condition is just what I insisted upon so
strongly while talking to you at my Thursday’s clinic,
on discharges from the ear, cleanliness.
Every few minutes the matter must be wiped away
with a soft rag, and once every fifteen or twenty min-
utes the eyelids should be gently opened and some warm
Water allowed to run from the end of the rag over the
ball to wash the accumulated matter from the con-
junctiva.
This can all be done without waking the child.
Local applications.
After you have thoroughly cleansed the eyes, in the
milder forms when the corneas are clear, and the lids
but little thickened I recommend you to use, especially
if you are not skillful in everting eyelids or can only
see your patient once or twice a week, a weak solution
of nitrate of silver gr. 3 or i. to 3i, a drop or two to be
placed between the lids every half hour during the day
if the solution is gr. 3, every hour or every two hours if
it is gr. i.
This plan succeeds well in a large number of cases
and can be carried out by the mother or nurse.
If there is a good deal of thickening of the conjunctiva,
the papillae promfinent, your surest plan is to see the
patient every day, place its head between your knees,
as I do here, by way of illustration, evert the lids, the
upper and lower at the same time or separately as you
are able, then brush them with a strong solution of the
nitrate, a ten or fifteen grain solution of the pure, or a
twenty or thirty of the mitigated, washing the solution
off immediately with salt and water, and finally with
pure water. Such an application as this once a day is
sufficient; using in the mean time, a collyrium of atro-
pine or morphine (gr. 3 aq. 3i), two or three drops of
which are to be gotten thoroughly into the eye three
times a day. I have never seen any cases where the
diphtheritic element was insufficient to modify the
plans of treatment marked out, necessitating the care
insisted upon in purulent ophthalmic of adults,
Pure diphtheritic inflammation is never met with in
new born infants, but some of its characters are : For
example, we sometimes find the lids pretty hard and
hot, with a palish conjunctiva secreting a thin dis-
charge of a filmy character that quickly covers the
surface of the membrane. Weaker in such cases recom-
mends internally a small quantity of calomel three
times a day and the rubbing on the brow of a little
mercurial ointment, discontinuing this treatment imme-
diately the purulent discharge thoroughly begins (See
vol. 1, part 1, 2d Ed. Maladies des Yeux). The all im-
portant question in this is how to act when there is an
affection of the cornea. Your attention must be con-
tinually directed to the state of the membrane, for in
complications on its part lie the dangers. Here we
want to get rid of the cause of the corneal affection, viz.,
the swelled lids and chemosed bulbous conjunctiva, as
rapidly as possible, hence, we continue the applications
and soothing wash : making use of extreme care if the
lids are everted.
If there is an ulcer a paracentesis of the anterior
chamber should be made to relieve the intra-ocular
tension.
If a perforation has occurred, and a prolapse of the
iris exists, it should be snipped off.
The perforation may be large and the eye become
staphylomatous, and require amputation.
The narration of a case that recently presented itself
at my private rooms, will be sufficient to put you on
your guard in the after treatment of eyes left with a
corneal cicatrix. -
54
[FEB. 3, 1872.
TIEI IED CT, I. TNT I C -
A girl of 13, had, while a child, some attacks of cir-
cumscribed keratitis, from which resulted rather a prom-
inent corneal cicatrix. No special attention was paid
to the eye, until the parents noticed an increase in its
size.
The cornea and pericorneal tissue had yielded, the
anterior chamber had increased in size and when I saw
the case, the papilla was cupped and the eye was blind
from glaucoma. I have put you on your guard what
are the objective symptoms to be loëked for, as in little
children, no subjective ones are to be expected.
Every eye that presents a corneal cicatrix, and espec-
ially an adherent one, the so-called leucoma adherems,
should be looked after.
Now if in such an eye, you at any time detect an in-
crease in the intra-ocular tension, an iridectomy should
be insisted upon at once. We had long been aware of
tle danger in such cases, but it remained for Graefe,
the great teacher whom all mourn, to put in a clear
light the exact relation between cause and effect, and
to show the steps that lead from one to the other.
—º-e-º--
A tropia as an Antidote to GPium.
BY
W. L. BUECHNER, M. D.
Yorngstown, Ohio,
Mrs. H. H., aged 33 years, had been suffering for a
week with severe facial neuralgia.
January 24, she took a large dose of morphia; about
four hours afterwards her condition alarmed her friends
and I was sent for. On my arrival I found her lips and
face purple, no pulse at the wrist, pulsation of heart
hardly perceptible, respirations six per minute, pupils
contracted to a small point, surface very cold. I pro-
nounced the case hopeless, but recalling a case reported
where the patient was saved by the hypodermic use of
atropia, I concluded to give it a trial. I injected 1–48
(one-forty-eighth) grain of Atrop. Sulph. In five min-
utes the breathing became better, the heart's activity
more vigorous, the pupils dilated slightly ; in half an
hour I repeated the dose (1–48th grain) and the case
improved rapidly; in about forty minutes from inject-
ing the first dose consciousness partially returned, and
in about an hour, the effects of the morphia had entirely
disappeared.
HospitaL CAPACITY IN VIENNA.—The number of
free beds in all the hospitals of Vienna is 219. There
is one bed, thus, for every 144 inhabitants. Paris has
one for every 151, London one for every 600 inhabitants.
The mortality rate of the two extreme cities, however,
differs materially. In London 22.4 in a thousand die
every year; in Vienna 81.4.
*
T H E s U R G E R Y or w Art.
BY
PROF. PIRogoFF.
Being an Abstract of an Eatensive Review of the Author's
Report on the Military Service ºf the late Franco-Ger-
manic War.
From the Allgemeine Miltārārztlichle Zeitung, Vienna, Dec. 24, 1871.
The fourth, the most extensive and important section
of this interesting volume, takes into consideration all
the essential questions concerning the surgery of war.
The author begins with the general treatment of gun-
shot wounds. Up to fifteen years ago all surgeons were
united in the belief that antiphlogosis, in the form of
ice, venesection, low diet, was a necessity in the treat-
ment of these wounds. This opinion prevails now no
longer. Even Esmarch, the enthusiast on the sulject
of ice, seems to have modified his views for in the Ber-
lin lazareths under his direction nothing is to be seen
of this treatment.
The injuries of the various parts of the body observed
are next taken up.
Concerning penetrating wounds of the head he states
that be only saw ten in all the Seventy lazareths and
in these there had been adopted neither an energetic
antiphlogosis nor any operative proceedure. The results
in the treatment of these wounds are now as form-
erly discouraging: they died also without the operation
of trephining.
Most brilliant was the result in the cases of penetrating
Chest wounds treated on the expectant plan. In each
of the 70 lazareths were observed 5 or 10 cases of re-
covery from these formerly considered fatal wounds. The
cause of these favorable results, however, is not to be
ascribed to treatment alone. The small size and the .
form of the chassepot projectile, whereby passage
through the intercostal spaces without injury to the
ribs might he effected, should also be considered: in
those cases where the ribs were splintered the result
was, in this war, unfavorable. The admirable construc-
tion of the German hospitals was an important element
in securing good results in all cases. In eight cases
paracentesis was followed by happy results; in two
cases recovery ensued after hernia of the Hung.
Of those wounded in the abdomen but five were found
alive. One of these was struck in the right hip joint
by a ball which remained concealed. There was dis-
charged from the wound at first, hairs, later bile, and
then cough ensued with expectoration of bile. In two
others wounded in the abdomen, the ball passed through
the convex surface of the liver. Finally there were two
with wounds of the large intestine. All these were
already out of danger.
FEB. 3, 1872.]
T TH. H. CT, INTI c.
55
The difference between the orifices of entrance and
exit could not be distinguished in this as in other Wars:
both openings presented the same appearance ; often,
thus, the opportunity was presented of observing the
healing of gunshot wounds without suppuration. The
“Debridement préventure” [enlargement of wounds] of
the French was nowhere adopted, on the other hand
surgeons had fallen into the opposite extreme, there was
fear of the often so efficacious dilatation of the wound.
Salves and cerates were seldom encountered, in their
place very frequently dilute solutions of carbolic acid;
the mixture of the acid with oil is not so suitable. The
author acknowledges himself an advocate of the
panspermist theory and accepts a double infection, either
by ferments developed from the constituents of pus and
decomposed blood or by ferments which have penetrated
from the external air. As to the closure of gunshot
wounds he can say little good of this method and believes
that the use of the lead plates of Burggräve and the
plaster and caoutchouc envelopments of Leudörfer may
be of injury. On the other hand he considers the
method of Guerin the treatment by aspiration, as worthy
of further trial. Borow's plan of exposing the wound
to the air without any bandage whatever is reprehensi-
ble because it does not sufficiently support the soft
parts in the vicinity of the wound, does not exercise
upon them antiphlogistic pressure and does not guard the
wound itself against injury. The author is a great
friend, however, of free drainage and irrigation. The
use of charpie, of gauze bandages and of oakum “marine
lint” which he found in the different hospitals is desig-
nated a progress in the treatment of gunshot wounds.
The teachings of Bouchet and Larrey as to the value
of early amputation were accepted doctrines in military
surgery thirty-five years ago; the authority of Dupuytren
contributed no little to the sustentation of this view:
It availed as a dogma in gunshot fractures to amputate
as quickly as possible: should time be allowed to inter-
vene more lives would be lost than limbs saved. The
author himself long sanctioned this doctrine, taught it
and widely extended it, and there are still many sur-
geons who maintain it firmly. But the great majority
of surgeons have retreated from this opinion and the
reasons of their retraction are:
1—The Introduction of Statistics in Surgery;
2—The Invention and Extension of Immovable Ban-
dages; - *
3—The Adoption of the Conservative Operations.
Malgaigne it was who first showed in 1841 that the
results of primary and secondary amputations of the
upper extremity were exactly the same; they both had
a mortality of 65-75 per cent. Malgaigne has further
proven that the results of amputations for organic bone
and joint diseases are more favorable than those from
trauma. . In the fortieth decade the immovable plaster
bandage attracted the attention of surgeons and about
the same time resections of joints began. Even in 1836
* 87 Pirogoff had not seen a single joint resection
either in Berlin or in Paris. , . .
This revolution of opinion is seen in most marked
degree in the treatment of gunshot fractures of the
femur. In these injuries even conservative surgeons
were convinced of the necessity of amputation. The
mortality, 90-95 per cent. of these amputations, however,
operated to the benefit of conservative principles. In
this war were found thirty cases of perfectly united frac-
tures in the middle and upper third of the thigh while
but very few cases of recovery after thigh amputations
were observed. -
But what neither he (Pirogoff) nor any other surgeon (?)
could have anticipated was the so extraordinarily happy
termination of a great number of cases of gunshot wound of
the knce joint.” He counted forty such fortunate cases;
$n Some cases, indeed, even motion was maintained in the
penetrated joint and in two instances of recovery the ball
was still in the bone. He ascribes these favorable results
to the smallness of the chassepot projectile and the direc-
tion of the wound, from before backwards.
In the treatment of gunshot fractures of the thigh, the
immovable bandage, the inclined plane or a particular
bed and permanent extension played a great role. As
to the immovable bandage, he says, it is often present
only in appearance not at all, then, fulfilling its design.
Only then does it meet its end when the limb is uniformly
enveloped and when both joints at the extremities of
the fractured bone are likewise enclosed. The method
of its present application is as follows: A drainage
tube is first introduced into the wound, this is covered
with charpie when the whole limb from above down-
wards is bandaged and covered with plaster. He next
takes a large piece of gauze wire, such as the sieve
makers use, cuts windows in it beats out its borders
smooth, bends over the sharp ends and then envelops
the limb with it over the plaster bandage. This is now
in turn covered with plaster and this again finally with
a bandage saturated in the same material. When the
plaster sets, the substance covering the windows is cut
out with a scalpel.
Sometimes he uses the inner bark of the linden tree
instead of the wire envelop whenever it is desirable to
have large windows that a loosened bandage inside may
be tightened or supported.
His method of preparing the bandage for removal and
reapplication is as follows: A flannel bandage is ac-
curately applied to the injured limb. This bandage is
uniformly smeared with a paste made of one pound of
boiled starch and one and a half to two beer glassesſul
of powdered gypsum. Several pasteboard splints plas-
tered with this mixture on both sides are then adjusted
* Neudorfer in his writings cites repeatedly cases of recovery after
gunshot wounds of the knee joint, some of them with partial use of the
injured joint. It is stated also in the appendix (p. 224) we may now
cherish the hope as well founded, if it should become an axiom in military
surgery, in cases of injury to the knee joint, to apply an immediate
plaster bandage instead of resorting as hitherto to immediate amputa.
tion. that the number of cases of recovery would be much greater;
might be cited, indeed, as of daily occurrence instead of being regarded
as rarities and fortunate exceptions to a rule. - -
66
[FEB. 3, 1872.
TIE-ITED CT, IT INT I. C. '
upon the bandage and fastened with a linen binder
which is again covered with the starch and gypsum
paste. This application dries in six to eight hours.
The whole bandage is then split through in its length
and painted with cabinet-makers varnish. In its reap-
plication a band is pasted along the divided edges and
the whole is fastened to the limb with five or six ban-
dages. e
As to the inclined plane in the freatment of gunshot
wound of the thigh, Pirogoff can not speak in its praise.
The Simon's bed consists of several separate and separa-
ble pieces of mattress for the pelvis and the two lower
extremities with a means of extension at the lower end:
yet here, too, is a gypsum bandage necessary. The
patient seen on the bed by Pirogoff at Simon's had in
consequence of absence of the bandage not only a short-
ening, but also an angular deformity. The price of the
bed is only 25 fl. [$10.]
Nothing encouraging was visible in resections of the
knee and hip. There were some 50 cases of recovery of
gunshot wounds of the shoulder, elbow and ankle, with-
out resection, a fact which is significant against the
adoption of early resections.
Of resections of the ankle-joint he saw some twenty,
among them, one where both astragalus and calcis were
removed. The constant warm bath which he designates
as maceration of the injured joint was nowhere in use.
Seventeen cases of ligation of large arteries were re-
lated to him : results were very sorrowful. He thinks
the reason of this bad result was the delay in operation,
the patients being already reduced by loss of blood.
The selection of the place for ligation was often enough
unfavorable; in hemorrhage from the femoral artery,
for instance, the ligature instead of being placed in the
external iliac was applied to the middle and upper third
of the thigh; in hemorrhage in the flexion of the elbow,
the brachial instead of the axillary was chosen. Prof.
Simon gives preference to digital compression within the
wound over the dangerous ligature in the treatment of
hemorrhages, and has had some success to show for its
adoption. Pirgoff, does not believe, however, that this
method will find general adoption, because these hemor-
rhages only occur in gangrene or that bad form of Sup-
puration which extends from the wound to the arteries
in reduced, cachectic individuals, diseased condition o
the vessel walls or in ligation near a departing branch.
It is certain that a ligature at a place removed from the
wound is better borne than when the pressure on the
diseased vessel occurs in the wound itself. In a case
where he would fear ligation, Pirogoff would give prefer-
ence to galvano-puncture of the arterial trunk. Three
times he saw the formation of varicose aneurisms after
perfect healing of gunshot wounds. All three
cases were situated in the inguinal region.
Next is disºussed the amputation of limbs. He says,
“This subject forms a chapter as melancholy in the mo'ern
history of military 8wrgery as in the ancient—Death and
again death—that has been the result earlier as well as later
in the majority of cases of amputations in the past war.”
What else became of the amputated, as so few were seen
in the 70 lazareths visited?
With this opportunity, he takes occasion to differ with
Langenbeck who stated at the 74th anniversary of the
Friedrich Wilhelm Institute, that field service could
only be of use to the severely wounded when it began
immediately after the battle and ceased not later than
two days after it; all unavoidable amputations, there-
fore, must be performed in the first 12–24 hours after
the battle. The later and intermediary amputations
give the most unfavorable mortality per cent.
Against this view, Pirogoff maintains that conserva-
tive treatment and late amputation are so indissolubly
united that if the possibility of the first be granted, the
probability of benefit from the last must be acknowl-
edged. The former doctrine of Bouchet and Larrey
was consistent; it demanded that amputations should
be as quickly performed as possible, because it claimed
that the preservation of limbs, was in general, more dan-
gerous than their amputation, and taught that whoever
did not amputate immediately after an injury ran the
risk, in the attempt of saving more limbs, of losing more
lives. So soon, however, as conservative surgery is con-
sidered admissible into military service, so soon, to be
consistent, must protest be entered against early ampu-
tations. To defend conservative surgery and at the
same time to advocate early amputations is to be incon-
sistent at once. In considering the favorable course of
early in comparison with the unfavorable course of later
amputations, it must not be forgotten that it was only
the upper extremity that furnished this favorable result.
And here conservative treatment has been attended by
the best results. At the lower extremity early, as well
as late amputations show the same unfavorable results.
Whoever here gives preference to late over early resec-
tion must give the same preference to late over early
amputations. In a word, the introduction of conserva-
tive treatment in modern military surgery is of itself a
protest against early amputation, which of course ad-
mits of no preservation of the limbs.
To the honor of modern surgery, he confesses, that on
the whole but few amputations of the upper extremity
were made.
Of cases of exarticulation of the humerus he found
only three or four alive, while after Sebastopol he saw
some thirty cases recover. But one case of exarticula-
tion of the elbow-joint he met—that was in Strasbourg,
and was near recovery.
Of amputations of the thigh he remarks that he found
about twenty convalescents in Strasbourg—amputations
at the lower and middle third—of amputations of the
upper third he met with but one living instance. Usu-
ally the circular incision was made, while he prefers
the flap, and in support of his preference he notices the
fact that the naked bone protruded in some ten of the
cases here encountered. Amputation by Gritti's method
was not performed. One case of recovery was observed
after amputatio transcondyloidea.
FEB, 3, 1872.]
Tº H. H. CT, ITNTIC .
57
Of cases of exarticulation at the hip and knee, he
found none living. Of amputations of the leg, also, but
few were met, and of these, half showed the anterior
angle of the tibia protruded from the ulcerated skin,
simply because the flaps were tunited in the transverse
instead of in the vertical direction. -
Of his osteoplastic resections performed on six patients,
five were in satisfactory condition.
Concerning pyacmia he remarks that this occurred
mostly after severe hemorrhages, especially when sec-
ondary hemorrhages ensued upon amputations render-
ing the repeated ligation of arteries necessary. Gangrene
exhibited preferably the diphtheritic type, nowhere was
the fungous or hemorrhagic form encountered. Hospital
erysipelas showed itself contagious in a few lazareths
where it was successfully treated with camphor. Acute
purulent infiltrations were relatively seldom encountered
in German hospitals. Tetanus occurred pericdically,
and was treated in some cases with large doses of chlo-
ral hydrate.
Cyanotic cholera and scurvy did not anywhere pre-
sent. As to the influence of syphilis on the treatment
of wounds he could furnish nothing reliable.
The fifth section of this interesting volume closes the
book with suggestions for improvement of the Russian
service, a subject only of interest, of course, to Russian
readers. -
—sº- e-º-
scIENTIFIC NOTES.
On NMultiple Metastatic Abscesses.
}Y
Von RECKLINGHAUSEN, (Würzburg.)
Transactions Würzburg Physik-Med. Gesellschaft,
As to the nature and origin of the multiple metas-
tatic abscesses of the different infectious diseases encoun-
tered in the organs supplied by both the pulmonary
and systemic circulations, there have prevailed, hitherto,
—in these cases where concomitant endocarditis was
absent—the most varied opinions. The view of Vir-
chow, that they were referable to capillary emboli has
been the most plausible.
V. Recklinghausen has succeeded in discovering in
a series of infectious diseases, especially in pyaemia and
puerperal fever, further in typhus and acute articular
rheumatism, and finally in urinary infiltration and gan-
greme of the lungs, the cause of the abscesses to be
Żmiliary accumulations of minute organisms which are to
be designated as microcci. These are identical with the
forms described by Buhl, Oertel and Nassiloff in diph-
theria, and Klebs in cystitis and pyonephritis, and are
definitely determined, both by their appearance and
nore especially by their great resistance to different
chemical agents, even caustic alkaſies, to be animal
bodies themselves or substances originating from the
retrograde metamaphosis of animal bodies,
In greatest frequency the author found these parasitic
deposits in the kidneys, sometimes perfectly recent,
without any manifestation of reaction about them,
again, and more frequently, surrounded by a zone of
tissue of hemorrhagic or purulent infiltration. Their
accumulation in the kidney is not limited only to the
bloodvessels of which the smallest veins contain the great-
est quaſitity; the author found them also in the urinary
tubules from which they had passed out with the urine,
proof that they were contained, either intra vitam or
post-mortem, in the bladder. The distension of these
different canals is at times so great that they assume a
varicose appearance and further on perforation is effected
and escap' of masses of parasites. A further variety of
parasite, in every respect different from the micrococcus,
a variety consisting of an accumulation of a greenish
color, the author discovered in a case of scarlatina; these
parasites in this case were the constituents of small ab-
scesses in the pyramids of the kidneys. The urine of
the pâtient at the 6th day of the disease contained casts
covered with the elements described.
The frequency of this presence of these various para-
sites in the kidneys and in the urine as well as their
extension and multiplicity there, affords, in the authors
opinion, a significant indication for the localisation of
the problematic germs of infectious diseases in general.
As emboli in the sense which Virchow attaches to
them may these parasite metastases not be regarded.
Their extra vascular position is opposed to this view—
moreover the author has demonstrated micrococci
within the alveolae of the lungs—and then what partic-
ularly refutes this opinion is the fact that in a great
number of closely studied cases concomitant endo-
carditis was not present. The small accumulation en-
countered but one time tipon the mitral valve may, in
all probability, be regarded as metastatic in the same
sense as abscesses occuring in other organs.
TRANSFUSION OF BIOOD.—Three interesting cases
of transfusion are recorded by Jürgensen (Centralblatt,
No. 28). The first was a case of phosphorus-poisoning.
The patient was reduced to the last extremity of weak-
mess, and suffered from hemorrhage and jaundice, when,
two months after the poisoning, about 580 cubic centi-
meters of blood, taken from three healthy persons, were
injected into the median vein. Nearly the same quan-
tity of blood was at the same time taken from the radial
artery. He began, to recover immediately, and in a
month could leave his bed. A syphilitic eruption, from
which the patient was suffering at the time, disappeared
after the transfusion, and did not return till two months
afterwards. In the second case, the patient was a young
woman in a state of extreme debility from gastric ulcer,
to which had succeeded peritonitis and pleurisy. The
blood used in the operation had to be brought some
distance to the patient's residence in small well-closed
A
58
[FEB. 3, 1872.
TIEEE E C T , T TNTT C.
bottles. It had been previously defibrinated, and before
use was warmed to the temperature of the body. At
the first operation, 350 cubic centimeters were injected
into a deep vein of the arm; and, ten days later, a
Smaller quantity into the peripheral end of the radial
artery ; while the same quantity was allowed to flow
from the central extremity. This had no favorable
result; and death subsequently ensued, after the evac-
uation of the pleuritic fluid by paracentesis. The third
case was that of a man poisoned by exposure to carbonic
acid in the hold of a ship. Nearly a day after exposure
to the gas, the patient was quite unconscious, and had
irregular and interrupted respiration and paroxysmal
muscular contractions, while the reflex irritability was
quite lost. In this case, 400 cubic centimeters of blood
were drawn from the median vein; and thereupon 375
cubic centimeters of defibrinated blood, taken immedi-
ately before from three other persons, were injected into
the same vessel. During the operation, the muscular
spasms ceased; and after the patient had been for one
hour in a warm bath, and subsequently had cold water
poured over him, he was able to open his eyes and to
drink. Three hours later, he answered questions; and
on the next morning consciousness was perfectly restor-
ed. Recovery was complicated by the formation of red
maculae, which subsequently became gangrenous, on the
skin. These were seen at the time of the operation, and
presumably were due to stoppage of minute vessels.
Jürgensen regards transfusion of blood as a most valu-
able remedial measure in carbonic acid poisoning, and
advises an early recourse to it.—Brit. Med. Jonrn., Dec.
23, '71.
-—sº-º-º-
MIEDICAL NEWS.
American Medicine.
From the London Med. Times and Gazette, Jan. 6, 72.
We this week publish the first of a regular series of
letters relating to the affairs and position of our Pro-
fession in America, which we trust will alike prove
useful to our subscribers here and gratifying to our
American brethren. It has ever been our desire to
foster progress in Medicine; and as there is no means
more useful towards that end, or more honorable in
every way, than giving credit to whom credit is due,
we have deemed it advisable to secure the services of
one of the most eminent men in the United States and
in our Australian colonies respectively to keep our
readers aw courant with what is doing in their several
localities.
It is at once our duty and our pleaure to watch the
changes of Medical doctrine and the improvements in
practice, as they are gradually evolved at home and
abroad, as nothing has struck us so much of late as the
marvelous strides American Medicine has made within
a few short years. This was most forcibly brought
home to us a short while ago, when we were asked to
recommend a book as the best on each of a certain
number of subjects. The list was not a long one, and
yet about one-half of those we had it on our conscience
to recommend were American. Now, if this is not say-
ing much for ourselves, it is saying much for our
American brethren. There has always been a number
of Physicians and Surgeons in America quite on a par
with the best in this country, but that number used
to be very limited. Furthermore, the American school
was marked by certain characters of its own—the cur-
riculum was exceedingly short, only the merest
smatterings of Medicine and Surgery could be picked
up in the period; and, with the exception of those
educated in the older schools and abroad, few of its
representatives could boast of great scientific attain-
ments. Nevertheless, the men so educated, had to
encounter the exigencies of Professional life as best they
might; and here the vigor of the national character
came prominently into play—so that, though rough,
the Medicine and Surgery of the States had an exceed-
ingly practical character. We have used the past tense
here; for all this, although within the memory of most
men now in the Profession, is already a matter of
history. American Medicine has fairly passed into the
scientific stage of development. It is well for us to look
this matter fairly in the face, and to ask how it has been
that, in America, Medicine has made such mighty
strides in such a short space of time. As to the reality
of the advance there can, we think, be no question; it is
evidenced in many ways, but in none more powerfully
than in the modern Medical literature, periodical and
permanent, of the United States. With the abandon-
ment of their dirty calf-binding and bad paper, the
Americans seem to have made other changes important
in every respect; and though we have not yet done
them the compliment of pirating, as it is called, their
works on this side the Atlantic, it is not becanse they
are not used, for they are daily to be seen in the hands
of students and practitioners alike.
We have heard it said that most of the American liter-
ature, as it comes to us, is not new—only reproduced—
and undoubtedly the criticism is in some sense true;
but the existence of such a literature implies a demand
for something more than the scanty facts of pocket text-
books, and is itself an evidence of the advance of which
we speak.
But this eager desire for the higher kinds of knowl-
edge is made still more clear, to those of us connected
with certain London institutions, by the crowds of men
from America who flock there and elsewhere, seeking to
prepare themselves to take a position in their own
country. We are constantly meeting Americans—
young and old—who have left America for one or two
years, which they are spending in traveling from school
to school, here and on the Continent, picking up every*
FEB. 8, 1872.]
T EHI E3 CT, ITNTI c.
59
thing that is to be learnt, and storing it up for future
use. Go to Vienna, and the great majority of the
English speakers there to be encountered are Americans;
So, too, though in a less degree, in Berlin, and So, too,
it used to be in Paris. These men have left their homes
in Search of knowledge, and we may be sure that,
having acquired it, they will reproduce it with interest
when the proper time arrives. These are the signs of
American advance, and true indications of future
American greatness.
We ourselves here in London would do well to
ponder these things, for there is, unhappily, a tendency
among us, more especially manifested in certain schools,
to a display of self-satisfaction fatal to progress. Un-
fortunately, our system of Hospital education leads to
fostel this; it is diligently instilled into the minds of
our students that to learn their Profession aright it is
unncessary to stir beyond the walls of their own Hos-
pital. When ideas are bred in-and-in too long, the
result is as disastrous as it is in animal life: a puerile
conceit is apt to take the place of a masculine breadth
of thought, and to beget its like in the minds of others.
But our English students neither pass from Hospital to
Hospital enough, nor do they go abroad. Of all the
means available for expanding the mind, none are equal
to travel; nor for producing catholicity in Medicine is
there anything like foreign study. In this we fear even
now the Americans are beating us. In the future we
shall have to look to our laurels.
HONORS TO THE PHYSICIANS OF THE PRINCE.--Dr.
Gull and Dr. Löwe, who were associated with Sir Wm.
Jenner in the treatment of the Prince of Wales, are to
be honored, the first with a baronetcy, the latter with a
knighthood. Dr. Gull is also to become one of the body
physicians to the Prince.
THE RITES OF Found ATION SACRIFICE.-There is
current is Scotland the belief that the Picts, to whom
local legend attributes buildings of prehistoric antiquity,
bathed their foundation-stones with human blood; and
legend even tells us that St. Columbia found it neces-
Sary to bury St. Oram alive beneath the foundation of
his monastery, in order to propitiate the spirits of the
soil who demolished by night what was built during the
day. So late as 1843, in Germany, when a new bridge
Was built at Halle, a notion was abroad among the peo-
ple that a child was wanted to be built into the founda-
tion. These ideas of church, or wall, or bridge, want-
ing human blood or an immured victim to make the
foundation steadfast, are not only wide-spread in Europ-
ean folk-lore, but chronicle or tradition asserts them as
matter of historical fact in district after district. Thus,
When the broken dam of the Negat had to be repaired
in 1468, the peasants, on the advice to throw in a living
nan, are said to have made a beggar drunk, and buried
him there. Thuringian legend declares that, to make
the Castle of Liebenstein fast and impregnable, a child
was bought for hard money of its mother, and walled
in. She was eating a cake while the masons were at
work, the story goes, and it cried out: “Mother, I see
thee still; ” then later, “Mother, I see thee a little
still;” and, as they put in the last stone, “Mother, now
I see thee no more l’” The wall of Copenhagen, legend
says, sank as fast as it was built; so they took an inno-
cent little girl, set her on a chair at a table with toys
and eatables, and, as she played and ate, twelve master-
masons closed a vault over her; then, with clanging
music, the wall was raised, and stood firm ever after.
Thus Italian legend tells of the bridge of Arta, that fell
in and fell in till they walled in the master-builder's
wife, and she spoke her dying curse that the bridge
should tremble like a flower-stalk henceforth. The
Slevonic chiefs founding Detinze, according to old
heathen custom, sent out men to take the first boy they
met and bury him in the foundation. Servian legend
tells how three brothers combined to build the fortress
of Stradra (Scutari); but year after year, the demon
(vila) razed by night what the three hundred masons
built by day. The fiend must be appeased by a human
sacrifice—the first of the three wives who should come
bringing food to the workmen. All three brothers swore
to keep the dreadful secret from their wives; but the
two eldest gave traitorous warning to theirs, and it was
the youngest brother's wife who came unsuspecting, and
they built her in. But she entreated that an opening
should be left for her to suckle her baby through, and
for a twelvemonth it was brought. To this day, Servian
wives visit the tomb of the good mother, still marked
by a stream of water which trickles, milky with lime,
down the fortress-wall. Lastly, there is our own legend
of Vortigern, who could not finish his tower till the
foundation-stone was wetted with the blood of a child
born of a mother without a father.—Journ. Psych. Med.,
Jan., 1872.
CIRCUMCISION OF CORPSES.—The laws of Austria as
is well known, forbid any compulsory execution of re-
ligious enactments. Many Jewish parents have taken
advantage of this to evade circumcision of their new
born male children. Lately the discovery has been
made that the corpses of those who died thus unconse-
crated had been circumcised in the Jewish burying
ground by some orthodox fanatics. An investigation
has beea ordered by the Government with a view of the
detection and punishment of the perpetrators.- Wien.
Med. Presse, Dec. 31, ’71.
A VALUABLE CARRIER PIGEON.—From the
Elizabeth Daily Journal of New Jersey of Nov. 28
we have a marvellous story of a carrier pigeon,
which we commend to the notice of Mr. Tegetmeier.
It performed the journey from Sopus Farm, Warren
Co., N.J., to Sandusky Ohio, a distance of 400 miles, in
exactly an hour, and its condition on its arrival at the
latter place is thus described:—I found the greatest
excitement had followed the arrival of the pigeon.
Mr. Smythe told me that at precisely two o'clock the
60
[FEB, 3, 1872.
TIH. H. C.T.INI c.
bird came like an arrow into his house. His movement
was more like a blue streak than a well-defined bird.
He seemed but little exhausted, although nearly all
the feathers were off his body, except the small patch held
on his back by the gutta-percha which fastened the note.
A few miles more would have worn every feather from
his wings, and then he would have to depend upon the
momentum already acquired to carry him on his jour-
ney, and to steer by a tailless rump, and perhaps be
killed in attempting to alight.” No wonder the owner
offers to match this pigeon “when he has grown a new
suit of feathers” for 1,000 dollars against any carrier
pigeon that has not done this distance in an equal time.
—Nature, Jan. 4, '72.
SMALL-Pox IN GERMANY.—The epidemic of small-
pox increases everywhere in intensity. The mortality
in Berlin alone reaches 9000; over one per cent. of the
population. Compulsory vaccination has been ordered
in Gotha.
CEREMONIAL PURIFICATION.—The seclusion and lus-
tration among North-American Indian tribes have been
compared with those of the Levitical law, but the ro-
semblance is not remarkably close, and belongs rather
to a stage of civilization than to the ordinance of a
particular nation. It is a good case of independent
development in such customs, that the right of putting
out the fires and kindling “new fire” on the woman's
return is common to the Iroquois and Sioux in North
America, and the Basutos in South Africa. These
latter have a well-marked rite of lustration by sprink-
ling, performed on girls at womanhood. The Hottentots
considered mother and child unclean till they had been
washed and smeared after the uncleanly native fashion.
Lustrations with water were usual in West Africa.
Tartar tribes in Mongolia used bathing, while in Siberia
the custom of 1 aping over a fire answered the purpose
of purification. The Mautras of the Malay Peninsula
have made the bathing of the mother after childbirth
into a ceremonial ordinance. It is so among the
indigenes of India, where both in northern and southern
districts the naming of the child comes into connection
with the purification of the mother, both ceremonies
being performed on the same day.—Journ. Psychol.
Med., Jan., '72. -
——º-e-Gº-
CLK NICAL Aſ ºf M C RAN ID. A.
A NEW REMEDY FOR SMALL-POX.—A letter from
Berlin, announces the use of a new remedy in the pres-
ent epidemic of small-pox in Berlin by Dr. Zuelger, the
Director of this department in the Charité. It is Xylol
(Dimethylbenzol)—two atoms of water substituted by
two atoms of methyl—of which 10–12 drops are admin-
istered in gelatine capsule every two or three hours.
of the epidemic renders its further trial easy.—Wien.
Med. Presse, Dec. 31, ’71.
CHLORAL IN GOUT.-Chloral must be an efficient
remedy in this disease as Dr. Puglièse (Lyon Medicale,
No. 21,) Says that he gave 30 grs. of it to a patient
suffering horrible agony, “never closing an eye from
Sept. 25th to Oct. 3rd, and ten minutes afterwards he
fell asleep to awake in a condition of “béatitude indescrip-
tible.”
CHARCOAL IN GASTRIC AND ENTERIC DISORDERS.—
Dr. Rémy highly commends the use of vegetable char-
coal prepared from the poplar after the process of M.
Belloc. He exalts its efficacy as “truly marvellous” in
the treatment of gastralgia, gastro-enteralgia, dyspepsia,
pyrosis, the greater number of nervous affections of the
stomach and bowels, and constipation. It is a valuable
adjunct in the tonic treatment of gastro-enteric affec-
tions. In certain cases of dysentery it has also been
found very useful, and in one such instance, reported
by Dr. Farr, of London, its effects was very satisfactory
in the form of enemata.-L' Union Medicale.
CIILORIDE OF AMMONIUM IN HEPATITIS AND HEPAT-
IC ABSCESS.—This remedy is highly lauded in all cases
of hepatic derangement where mercury or other re-
solvants are indicated, both in France and Germany.
It is given in doses of one gramme [15 gr.] morning and
evening.—Bull. Therap., Dec. 15, 71. -
VoyſITING OF PREGNANCY TREATED BY ELECTRIC-
ITY..—Dr. S. Iffla presented a memoire to the medical
association of Victoria, (Australia) communicating the
great value of electricity in cases of obstinate vomiting of
pregnancy. In one remarkable case, defiant of all med-
ication, where the patient was reduced to the last
degree, prompt recovery followed the application of the
constant current to the epigastric region. A recurrence
of the same difficulty in the same case in a subsequent
pregnancy as promptly yielded a second time to the
same means.—Bull. Therap. Dec. 15, '71.
—cº-O-ºs-
I H [ON IFE NEWS.
DURING the month of January 270 cases were treated
at the College Dispensary. An abundance of material
for physical diagnosis, eye and ear disease, specific dis-
ease, etc., etc., is thus secured for the ensuing Spring
Course.
Quite a number of Reviews are crowded out this
week for want of space.
Wanted—Nos. 2 and 8 of THE CLINIC by Dr. G. C.
Most excellent results are reported. The great extent | Conard, Peru, Ind.
F. E. SUIR F. E. S. WAYNE
F. E. suire & Co.,
WHOLESALE DBUGGISTS,
INZL A-IN TJ E A C T U ER, TIN G-
£HEMists AND f'HARMAceutists,
CINGINNATI, OHIO.
Have constantly on hand a full assortment of
sxex,xecºcºo ox{U GS ANYO myx)&Yoxc)(xxes,
cxxxeryxxCAX, Axºp AYKAYºus,
TESTs, MEDICAL, GLAss waRE, &c, &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordince with the U. S. P. and other recognized authori-
Ç8.
FINIHE AND FE.A.R.H. CHEMICALs,
Of the popular class of preparations known as
IE T, IDX IIHR, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
In the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c.
AGENTS FOR BULLOCK & CRENSHAW's
Sugar-coated Pills and Granules.
)
Price Lists of preparations and of Sugar-coated Pills sent by Mail
"Pon application. The long standing and well and widely known repu-
*tion of our house we offer as a guarantee for the reliability of our |
P**Paration, and the quality of the goods sold by us generally.
: tºº sº
F= }
JAMES FosſºR, JR., & Co.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having" been established since 1836), and in the
reorganizatiºn of their firm will endeavor to merit a continuation ºf the
same, We wish it understood by the Professiºn and the Public generally
|tº our invariable rule is, to make or import none but the best in .
struments. Those in want of a try of the acknow ledged googl aids of
ivisiºn to immerfect eyes. will always find the best and largest stock of
Lenases, Spectacles, and the best models procurable. with pains-
taking skill to adjust them to all conditions ºf sight, at our hºu-e.
Special attention paid to orders fºr Fine Microscopic Objects
and Microscopic Apparatus, Magnifiers aud" Readers it
great variºt v. Medical Batteries, Barometers, Thermo-
meters, Hygrometers, Urinometers and Rain Gauges,
of the most approved construction always on hand. All orders promptly
and accurately fill d.
JAS. FOSTER, JR. deali
F. S. SHACK L EFORD, } *** ** JAS. Fost ER, JR. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TDIER,. S-INT-TV/I_A_TER/STEI’S
No. 758 BR0 Apw AY, New York
HAVF been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last tight years, tº the ex-
clusion of all others, and have found it to give general satisfaction. effect-
ing a radical cure, in the nuljority of cases, in a very few months.
As a Truss for the radical cure of Ilernia, I think it lar preferable to
any I have ever examined. LE \\ IS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General IIospital.
B EG leave to state for the benefit of all concerned. thmt I have known
lºr. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treattuent. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with a ti v of the risks to the patient
that exist in many of the plans suggested aud at teulpted to be carried
into execution. I have confidence in Dr. Maish Rs a gentleman of honor
and integrity, and as such recommeud him to the members of the medi-
cal profession generally. WI L I. A l; O PA 18 K E R., M. 11.
Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, bow Legs. * ind all
other Physical Defortnities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. M. AltSil & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSli, COR LISS & CU., No. 3 West Fourth St.,
between Main and Walnut, Ciucinnati.
OPPOSITE THE ulgeſ STEEPLE.



Carriage Manufacturer,
Nos. 9 and 11 East Sixth Street, bet. Main & Sycamore. g
I MAKE NOTHING BUT
A"/#,S 7" CºA ºf S.S. W’0 A A',
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur.
passed. Of
LIGHT FAMILY CARRIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to -
PHYSEEFANS” {jSE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen's
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
Physicians in the city and neighborhood.



Wm. Wilson McGrew,
- JWo. 2% Irasr Fownrir Szwarz,
PIKE's OPERA HOUSE BUILDING,
** * \'º - Z:. . . .
w - .” *
º, ºf : : -ºº ºn
l; . . . . º.- : *** - ; :
|rter and Dealer
Diamond and Gold Jewelry,
Watches for Ladies and Gentlemen, -
Sterling Silver Tableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
Marble Statuary,
G ENER ALLY.


CAMARGO
MANUFACTURING COMPANY.,
MANUFACTURERS AND IMPORTERS OF
Y S S rin §§
WS § NS S.
S$
AND
Window Shades,
67 WºSz' Aſoterºzºz Szºkºz',
CINCINNXT, O,
H. H. BRENEMAN, Proprietor,
UNI) ERWEAR
GENTLEMEN.
Handling much larger quantities of fine and
valuable Underwear than any other firm in the
West, we are enabled to purchase at closer fig-
ures. We are therefore prepared to offer extra
inducements to consumers.
IHOSIEERY,
FULL LINES OF THE BEST ALWAYS ON
SHIRTS MADE TO ORDER.
WILSON BROS,
Pilke’s Opera House, Cincinnati; 931 Wabash Ave-
nue, and 88 West Washington street, Chicago.
HAND.
M A F P& T VVA. IN'S
NIEVV E O OILC
IS NOVV READY FOR CA NVASSERS.
It contains over 600 pages of reading matter, with 250
engravings, designed cypressly for this work, by the best
artists in the country. Agents now at work upon it are
meeting with unparalleled success. Agents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re-
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 Jºlm Street, Cincinnati, O.
BASCOM & CARFENTER,
Stationers, Printers
-AND- .
Blank Book Manufacturers,
136 VINE sºrrºr:ET,
&\\\\\\\\\\\e
E. D. ALBRO & BRO.
IMPORTERS AND MANUFACTURERS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
frºm?!-Maºri', 'al-Builiºſi'ani air-Blileº's,
The only house in the Western country that saws Spanish and Mexi-
can Cedar for Cigar-Box Makers. We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 West Second Street,
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI,



List of Pharmaceutical Preparations,
MANUFACTURED BY
Jonºv. Irrezºn & phozººn,
PHILADELPHIA.
—dº-
ELIX PHOS. IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
, ELIXIR WALERIANATE OF AMMONIA,
(Goddard’s Formula,) -
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON, *
Hron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK, -
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES, …
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
* x FERRATED CORDIAL ELIXIR,
ELIXIR, CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK,
* FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
* TASTEIESS COD LIVER OIL,
TASTELESS CODLIVER OIL. FERRATED,
BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIRVALERIANATE OF STRYCHNIA,
–––––– Q wiNE OF PEPSIN,
SYRUP SUPERPHOSPHATE OF IRON. FEFSI.
- * ELIXIR OF BISMUTH,
COMP. FLUIDEXT. BUCHU AND PAREIRA BRAVA.
st JFE” O’s IT ( > Fr LEs.
Rectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and style, made of finest quality of spongo.
Wººf, º ſº.
Zººs sº §º: ... AºA, ſº º A'A' ºr
# 5. sºlº º sº sº E
sº |Tºº
... " 3. º - t i
§:2S. "
º lºſſ!!!!
º ...:
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|
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#
L 2-5
tiºn - º
*
§ſº
*Nº, N.'
- *
ſºft ... [i]||.
S.
ſº
sº
CINCINN ATI.
E" A C TU L T Y -
J A M E S G R A H. A. M., M. D., D E A N ,
Professor of the Theory and Practice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., & W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomy. † - Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D., º - T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
– W. W. SEELY, M.D., JOHN L. CLEVELAND, M.D.,
Professor of Diseases of the Eye and Ear. Demonstrator of Anatomy.
SAMUEL NICKLES, M.D., ...' CHARLES KEARNS, M. D.,
Professor of Physics and Medical Chemistry. Assistant to the Chair of Surgery.
J. A. M. E. s r. W H ITT A R E R , *
Professor of Physiology and Secretary of the Faculty. - s
T. Louis BRowN, Prosector of Anatomy. ...' Janitor, College Building, Sixth St., bet. Vine and Race.
Printed and Published by Norbus & M URBY, Medical College of Ohio Building, Cincinnati.



















THE CLINIC,
PUBLISHED EVERY SATURDAY.
* R. R. M. S.–$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
$ ~ 3
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer, Af
-->
Vol. 2. C IN C IN N A TI, F E B R U A R Y 10, 1872. No. 6.
*—
—r
JAS. T. VVHITTAKER, M. D. * gº mºs Editor.
No. 101 West Ninth Street, Cincinnati. Çgº A. Bºſ tº CO =
JASSOCIE.A.T.E. Hºº). ITO.R.S.
W. W. DAWSON, M. D. THAD. A. REAMY. M. D. ſº
P. S. ConneR, iM. D. C. D. PALMER, M. D. F ashionable Hatter §s,
W. W. SEELY, M. D. SAMUEL NICKLEs, M. D.
CHAs. KEARNs, M. D. JNo. L. CLEvel,AND, M. D. IMPORTERS AND MANUFACTURERS OF
RoBERTs BARTHollow, M. D.
W. W. SEELY, M. D., - - - - - - TREASURER. #A}}{ES.” FºrS,
No. 118 West Seventh Street, Cincinnati.
92 WEST FOTTERTIE-L ST.
Opposite Post Office,
C L J B R A T E S.
*-
4 Copies to one address * * * * * * * * * * * * * * * * * * * * * * * * * * * = e e º a e º e º 'º $ 7.00 CINCININATI.
6 & 4 sº *~ 10,00 ' | *Special Inducements to Medical Men.
I2 4 & 6 4. 18.00 |
* ~ : 7 TV = alsº º, T. ºr sº
C O N T E N T S. . . . . Boº Stºkºſan
— Page. . ºbesic N E. Rs AND is
oric INAL ARTICLEs º -ºblºn EKºº
Agoraphobia, by John D. Jackson, M. D 6|| . E.NGR AVE R S O NWO ODI
On the Treatment of Inflammations by Means of an Air-Exhaust- ºlº 2. Wºº U.5995 IH. Sãº-º-º:
ing Apparatus, by J. Bradley, M. D. 62 : CINCINN: *TI; OHIO.
TRANSI LATION
Gastric Juice and Pepine Solutions in the Treatment of Syphilis J. TAFT, W. TAFT.
and Cancer (from Schmidt’s Jahrbücher, Jan., 1872)................. 62 Editor Dental Register
SCIENTIFIC NOTES
Urea formed in the Liver—Electrophysiologica 64-67 J. & W W Q TAF T,
MIE DI (CAEL NEWS
The Oldest Existing Medical Work—Plague in Bombay—Heels vs.
Brains—The Hop Pillow—Fertility of American Women............ 67 T) IET: INT T T S T S
CORRESPONDENCE
Letter from Berlin (from the Brit. Med. Journ. (Dec. 31, ’71).-An *
Exegetic Document st 67-68 11 7 W EST FOU RT H STR E ET,
REVIEWS
The Principles and Practice of Surgery, by John Ashburst, Jr., CH N CI TN N_A_T}{ 9 O.
M. D. Philadelphia, H. C. Lea, 1871—Pulmonary Consump-
tion, by Jas. H. Bennet, M. D.—Traité des Maladies du Fond
de L’Oeil, etc., by Wecker and Jaeger—An Ophthalmological
9)
Encyclopedia—Consumption, its Pathology and Treatment, by
Wade Minor Iogan, M. D. S. W. Butler, Phila, 1871.......... 68-70
A Monthly Journal,
CLINICAI, NIEM [ORANIDA
Electricity in the Treatment of Tumors.................................... 70-72 CONTAINING 48 PAGES,
HOME NEWS * 72
The Spring Course of 1872........ .. Tº Devoted to the Interests of the Dental Profession,























ROBT CLARKE & Co.
William Autenrieth,
PUBLISHERS,
hillinºiſ,
N0, 65 WEST FOURTH STREET,
Call the attention of the Medical Profession
to their Extensive Stock of
&nglish, Āmerican and £venth
J/AA/º/, Aº(262/.S.
'Paying particular attention to this branch of
their business, they are enabled to execute all
orders on the shortest notice, and at the most
reasonable rates. Their facilities for the impor-
tation of FOREIGN BOOKS, THE PROCEED-
INGS OF SOCIETIES and HOSPITAL RE-
PORTS are unsurpassed, and any orders en-
trusted to their care will be filled promptly, and
at the lowest rates.
Subscriptions received for FOREIGN and
AMERICAN PERIODICALS.
All the New Publications received as soon
as issued.
Letters of Inquiry will receive our prompt
and full attention.
Catalogues furnished gratis on application.
ROBERT CLARKE & Co.,
lºwhilºlº, mºtiºn
PRINTERS AND BLANK BOOK MANUFACTURERS,
2eaders 22 Zaze,_Medicaë, Z/ºeoſoyacal,
&chooč, azed./esce&azzeocas ZPoo/s,
65& West Fourth Street,
CINCINNATI, O.
* *
|No. 71 wrest sIxTH sºrrºrder,
BETWEEN WAINUT Añº WINE,
CINCINNATI, OHIO,
III in Immº III.
Abdominal Supporters, Trusses,
GLUB-F00T SHOES,
SPINAL APPARATUS, ETC
&
Keeps constantly on hand a full variety of
Metalic and Rubber Syringes,
Storm.ach Pumps, Etc.
stockings Foh waſticose veins.
Special attention given to the fitting of Apparatus for Deformities.
gº Agent for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
-ALSO-
DR. AHL's POROUS FELT SPLINTs,
• --ALSO–
D A Y’s ser, INTs
*s,
-AND-
6.
S. We Elliott's Saddle=bags
AHé
iſſiſſilij
º
- *::::=ºſºft #Fººlſ: ºftº === i ºffl ºil-
===ºiſºft jºiº ". -
#E; i # | | º
*E. º ºf . . f .# i. º º | j.
#|i. ##! |† º # * † := -:S,
§§sºs §: 5. =#. - ſº !" -ºšilláſi | |
Fº: B * … . . . a ſº- lºº º_º|||||| ~-
Sº § |
ES:
º
Ş.
i: ſi.
ºft
Sºsº* § - -----
§§ § %233; ;
šº
iº G |º
-
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of Sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
pointments of a First-class Hospital. Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand o
service. -
&" Address,
SISTER ANTHON.Y.,
EIospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincipanati, Ohio.

















































* * …” A : *
*
bºrº 2
*- -
* : *% º
E---
sº
º NSJ
Carriage
NOS. 9 and 11 East Sixth Street, bet. Main & Sycamore.
- I MAKE NOTHING BUT
Jº ZAPS 7" CZ.Z.S.S. WºO /*A*.
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
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Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
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PHYSICEANs' USE.
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
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The superiority of my light gentlemen’s
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RzsPeoTruſ.I.Y. YoUEs,
E. S. Wayne, Analytic chemist

^ y T EEE EIH C T , T INTT C -
61
vol. 2..] s A T U R D A Y, F E B R U A R Y 10, 1872. [No. 6.
O R. I.G IN A L A R T I C L E S.
A G O R A P J H I O B H A •
Eisophobia, Autophobia.
BY
JoHN D. JACKson, M. D.
Danville, Ky.
On p. 116 of THE CLINIC for Oct. 14, 1871, under
the heading AGORAPHOBIA, is a short paragraph from
the Archiv Psychiatrie, giving some account of a neuro-
pathic affection encountered by Westphal, and to which
he has applied that name. It says, the most essential
symptom of it “is a most acute anxiety or fear, ex-
perienced in open spaces, long passages, theatres, concert
saloons, etc., with no other cerebral disturbance. This
feeling of dread, is lessened if a wagon or an individual
stand in close vicinity, as also in the neighborhood of
a well known house.” ';
Though I have no recollection of having elsewhere
seen any account of this curious affection, yet inasmuch
as I am myself cognizant of two cases, I doubt whether
if attention of the profession were generally directed
toward it, it would prove after all, to be so very rare.
One of the sufferers is a medical friend residing in
the country, and although he to-day still does quite
a respectable practice, yet, as he informs me, he has not
for years ventured out of sight of his house, without
an attendant.
Like in Westphal's cases, he is a man of intelligence,
and has frequently brought to bear every argument
which his reason could summon, and all the force of
his will against it. Unlike Westphal’s patients, he has
never been subject to epilepsy or to any symptoms
standing in a close connection to epilepsy. Nor with
him, is there any hereditary connection. I might say
furthermore, that he is what the world would term “a
Well balanced man,” and usually free from eccentrici-
ties or oddways. In society, his temper is remarkably
cheerful and good humored, and in estimating his char-
acter, I should pronounce him rather a man of fortiter
&n re, than timidity. For a long time, he was sensitive
regarding his trouble, and tried to conceal it from the
World, but of late years, has pretty much given up all
hope of overcoming the difficulty, and looks upon it as
an evil to be viewed and discussed, as any other malady
of the flesh. -
He has been kind enough at my request, to write out
* brief description of his case, which I append. Before
doing so, however, I would Suggest another name than
that proposed by Westphal. By the word agoraphobia,
I suppose he means to indicate a fear while out in pub-
lic places, or highways [agora phobia], but if we analyse
the cases, we find that this is not exactly so—since this
dread only comes over the person when he is there
alone. It seems to me that the term isolophobia,
eisophobia or autophobia, would more correctly express
it.
“The affection which you have requested me to give
some account of, I have suffered from for a number
of years. To give you the opportunity of estimating
the value of antecedents and sequences, I might tell
you that in childhood, I had Hooping-Cough, attended
by violent attacks of epistaxis, repeatedly bleeding until
I was exhausted. On recovering from this, I had
asthma, until I was fourteen years of age; at puberty
I was about rid of asthma, but dyspepsia with its train
of troubles and horrors set in, and was accompanied by
obstinate constipation, and haemorrhoids, from which
latter, I suffered repeated and exhausting hemorrhages.
“About nine or ten years since, I commenced suffer-
ing from palpitations, attended with a sense of great
fear of death, and an intense desire all the while to have
some person with me. Each attack gave me great un-
easiness, fearing it would be followed by another. A
thought of it filled me with dread, and I began to avoid
traveling about by myself, but on account of my re-
covering so rapidly from the sensations, I would take
heart, and kept my troubles to myself, and for a year
perhaps I did not mention them to a soul—not even
my wife—for all the while I was impressed as much as
any one could be, with their puerile character, and
feared on speaking of them, that I would be laughed
at, or not believed. The spells grew more frequent
during the next two or three years, though for two
years, I never had one while in company with a single
human being, even a helpless child; but in the third
year, when in company with a single individual, I occa-
sionally suffered it in an unfrequented place, and more
especially when at a considerable distance from a house,
but never when in close company with two or more
persons.
This grew upon me, until I was afraid to go a hun-
dred yards by myself, even out in my own premises.
Any violent physical exertion at this time produced
suffering. Engaged at the time in the practice of med-
icine and farming, of course my business had to suffer,
and I grew melancholy, feeling that all my prospects
in life were blighted. I however tried manfully to brave
off the spells, though at each time I permitted myself to
be alone, I suffered terrible agony from the sense of
impending death, which was always accompanied
by palpitations and rigors sometimes culminating in
actual shakings, and occasionally accompanied with
severe neuralgic pain in my back, and side or shoulders,
followed by heat and thirst. My sufferings were great-
est between 1866 and 1869, during wnich time I under-
went two operations for haemorrhoids. Since then,
62
[FEB. 10, 1872.
T IEEE THE C T , T IN. T. C.
being cured of my hamorrhoidal troubles, and never
venturing to go out by myself, I have grown somewhat
better.
“I have faithfully endeavored to break up this
trouble in every conceivable way, but reasoning and
medication have been in vain. As I have before inti-
mated, I have again and again voluntarily been alone,
and have tried to abstract my mind by firing shot after
shot from my revolver, riding my horse at full speed,
hallooing, whistling, counting, reading, and heaven
only knows what all, but every expedient has been in
vain. For six or eight years, I may say that I have
never traveled a quarter of a mile alone, and as silly as
it may sound to other ears, I but speak the plain truth,
when I tell you that to-day, the wealth of all the
Indies could not tempt me to do so.”
——-º-O-º-
The Treatment of Inflammations by Means of Air
Exhausting Apparatus.
BY
J. BRADLEY, M. D.
St, Marys, Ohio,
Dr. Arnott of London, I believe, has the credit of
being the first to apply a partial vacuum to the lower
extremities as a substitute for blood-letting; and from
the reports I have seen with entire success. Notwith-
standing the favorable reports given, it has, it seems,
attracted but little attention in the old world, and
about none at all in this country.
Being impressed with the efficiency of inducing a vac-
uum in the lower extremities for the cure of certain
diseases, I had a pair of exhausters made after my own
notion, vacuum boots I may style them, about three
years ago, which I have been using since in every case
that would admit of such treatment, and with really
wonderful results. Profound congestion may thus be
induced in the lower extremities to extent, indeed, of
approaching syncope. This for the cure of certain in-
flammations, is surely more potent for good than blood-
letter can be ; for not only is the blood detracted from
the inflamed parts, but it carries with it the nerve
force that induced the inflammation. Physiologically
considered it could not otherwise than have this effect.
This is not the case in blood-letting. Many a patient,
years ago, I have bled in pneumonia, and have observed
that after the bleeding the congestion was the same.
But in using my exhausters I have never been disap-
pointed; the effect is certain for good if they are only
used early in the disease.
In all cases of congestive headaches that occur in fevers,
or otherwise, I have succeeded in checking the pain in
from five to twenty minutes, and this, as yet, without
a single failure. I have had one case of epistaxis, and
one of hemoptysis; both these were checked at once
without the use of other means. For the cure of inflam-
mations, I set my patient well up in bed, then apply
my exhausters and bring him to the condition of an
approaching syncope; if this be not brought about in
ten or fifteen minutes, I begin to give small doses of
antim. tart. or tr. lobelia, which soon induces the desired
effect. In this condition now, I hold my patient an
hour or more, to produce a lasting impression. I place
him then in dorsal decubitus, give him a Dover's powder
and apply a hot brick to the feet; if the inflammation
be in the first stage, the treatment is ended—my patient
is well.
From the trials I have made in pneumonia I think I
have lost my last patient from that disease; if I have
been called during the congestive stage. I will give
cases hereafter.
—e-e—e-–
Gastric Juice and Pepsime SoHutions in Cancer
and Syphilis.
BY
DR. AUG, STöHR, Private Docent (Würzburg).
Lussana, in particular, has recently recommended the
gastric juice of the dog removed by fistula for the de-
struction of malignant neoplasms; after him, the Italian,
physicians made numerous experiments with the same
agent. Stöhr's experiments began in winter (1869)
while he was assistant at the medical clinic at Würz-
burg. These he continued afterwards in private prac-
tice and in his subsequent position of Ordinarius in
the syphilitic department of the Würzburg military
hospital where abundant material was present.
It seemed of greatest importance to study the action
of gastric juice on inoculable secretions. The author
selected as the most suitable subject the inoculable
chancre as this could be produced to any extent by
inoculation rendering all kinds of experimentation
possible. .
At first was employed the juice taken from the stom-
ach directly by fistula. The fistula was made in the
usual manner. Escape of the contents of the stomach
was prevented by the insertion of a canula or by simple
cover of the orifice. During the first four or five weeks
the opening remained sufficiently large, then exuber-
ant granulations interfered to partially close the wound,
so that many difficulties in obtaining the juice were
experienced. It was furnished purest when, after the
animals had hungered for a short time, small stones or
bone fragments were introduced. The chyme was then
strained through a linen and flannel filter. A tolerably
clear fluid of acid reaction and amber color was thus
obtained. The quantity secured, in several experiments,
amounted, in a dog of average size, to 40–160 grim. only.
The juice was easier obtained from a dog that had been
killed as Schiff has stated. On several occasions, also,
Wittich's method of obtaining the juice in glycerine
was adopted. The juice of birds (owls and crows) which
FEB. 10, 1872.]
T ET H. C.T.I.N.I.C.
63
possesses the greatest digestive and antiseptic action was
obtained by the old method of Spallanzani, viz., by the
introduction of sponges into the oesophagus. To preserve
the juice prepared artificially, variable quantities of
hydrochloric acid and a small amount of chloride of so-
dium were added; the fluid was then placed in well
stoppered bottles where it would be preserved for sev-
eral weeks without decomposition.
The application was made either with a pencil by
means of which the juice was painted over the surface
15–20 times a day or small pieces of cotton were satu-
rated in the solution and kept upon the surface; in this
latter case a larger layer of wadding soaked in a very
dilute Solution of hydrochloric acid was applied over
the cotton. The dressing must be kept constantly moist,
since the transformation of albumen into peptones can
only occur in the presence of an abundance of water.
The following was the method of treatment of the
chancres induced by inoculation. The application of
the juice was commenced assoon as the ulcer has reached
the size of a silver dime (8th–10th day). In almost all
cases it was perfectly painless, a few patients stating that
they experienced a slight itching or slight burning sen-
sation at the margin of the ulcer shortly after the first
application. An examination after three or four hours
showed upon the surface a layer of grayish-white semi-
transparent substance of * gºlaºu, aspect. In rarer
cases this could be removed as a ‘continuous membrane;
it adhered with moderate firmness so that it could be
removed but with difficulty by a stream of water let
fall beneath it. This was seen under the microscope to
consist of corium elements and different forms of cells.
As the application was continued this gelatinous layer
became thicker though a purulent fringe was still dem-
onstrable at the borders; after 24–36 hours, the borders
Were somewhat contracted presenting less of the appear-
ance of being punched out. If now the application of
the juice was discontinued and the ulcer left without
dressing, the gelatinous layer gradually dried, contracted
concentrically and the surface presented a vaulted gray-
ish-white crust of horny firmness, difficult to detach.
Beneath this often was a layer of thick creamy pus. If
this incrustation were not removed it remained fixed
5–11 days. Cicatrization then commenced about its
edges and if it were now detached by force—which
Would cause often hemorrhage—the ulcer beneath it
Was found much smaller and with a good granulating
surface. Perfect coating of the surface would then fol-
low in a very short time under simple water dressings.
In most cases, however, the author detached this layer
several times from the bottom of the ulcer and applied
*nd reapplied gastric juice until satisfied that no inocul-
able material was left behind. The tendency of these
ulcers, then, towards cicatrisation was particularly
marked and followed usually between the fourth and
*Venth day. In order to assure himself that this favor.
able effect was not partly or totally due to the hydro-
chloric acid always present in the juice employed, the
author made numerous experiments which yielded al-
ways negative results. The digestive fluid acts upon
the ordinary chancre in the same way as upon that pro-
duced by inoculation. In forty cases the mean duration
of treatment was a fraction over nine days, the shortest
five, the longest seventeen days. The inoculability of
the secretion of the ulcer is totally lost after long con-
tinued application of the gastric juice. In repeated ex-
periments it was proven that inoculations with neither
the translucent layer mentioned nor with the pus of the
granulating surface after detachment of the crust could
produce any reaction. To establish these results most
conclusively he experimented in the following manner:
in one series of cases he inoculated with a mixture of
the pus of a freshly opened bubo with ten times its vol-
ume of a dilute solution of hydrochloric acid, in another
series with a mixture of the same pus with ten times its
volume of the gastric juice of the dog. In the first series
(six in number) but one inoculation failed, in the Second
series no single inoculation succeeded, showed even not
the least reaction.
The author is of opinion that the gastric juice has, in
a certain sense, the full action of a caustic. The inocul-
able material of the secretion of the ulcer is totally
destroyed, as also, of course, the inoculability of the
secretion. This destruction is effected without pain,
gradually, interstitially, penetrating to and macerating
the ultimate histological elements of the tissue. To
what depth the tissue must be “digested” to transform
an infectious ulcer into a simple loss of substance, only
experience with individual cases can teach. So soon as
the conviction is reached that this transformation has
been affected, so soon may the treatment with the juice
be discontinued.
Phagedemic chancres treated in this way are soon
covered with luxuriant granulations. Condylomata
and syphilitic neoplasms call for this treatment only
when the surface is ulcerated.
This transformation of the tissues into peptone re-
quires a large amount of gastric juice and on this
account the use of the juice for the destruction of large
carcinomata and similar tumors has but little promise
of success. It is probable, however, that after the ex-
tirpation of such tumors the prolonged treatment of the
base by applications of the juice wonld prevent their
recurrenbe. Tissues which are highly vascular con-
tra-indieate injections of gastric juice. Diphtheritic
membrängs are easily dissolved or rather digested with
large quantities of gastric juice. Whether this result
may be obtained by simply peneiling the surface of the
fauces is doubtful. The author has only tried the appli-
cation to one light case of diphtheritic angina in Scarla-
tina. He used the artificial juice and brought it to the
surface with an atomizer. The individual “plaques”
rapidly disappeared. It is probable that the gastric
juice in this case attacks the low vegetable organisms
which are known to exuberate so luxuriously in diph-
theritic membranes. *
64
[FEB. 10, 1872.
TIH. H. C.I.IISTI c.

The most active of the different kinds of gastric juice
was that obtained from fistulae or from the stomachs of
dead dogs. The varieties of pepsine sold in the stores are
only of value when not mixed with starch. The author
usually employed a mixture of pepsine, one grn.
[15 gr.] dissolved in 100–150 grim. distilled water to
which were added 5–10 drops solution hydrochloric acid
and 0.5 grm. common salt. Such mixtures are certainly
inferior in the energy and rapidity of their caustic and
disinfecting action to the natural juice, but they com-
pensate for these deficiencies in the facility of their
obtainment.
--—sº- e <>--— — — —
SCIENTIFFIC NOTES.
UREA FORMED IN THE LIVER,-Next to the forma-
tion of the urea physiologists are most interested in the
place of its formation. Is the urea first made in the
blood, and have the kidneys only to eliminate it? Or
are the kidneys the place where it takes its origin 7 To
solve this contested question N. Gréhant repeated in
C. Bernard's laboratory the following decisive experi-
ments. He extirpated both kidneys of a dog, and found,
after this operation, that the blood contained more urea
than before. The same results followed the placing of
ligatures ºn the ureters. Both experiments proved the
accumulation of urea in the blood.
If the blood of the renal vein and artery of a perfectly
healthy kidney be examined, it will be found that the
venous blood contains less urea than the arterial, which
shows us that some urea is lost during the passage of the
blood through the kidneys. If the two ureters are tied
so that no urea can be eliminated, the blood in the veins
and arteries contains the same per-centage of urea. This
is an indisputable proof that the urea is not formed in
the kidneys, otherwise the venous blood would contain
more urea than the arterial. The great mass of urea in
the blood after the extirpation of the kidneys proves the
same, for if this were not true the production of urea
would cease after the kidneys have been extirpated. To
determine the quantity of urea Gréhant used Millon's
fluid. - . . - -
Induced by the observations of Gréhent, Cyon at-
tempted to prove that urea is produced in the liver.
To this end blood was taken from the carotid of a dog
which had not been narcotized, quickly defibrinized,
and a part of it placed in an apparatus by means of
which, it was to be forced through the liver. These,
tubes were introduced respectively into the vena cava
inferior, arteria hepatica, and vena porta, then the liver
cut out of the body and placed in a vessel heated to the
temperature of the blood. The first tube was connected
with an aspirator, the second and third with the above-
mentioned apparatus, in which the blood was contained.
The circulation of the blood through the liver could be
kept up by means of a connecting tube, which returned
the blood on its arrival in the aspirator into the first
showing that, in this Bº
vessel, from which it could be again forced through the
liver. After the blood had been several times passed
through the liver it showed a greater per-centage of
urea than a like quantity of the active blood of the same
animal. Cyon draws, therefore, the conclusion that the
liver is the place of formation of the urea. He promises,
at the same time, to follow these short communications
with a more elaborate article. (Hr. E. Cyon, “Ueber
Harnstoffbildung in der Leber,” “Centralblat für die
medicinischen Wissenschaften,’ 1870, No. 37.) p. 580.-
Brit. For. Med. Chir. Rev., Jan., 1872. -
– sº-º-º-
E L E G T R o P HY s I o Lo G 10 A.
Being an Attempt to show how Electricity may do
much of what is commonly believed to be
the special work of a vital Principle.
BY
C. B. RADCLIFFE.
[From Nature, Jan. 4, 1872.]
On a white marble slab let into the front of a house
in the Strada Felicº at Bologna is an inscription
house, then this temporary dwell-
ing place, at the beginning of September 1786, Galvani
discovered animal electricity in the dead frog, and hail-
ing this event as the well-spring of wonders for all-ages
(Luigi Galvani in questa casa di Sua temporaria dimora
al primi di Septembre dell' anno 1786, scoperse dalle
morte rane La Ellettricita Animale—Fonte di
maraviglie a tutti secoli). Animal electricity, well
spring of wonders for all ages! Yes, said I, as I copied
these words a few weeks ago, and as I went into the
house repeating them to myself. Yes, still said I, after
seeing what was to be seen within the house. Within
the house, indeed, there was much to excite the imagi-
nation and to make me more ready to accept these
words as the sober utterance of simple truth. Still the
same were the common stairs leading from the open,
outer door to the landing on the first floor, with its two
main doors, one on each side, each one opening to a
distinct set of apartments, in one of which had lived the
discoverer of animal electricity; and the only change
of moment was one which served to call back more
vividly the memorablé past—a portrait in lithograph
of Galvani himself hanging upon the wall facing the
stair-head. Still the same was a third and smaller
door, at which the portrait seemed to be looking, and
beyond which were the stairs leading to the
belvedere on the roof so common in Italian houses here-
abouts. Still the same were these, stairs, the lower
flights of even bricks, the upper of ricketty woodwork,
unmended, scarcely swept, since the time when Galvani
went up and down them afire with the discovery made
FEB. 10, 1872.]
T EEE CT, IISTI c.
65
in the belvedere to which they led. Still the same was
the belvedere itself—the same walls, blank on one side,
pierced on the three others with arched openings, two
at each end, three at the front, each opening being
built up breast-high so as to form the parapet—the same
roof overhead with its bare rafters and tiles—and, run-
ning across, each opening a little below its arched top
and parallel with the parapet, the very same iron bar
upon which the frogs' limbs had been suspended by cop-
per hooks in the experiment to which the inscription
on the slab outside the house refers. So little change
was there, indeed, that, forgetting the present altogether,
I could only think of this experiment in which the ex-
istence of animal electricity was divined, and of those
myriad other experiments to which it had led, and by
which in the end the truth had been made manifest.
So absorbed was I in these thoughts that I even forgot
to look through the open arches of the belvedere at the
blue Italian sky and other beauties of the prospect.
And when at length I came down, I was more than
ever in the mind to assent unhesitatingly to the words,
“la elletricita animale, fonte di maraviglie a tutti secoli”
—more than ever convinced that animal electricity
would prove to be the key by which to unlock not a
few of the secrets which are supposed to be exclusively
in the keeping of life—more than ever resolved still to
go on seeking for truth in the path along which I was
urged to go by this conviction.
Nor was I long at a loss how to begin to carry out
this resolntion. I wanted to reiterate briefly and more
clearly some of the things which I had said before
respecting animal electricity, and the way in which
this force may do a work ascribed to life in muscular
action and nervous action; and at the same time to
make use of certain new facts which were not a little
calculated to confirm former conclusions. I wanted to
show that the same workings of animal electricity may
be detected in the condition called tone, and even in
growth, and that these processes, no less than muscular
action and nervous action, may have to be looked upon
as electrical rather than as vital manifestations. A
natural way of carrying out the resolution I had formed
was, indeed, to do the work ready for me; and therefore
the task I have now set myself is to do this work, begin-
ning with an attempt to set forth a new theory of
animal electricity, and then proceeding to say some-
thing in turn on the way in which this theory sheds
light upon muscular action, nervous action, the mainten-
ance of the state called tone, and the process of growth
in cells and certain fibres—something calculated to
show that in each of these cases animal electricity may
have to do much of what is commonly believed to be
the work of a vital principle.
1. On a theory of animal electricity which seems to arise
*aturally out of the facts.
A Current, to which the name of muscle-current is
§lven, may easily be detected in living muscle. It may
be detected by applying the electrodes of the galvanom-
eter, the one to the surface made up of the sides of the
fibres, the other to that made up of either one of the
two ends of the fibres, and also, though much less
clearly, by examining either of these two surfaces singly,
provided only the two points to which the electrodes
are applied are at unequal distances from the central
point of the surface. It may not be detected, if, instead
of applying them in this manner, the electrodes are
applied so as to connect either the two surfaces made up
of the ends of the fibres, or two points equidistant from
the central point of the surface made up of the sides, or
of that formed by either one of the ends of these fibres.
A current may or may not be detected under such cir-
cumstances, and when it is detected its direction is such
as to show that the surface made up of the sides of the
fibre is positive in relation to that made up of either
one of the two ends, and that the former surface is more
positive and the latter more negative as the distance in-
creases from the line of junction between these two sur-
faces. In this way the galvanometer makes known the
existence of points of similar and dissimilar electric
tension in living muscle; and the only inference from
the facts would seem to be that there is a curreat when
the electrodes are applied so as to bring together points
of dissimilar tension, but not othelwise. The facts are
not to be questioned. The inferences arising from them
can scarcely be mistaken.
This current is to be detected in living muscle, but
not in muscle which has passed into the state of rigor
mortis. As muscle loses its “irritability,” indeed, it
ceases to act upon the galvanometer, and no trace of the
current is to be met with after the establishment of
rigor mortis. As a rule, too, nothing is to be noticed
except a gradual failure of current ; bnt now and then
(though not in the frog) there may be a reversal in di-
rection in the last moments preceding this final disap-
pearance. * * * * *
These, then, are the facts which may be looked upon
as fundamental. There are the facts brought to light
by Du Bois-Reymond through the instrumentality of
the galvanometer—the muscle-current, present in living
muscle during the state of rest, suddenly disappearing
wben the state of rest changes for that of action, grad-
ually disappearing as muscle loses its “irritably,” and
absent altogether in rigor mortis; there are the facts
which I myself have been able to make out for the first
time by means of the wonderfully sensitive new quadrant
electrometer of Sir William Thompson—the two op-
posite charges of electricity, one positive, the other neg-
ative, present in living-muscle during the state of rest,
disappearing suddenly when this state changes for that
of action, gradually disappearing before, and altogether
absent in rigor mortis. And this is all that need be
said upon this subject at present.
And as in muscular so in nerve tissue, there is the
current, in this case called the nerve-current, and there
are the two opposite charges, positive and negative, this
66
[FEB. 10, 1872.
TIEEI IEH C T , T: INT I. C.
current and these charges being present during life, dis-
appearing suddenly when the state of rest changes for
that of action, disappearing gradually pari passw with
the “irritability,” and absent altogether at the time
when rigor mortis seized upon the muscles; and in
truth every particular in the electrical history of the
muscle is repeated with strict exactness in the electrical
history of the nerve.
In these two tissues, muscle and nerve, there is no
difficulty in arriving at a knowledge of these facts; in
other tissues, indeed, all that can be said is that faint
indications of electricity are to be detected during life
only, and that in Some of the fibrous structures there
are differences between the surface made up of the sides
of the fibres and that made up by either one of the two
ends, which correspond to those met with in muscle
and nerve. -
These then being the fundamental points in the his-
tory of animal electricity, the question is as to their
meaning. To what theory do they point?
In order to account for this muscle-current and nerve-
current, Dr Du Bois-Reymond supposes that the muscle-
fibre and nerve-fibre (the same law applies absolutely to
both) are made up of what he calls peripolar molecules
—of molecules, that is to say, which are (with the ex-
ception of certain moments in which these electric rela-
tions may be revresed) negative at the two poles and
positive in the equatorial belt between those poles. He
supposes that the sides of the fibres are positive because
the positive equatorial belts are turned in this direction,
and that the two ends are negative because the negative
poles of the molecules face downwards to the ends. He
supposed also that the muscle-current and nerve-current
are merely the out-flowings of infinitely stronger
currents ever circulating, closed around the peripolar
molecules of the muscle and nerve respectively. And
this view no doubt has much to recommend it.
But another view may be taken of this matter—a
view according to which this electrical condition of
living muscle and nerve during rest is, not current, but
static; and this view is that which recommends itself
to my mind as in every way more simple, more compre-
hensive, and more to the point practically.
In taking this view the great resistance of the animal
tissues to electrical conduction serves as the starting
point. I assume that parts of these tissues may be bad
enough conductors to allow them to act as dielectrics.
I assume that the parts which are thus capable of act-
ing as dielectrics are the sheaths of the fibres in muscle
and nerve, or the cell-membrane of the contractile cells
of those fibres in muscle which have no proper sheath.
I assume that a charge, usually the negative, may
originate in the molecular reactions of the contents of
the sheath or cell-membrane, and that this charge, act-
ing upon the inner surface of the sheath or cell-mem-
brane, may induce the opposite charge upon the outer
surface of the sheath or cell-membrane, and that in this
way the sheath or cell-membrane during rest is virtually
a charged Leyden-jar. I assume this charge is dis-
charged when the state of rest changes for that of action.
I assume that the surface made up of the sides of the
fibres in muscle and nerve is positive because positive
electricity has been induced upon this surface, and that
the surface made up of either cut-end of the fibre is
negative, because the negative electricity, developed
upon the inner surface of the sheath or cell-membrane,
is conducted to these ends by the contents of the sheath
or cell. -
All that I assume, indeed, may be readily illustrated
upon a small cylinder of wood, left bare at its two ends,
and having its sides covered with a coating which may
be charged as a Leyden-jar is charged—a threefold
coating, formed of an inner and outer layer of tinfoil,
with an intermediate layer of gutta-perchasheeting, the
latter layer projecting a little towards the two ends of
the cylinder, so as to secure the necessary insulation of
the inner and outer metallic surfaces; for by charging
the inner layer of foil with negative electricity, this
cylinder, which may be regarded as a model of muscular
fibre, is found to be, not only positive at the sides and
negative at the two ends, but more positive at the sides
and more negative at each end as the distance increases
from the line of junction between the sides and ends.
With this model thus charged, indeed, it is easy to im-
itate all the phenomena of the nerve-current and muscle-
current, provided the electrodes of the galvanometer be
applied in a suitable manner, and the charge be kept up.
With this model thus charged, it is also easy to imitate
all the tensional phenomena of nerve and muscle which
are made known by the electrometer. And thus the
nerve-current and muscle-current, instead of being out-
flowings of infinitely stronger currents ever circulating
around peripolar molecules, may be secondary phenom-
ena only, the accidental result of dissimilar electric
tension upon the surface of the fibres of muscle
and nerve being brought into relation by means of the
galvanometer or the electro-meter, as the case may
be. X % + 3 +
These, then, being the facts, it was evidently useless
to go on searching for any numbers which could express
anything like a common mean of resistance. It was
evident, indeed, that the Soft tissues, one and all, apart
from moisture, were to be looked upon as insulators,
rather than as conductors. Nay, it was possible that
they might be insulators rather than conductors even in
the fresh state; for it is quite supposable that in this
fresh state the walls of the fibres and cells forming these
tissues may be virtually dry, with moisture on each
side, not with moisture percolating from side to side,
and that the degree of resistance presented by these
tissues, when fresh, is not that which would be encoun-
tered if the current passed across these walls, but that
which is encountered by the current in passing along
their outer moistened surface. It is quite supposable.
that the measuring current may not pass across the walls
of the cells and fibres at all, but may glide over and
FEB, 10, 1872.]
TIH. H. cI, IISTI c.
67
between them only. All this is supposable; and there-
fore, the facts being as they are, I am, as I conceive, at
liberty to assume that the walls of fibres and cells are
sufficiently non-conducting to justify me in adopting
the theory which I have ventured to propose—a theory,
according to which, the electrical condition of muscle
and nerve during rest is, not current, but static—the
sheath of the fibre, or membrane, taking its place,
being always charged as a Leyden-jar is charged, except
during the time of action when there is a discharge of
this charge—a theory which, to say the least, has a less
visionary foundation than that which rests on peripolar
molecules seeing that it rests upon structural facts
which cannot be called in question—a theory also which,
as will be seen in due time, has this in its favor, that
it will simplify not a little several important problems
in physiology. - -
—sº-º-º-
MIE OLEGAL NEWS.
THE OLDEST MEDICAL WORK IN EXISTENCE.-An
Egyptian papyrus, written in the days of Cheops, the
monarch of the Fourth Dynasty, has recently been pre-
sented to the British Museum by the Royal Institution.
It is 7 feet 6inches long by 7 inches wide. Its contents are
a series of recipes or modes of cure for different maladies,
unaccompanied by any diagnosis or account of the dis-
ease itself. Among the drugs mentioned are wax, fat,
and incense. One remedy is for hemorhage from the
head and other parts of the body, shavings or twigs of
acacia, grains of a substance called kašpr, to be burnt;
also milk, branches of olive, the hair of a cat, and honey.
Many of the recipes date from an early period, as that
of Amenophis III. of the eighteenth century.—Com-
pendium of Medical Science.
PLAGUE IN BOMBAY.—In the native State of
Rolapore in the Bombay Presidency sheep suffered from
a strange form of animal plague. This consists of a
swarm of unusually voracious leeches. Besides this the
Wolves were out, carrying off children, invalids, and the
aged in the exposed villages.
HEELs vs. BRAINS.–To show how very tenacious
ladies are on this point, last year I was sent for to see a
young lady in one of our London hotels. She wished
to consult me about her foot. On Seeing it, I thought
its state depended on her boots, and I asked to see them,
The boots were brought in by the lady's maid, but the
only thing I could observe about them was an im-
mensely high heel. I said, ‘It is the high heel of your
boots that causes the mischief, and unless you diminish
this I can do nothing for you.” She became quite angry,
and said she could not alter them: ‘I cannot do it, and
I will not.” Suddenly she toned down, and said, ‘Pray,
sir, what would people say if they saw me walking
about the Park without high heels?' I said, ‘It is sim-
ply heels versus brains. If you have brains, you will
cut off the heels; if you have no brains, you will con-
tinue to wear them.” She fortunately had brains, cut
off the heels, and her foot got quite well.—Hewett—
Phil. Times, Feb. 1772.
THE HOP PILLow.—During the illness of the Prince
of Wales, when all other remedies failed to produce a
Soporific effect, the old-fashioned hop pillow was placed
under his head and quiet sleep followed.
THE AMERICAN MOTHER GROWING LESS PROLIFIC.
—Dr. Toner of Washington, D. C., the statistician, in
his diagram shows that what is held up as the peculiar
shame of Massachusetts is equally true of all her sister
States. It is shown that only one-half as many children
are now born to each thousand women as in 1800, and
that there has been a regular decrease from one decade
of years to another.
—-º-º-º-
CORRESPONDENCE.
How Professors are Appointed in Germany.
It cannot but seem surprising that the appointment
of a man so widely and favorably known as Frerichs is
should have called forth So outspoken an opposition;
and one can only find in this incident another illustra-
tion of the maxim that, in appointments such as this,
and in the election of university professors, no other
consideration but that of efficiency is to have any weight.
Another illustration of the same thing is to be found in
the circumstance connected with the election or a suc-
cessor to Oppolzer at Vienna, where a great clinical
professorship has been standing vacant; and, though
this delay points to a conflict of interest, it also betokens
clearly enough a high sense of responsibility impressed
upon those who have the patronage. From the oppo-
sition that they have excited, both the Frerichs affair
and the appointment at Vienna may be regarded as
exceptions of the kind that prove the rule; and they at
the same time prove clearly enough that, if in Germany
the best man is usually chosen for the post, the cause of
this is not, as has been alleged, that the patronage is
exercised by a Minister of State. It is hardly an exag-
eration to say that the man who is best entitled to this
or that vacant professorship in science or in medicine
can be pointed to in much the same way as at Cam-
bridge one may hear who is to be the first wrangler on
the next occasion. In both cases, the antecedents of the
individual—the work that he has done—are freely can-
vassed; and they constitute the reliable data to judge
by. The whole system of study at a German University
is calculated to bring the able and zealous workers in
any department into the clearest prominence. A stu-
dent, as he advances in his studies, develops a talent
for this or that particular branch, which he is at liberty
to follow out unrestricted. He enters a laboratory, and
68
[FEB. 10, 1872.
TIEEE THE CIT, ITNT I. C.
there undergoes a course of training ; and, when he has
passed his professional examination, if he have a mind,
he is encouraged to resume his work in the laboratory;
and in course of time he completes some original re-
search, as in physiology or pathology. Then, if he have
shown himself a capable worker, he gets the next vacant
assistantship; and if, as an assistant, he do not in the
course of a year or two make some considerable contri-
butions to the researches in his department, he is looked
upon as falling short of his duties, and he will probably
lack advancement. If, however, as is usually the case,
he avail himself of his many opportunities, and under-
takes researches to clear up this or the other doubtful
point, he becomes favorably known to the scientific world;
and in due time, and while he is yet a young man, he is
rewarded with a professorship. And so, within a very
few years, the Pathological Institute at Berlin has fur-
nished from its assistants no fewer than five professors
to various universities. These are Hoppe Seyler, Von
Recklinghausen, Klebs, Kühne, and Cohnheim ; and
the important work that these men have done testifies
to the excellence of the system in which they were
trained, and according to which they were promoted.
Another series of names, though perhaps not so remark-
able, could be furnished from the annals of the Physi-
ological Institute; and indeed, there is hardly a great
laboratory or a great clinique in Germany but can point
to similar instances. Again, there are the docenten or
lecturers, who reach their position through the same
steps as the assistants, and who may have been assistants
also. From them, too, the professors are chosen,
although this is more the case in the non-medical
faculties.
Thus it will appear that efficiency in professorial
chairs is secured, more than anything else, by the com-
pletely organised system in which the rising generation
of scientific workers are trained. When an appoint-
ment comes to be made, it is usually done very quietly
and to the general satisfaction. The other professors of
the faculty in which the vacancy has occurred, agree
upon some name, which they submit to the education
minister. It does not appear that the professors have an
actual privilege in this matter, but no doubt their rec-
ommendatoin is invited, and is seldom or never set
aside. The assistant or docent who has been thus nom-
inated, “receives a call” to the professorship, and
departs to take charge of an institute, or laboratory, or
clinic of his own. He has not canvassed heaven and
carth for testimonials; the custom is not known in
Germany; and when a German savant receives a letter
from foreign parts, requesting him to certify to what he
can about his foreign confrère he is as much puzzled as
if the request had been for a lock of his hair; he has
not issued a bulky volume of those monotonous docu-
ments translated from every language under the sun,
and gathered together from the remotest corners of the
educated world—the more remote the better. He
finds, however that his qualifications are known with-
out any effort on his part; and those who have nomi-
nated him are content to rely on the long and testing
apprenticeship which he has served to his special study.
In other countries, again, it sometimes happens that
natural, or even hereditary, genius is the only thing
that can be appealed to.—Brit. Med. Journ., Dec. 30, 71.
—-º-e-º-
, –, Jan. 25, 1872.
EDS. CLINIC :
I have received several numbers of “THE CLINIC” in
regular succession during the present month. As the
first two contained a paper by Dr. , I thought
they were sent by him. Two other numbers have come
to hand with marks of being sent from the office of pub-
lication. If they are sent from the office of publication
with the design of making me an involuntary subscriber,
pray, please excuse me. I buy and pay for sundry
medical periodicals, home and foreign, and really do not
desire to increase my expenditures in that direction.
If the copy forwarded is intended as complimentary, or
to solicit contributions to its pages from myself, that is
quite a different matter. Writing out of customary
channels of thought and observation, my papers cost
me much labor, for it is difficult—exceedingly difficult,
I find, to overcome early educational influnces; and so,
not get myself confused in writing up life from its facts.
The hypotheses, assumptions, traditions, etc., now in
use are exceedingly convenient to avoid study. Nev-
ertheless, I think I could promise you at least one, but
not more than two articles per year. More than that
would be accidental and supplemental or exigetic.
With this explanation of my wishes in the matter,
you can either discontinue The Clinic coming to my ad-
dress, if it comes from the office of publication, or con-
tinue it, as you please. If it is continued I will regard
it as complimentary, and in due time offer a paper for
publication in its pages.
Very Truly,
The publishers were interviewed forthwith. The
transmission of THE CLINIC to the above address is
discontinued. -
—º-e-Gº-
I REVIEWS.
THE PRINCIPLES AND PRACTICE of SURGERY. By
John Ashhurst, Jr., M. D. Philadelphia, Henry
C. Lea. 1871.-pp. IO11—Cloth $6 50, Leather $7 50.
Cincinnati, Robert Clarke & Co.
Leaving out of consideration the masterly work by
Prof. Gross, and the very valuable collection of surgical
monographs published under the general title of “Holmes
System of Surgery,” the works most prominently
brought to the notice of our general practitioners and
students, during the past ten years, have been those of
Druitt and Erichsen. Until the lately issued edition of
FEB. 10, 1872.]
TIEEE IEH C T , T N T C .
69
the latter edited by Ashhurst of Philadelphia, the Amer-
ican reprints of Druitt and Erichsen did not represent,
either the actual state of scientific knowledge, or the
improvements made in the later English editions of the
works themselves. Following close upon his labors as
American editor of Erichsen, Dr. Ashhurst has given
to the profession a work of his own, in the preparation
of which he has evidently availed himself of the recent
contributions to surgery made by English and Continen-
tal writers, of the labors of American surgeons, and of
the clinical advantages afforded him by his position as
surgeon to the Episcopal and Childrens' Hospitals in
Philadelphia, and U. S. Army Hospitals during the
late war. Of the forty-seven chapters into which the
work is divided, two are occupied with “Inflammation,”
its nature and treatment; two with “Operations in
General and Minor Surgery;” two with “Amputations;”
thirteen with “Surgical Injuries,” of vessels, nerves
muscles, bones, joints and special regions; and the
remainder with “Surgical Diseases,” local and general.
The chapters upon “inflammation” are of special interest
and value, particularly to students, from the fact that
they present clearly, and with marked brevity, the
pathological views at present entertained, without
dogmatically pronouncing a decisive opinion upon ques-
tions yet unsettled. For example, with reference to the
vexed question of the origin of the pus corpuscle, the
author says, “It is even more difficult to speak positively
of the origin of the pus cell than of that of the lymph
corpuscle. In many cases (as in abscesses) the former
seems to originate directly from the latter by a simple
liquefaction of the gelatinous intercellular substance of
lymph; but in other instances the pus cell appears to
have a different source. Virchow and other observers
believe that pus corpuscles originate from rapid prolif-
eration (luxuriation) of connective-tissue and other
nucleated cells; while Cohnheim on the other hand
maintains that the sole origin of the pus corpuscle is
the migration by amoeboid movements of the white
blood-corpuscle through the vascular walls. Finally
Dr. Stricker and his co-laborers, while acknowledging
the origin of pus cells from both these sources, have
shown that the pus corpuscles themselves divide and
multiply, and that in profuse Suppurations this is prob-
ably the chief mode of pus formation.” In the chapter
upon “operations in general,” in reference to anaesthetics,
We find the following remarks which are as true as they
are worthy of careful remembrance, “It is to be feared
that students and young practitioners often get a false
impression upon this point, and from seeing the fre-
Quency and apparent profusion with which anaesthetics
are administered by their clinical teachers, derive a
notion that these agents are perfectly harmless, and
may be indiscriminately resorted to under all circum-
stances. The true rule upon this matter, (a rule which
is indeed applicable to all our perturbing modes of
treatment), is, that when anaesthetics are not positively
beneficial they are injurious. Hence under ordinary
circumstances, they should not, I think, be employed
except for really important operations, and those which
without their use would be tedious and painful.” As
respects the choice between the various anaesthetic
agents, the author expresses a preference for ether in a
very large majority of cases; a preference certainly
not shared by the greater number of surgeons; although
it must be confessed that the rapidly increasing list of
deaths from the administration of chloroform, is causing
many an operator to question the propriety of contin-
uing the use of his hitherto favorite anaesthetic agent.
The relative merits of the different methods of ampu-
tating are thus put by Dr. Ashhurst, “If any general
rule were to be given, I should say that the circular in-
cision or Teale's method gives the best stumps in the
fore-arm, the modified-circular in the upper arm and
the upper part of the thigh, the common double flap
operation immediately above and below the knee, the
circular or lateral flap in the lower part of the leg, and
the oval operation at the joints.” In this opinion we
would most heartily concur, and we are satisfied that
there exists, particularly among many civil surgeons,
an unjust prejudice against the circular or modified-
circular operation. Our author is evidently not very
strongly inclined to favor the special antiseptic treat-
ment, which has of late attracted so much attention.
“As has already been said, the merits of the antiseptic
method cannot yet be considered as positively determ-
ined. Failure on the part of other surgeons to attain
the expected results, is attributed by the advocates of
the plan to some mistake or neglect in the application ;
and such may doubtless be the case. But it is obvious
that any mode of treatment which is so intricate and
complicated as to elude the skill of such excellent sur-
geons as have failed with the antiseptic dressing, is not
likely ever to be adopted for general employment.”
We are inclined to think that it is not the intricacy nor
complicated nature of the antiseptic dressing that
causes the frequent failure in the hands of different
surgeons, so much as want of care in the application
and unwillingness to devote the time required for such
application. So far as our own observation has gone,
what is commonly denominated antiseptic dressing, is
in no respect a dressing that excludes all undisinfected
air from the wound under treatment, in other words,
is not the antiseptic dressing at all. Thirty-eight pages
are devoted to the consideration of “venereal diseases”
which our author considers as three in number, “gon-
orrhoea, chancroid, and syphilis.” The unity of the
latter affections is claimed by but few writers of the
present day, though their diversity is as Dr. Ashhurst
says, “even now denied by a good many surgeons, and
is practically ignored by a still larger number.” The
major part of the book, of course, is devoted to the con-
sideration of local diseases and injuries, special refer-
ences to which cannot be made within the limits of a
review of this character. The work is illustrated with
533 wood engravings, very many of which might have
70
[FEB. 10, 1872.
TIEEI IET: C T II INTI C.
been omitted without impairing in the least its value.
Some of them are old friends, whose faces however
have been seen so often and in so many different Works
that we really begin to tire of them, friends though
they are. One engraving indeed we notice upside
down. We fear that some unfortunate student will ac-
quire from it rather a queer idea of Bronchocele, and
the position and relations of the larynx, trachea, and
thyroid gland. Notwithstanding, however such little
imperfections, “Ashhurst's Surgery” is of decided value,
and better adapted to the wants of students and general
practitioners than any other work of its size that has of
late appeared. American surgery owes its thanks to
Dr. Ashhurst for his very creditable contribution to the
professional literature of the country; a contribution
in which he has not failed to make due recognition of
the labors of his fellow workers on this side of the At-
lantic; and these fellow workers will have frequent oc-
casion to avail themselves of the numerous statistical
tables which he has elaborated and incorporated in the
present volume. That the work is issued by Henry C.
Lea is a sufficient guarantee of its typographical
merits. -
PULMONARY CONSUMPTION. By James Henry Ben-
net, M. D. For Sale by Robert Clarke & Co.
The first edition of this monograph was published in
1866, and was then entirely clinical; it was chiefly de-
voted to proving the superiority of the “Hygienic or
Sthenic method” of treatment over the old antiphlogistic
plan. The progress of medicine now renders this no
longer a question for discussion, but the rise and pro-
gress of Virchow's doctrine of the inflammatory origin
of pulmonary consumption allows the author to review
simply the histology of this disease.
This new doctrine of neoplastic growths is set aside
and the old theory of tubercular origin is adhered to,
with the conclusion that age and experience sustains the
latter, while “on the other hand, most of the followers of
the new ‘inflammation doctrines' are young, enthusiastic
physicians full of knowledge but insufficient in ex-
perience.”
Whether the deposit be tubercular or inflammatory
it is merely the evidence of exhausted vitality and gen-
eral bodily decay. Such a condition cannot be remedied
by medicine; it can only be the “handmaiden” of phys-
iology. The author shows from his own personal (he
having been a sufferer from this disease) and observed
experience, that this condition is curable, and in some
cases self limiting, as is evidenced by the old cicatrices
found in the lungs in post-mortems of patients who have
died from other causes.
Whatever objections might be made to the histology
of the author, his conclusions in regard to bodily hy-
giene, climate, and medical treatment of this disease are
sound and represent the views of modern science on this
point,
TRAITEY DES MALADIES DU FOND DE L'OEIL ET ATLAS
D’OPHTHALMOSCOPIE, PAR L. de Wecker et E. de
Jaeger.
(A treatise on disease of the bottom of the eye and an
ophthalmoscopic atlas).
The descriptions are given in Wecker's splendid style
and the ophthalmoscopic figures in illustration need no
COmment.
AN Ophthalmological Encyclopedia is to be brought
out under the editorship of Profs. Saemisch (of Bonn)
and Alfred Graefe (of Halle). They will be assisted by
various well known professors and doctors. The work
will be divided into two parts.
1.—Anatomo-physiological.
2.—Pathological. -
The entire work is to be completed by 1874.
CONSUMPTION, ITS PATHOLOGY AND TREATMENT,
by Wade Minor Logan, M. D. S. W. Butler, Phil-
adelphia, 1871.
This little monograph begins with a pleasant preface.
“My object in offering this little work “ ” * is simply
to afford the results of some observations made, etc.; ”
modest, unassuming, preposessing at once.
But the text and preface differ materially. To
such degree, indeed, as to recall a criticism men-
tioned in Forster's Life of Goldsmith. ; “To seek to con-
nect the preface in any way with the work prefaced
would be generally labor in vain. The moral of it is in
a remark of Johnson's when Boswell, admiring greatly
his preface to Rolt's Dictionary of Trade and Commerce,
asked him whether he knew much of Rolt and of his
work, “Sir,” said Johnson, “I never saw the man and
never read the book. The booksellers wanted a Preface
to a Dictionary of Trade and Commerce, I knew very
well what such a Dictionary should be and I wrote a
Preface accordingly.” -
Any one in the least familiar with the history of the
literature of this subject must have been astounded at
the claim of originality in its treatment by nitric acid.
It is a presumption little short of effrontery, moreover,
to parade as new at this period of our century views in
pathology which were exploded long before the century
was born. • * -
While it is true therefore of the book that it is an
ancient idea, backed chiefly by antediluvian authority
it is true of its author that the work represents an
honest effort which is in every sense worthy of encour-
agement. There is this dogged striving after personal
advancement manifested throughout the book, and as
every kind of work conduces to this end the author has
already succeeded in raising himself out of the mire of
indolence and sloth. If he will only advance in the
path he has thus struck out for himself the continued
progress of the pilgrim is secure.
FEB, 10, 1872.]
T H E CIT, ITNTI C.
71
CILINICAL MEMORANDA.
Electricity in the Treatment of Tumors.
BY
PROF. BENEDIKT.
Transactions of the Vienna Medical Society, Dec. 31, ’71.
Above all things is to be emphasized the progress in
the technics of electricity in the treatment of tumors.
This consists on the one hand, in the fact that instead
of simple cutaneous application, acupuncture needles
are in most general use, and this, not only by the uni-
polar, but also by the bipolar method; further there is
attached to each pole a whole series of needles instead of
but a few as formerly. On the other hand, progress is
attained by prolonging the duration of the current, and
further by employing the different kinds of batteries, as
for instance, besides that of Siemens', also those of stronger
chemical action as the lead-zinc battery of Frommhold.
The speaker exhibits a carbon-zinc battery whose inten-
sity can be varied by the amount of fluid present. The
most useful fluids are solutions of bichromate of potash
and sulphuric acid (1:15). In inflammatory swellings,
particularly of the joints, the cutaneous application is
preferred. It is to be mentioned, however, that the
current is not always to be applied directly to the in-
flammatory swelling; the desired effect may also be at-
tained indirectly through excitation of the nerves as of
the sympathetic, of the spinal cord, of the nerve trunks,
etc. For direct applications the Faradic current may
also, under proper circumstances, be applied.
Fluid accumulations, as sequelae of inflammations,
cysts and collections in the various cavities are best
treated by acupuncture and Siemens' elements.
Barns has stated, however, good effects may be obtained
in hydrocele by acupuncture alone. As a matter of in-
terest, it is stated that hydatids of the liver have been
repeatedly treated successfully by galvanism in the
London hospitals.
The application of the constant current is perhaps of
the greatest value in hemorrhagic tumors. Angioma
of all sizes are treated with the best results, usually,
indeed, in a single session. The best form of electricity
is that which furnishes medium quantity as in the bat-
tery of the speaker. The needles of the positive pole
are inserted and the other pole is either applied cutane-
ously by means of a sponge, or a few negative needles
are also introduced. It is essential to perforate at the
base of the tumor. It may be mentioned here that
“Very arterial hemorrhage produced by the needles or
by any other cause may be instantly checked by the
insertion of the needles connected with the positive
pole. This method of arresting hemorrhage is of great-
est value in bleeding after trauma, as it is often much
* to check it in this way than to find a surgeon to
the negative pole.
As.
ligate the bleeding vessels. The treatment of aneurisms
by electro-puncture has also been materially advanced
by the perfections in technic. There has always been
fear that the acupuncture needle would open a channel
of passage from the aneurism to the surrounding parts.
Experience has shown this to be a theoretical objection
only. With what impunity an acupuncture needle may
|be penetrated into the depths of the body is evidenced
in a case of fibroma uteri treated by the speaker, by
means of long needles pushed through the abdominal
walls; not the least reaction ensued along the canal of
passage. The best battery for the treatment of aneurisms
is that which, in quantity, is between the Siemens' and
the galvano-caustic battery. The most efficient treat-
ment is to plunge a series of needles, connected with
the positive pole directly into the aneurismal sac. In
general it may be stated, however, that the positive
pole softens and liquefies, the negative clots and hardens,
so that the former acts like caustic alkalies, the latter
like the acids.
In lymphatic tumors, i. e., swellings of the glands, the
best method is the cutaneous application with Siemens'
elements, or the acupuncture needlesin connection with
Under this treatment, depressions
are produced in the tumor, it is broken up, in other
words, into smaller tumors and gradually total dissolu-
tion is effected. The stronger chemical batteries are apt
to cause ulceration and suppuration, and are, therefore,
to be avoided.
Chvostek has obtained excellent results in the treat-
ment of indolent buboes. Numerous observations con-
firm the benefits of this treatment in strumous swell-
ings. The cutaneous application is often sufficient here.
In many cases, most especially in cystic goitre, acu-
puncture should be practiced in the same way as in
glandular swellings. In that form of struma known as
Morbus Basedowii, diminution of the swelling is obtained
by galvanizing the sympathetic. The good results here
are not to be referred to direct effects of the current as
they are manifest after relatively feeble currents of
short duration. In the treatment of neoplasms Prof. Groh,
of Olmütz, deserves, according to Althaus, particular
mention as many of theimprovements in technic are of his
device. Benign tumors are much easier dissipated when
the base is brought into a condition of necrosis and mor-
tification. In carcinoma it is necessary to operate with
the strongest currents of an hour or longer duration.
To effect this the patient must be narcotized, as by
morphia hypodermically. If feeble currents of short
duration be used the growth of the tumor is stimulated;
it increases then more rapidly than it is destroyed. The
speaker has arrived at this conclusion from his own ex-
perience and this conclusion has been confirmed, recently
by others—that electrical excitation may stimulate these
neoplasms to more rapid growth. Neftel of New York
created quite a Sensation with his statement that he had
cured a cancerous tumor of the size of an orrange and
dissipated the cancerous cachexia in a few sessions. This
72
[FEB. 10, 1872.
THE CLINT c.
case is to be regarded as a remarkable exception to the
rule as his patient seems to have been able to endure a
great number of Siemens' elements without narcosis,
what is certainly not usually the case. The unhealthy
appearance of a patient is surely not always to be
considered a cancerous cachexia. Neftel's method must
be regarded as insufficient for most cases as in the first
place so many elements can not be borne without nar-
cosis, and in the Second place, unipolar puncture is sel-
dom enough; the Siemens' elements further are not
emergetic enough in effecting destruction.
By means of the method above described Groh has
cured thirteen of seventeen cases, several in a single
session. . Groh has also cured two benign neoplasms of
considerable size and one carcinoma of hazel-nut size by
means of frequent applications, of several hours dura-
tion, of weak currents of the Daniel's battery. The
great advantage of electricity in the treatment of cancer
is the total absence of loss of blood and of all reactionary
manifestations. Moreover electrolysis may be further
applied in situations where the knife would be danger-
ous or when there would be risk of opening internal
cavities. Whether treatment by electrolysis is more
exempt from recurrence of the disease than treatment
by operative proceedure is a question still subjudice.
The experiments of Tripier and Malez in the treat-
ment of strictures created at the time no little sensation.
They effected cure in a whole series of cases very rapidly,
often in a single session of but few minutes duration. |
They used the Siemens' elements with a covered catheter
connected with the negative pole and brought into con-
tact with the cicatrix.
Less favorable was the experience of Couriard, of St.
Petersburg, who lost one case from pyaemia resulting
from this treatment. The speaker has not had the op-
portunity of collecting results in the treatment of cases
of cicatrices in general or in special of strictures of the
urethra. At least it must be said that this method of
their treatment is not without danger, as the urethral
wall may easily be severely cauterized; strong currents,
therefore, are to be avoided.
—-º-º-º-
I HOMHE NEWS.
*
The Commencement Exercises will be held on Friday
Evening March 1st. Ninety-one Candidates have
registered for examination. -
A bandaging contest was held at the Good Samaritan
last week for a prize of a complete case of Surgical in-
struments offered by Prof. Dawson. Eleven contest-
ants entered the lists. Drs. Mussey, Juler and Dandridge
were appointed referees. The general excellence
displayed is best exemplified by the fact that the jury
were unable to decide between five students, Messrs.
Brown, Blackstone, Plummer, Lyle and Lockhart.
Lots were drawn and the laurel fell upon the brow of
Mr. T. Blackstone of Bainbridge, Ross Co. Ohio.
Medical CoHHege of Ohio.
SPRING c 0 U R S E.
The regular eight weeks course of practical instruc-
tion for the Spring of 1872 commences March 15. Un-
usual advantages are offered this year in the fact that
the course will be conducted by the entire Faculty of the
College. - -
The course will embrace the following topics:
Clinical Medicine—Bartholow.
“ Surgery—Dawson.
Anatomy Brain and Nervous System—Gobrecht.
Operative Surgery—Conner.
“ Obstetrics—Reamy.
“ Ophthalmology—Seely.
Female Pelvic Surgery—Palmer.
TJrinalysis—Nickles.
Physical Diagnosis—Cleveland.
Fractures and Dislocations—Kearns.
Genito-Urin. Dis.—Anderson.
Microscropy—Whittaker.
Prof. Graham will deliver occasional lectures on Clin-
ical Medicine and Diseases of the Chest during the pro
gress of the Course.
The design of the Course is to present instruction in
a thoroughly practical manner. Physical Diagnosis is
to be demonstrated in the hospital wards; Operative
Surgery, Operative Obstetrics, Operative Ophthalmology,
and Operative Gynaecology on the cadaver. -
The Dissecting Room will be under the supervision of
Dr. where abundant material will be provided.
Special attention will be paid to the chemical and mi-
croscopical analysis of morbid urine.
In order to render this course the most practical pos-
sible, an opportunity will be afforded each individual of
the class to make the various examinations and opera-
tions on the living and dead subjects. Regular daily
Medical and Surgical Clinics will be held at the
Good Samaritan Hospital: Two Daily Clinics will be
regularly held in the Cincinnati Hospital, throughout the
entire course; and a Daily Clinic will be held at the
Dispensary of the Medical College of Ohio.
One hour each evening will be devoted to Recitations
on Anatomy, Physiology, Practice, Surgery, Obstetrics,
and Materia Medica.
The eminently praetical nature of this course, and its
shortness of duration, together with the great clinical
advantages presented in Cincinnati, can but commend
themselves favorably to the practitioner as well as the
student. -
FEES FOR THE ENTIRE CourSE, $10
As this Course does not count towards graduation,
being considered supplemental to the regular winter
course, graduates of the College are not required to
matriculate. The matriculation of non-graduates is
deducted from the fees of the ensuing winter session.
:- F. E. SUIR F. - E. S. WAYNE
IET. THX. Suire & Co.,
WHOLESALE DRUGGDSTS,
M. A.IN UFA CTU. R.I.N. G.
pHEMists AND PHARMAceutists,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
sye), Ecºexex, Yoº J Gºs ANOO woex,xc)(N)es,
cºery)(XCA), Alex’AkkAºcus,
TESTs, MEDICAL, GLAss warE, &c, &c.,
And solicits the patronage of the trade and profession.
we would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
ti Made in accordance with the U. S. P. and other recognized authori-
ÇS. - -
ETINIFD AND EARH, CHEMICALs,
Of the popular class of preparations known as
II, T, IIXIII, s,
We manufacture a full line. Those of our make may be relied 5pon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c.
AGENTS FOR BULLock & CRENSHAw's
Sugar-coated Pills and Granules.
) -
* Lists of preparations and of Sugar-coated Pills sent by Mail
wºn *PPication. The long standing and well and widely known repu-
*tion of our house we offer as a guarantee for the reliability of our
**on, and the quality of the goods sold by us generally,
|TIER, S.INT.INMA ERSEI
mºll
Eº
JAMES FOSTER, JR., & Co.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
|same. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in-
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Lenses, Spectacles, and the best models procurable, with pains-
taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopie Objects
and Microscopic Apparatus, Magnifiers and Readers in
great variety. edical Batteries, Barometers, Thermo-
meters, Hygrometers, Urinometers and Rain Gauges,
of the most approved construction always on hand. All orders promptly
| and accurately filled.
JAS. FOSTER. J.R. &
F. S. SEACKEEford, ! ** JAs. FostER, JR. & co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
S
2
Ke TRUSSES. 392
No. 758 BRoadway, New York
I HAVE been in the habit of applying and recommending the Truss
: manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
BEG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
Professor of Surgery, New York City
*
Dr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
|Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & CO., No. 2 Vesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
OPPOSITE THE HIGH STEEPLE,











HMHillſ. Wilſº twº
SAML. P. THOMAS
167 EAST 34TH-ST., NEW YORK,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANUFACTURERS OF PORTABLE
ELECTR0-MAGNETIC MACHINES, º
Portable Galwanic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
|M|| |||||—|| |||||||}
PERMANIENT BATTERIEs,
For Hospitals and General Practitioners,
IETIECTIER, CIDIES.
For Eye, Ear, Larynx, Nose, Uterus, Vagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Elec.
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
-
EXTRA (4TS FROM THE OPINIONS OF THE MOST
JEI/IIIN ENT MEMBERS OF THIE PROFESS / ON.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Nothing CAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.” -
We are authorized by Prof. Hammond to announce en-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
* MEREDITH CLY MUER, M. D., Prof. of Diseases of the 'Ner-
vous System and of the Mind, &c., &c.—“I consider theºr
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prºf. of Surgery, St. Louis:—“In neat-
ness, compactness and efficacy, they can not be excelled.”
A LFRED C. G ARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.” -
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
j
IDEALER IN
English, French and Scotch
GOOD's,
34 West Fourth Street,
("Z.W*("A.W.W.??"/.
Fosrº-R's,
IE'_A_TIEHINTT
Are furnished to Officers and Soldiers on Government
a CCount. -
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTER,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 172 Jeff-
ferson Avenue, ioetroit, ñrich. -






O ID O E L E S S A. N. D. P.A. L. A. T A E II, E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. - -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c. -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent. *
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
“We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
** in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

List of Pharmaceutical Preparations,
MANUEFACTUREED BY
Jonºv wrºza e amozwan,
FEIILADELPHIA.
-º-h
ELIX, PHOS, IRON, QUININE AND STRYCHNIA, *
- ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA, s
(Goddard’s Formula,)
ELIXIE VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
.”
ELIXIR OF CALISAYA BARK,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES, . .
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON, . . . .
Citrate of Iron and Peruvian Bark, FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK, -
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH, - -
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED, -
BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and Sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA,
WINE OF PEPSIN,
SYRUP SUPERPHOSPHATE OF IRON,
ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRA BRAVA.
STUTEPEPOSITOTER, ITES.
Rectum, Vaginal, and Male Urethral Suppositories and Soluble Pessaries of Pnre Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and style, made of finest quality of sponge.
MANUFACTURING COMPANY.
MANUFACTURERS AND IMPORTERs of
AND
Window Shades,
37 Wasr Fowarm scºrer,
CINGINNXT, 0.
H. H. BRENEMAN, Proprietor,
IRT S
Made to order of N. Y. M. Muslin and 2300
HEAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.0)
First three qualities have ALL LIN EN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less.
Perfect satisfaction given or money cheerfully
refunded. - - -
... Also import and Manufacture Men's Furnish-
ing Goods. -
Pilce’s Opera-House, Fourth Street, Cincinnati; 9s 1 ||
Wabash Avenue, and SS West Washington
Street, Chicago.
M A R K TVA IN'S
NEW E O OIX
IS NOVV READY FOR CAN VASSERS.
It contains over 600 pages of reading matter, with 250
engravings, designed expressly for this work, by the best
artists in the country. Agents now at work upon it are
meeting with unparalleled success. Agents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re-
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 Elm Street, Cincinnati, O.
BASCOM & CARPENTER,
Stationers, Printers
-AND-
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In Veneers, Boards and Plank,
frºnt-Maºri', 'al-Biliń'ani Star-Billiº,
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can Cedar for Cigar-Box Makers We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
office and warerooms, 136 and 138 West Second Street,
veneer Min, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI.




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E" A C TUſ I, T Y - -
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Vol. 2. C IN C IN N A TI, F E B R U A R Y 17, 1872. No. 7.
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==º Page
ORIGINAL ARTICLEs
The Acid Treatment of Rheumatism by D.T. Gilliam M. D.....…78 -
Treatment of Dysentery by Ipecac Enemata by H. V. Ferrel M. D....74
TRANSLATHON - -
Cancroid, Impetigo, etc., Their Diagnosis and Therapy, by M. A.
Duvergie, (From the Bulletin Therapeutique, Nov.30, 1871)........74|
SCIENTIFIC NOTES
Vaso-Motor and Trophic Neuroses—The Chemistry of Hail—Fecun-
dity of Germs 76–79
MEDICAL NEWS
Charles Lever on the Medical Profession—German Provisions for
Science—An Error of the Empire—The Revealer of Anaesthesia
—The Würzburg Clinic—A New Field for Hoppe Seyler—Death
of Jaeger—Honors to Dr. Cormack—Chloroform an Ineligible
Agent for Robbers................................................................. 79-80
- correspond ENCE
Letter from Vienna—The Diagnosis of Syphilis by the Microscopic
Examination of the Blood...............--------------------------------------, 80-81
Books and Pamphlets Received....................................... 81
- CLINICAL MEMORANIDA,
Phrenic Neuralgia—Intestinal Obstruction treated by Ice—Extract
of Meat—A Case of Acute Cataract—Treatment of Pruritus
Vulvae—Hot Baths in Hydrops—Indications for the Employ-
ment of the Catheter in Old People—Antidote to Carbolc Acid
—Opium in Phagedæna–Fistula for Cystitis......................... 82-84
* NºWs................................................................................ 84|
THE discovery of peculiar germs in the blood of syph-
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creating a profound sensation throughout Europe. If
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MR. FREDERICK KRAUs: CINCINNAT1, February 15, 1871. -
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f


T H E CI.I.N.I.C.
Vol. 2..] S A T U R D A Y, F E B R U A R Y 17, 1872. [No. 7.
O RIG IN A L A RTI C L E S.
- 3 - - -
ACHID . TREATMENT OF RIHIEUMIATISM.
BY
D. T. GILLIAM, M. D.
Nelsonville, Ohio,
It is not so much the intention of this article to in-
troduce an innovation in the treatment of this disease,
as to call the attention of the profession to certain facts,
which I conceive to be of importance thereto.
Our present accepted ideas of rheumatism are, that it
is a disease of the blood—that the circulating fluid con-
tains a materies morbi which gives rise to the various
phenomena witnessed in the disease.
Prout goes so far as to name the offending matter.
His theory is—and it is only theory; having as yet never
been satisfactorily demonstrated—that lactic acid is the
morbific agent.
The theory is good, and is so plausibly sustained that
we are fain to accept it. .- .
On these premises we base our so-called rational
treatment. But while we endorse Prout's theory, and
adopt the alkaline treatment as being that rationally
indicated, we still cling to other methods of treatment,
that are not rational as it seems to us, simply because they
yield us good results. These are the less rational, but
but by no means the less useful. -
The object of this article is, to show that certain
remedies heretofore used as empirical, are as justly en-
titled to the appellation of rational, as many that are
at present considered as such. &
Now lactic acid in certain proportions exists in the
blood as a proper constituent, and consequently its
mere presence there cannot be considered as deleterious.
But if it exist in disproportionate quantities, then we
may believe that it exerts a bad influence.
If, then, it be superabundant in the blood, it is so
from one of two causes, if not from both together;
1st. It is because it is not metamorphosed or expelled
from the system as it should be; or,
2nd. Because it is produced more rapidly than it
Ought to be. -
If it depend on the first condition, what are the in-
dications of treatment?
Evidently to promote its expulsion, or destruction,
or its change into those principles into which it normally
resolves.
To promote its expulsion is not easily directly attain-
able. But to destroy it, or promote the retrograde
metamorphosis, if indeed it be a retrograde process—is
not so difficult.
Being an acid, we feel confident that it can be
neutralized by an alkali; but while we are attempting
to neutralize it, we are fulfilling the other indićation,
viz., promoting its normal metamorphosis.
This is clear enough when we consider how this
change is wrought; the lactic acid after having played
its part in the economy seeks an alkali with which to
combine, (the free soda of the blood) and the resulting
compound being oxidized, carbonate of soda and water
is formed.
Hence the use of alkalies in this condition is right,
and proper, and eminently rational.
So far allis well; but let us go on and see if there be
any other phase of the subject.
There are doubtless cases in which the second condi-
tion obtains—where the lactic acid is produced more
rapidly than it should be.
Given, a case of this kind, what now are the indica-
tions for treatment 7
Without hesitation we should say neutralize it—give
the alkali.
But such a course would be eminently improper.
In order that we may understand why it would be im-
proper, it will be necessary to ascertain what forces are
at work to produce this excess of lactic acid.
Lactic acid is derived from glucose, and glucose is
derived from a great variety of sources. -
The change from glucose into lactic acid is a natural
transition, and is facilitated by an alkaline state of the
blood.
“Dr. Pavy conceives that particles of fibrin under-
going change or decay constitute the natural ferment
which converts glucose into lactic acid. An acid state
of the blood is found to hinder this metamorphosis.
(Headland on Medicines, pp. 128).
Miathe affirms; “the natural transformation of glucose
into lactic acid is hindered by tendency to acidity of the
blood;’ and then, “the presence of an alkali is necessary
to this transformation.” (Ch. Appliquée, pp. 75).
Hence if we would prevent, or retard, the formation of
lactic acid, we must reduce the alkalinity of the blood.
It may seem paradoxical to advocate the administra-
tion of acids to correct acidity of the blood, but is prob-
ably not more so, than to administer acids for acidity of
the stomach; a practice, the utility of which, will
hardly be called in question.
Acids have been used in the treatment of rheumatism
and have yielded results the most gratifying.
The books are full of enconiums on the excellent virtuºs
of lemon juice as an anti-rheumatic; but some in their
inordinate love for rationalism, seeing and acknowledg-
ing its excellencies as a therapeutic agent in this dis-
ease, have convinced themselves that black is white,
and that lemon juice is not acid but preeminently
alkaline. Then again most agree in using an alkali
combined with an acid such as the acetate of potassa
74 T IEI IET C
T III. TNT I C - [FEB. 17, 1872.
in preference to the free alkali, claiming that they get
better results.
It would be a pleasant, though perhaps not profitable
task, to trace these salts through the system, and note
how speedily and effectually the alkali is expelled from
the system, while the acid is retained and utilized. I
have purposely refrained from alluding to the excellent
influence acids exert over fevers and inflammatory
affections in general, but in the Selection of our reme-
dies all these things should be considered.
The question now is, how to distinguish a rheumatism
depending on a condition where the alkaline treatment
is indicated, from one calling for acids.
At present this is hardly possible, but when we con-
sider that the animal economy is furnished with ample
facilities for throwing off effete and deleterious matters,
we may rest assured, that if the excessive supply of the
offending matter be cut off, the system will quickly rid
itself of that which remains.
—-º-º-º-
Treatment of Dysentery by Hpecac Rºmelmata.
BY
H. W. FERRELL, M. D.
Carbondale, Ills,
The Am. Journ. Med. Sciences, Jan., 1872, p. 254,
notices an article from Dr. Jessop, in The Indian Med.
Gazette, upon the use of ipecac by enema for the cure
of dysentery.
In July and August, 1870, during an epidemic of that
disease in this section I treated thirteen cases of acute
dysentery; the first and second in the usual manner.
The first recovered, the Second, a child, aet 18 mo., died.
The third and fourth, parents of the child (their other
child had already died of the disease under the common
treatment by another physician), were treated with lead
and opium till I thought they too would die, when I
decided to use ipecac. It was administered as follows:
B.
Pulv. Ipecac. 3i.’
Mucilag. Acacia, 3 vi.
M. Give as Enema.
This was repeated three times a day for three days,
when a complete cure was effected. In another case,
male, aet 40, its benefits were even more strikingly dis-
played.
Of the thirteen cases, two were treated with-
out igecac ; one recovered and one died; three were evi-
dently saved by it after the most approved treatment
had entirely failed. In the remaining eight cases it was
used early and alone, and in none did any symptoms
arise betokening great danger,
In July last I treated Mrs. I., widow, act about 50,
for sporadic dysentery. Ipecac was administered per
enema, and she made a hasty recovery—in her case, to
relieve the excessive tormina, gtt. xv. fl. ext. hyosciami
were added and had the desired effect.
Dr. Jessop gives 10 gr. of the powder with 3.SS tr. opii
in 3ii arrow root decoc. or mucilage three times a day.
I have never given to an adult less than 60 gr. of the
powder and in 3 vimucilage acacia or slippery elm which
is as good and can often be obtained when others can
not.
—sº-º-º-o-
Cameroid, Noli-Me-Tangere, Ulcerous HImpetigo
Rodems, and Non-Ulcerous Impetigo Rodems.
Their HDifferential Diagnosis amad Therapy.
13Y
M. A. DEVERGIE.
Member of the Academy of Medicine, Honorary Physician to the
St. Louis (Paris) Hospital,
From the Bull. Therap., Ncv. 30, 1871.
In 1854 in the first edition of my “Treatise on Dig.
eases of the Skin,” I thus expressed myself in reference
to impetigo rodens; “This is a form of chronic impetigo
very badly described, I might indeed say unknown, of
which French writers have treated very imperfectly, or
have not treated at all. I have had my attention di-
rected to it for Some Seven or eight years, originally by
a patient who had been suffering from it for nine years,
and had been under the care of all the dermatologists
in Paris, without obtaining relief.” In 1854 I had
described three different forms of impetigo rodens, two
non-ulcerous, and the third ulcerous, and had established
several characteristics which serve to distinguish the
latter species, (wlcerous impetigo rodens,) from noli-me-
tangere. Since that time I have constantly studied this
disease, and have established its treatment according to
its varieties.
If Alibert does not speak of impetigo rodens, he
confounds its forms in the descriptions that he
has given of the “dartre rongeante.” Willan & Bate-
man (Ed. 1820, p. 204) devoted only a few words
to this affection, which they have however des-
ignated by name. What they do say, shows that
they had but very imperfectly observed it. Their first
Sentence proves this; “This variety of this disease stub-
bornly resists the treatment employed; without doubt,
because of the cancerous affection with which the
cellular tissues and skin are attacked.” Rayer, Cazen-
ave, Bazin, Hardy, make no mention of it in their
works. M. Gibert devotes a short article to impetigo
rodens, the seat of which he places upon and about the
nose; but he very soon confounds it with certain forms
of lupus. As to any special treatment of this variety
he says nothing. The four affections embraced in the
title of this article have between them correspondencies
that I endeavored to establish in my “treatise on
diseases of the skin,” as the result of the special observa-
tions that I had then made. Time has enlarged the
circle of these facts, and unhoped for cures have been
FEB. 17, 1872.]
TIEEI IET: C T , IIINT I C -
75
added to cures effected in diseases less grave; divers
means, that I have employed since 1852, have enabled
me to secure success more and more determined. It is
this which has decided me to publish this new paper,
and to call the attention of my fellow practitioners to
these singular diseases in their but-little-known forms.
Surgery applies to them too often the knife, and Med-
icine dares not touch them, but confines herself to ad-
vising the use of topical remedies which produce no
effect. I shall first endeavor to establish between these
affections the morbid differences, which will enable us
to characterize them, and distinguish between them ;
and shall then lay down a basis for their treatment, with
such details as the subject may demand. The cancroid
affection may be defined (regarding simply its appear-
ance) as an ulceration of the skin, having its edges
indurated, granular, mammillated, and resting upon a
base, indurated in its centre as well as its circumference.
Thenoli-me-tangere is nothing else; I mention this name in
order to show that it is a synonym of cancroid disease
and that we may not be compelled to return to it again.
But if cancroid presents itself to our eyes under the
form of an ulceration of the skin, having indurated
edges, the disease that I have called ulcerous impetigo
rodens presents often times conditions and an appearance
very similar. However, it seems to me, the cancroid
differs from the impetigo rodens in several respects.
First. Not only in the cancroid is there induration of the
edges of the sore, but the induration involves the whole
surface; the ulceration rests upon tissue whose indura-
tion is more or less strongly marked, so as to make the
cancroid approach in character true cancer; in the
wlcerous impetigo rodens the induration is found only in
the prominent edges of the ulcer. Second. The appear-
ance of ulcerous impetigo rodens approaches in many
respects that of the syphilitic ulcer, that is to say, the
ulcer is more or less scooped out, its edges elevated,
eliptical, and not rounded as in the cancroid. Third. In
the cancroid the secretion resembles the fetid sanies of
cancer, while in the ulcerous impetigo rodens it partakes
of the character of pus' and sanies. It is not so much
that serous secretion which passes through all the dress-
ings, as in cancer, and has a penetrating odor, as it is
a mixture of pus of good character with a serous secre-
tion which has no very marked odor. Fourth. In
impetigo rodens we are very liable to have a flow of
blood upon the slightest touch, the least rubbing; a
disposition much less prominent in cancroid. Fifth.
Without giving as a distinctive characteristic, the
difference in location of the one and the other affection,
yet there is in this respect a shade of difference that
*y be established. Both are seated most often upon
the face, but while the caneroid may attack all points
of the face, and particularly the lips, under the form of
* *gorgement, most often non-ulcerous at the outset,
* embracing the whole thickness of the tissues; the
* impetigo rodens is seated almost constantly at
* of the corners of the eyes or on the side of the
nose. Let it not be thought to be limited to small super-
ficial ulcerations; its ulcers are sometimes 4 or 5 centi-
metres in diameter, they are deep, of unhealthy appear-
ance, with elevated indurated edges, bleeding, their sur-
face generally longer than it is broad, sinuous, turn-
ing from right to left, sometimes multiple and connected
by ulcerated linear tracts, or separated by bands of
healthy skin. To the touch, itsedges are hard and present
a certain resemblance to cancroid. Sixth. It is a remark-
able thing that the impetiginous disease originates in
very circumscribed points, these points requiring years
to attain diameters of from 2 to 3 centimetres. The
surrounding skin is supple and perfectly healthy.
There is no acute lancinating pain as in cancroid,
simply tingling, like the sensation of a fly on the parts.
These last characteristics are the most important, viz., the
time that the disease requires to attain its small
size, and the absence of shooting pains, in place of which
there is tingliag in all the parts. While a pustular
button with a sanious top resting upon an indurated
base is the commencement of the trouble in cancroid,
quickly transformed into an ulcer with elevated edges;
wlcerous impetigo rodens shows itself by a circum-
scribed point or linear ulceration, very slowly progress-
ing, affecting principally, one of the angles of the eye,
and the external angle by preference. Often, indeed,
it is followed and that at a distance somewhat removed
by a new small ulcer. The one and the other require
years to attain any special size. This multiplicity of
the points of departure, is a strong indication of impetigo
rodens, for in the caneroid the outset and progress of the
disease is almost constantly from a single point. An
ulcer of impetigo rodens will require 3, 4, or 6 years to
reach a length of from 10 to 25 millimetres; whlie in
the course of a single year the cancroid will reach in
extent and depth 3 or 4 centimetres, more or less.
Seventh. In the cancroid the induration of the tissues
shows itself with the disease, while indulation of a certain
part of the sore will not appear in impetigo rodens till many
years after its first manifestation. Such are the distinctive
characteristics that I believe can be established between
these two diseases. There are in them both peculiarities
that we cannot point out before noticing the characters
of ordinary impetigo. The name, impetigo, has been
always given to a superficial pustular eruption, made
up of psydracious pustules; that is to say, of pustules
exceedingly thin, running together, drying rapidly and
forming a crust, more or less yellow, sometimes
canary-yellow, as in ordinary impetigo occurring
in young persons. This then is the first char-
acteristic to be noticed in the disease which occupies
our attention. The second is indicated by the word
rodens, “gnawing,” which signifies a disease which
destroys more or less tissue. Simple impetigo is an affec-
tion of the skin wholly superficial, which never leaves
its traces other than in those exceptional cases where
parents have left for years upon the head and forehead
of the child an indolent dry crust without making any
76
[FEB. 17, 1872.
T THE IFE C T , IL N T C -
effort to remove it, in which cases the pressure of the
crust upon the tissue ends in leaving a mark which is
not effaced for a long time. But this is a print rather
than a cicatria. In impetigo rodens the fall of the crust
leaves always its indelible trace.
petigo rodens which is always of more or less long stand-
ing, the characters of the pustule of impetigo have dis-
appeared, but any slight artificial irritation, as by a
caustic application to one of the points of the surface,
will suffice to bring out again the characteristics of the
impetiginous secretion. The practitioner may by this
means establish a diagnosis, differential and precise.
[To be Continued.]
---—-mº-e-ºº--—
SCIENTIFIC NOTES.
•º.
Vaso-MI6tor and Trophic Néuroses.
IBY
DR. A. EULENBURG (Berlin).
A Lecture delivered before the Hufeland Society, Oct. 27, 71. (From
the Berlin Klin. Wochertschr, Jan: 8, '72);
GENTLEMEN :
Allow me to make a little excursion into a region
of nerve pathology that is perhaps of all the least circum-
scribed in its range—the region of the vaso-motor and
trophic neuroses. I can not of course conceive that I
may be able to treat this subject here in any manner
exhaustively, but I may attempt to bring out a few
leading points that may serve as guides to further ex-
planations in a territory so obscure. As chief considera-
tion upon which I would like to dwell are the differ-
entiations and analogies between vaso-motor and trophic
neuroses, or, in a word, between angio-neuroses and
tropho-neuroses. As is well known, the latter com-
menced to play an important role in nerve pathology at
an earlier period. I may only remind you that Rom-
berg and Bergson designated progressive, one sided facial
atrophy as a tropho-neurosis and Baerensprung derived
herpes zoster from an affection of the trophic fibres aris-
ing from the ganglia of the spinal cord. These views
were adopted at a time, however, when the existence of
trophic nerves was by no means demonstrated, but was
considered only as a theoretical postulate. When some
ten years ago these investigations on the vaso-motors
received their new impulse from the labors of v. Bezold,
Goltz, Ludwig, Thirg and others, there was the tendency
to refer all pathological alterations of nervous origin not
only in the circulation, but also in temperature, secre-
tion and nutrition of individual parts of the body to a mor-
bid action of the vaso-motor nerves. These efforts, in
which I myself was extensively engaged, had, without
doubt, much to justify them ; but they were carried too
far, as actions were ascribed to the vaso-motor system
In the ulcerous im-
which we now know to be only effected with the con-
currence of certain other factors of the nervous system.
And when the term “trophic nerves” is applied to these
factors, still is the conception an imperfect one. The
general idea, however, is this; these nerves have to do
not only with the nutrition of the parts in the narrower
Sense of the term, but also with the regulation of the
Secretory and absorptive processes of the economy.
Later experimental investigations have demonstrated
that the accomplishment of these processes is effected by
nerves which may not be regarded as of vaso-motor
function as these processes are continued even after
destruction of the circulation. I may mention, for ex-
ample, in regard to Secretion, the experiments of Ludwig
and v. Wittich on the parotid gland. Ludwig has shown
that the secretion of saliva is independent of blood pres-
sure; when the nerves of the salivary glands are irri-
tated, the pressure of the secreted saliva is greater than
the pressure in the carotid artery; so likewise the tem-
perature of the saliva may be higher than that of the
blood. Wittich has proven that excitation of the cervi-
cal sympathetic acts upon glandular Secretion in the
same way even after arterial anaemia has been induced
in the gland by ligation of the carotid artery. In ab-
sorption Goltz has recently developed some facts by his
very interesting experiments. If water or a Salt solution
were injected into the lymph vessels of frogs after all
the circulation had been arrested by ligation of the
heart, while the brain and cord were left intact, the
fluid injected was nevertheless almost totally absorbed
—on the other hand, if the brain and cord were de-
stroyed absorption was not affected. I may mention
incidentally, also, other experiments of Goltz which dem-
onstrate that the shiny, moist and wrinkled condition
of the skin of the frog is maintained so long as the cen-
tral nervous system is preserved intact; that, further,
after destruction of the nervous system and one-sided
section of the nerves distributed to the skin, the skin in the
side of Section becomes more transparent because of the
death of its pigment cells. Later histological develop-
ments coincide with these results of experimentation.
I remind you especially of the path-breaking discoveries
of Pflüger, as to the different terminations of nerves in
the gland cells of the salivary glands as well as of the
liver and pancreas. These are nerves which Pflüger
has designated nerves of Secretion. Pathological disturb-
ances of these nerves may be termed appropriately
neuroses Sui generis, glandular or Secretory neuroses.
Still later discoveries have taught us further that not
only the gland cells, but also cells of other tissues espec-
ially of the epithelial contain terminations of nerve
fi res. ' hey have been demonstrated in the posterior
epithelial layer of the cornea, and in the nucleoli of their
cell elements (Lipmann), further in the epithelium of
the frog skin, in the connective tissue of the tail of the
tad-pole (Hensen, Eberth). All these, so to speak,
cellular nerves are probably of essential influence on
the vitality of their cells as well as on the transforma-
FEB. 17, 1872.]
T IEI IET: C T , T INT I C.
77
tions of constructive and retrograde metamorphosis:
and through this influence we are possessed of a surpris-
ing confirmation of many pathological conditions, as,
for instance, the corneal affections in the neuroparalytic
affections consequent upon lesions of the trigeminal
Iner Ve.
It is not at all improbable that we may finally
succeed, by the method of developing terminal nerve
fibres, which is so essentially perfected in modern times,
in demonstrating the connections of nerve fibres with
other gland cells and with the cellular elements also of
other tissues and thus may enlarge the histological field
of the secretory and in a narrower sense the trophic
neuroses. Experiment and pathology have, in a sense,
anticipated these discoveries in histology, since they
bave demonstrated that alterations in the nutrition o.
the most different tissues—epidermoid, subcutaneous,
muscular, osseous, articular, lymphatic—ensue in cont
sequence of artificial or accidental injuries of nerves.
Without mentioning the numerous experiments per
formed in proof, I will only call to mind the phenom-
ena following gunshot injuries or other traumata
causing partial or total destruction of mixed nerve
trunks. Our late war has furnished abundant material
for this purpose and I have myself observed the most
exquisite examples in proof. I am treating at present,
for instan :e, a case of destruction of the ulnar nerve
above the wrist: in this case the skin in the whole ulnar
region of the finger is remarkably cool and pale as well
as smooth, dry, and totally void of Secretion; the last
phalanges are narrow and pointed, the nails are deformed
and hypertrophic. The muscular tissue of the little
finger is gone; there is constant tendency to panarities
(felon) and ulceration. In other cases, as Fischer has
lately exhibited, oedema and erysipelatous reddening
(the shiny fingers and toes of Paget), further, anomalies
in the growth of the hair, exanthemata, anchylotic joint
inflammations, contractions, hyperplasia, and later, con-
centric atrophy of the bones have all been observed
after injury of the nerves of the extremities. To refer
all these alterations exclusively to injury of the vaso-
motor nerve fibres would be a labor of the greatest diffi-
culty; for we know that elevation of temperature, red-
dening and increase of secretion occur after division of
the vaso-motors—effects which, after injuries of mixed
nerve trunks, either do not present at all or only transi-
torily, and, as a rule, soon to manifest opposite appear-
ances. There must be, therefore, some further condition
which compensates or more than compensates for the
injury of the vaso-motors, and this, in the injury of mix-
ed nerve trunks, is the concomitant injury of the secretory,
and in a narrower sense, the trophic nerve fibres. When
We, thus, in future, disassociate the disturbances of the
vaso-motor, secretory and trophic nerve systems more dis-
tinctly than ever before, we dissipate, to great extent,
the cloud of obscurities and seeming contradictions
which has hitherto and in high degree rendered difficult
the comprehension of numerous neuropathological con-
ditions. These difficulties depend mainly upon the fact
that all disturbances of secretion and nutrition of neu-
rotic origin were referred to disease of the vaso-motor
fibres, either to their excitation or paralysis. As exam-
ples, I may cite the disturbances of nutrition incident
to many cases of trigeminal neuralgia, as ophthalmiae,
herpetic and other exanthemata, atrophy and decolori-
zation of the ciliae, superciliae and hairs of the head,
atrophy of the skin and of the other soft or even bony
parts of the face. These manifestations are referable
neither to a contraction nor a reflex paralytic relaxation
of the bloodvessels, since the symptoms proper to these
conditions may be totally absent. On the other hand,
in other cases of trigeminal neuralgia and still more in
hemicrania we observe these vaSO-motor symptoms
prominent while trophic disturbances of the kind just
portrayed are absent. Meissner thus maintains and
with great probability that ophthalmia neuroparalytica
after injuries to the trigeminus does not depend upon a
lesion of the vaso-motor, but of the specific trophic fibres
accompanying the trigeminus beneath the Casserian
ganglion. The one-sided progressive atrophy of the face
occurring occasionally as an isolated disease it is cer-
tainly unreasonable to refer to vaSO-motor cramp of a
years duration; as little, too, are evidences of a relaxa-
tion of vessels present, so that we must necessarily recur
here to disturbances in the trophic symptom as Samuel
has long ago justly maintained. It is worthy of men-
tion, too, that hypertrophy of one side of the face may
occur in connection with injuries of nerves; Sterling
has already communicated an interesting case of this
kind. This coincides perfectly with the experiments of
Mantegazza who has observed hypertrophy of the con-
nective tissue, of the periosteum, the bones, lymph
glands, etc., in animals after section of the nerves.
Morbus Basedowii, also, belongs in all probability to
the trophic neuroses. Just here irreconcilable con-
tradictions present on the old theory. The acceler-
ated pulse was derived from an excitation of the cervi-
cal sympathetic while the struma and exophthalmus
were referred to a paralysis of the vaSO-motors of the
cervical sympathetic (or their spinal centres) supplying
the different vessels concerned. It is, probably, much
nearer the truth to believe that an affection of the spe-
cific trophic nerves is the cause of the glandular hyper-
plasia and perhaps also of the remarkable increase in the
retro-bulbar adipose tissue of the eye.
Permit me now, in brief, to present another side of
this subject, viz., the new and valuable points that may
often be obtained in more accurate local diagnosis by
this separation of vaso-motor and trophic symptoms.
In lesions of peripheric mixed nerve trunks, in the rule,
trophic and vaso-motor fibres are simultaneously affected.
Våso-motor and trophic symptoms, therefore will mani-
fest coincidently or in succession, as has been stated to
occur after traumatic injuries to mixed nerve trunks.
Nearer the centre, however, the vaso-motor and trophic
tracts separate from each other as distinctly as do motor
78
[FEB. 17, 1872.
T IEEE THE C T , T N T C .
and sensitive fibres. It may be regarded as pretty well
demonstrated that as there are separate centres for
innervation of the heart, and bloodvessel tonicity so
there are also separate centres for the regulation of ani-
mal heat and of nutritive interchanges, but particularly
for the nutrition of muscle. Concerning this tissue,
especially, these centres for the voluntary muscles of the
trunk and extremities are plainly situated in the anterior
columns of the spinal cord and their fibres pass out into
the anterior lateral columns of the cord and the anterior
roots. Pathological conditions speak with decision in
favor of this view. Confirmation is much more fre-
quently found in recent times with the frequent and
accurate microscopic examinations of the hardened cord
than formerly under the more imperfect means of inves-
tigation. Thus it is more and more frequently found
to be true that the neuroses marked by extensive mus-
cular atrophy, especially the so-called progressive muscu-
lar atrophy is a aconsequence of a chronic myelitis or a simple
degenerative atrophy of the anterior column of ganglion
cells, and of the anterior column and root fibres of the spinal
cord. I may remind you here of the older descriptions
of Valentiner, Gull, Clarke, Luys and the later of
Grimm, Bamberger, Joffroy, Rosenthal and others.
That interesting neurosis described by Leyden, the so-
called paralysis glosso-pharyngolabialis belongs here also.
This is likewise attended with atrophy of the muscles
concerned and is often associate with progressive mus-
cular atrophy, being either the beginning of this affec-
tion or complicating its close. Leyden found chronic
myelitis constantly in this disease, particularly in the
upper cervical region of the cord with degeneration of
the anterior lateral columns and fatty atrophy of the
anterior roots. In a third, only lately frequently ob-
served neurosis, progressive muscular hypertrophy or
lipomatosis musculorum luxurians where the volume of
the muscle attacked seems to be increased by interstitial
increase of fat while the muscular tissue itself disappears,
I have already upon a former occasion felt myself con-
strained to accept the view of a special origin of the dis-
ease. I based this especially upon clinical grounds,
particularly on the coincidence of this process, as I my-
self first observed, with progressive atrophy in other
muscle regions. This view, too, has been confirmed in
the meantime by Barth, who demonstrated in a case,
points of degeneration in the anterior horns and anterior
lateral columns of the spinal cord. Finally there is to
be arrayed here also a fourth affection, namely, the so-
called essential or spinal paralysis of childhood. It is well
known that in this condition there is by no means a
definite paralysis, but an often rapid atrophy of muscles
sometimes even of an entire extremity. It is then much
more proper to designate the effection an essential atrophy
or at least with Duchenne, a paralysie atrophique. The
presumption was a safe one, therefore, to locate this
affection as a primary lesion of the above mentioned
regions of the spinal cord and to explain by its grade the
variable extension of the peripheric muscular disease.
But till now, there were lacking any more definite and
exact results in confirmation. These deficiencies, how-
ever, have been lately been filled by several French
pathologists, Charcot, Parrot, Joffroy and Vulpian.
They all found—and they were unanimous in descrip-
tion—degenerative changes in the anterior horns and
the anterior lateral columns as well as in the anterior
roots of the spinal cord; differing only in grade accord-
ing to the duration of the disease process, corresponding
in all cases to the extent of peripheric muscular affec-
tion. Recklinghausen, also (according to Rinecker), has
observed in these cases atrophy of the anterior ganglion
cells, of the anterior columns and of the anterior por-
tions of the lateral columns of the cord. We may there-
fore consider the proposition as established, that mus-
cular atrophy may be ascribed to disease of the anterior
column of ganglion cells including the anterior column
and root fibres of the spinal cord. Thus also the occur-
rence of diffuse muscular atrophy in connection with
other spinal symptoms—paraplegia or spinal ataxia, for
instance—signifies and is to be regarded usually as an
extension of the original disease process to the gray sub-
stance ef the anterior columns and the anterior ganglion
cells.
You observe thus, gentlemen, that clinical observa-
tion and pathological anatomy must advance hand in
hand with physiological experimentation to render at
all possible any accurate comprehension of the multi-
form disease processes of the nervous system. You see
also how wide a field in this direction opens out before
us. In the department of pathology it is not so much
facts that are wanting as the proper interpretation of
these facts, their reconciliation with established physio-
logical data. This deficiency is easily understood when
we remember that the physiology of the nervous system
is still only in progress of revelation. The results of
these investigations are of highest consequence in
therapy, a department which already counts so many
and so important acquisitions and yet has fallen into
So many deplorable errors; errors rooted in the main in
unphysiological comprehensions of the applications of
valuable remedies. I refrain from entering this subject
further although my theme admits a most instructive
corollary. May we never forget that the pathology of
the nervous system owes its brilliant inception and its
entire development to the fact that its indomitable
founder has bound it indissolubly with the physiology
or (as J. Müller puts it) with the physics of the nerves |
THE CHEMISTRY of HAIL–Prof. Kengott, of Zurich,
states that a hail-storm lasting five minutes occurred
at eleven o’clock in the morning of August 20, 1871,
the stones from which were found to possess a salty
taste. Some of them weighed twelve grains. They
were found to consist essentially of true salt, such as oc-
curs in Northern Africa on the surface of the plains,
mainly in hexahedric crystals or their fragments, of a
white color, with partly sharp and partly rounded
FEB. 17, 1872.]
T H H C T.I.N.T. C.
79
grains and edges. None of the crystals were entirely
perfect, but appeared as if they had been roughly de-
veloped on some surface. They had probably been
taken up and brought over the Mediterranean from
Some part of Africa, just as sand is occasionally trans-
ported hence to the European continent and the
Canaries by means of hurricanes. A still more remark-
able phenomenon has been recently recorded by Prof.
Eversmann, of Kasan—namely, the occurrence of Hail-
stones, each containing a small crystal of sulphuret of
iron. These crystals were probably weathered from
Some rocks in large quantity, and were then taken up
from the surface of the ground by a storm, and when
carried into the hail-forming clouds served as a nucleus
for the formation of hail-stones.—Nature, Jan. 11, ’72.
THE FECUNDITY OF GERMS.—For we know that
these low forms of organization are especially distin-
guished by their power of rapid multiplication. Each
individual plant of Reticularia marima,” a species of
fungoid vegetable, produces no less than ten million of
spores; and, according to Dr. Carpenter, a large kind
of fungus, the Bovista giganteum, has been known to
grow so rapidly that its cells must have been produced
at the rate of four thousand millions per hour. Many
of the infusoria also multiply themselves by division,
and in this way increase rapidly in numbers in any in-
fusion which is suitable for their growth. Prof. Bastiani
has seen under the microscope a bacterium, of moder-
ate size, “divide into two, and each of these into two
others, somewhat smaller, in the course of fifteen min-
utes.” But if such an organism were only to divide
into two once in every fifteen minutes, and if this
process were to go on for six hours, we shonld have at
the end of that time over sixteen millions of bacteria,
produced from a single individual. There is no diffi-
culty, therefore, in accounting for the abundance in
which the infusoria may appear in a solution, after a
few germs have once been introduced from the atmos-
phere.—Dalton–N. Y. Med. Journ., Feb., 72.
—sº-G-seºn---
MEDICAL NEWS.
CHARLES LEVER ON THE MEDICAL PROFESSION.—
We print elsewhere a letter bearing the signature of
Charles Lever, which appeared in the Pall Mall Gazette
of Tuesday last and which bears a tribute, of which we
may be justly proud, to the high moral and intellectual
qualities of the members of the medical profession:
qualities in no small degree due to the exercise of the
calling in which the medical life is spent. Mr. Lever
justly points out that the doctor is familiar at once with
some of the deepest problems of science, and of the
Practical working of the truths whence these problems
T--—
*9ted in Longet, Traité de Physiologie, vol. ii., part iii., p. 13
tºeneral and Comparitive Physiology, p. 95.
torigin of the Lowest Organisms, p. 6. London, 1871.
proceed. He shows also how the familiarity with the
profession with all classes raises it above the prejudices
of any, and renders it peculiarly fit to guage the state
and tendencies of the national mind. We can not but
warmly welcome an advocate so able; who says for our
calling so much that modesty prevents us saying for
ourselves, but which it would be mock modesty not to
accept when said by another. It is not the least among
the triumphs of medicine that it has numbered amongst
its panegyrists the greatest names in literature. The
eulogy sung by Homer has been reechoed from his time
to ours; and Mr. Lever does but strike a chord that has
already responded to the master touch of Thackeray
and of Dickens.—London Lancet, Jan. 20, '72.
GERMAN PROVISIONS FOR THE STUDY OF SCIENCE.-
Although a stranger visiting Germany is in admiration
at the number of laboratories and institutes that he
sees everywhere, the Germans themselves are in the
habit of grumbling that they have not enough;
and just recently, provision has been made, in the
budgets adopted by the legislature, for some consider-
able extensions. Munich is to have a new pathological
institute, separate from the hospital, at a cost of about
£16,000, and £4,000, is to be spent on extending the
physiological laboratory. Erlangen, also, another Bava-
rian University, is to have a new pathological institute.
The University of Berlin has had the sum of half a
million thalers (about £75,000) voted to it for similar
purposes. A fourth part of this sum is to be expended
on a new physiological laboratory; and it is expected
that a laboratory for physics will be built ajoining it.
The pathological institute, already very complete, will
be enlarged, at the cost of about £3,000, the extension
being mostly in the department for pathological chem-
istry, to which a suite of five rooms will be added, pro-
viding accommodation for physiological and physical
apparatus. It may be useful to mention that there is a
description of the pathological institute at Göttingen,
accompanied by plans written by Professor Krause, the
director of the institute. In about one half of the
German Universities there is an institute for path-
ology separate Some little distance from the hospital;
and this arrangement is found to be so convenient, that
it will no doubt soon be universal.
AN ERROR OF THE EMPIRE-The new and magnifi-
cent Hotel Dieu whose construction has already cost
many millions of francs and which would require in ad-
dition for its completion, at least five millions, and for
the roofing and walls two millions, has been utterly
condemned by a commission of the hospital surgeons
and physicians of Paris, after a thorough examination.
After hearing the report of some of the most competent
authorities, the Society of Hospital physicians and
surgeons unanimously resolved that the Hotel Dieu, by
its construction does not fulfill the conditions required
by a hospital in the actual state of science and hygiene.
Drs. Hérard and Hardy alone, while admitting the con-
80
[FEB. 17, 1872.
T TEI IET: C T I I INTT C.
struction of the hospital to be detestable would have
been willing that the eight hundred beds should be re-
duced to four hundred, and the building utilized for
diseases of the skin, eyes, etc., keeping away really sick
people—a proposition which was emphatically negatived.
As a hospital this costly error of the empire would be
more murderous than a great battle. It may be utilized
as a Hotel de Ville in lieu of the building destroyed by
the communists.-Brit. Med. Journ., Jan. 20, '72.
“THE INVENTOR AND REVEALER OE ANAESTHETIC
INHALATION.”—The committee of citizens of Boston
chosen to raise a Morton Testimonial Fund, claim that
no one, either in or out of the profession, up to the
final experiment with ether at the Massachusetts Gen-
eral Hospital in 1846, by William T. G. Morton had
ever dared, in public or private, to saturate a man with
ether, with the intention of producing insensibility to
pain, and still less with the idea of urging a surgeon to
perform a long and painful operation upon the uncon-
scious patient. “The Historical Memoranda” states
that “more than a year after the first operations were
performed, the late Sir James Y. Simpson sent his
pamphlet on chloroform to Dr. Morton, and after speak-
ing of ether, and of its use as an anaesthetic,” he adds,
—“Of course, the great thought is that of producing in-
sensibility to pain; and for that the world is, I think,
indebted to you.” .
The Committee to obtain a proper testimonial for the
family of the late Dr. Wm. T. G. Morton is composed
of the following gentlemen: Drs. Chas. G. Putnam,
Henry I. Bowditch, Geo. Hayward, R. M. Hodges,
Luther Parks, Sam’l Kneeland, John C. Warren, and
Fracis Minot, of Boston.
The names of the following physicians of New York
and Philadelphia have been added, with the consent of
the various parties: Drs. E. R. Peaslee and Willard
Parker, of New York, and Drs. S. D. Gross, J. M. Da
Costa, and S. Weir Mitchell, of Philadelphia.-N. Y.
Med. Rec., Feb. 1, ’72.
THE WURzBURG CLINIC.—For the Professorship
vacated by Bamberger, called to Vienna, the names of
Prof. Biermer (Zurich), Prof. Gerhardt (Jena), and
Prof. Leyden (Königsberg) are proposed. The Prussian
journals lament the possibility of the loss of Leyden
from one of their universities.
A NEW FIELD FOR HOPPE SEYLER.—Hoppe Seyler,
hitherto in Tübingen, has received a call to the chair of
medical chemistry in the newly established university of
Strasbourg.
DEATH OF JAGER.—The renowned ophthalmologist
Friedrich Jäger, Ritter von Jaxtthal, died in Vienna,
Dec. 26, ’71, in the 88th year of his age. His no less
distinguished son Prof. Edward Jäger continues in pos-
ition. *
HoNors To DR. CoRMACK.—Dr. John Rose Cormack,
the correspondent of the British Medical Journal during
the Franco-Prussian War, and formerly its editºr, is
about to receive the honor of Knighthood for his devo-
tion to the cause of the wounded during the sieges. His
Services have already secured for him the thanks of the
French and English Governments, and the Cross of the
Legion of Honor.
CHLOROFORM AN INELIGIBLE AGENT FOR ROBBERS.
—Dr. Stephen Rogers, of New York, in a reprint on
“Can Chloroform be used to facilitate Robbery 7” re-
cords some facts which prove it to be an ineligible agent
for the use of robbers. 1st. As to its use to promote
the greater security from the disturbance of the sleeper,
even were that practicable, the very time that would
be consumed in the gradual and cautious administration
of the vapor—the only possible theoretical manner of
accomplishing it—would so increase the danger of detec-
tion that few thieves would think of employing it. 2d.
During the course of the administration of chloroform,
whatever manner may be adopted, the patient or sub-
ject, as a rule, becomes excited, often very violent and
turbulent, with an irrepressible propensity to sing or
shout, which is often so loud as to alarm the inmates of
the whole house. He is in a state of wild chloroformic
intoxication. The exceptions to this rule are so few
that no prudent thief would think of running the risk
of not meeting one of those exceptions; 3d. Supposing
the two preceding obstacles overcome, and the victim
thoroughly quieted into a narcotic sleep, a third and
very frequent complication arises: he begins to vomit,
and, while he does not generally make much noise
about it, still he may, and he always requires attention
lest fatal strangulation occur. The knowledge, among
the criminal classes, that the abandonment of their vic-
tim with a towel still over his face, to the liabilities
of vomiting and strangulation, would often add the
crime of murder to that of robbery, would have great
effect in deterring them from the further employment
of it.—Med. Rec., Feb. 1, ’72.
—sº- e-Gº--—
correspondence.
Diagnosis of Syphilis by the Microscopic
Examination of the Blood.
VIENNA, January 12, 1872.
MESSRS, EDITORS,--I have just returned from a meet-
ing of the “Gesellschaft der Aerzte,” at which was
announced a discovery of the most stupendous impor-
tance. I am eager to be the first to herald to the new
World, through your pages, the greatest success—I may
venture to say—as yet achived by the microscope, to
wit, the certain diagnosis of syphilis, I will give
briefly, from memory, the course of procedure which
led to this grand result, having first recorded the name
of the propounder of the new theory as Dr. Lostorfer.
Wishing to make a series of examinations of blood from
FEB. 17, 1872.]
syphilitic patients, Dr. L. applied to Prof. Zeissl, in
August last, who at once placed his wards at the service
of the investigator. The manner of conducting the re-
Searches consisted in taking a drop of blood, placing it
immediately between a slide and covering glass, then
Setting the specimen under cover. A large number of
slides were thus prepared, and daily examined micro-
Scopically with a No. 10 immersion lens, Hartnack.
The first two days nothing abnormal presented itself;
but, on the third, minute shining bodies were discerned,
which grew from day to day, until they attained the
size of red blood-corpuscles. The shape was, in most
instances, round, but modifications of that form were
here and there noticed; they were all, however, provi-
ded with tapering processes or “sprouts” The number
of these corpuscles to be seen at one time within the
field of the microscope was variable, amounting in only
one specimen to fifty. A month later these objects were
still visible. A solution of sugar, as well as several
other solutions, caused them to shrivel up, become, as
it were, folded upon themselves, lose their shining
aspect, and cease to grow. Cold was also found to
effect their development, inasmuch as a temperature
below 10° Reaumur (54°Fah.) put a stop to all growth
To prove the connection between these bodies and
syphilis very many experiments were made with
healthy and diseased blood, and the diagnosis confirmed
beyond the possibility of doubt.
Blood was then daily examined while the patients
were undergoing treatment with mercury (einreibun-
gen), and, after a certain time (in one case twenty-five
days), during which the number of corpuscles was stead-
ily decreasing, they had wholly vanished from the field.
After these experiments, Dr. Lostorfer submitted him-
self to Prof. Stricker and later to Prof. Hebra to have
his power of diagnosticating syphilis, by the microscopic
appearances of the blood, put to the test. On various
occasions he received from them numbered slides with
blood of syphilitic and non-syphilitic individuals.
To their astonishment, he unerringly selected from the
preparations those where the blood was tainted with
syphilis, with the exception that on certain slides the
blood was pronounced to be in a condition allowing of
no conclusion being arrived at.
The discoverer gives the name of syphilitic corpuscles
to these bodies, which, he said, must originate in one or
two ways—either from germs always present in the
blood, but stimulated to #." by the syphilitic virus
alone, or from such introduced bodily into the blood at
the time of infection.
In conclusion, he read the records of a number of
cases with his microscopic observations of the
blood from day to day. As Dr. Lostorfer ceased
Speaking, a burst of genuine enthusiasm escaped from
the assembled physicians, while Prof. Sºoda rose to
greet the hero of the evening, as the proclaimer of what
was destined to prove one of the most important discov-
°ries of the age. He regretted that it was not customary
TIH. H. cI.TINT C.
81
in Austria to give medals or other rewards of merit in
such cases, stating that, had this statement been made
in Paris, he would have been crowned, as he deserved.
Prof. Stricker detailed the precautions taken to avoid
error or deception in each of the trials to which Dr. L.
was subjected. The latter's selection of diseased blood
was always correct, and decided, except in the few
ruined specimens. To ensure the purity of the healthy
blood, he had taken his own and that of his servant.
After a while Dr. L. distinguished between these two,
inasmuch as the professor's was thicker and “dirtier.”
Prof. Hebra confirmed all that had gone before, and
said he had been so much struck with the discovery,
that Prof. Stricker’s blood “contained more filth
(schweinerei) than that of any other living man,” that
he had instituted researches for similar peculiarities
among his patients, but, thus far, without result. No
words are needed to show the immense field for research,
thus suddenly thrown open to investigators, nor can the
practical results likly to proceed from this study be
over-estimated. Microscopes all over the world will
now be turned toward these new constellations, and
their every freak recorded.
Theories of unity and duality will soon cease to vex
the earnest student and practitioner, and half the skill
and learning of dermatologists is made of no value by
this simple and certain indication of the presence of the
syphilitic virus. The testimony of two such renowned
and incredulous men as Professors Stricker and Hebra
is a convincing proof that these corpuscles are not bub-
bles to be pricked by the next impertinent microscopist.
I trust I have not omitted nor misstated any of the
main points of Dr. Lostorfer's paper, but if so, will send
you in expiation of my offence a copy of his article, as
Soon as printed.
I am yours, &c.,
James R. Chadwick, M. D.
—Bost. Med. Journ., Feb. 8, '72.
—-º-º-º-
ICOOIKS AND PAMIPIHILETS RECEIVERD.
DALTON'S TREATISE ON HUMAN PHYSIOLOGY-
Fifth Edition Revised and Enlarged—Philadelphia,
Henry C. Lea, 1871—For sale by Robert Clarke.
The best text book on Physiology extant in any
land or language.
HAND BOOK OF SIKIN DISEASES BY DR. ISIDOR NEU-
MANN–Translated from the Second German Ed. by
Lucias D. Bulkley, A. M. M. D. New York, D. Apple-
ton & Co., I872. For sale by Geo. E. Stevens & Co.
To be Reviewed. -
PULMONARY CONSUMPTION, ITs NATURE, VARIE-
TIES AND TTEATMENT by C. J. B. Williams, M. D. F.
R. S., and Chas. T. Williams, A. M. M. D. Philadel-
phia, Henry C. Lea, 1872. For ſale by Robert
Clarke, $300.
To be Reviewed,
82
[FEB. 17, 1872.
TIEEE CI.I.INI c.
WoRKS OF SIR. J. Y. SIMPSON.—Anaesthesia, Hospit-
alism, Hermaphroditism. New York, D. Appleton
& Co., 1872. For sale by Robert Clarke, $500.
To be Reviewed.
ESSENTIALs of THE PRINCIPLES AND PRACTICE OF
MEDICINE by Henry Hartshorne, A. M. M. D. Phila.,
H. C. Lea, 1871—Third Ed., thoroughly revised. For
sale by Robert Clarke & Co., $238.
The best “crammer” out. Like all short cuts to
knowledge, however, abrupt and deficient.
THE AMERICAN PRACTITIONER–2 Vols., 1871.
Superbly bound volumes of a first class journal.
FIRST SPECIAL REPORT OF THE CHICAGO RELIEF
AND AID SOCIETY.—Chicago, 1871—A thorough ex-
posè of the world’s charity to our distressed sister city.
TWELFTH ANNUAL REPORT OF LONGVIEW ASYLUM
for the year 1871.
THE INFLUENCE OF SPECULATIVE BELIEFS IN MED-
CINE by Z. C. McElroy, M. D. Reprinted from the
Cincinnati Lancet and Observer, Jan., 1872.
Trash.
THE HEALTH AND WEALTH OF THE CITY OF
WHEELING by Jas. E. Reeves, M. D., Health Officer,
1871.
A model report.
—º-e—sº-
(CJLHN}{{`AH, MIFMIORAN IDA.
Phrenic Neuralgia.
BY
DR, MICHEL PETER (Paris).
With this name is offered to neuropathology a hither-
to unknown, at least undescribed form of neuralgia
which is by no means of seldom occurrence, and which
owes its symtomatology to several well known forms of
disease, as angina pectoris, pleuritis diaphragmatica,
pericarditis and hepatitis.
It has been hitherto unrecognized because the mixed
character of the phrenic has not until of late been
recognized.
Its characteristic symptoms are as follows:
1. Jaliopathic pains, most severe in the lower part of
the chest and in the shoulder, less in the neck and
nucha. These pains are increased by pressure.
2. Points of tenderness, corresponding to the course
of the phrenic nerve, thus, at the anterior attachment
of the diaphragm from the 7th-10th, particularly at the
9th rib ; at its posterior attachment, particularly at the
angle of the last rib, further, at the trunk of the nerve,
in front of the scalenus anticus, in the lateral region of
the thorax in the 2nd and 3rd intercostal space, especially
at the junction of the 3rd rib with its cartilage, some-
times a little lower. These last points correspond to the
. connections of the phrenic with the cardiac plexus.
3. Irradiating pains due to the connections of the
phrenic with the nerves affected. In case of the cer-
vical plexus, these are experienced inside the middle
of the clavicle, and on the sides of the neck up to the
lower jaw; in case of the brachial plexus, pains in the
shoulder, inner surface of the arm, elbow and little
finger. - -
4. Pains at the spinous processes of the 2nd-4th cervical
vertebræ particularly at the 3rd and 4th.
5. Functional disturbances of respiration, mastication,
deglutition and motion of the left arm. -
Respiration is labored, imperfect and painful as are
all acts in which the diaphragm participates—it becomes
still more imperfect, even checked altogether by pres-
sure on the nerves of the neck which sometimes causes
coughing. .
The impairment of motion of the arm depends partly
on the pains in the shoulder and partly on paresis.
The left arm suffers in affections of the heart, pericar-
dium and spleen, the right in affections of the liver;
affections of the diaphragm affect now one arm, now the
other, again both. -
Differential diagnosis between phrenic and intercostal
neuralgia is easy. • *. -
Rheumatism of the diaphragm cannot be differentiated
from this affection. The one-sidedness of neuralgia
may be a point of value. Diaphragmatic pleurisy is
attended with fever ; its symptoms are much more in-
tense. This depends, partly, however, upon the con-
comitant neuralgia. The same is the case in heart
affections; the pain in the shoulder will here excite
suspicion. Diaphragmatic peritonitis and hepatitis have
their own specific symptoms in differentiation. Angina
pectoris has the radiating pains in common with the
affection of the text but the anxiety and local cardiac
symptoms allow a distinction. Gastralgia which might
confuse diagnosis by its spontaneous pains does not
possess the points of tenderness described. Intercostal
neuralgia, finally, has also its specific character and is
usually seated in the middle intercostal region.
Phrenic neuralgia occurs Sometimes isolated, some-
times intercurrent with other affections, especially
hysteria and epilepsy, or with angina pectoris with or
without heart disease or with Morbus Basedorwii, with
|spleen affections, particularly in consequence of mi-
asm or finally with affections of the liver.
Prognosis, hence, varies according to these conditions.
In simple neuralgia, it is favorable.
Its treatment is that for neuralgia in general, wet
cups, vesicants, morphia hypodermically, or simple
sinapisms with anodyne applications. When the dis-
ease is only a symptom, therapy must be directed to its
C3, UISC,
[Details of 16 cases follow].-Arch. Gen., 6 Str. avii.
303—Schmidt’s Jahrbücher, Jan., '72. "
FEB. 17, 1872.]
INTESTINAL OBSTRUCTION FROM ACCUMULATION OF
FAECES CURED BY THE INTERNAL AND ExTERNAL
USE OF ICE.-M. Prunac reports (L’Abeille Médicale,
December 25; from Le Gazette des Hôpitauw) a case in
which urgent symptoms of intestinal obstruction, de-
pendent upon this cause, yielded to the application of
ice to the abdomen, and to injections of ice-water every
quarter of an hour, after having resisted the more usual
methods of treatment.
EXTRACT OF MEAT.-Some of the recent experiments
on the nutritive value of the Extractum carnis do not
give a high estimate of its physiological importance.
Herr G. Bunge, who has been lately investigating this
subject, under the direction of Dr. Schmiedeberg, of
Dorpat, assigns a lower value (as a nutrient material)
to the extract than to coffee, tea, or alcohol.—Archiv
fur die gesammte Physiologie, Bd. iv.
A CASE OF ACUTE CATARACT.-In the Klin. Monats-
blat f Augenheilkinde (1870), Ritter reports a case of
double cataract formed in less than seven days attended
with no symptoms of irritation on the part of the exter-
nal or internal membranes of the eye, with no alteration
in the aqueous or vitreous humor. As the patient was
a fireman the writer considered the intense heat as the
cause of the opacity of the lenses.
TREATMENToR PRURITUs VULVE.—Those who have
had any experience in the treatment of this troublesome
affection will learn with interest that Mr. McGrath
states (The Canada Lancet, November, 1871) that he
has found the following, applied by means of a soft
Sponge after ablution morning and evening, attended
with the most satisfactory and speedy result;-Biborate
of soda, 3ij; hydrochlorate of morphia, gr. xx; hydro-
cyanic acid, 3.j; glycerine, fºj; distilled rose-water,
f; viij–Phil. Times, Feb. 1, ’72.
HOT BATEIS IN HYDROPS.–These baths 28°-34° R.,
[89°-97°F.] with after perspiration of two or three hours
have their indications and contra-indications. No age
excludes them, the previous strength of constitution
need not be regarded, except that caution must be ex-
ercised in debilitated subjects. They are indicated in
diffuse transudations in the subcutaneous tissue if not
too extensive, in effusions into the peritoneum, pleura,
pericardium, etc. If these dropsies are consequences of
mal-nutrition—this is to be remedied.
Transudations from depression of the heart's energy
disappear under appropriate treatment. Transudations
after Scarlatina form an extensive field for hot baths.
Relief of transudations caused by pathological pro-
Cesses is only possible when these lesions can be relieved.
If these cannot be relieved the transudation can only
be transitorily affected. Even this, however, is a great ||
comfort to the patient.
Hot baths are contra-indicated in capillary bronchitis,
beginning lung cedema, diminished excretion of
urine, (in which latter case uraemic convulsions may
occur). -
T EIIL c1. INTI c.
83
They are indicated in chronic liver and spleen affec-
tions as also in chronic heart disease as is demonstrated
by cases in illustration.
Most decidedly are they contra-indicated when fever
is present, or disease of the brain or its membranes, in
pericardial effusions of high degree or finally when the
general strength is extremely prostrated,—Jahrb. f.
Rinderheilk. N. F. 3, 1871—Schmidt’s Jahrb., Jan. 2, '72.
—º-gº-ºº--—
Indications for the Employment of the Catheter
in Old People.
M. Guyon, in one of his clinical conferences at the
Hôpital Necker, lately remarked that retention of the
urine is very common in old men, depending generally
on affections of the bladder, or of the neck of the blad-
der, or of the prostate. Many cases of supposed vesical
paralysis are in reality due to prostatic disease. Reten-
tion of urine in old people displays itself by symptoms
that are eminently variable. Sometimes these symp-
toms are strongly marked: the patients require to
micturate frequently, and in doing so experience pain
and burning heat which lasts for a long time; there
may even be constitutional and febrile symptoms. In
other instances, again, the symptoms are by no means
prominent, especially in those cases where the bladder
is but little contractile; the retention is then only indi-
cated by percussion, palpation, and catheterism, the
latter alone in many cases being reliable evidence of its
presence. But this indication that catheterism should
be adopted as an exploratory means is somewhat deli-
cate, for the operation is not always inoffensive, and the
patient suffering but little, subsequent troubles may be
attributed by the patient or by his friends to the injudi-
cious interference of the surgeon. If, however, the
symptoms be well marked, then there is no room for
hesitation, and M. Guyon even goes so far as to say
that the catheter should be passed in the case of every
old man who evacuates the contents of his bladder im-
perfectly. He thinks that it is not necessary that it
should enter the organ on the first occasion, since, if
only introduced as far as the neck, it habituates the
tissues to the contact of instruments, and indicates, in
part at least, the seat of the disease. Stoppage of the
flow of water is always a serious symptom in old people,
and the best advice that can be given to them is to be
sounded either with a simple sound or with a catheter,
and that frequently. Indeed, if relief be not speedily
afforded to such patients, dangerous symptoms soon
make their appearance in the form of rigors, purulent
urine, and violent reaction.
Purely medical treatment is of no service in such
cases, and he gives an instance in point. In 1869, in
the month of September, M. Guyon had in his wards a
man aged 48, who, after having been treated by ordinary
remedies and by rest, left the hospital, but returned in
January, 1870. He was now suffering from orchitis and
84
[FEB. 17, 1872.
T H. H. C. T., IISTIC .
distinct enlargement of the prostate; he passed water
frequently; the urine was thick, but was voided in suffi-
cient quantities to lead to the belief that the bladder
was thoroughly emptied. On the 1st of February there
was some fever present, and on the catheter being intro-
duced about four ounces of urine were drawn off, and
on a second occasion about six ounces. He was sounded
four times, and was then told to sound himself. No
other treatment was adopted. On the 7th the urine was
clear yellow, and on the 15th he was able to remain five
hours without urinating. Catheterism practiced in his
case twice a day caused no return of the epididymitis.
In another case, occurring in a dyspeptic subject, all
the symptoms of cystitis were present. For a long time
M. Guyon hesitated to sound him, and for two months
he was treated medicinally without effect. At length
he was catheterised, and the urine drawn off. The
symptoms immediately diminished in intensity, and
from this moment the urine, which had up to that time
been troubled and imperfectly discharged, became
limpid and even entirely evacuated. A third patient
passed blood, and was obliged to remain in the recum-
bent position. After careful exploration M. Guyon
recognised the existence of retention of urine, and passed
a catheter. From this time all the symptions of stone
of which the patient complained disappeared. Thus
not only stoppage of the flow of water occasions grave
accidents, but it stimulates other diseases; it causes
alterations of the walls of the bladder, and provokes
cystitis. When the bladder is greatly distended, how-
ever, it is imprudent to evacuate it completely. The
frequency with which catheterism should be repeated is
an important question. No absolute rule can be laid
down, but it may be performed every five hours; but
commonly the instrument should only be passed when
there is intense desire to urinate. If, however, he ex-
perience but little or no inconvenience, it should be
passed at regular intervals. As a rule, the permanent
retention of the catheter in the bladder is to be avoided,
except perhaps in cases when the desire to pass water is
very intense and frequent, or when the introduction of
a catheter is very difficult. M. Guyon cites a case
where it was worn for two years. It should in general
be fixed in position till the bladder is habituated to
catheterism. As adjuvants to the above treatment, in-
jections may be employed, which may be hot, cold, or
medicamented as occasion may require. (Lucas-
Championnière's Journal de Médecine, tome xlii., cahier 2).
— The London Practitioner, Jan., '72.
ANTIDOTE TO CARBOLIC ACID.—Dr. T. Hasemann,
from numerous careful experiments, both chemical and
medicinal, advocates the use of a strong solution of
Saccharate of lime, of course to be taken as soon as possi-
ble, as an antidote to carbolic acid.—News and Library,
Jan., '72.
PHAGADAENA OF THE PENIS TREATED BY OPIUM.–
A case under the care of Mr. Pollock, of St. George's
Hospital, shows the advantage of this plan of treatment
well. The patient was admitted with a phagadaenic
ulceration of the glans penis, probably of syphilitic
origin. He was ordered fifteen drops of tincture of
opium every four hours; but as at the end of two days
the patient had not made satisfactory progress, the
dose was increased to twenty drops, and was combined
with half a drachm of compound spirit of ammonia.
At the same time a weak solution of carbolic acid was
applied locally on lint. A speedy improvement was
now observed, and cicatrisation was almost complete in
a fortnight.—The London Practitioner, Jan., 1872.
FISTULA FOR CYSTITIS.—Dr. Emmet reports in de-
tail the history and treatment of several cases of cystitis
in which a vesico-vaginal fistula was made for relief.
He says “in making the selection I have intentionally
presented some of the cases with which I have had most
difficulty, wishing rather to give prominence to the
dangers than to mislead.” In all he has operated
in some ten or twelve cases, of which the present report
embraces four, “I have had but one death follow the
operation, the history of which is given in my work on
Vesico-vaginal Fistula, p. 237. Case LXXIV—Cystitis
resulting from cold, of eighteen years duration, followed
by a pelvic abscess, which soon afterwards opened
into the bladder and vagina. Fifteen months previ-
ous to admission incontinence of urine suddenly took
place with partial relief of the cystitis afterward. The
vesico-vaginal sinus was enlarged so as to allow of the
free escape of urine. Death from uraemia 48 hours after
the operation. * % 3& *
“With the exception of a patient who suffered from
an attack of peritonitis, due to accidental exposure a
week or more after the operation, I have met with but
little difficulty in the after-treatment of other cases,
and therefore have thought it unnecessary to extend
this paper to a greater length.”—Am. Pract., Feb., '72.
—- sº-º-º-
HoME NEws.
CoRRECTIONs Semi-Centennial Catalogue reported to
date : Dr. W. S. Oneal instead of Dr. W. S. P. Neal.
As THE CLINIC is constantly engaged in bringing to
domestic notice the names of eminent foreigners it is no
more than fair that foreign notices of domestic papers
should be likewise duly chronicled. We observe thus
in the last number of Virchow's Jahresbericht der
Gesammt. Med., a notice of Prof. Dawson's case of
hernia as presented to the Academy of Medicine, no less
than ten different notices of various papers by Prof.
Bartholow, and three of Prof. Blackman, besides the full
abstract of Prof. Conner's paper mentioned a few weeks
ago. The last number of the Paris Annales d’Oculistique
contains a full abstract of Prof. Seely's paper on Stric-
tures of the Nasal Duct, and the last number of the
Archiv. f. Gynaekologie refers to a paper by a Cincin-
nati Physician on the Morbid Anatomy of the Placenta.
THE Commencement Exercises of this year will attract,
it is hoped, a large number of the old graduates all over
the land. It is proposed to establish an Alumni associa-
tion to hold annual reunions each commencement.
F. E. SUIR . . E. S. WAYNE
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Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to nuerit a continuation of the
same. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in-
struments. Those in want of any of the acknowledged good aids of
Wision to imperfect eyes, will always find the best and largest stock of
Leinses, Spectacles, and the best models procurable, with pains-
taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopic Objects
and Microscopic Apparatus, Magnifiers and Readers in
great varietv. Medical Batteries, Barometers, Thermo-
rameters, Hygrometers, Urinometers and Rain Gauges,
of the most approved coustruction always on hand. All orders promptly
and accurately filled.
JAS. FOSTER, JR. dealing -
F. S. SHACKLEFORD, ; *** * JAs. FostER, JR. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TIER). S-INT-INAL_A_IER,SIET’S
No. 758 BROADWAY, New York
HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it tar preferable to
any I have ever examined. LEWIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, MI. D., Surgeon to the
Massachusetts General IIospital,
B EG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with an v of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Mal sh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. • WILLA RD PARKER, MI. I.).
Professor of Surgery, New York City
IDr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSHI & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati. w
OPPOSITE THE HIGH STEEPLR,



t|M|| Wilſº Mºſ
SAML. P. THOMAS
167 EAST 34 TLI-ST., NE IV YO RIC,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANUE ACTURERS OF PORTABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwamic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871. *
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
|| || |||||—|| ||||||}}
PERMANIENT EATTERIEs,
For Hospitals and General Practitioners,
TEIT IIECTIER, OTDIES.
For Eye, Ear, Larynx, Nose, Uterus, Vagina, Bladder, Reč-
tum, Feet, Phrenic and Sympathetic Nerves, Elec.
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
->O->O->-
EXTIRA (4TS FROMr TFIE O PINIONS OF THE IrOST
JEMI NENT IMIEIM BERS OF THIS PROFESS E O N.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Nothing cAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. IIammond to announce ern-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
provel and re-modified Instruments made by our Company.
* \l EREDITH CLY MUER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider their
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:—“In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. G. AR RATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, MI. D.; E. C. SEGUIN, MI. D.;
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOIIN J. CALDWELL, MI. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST,
DE ALER IN
English, French and Scotch
GOOD's,
34 West Fourth Street,
("Z.W*("A.W.W.? 7"A.
Are furnished to Officers and Soldiers on Government
account.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to, manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTEE,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 172 Jef-
ferson Avenue, Detroit, Mich.


List of Pharmaceutical Preparations,
won.v. Irrazºn dº anoznan,
FEIILADELPHIA.
ELIX. PHOS, IRON, QUININE AND STRYCHNIA, -
. . ." ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA,
(Goddard’s Formula,)
- - ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
" . . ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER wine OFIRoş,
citrate of Iron and Peruvian Bark,
- - FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK, -
-- - - FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
- * TASTELESS COD LIVER OIL,
TASTELESSCODLIVER OIL. FERRATED,
BEEF. IRON AND WINE. e
ELIXIRVALERIANATE OF STRYCHNIA, WINE OF rººm
SYRUPSUPERPHOSPHATE OF IRON, - --- i lºw y
ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRA BRAVA.
. . STUI PIPOSITOTER, TIES.
Rectum, vaginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
care, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and style made of finest quality of sponge.

O' D C R LEs s AN ID PA. LATA B L E.
~
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c. • -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent. *
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only. *
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

CAMARGO
MANUFACTURING COMPANY,
MANUFACTURERS AND IMPORTERS OF
../ſº
SS
* NS
3 .
# *f
AND
Window Shades,
67 WºSz' A'oºziz Szºzzº,
CINCINNXT, O,
H. H. BRENEMAN, Proprietor,
WILSON B
Made to order of N. Y. M. Muslin and 2300
IIEAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.0)
First three qualities have ALL LIN EN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less.
Perfect satisfaction given or money cheerfully
refunded. * . . .
* Also import and Manufacture Men’s Furnish-
ing Goods. . . .” -
rikes. Opera-House, Fourth Street, Cincinnati; 931
Wabasha Avenue, and ss West Washington
* - Street, Chicago.
|M. A. F. K TVA IN'S
NIEVV B O O IX
IS NOVV READY FOR CA N VASSE FRS.
It contains over 600 pages of read:ng matter, with 250
engravings, designed expressly for this work, by the beft
artists in the country. Agents now at work upon it are
meeting with unparalleled success. Agents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re-
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 Elm Street, Cincinnati, O.
BASCOM & CARFENTER,
Stationers, Printers
-AND-.
Blank Book Manufacturers,
136 v1.NE stre+ET,
syssWSNs
º:
E. D. ALBRO & BRO.
IMPORTERS AND MANU FACTUREIRS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
frº-Mikº','!-Biliń'milli-Biº":
The only house in the Western country that saws Spanish and Mexi-
can cedar for Cigar-Box Makers We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers. -
Office and Warerooms, 136 and 138 West Second Street,
Veneer Min, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNAT1.




sºlº-
} º º, ºr AS ºs.
Nº.
º * —d : *
fºr .. , , , . --- . . . . . . - * . . . º: * : * ~ *-*.
iſ . º. WSºjº º 'º lºssº º
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E.--~~~~
; : : º
CINCINNATI.
—º-
FA C U L T Y.
J A M ES G R A H A M, M. D., DEAN,
IProfessor of the Theory and IPractice of IMCedicine and Cli
•. S
nical Medicine.
-* *.
, ... • * * : *
ROBERTS BARTHOLOW, M.D., w. W. DAWSON, M. D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., - - -º- ' - C. D. PALMER, M.D., * * *
Professor of Anatomy. Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D.,
T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
W. W. SEELY, M.D.,
JOHN L. CLEVELAND, M.D.,
Professor of Diseases of the Eye and Ear.
Demonstrator of Anatomy.
SAMUEL NICKLYSS, M.D., CHARLES KEARNS, M.D.,
Professor of Physics and Medical Chemistry. Assist, aſ to the Chair of Surgery.
*... . . . .
. . . . . * *
J A MC E S TC - W H IT TD AL ES Jº, ER, • ** * * *
Professor of Physiology and Secretary of the Faculty.
agº"T"-se
T. Louis Baown, Prosector of Anatomy.
s —- --~~
Janitor, Collège Building, Sixth St., bet. Vine and Race.
Printed and Published by Norris & M cFRY,
Medical College of Ohio Building, Cincinnati.

































THE CLINIC,
PUBLISHIED EVERY SATURDAY.
TER M S-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
Vol. 2. C IN C IN N ATI,
F E B R U A R Y 24, 1872.
—º
No. 8.
JAS. T. VV HIT TAKER, M. D. Editor.
Nq. 101 West Ninth Street, Cincinnati.
-A-SSOCIC A.T.E. H. DITOIES.
W. W. D.Awson, M. D. TILAD. A. ReAMy, M. D.
IP. S. Con NER, M. D. C. D. PALM :R, M. D.
W. W. SEELY. M. D. SAMUEL NICKLEs, M. D.
CIIAs. KEARNs, M. D. JNo. L. CLEVELAND, M. D.
Roperts BARTHoLow, M. D.
W. W. SEELY, M. D., sº me º a sº tº TREASUREIt.
No. 118 West Seventh Street, Cincinnati.
C L U B R A T E S,
4 Copies to one address...................................................... $ 7.00
6 & & 4 10.00
12 ſ & & 4 18.00
C O N T E N T S. - *
-º- Page:
orrorNAL ARTICLEs
Medical Electricity and Medical Electrical Apparatus—The Eee-
tric Chamber of the Good Samaritan Hospital, by Roberts -
Bartholow, M. D & & e º e º ºs e º ſº tº a º sº e s m s m ºn tº e s e º e º e º a gº tº e º 'º e s ſº tº e º 'º e º 'º e º 'º - ºr e º 'º e º e a 8?
TRANSI LATION
Cancroid, Impetigo, etc., Their Diagnosis and Therapy, by M. A.
Duvergie, (From the Bulletin Therapeutique, Nov. 30, 1871)........90
Coal Dust in the Lungs, (A Chapter from Hirt's Staub-Inhalations
Krankheiten, Breslau, 1871.)..................................................... 9]
SCIENTIFIC NOTES
Diagnosis of Syphilis by the Microscope—Sarcina in Blood........ 93-94
M. IE DICALL NEWS
A Curious Suggestion—Quacks excluded from Penn. Hospital—A
Facetious Review.................................................................. 94-95.
CORRESPONDENCE
Letter from Dr. Juler—The Recent Bandaging Contest.................... 95
CILINICAL, MIEN IORANIDA
Turpentine in Acute Affections of the Middle Ear–Sºin Puncture
s
in Anasarca Qſ
HOME NEWS................................................................................ 9(
The Spring Course of 1872 90
*-
* * * * * * * * *-*.
WE hear a good deaſ in Cincinnati about the effects
of our smoky atmosphere. Our information on this
subject hitherto has been mostly in the way of glitter-
ing generalities. THE CLINIC commences a series of
translations in this number with some positive knowl-
edge on this subject.
Further in detail is presented, also, of Lostorfer's great
discovery of the “syphilis corpuscle.” "
coaxN te co-
Fashionable Hatters,
lyſportERS AND MANUFACTURElis 0F
EA}}{ES” FºrS,
92 WEST FOTTERTH ST.
Opposite Post Office,
CINCININATI.
& Special Inducements to Medical Mem.
s #: º
*A. OD
jºsº. 32. WºST FOURTH: Sº &---.
Nº CINCINNATI, OHIO:
e we wº. -- *-
J. TAFT, W. TAFT.
Editor Dental Register
J. & W. TAFT,
IDENTIsTs
117 WEST FOURTH STREET,
CHN CIN NATI, O.
Registers
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,











MARviv's


COTD IT IIITVTIEHIER, GDIT_
O D O R. L. E S S A. IN ID PA I, A. T A E I L IE •
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. *
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its meri”
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufact
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.
ROBERT CLARKE & Gū’S,
LIST . OF NEW
Mail, iTºm Mºulis in:
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo
Cloth. $2 5c - -
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 ot
DILLENBERGER ON WOMEN AND CHILDREN’S DIS
EASES. 12mo. $1 75 -
BENNETT ON PULMONORY CONSUMPTION. 8vo. $1 5¢
FIRST HELP IN ACCIDENTS. 12mo. $1 50
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 5o
ECHEVERRIA ON EPILEPSY. 8vo. Cloth. $5 oc
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASES. 8vo. $; oo
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oc
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 od Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth. $2 5c
TANNER'S HANDBOOK OF OBSTETRICS. 12 mo. $2 oc
VAN BUREN ON DISEASES OF THE RECTUM. 12mo.
Cloth. $1 5o
FLINT’S EXAMINATION OF URINE. 12mo, Cloth. $ 1 oc
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 5¢
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRIGITY. 8vo. Cloth. $4 5o
ATTFIELD'S MEDICAL CHEMISTRY. 12mo. Cloth. $2.75
Leather. $3 25
BARTHOLOW'S HYPODERMIC MEDICATION.
Cloth. $1 5o
TURNBULL’S DISEASES OF THE EAR. 8vo. Cloth. $5 od
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 od
NEUMANN'S HAND-BOOK OF SKIN DISEASES.
Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 oo.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
- plates. $1o oo
HOOD ON BONE SETTING. 12mo. $1 5o
RINGER'S HAND-BOOK OF THER APEUTICS. 8vo. $4 oo
I 2, TIMO.
8vo.
HOLBROOK’S PARTURITION WITHOUT PAIN. 16mo.
- $1 oo
PROCTER'S LIGHT SCIENCE FOR LEISURE HOURS.
12mo. $1 75 -
BERNARD’S PHYSIOLOGY OF THE HEART: 50 cts.
BARNES’ OBSTETRICAL OPERATIONS. 8vo. $4 5o
NICHOL’S FIRESIDE SCIENCE. 12mo. $1 5o.
WOHLER'S MINERAL ANALYSIS. 12mo. Cloth. $3 oc
PLATTNER'S MANUAL OF ANALYSIS WITH THE
BLOWPIPE. 8vo. Cloth. $7 5o
JEFFRIES ON THE EYE. 8vo. Cloth. $1 oo
MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
JEFFRIES ON THE SKIN. 8vo. Cloth. $1 oo -
GARDENING FOR PROFIT. 12mo. Cloth. $1 5o
PRACTICAL FLORICULTURE. 12mo.
FULLER'S SMALL FRUIT CULTURE. 12mo. Cloth. $1 5o
WOOD WARD's countRY HOMES. 12mo. Cloth. $1 5c
DARWIN'S ORIGIN OF SPECIES. 12mo. Cloth. $2 oc
ARTHUR'S TREATMENT AND PREVENTION OF DE-
CAY OF THE TEETH. 12mo. $1 5o
TYND ALL ON LIGHT AND ELECTRICITY. 12mo. $1 25
THE AMATEUK MICROSCOPIST. Small 4to. $1 75
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMEN.
ROBERTS ON RENAL DISEASES.
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN.
Medical, Scientific, and other Catologues sent on application. *
Any book in the above list sent by mail or express, free of charge
on receipt of price. .
Cloth. $1 5o
65 West 4th Street, Cincinnati, Ohio. §
William Autenrieth,
No. 71 west sIXTH stre+EET,
BKTWEEN WALWUT Año VINE,
cincinnati, ohio,
MANUFACTURER OF AND DEALER IN
|| || || ||||||||
Abdominal Supporters, Trusses,
TUB-F00T SHOES,
SPINAL APPARATUS, ETſ .
Keeps constantly on hand a full variety of
Metalic and ERubber syringes,
Stormzach Pumps, Etc.
stockINGs Foſt vanicose veins,
Special attention given to the fitting of Apparatus for Deformities.
B& Agent for DR. L. A. BABCOCK'S
§ilver Uterine Supporter,
—ALSo—
DR. AHL'S POROUS FELT SPLINTS,
~ALSO–
DAY's spi, INTs
-AND-
S. W. Elliott's Saddle-bags
List of Pharmaceutical Preparations,
MANUEFACTURED EY
Jø/ZW WJZZZZ & B/P0ZZZºº,
FIHºrrº.4\D.E.L.F.H.I.A.
—dº-
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERTANATE OF AMMONIA,
(Goddardi's Formula,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK, º
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
* COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH, -
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK,
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUP SUPERPHOSPHATE OF IRON, y
ELIXIR OF BISMUTH,
COMP. FLUIDEXT. BUCHU AND PAREIRA BRAWA.
STUIEPEPOSITOTER, TIES.
Rectum, Vaginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
care, and of every variety of combination. Lists sent on application.
SPOINGE TENTS.–For the Urethra, of every size and 8tyle, made of finest quality of sponge.
FOSTE: Fº’5
152 ALTTE INT
Are furnished to Officers and Soldiers on Government
account.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTEER,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 172 Jef-
ferson Avenue, Detroit, Mich.
..e. --
SAML. P. THOMAS
T.A.. I I, OR,
IDEALER IN
English, French and Scotch
GOOIDs,
34 West Fourth Street,
("A.W'6"A.W.W.??"}.
||||||}|| || ||M||
167 EAST 34TH-ST., NEW YOI: R,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANUFACTURERS OF POP TABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwamic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
|||||| ||||||—|| |||||||
E’ERMIANENT BATTERIEs,
For Hospitals and General Practitioners,
-TET IIECTIER, OTDIEGS-
For Eye, Ear, Larynx, Nose, Uterus, Wagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Elec.
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
EXTRA 64TS FROIſ THE OPINIONS OF THE MOST
JEIHINENT MEMBERS OF THIS PROFESS / ON.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Not HING CAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. Hammond to announce eun-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
* MEREDITH CLYMER, M. D., Prof. of Diseases of the Ner-
vous System and of the Mind, &c., &c.—“I consider theºr
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:—“In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. GARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes. --
CALL OR SEND FOR CIRCULAR AND PRICE LIST.

DIVIDED MEDICINES,
The Divided Medicine Com’y,
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExCEEDINGLY PRACTICAI,
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. sº -
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities.
But not only SolueIE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. * - - |}
* This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; , , , ºo, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines.
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For Samples, Price Lists, and Agencies, address
IECX 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
MR. FREDERICK KRAUs: CINGINNAT1, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: . -
SULPH:MORPH II....................... % grain in each square. ARSEN: ACID..........................1-20 grain in each square.
** CH IN INI .......................] ** * * 46 CALOMEL 34 “ “ “
“. COPPER ....................... 3% 66
ResPECTFULLY You Bs,
E. S. WAYNE, Analytic Chemist.




T TELIED CT I I INT I C . 85
Vol. 2..] S A T U R D A Y, F E B R U A R Y 24, 1872. [No. 8.
|
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T H E C O N S T A N T C U R R E N T B A TT E R Y A N D R E G U L A T O R () F T H E
E L E C T R T C C H A M B E R O F T H E H O S P IT A L OF T H E
G O O D S A M A R IT A. N. ( for description see meat page.)

86
[FEB. 24, 1872.
T THITE C T , T IN IT. C.
M IELDICAL ELECTRICITY AND MIEDICAL
IELECT RICA L AIP PARATUS.
The Electrical Room of the Good Samaritan
Hospital.
BY
ROBERTS BARTHOLOW, M. D.
Number 7.
The applications of electricity to the treatment of
disease have become so numerous and important, that
no hospital can be considered properly provided, which
does not contain the most approved electrical apparatus.
We can now say that a hospital in Cincinnati is as
By
thoroughly equipped in this respect as any other.
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the intelligent liberality of a gentleman of this city, the
Good Samaritan Hospital now contains an electrical
room furnished with all the appliances needed for the
practical uses and scientific study of electricity. The
patients will have the advantage of the undeniable good
which comes of the use of electricity in suitable cases;
the therapeutical resources of the Staff will be greatly
increased, and the numerous students who attend the
clinical courses will have the opportunity to learn all
that has been, and is being accomplished in this depart-
ment of medical Science. It is, therefore, with unmixed
gratification that we submit to our readers an account
of the Electrical Room of the Good Samaritan Hospital.
The room is in close juxtaposition to the clinical
| | ...~~
lecture room, and contains a permanent galvanic battery
of sixty elements with regulator and the various forms
of electrodes; an induction machine; a galvano-caustic
battery, and galvano-caustic electrodes; and an exten-
sion chair for the comfortable placing of the patient.
Galvanie Battery.—The cups of the permanent battery
are that modification of Daniell’s, known as Siemens and
Halske's, and were made in the most excellent manner
by Mr. Brown, a medical student and electrician of
this city. This form of battery was originally intro-
duced by Remak, and is now almost exclusively used
by the continental electricians. It has the great merit
of being truly constant; it remains long in action with-
out losing power, and is very durable. As it has already
been described in the columns of THE CLINIC it is not
necessary to enter into any further particulars.
The cups of the battery are connected with the Regu-
lator of the Galvano-Faradic Company. This admirable
instrument is provided with galvanometer, current
wº
assº
. …"
; , , ſº
*
--~~
interrupter, polarity changer, current modifiers, and
current selectors, thus permitting to the operator the
production of all the electro-physiological and electro-
therapeutical effects. On the left side of the regulator,
communication may be made with 2, 4, 6, 8 and 10,
and on the right with 10, 20, 30, 40 and 50 cups. The
current flowing through either or both poles may be
further modified by the right and left hand modifiers.
The cups are contained in a neat upright walnut case
in shape like a book case, and the regulator is placed
on the table in front, which with its tiers of drawers
resembles an office desk. (The first page wood-cut
shows the arrangement). Wires pass from the regula-
|tor to the lecture room so that applications may be


FEB. 24, 1872.]
made in presence of the class. In the same way one or
all the wards of the hospital may be brought into
direct communication with the battery.
Faradic Machine.—The Faradic instrument selected,
is the ingenious and excellent arrangement of the Galva-
no-Faradic Company. It is represented in Fig. 2, (p.86)
with one cell, but the hospital instrument is the “double
cell battery.” The cellis Stoehrer's modification of Bun-
sen's carbon battery, and consists of two carbon plates
and one zinc plate. By means of the graduated hinged
rod A, the zinc element is raised from or lowered into
the exciting fluid, so that when not in use the zinc may
be preserved from loss. A very important feature of
this instrument is the “adjustable elastic fork” attached
to the rheotome by which the operator may control the
T TEI IET: C T IIINT I C -
rapidity of the interruptions, making them slow or fast
at will. In the instruments ordinarily in use the inter-
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87
different degrees of susceptibility evinced on each
occasion. As the strength of the primary current is in-
creased by drawing out the movable coil 4, we count
from left to right when we apply that current. The in-
tensity of the secondary current is increased by pushing
the movable coil inwards. In this case we make the
record from right to left. -
Galvano-Caustic Battery.—The engraving below rep-
resents the hospital galvano-caustic battery, an im-
proved modification of Stöhrer's and Grenet's. There
are four capacious glass cells, each containing four large .
zinc and three carbon plates. This is the “American
Galvano-Caustic Battery” of the Galvano-Faradic Com-
pany. It consists of zinc and carbon elements, the ex-
citing fluid being a solution of bi-chromate of potash in
dilute sulphuric acid. The elements may, as will be
perceived on examination of the engraving, be raised
{, }
|º
|
- |
º | | 1.
Lº
/ \ º
ºf sº
-*-*
… --, -se------------
ruptions occur so rapidly that the muscles are kept in a
state of tonic contraction; whereas, in this, there may
be, by regulating the vibrations of the hammer, distinct
contraction and relaxation. Any electro-therapeutist
will readily appreciate the advantages which belong to
such an arrangement. Both the inducing and the in-
duced currents are obtained from this machine, and an
arrangement exists for changing from one to the other
and for reversing the polarity of either. This instru-
ment has the further advantage of a cell cover (Powell's
Hydrostat F) which renders it perfectly portable with-
out the necessity for emptying out the liquid.
G, represents an indicator or scale affixed beneath the
movable coil 4, graduated both ways, to enable the
operator to make an exact record of the electricity ap-
plied to his patient at each seance, thus determining the
out of or lowered into the exciting fluid. When the
action flags, air is blown into the fluid by the bellows.
This battery is accompanied by a case containing all
the galvano-caustic electrodes in situ. (Fig. 4, p. 88.)
1. Handle for looped electrodes.
2. Stem for loops.
3. Long tubes for laryngaeal application, for nasal
polypi, etc.
4. Short tubes for loop.
5. Universal handle.—The upper end of each of the
other cauteries can be inserted in the socket of this
handle.
6. Platina point cauterizer for concentrated cauteriza-
tion, counter irritation, etc.
7, 8, 9. Dome cauteries for cauterization of sinuses,
bleeding surfaces, bases of ulcers, places where cicatricial














88
[FEB. 24, 1872.
T TE:L THE CIT IIIN T C.
contraction is desired, for the destruction of small
growths, etc.
10. Long curved stem cauterizer for cavities, sinuses,
€tC.
11.
12.
13.
14.
15.
16.
17.
Straight stem cauterizer.
Galvanic knife cautery.
Right angle loop, which may be used as a knife.
Galvanic curette. •
Beak cautery for counter irritation.
Short curved stem for cavities, sinuses, etc.
Pocket for platina wire and porcelain domes.
†
* 7 O/ZZZ
Fig. 4.
This case contains most of the apparatus necessary
for the surgical uses of electricity. It need hardly be
remarked how important these uses are, and to what an
extent the various galvano-caustic instruments are ap-
plicable to the treatment of lesions hitherto remediable
only by the surgeon's knife and to some, indeed curable
by no other methods. For the benefit of the skeptical
it may be stated that polypi, have by the galvanic loop
been removed from the naso-pharyngeal space, from the
larynx and from the uterus. By the same means the
cervix uteri has been amputated and hemorrhoids ex-
cised. By the electrolytic decomposition tumors and
glandular enlargements have been resolved, aneurisms -
consolidated, and hydatids of the liver destroyed. The
needles for electrolysis are represented in Fig. 5.
Fig. 5.
For galvanization of the male bladder and urethra, the
electrical room is provided with the catheters and sounds
shown in Figs. 6, 7 and 8.
For the electrical treatment of uterine maladies we
have the various forms of electrodes represented in Figé.
9, 10, 11, 12, 13, 14, 15, 16 and 17.
E::=>==E-BE:-----
FE-Erz:TET=-EEE------------------
---











FEB. 24, 1872.]
TIEI IEH C T , IIINTI C.
89
Fig. 18 represents Duchenne's ear electrode and Fig. |
19, a laryngeal electrode. Duchenne's electrodes for
electrizing muscles is shown in Fig. 20.
Beside the foregoing the electrical room is supplied
with various electrodes for the general purposes of elec-
trical application. Some of them are represented
below. -
Fig. 21. Sponge covered electrode for feet. -
Fig. 22. Phrenic nerve electrode.
Fig. 23. Metallic brush electrode.
In the following woodcuts are shown various forms
of single and double electrodes. Figs. 24, 25, 26, 27, 28.
| n
Winſ;
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|
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º
º
.
º

























90,
[FEB. 24, 1872.
T IEEE IET; C T , T: INTIC.
Cancroid, Noli-Me-Tangere, UIcerous Impetigo
Rodens, and Non-Ulcerous Impetigo Rodens.
Their Differential Diagnosis and Therapy.
BY
M. A. DEVERGIE.
Member of the Academy of Medicine, Honorary Physician to the
St. Louis (Paris) Hospital,
From the Bull. Therap., Ncy. 30, 1871.
Continued from No. 7.
Varieties and species of impetigo rodens. I have
divided impetigo rodens into two varieties and species, the
non-ulcerous and ulcerous. The first shows itself under
two different forms. In the first is presented the ap-
pearances of a lenticular circumscribed spot of sebaceous-
acne, that is to say, of a grayish slightly-prominent
growth, a little greasy and capable of being detached
either by a fatty substance applied for some hours, or
by a light poultice. This form is very often multiple,
situated upon the eyelids or upon the side or back of
the nose; and, despite its insignificant appearance, it
leaves the prints of its existence upon the skin, and re-
appears at the same points. In the other form, the
disease has at its outset a more pronounced character,
as a vesiculo-pustular affection. It shows itself at but
a single point, most usually at the internal angle of the
eye. It originates in some small inperceptible vesicles
attended with the sensation as of a fly walking upon
the skin. The vesicles open spontaneously—and become
changed into a small, wrinkled, yellowish crust. The
whole of these morbid productions occupy a space the
size of a large pin-head. This state of things remains
stationary for a longer or shorter period, ten, fifteen,
twenty days or more, during which time the crust falls
off, leaving an almost in perceptible cicatrix. A second
eruption similar to the first then occurs, having for its
point of departure the extreme circumference of the
cicatrix produced by the first. This eruption advances
in such a manner as to extend the length of the diseased
patch and slightly its breadth. But such is the slow-
ness of the development of the disease that it is only
after many months, Sometimes many years, that there
is noticed a diseased patch, partly cicatrized, partly
covered by a crust, occupying a space of a half centi-
metre, oval in shape, and causing real inconvenience
only as it affects the expression, thus becoming disagree-
able to the patient. So little is the inconvenience that
results from it, that patients do not ordinarily consult
a physician for two or three years. One very remark-
able thing is, that this sort of affection is so very com-
mon in men and rare in women. Without attempting
to estimate with any exactness, I would say that it
will be met with ninety times in a hundred in men.
With ulcerous impetigo rodens it is altogether different,
–E–
for it probably attacks women as often if not more often
than men. Whenever non-ulcerous impetigo rodens
has attained the size that I have spoken of its surface is
seen to be composed of two parts, of differentappearances;
the one shows the skin depressed, indicating a cicatrix,
the other is covered with a small impetiginous crust,
rough to the touch, of a grayish color, and made up of the
debris of the vesicles. This impetigo rodens may last for
fifteen years and present the same characters, (aside from
its increased dimensions,) without changing its nature or
appearance. The ulcerous impetigo rodens is ulcerous
from the start. Commencing with the appearances of
impetigo, there is formed in a little while a very small
ulceration, Scooping out the tissues. It enlarges by a
-
series of vesiculo-pustular eruptions, until it has attained
such dimensions that the patient is obliged to dress it
with cerate or pommades, which modify the primitive
character of the eruption. Then the borders of the
ulcer are elevated, somewhat indurated, bleeding upon
the slightest touch, even on the least lifting of the little
bit of charpie adherent to it. But the induration very
rarely reaches the intensity of the cancroid. This
variety shows itself tipon the cheeks, in the neighbor-
hood of the nose and eyes. It is often multiple, spreads,
destroying the angles of the lids, and giving rise to pus
more or less well-elaborated. It is not acutely painful,
and the pain is never of the lancinating character. There'
is another disease with which the authors I have men-
tioned, particularly Alibert and Bateman, have confound- .
ed it; that is lupus.
But there exists between the two
affections very marked differences. First as to locality:
lupus attacks most commonly, the end of the nose and
upper lip. If it appears on the cheek it is generally but
by extension, or if it commences there it is especially in
the center and lower part of it. Again lupus may be
developed upon any part of the body. Ulcerous impetigo
rodens almost never shows itself except in the neigh-
borhood of the eyelids,and one of their angles, or on the
side of the nose, always the upper part of the nose.
Lupus is never clearly circumscribed, its circumference
is always surrounded by reddened, thickened skin, the
turgescence of which is insensibly lost in healthy tissue.
In impetigo rodens the disease is so sharply circumscribed,
that the transition is abrupt from the diseased to healthy
tissue. Lupus is developed almost always in those of
lymphatic temperament and more or less scrofulous,
save certain exceptions in this respect, in which the ev-
idences of scrofula are not clearly apparent. If scrofula.
has relations with impetigo rodens, which I do not
dombt in certain cases, judging from appearances, they
are far from being so marked as with lupus.
To be Continued.
—º-e-tº-
HoNORS DECLINED.—Profs. Billroth and Brücke, of
Vienna, have been offered chairs in the University of
Strasbourg. They have, however, decided on remain-
ing in Vienna.
#
FEB. 24, 1872.]
T IEI IEH C T , II INTIL C.
91
C O AL ID U S T IN T H E L UN G. S.
Anthracosis Pulmonum (Stratton), The Coal or
the Miner’s Lung.
BY
DR. LUDWIG HIRT, (Breslau).
A Chapter selected from the Author's work on “The Diseases of Labor-
ers from the Inhalation of the Manufactory Dusts” (Die Stanbinhala-
tions Krankheiten, Breslau, 1871.)
SYNONYMs: Black Lung Infiltration (Gregory), False
Melanosis (Marshall, Rilliet), Coal Miner's Lung, Coal
in the Lungs (Graham, Thompson), Melanidie (Maurice),
Encombrement Charbonneua, des Poumong (Riembault),
Black Spit, etc.
The history of this affection extendsbacksome distance
in the past. Investigations concerning the penetration of
dust into the lungs were excited by the discovery of the
black coloring of the lungs, the lung pigment of Virchow,
which was thought to depend upon the inhalation of
fine particles of coal. All attention, then, was directed,
especially, to the penetration of coal dust in the pulmo-
nary tissue, and it is only in quite recent times that
the action of other kinds of dust was subjected to accu-
rate investigation. To an Englishman, Pearson, is due
the credit of having been the first to establish this
view. His statements, it is true, were not always correct
yet they broke ground and led to valuable investigations.
He based his view (1813) on chemical examinations of
the black coloring matter of the lungs and bronchial
glands and demonstrated their identity with carbon.
As we have convinced ourselves by most searching in-
vestigations of the Paris Bibliothéque Impériale, Laennec
was not the first to express a suspicion of this kind.
Neither the Mémoire of the Bulletin de la Faculté de
Médecine de Paris, 1806, II, concerning Melanosis, cited
by Zenker, nor in another of Lænnec's works written
in 1819 is there any mention of this subject. It was
only in 1819 in his Traité de l'Auscultation, tom. II.
that he says that “He has several times entertained the
suspicion that these black particles may originate from
lamp smoke and other burning substances used in heat
and illumination. This view received probability when
Gregory (1831) first published a case in which the pig-
mentation was confidently attributed to the inhalation
of coal dust. The lungs in this case presented, besides
the usual pigmentation, alterations in their tissue; they
were lungs, moreover, of a coal miner. Similar contribu-
tions were offered in England by Thompson, father and
son, Philp, Simson, Stratton (author of the name
anthracosis), Gibson, Mackela, Hamilton and others.
The last mentioned furnished a report on the case of a
moulder in a foundry. In France Andral (1837) pub-
lished the case of a coal worker observed by Béhier;
then and especially the anatomist Bourgery, Piorry,
Tardieu, Bouillard, Villaret Reimbault all attempted by
continued observations to establish the suspicion as a
certainty. Maurice called particular attention to the
fact that the material of the lungs of workers in coal
was distinguishable from the true pigment of the lungs
by the fact that the deposit was but little affected by all
the acids and alkalies; it was therefore not pigment, it
was coal.
In Germany, among the oldest works should be men-
tioned those of Erdmann (1831), and Brockmann (1851).
The last mentioned claims besides the asthma metallarg-
icum pneumonodes still another pulmonary melanosis
which is not identical with anthracosis. The pigment
found in the lungs is not a vegetable coal but a mixture
of the vegetable and animal. These works did not
meet much consideration at first in Germany since no
one seemed able to regard these depositions as anything
but true pigmentation. Even Virchow was at first
opposed to the view of their carbonaceous nature, since
the method of their deposition “the entire absence of
pigment in the interalveolar septa and the immense ac-
cumulation under the pleurae are facts which correspond
very little to a progressive absorption.” Oppert (1857)
supported Virchow. Then appeared Tranbe’s widely
known and highly interesting and instructive case. It
was that of a laborer who had long been engaged in an
atmosphere charged with charcoal; who had expect-
orated masses of black matter which the microscope
demonstrated to contain fine particles of charcoal.
These particles were irregular, angular, and of consider-
able size; they were found some within, and some with-
out the cells, some even in the act of penetration. They
showed in the lungs a peculiar ruby-red color. On
autopsy the lungs were found perfectly black and the
fluid escaping from the surface of section was seen to
contain particles of coal. While, now, there appeared
in France the valuable investigations of Ruborn, Crocq,
and others there was published in Germany by Seltman
a most thorough work following the recent observations
of Traube, Cohnheim, Kussmaul, Rosenthal, Levin, etc.,
more and more clearly determining the nature of our
subject. Förster and Friedreich raised the last voices
in doubt; they still held fast to the doctrine of pigmen-
tation. Last of all came forth the classical work of
Zenker, who demonstrated the penetration in lung
tissue of particles of iron dust in the same manner as
coal, now an accepted fact, overcoming by this announce-
ment the very analogy postulated by Friedreich himself
and silencing, thus, the last doubter on the whole sub-
ject. This closed the long line of disputants pro. and
con, to open, as we have already intimated, a new field
for wider investigation, namely, besides the penetration
of iron into lung tissue that of still other kinds of dust
and thus to render it possible to draw from the path-
92
[FEB. 24, 1872.
TIEEE IEH C T , I INTI C -
ologico-anatomical condition of the lungs on autopsy a
relatively certain conclusion as to the avocation of the
individual during life.
The most recent experiments of Slavyansky have
shown that substances in minute subdivision entering
the trachea may penetrate into the alveolae of the lungs
and into the pulmonary tissue of animals, and may
reach thus the lymphatic glands and the blood, moving
most probably with the fluids of these canals respectively.
With this there remains to mention still one other
work, Dressler's, in the Prager Viertel-Jahrschrift to
which we shall return, for a moment, later.
Having thus made ourselves familiar with the cardinal
points of the history of this, in every sense, so interesting
affection we may turn to the consideration of its sym-
tomatology and cause. Concerning symptoms, then, it
is first to be specially and emphatically remarked that
they correspond in no way to the marked anatomical
lesions found present. The single characteristic, path-
ognomonic symptom is the black expectoration of the
laborer, and this must continue a long time after re-
moval from the conditions of its production. Such ex-
pectoration during and immediately after labor is totally
without value in the diagnosis of anthracosis as it then
comes from the trachea and larger tubes only. This ex-
pectoration has been subjected to frequent and thorough
investigation more especially by Friedreich, Traube,
Sanders and many others.” According to the first
mentioned of these investigators the black-wedge or
heedle-shaped coal particles are found inside of the cells
a view with which Traube and Mannkopf's observa-
tions do not coincide. Traube, as already stated, found
these coal particles partly inside the epithelial and
mucous cells while Mannkopf found them only outside
of the same. Friedreich maintains that this condition
described, namely, the presence of coal particles partly
enclosed in the cells and partly free—a condition which
is really almost without exception in the lungs of coal
miners—is only encountered in exceptional cases.
Besides the particles of dust and the nucleated cells en-
closing them, [lymph-like bodies are often observed in
the sputa and not seldom also elastic fibres and tissue
detritus. Except the presence of these constituents of
the sputa just described, and their presence too, as we
once again emphatically state, long after the avocation
has ceased, there is no characteristic symptom which
may establish the diagnosis of anthracosis during life.
This we shall see exemplified in the closer investigation
into the course of the disease which shall now engage
UlS.
According to the different views of different authors
two or three different stages are to be recognized in this
affection. If different stages are to be recognized, in
general, it is best to accept those of Crocq+ and Tardieu.
Crocq states that the first stage is marked by an
anaemia of high degree with an occasional occurrence of
the expectoration described as characteristic. Associate
with these symptoms is a light dyspnoea [Kurzathmig-
keit, short breathedness] with a sense of weariness
towards evening. The second stage is caused by an ac-
cumulation of coal particles and a corresponding dim-
inution of the capacity of the lungs. It is evidenced by
symptoms of asthma and is distinguished from other
forms of this disease by its sudden inception, long dura-
tion and imperfect remissions. That Crocq has gone
too far in this view and that the disease here is nothing
else than a simple emphysema induced by bronchial
catarrh of many years duration, a bronchial catarrh not
directly caused by coal dust inhalations, seems now,
established beyond doubt. Tardieu characterises the
second stage by the occurrence of anaemic manifestions,
a pale, bluish-gray teint and wearisome gait. The
dyspnoea is marked, all the respiratory muscles are
strained, cough is at times continuous, at times periodic
in acute attacks. The black expectoration which may
last six years after the avocation is changed is sometimes
of the character of bloody mucus. In description of the
third stage, finally, both authors agree; it is the stage
of consumption—phthisis anthracotica—differing only
in its manifestations from the symptoms of the second
stage by their greater intensity.
This division into three stages or grades, on more
thorough investigation, seems neither necessary nor
practicably justifiable, as very frequently cases
present which defy all classification, since the disease,
in the first place, may be present in high degree and
yet run its course without any symptoms whatever, or,
in the second place, symptoms may present in entirely
different sequence as the authors mentioned have por-
trayed. It is best then to disregard the disvision into
various stages, at least, to be familiar with the fact that
we can by no means succeed in all cases in diagnosti-
cating anthracosis from the symptoms during life since
with the exception of the characteristic sputa mentioned
they are common to many other affections which have
nothing to do with this disease. It is only when this
black sputa persists, when emphysema of high degree,
heart disease and chronic tuberculosis manifest either
as sequelae or complications “when all these symptoms
bear with anthracosis a common stamp” that the diag-
nosis is almost certain. The pulse, then, is quickened,
cough is severe, the skin is dry, appetite is gone, diges-
tion feeble, urine scant and general strength sinks
rapidly to the most extreme marasmus. Physical ex-
amination of the chest, then towards the end of the
disease, reveals often caverns in the lungs but earlier
in its course there is nothing specific observed that may
render diagnosis sure.
While we must confess that the affection in question
presents us but little that is really characteristic in life,
the pathologico-anotomical condition observed after
* Wide Schmidt's Jahrbücher, W. 124, p. 149, 1864.
#Schmidt's Jahrbücher, W. 126, p. 98, 1865.
*Seltman, Die Anthracosis der Lungen, etc. Archiv. f. Klin. Med.
Vol. II. p. 300,
FEB. 24, 1872.]
death is markedly characteristic and establishes the dis-
ease in most cases at the first glance. In the beginning
the minute coal particles are seen as disseminated black
points in the alveolae and parenchyma; soon, now,
larger masses are accumulated to form black figures
of different variety. On the surface these spots seem
tolerably equally distributed; they are neither thicker
nor more abundant in the upper lobe. The pleura pre-
sents a marbled appearance, it is at first smooth, later
thicker and adherent in its two layers. In its further
course whole sections of the parenchyma are changed
into a black mass and in place of the former spots upon
the surface there are black hard nodules of the size of a
barley grain consisting of minute particles. Finally
the tissue becomes a uniform black mass, containing a
dark frothy fluid which stains substances in contact
with it with a dark color. No trace of normal struc-
ture now remains. Nodules of the size of cherry seed
are deposited more especially in the middle and lower
lobes. Lecanu, Grassi, Magendie and others found in
these nodules vegetable coal with 18.4 per cent. ashes.
As a rule, caverns are but seldom encountered, their
origin, when present, is most probably from an ulcera-
tion of the bronchial mucous membrane. This ulcera-
tion, as we have already exhibited in the study of
bronchiectasis, is by no means rare. It is only ob-
served, however, in old miners that have worked for
years in an atmosphere charged with coal dust ; such
only are the cases which present the perfect picture of
anthracosis. Varying in size and number these ulcera-
tions are encountered in the upper as well as in the
lower lobes at the periphery as well as towards the
centre. Their usually uneven, seldom smooth, walls en-
close dark colored pus. The bronchi contain also
isolated coal particles but no spots such as are observed
in the parenchyma. The bronchial glands in graver
cases are enlarged and degenerated, and contain particles
of coal. The coal nature of these particles is proven by
the fact they are not attacked by concentrated acids
and alkalies. They burn with a brignt, illuminating
flame, on the platinum plate and are found almost
perfectly free (Seltmann), very seldom enclosed in
epithelial cells.
We shall have opportunity again to show that this
condition on autopsy is found in all cases of pneu-
monoconiosis when we shall again call attention to its
significance.
Concerning the etiology of this affection there re-
mains now not little to be said. It has but one cause
and that is a long continued more or less abundant in-
halation of the dust of coal. All circumstances which
favor the abundant development of this variety of dust
and favor its inhalation into the organs of respiration—
dry rooms and chambers in manufactories, defective
or no ventilation—favor also the production of this dis-
† According to Dressler, loc. cit, the pigment of the bronchial glands
is perfectly identical with vegetable coal. It is also of a deep black
color and is insoluble in alkalies, acids, alcohol, ether and chloroform.
T E-ITED CT I I INT I C -
93
ease in every individual long exposed. In the com-
mencement of the disease an existing catarrh of the
respiratory organs or even a great disposition thereto
accelerates in marked degree the development of this
disease which in prognosis is without exception un-
favorable. Favorable circumstances may unquestion-
ably so delay the end that the patient may still, con-
sidering the gravity of the affection, attain to an age
comparatively advanced.
There is of course no special therapy for such an
affection. We possess no means of removing firmly
fixed foreign bodies from the substance of the lungs.
The skill of the physician therefore is limited to a
purely symptomatic treatment which is too well known
to require mention here. If it be true anywhere, cer-
tainly it is true here, as in all diseases caused by the
inhalation of the various dusts, that it is much easier to
prevent such affections than to cure them.
[To be Continued.]
–sº-º-º-
SCIENTIFIC NOTES.
On The Diagnosis of Syphilis by the Microscope.
Dr. Lostorfer thinks that the negative results of blood
investigation have been due to two causes, namely—1.
Hitherto nearly all researches have been made with too
low powers; he is convinced that such investigations
cannot be made with a less magnifying power than
with Hartnack's eyepiece No. 3, and the immersion-lens
No. 10. 2. All researches have been made with fresh
blood, and the objects soon spoiled by an unfavorable
method of preservation. The opinion has, unfortun-
ately, always been prevalent, that what is to be seen in
blood must be seen best in fresh blood, but it has been
overlooked that things may be so minute as not to be
viewed at first, but that they may grow to a visible size.
Under these considerations, Dr. Lostorfer commenced
his researches in August, 1871, in Professor Zeissl's
wards for syphilis. The method observed was excess-
ively simple. A small drop of blood, taken from a
syphilitic patient, was put as quickly as possible on a
clean object-glass, covered, the whole object conveyed
to an exsiccatorium, arranged in a kind of Recklinghau-
sen's moist camera, and daily carefully examined with
the magnifying powers mentioned above. The result
of the first four objects was already positive, and re-
mained so afterwards in large numbers of objects, the
blood having been taken from different patients suffer-
ing from various, yet unmistakable, forms of syphilis.
During the first two days of investigation nothing
could be seen except vibriones, bacteria, and commen-
cing forms of Sarcina. In the third or fourth day, how-
ever, and, in exceptional cases, after the lapse of twenty-
four hours, minute bright corpuscles became visible,
some of which remained immovable whilst others con-
94
[FEB. 24, 1872.
TIEH FL, C T , T N T C.
tinued in a state of undulation. Some of these bodies
exhibited a projection. On the fourth day (exception-
ally on the third, fifth, or sixth day) the corpuscles
were enlarged in bulk and in numbers. Of those en-
larged, the majority had the projections just named,
which were undoubtedly a kind of sprouts, which in
some cases were larger in size than the corpuscle itself.
In the following days the growing continued, so that
some of these bodies became as big as, and even bigger
than, red blood-corpuscles. Besides these, there were
numbers of smaller corpuscles visible, growing and
sprouting, some exhibiting one projection, others three
or more projections; the latter were sessile, or had a
minute pedicle. The corpuscles were by no means all
globular, but of different irregular shapes. After eight
or ten days a vacuola was formed in the larger corpus-
cles, which extended over the whole corpuscle, and
terminated the further development of the growth,
Different fluids, as sugar, Pasteur’s liquid, common Salt,
acetic acid, etc., were not able to arrest the shrivelling
of the bodies and further retrograde development.
Concerning the number of corpuscles, it varies greatly
in difierent cases. Whether this be dependent upon the
different stage of the disease, cannot yet be said, and
must be reserved for further investigation. Dr. Lostor-
fer has treated in a similar manner the blood of patients
laboring under gonorrhoea, diphtheria, eczema, typhus,
elephantiasis, and lupus, but never found anything to
be compared with the appearance of syphilitic blood.
Dr. Lostorfer is cautious enough not to give any
opinion as to the relation of the “syphilis-corpuscles,”
as he calls them, to the disease; whether they be the
cause or the result of the latter he pretends not to know,
but contents himself to state the facts he has found.
After having alluded to a number of patients (and
their histories) from whom he had procured blood for
examination, he winds up with the statement that he is
able in any case to form the diagnosis of syphilis by ex-
amining the blood microscopically.
After the paper was read, and received with great
applause and encomiums by Skoda and Hebra, Professor
Stricker confirmed, in addition, that the author of the
paper has been tried seven times—viz., five times by
Stricker, and twice by Hebra—in the following man-
ner: In the first trial, twelve objects, numbered and
registered, were given to Dr. Lostorfer; two (Nos. 8 and
9) were taken from healthy persons, the other ten from
three patients suffering from different forms of syphilis.
After a few days, Dr. Lostorfer responded:—“Nos. 8 and
9 healthy, two objects spoiled, the rest syphilitic.”
Second trial, made with seven objects—“Nos. 3, 5, and
8 syphilitic, the rest healthy.” In both trials, after four
days the healthy objects were picked out from the syph-
ilitic ones, with the exception of the two objects which
were spoiled. Fourth trial, with twelve objects—four
syphilitic, and eight healthy. (The objects by some
accident having been exposed to a temperature of
12-15°C., previous to their deliverance to Dr. Lostorfer,
the latter replied that “Nothing abnormal could be de-
tected.”) Fifth trial, with four healthy and three syph-
ilitic objects. The reply was corresponding to the
registration made by Professor Hebra and kept by himself
secretly. In the sixth trial, one syphilitic object was
given, and five healthy; in the seventh, two syphilitic
and four healthy; and in both cases recognised accor-
dingly.—Lond. Med. Gaz., Jan. 27, '72.
SARCINA IN BLOOD.—Dr. Ferrier of King's College,
London, calls attention to a curious fact which he has
just discovered, of great importance in reference to the
much-discussed subject of disease-germs. He states that
the peculiar microscopic organism, the Sarcina ventriculi,
which has hitherto been found almost exclusively in
diseased conditions of the stomach, exists in an unde-
veloped state constantly in the blood of the lower ani-
mals and in human blood, both in health and disease.
Dr. Ferrier further states that the minute particles
which are constantly found in vaccine lymph, and
which have been supposed to be the active agents of
the vaccine virus, are nothing more than undeveloped
sarcinae.—Brit. Med. Journ., Jan. 27, '72.
——º-e—sº-
MEDICAL NEws.
A CURIOUS SUGGESTION.—Sir Dominic Corrigan has
proposed, in a letter to the Dublin papers, that patients
suffering under small-pox should be conveyed through
the streets of that city on shallow baskets or cots six
feet long, resting on poles on men's shoulders. “No
suggestion,” says the Irish Times, “was ever made so
well calculated to drive from the city of Dublin every-
one who could leave it.
QUACKS SHUT OUT FROM PENN. HoSPITAL.-The
announcement of the Eclectic Medical College, in addi-
tion to setting forth the great advantage which it offers
to its students, says that these have access to the clin-
ical lectures delivered at the Pennsylvania Hospital.
This, we are glad to be able to say, is no longer true.
The Managers of the Hospital have given the members
of the medical and surgical staff the power to exclude
the students of any medical institution that they may
please, and acting under their directions, the Steward
of the Hospital has declined to issue tickets to students
of the Eclectic Medical College. This action on the
part of the staff has called forth a note from the Dean,
who must be a gentleman of most refreshing coolness.
The note is as follows:
“DEAR SIR:—You have intimated to our students
that they cannot attend the Pennsylvania Hospital,—a
state institution, which we aid in supporting. Before
applying to the court for a mandamus, I merely desire
to know if you persist in their exclusion. Please
inform bearer.
“Very respectfully, JosLPH SITES, Dean.”
The only reply made by the Steward to this threaten-
FEB. 24, 1872.]
T THIIH, C T , ITNT I C .
95
ing epistle was that Dr. Sites was correctly informed;
and up to this time no legal measures have been taker,
so far as we are aware, to force the hospital to open its
gates to the doctor's protégés. The Pennsylvania Hos-
pital is not a public institution, but is supported entirely
by voluntary contributions; but, even taking the view
of it that Dr. Sites does, we cannot imagine how the
Eclectic Medical College can possibly aid in its support,
or in the support of any of the public institutions of the
city; and the note is simply a piece of bravado, and was
so regarded by the gentleman to whom it was addressed.
It has been usual to grant certificates of attendance
to all students who have taken the Hospital ticket; but,
as there is evidence that these certificates have been
made to serve for diplomas, the staff has determined to
issue them only to the students of the regular colleges.
—Phil. Times, Feb. 15, 272.
THE following review is just as good as if it had origi-
nated in the pages of THE CLINIC :
A CONTRIBUTION TO THE TREATMENT OF VERSIONS
AND FLEXIONS OF THE UNIMPREGNATED UTERUS. By
EPH. CUTTER, A. M., M. D. Pamphlet, 8vo, pp. 44.
Boston, James Campbell & Co., 1871.-Another effort
towards a more successful treatment of uterine displace-
ments. Dr. Cutter brings forward two pessaries, one of
which he describes as “purely his own.” Both act as
bent levers, the anterior edge of the perineum being the
fulcrum, the cervix the point to be held or moved,
while to the short external arm, force is applied by a
band of india-rubber tubing, passing backwards between
the nates and upwards to a waist-band. In their adjust-
ment we are introduced to a new family of uterine in-
struments, loop- and T-pessaries, vaginometer, vaginal
sounds, perineal elastic bands, defecating attachment
and joint—we become bewildered at the fertility of
mechanical ingenuity. Amid the maze, some, doubt-
less simple, points still preplex us. In regard to the
short arm, we read, p. 13, “The perineal hook should
surround the perineum without touching it,”—seem-
ingly a difficult task for the hook; and how, we ask,
are we to discover “if air does not circulate between it
and the perineum” 7
Again, both elastic tube and hook are directly in the
way of defecation. P. 13, “Patients should be instructed
to loosen the belt about two inches before defecation,
then turn the hook forwards and hold.” Fancy the
agony of one seized with imperative intestinal premoni-
tions, striving in vain at the last moment to remember
the lucid directions, “loosen the belt about two inches
before defecation,” etc. . Why about two inches before
defecation, when another instrument might be so readily
devised to measure it more accurately 2
On p. 15 we are told that should subsequent discom-
fort arise there must be something wrong, either with
the patient or pessary; and we learn that iodoform sup-
positories are useful in allaying vaginal irritation before
or after using this pessary, which doubtless possesses
some subtile influence over that refractory drug which
other pessaries do not.
How truly and graphically could a grateful patient
describe herself, after being relieved, as right to a Tl
On page 31 the author shows how he often persuades
unwilling patients to be bled: he tells them, “Water is
indispensable to human life. If people fall into the
water, and life is destroyed, is this an argument against
its use as a beverage?” This is unanswerable, and al-
most equal in clearness and simplicity to his “homely
illustration” a few pages before: “Suppose you have a
uterus in your coat-sleeve.” Excuse us; we had
rather not. w
We get on page 41 a chance insight into the personal
habits of the author. What a simple, honest taste is
expressed in the words, “I say lard, because I like it
better than anything else.” I Better even than obstetric
surgery, doctor? -
We are advised that vaginal examinations be made
upon a “dining-table.” Why, we ask, on a dining-table 7
True, he explains somewhat later, “because they [the
patients] do not sink in.” Does ‘anybody suppose they
do? We should fancy, however, that after submitting
to his mechanical measurements and appliances they
might be desirous of doing so, if they could.—Phil.
Times, Feb. 15, '72.
——sº- e-º-
CORRESPONIDENCE.
EDS. CLINIC:
GENTLIMEN : In your notice of the bandaging con-
test, inaugurated by Prof. Dawson, at the Good Samari-
tan Hospital, it is intimated that the jury convened for
the occasion, were unable to decide between five of the
eleven contestants, and consequently that the prize had
to be awarded by drawing lots. I desire to correct this
statement. The fact is that the students having shown
their general proficiency in the arena by using different
kinds of bandages and applying them to dissimilar parts
of the body, the jury selected from their number, those
who had attracted the most attention, and in order that
the contest might be fair, confined them to the use of
exactly similar bandages applied to exactly similar
parts. While admiring the adroitness and exactness in
bandaging of Messrs. Brown, Lockhart and Lyle, the
race from the first appeared to be between Messrs. Black-
stone and Plummer and was at length run conjointly,
or almost so, by them. After the jury had discussed
the respective merits of the two gentlemen, each of the
two had a vote cast in his favor. It then rested with
the third juryman to award the prize; it was decided
that he should draw lots, and the luck fell to Mr. Black-
stone whose rapidity and evenness in bandaging made
him fully equal to Mr. Plummer, who excelled him in
some other particulars.
Yours Obediently, -
CUNDEL JULER, M. D., M. R. C. S. L.
96
[FEB. 24, 1872.
T IEEE IET: C T I I INT I C -
CLINICAL MEMORANDA.
TURPENTINE IN ACUTE AFFECTIONS OF THE MID-
DLE EAR.—Dr. Weber, of Berlin, says he has used
Oleum Terebinthinae internally, for two years, in acute
and painful affections of the middle ear, and regards it
a specific. He prescribes it in every stage of acute
otitis media. In order for it to be effective it must be
given in pretty large doses; e.g., twice during the day
not quite a teaspoonful and in the evening a full one.
If it produces nausea and dizziness, as it sometimes
does, the doses during the day can be lessened, but not
the one for the evening. . Even if the patient has suffered
for weeks and been unable to sleep, in most cases sleep
will be had on the first might.
He regards its efficacy the most striking in acute
rheumatic middle ear affections as contrasted with those
the result of acute nasal catarrh.
In the latter he recommends the inhalation of the
steam from camomile tea with the addition of some
balsam by which the patient is thrown into a heavy
perspiration.
Fresh acute otitis can, according to the author, be
strangulated by the oil. He uses it even in traumatic
middle ear affections, e. g., in tenotomy of the tensor
tympani, also as a prophylactic before such an opera-
tion.—Monatsschr. f. Ohrenh.
[It might be well to state that inflation of the ear is
used along with the oil, a proceeding that in itself in a
large number of cases of acute middle ear affections is
followed by the most marked relief].
SKIN PUNCTURE IN ANASARCA.—When other means
fail to prevent the increase of dropsy, the anasarcous
fluid may be allowed to escape through incisions or
punctures in the legs. The drain of liquid usually
affords great temporary relief, and is often followed by
a copious Secretion of urine. It is not to be denied—
and the patient and his friends should be informed—
that incisions or punctures are sometimes followed by
inflammation and sloughing of the integuments; but
then, on the other hand, distension of the skin by an
excessive dropsical accumulation is not unfrequently
attended with the same unpleasant results. In my ex-
perience, erysipelatous inflammation and sloughing
have resulted more frequently from over-distension of
the integuments than from punctures made to remove
distension. On the whole, then, puncturing anasarcous
legs is an operation which, when done with proper pre-
cautions, is so advantageous to the patient, that we
dare not shrink from the responsibility of advising it.
Many instances have come under my observation in
which this simple operation has prolonged life in com-
parative comfort for a very considerable period.—John-
son—Brit. Med. Journ., Jan. 27, 1872.
—sº-º-º-
IHOMIE NEWS.
THE following gentlemen are appointed internes to
the City Hospital for the ensuing year:—Jas. H. Brown,
W. H. Falls, Jas. G. Hyndman, Ferdinand Kramer,
J. L. Neave, B. Rattermann.
During the past week the lecture rooms have present-
ed a picturesque appearance. Ninety-five students
might have been seen at any hour of the day nervously
studying the ten questions posted on the board on all
the branches of medicine successively. The agony of
the week is over. Two days of cloudy anxiety now and
then the sunshine of peace forever,
Medical College of Ohio.
S P R | N G C 0 U R S E ,
*
&
The regular eight weeks course of practical instruc-
tion for the Spring of 1872 commences March 15. Un-
usual advantages are offered this year in the fact that
the course will be conducted by the entire Faculty of the
College.
The course will embrace the following topics:
Clinical Medicine—Bartholow.
“ Surgery—Dawson. -
Anatomy Brain and Nervous System—Gobrecht.
Operative Surgery—Conner.
{{ Obstetrics—Reamy.
& & Ophthalmology—Seely.
Female Pelvic Surgery—Palmer.
Urinalysis—Nickles.
Physical Diagnosis—Cleveland.
Fractures and Dislocations—Kearns.
Genito-Urin. Dis.—Anderson.
Microscropy—Whittaker.
Prof. Graham will deliver occasional lectures on Clin-
ical Medicine and Diseases of the Chest during the pro
gress of the Course.
The design of the Course is to present instruction in
a thoroughly practical manner. Physical Diagnosis is
to be demonstrated in the hospital wards; Operative
Surgery, Operative Obstetrics, Operative Ophthalmology,
and Operative Gynaecology on the cadaver. -
The Dissecting Room will be under the supervisionof
Dr. where abundant material will be provided.
Special attention will be paid to the chemical and mi-
croscopical analysis of morbid urine.
In order to render this course the most practical pos-
sible, an opportunity will be afforded each individual of
the class to make the various examinations and opera-
tions on the living and dead subjects. Regular daily
Medical and Surgical Clinics will be held at the
Good Samaritan Hospital: Two Daily Clinics will be
regularly held in the Cincinnati Hospital, throughout the
entire course; and a Daily Clinic will be held at the
Dispensary of the Medical College of Ohio.
One hour each evening will be devoted to Recitations
on Anatomy, Physiology, Practice, Surgery, Obstetrics,
and Materia Medica.
The eminently practical nature of this course, and its
shortness of duration, together with the great clinical
advantages presented in Cincinnati, can but commend
themselves favorably to the practitioner as well as the
student.
FEES FOR THE ENTIRE Course, $10
As this Course does not count towards graduation,
being considered supplemental to the regular winter
course, graduates of the College are not required to
matriculate. The matriculation of non-graduates is
deducted from the fees of the ensuing winter session.
F. E. SUIRE. * E. S. WAYNE
F. E. Suire & Co.,
WHOLESALE DBUGGDSTS,
M. A. N. U E A CT UER IN G.
£Hemists AND FHAR MACEUTISTS,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
s)ex.):cºexexo ox{UGS ANYO WXYºoxc)(N)es,.
cºeryxxcAM. Aexas Aºcus,
TESTs, MEDICAL GLASS WARE, &c, &c.,
And solicits the patronage of the trade and profession-
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordance with the U. S. P. and other recognized authori-
ties.
. FINE AND RAERE CHEMICALs,
Of the popular class of preparations known as
H. T. IIXIIIR, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take. .
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c.
AGENTS FOR BULLOCK & CRENSHAW's
Sugar-coated Pills and Granules.
3.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
Preparation, and the quality of the goods sold by us generally.
... tº sº. 8 º' -
JAMES FOSTER, JR., & CO.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
same. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in-
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Lenses, Spectacles, and the best models procurable, with pains-
taking skill to adjust them to all conditions of sight, . at our house.
Special attention paid to orders for Fine Microscopic Objects
and Microscopic Apparatus, Magnifiers and Readers in
great variety. Medical Batteries, Barometers, Thermo-
meters, Hygrometers, Urinometers and Rain Gauges,
of the most approved construction always on hand. All orders promptly
and accurately filled.
JAS. FOSTER, JR. dealing
F. S. SHACKLEFORD, : *** * JAS. FostER, JR. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TIER, S.INT.INMA ERSEHI’s
- No. 758 BRoapw AY, New York
I HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
. As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
BEG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with anv of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. 1).
- Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
OPPOSITE THE HIGH STEEPLE.



JW2, Ž% WºSA," Fovara. Szºnºr, -
PIKE's OPERA HOUSE BUILDING,
/
ealer
In porter and
Diamond and Gold Jewelry,
watches for Ladies and Gentlemen,
Sterling Silver Tableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
. Marble statuary, .
FAN cºr Co O DS,
G ENER ALLY.


CAMARGO
MANUFACTURING COMPANY,
Hangi
Window Shades,
& West Fovazz Sragar,
CINCINNXT, O,
H. H. BRENEMAN, Proprietor.
WILSON BRO
S H IR
Made to order of N. Y. M. Muslin and 2300
IlBAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 IIEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.0)
First three qualities have ALL LIN EN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac.
ture, ready-made, $3 per dozen less.
º
ºf -
W.
Perfect satisfaction given or money cheerfully
refunded.
Also import and Manufacture Men's Furnish-
ing Goods.
M A F K TVA IN'S
- NEW IB O O. Ex
IS NOVV READY FOR CA NVASSERS.
It contains over 600 pages of reading matter, with 250
engravings, designed cypressly for this work, by the best
artists in the country. A gents now at work upon it are
meeting with unparalleled success. A gents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports J75 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re-
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
I61 Elm Street, Cincinnati, O.
BASCOM & CARPENTER,
Stationers, Printers
---, --, Sºz
-AND-- .
Blank Book Manufacturers,
136 VINE sº IREET, "
&\\\\\\\\\\\e
E. De ALBRO & BRO.
IMPORTERS JAND MANU FACTURERS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
fºr ſaint-Maºri', 'it-Bºilèſ'ari Stair-Blileº'º.
Pike's opern-House, Fourth Street, Cinefnmati; 931
Wabash Avenue, and SS West Washington
* street, Chicago. - -
** -> * * * : * > .
The only house in the Western country that saws Spanish and Mexi-
can Cedar for Cigar-Box Makers We import our owu wood direct, and
can sell at prices to compete with any and everybody.
Also saw a tid keen on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
office and Warerooms, 136 and 138 West Second Street,
Wenyer Mill, 507, 509, 541, 513 & 515 W. Sixth St., CINCINNATI,






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GooD sAMARITAN HOSPITAT.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished through9% and is provided with all the necessary ap-
pointments of a First-class Hospital. Porticoes,
with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the
Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to
quiet asylum in any
some stay is necessary in after treatment.
Rooms vary in price,
general terms, between $3.00 and $15.00 per week. This includes, of course,
Bºy" Address,
SISTEER ANTHONY,
Invalids throughout the State as a safe and
case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
according to the character of appointments necessary and service required, ranging, iº
the diet list, and every demand of
º:
FIospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio-












































































































































||NF||RTS,
Carriage Manufacturer,
Nº. 9 and Il Fast Sixth Street, bet. Main & Sycamore.
I MAKE NOTHING BUT
Jº ZºS 7" CºA ºf S.S. W’0/*A*,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of
LIGHT FAMILY CAFFIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
... tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to
PHYSECHANS” {jSE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen's
g:=s ---
fºº::=ºs
ea ººs
- wº- . . . . . . tº
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
Physicians in the city and neighborhood.





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CINCINN ATI.
e-º-5-3-
—-º-
--~~~~
IF. A. C. LJ I, T Y .
J A M E S G R A H A M, M. D., D E A N,
Professor of the Theory and Practice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D.,
Professor of Materia Medica and Therapeutics.
W. H. GOBRECHT, M.D.,
Professor of Anatomy.
P. S. CONNER, M.D.,
Professor of Surgical Anatomy.
W. W. SEELY, M.D.,
Professor of Diseases of the Eye and Ear.
SAMUEL NICKLY'S, M.D.,
Professor of Physics and Medical Chemistry.
J. A. VI E S T * .
W. W. DAWSON, M.D.,
Professor of Principles and Practice of Surgery and Clinical Surgery
C. D. PALMER, M.D.,
Professor of Medical and Surgical Diseases of Women.
T. A. REAMY, M.D.,
Professor of Obstetrics and Diseases of Children.
JOHN L. CLEVELAND, M.D.,
Demonstrator of Anatomy.
CHARLES KEARNS, M.D.,
Assistant to the Chair of Surgery.
W H ITT A. Ex E. F. ,
Professor of Physiology and Secretary of the Faculty.
,--~~~~
T. LOUIS BRown, Prosector of , ! watomy.
Janitor, College Building, Sixth St., bel. Vine and Race.
Printed and Published by Noahrº & MURRY, Medical College of Ohio Building, Cincinnati,








































THE CLINI C.
PTſIELISHED EVERY SATURDAY.
T E R M S-$2.00° a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
Vol. 2. C IN C IN N A TI,
Tºº
M A R C H 2, 1872. No. 9.
JAS. T. VVHITTAKER, M. D.
No. 101 West Ninth Street, Cincinnati.
_ASSOCIALTE EIDIETO-E,S.
W. W. Dawson, M. D. THAD. A. REAMY, M. D.
P. S. ConneR, M. D. C. D. PALMER, M. D.
W. W. SEELY, M. D. SAMUEL. NICKLEs, M. D.
CHAs. KEARNs, M. D. JNo. L. CLEvKLAND, M. D.
RoRERTs BARTHolow, M. D.
W. W. SEELY, M. D.,
No. 118 West Seventh Street, Cincinnati.
-> º - Editor.
TREASURER.
C L U B R A TES,
*-*s
4 Copies to one address.-----................................................ $ 7.00
6 & © 44. * 10,00
12 4 & & £ 18.00
C O N T E N T S.
*-*- Page.]
ORIGINAL AIRTICLES
Purulent and Gonorrheal Conjunctivitis, by W. W. Seely, M.D........97
.** * A. - ºr ºr * ~~ * * *
A Windication of the Hydrate of Chloral, by C. W. Cram, M, D.......... 98
TRANSTLATION
Coal Dust in the Lungs, (A Chapter from Hirt's Staub-Inhalations
Krankheiten, Breslau, 1871.) I02
SCIENTIFIC NOTES
Recent Progressin Chemistry—The Painless Destruction of Animal
Life .....
NIELD ICAI, NEWS
Loyalty to Science—Statistics of the Race
CORRESPONDENCE
Letter from Dr. Trush, Vienna—A Case of Extra-Uterine Preg-
nancy * 105
CLINICAL MEMORANIDA
Sick Head-ache 107
Questions of the Examination..... 107
RIOME NEWS 108
THE CLINIC of this week-continues the exceedingly
interesting series of articles on coal dust inhalation.
The series will be concluded in the next number. It is
a matter of regret that the translation on cancroid, etc.,
is unavoidably crowded over. In its place is presented,
in a letter from our Vienna correspondent, a detailed
account of a remarkable case of extra-uterine foetation.
By request of a number of the students the questions
of the examination are inserted in this number.
co-Ary tº ce.
Fashionable Hatters,
IMPORTERS AND MANUFACTURERs of
92 WEST ENOTTERTIEH ST.
Opposite Post Office,
CINCININATI.
sºrspecial Inducements to Medical Men.
§§AN
ºbesicNºs Alº
… . . . . . . . 2, sº gº º A *...* 2:... . ºf . ---- ºr , -, -- " .
= re^Sººt & 2. WES 77 FC JR. H. Sº º-º-º-
SºciNCINNATI, ofilo.
É. -
J. TAFT,
Editor Dental Fregister
J. & W. TAFT,
TXTEINTTISTS
117 WEST FOURTH STREET,
W. TAFT.
CINCIN NATI, O.
A MOnthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,


















O ID O ER, IL E S S A. IN ID PA. L. A. T. A. B. L. E .
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our motice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. sº
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

William Autenrieth,
No. 71 WEst, sIXTH strºBET,
CINCINNATI, OHIO,
MANUEACTURER OF AND DEALER IN
|| || || || ||
Abdominal Supporters, Trusses,
GLUB-F00T SHOES,
Keeps constantly on hand a full variety of
Metaſic and Eubber syringes,
Storm.ach Pumps, Etc.
STOCKINGS FOR WAR}}(GOSE WEBNS,
Special attention given to the fitting of Apparatus for Deformities.
gº Agent for DR. L. A. BABCOCK'S
tsilver Uterine Supporter,
DR. AHL's POROUS FELT SPLINTS,
D A. Y. * S S E LIN TS
S. W.
BETWEEN WALWUT Aib WIME,
J
5.
illiott’s Saddle-bags
SPINAL APPARATUS, ETC
-ALSO–
—ALSO–
-AND-
ROBERT CLARKE & Gū’S.
LIST OF NEW
Mill, iTH in Mºulis Hill;
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5c -
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLEN BERGER ON WOMEN AND CHILDREN’S DIS-
EASES. 12mo. $1 75
BENNETT ON PULMonoRY CONSUMPTION. 8vo. $1 5o
FIRST HELP IN ACCIDENTS. 12mo. $1 50
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 50
ECHEVERRIA ON EPILEPSY. 8vo. Cloth. $5 od
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASES. 8vo. $5 od
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 oc Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth. $2 50
TANNER'S HANDBOOK OE OBSTETRICS. I 2 mo. $2 oo
WAN BUREN ON DISEASES OF THE RECTUM. 12mo.
Cloth. $1 5o
FLINT'S EXAMINATION OF URINE. 12mo. Cloth. $1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 50
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRICITY. 8vo. Cloth. $4 50
ATTFIELD'S MEDICAL CHEMISTRY. 12mo. Cloth. $2.75
Leather. $3 25
BARTHOLOW’S HYPODERMIC MEDICATION. I 2 mo.
Cloth. $1 5o
TURNBULL’S DISEASES OF THE EAR. 8vo. Cloth. $5 oc
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 oc
NEUMANN'S HAND-BOOK OF SKIN DISEASES. 8vo.
Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 oo.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $1 o oo
HOOD ON BONE SETTING. Izmo. $1 5o
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo
HOLBROOK’S PARTURITION WITHOUT PAIN. I. 6mo.
$1 oo
PROCTER'S LIGHT SCIENCE FOR LEISURE HOURS.
12mo. $1 75
BERNARD’S PHYSIOLOGY OF THE HEART: 50 cts.
BARNES’ OBSTETRICAL OPERATIONS. 8vo. $4 50
NICHOL’S FIRESIDE SCIENCE. 12mo. $1 50.
WOHLER'S MINERAL ANALYSIS. 12mo. Cloth. $3 oo
PLATTNER'S MANUAL OF ANALYSIS WITH THE
BLOWPIPE. 8vo. Cloth. $7 50
JEFFRIES ON THE EYE. 8vo. Cloth. $1 oo
MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
JEFFRIES ON THE SKIN. 8vo. Cloth. $1 oo
GARDENING FOR PROFIT. 12mo. Cloth. $1 50
PRACTICAL FLORICULTURE. 12mo. Cloth. $1 5o
FULLER'S SMALL FRUIT CULTURE. 12mo. Cloth. $1 50
WOODWARD'S COUNTRY HOMES. 12mo. Cloth. $1 50
DARWIN'S ORIGIN OF SPECIES. 12mo. Cloth. $2 oo
ARTHUR'S TREATMENT AND PREVENTION OF DE-
CAY OF THE TEETH. 12mo. $1 50
TYNDALL ON LIGHT AND ELECTRICITY. 12mo. $1 25
THE AMATEUR MICROSCOPIST. Small 4to. $1 75
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMEN.
ROBERTS ON RENAL DISEASES.
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN.
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by mail or express, free of charge
on receipt of price.
65 West 4th Street, Cincinnati, Ohio.



List of Pharmaceutical Preparations,
MANU FACTURE O BY
Jø/ZW WWZZZZ & ZºoZººZºº,
FELLIADFELFECIA.
—-º-
ELIX. PHOS IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR, WALERIANATE OF AMMONIA, /*
(Goddard's Formuła,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Krom, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Kron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Hron and Peruvian Bark,
FERRATED CORDIAL ELIXIR,
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T H E CI, IISTI c.
97
vol. 2.) S A T U R D A Y, M A R C H 2, 1872. [No. 9.
O R. I.G IN A L A R T H C L E S.
—---—
PURULENT AND GONORE HEAL CONJUNCTIVITHS.
+ BY
PROF. SEELY.
A Clinical Lecture at the Dispensary of the Medical College of Ohio.
I am unable to tell you, gentlemen, why as the re-
sult of a given cause we find in our case one form of
inflammation and in another case some other form.
I present you to-day with two cases of inflammation
of the conjunctiva, attended with a purulent discharge.
The first case, as you see, presents all the symptoms
of a violent inflammation, viz., great swelling of the
lids, which are hot and Oedematous, the eyelashes
matted together, great chemosis of the bulbous conjunc-
tiva and an abundant purulent discharge.
On questioning the patient we make out no infection
by gonorrheal matter, but find that he has had weak
eyes for sometime and that, being very much exposed,
the eyes suddenly became greatly swollen, and in a day
or two began to discharge freely.
While speaking of granulations I told you that a
possible termination to such a condition might in the
appearance of all the symptoms be presented here. I also
remarked that the manner in which granulations disap-
peared was through absorption, and hence a certain
amount of inflammation was necessary to rid the con-
junctiva of the new growths. I also spoke of the process
of getting rid of these bodies—the so-called inoculation
method. I have also shown you how moist warmth
may be applied to bring about a similar state of things.
If my diagnosis is correct we have here a purulent in-
flammatory process engrafted upon the trachoma.
Everything seems to point in that direction. When
we evert the lids we are unable to see any granulations
it is true, because the papillae are enormously enlarged,
and yet when you have seen a few cases of trachomatous
conjunctiva convérted into the purulent and of the
papillated the result of purulent primary inflammation
you will be able to see that something which I
think indicates a difference. - (*
Here, as is usual, we have the statement that
the
eyes had been weak for some time. & -
While speaking of this possible termination of granu-
lations, I specially called your attention to the points
in the therapeutical management, for in this resides the
chief interest.
In these conjunctival inflammations the danger is
in complications on the part of the cornea.
posed in part of calomel.
Let us look then for a few moments at the points in
treatment. In this country we see but seldom that
terrible inflammation that attacks the conjunctiva, the
diphtheritic, characterized by extreme hardness of the
lid, due to a fibrinous exudation into the conjunctiva
and sub-conjunctival tissue, bulbous as well as palpebral,
that may bring about destruction of the cornea in some
cases in 36 hours. -
However, we not infrequently do see symptoms
which indicate that we are in the presence of more or
less stasis in the circulation.
In the stage of inflammation and swelling that im-
mediately precedes the purulent, in purulent conjunc-
tivitis then, the point is to beware of the use of astring-
ents, in fact I may say that is the safe general rule that
cannot be insisted upon too strongly. In this stage
your reliance must be upon a general and local anti-
phlogistic treatment. A brisk purgative or two, com-
Opium for the relief of
pain. -
Quiet in bed with the room moderately darkened.
Locally, if the patient is in a physical condition that
justifies it, blood-letting by leeches or cups. If the lids
are greatly swollen a lengthening of the commissure by
slitting the external angle, which of itself may let out
the necessary amount of blood. -
As a wash, the Sulphate of Atropia. (gr. jv. ad. 3.j).
I say nothing of the application of cold as it requires
such great care to be followed by beneficial results.
After the purulent stage begins, indicated by the ap-
pearance of pus, your more active local interference
comes in. -
The same cautioning at the beginning of this stage
applies in this country as well as in Europe, “begin
your astringents carefully,” for fear of producing a
stasis in the circulation and changing the resolution
stage into a violently active one, that gives rise to
layers of lymph upon the surface of the conjunctiva,
and possible a fibrinous exudation into its substance,
As to the therapeutic agents, the one generally recom-
mended in all purulent inflammations, is nitrate of silver.
Then begin by applying a weak solution of the nitrate,
(gr. v. ad. 3.j.) on the appearance of the purulent dis-
charge, brushing it upon the everted lids, or on the
lower if they cannot be everted on account of the
swelling. -
If the next day the purulency has increased you can
apply a still stronger solution, and neutralize it with
salt and water. When the symptoms of acuteness
have began after a few days to subside your antiphlo-
gistic treatment should be abandoned.
For some little time after your brushing with the
nitrate you can apply cold compresses to the lids,
changing them every minute or two.
The atropia and brushings with the nitrate should be
continued until the purulent discharge has entirely
ceased. -
If complications on the part of the cornea arise there
98
[MAR. 2, 1872.
T IEI IE C T , I INTI C.
will be no reason for a discontinuance of the brushings,
only more care must be taken not to make pressure on
the cornea, and not to allow any of the nitrate to touch
it. If there is an ulcer forming, the lower lid can still
be brushed, and a compress bandage applied firmly over
the eye, to be removed several times a day to cleanse
the eye.
This will probably be all that most of you will be
able to do ; of course by such treatment you will only
have met one part of the indications, for there is needed
not only support to the weakened tissue to help it to
bear the intra-ocular tension, but also a reduction of
this intra-ocular tension, which is to Some extent ac-
complished by the atropia. -
So if it is possible a paracentesis of the anterior cham-
ber should be made.
If the ulcer is small, a perforation may take place
beneath the bandage and no harm result further than
a small opacity. -
If the ulcer has perforated, and there is a prolapse of
the iris, it is best to puncture it, then snip it off with
the scissors. -
What shall be our course in the case before us as re-
gards the therapeutic management 2 I am specially
glad of an opportunity to illustrate the differential
treatment, if you will allow me the expression, between
such a case and one of idiopathic purulent conjunctivitis.
If my diagnosis is correct, we have a state of things that
will rid the patient of these granulations provided we
treat him properly. What is indicated ? What are we
to do? I take it we are simply to be on guard to pre-
vent mischief.
We will prescribe a solution of atropine (gr. v.jjad.3.j),
and simply have the eye kept clean. -
If we cut short the suppurative stage we will interfere
with the production of the very result hoped for, viz.,
the absorption of the granulations.
Then in such cases keep in view what is to be accom-
plished and only interfere when danger threatens, for
example, implication of the cornea.
Gonorrheal Ophthalmia.
Here is an illustrative case. Not very violent, for,
fortunately, the patient's eyes have withstood the worst
of the siege. We still have quite an abundant discharge
of pus, but the lids are not nearly so swollen as they
were two days ago. - -
This disease is undoubtedly one of the gravest that
attacks the eye. . It is, if you please, an exaggerated
purulent conjunctivitis. The cause is very virulent,
and hence we have a correspondingly active inflamma-
tion.
The early symptoms differ little from those usually
given for other inflammations of the conjunctiva, but
pass on far more rapidly to the characters that corres-
pond to so grave a disease, viz., extreme swelling of the
lids, they are hot, red, and Oedematous; the conjunctiva
is swollen and greatly chemosed, so that the cornea is
almost hidden by its rolls.
The purulent discharge is thick and yellow, profuse,
running out upon the cheeks as it does in this patient's
right eye when the lids are opened.
You see that we are really in the presence of symp-
toms of a violent purulent conjunctivitis. The history
of the case makes us call it gonorrheal ophthalmia. An
inflammation produced by getting some of the urethral
pus into the eye. -
Gonorrheal ophthalmia is a purulent conjunctivitis
produced by contagion in the manner just stated.
Even the discharge from the urethra termed gleet, the
remains of gonorrhea, may produce a violent purulent
conjunctivitis. So patients should always be on their
guard so long as any discharge remains.
We have seen then that here we have to do with an
exaggerated purulent conjunctivitis, differing in degree,
but not in kind. What are the therapeutic indications?
If symptoms of conjunctival irritation appear in a
patient suffering from gonorrhea they must be immedi-
ately combatted by morphia or atrophia solutions, if
considerable swelling is already present, I would recom-
mend the same kind of treatment that I have given for
commencing ophthalmia neonatorum, a weak solution
of nitrate of silver used several times a day; even
brushing the lids with a moderately strong solution
and afterwards using ice or ice-cold compresses.
The further indications differ in no respect from
those in purulent conjunctivitis.
sº e-ºn- -** wº
A Vindication of the Hydrate of Chloral.
BY
C. W. CRAM, M. D.
Columbus, Ohio.
I read with much interest, in the January number of
the London Lancet, the views of one of our own eminent
surgeons, Dr. N. R. Smith, of Baltimore, regarding the
use of the hydrate of chloral, but I cannot adopt his
views. The article in question is headed “The Toxical
Effects of Chloral Hydrate when persistently used as a
Hypnotic, and Fatal Results of Large Doses.” To sus-
tain the views here indicated the Doctor presents several
cases that came under his care, observation or knowledge.
Two cases in which toxical effects resulting from its
continued use were claimed, were very similar. There
was an eruption upon the fingers, erythematous inflam-
mation, desquamation, with ulceration about the nails
in each case. Upon inquiry it was found that, in each
case, chloral had for sometime been taken for its hypnotic
effect: and the eruption was concluded to be a conse-
quence of its poisonous influence upon the blood.
But not only at this point does chloral appear under
the ban, but its evil influence, according to the belief of
the parties concerned, still continued in the two cases;
for while the eruption was apparently cured by topical
MAR 2, 1872.]
TIE-ITEB C T , T IN IT. C.
99
applications; in case No. 1, the patient, a gentleman of
seventy years of age, was, after a few weeks, attacked
with bronchitis, of which he died; while in case No. 2,
the patient, a young lady of twenty-two years, was
attacked with albuminuria, accompanied with general
anasarca of which she finally recovered. And for these
subsequent attacks—one of them fatal, chloral was held
to answer as the cause. -
Now is there anything in this outline sketch of these
two cases that will warrant such a conclusion ? On the
contrary, are we not justified in the belief that chloral
had nothing to do with the abnormal condition as rep-
resented in the eruption, save as a co-incident, and that
it was innocent of any connection with the subsequent
illness in either case? -
Of course some systemic ailment preceded the erup-
tion, causing pain or inability to sleep or the chloral
would not have been called for ; and it appears to me
by far more reasonable to associate the double illness in
each case with this anterior ailment, as a pre-existing
cause, rather than with chloral.
H remember very well a case that was, in my belief,
exactly in point with the two above given. It occurred
over four years ago in the hospital to which I shall soon
allude more in detail in connection with this medicine.
It was a case of desquamative eruption upon the mid-
dle third of the right leg, extending from the tibia out
over the fibula, and occupying a space equal to the
palmar surface of the hand. I had not then and have
not since seen anything like it; and I have tried with-
out success to class it in the books on skin diseases; but
whatever it was, it certainly did not have chloral for
its cause, as it was before this medicine was known.
The patient was a strong man, apparently, but of sickly
look, of about forty-five years of age. He stated
that attempts had been made to cure it, but without
avail. As he made no complaint aside from the local
trouble, I applied remedies only to the part involved;
and brushing this with creasote diluted with five parts
of glycerine, and following this with lint saturated with
olive oil, I had the pleasure of Seeing the parts com-
pletely well in less than two weeks. But this pleasure
was of short life. In a few days the man returned to
the hospital looking deathly sick. There was entire
loss of appetite, and anemia and emaciation rapidly
ensued. Aside from these manifestations, his disease
was obscure. He was in the hospital about four weeks
and was considered dangerously sick, but he recovered
under the active use of tonics and stimulants, and forced
nourishment. Now my belief was then and is now,
that this attack of sickness was due to systemic ailment
that existed prior to and was the cause of the eruption;
and that the suppression of the eruption without recog-
nising and acting upon this fact by administering inter-
mal remedies, had more or less to do with instituting the
subsequent sickness, and was, consequently, bad prac-
tºge, Dr. Smith follows the same plan of medication
with the same result, and then attempts to throw the
responsibility of the final result upon chloral.
Next to these two cases comes one in which a young
man, after taking a very large dose of chloral, was found
dead upon the floor of his room, and his death attributed
to this medicine. Now as there was no post-mortem ex-
amination in the case, it cannot be known that his
death was not due to some internal lesion with which
medicine had nothing to do. But if we attribute death
to chloral, it may have been only a remote cause, while
a fall upon the floor was the immediate cause of the
fatal result. The effect of this medicine is as stealthy
as it is rapid; the patient under its influence often fall-
ing asleep before he is aware of any such pending dispo-
sition. Consequently we can easily see that a person,
after taking a very large dose of it, might attempt to
walk across a room, and, suddenly seized by its influence,
fall to the floor and die; the death being largely due to
the fall; while, over the same person quietly in bed the
same amount of the medicine, although a very danger-
ous dose might not prove fatal.
Then follows a case in which death was attributed to
this medicine, which was supposed to have been given in
an ordinary dose, although it was preceded by a hypo-
dermic injection of morphine, the amount of which was
not known. Now it is singularly strange to me that one
of so large an experience as the writer of the article in
question, should hold the fatal result in this case to be
“manifestly from an overdose of chloral.” Has the
hypodermic injection of morphine, since this method of
its use was first began, been wholly innocent? Possibly
it has been in the hands of Dr. Smith; but there are
practitioners of high standing who consider it dangerous
to a degree that wholly forbids their use of this instru-
ment, save in exceptional cases, where the morphine is
contra-indicated by other modes of administration; and
in these cases they govern its use with the most scru-
pulous care. With this fact in view when there is a
hypodermic injection of morphine in unknown quantity
by an irregular practitioner, and this followed after an
unknown length of time by a dose of chloral, and this
followed by death after a space of time equally unknown
—all of which occurred in the case under consideration,
we should be very slow indeed to arraign chloral on the
fatal result, while we allow morphine and the hypoder-
mic syringe to go free.
The next and last case presented is one where the
death of the patient was supposed to be induced by the
injection of a drachm and a half of chloral. In order
to understand with any degree of certainty the connec-
tion existing between the medicine and the fatal result
in this case, it is important that we should have some
knowledge of certain points upon which the article in
question gives no information. The patient had sub-
mitted to a severe surgical operation. Yet we are not
told whether anaesthetics were used or not, or whether
the shock to the system was light or severe, nor are we
informed as to the length of time that elapsed between
the operation and the administration of the chloral; in
fact we are left wholly uninformed as to the nature of
100 T IEEE IET: C
T I I INT I C - [MAR. 2, 1872.
the operation and the condition of the patient following
it. But passing by these essential conditions to the fair
understanding of the case, without which no one can
form a reliable opinion as to the cause of death, I think
it safe to assert that the amount injected was three times
too large. Not over half a drachm should be injected
unless the patient is accustomed to its use.
Now if a physician administers three times the proper
amount of this medicine, and death results as a conse-
quence, is the medicine responsible? If a physician in
treating paralysis gives a large and fatal dose of Strychnia,
is this remedy to answer for the result 2 .
The aw of itself is a harmeless implement of industrial
use and of much value, but if anyone using it as a wea-
pon, destroys life with it, is the aa, to be held account-
able? Or does the guilt rest upon him who, as the
active controlling agent, either thoughtlessly or pur-
posely belies the true character of the implement by
instituting for it an improper and illegal use? The answer
is evident. And yet we often exonerate the active,
culpable agent, while we censure that which is only
passive.
Now, having in our experience, formed views differ-
ent from those advanced in the Lancet article, we will
proceed to give them and the leading facts upon which
they are based,
In the Hospital of the Ohio Penitentiary, there are at
present 43 patients, which is about the average number,
exclusive of out-patients. Of this hospital I have im-
mediate charge through the night; Dr. N. Gray, a prac-
titioner of large experience having general charge, but
visiting the hospital during the day. Now by reference
to the books I find that 43 lbs. of the hydrate of chloral
have been given our pstients during the last twenty-two
months. This amount at 20 grs. a dose, would give
1,662 doses, certainly a sufficient number to form reli-
able data.
Being in the hospital and among the patients during
the whole night, I have a good opportunity to see the
effects produced by this class of medicines. Watching
these effects, I have been very strongly impressed with
the great value of chloral. Here are what we deem its
advantages:—
1st. It is prompt in its action, sleep being almost
invariably induced in from fifteen to twenty minutes
unless the patient has become accustomed to its use.
2d. The sleep it produces is remarkably quiet, being
very seldom disturbed by dreams or any other form of
restlessness. •
3d. Its action is not complicated by those disagreeable
attendants that so often follow the use of the prepara-
tions of opium, viz., nausea, constipation and paralysis
of the bladder; the former, in some cases, in anticipation,
strongly contra-indicating the use of any form of this
drug.
#. Its use is not followed by that craving for its
continuance which so often attends the administration
of the preparations of opium, particularly morphine,
producing a multitude of opium eaters.
5th. It is safe, when given in a proper dose.
We will now notice these five points in their order.
a. That it is promptin its action is undisputed. And
this is of much importance, as there are many cases that
require to be brought as quickly as possible under the
influence of some medicine of this class. It is more
prompt, and in our belief more safe in its action, than .
morphine by hypodermic injection.
b. Not only is sleep undisturbed, but respiration is
remarkably easy and regular. I have not seen a single
exception to this. There is one among our number of
patients who cannot take morphine without producing
while asleep, a condition in which he will “catch” his
breath, the respiratory acts taking place only from three
to six times a minute. I have several times waked him
from this, as I supposed, dangerous condition. Yet he
was not in the least narcotized. On this man chloral
has no such effect; but, sleeping under its influence,
his respiration is easy and natural. This is a patient
with tuberculosis. Another patient, with the same dis-
ease, had occasionally been taking 3 gr. doses of morph-
ine to quiet pain. One night he was unable to obtain
sleep, and I gave him a full dose of morphine twice with-
out any effect. Dr. Gray, when he made his call in the
morning, ordered the same by hypodermic injection of
3 gr., but it had no effect. In the evening I repeated it
with no better result. After three hours had elapsed,
as he objected to the syringe, I again gave it by the
mouth. This was continued until he had taken, during
the night, 2% grs. of morphine, with no other effect, ap-
parently, than to make him more wide-awake than be-
fore. He expressed himself as feeling “mighty good,”
but was the farthest from sleep possible. This condition
continued through the day. In the evening I gave him
thirty grs. of chloral, and in twenty minutes he was in
a quiet sleep, in which he continued for three hours.
When he awoke the same amount was repeated, when
his sleep was continued through the remaining portion
of the night. -
This is but one of several similar cases that have
occurred in the hospital; and they prove that under
certain circumstances, the hydrate of chloral has a
power that morphine, though given in what might be
at another time a fatal dose, does not possess.
c. As to the troublesome attendants that often follow
in the train of opium, and its preparation :-that they
are not associated with chloral, is very evident indeed.
We have never seen them, have never heard of them,
and have never read of them save in some uncertain
cases. There were two or three cases among our patients
in which its use was followed by diarrhoea; but as it
was at a season of the year when this disorder was pre-
valent, and as chloral has been at times successfully
given in the treatment of the same, it is but fair to pre-
sume that the complication was due to some cause
other than the medicine in question. -
For some time past, in order to ascertain as far as
possible the relative merits of chloral and morphine, as
‘MAR, 2, 1872.]
TIEHC E C I I INTI C.
101
sleep-producing agents, I have made diligent inquiry of
the patients upon this point, but have not yet found
the first instance where the chloral has been followed by
indigestion, nausea, vomiting, loss of appetite, constipa-
tion or paralysis of the bladder; while, upon the other
hand, all of these often follow the administration of
morphine,—a general interference with the Secretions
as well as excretions, taking place; and so often does
vomiting follow it that the cautious and conscientious
physician can hardly prescribe this medicine without
feeling that he is about to inflict upon his patient the
torments of a slow emetic.
d. It is well known to all physicians, that morphine,
when administered a number of times successively, has
a tendency, in some cases, to excite a strong and alarm-
ing desire for its continuance—this desire soon culmin-
ating in a complete infatuation, in which the patient is
powerless to resist its influence. And there are cases
known to almost every physician where the unfortunate
victims of this habit take from half a drachm to a drachm
of morphine daily. This is no exaggeration. We know
of three such cases, one of them in this city. And we
recently learned of a respectable young lady yet in her
'teens, who, without the knowledge of her parents, takes
constant care to keep in possession for daily use, this
trouble-defying, but nerve killing drug. And cases
where several grains are taken daily are quite numerous.
A few years ago, in an adjoining county, one of the most
popular ministers of the Methodist Conference, com-
mitted suicide, simply from the fact that he was
an opium eater; and having for years struggled,
with mind bordering upon despair, to break the hold of
the evil influence, he finally determined to terminate
the contest by terminating his own life.
Now the miserable condition of persons who are
addicted to this fearful habit, is almost invariably
brought about—by the prescription of a physician, who,
to lull the aching nerves, or induce sleep, has dosed and
dosed with some form of opium, thoughtless of conse-
quences. That this condition can be avoided in many
instances, by the use of chloral, we firmly believe: and
this consideration alone, where other points are supposed
to be equal, should instantly turn the scale in favor of
chloral, in all cases where a favorable prognosis is enter-
tained; for this medicine appears to have no more ten-
dency to arouse desire and set up a pernicious habit in
its gratification, than does quinine. -
e. It is safe, comparatively. As a rule, medicines of
real value, will, if improperly given, prove capable of
producing very injurious results; such a medicine is
chloral.
an instrument of evil, if not well directed. Of the 4;
lbs. of this medicine used as already indicated, not a
dose has given rise to an unfavorable symptom, either
in immediate or remote effect, as far as I am aware.
Certainly no death has resulted from its use. One
patient, a female, sick of pulmonary tuberculosis began
taking it over six months ago. In her case it does not
Powerful for good, it is necessarily efficient as |
seem to loose its effect, for she is still taking it, and the
dose has not been increased. She appears to derive
much benefit from it; for though sick for over two
years, and a year ago considered likely to die at any
moment, she still lives. Another patient, a male,
prostrated by paralysis, took this medicine for over
three months. He improved slowly, and is now at work.
Another has taken it for over three months, and is much
better than when he began its use. Others have taken
it for three or four weeks, without any appearance of, or
increase of anaemia. And no eruption has ever been
seen upon the body or extremities that could be attrib-
uted to its influence.
We have usually given this medicine in 20 gr. doses,
increased to 30 grs. where the patient has become accus-
tomed to its use. In case of its failure to act promptly
the dose has been repeated in half an hour but not
Sooner. It is of the highest importance that great care
should be exercised to determine the necessity for a
repetition of a dose. Its influence extends through sev-
eral hours; consequently, if two or three full doses were
to be pushed rapidly at intervals of only fifteen or twenty
minutes, when, with the exercise of a little patience the
first dose would be sufficient, it might possibly prove
that the cumulative influence would be at least enough
to excite anxiety to the result.
Now it appears to me that this encouraging experience
with this medicine, involving its use in about 1,660
doses, is sufficient to go far in warranting its general
use as a hypnotic. And I cannot see that there is any
thing reliable in the Lancet article that will conflict with
this view; for of the five cases therein adduced in oppo-
sition to chloral, only two—the “eruption” cases, were
within the purview of Dr. Smith's own knowledge; and
to these he was called after the chloral had been given
by other parties. While for chloral I write what I do
know when I claim for it, in this hospital practice, ex-
ceedingly marked and beneficial effects: this knowledge
of its effect being acquired by attention to the sick
through the whole night, which is an opportunity for
studying the action of medicines used for hypnotic
effect that but few possess.
The claim of the article in question, that chloral pro-
duces an eruption upon the extremities on the same
principle upon which ergot prodnces dry gangrene, we
cannot adopt; and the theory that chloral produces its
effects by the liberation of chloroform in the blood, is,
in our belief, hardly to be credited; for it appears to
have an action distinctly its own, which is farther re-
moved from chloroform than from alcohol.
—-º-º-º---—
A VENERABLE SURGEON AND A TOUGH PATIENT.-
A short time ago Dr. Joseph Stevens, now in his 82nd
year, amputated a thigh of a patient, 66 years old, for
obstimate and extensive ulceration of the foot and leg
of forty years duration On the second day the patient
sat up in bed, and shaved himself, and before the end
of a week was able to get out of bed, without assistance,
each morning, to have his bed arranged.
102
[MAR. 2, 1872.
TIEI IEH C T , I. NT I. C.
C o A L D Us T IN T H E L J N G s.
Anthraeosis Pulmonum (Strattorn), The Ceal or
the Miner’s Lºng.
BY
DR. LUDwig HIRT, (Breslau).
A Chapter selected from the Anthor's work on “The Eiseases of Labor-
ers from the Inhalation of the Manufactory Dusts” (Die Starºbinhala-
tions Krankheiten, Breslau, 1871.)
Continued from No. 8.
In the portrayal of the history of this affection we
have already taken occasion to remark that the influ-
ence of coal dust upon the health of the laborer has
been made the subject of manifold investigation for a
long period of time. We have discussed also the fact
of penetration of this dust into pulmonary tissue and
the pathologico-anatomical changes there induced. We
pass now to the investigation and discussion of further
points; the influence of coal dust upon the individual
organs of economy, upon the genesis of individual dis-
eases and the sanitary condition of coal workers in gen-
eral. Such investigations regarding of course the rates
of disease add mortality among these laborers are only
of value when deduced from extensive statistics. It is
lamentable, therefore, that all the works which treat
of the influence of coal dust upon laborers, thorough as
they are in some points, have, with few exceptions,
disregarded statistics, or at least furnished them so
scantily that definite conclusions are almost impossible.
True, such statistics are not easily attained. Avocations
implying an uninterrupted inhalation of coal dust are
but few, as among 12.647 laborers whose diseases the
author has studied, but 49 were workers in coal. But
we may draw into the field of statistics—and we are
perfectly justified in so doing when we are treating of
the frequency of individual diseases—the laborers in
coal mines themselves, and thus in marked degree
facilitate investigations. To this intent the author
visited the Knappschaftsverein of upper Silesia where
thanks to the kindness of Dr. Lörve in Siemianonitz and
director Scholinus in Tarnowitz he was put in possession
of the sanitary reports for the six years 1862-67 whence
the following statistics are drawn.t
Concerning now first the morphological condition of
coal dust it is to be remarked that stome coal presents
under the microscope as sharply defined, polygonal or
rounded, only seldom sharp pointed molecules, while
# These reports, as the author has subsequently learned, were also
need by Moll in his Inaugural Dissertation “Die Krankheiten der
Bergarbeiter in Allgemeinen und der Oberschlesiens in Besonderen,”
Berlin, 1869.
wood coal, on the contrary, consists almost entirely of
sharp, pointed, almost arrow-shaped particles showing
at times unmistakably the nature of wood. Chiefly,
however, wood coal is recognized by the circular orifices,
the porous canals of the coniferae and by the brownish
color which thin layers display. The soot, finally, an
extremely fine, foose impalpable powder, shows no trace
of angular or pointed molecules, consists rather
essentially of roundish modules in conglomerate apposi-
tion. When impurities are present in the dust—what
is not seldom the case—they are easily detected under
the microscope. It is of significance as to the effect
when particles of flint are encountered ; they are recog-
nized by their sharp, angular borders. Dust may con-
tain even 30 per cent. of these impurities; the evil
effects induced are referable then solely to them.
Let us pass now to the consideration of the influence
of coal dust upon the health of laborers and the method
of its action. As we have already remarked the most
different, at times even diametrically opposed, views
have been proposed. On the one hand the inhalation
of coal dust is considered as not wholly free from
danger. Supporters of this view are Parent-Duchatelet,
Pantries, Patissier, Vernois, Guillol; it may be, they
claim, perfectly compatible with health; Beddoes even
goes so far as to prescribe it medicinally. On the other
hand there are those who regard it as one of the greatest
enemies to health, an enemy which destroys all lungs
and all Iaborers compelled to breathe it, which induces
an early consumption and death. Supporters of this
view, or in modifiéd form, are Mélier, Tardieu, Kuborn,
Seltmann, Cox. Between these two extremes, as advo-
cates of peace, stand Riembault, Böens-Boisseau and
others who attempt to reconcile and harmonize the
opposing views. The position of the author will be
Iearned from the conclusions based upon the statistics
furnished. **.*
In order to obtain an idea of the general effect of
coal dust inhalation it is perhaps best to investigate its
influence on the individual organs of greatest importance
and to ascertain the frequency of their diseases; it is
of course proper that the respiratory organs as those most
affected and endangered should receive the closest re-
gard. Of the organs of respiration the bronchia shall
first engage us. ' Almost all observers fully agree in the
fact that the bronchial mucous membrane in constant
or frequent contact with coal dust is strongly disposed
to acute and still more to chronic affections, particularly
catarrhs characterized by the expectoration of black
sputa. The result of our observations fully confirms
this condition and it is evident from the above mentioned
sanitary report that next to rheumatism—that unavoid-
able plague of miners—bronchial catarrhs claim the
highest per cent. of all internal diseases. During the
six years 1862-67, 30.879 miners suffered with internal
diseases, of these 6.555, i.e., 16.4 per cent. are registered
as catarrh of the organs of respiration. Further,
in the district Hörde according to Sr. Martens observa-
MAR, 2, 1872.]
103
- tions 11,499 suffered with internal diseases from 1842-58
inclusive; of these 2,213, i. e., 18.3 per cent. are regis-
tered as catarrh (here, it is true, stomach and intestinal
catarrh were included). Again, of 255 charbonniers
examined by Vernois, 23 were sick; of these 13 suffered
with habitual, 3 with acute bronchitis, a percentage
(from very small numbers truly) raised to 69. Finally
the author found among the 49 miners admitted to the
Breslau (Allerheiligen) hospital during the years
1859–69, eleven, i. e., 22.4 per cent. patients with bron-
chitis. There is no doubt, then, but that bronchial
catarrhs hold a high numerical position among laborers
exposed to coal dust inhalations, and that these catarrhs
are remarkably frequently excited in this way.
If we now examine the relation of coal dust inhalation
to the genesis of diseases of the lungs we shall have to
regard chiefly, inflammation, emphysema and tubercu-
losis since other pulmonary affections—as in no way
standing in this connection—may not be brought into
consideration. Concerning pneumonia, then, first, We
have to remark that although this disease, as we have
already statistically demonstrated, occurs more fre-
quently among dust inhalers than among other laborers
yet it is but remarkably seldom excited by coal dust.
This is a fact established alike from the extensive statis-
tics of Upper Silesia and of Hörde, though the experience
of the Breslau Hospital is not in unision therewith.
Of the 39,879 patients of Upper Silesia 1,836, i.e., 4.7
per cent. were attacked with pneumonia ; of the 11,499
patients of Hörde 313, i. e., 3.6 per cent. were pneumo-
nic while in Breslau Seven, i. e., 14.4 per cent. were
sufferers from this disease. This gives us, thus, a per-
centage (excepting the uncertain Breslau rates) which
equals that of laborers engaged in other than “dusty”
pursuits. This relatively seldom occurrence of the dis-
ease is perhaps explained by the fact that the coal part-
icles which penetrate into the lungs, as they (excepting
wood coal) do not possess sharp edges, fail to exercise
that amount of irritation necessary to inflammation.
When, further, they are present in mass they merely
fill the tissue and induce by gradual accumulation the
alterations already described as characteristic of anthra-
cosis. This condition, as is well known, may be present
at times in light degree without any marked symptoms.
Why it is, however, that sharp particles of wood coal
may exist in quantity for years, as often enough occurs,
without inducing pneumonia is hardly clear from the
explanation just given. Of course, a large number of
the cases of pneumonia cited must be attributed to ex-
posure to cold, an agent which plays so important a role
in the etiology of this affection in general. But except-
ing these it must be stated that this negative property
of coal dust, i. e., that it seldom or never excites an
acute or chronic inflammation, is a peculiarity, a char-
acteristic, which distinguishes it clearly from all vegeta-
ble, even from all organic dusts.
With reference to the frequency of emphysema among
workers in coal we have to remark as follows: according
394, i. e., 0.9 per cent. were sufferers.
| them confirmation or probability.
to the statistics of Upper Silesia of the 39,879 laborers,
Of the 23 patients
observed by Vernois, four, i.e., 17.3 per cent.; of the
49 of the hospitals, four, i. e., 8.1 per cent, were patients
with emphysema. The first pencentage (0.9) is un-
precedently low. This is scarcely reached, as we have
already shown, in the statistics of laborers in any of the
manufactory dusts. The rates of the two others,
especially those of Vernois (17.3) belong to the highest.
It is certainly not to be forgotten that the last numbers
are very small, hence scarcely suitable for the deduction
of conclusions. When we reflect how simple a matter
it is for four individuals among 23 or 49 laborers to be
sufferers with emphysema without any connection with
dust inhalation; when we reflect, further, what an im-
mense influence so small a number at once exercises
upon a percentage of cases only 23 or 49 in whole num-
ber, we must certainly accept their deductions with
caution until at least more extended experience lend
The rates of Upper
Silesia do not furnish this confirmation; they present,
rather, such a low percentage for the frequency of
emphysema here that we are almost constrained to
believe that coal dust, ceteris paribus, has the property
of preventing the disease, a view which is, of course,
at once irrational and untenable. We are justified in
raising these rates by the fact, on the one hand, that the
lighter grades of emphysema so often present without
occasioning such difficulty as to bring the patient to a
physician and, on the other, that the small percentage
is drawn from the few cases actually treated. The view
that coal dust is an active excitant of emphysema is
one of wide belief and is even now defended, though
certainly without foundation. Coal dust, of itself,
never induces emphysema. As a dust it may have
emphysema, like any other dust, as a sequence. This
is effected by the previous induction of broncluial
catarrh and by the fact of the obliteration of the alveolae
gradually effected by the deposition into their interior.
Pulmonary tissue in proximity to affected parts has
then a compensatory action to perform and then, of
course, it may become emphysematous. These two cir-
cumstances, catarrh and obliteration, may suffice, then,
to induce an emphysema; they are circumstances, how-
ever, which pertain to every other kind of dust inhaled
and which do not, therefore, by any means justify the
view that coal dust is a specific or frequent excitant
of the disease. According to a statement made to me
by Schöfeld of Brussels, emphysema is becoming much
more infrequent among coal miners since they are no
longer compelled to work in a stooped posture with the
body half flexed, since, in other words, the passages
have been enlarged so as to enable them to pursue their
avocation in an erect posture. Thus we are gradually
forced to the view that when emphysema is extremely
frequent among coal miners, this frequency is to be
ascribed to other causes than the inhalation of coal
dust. We may express ourselves then, in consideration
104
[MAR. 2, 1872.
T EEE THE C T , T N T C.
of all these circumstances, as follows: 1.-Coal dust ea.
cites emphysema, no oftener than any other organic or in-
organic dust. Proof is the percentage of Upper Silesia
taken from a list of 40,000 patients (coal miners) suffer-
ing in six years with internal diseases, and convincing
proof it remains even after increasing this percentage
for the reasons stated above. 2.- The cases which do
present are not to be ascribed to any specific action of coal
dust upon the alveolae but to the effects of previous bron-
chial catarrh, in some cases to mechanical obliteration
of portions of pulmonary tissue, to over exertion, to
. cold and perhaps to the more or less injurious effects
of bad posture.
Most essential and interesting, finally, is the study of
the relations of coal dust inhalations to the development
of pulmonary consumption, a question which will regard,
of course, the frequency of this disease among miners,
a question which thanks to the richness of our statistics
admits of thorough and satisfactory investigation.
[To be Concluded.]
—— — —-º-o-º----——
SCHENTIFIC NOTES.
TECENT PROGRESS IN CHEMISTRY.-Mr. E. C. C.
Stanford, says:—I wonder what Sir Humphrey Davy
would have said to any one who talked about stellar
chemistry. That great man, in ridiculing the idea of
lighting London with gas, triumphantly asked the
famatics who proposed such a wild scheme, whether the
dome of St. Paul's was to be the gasometer? Yet we
cannot imagine Regent street illuminated, or rather
darkened, with dips again, and to us stellar chemistry
has a real meaning. Who will venture to bound a
science which reaches far away through space, and with
unerring accuracy tells us the composition of distant
worlds and distant suns. What can be more humiliating
to our small intelligences than the reflection that a
distant star will photograph its spectrum on a sensitive
surface with the ray of light that left it when the oldest
man in this room was a boy 7 What would the great
father of British chemistry have said, had he stood in
the lecture room of the Royal Institution, where his
great discoveries were made, and seen the burning hy-
drogen extracted by our great countryman Graham,
from a meteorite, the heat and light of another world;
or could he look with Lockyer on the burning flames
of hydrogen, which dart up from the sun to a height
of 50,000 miles, or could he read the flashing telegrams
which run so rapidly round our world, that all our
notions of time are completely upset, and we actually
receive intelligence to-day which was sent to-morrow 2
(Excuse the apparent absurdity; it only shows how
powerless language is to keep up with human progress).
Had he lived with us, he would have seen a large city
dependent entirely for its communication with the
outer world by a marvellous kind of photography, so
minute that it enables a pigeon to carry a proof sheet
of the Times under its wing.—Med, and Surg. Reporter.
THE PAINLESS DESTRUCTION OF ANIMAL LIFE.-
From a social point of view this question has no little
interest. We therefore record that at the Medical So-
ciety of London, October 16, 1871, Dr. B. W. Richard-
son read a paper “On the Possibility of Destroying
Animals intended for Human Consumption without
the Infliction of Pain.” After reviewing the various
means employed in the execution of this humane project,
with partial success, he recommended the following
vapors:–1. Hydramyle and bichloride of methylene.
2. Carbon disulphide and methylene bichloride.
3. Chloroform, or methylene and coal-gas. In sleep all
Sensibility is destroyed in fifty or one hundred seconds.
Two drachms is poured on domette, in a conical in-
haler; the animal does not struggle; the butcher kills in
the usual way; bleeding follows. First, primary
syncopal convulsion (after loss of forty ounces of blood);
Second, fatal convulsive paroxysm (after the loss of ten
ounces more); the heart ceases to play. During
narcotism the primary convulsion is suspended, or mnch
reduced in force. The second convulsion (an entirely .
reflex and painless phenomenon), insensibility, is
quickly produced; no odor or taste is left. An ingeni-
ous apparatus was shown, to contain the narcotic vapor,
and to allow coal-gas to flow through. For oxen, a
number of chambers could be devised, with swinging
doors, through which oxen could be drawn on trucks by
means of an endless chain, the chambers to be filled
with the narcotising vapor. Animals could pass
through the Lethal river of vapor, and be made oblivi-
ous of death, at the rate of sixty per hour
—sº-o-º--—
MIEDICAL NEWS.
LOYALTY TO SCIENCE.-The Paris Academy of Med-
icine have refused to strike off the names of their emi-
nent German colleagues from the roll of members, as
they have been commanded to do.
STATISTICS OF THE RACE,--The earth is inhabited by
about, 1,380,000,000 of inhabitants, namely: 380,000,
000 of the Caucasian race, 580,000,000 of the Mongolian,
200,000,000 of the Ethiopian, 220,000,000 of the Malay
races, and 1,000,000 of the American Indian. All these
respectively speak 3,064 languages, and possess 1,000
different religions. The amount of deaths per annum, is
333,333,333, or 91,954 per day, 3,730 per hour, 60 per
minute, or one per second. This loss is compensated
by an equal number of births. The average duration
of life throughout the globe is thirty-three years. One-
fourth of its population dies before the seventh year,
and one-half before the seventeenth. Out of 10,000
persons only one reaches his hundredth year; only one
in 500 his eightieth; and only one in 100 his sixty-fifth.
Married people live longer than unmarried ones, and a
MAR. 2, 1872.]
T EL ED CT, IT INT I C -
10
tall man is likely to live longer than a short one.
Until the fiftieth year, women have a better chance of
life than men; but beyond that period the chances are
equal. Sixty-five persons out of 1,000 marry. The
months of June and December are those in which mar-
riages are most frequent. Children born in spring are
generally stronger than those born in other seasons.
Births and deaths chiefly occur at night. The number
of men able to bear arms is but one eighth of the pop-
ulation.—N. Y. Observer Year-Book. .
—-º-º-º-
correspond ENCE.
A Case of Extra-Uterine Pregnancy.
Reported by J. TRUSH, M. D.
VIENNA, AUSTRIA, Jan. 17, '72.
On the 26th. of November last was presented to the
Collegium by Professor Carl Braun, a woman, about 30
years of age, pregnant with her third child, and then,
according to her statement, near the end of gestation.
She had been in the house for several days, but up to
that moment had not been examined by Prof. Braun;
he had been informed by one of his assistants that cer-
tain anomalies were present in her case; he would now
endeavor to ascertain the nature of the abnormal condi-
tions. In the examination the following points were
demonstrated: - gº -
Patient feeble and much emaciated, although she had
not been actually sick for some months past; her abdo-
men was large and presented the contours of two une-
qual growths, or tumors, the line of demarcation
between them—a shallow, but distinct furrow—running
across the abdomen from one anterior superior process
of the ilium to the other. The larger one of these
evidently contained the foetus and that a vigorous one,
its motions being quite apparent at Some distance, and
through palpation its approximate size and position
were readily ascertainable—it could not weigh less than
six-pounds, consequently was of fair size and lay in a
so-called “cross position”, the head being high up in the
left iliac region, the breech in the corresponding locality
to the right. Examining in the same mannner the
lower, smaller tumor, it was found to be a firm some-
What elastic substance, susceptible of more or less
distinct isolation from the foetal tumor, along the
furrow above alluded to. To prove that this was not
a distended bladder, a catheter was introduced, but only
three or four ounces of urine passed off, without, in the:
least, affecting the size of the growth; through the
Vagina the finger came upon a tumor, similar in consis-
tence to that noticed externally, it occupied the cul-de-
Sac Óf Douglas and éntire right side of the pelvis. The
Cervix uteri was found displaced towards the left, it was
Soft, the os externum open, passable for one finger, but
no foetal parts could be felt, either through the os uteri,
or from any point of the vagina. The sound introduced
into the uterus passed with facility, obliquely upwards
and to the left, to the depth of four inches; for fear of
rupturing “the membranes,”(?) no attempt was made, at
this time, to pass it further, or in a different direction.
From these data the diagnosis could not be made with
absolute certainty, a more thorough exploration of the
cavum uteri would be nesessary, nevertheless the case
was believed to be one of normal pregnancy, with low
attachment of the placenta and complicated with ovar-
ian disease. An insertion of the placenta near the os
internum uteri and the presence of an ovarian cyst,
would, it was thought, account for the peculiar appear-
ances of the abdomen and the condition of parts in the
vagina.
In the succeeding three or four days the “more thor-
ough” exploration of the uterine cavity took place.
A sound was introduced, as before, to the extent of four
inches and then the point of the instrument directed
towards the right, and, really, comparatively little
pressure seemed to be necessary, to cause it to pass
several inches further, but, no liquor amnii escaped, as
had been anticipated would follow the execution of this
maneuver; it was a circumstance that spoke strongly
against the diagnosis of normal pregnancy with com-
plications; the great probability now seemed to be,
that the sound had passed into the right Fallopian tube,
that the uterus was empty and the case consequently
one of extra-uterine pregnancy. In order to clear up
the last shadow of a doubt, the patient was placed
under the influence of chloroform and a digital examin-
ation of the uterine cavity-resorted to. It was empty
—the examining finger could, on all sides, touch the
parietes of the organ inside, therefore it could not con-
tain a foetal head, and the larger and living foetus had
attained its growth and development external to the
uterine cavity. In relation to the pelvic tumor, it was
still believed that its greatest bulk was due to an
ovarian cyst, the remainder to the enlarged uterus and
the extra-uterine placenta.
Prior to the last series of explorations the patient had
suffered no pain, certainly had perceived nothing like
labor pains; shortly after these examinations however,
abdominal pain and tenderness set in, gradually grow-
ing more severe, but never assuming a paroxysmal
character, accompanied by moderate febrile movement
and increased frequency of pulse. Having been already
feeble on entering the Hospital, the woman after the ac-
cession of pain, etc., began to fail rapidly and it soon
became evident that the exitus lethalis was near at hand.
Nothing was to be hoped, under the circumstances,
from the Cesarian section, except that the life of the
child might perhaps be preserved thereby, hence her
peculiar and deplorable condition and the operation re-
quisite for delivery were explained to the patient, but
she would listen to no such operative proceedings; she
had been confined twice already in the natural way,
that now it should be necessary to remove the child
106
[MAR. 2, 1872.
TIEI IEH C T , IIIN IT. C.
through an artificial opening, made with the knife in
the abdominal walls, she could not and would not be-
lieve. Nothing remained to be done therefore but to
await the coming of events and act as circumstances
might demand. The patient sank rapidly became un-
conscious on the 3rd. and died comatose on the night of
the 4th. of December. Immediately, Cesarian section
was performed and the foetus removed but too late,
for, though it gasped two or three times, yet the most
persevering efforts at resusitation failed to establish
normal respiration. . A considerable quantity of a
greenish fluid was also removed at this time from the
abdominal cavity of the deceased mother, but no exam-
ination of the parts undertaken, it being the prerogative
of the pathologist to do this
The child proved to be much larger than had been
anticipated; it weighed ten pounds, avoirdupois.
Sectio Cadaveris, 34 hours after death.
Much emaciated ; rigor mortis feeble expressed;
brain anaemic; otherwise healthy; lungs, aside from
hypostatic congestion normal. On opening the abdom-
inal cavity the following condition of parts presented
itself: At a point, about midway between ensiform car-
tilage and umbilicus, an abnormal partition was stretch-
ed across the cavity, formed by the transverse colon and
great omentum, the latter appendage being firmly
adherent to the abdominal walls, anteriorly and latterly.
Above this partition lay the liver, duodenum, stomach
and spleen; below it, the small intestines, ascending
and descending colon, etc. The small intestines were
spread out evenly over the posterior and lateral walls of
the lower cavity; the several coils bound to each other
and to the deeper lying partly by strong fibrous bands,
giving to the whole a kind of basket-like appearance.
The inferior boundary or floor of this cavity, was formed
to the right, by some kind of tumor filling the iliac
fossa on that side and extending some two inches beyond
the median line of the body; on the left by the uterus,
occupying the iliac fossa on this side and overlapping
the tumor near the middle line, to the extent of one
and a half, or two inches, being in front of it; and
finally, by the bladder, located in front of both and in
its normal central position. In the cavity thus described
the foetus had been found, the greater portion of the
umbilical cord still lay here, also a few ounces of turbid
greenish liquid. It will be remembered that a consider-
able quantity of such fluid—between two and three
pints—had been removed at the time the sectio, Cesaris
was made. In addition to the evidences of bygone in-
flammatory processes, the adhesions, strong fibrous
bands, etc., were also present those of recent peritoneal
inflammation, in the shape of a pulpy exudation, dis-
tributed in layers and strings over the various organs.
Upon following the cord to its attachment, it was found
to enter the oft mentioned tumor by an opening about
two inches in diameter, situated just behind and a lit-
tle above the right border of the uterus, thence to pass
downwards within the envelope of the tumor to the
reflection of the peritoneum and there to be inserted
into its placenta. Through this opening protruded also,
in a ruffle-like manner, a cream colored, shining mem-
brane. More minute examination of this tumor proved
it to be really nothing than an enormous placenta,
enclosed in a strong membranous sack: the great size
of the placenta being due to interstitial extravasation of
blood which had become partially organized. The pro-
truding membranes were connected with the placenta
in the same manner as in normal pregnancy; they lay
shriveled up on the anterior surface of the placenta and
were to the greater extent, adherent to the enveloping
fibrous sack. In bulk this tumor—placenta and mem-
brane—was well nigh equal to an adult head. The
uterus on the other hand was scarcely more than half
the size usually found immediately after delivery
in normal pregnancy. The measurement taken of
the uterine cavity and cervix during life proved to be
correct and on directing the point of the sound towards
the region of the right Fallopian tube it also entered
readily some kind of canal, but evidently not the
Fallopian tube for, after passing through the wall of the
uterus it appeared upon the free surface of the placenta
sack. Laying open the uterine cavity, its interior sur-
face was found lined with thick shaggy membrane—
decidua vera—and the pathologist also demonstrated the
orifice of the right Fallopian tube and immediately be-
hind this the orifice through which the sound had passed.
A fine probe could only be made to enter the Fallopian
tube to the depth of two inches, there, to all appearances,
it became impervious, could however be followed up to
its termination near the right border of the placenta-
tumor, it being located quite superficially upon the
anterior surface of the same. Nothing was found of the
right ovary. The left ovary and Fallopian tube pre-
sented nothing abnormal.
Concluding Remarks. The autopsy of the case dem-
onstrated that the diagnosis made during life was as
nearly correct as it was well possible to make it. True,
the real character of the pelvic tumor had not been
made out, nor had it been recognized that the foetus had
already been born once, namely, into the abdominal
cavity, and was then only waiting to be born again.
But, as such cases are somewhat rare, no similar one
having come under obrervation at the Vienna Lying-in
Hospital during the last twenty years, it is not to be
wondered that these conditions were not appreciated,
even by gentlemen of such vast experience, as those who
examined and diagnosed the case, Professors Braun and
Spaeth.
Whether or not it should be a matter of surprise that
a Simpsons sound was pushed through the uterine par-
ietes, when it was supposed to have entered the Fallo-
pian tube and passed through this.into the foetal sack,
is left for the reader to decide. *
Since the autopsy it hs been ascertained that during
the month of July last, this woman was treated at the
“Rudolf’s” Hospital of this city for a disease presenting
MAR. 2, 1872.]
T TH THE CIT I I INT I C .
107
many of the well known symptoms of peritonitis. It is
almost certain that at that time rupture of the primary
foetal envelops occurred and that thenceforward the
foetus lived and attained its full development among the
intestines in the common cavity of the abdomen. As
will have been perceived the location and condition of
the Fallopian tube indicate that the fecundated ovum
became attached to some part of the fimbriated extrem-
ity of the tube and there reached a certain degree of
development, when rupture of the sack and escape of
the foetus into the abdominal cavity took place, followed
by a mild peritonitis, this passing away without in the
least, interrupting the growth of the foetus.
C. LINICAL MEMORANIDA.
SICK HEAD-ACHE,--The only remedies which are of:
any avail are those which act on the nervous system,
such as hot tea and coffee; or, after the stomaeh is
quieter, and the more urgent symptoms have passed off,
a little wine or ammonia. If the head-ache take more
the form of hemicrania, then remedies are occasionally
useful, as the local application of the bisulphide of car-
bon, or galvanism, and internally the bromide of potas-
sium. This is the only drug which I have really seen
to be serviceable. Whilst the nausea exists and the
worst symptoms prevail, even this remedy is of no avail.
—Wilks—Brit. Med. Journ.
QUESTIONS OF THE EXAMINATION.
The Following Questions, Tem in Each Department
were submitted to the Graduating Class of ’72.
ANATOMY.
1. Give a general description of the skeleton.
. Describe the os femoris.
. What are the essential components of any entirely
moveable joint? -
. Describe the elbow joint.
. Describe the heart.
. Give its position.
. Describe the larynx.
. Describe the trachea, bronchi and bronchia.
. What are the enveloping membranes of the cerebro-
spinal axis? .”
What are the great divisions of the encephalic mass
and their relation ? .
:
.
10,
SURGICAL ANATOMY.
1. What is the best place for ligating the common
carotid artery, and what are its relations at that ||
part? - -
2. Popliteal artery, where found and relations?
8. What are the anatomical objections to ligating the
first and second portions of the subclavian artery?
4
5
:
:
10.
Scarpa's triangle, boundaries and important parts
contained. -
By what muscles is the inner border of the foot
elevated ?
. Fractures in the upper third of radius, in what posi-
tion best treated, and why?
. What are the parts divided in the lateral operation
of lithotomy?
. Surgical anatomy of the shoulder joint.
. Surgical anatomy of the elbow joint.
. Surgical anatomy of the hip joint.
PHYSIOLOGY.
. The digestive juice with the widest range of action,
and its chief ingredients? P
. Trace fat through the system.
. The cause or causes of circulation in the veins ?
. Capillary circulation, continuous or intermittent,
in either case why 7
. Chief use of the red blood corpuscles?
. Uses of sweat 7 ---
. The immediate and subsequent effects of wounding
the cerebellum ?
. The diurnal range of temperature and the variations
compatible with health 7
. The necessary quantity of air in cubic feet for 24
hours?
Describe a spermatozoid.
CHEMISTRY.
1. Enumerate the general properties of acids and bases.
i2
8
10.
5
. Give the composition, formula, and mode of prepa-
ration of hydrochloric acid.
. Describe the tests for arsenic.
. What is the antidote to arsenic and how prepared ?
. Describe normal urine. *
. How is urea obtained from urine?
. How are chlorine, Sulphuric acid, potassium and
sodium detected in urine 7
. Describe the tests for sugar in urine.
. How would you determine whether a deposit con-
sists of urates, phosphates, oxalate of lime or
uric acid 7
How would you discover blood in urine?
SURGERY.
. What are the various processes by which fractured
bones unite 7
. What are the means you would use for strangulated
hernia before resorting to an operation, and, fail-
ing in these, what are the operations recommended
and the advantages of each 7
. In what injuries of the ankle joint is deformity
inevitable?
. What are the stages of hip-joint disease and the
treatment of each stage 7
. How would you treat wounds of the stomach 3
, What are the indications for amputation ?
• - *** - , º, .
108
IMAR 2, 1 87
TIH. H. C.L.INI c.
7
10.
:
9
10.
:
5
6
. Describe the various methods of acupuncture.
. Differentiate between intra and extra-capsular frac-
ture of the neck of the femur.
. Differentiate between abscess, encephaloid, aneur-
ism, hernia and adenoma. -
Name the principal disease which affect bones.
PRACTICE.
. State the prominent facts in the clinical history of
malarial fevers.
. What is the cause, course and termination of hepatic
abscess?
. What are the symptoms and dangers of desquama-
tive nephritis?
. Diagnosis between real and feigned epilepsy 7
. How treat habitual constipation?
. What are the physical signs of pericarditis?
. Diagnosis between peritonitis and enteritis. ... . .
. How distinguish fixed neuralgia from inflammatory
pain?
. Give the dry and moistråles; what do they indicate?
. How would you treat cardiac hypertrophy.
GYNAECOLOGY.
. Describe the uterus, location, size, weight, divisions,
StructureS.
. In what particulars does the neck of the womb
differ from the body of the womb 7
. Describe ovulation and menstruation.
. What circumstances would enable you (if possible)|
to determine the difference between specific and
non-specific vaginitis?
. Mention the most common diseases of the uterus in
the order of their frequency.
. Name the various substances which may be expelled
from the female pelvic organs.
. Give the probable and positive evidences of the ex-
istence of uterine cancer.
. Mention the forms of dysmenorrhoea and differential
diagnosis.
. What are the conditions capable of producing amen-
orrhoea?
What are the diseases which may produce pelvic
abscess?
OBSTETRICS.
. Give positive signs and duration of pregnancy.
. Give diameters of pelvis at brim and outlet.
. Give diameters of foetal head.
. Describe the anterior and posterior lateral inclined
planes, and their relations to the mechanism of
labor.
. Give the four cranial presentations, with the diag-
nosis of the first.
. Management of natural labor. p
. Under what circumstances would you turn, and
how 7
. Cause, symptoms, and treatment of unavoidable
hemorrhage.
9. Cause and treatment of post-partum hemorrhage 2
10. Symptoms and treatment of puerperal convulsions?
OPHTHALMOLOGY.
1. Name the bones that form the orbit.
. Name the muscles found in the orbits giving the
nerves that innervate them. :
3. Given a case of internal squint, how could you tell
whether it was paralytic or not.?
. Give the condition of the lids in ptosis and facial
paralysis, with the muscles and nerves involved.
. Give the structures of the eye from before back-
wards.
6. Give the points of differential diagnosis in the
various conjunctival inflammations.
. Differential diagnosis of iridal and corneal inflam-
mation with the general plan of treatment in the
latter and the particular of the former.
8. Of what does the lachrymal apparatus consist and
what may interfere with the carrying off of the
tears ? - -
9. What is cataract, and what is its treatment?
. What are the two methods of examining the eye
with artificial light?
MATERIA MEDICA.
1. Why is cod liver oil the best form in which to ad-
minister a fat 2
. Describe the effects of arsenic on the primary assim-
ilation. - - -
3. Name the preparations of arsenic and the dose of
each.
. Give the composition of opium.
. What is the treatment of opium narcosis?
6. What practical tests for the purity of chloroform
may be made at the bedside?
7. In danger from chloroform narcosis what methods of
resuscitation are proper?
8. What is the distinction between galvanism and
Faradism 2 -
9. To what class of cases are these two forms of elec-
tricity especially applicable?
10. Write a prescription for a purgative pill.
—º-O-ºsm--
IHION II E NEWS.
THE report of the Commencement Exercises came to
hand too late for insertion in this number.
DR. THos. L. BROWN is about to establish himself
permanently as an electrician. Brown is a master work-
I (18.Il.
DR. WADE MINOR LOGAN as we are informed begins
soon a series of articles in a Journal of Mechanics on the
diseases of laborers. Dr. Logan will work this subject
up to general profit. He is blessed with the working
capacity.
DIVIDED MEDICINES,
PREPARED BY
The Divided Medicine Comy,
CINCINNATI, OHIO.
* The Company have the honor of bringing to the notice of the Profession, this NEW AND ExCEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUS, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. º
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities.
But not only SoLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. -
This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; : #. sh, 1.0, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. -
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH OF TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For Samples, Price Lists, and Agencies, address
- sº |s – S R İş.
The Divided Medicine
- - IECIX: 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
MR. FREDERICK KRAUs: CINCINNATI, February 15, 1871.
Dear Sir–The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
Specified in each, viz: -
SULPH:MORPHII.......................% grain in each square. ARSEN:ACID......................... .1-20 grain in each square.
“ CHIN INI ....................... 1 * * * * $6 CALOMEL 34 “ -- 66
& 6 COPPER ................. .......}% & ſº
RespecTFULLY YoUBs,
E. S. WAYNE, Analytic Chemist.


||||||}|| MM|| ||M||
FOSTER’s
167 E4ST 34 T LI-ST., NE IV YO It K,
By Special Appointment Electrical Instrument Makers tº
the New York State Hospital for Nervous Diseases,
MAN UF ACTU. RERS () F PORTABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwanic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery ſºluid. -
|M|| |||||—|| |||||||}
PEERMIAN ENT B ATTERIEs,
For Hospitals and General Practitioners,
TEIT IIECTIER, OTDIES.
For Eye, Ear, Larynx, Nose, Uterus, Vagina, Bladder, Rec-
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—-->O-O-c-
AEXTRA ('TS
JEMI NENT IM EMI E3 ERS OF THIS PIR OFESS / O N.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Nothing cAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. Hammond to announce en-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
W M EREDITH CLYM ER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider their
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:–“ In neat-
ness, compactness and efficacy, they can not be excelled.”
A LFRED C. G AR 8 ATT, M. D., Boston :-" In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Simi ar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WANN IE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAY ER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
FROMr TH E O PINIONS OF THI E' WOST
IF_A_TIEI, NTT
Are furnished to Officers and Soldiers on Government
àCCOunt.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is, it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those .
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
J AMIES AL. FOSTETER.
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 172 Jef-
ferson Avenue, Detroit, Mich.
SAML. P. THOMAS
TA II, OR,
D E A LEF IN
English, French and Scotch
GO. O. D's,
34 West Fourth Street,
CA.Y.cz.w.war zºr.

Made to order of N. Y. M. Muslin and 2300
HEAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.0)
First three qualities have ALL LIN EN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
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Perfect satisfaction given or money cheerfully
refunded. .
Also import and Manufacture Men's Furnish-
ing Goods.
Pike's Opera-House, Fourth Street, Cincinnati; 931
Wabash Avenue, and 88 West Washington
- street, Chicago.
CAMARGO
MANUFACTURING COMPANY.
Manufacturers AND IMPORTERs of
AND
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67 Wasz Kovzzy Szarmºz,
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IN EVV B O O IX
IS NOVV READY FOR CA N VASSEFS.
It contains over 600 pages of read ng matter, with 250
engravings, designed expressly for this work, by the best
artists in the country. Agents now at work upon it are
Agents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re-
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 Elm Street, Cincinnati, O.
BASCOM & CARPENTER,
Stationers, Printers
—AND-
Blank Book Manufacturers,
136 VINE sº DEREET,
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IE. D. ALBIRO & BRO.
IMPORTERS AND MANUFACTURERS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
fººlinaiºhirº
The only house in the Western country that saws Spanish and Mexi-
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can sell at prices to compete with any and everybody.
Also º keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 West Second Street,
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI,


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GooD sAMARITAN HOSPITAL.
The GooD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
pointments of a First-class Hospital. Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
sistºrs or on ARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand ot
Bºy" Address,
SISTEF, ANTHONY,
Hospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio-















































































Manufacturer,
Nº. 9 and Il Bast Sixth Street, bet. Main & Sycamore.
I MAKE NOTHING BUT
"62 /*A*,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of - 4. - - -
LIGHT FAMILY CAFFIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose. - -
The superiority of my light gentlemen’s
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
'to Dr. W. W. Dawson and all the leading






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CINCINN ATI.
E" A C TU L T Y -
J A M E S G R A H A M, M. D., D E A N,
Professor of the The ory and Practice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomy. Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D., - T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
W. W. SEELY, M.D., JOHN L. CLEVELAND, M.D.,
Professor of Diseases of the Eye and Ear. Lemonstrator of Anatomy.
SAMUEL NICKLES, M.D., CHARLES KEARNS, M. D.,
Professor of Physics and Medical Chemistry Assistant to the Chair of Surgery.
.J A MC HD S T - W H ITT A 13 FC R, ,
Professor of Physiologv and Secretary of the Faculty.
Janitor, College Building, Sixth St., bet. Vine and Race.
*-
T. Louis Brown, Prosector of Anatomy.
Printed and Published by Nor his & M URRY, Medical College of 9hio Building, Cincinnati,


















































































INIC.
PUBLISHED EVERY SATURDAY.
T E R MS-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor :
All Communications relating to Business, Subs
criptions, Advertisements, etc., to the Treasurer.
Vol. 2. C IN C IN N A TI,
–sº
M A R C H 9, 1872. No. 10.
wº Q.º sit Editor.
JAs. T. whitTAKER, M. D.
No. 101 West Ninth Street, Cincinnati,
Associ..A.T.E. EDITORs.
W. W. D.Awson, M. D. THAD. A. REAMY, M. D.
P. S. ConneR, M. D. C. D. PALMER, M. D.
W. W. SEELY, M. D. SAMUEL NICKLEs, M. D.
coars e co-
Fashionable Hatters,
IMPORTERS AND MANUFACTURERs OF
CHAs. KEARNs, M. D. JNo. L. CLEVELAND, M. D. -
Roberts. BARTHôLow, M. D. . . . - A Yº iſ& 9) -->gº
- . — ........| Hºş’ FºS
W. W, SEELY, M. D., • * * sº * = tº & º TREASURER. łºńºß Sº
No. 118 West Seventh Street, Cincinnati. . . . . . . . . -- . . t - -
- -- - 92 WEST ENOTTERTH ST.
C L U B R A TES, _** y --~~~ ' -- ... ' Past office,
- - * º
' ' ||
4 Copies to one address $ 7.00 || CIN
6 § { “ --------------------------------------------.......... 10,00 ſ sº special Inducerments to Medical Men.
12 § { 6 & 18.0% -
o o N T E N T S. .."
— Päge
*. origiNAL ARTICLEs
Corpulence, by J. L. Cleveland, M. P.” * - - - - - 109
Solid Food in Typhoid Fever, by Sam’l D. Turner........................... 109
scIENTIFIC NoTEs
Signs of Death........................................................................ *J. TAFT W Tart.
ſº 3. e - gº
TRANSI LATION
Coal Dust in the Lungs, (A Chapter from Hirt's Staub-Inhalations
Krankheiten, Breslau, 1871.).................................................... 102
118
Books and Pamphlets Received—Journal Changes
(CILINICAL MEA. IORANIDA
Treatment of Sick Head-ache—The Relative Value of the Quinine
Salts... s - - - - - - - - - - - - - - - - - - - - - - - 118-119
HOME NEWS II Q
The Spring Course of 1872.......................... 120
The results of investigations into the influence of
coal dust upon the genesis and course of pulmonary con-
sumption, showing as they do conclusively, that the
inhalation of this dust is decidedly prophylactic, are as
gratifying as unexpectéd. The whole article is worthy
of the careful study of the sanitarian, The signs of
death as exhibited by Caspar in his recent work on Med.
ical Jurisprudence, as the latest on this subject from
the highest medico-legal authority in the world, are of
J. & W. TAFT,
TIENTIST's
17 WEST FOURTH STREET,
CINCIN NATI, O.
The Registers
A Monthly Journal,
no less importance in a forensic point of view: Allbutt's
views as to the nature and treatment Óf sick head-ache
cannot fail to interest any physician who has had to
CONTAINING 48 PAGES,
deal with this malady so distressing and so intractable.
Devoted to the Interests of the Dental Profession,




O' D C F& L IRC S S A N ID IP A. L. A. T A E L E -
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERS & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market. §
Our notice was ed to this Oil-by several leading physicians of the city, who had
as not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency.
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent. * #
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.



william Autenrieth,
\
No. 71 west sixTH stre+BET,
BETWEEN WAINUT A&E WINE,
CINCINNATI, OHIO,
MANUFACTURER OF AND DEALER IN
||| || || |||||||}
Abdominal Supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
Metalic and ERubber Syringes,
Stormtach Pumps, Etc.
STOCKINGS FOR WABDCOSE WEDNS,
Special attention given to the fitting of Apparatus for Deformities.
Lºſ Agent for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
--ALSO–
DR. AHL'S POROUS FELT SPLINTS,
--ALSO –
D A. Y. * S S R T, IN T S
-AND-
ROBERT CLARKE & G0°S.
LIST QF NEW
MHL iTH II MEHull; Hill;
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5o
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN’S DIS-
EASES. 12mo. $1 75
BENNETT ON PULMONORY CONSUMPTION. 8vo. $1 50
FIRST HELP IN ACCIDENTS. 12mo. $1 50
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 5o
ECHEVERRIA ON EPILEPSY. 8vo. Cloth. $5 od
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASES. 8vo. $5 od
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 oc Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth. $2 5o
TANNER'S HANDBOOK OF OBSTETRICS. 12 mo. $2 oo
VAN BUREN ON DISEASES OF THE RECTUM. 12mo.
Cloth. $1 5o
FLINT’S EXAMINATION OF URINE. 12mo. Cloth. $ 1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 50
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRICITY. 8vo. Cloth. $4 50
ATTFIELD'S MEDICAL CHEMISTRY. 12mo. Cloth. $2.75
Leather. $3 25
BARTHOLOW'S HYPODERMIC MEDICATION. 12mo.
Cloth. $1 5o
TURNBULL’S DISEASES OF THE EAR. 8vo. Cloth. $5 od
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 od
NEUMANN'S HAND-BOOK OF SKIN DISEASES. 8vo.
Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 OO.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $1 o oo
HOOD ON BONE SETTING. 12mo. $1 50
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo
HOLBROOK’S PARTURITION WITHOUT PAIN. I 6mo.
$1 oo
PROCTER'S LIGHT SCIENCE FOR LEISURE HOURS.
12mo. $1 75
BERNARD’S PHYSIOLOGY OF THE HEART. 5o cts.
BARNES’ OBSTETRICAL OPERATIONS. 8vo. $4 50
NICHOL’S FIRESIDE SCIENCE. 12mo. $1 5o.
WOHLER'S MINERAL ANALYSIS. I 2 mo. Cloth. $3 OO
PLATTNER'S MANUAL OF ANALYSIS WITH THE
BLOWPIPE. 8vo. Cloth. $7 50
JEFFRIES ON THE EYE. 8vo. Cloth. $1 oo
MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
JEFFRIES ON THE SKIN. 8vo. Cloth. $1 oo
GARDENING FOR PROFIT. 12mo. Cloth. $1 5o
PRACTICAL FLORICULTURE. 12mo. Cloth. $1 5o
FULLER'S SMALL FRUIT CULTURE. 12mo. Cloth. $ I 5o
WOODWARD'S COUNTRY HOMES. 12mo. Cloth. $1 5o
DARWIN’S ORIGIN OF SPECIES. 12 mo. Cloth. $2 oo
ARTHUR'S TREATMENT AND PREVENTION OF DE-
CAY OF THE TEETH. 12mo. $1 5o
TYND ALL ON LIGHT AND ELECTRIC1TY. 12mo. $1 25
THE AMATEUR MICROSCOPIST. Small 4to. $1 75
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMEN.
ROBERTS ON RENAL DISEASES.
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN.
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by mail or express, free of charge
on receipt of price.
S. W. Eſiliott’s Saddle-bags
65 West 4th Street, Cincinnati, Ohio.
List of Pharmaceutical Preparations,
MANUFACTUREID BY
won.w’ Irrazºn 4 amoznan,
FEIILADELPHIA.
—dº
ELIX, PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR, WALERIANATE OF AMMONIA,
(Goddard’s Formula,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES, -
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK,
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH, *}.
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED, -
e BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and Sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA, -r
* WINE OF PEPSIN,
SYRUP SUPERPHOSPHATE OF IRON,
ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRA BRAWA. *
STUTEPIEPOSITOTER, II ES.
Rectum, Vaginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and Btyle, made of finest quality of sponge.
FosſºR, JR., & co.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
same. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in-
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Lenses, Spectacles, and the best models procurable, with pains-
taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopic Objects
and Microscopic Apparatus, Magnifiers and Readers in
great variety. edical Batteries, Barometers, Thermo-
meters, Hygrometers, Urinometers and Rain Gauges,
of the most approved constraction always on hand. All orders promptly
and accurately filled. - . . . -
JAS. FOSTER, JR.
F. S. SHACKLEFORD, } *** * JAs. FostER, JR. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TIER,.S. INT.INMA ER.S.H.’s
-tº
:Sºx) TRUSSES. gº
- - No. 758 BROADw AY, NEw Yoes
HAVE been in the habit. of applying and recommending the Truss
I manufactured by Drs S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a 'l russ for the radical cure of Hernia, I think it far preferable to
any l have ever examined. LEWIS A. SAYRE, M. D.
- Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
T B EG leave to state for the benefit of āfi concerned, that I have known
I Dr. S. N. Marsh the last fifteen years. * * I am in the constant
abit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of
Trusses Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & CO., No. 2 Vesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
OPPOSITE THE HIGH STEEPLE,
F. E. SUIR F. E. S. WAYNE
F. E. Suire & Co.,
WHOLESALE DBUGGDST3,
INZL AL INT TJ E A C T TJ IF, I INT G-
£Hemists AND f'HARM aceutists,
\
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
sye), ecºx) ox{UGS ANYO WOEXOXCXN Es,
cºeryxxcAx. AxºpA}{A}^Us,
TESTS, MEDICAL, GLASS WARE, &c., &c.,
p ‘s
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accord.ince with the U. S. P. and other recognized authori-
ties.
ETINIFD ANTO EARHC CHEMICA LS,
Of the popular class of preparations known as
H. T., IL& IIER, S,
We manufacture a full line. Those of our make may be relied apon (Aſº
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c.
AGENTS FOR BULLock & CRENSHAw's
Sugar-coated Pills and Granules.
&
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.
















* > **
DIVIDED MEDICINES,
The Divided Medicine Comy,
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExcEEDINGLY PRACTICAI,
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general. .
The Divided Medicines are prepared by FREDERICK KRAUS, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. .
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities.
But not only SoDUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. Vº - ºy
This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; : #. sh. 10, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. -
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH OF TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste. -
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed !
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For samples, Price Lists, and Agencies, address -
. "Iso- 2ese,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
MR. FREDERICK KRAUs: CINCINNATI, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: -
SULPH:M0 RPTIII....................... % grain in each square. AT&SFN: A CID..........................1-20 grain in each square.
“ CfI [N INI .......................1 “ “ {{. CALOMEL 34 “ - 4 4
“. COPPER ....................... % {{
RESPECTFULLY Yours,
E. S. WAYNE, Analytic Chemist

T H H C T ITNTIC .
109
Vol. 2.] S A T U R D A Y, M A R C H 9, 1872. [No. 10.
O R. I G IN A L A R T I C L E S.
–-º-º-º-
C O R P U L E N C E .
. A Case IIIustrating its Treatment.
BY
J. L. CLEVELAND, M. D.
This condition is either the result of over-feeding or
perverted assimilation. Adipose tissue when in its normal
proportion, beautifies the body and serves for purposes
of utility and comfort; but when increased much
beyond a given proportion becomes an element of
deformity and a source of very great discomfort, etc.
It is not always easy to draw the line of demarcation
between corpulence as robust health, and corpulence as
an expression of disease. It has been defined a disease
“when it renders persons, from a deficient respiration,
uneasy in themselves, and from the inability to exercise,
unfit for discharging the duties of life.” This allows us
much latitude, which is required in the nature of the
case, since a degree of obesity that would be disease in
one, might be health in another; age, physical vigor,
temperament, some other features perhaps, extraneous
to the condition, constituting the difference. How-
ever well persuaded medical men may be of the fact
that corpulence is a disease, it does not alter the
popular regard in which this condition is held. Jack
Falstaff was a jest upon this class, who are still fre-
quently made the “jest of the world.” The Spartan
laws regarded the corpulent as subjects for punishment:
“Citizens who grew too fat were soundly whipped.”
“Namilus, the son of Pohytrus, was brought before the
Ephori, and his excessive corpulence was exposed to the
public. He was moreover treated with perpetual
banishment if he failed to reduce his body within reason-
able dimensions.” g
Obese persons suffer from a diminution of vital power,
and an unfitness for muscular activity, they are short-
Winded, suffering from bodily torpor and mental
hebetude. Lord Chesterfield thought fat and stupidity
convertible terms; and Shakspere speaks of the fat-witted:
the fat boy of the ‘Pickwick Papers' is sleepy-headed.
Dr. T. K. Chambers, from his observation of 38 per-
Sons, whose weight varied from 224 to 504 pounds, came
to the following conclusions: the bony frame-work is
less massive than in the spare, indicated by the small-
*ss of the hands and feet. The skin is usually fresh
colored and thin; the respiratory functions present a
*Versal and well marked peculiarity, namely, the
volume of air they are capable of taking in and expiring
from the chest is considerably less than the average
quantity contained and expired by healthy persons of
equal height. The vital capacity is diminished and
less carbon is expired.
Adipose tissue may be distributed generally, or unusu-
ally developed in certain localities, as in the mammae of
the female, or in the omentum, thus spoiling fair propor-
tions as well as being a Source of discomfort: It is not
often met with before 30, though in some cases there is
a congenital tendency to it. The cause and pathology
of corpulence may be arrived at by noting the facts
given us by physiological research, concerning the effects
of food upon the animal economy. It has been found
that to keep the body in a healthy state it requires
from 5 to 8 pounds of mixed food every 24 hours; that
is from I-26 to 1-20 of the weight of the individual in
solid and liquid food, (supposing the body to be in a
normal condition). This amount is about in the follow-
ing proportion; the so-called solid food from 2 to 3
pounds. Liquids from 3 to 5 pounds. This represents
the amount required under ordinary circumstances. A
state of inactivity requiring less, and during extra-
ordinary exertion much more food is required. Further,
in order to have a healthy condition of body, the food
must be mixed. Custom and instinct point to this
physiological fact. Neither man nor the lower animals
can live on the nitrogenous elements (albumen, fibrin
casein, gluten, etc.,) alone, in a short time they will
sicken and die; nor upon the non-nitrogenous elements
(sugar, starch and fat,) on these they will likewise
waste away, and starve in the midst of plenty. Nature
fortunately has not left us to Select these elements for
food, according to physiological laws, but we find them
already combined in perfect harmony to the demands
of the animal organism, and it only remains for us to
follow the unperverted instinct of appetite. This
should produce the normal amount of fat; which
in health is about 1-20 the weight of the body in the
male, and about 1-16 the weight of the body in the
female. In the excessive disproportion that we have in
corpulence, we may in some cases apply some of the
facts that have been elicited by physiological research
with very great advantage. The steps to be taken are
simply these: the elements which produce fat in the
system having been determined, the patient will avoid
those elements as far as possible. Too much non-nitro-
genous food favors the development of fat, and interferes
with the proper nutrition of the muscular tissues,
hence we find that rice feeders, potato eaters and those
who indulge in fermented liquors are often bloated in
their appearance and become extremely fat, and are
not capable of extreme exertion. “The brewers dray-
man although he has the appearance of robust health,
is not a good subject for a college.” His muscular
tisssue has been encroached upon by the fat, and his
power has been weakened by an undue quantity of the
respiratory element. The negroes on the sugar planta-
%
110
[MAR. 9, 1872.
TIEI IET: C T I I INTI C.
tions are said to grow fat during the sugar season.
Corpulent persons are generally vegetarians. “There
is a sect of Brahmins who pride themselves upon their
obesity, considering it a sign of wealth, whose diet con-
sists exclusively of ſarinaceous vegetables. Fotherigal
states that a rigid vegetable diet produces fat more cer-
tainly than any other method. Bears fed exclusively
upon bread grow very fat. It is well determined that
food rich in fat and starches, as oils, fat meat, greasy
gravies, sugars, the farinaceous vegetables or fluids con-
taining oil, as milk, or alcohol; and sugar, as beer, ale,
and strong wines, favor the production of adipose tissue.
Dr. Chambers thinks that defective sun-light may be
an important agent in developing fat, and relates a
case that seems to sustain the view. Though corpulent
men are generally “surfeit swelled,” they are not
always either large or gross eaters, but they are invaria-
bly great water drinkers, taking large draughts. Some-
times corpulence is hereditary, it is then much more
obstinate to treatment. -
From the above remarks the treatment of corpulence
naturally suggests itself, viz., to avoid as far as possible
those kinds of food containing fat, sugar and starch.
These principles were laid down by Dr. T. K. Chambers
and were adopted by Dr. Harvey, in the so-called
Banting system, which attracted so much attention
several years ago. Bearing in mind the requirements
of the animal economy, it is evident that a treatment
upon this plan cannot be exclusive, as disease and
debility will be the result. The animal diet when rigidly
adhered to is often followed by grave consequences, as
disorders of the nervous system, feeble digestion, obsti-
nate constipation, general sluggishness, and, after a
time, evidences of mal-nutrition. A dietary based
upon sound physiological principles requires careful
selections and close observation as to the effect that is
being produced, making the changes that each individ-
ual case calls for. Hence the necessity of intelligent
advice whenever this method is to be adopted.
The following case which I will narrate, while it
illustrates the views that have been taken, also shows
the necessity of exercising great care. A professional
man, 29 years of age, about six feet high, weighed Sept.
25th, 224 pounds. This amount of fat did not
interfere seriously with his locomotion, but he felt ap-
prehensive in regard to the future, as he found that his
weight was steadily increasing; besides he found that
he was suffering from great hebetude of mind; in the
afternoon when he sat down to his studies he would fall
asleep in spite of every effort; this was not on account
of a large dinner, for he was a light eater. He was
much annoyed by this torpid condition of mind, and
could rouse himself to mental activity only by great
effort. This was very annoying to him as he is a man of
more than ordinary mental and physical energy, and
is actively engaged in the duties of his profession. He
had tried the “Banting plan,” but was compelled to
leave it off on account of the obstinate constipation it
induced. He was satisfied that there was virtue in the
method for by it he could always succeed in reducing
his weight. He requested me to arrange for him a
dietary and give him whatever advice I thought his
case called for. The bill of fare was based upon the
ideas that have been stated. Animal food was chiefly
recommended, the fatty varieties avoided being veget-
ables containing sugar, starch or oil. Tea and coffee
without milk or sugar. No malt or alcoholic liquors and
water only as required. I ordered vegetable and animal
food in sufficient variety, as I supposed, to supply the
physiological demands of the body, limiting him only in
the use of certain articles. The faithfulness and resolu-
tion with which my recommendations were carried out,
may be inferred from the following table.
He weighed regularly once a week on the same scales
for fourteen weeks; this is the record.
1st week Sept 25th, weighed 224 pounds.
• 2d “ Oct. 3d, {& 220 & 4
3d & & “ 10th, {{ 216 {&
4th “ “ 18th, “ 217 ºt
5th “ “ 23d, {{ 218 & &
6th “ “ 31st, 6 & 213; “
7th “ Nov. 7th, “, 213 {&
8th “ “ 14th, {{ 211 & &
9th “ “ 21st, “ 210 {&
10th “ “ 28th, {{ 207 & &
11th “ Dec. 5th, ( & 205 & &
12th “ “ 12th, & 4 200 {{
13th “ “ 19th, & 4 196 {{
14th “ “ 26th, & & 192 &&.
Feb. 13th, of this year 6 & 188 {{
Accompanying the above table was the following note:
“There is I should judge at least 7 pounds difference
between the clothing I wore on September 25th and
those I now wear. So that I can justly claim to have
lost seven pounds more than the record shows, as the
record shows the loss without considering the additional
increase in the weight of clothes. I have in the mean-
time enjoyed perfect health, until about a week ago
when I contracted a violent cold which has been troub-
ling me since. I am so well satisfied with the experi-
ment that I shall keep it up and advise you from time
to time.”
The gentleman also states that the heaviness and dis-
position to sleep which formerly so much annoyed him,
has entirely disappeared and has been replaced by a
feeling of buoyancy and an ability to work much more
satisfactory. He has not been troubled at all with
constipation and he finds that he is beginning to lose
taste for starchy and saccharine varieties of food of which
he was formerly very fond. This change in the physio-
logical habit of the system was not brought about (as is
apparent from the record) without some shock; he con-
tracted a “violent cold” which has proved very obstinate.
This condition of catarrh of the upper air passages from
which he has been suffering, was induced in all proba-
MAR. 9, 1872.]
T EL E. c 1 INTI c.
111
bility by the physiological change that is being wrought.
Besides I would suggest that fat, which has been with-
drawn in a great measure as food, is not only a calori-
facient, but protects from cold as a non-conductor by
means of the subcutaneous layer that invests the body,
and this is gradually being reduced by means of the
treatment. - *
It is evident that patients undergoing this form of
treatment are liable to various complications regulated
by their constitutional tendencies. It is also generally
evident that under appropriate advisement they can
hardly suffer any serious consequences. It is not likely
that most cases would yield so readily to treatment as
the one just narrated without any medical interference;
in most cases it will be found profitable, in some cases
necessary, to use adjuvant remedies of various kinds,
the alkalies, laxatives, tonics, etc. But after all, perhaps
the most serious obstacle in the way of the success of i
this method will be found in the patients themselves
refusing or at least failing to conform fully to the
requirements of the method.
—-º-º-º-
SOLID FOOD IN TYPHOID FEVER.
* BY
SAM'L D. TURNER, M. D.
Circleville, Ohio,
Without entering into a detailed history of the changes
in opinion on the causes, course and treatment of typhoid
fever, it is sufficient to allude to the fact, that this disease
to-day is recognized as one of self-limitation, having like
the other fevers a definite duration, course and
specific lesion. -
This recognition of the unity of the disease has so
far modified treatment, that the physician is now con-
tented to guide where he formerly sought to control or
arrest; to put his patient in the most favorable position
for recovery and trust to the restorative powers of na-
ture for cure.
In nothing is this change more marked than in the
use of food. It is clear to us now, that much of the
gravity of the disease was due to imperfect nutrition.
Starvation undoubtedly killed more than the fever.
We now see that increased heat, delirium, exhaustive
diarrhoea, emaciation, fetid breath, destruction of elim-
inative organs were common effects of starvation and
typhoid fever. -
Guided then by better knowledge and more extended
observation, all modern authors urge the necessity of
supplying the patient with a sufficient amount of nutri-
tive food. With an equal agreement, authors join in
recommending that all food should be fluid and point
out the great danger of aggravated diarrhoea and possi-
ble perforation of the bowels from the effect of solid food.
Flint, Wood, Watson Niemeyer, Aitken, Reynolds,
Murchison, and others, all agree in condemning its use.
It is with diffidence, then, that I express my dissent
from this view, and were my opinion not backed by a
successful experience of eighteen years of moderately
active practice, I would be content to keep a becoming
silence. But this experience has taught me that these
dangers are imaginary and that the advantages of solid
over fluid food in typhoid fever are as great as fluid
food is acknowledged to be over the older practice of
semi-starvation. .
Solid food does not cause indigestion, does not irritate
the stomach or bowels. Given before structural altera-
tions of the mucous coat, before privation of food has in-
terfered with proper discharge of function, say within the
1st week, the stomach recoverstone, lost appetite returns,
food is thoroughly digested, diarrhoea diminishes and
disappears, the feces become natural in quantity and
quality, delirium subsides, fever and thirst abate, reso-
lution of the infarction of Pyers glands takes place, the
evidences of mucousinflammation pass away and instead
of all the symptoms increasing in gravity with the con-
tinuance of the disease and the necessity arising for
supporting the flagging strength with large doses of
alcoholic stimulants and beef tea, the gravest attack
grows mild, with the restoration of appetite, and the
patient passes into convalescence by such imperceptible
gradations that in most cases it becomes difficult to
say at what time the fever ceased.
I have yet to see the case in which solid food has
aggravated in any way a single symptom. Where this
has been properly administered I have never known
death from perforation of or hemorrhage from the
bowels or from intractable diarrhoea.
Unfortunately Ihave kept no record of cases and can
give no exact statement of results. From memory and
from a partial examination of my note books I cannot
place the ratio of deaths to recoveries at more than one
in twenty, probably less.
Such candidly and very briefly is the result of what
may be called preeminently the food treatment of typh-
oid fever, not to the entire exclusion of medicines, but
with the minimum amount of dosage. I do not wish to
set up a claim of originality in this matter and will
merely call to the notice of the medical profession a brief
article by Dr. Hooker, written many years ago on this
subject. I was then led by satisfactory experience to
adopt his conclusions.
Give the patient at his usual meal times—thus observ-
ing the habits of the digestive system—a regular diet of
roasted potatoes, buttered toast, broiled beef steak, game
or any other digestible fresh meat well served and prop-
erly seasoned. Give little or no fluids while eating.
Encourage Salivation by thorough mastication.
The patient at the commencement loathes food more
than medicine and it requires a full explanation of the
benefits to follow and some moral force on the part of
the physician to induce him to swallow a few mouthsful,
but with each repetition the difficulties grow less and a
steady persistence of a few days—ordinarily within four
II2
[MAR. 9, 1872.
TIEEE CI.INTI c.
—sees the patient ready to take his meals with relishing
appetite. The case can then be left largely to the point-
ings of nature.
I have nothing to offerin regard to medical treatment.
Systematic treatises on medicine of the present day
mostly agree upon this. But, in passing, I cannot re-
frain from heartily disapproving of Niemeyer's endorse-
ment of Wunderlich's large doses of calomel. If this
practice and semi-starvation are followed on the con-
tinent, I can not wonder at the fearful mortality there.
Living in a rural district, quinine in large doses is at
first administered. This not only clears up the diag-
nosis but has a modifying effect upon the febrile action;
an opiate to cheek early and profuse diarrhoea and pro-
cure rest, and in graver cases of blood contamination,
iron and chlorate of potassa, and sometimes stimulants,
are indicated until the stomach recovers tone enough to
digest natures only reliable stimulant—food. And then
regimen and time.
———-º-º-º---——
$CHENTIFIC NOTES,
$FIGNS OF D9EATH
Johann Ludwig Casper, in his exhaustive work on
Medical Jurisprudence, after referring to Frank's state-
ment regarding the ease with which the conjunctiva
may be separated from the cornea and to Larcher's black
spot on the sclerotica, as scientific curiosities, says, em-
phatically, that the well known signs of death are fully
sufficient for a diagnosis. He enumerates the following
stages between death and decomposition.
1. Respiration and Circulation have ceased.
2. Immediately after death the lustre of the eyes dis-
appears. Who has not, he says, on raising the lids of a
deceased person, noticed that peculiar, lifeless stare,
which cannot be described ? Light, of course, has no
effect on the pupils.
3. A reaction cannot be brought about by any means,
in any part of the body. We say nothing, here, of the
experiments with electricity, because they do not prop-
erly helong to this subject.
4. The entire body grows pale. Still, persons that
had, in life, a marked florid countenance, retain a good
deal of color for many days after death. So, too, the
red or livid margins of tumors do not change to the pale
color of the corpse. Nor do the red, black or blue
marks, made by tattooing disappear. Again, if there
was present, at death, an icteric color, it does not change
to white; and, finally, all marks of blows or bruises re-
tain the color which they had at death.
5. The animal heat which existed at death, is retained
for a time, because the cellular tissue is a poor conductor
of heat. This is especially true of fat corpses, which,
ceteris paribus, remain warm longer than those that are
lean. But, in general, there are other circumstances,
which is soon followed by other symptoms.
that influence the retention of animal heat, such as the
temperature of the place where the corpse is, and the
manner in which death was brought about. It is well
known how soon corpses grow cold in water, which,
even in the hottest of summers, is colder than the air.
In privy vaults and heaps of manure, a corpse naturally
retains heat longer. The same must be said of persons
that remain covered with bedding, after death. Persons
who died of suffocation retain the animal heat notably
longer than others.--It may be laid down as a general rule
that in the great majority of corpses, the animal heat as far
as the sense offeeling is concerned, disappears in from eight
to twelve hours. In experiments with the thermometer
this time is, on an average, doubled.
6. Immediately at, and after, death there occurs, also,
a general relaxation of the muscles, the earliest symp-
toms that prove the extinction of the turgor vitalis, and
A corpse
that shows only the signs enumerated (1 to 6) may be re-
garded as that of a person who has been dead for from ten
to twelve hours. -
7. A valuable proof of the extinction of the turgor
vitalis is furnished by the softening and yielding of the
eye ball. This may be distinctly noticed, in all corpses,
after a lapse of from 24 to 30 hours; sometimes sooner,
whilst the living eye ball resists the pressure of the
finger under all possible circumstances, even in patients
attacked with cholera and in persons just dying; in from
24 to 30 hours after death this resistance has ceased.
The bulb yields, becomes soft as butter, until at an early
stage of decomposition it bursts and pours oat its liquid.
8. The same cause, i.e., the extinction of the turgor,
brings gradually about the well known flattening of the
muscles in those parts on which the corpse lies, not only,
therefore in the buttocks and calves, but also in the
lateral portions of the upper and lower extremities, the
cheeks, the anterior portion of the thigh, etc., accor-
ding to the position in which the patient died or which
he retained after death.
9. Hypostases, the result of the subsidence of the blood
in the capillaries, according to the law of gravitation.
They are, for this reason, found on the entire posterior
(inferior) plane, the back, the nates, and the calves;
but frequently, also, in the face, on the ears, on the
lateral portions of the breast and the extremities. It is
plain, therefore, that all hypostases may and do occur
also on such unusual anterior and lateral portions of
the body as the anterior region of the stomach, etc.;
and in such cases we can determine, with a great degree
of certainty, the position in which the deceased must
have been, at or soon after, death.
These hypostases become visible on the corpse, in
from 6 to 12 hours after death, in rare cases even before
that time. They gradually increase in extent until
decomposition sets in. They are, in themselves, a perfect
sign of real death. We must distinguish exterior from
interior hypostases. -
MAR. 9, 1872.]
TIEEE IEH C T , I INTT C.
113
Eacterior Hypostases.
Hypostases of the sub-cutaneous cellular tissue.
Todtenflecke (death spots) constitute a significant symp-
tom of death. The unskilled are in danger of confound-
ing them with the marks of bruises, blows and the like,
from which, however, they may easily be distinguished
by incisions. An incision with the scalpel, in a Todten-
jleck, will never reveal diffused liquid or coagulated
blood at the base of the incision, at most a few small
points of blood caused by several cutaneous veins,
whilst an incision in the very smallest mark of a blow
, or bruise is followed by a diffusion of blood. This
being an infallible, and the only, diagnostic means of
distinguishing exterior hypostases from the marks of
blows and bruises, it ought never to be neglected.
The color of exterior hypostases differs little from that
of the crawfish, of copper or a bluish-red. As may
readily be understood, they are never in the least ele-
vated above the cuticle. Their form is very uncertain,
sometimes striped, sometimes round, in other cases an-
gular. At first they are found only here and there on
the corpse, of the size of a walnut, an apple, or a dinner
plate, until, gradually, they become confluent and
cover entire portions of the body, such as the half of, or
the entire back. Age, sex, constitution and the mode
of death, have no influence on their formation; they
are found even in cases of death caused by an excessive
loss of blood. - -
Interior Hypostases.
These occur more especially in the following organs:
1. In the Brain. Here their presence is evinced by
a fulness of the veins of the pia mater, which, in cases
of a general abundance of blood in the cavity, is yet
notably more marked than usual, and, in cases of
anaemia, may still be easily seen. These hypostases of
the brain occur even in cases of death from loss of blood.
It is important not to confound them with hyperaemia
of the brain (apoplexy)
2. The most constant interior hypostasis is that of
the lungs. Orfila, says it becomes visible in from 24 to
86 hours after death; but it occurs really much sooner
and at the time when a subsidence of the blood takes
place in all the other parts of the body. The entire
posterior of both lungs, about one-fourth of the complete
parenchyma, is, in corpses lying on their backs, of a
much deeper color than other portions, and an incision
in the lungs, even in cases of aaaemia, reveals a notable
fullness of blood. This is so remarkable, that the un-
skilled are easily led into errors of diagnosis as to the
Cause of death, e.g., apoplexy of the lungs, pneumonia,
etc. This will especially occur where the blood is very
dark and in cases of more or less cedema of the lungs.
8. Among the organs of the abdomen, hypostases
occur, generally, in the intestines, and in the kidneys.
They are quite common in the intestines, especially in
the portions located in the pelvis. The bluish-red
color of the inferior portion can deceive only the inex-
perienced. The difference between places reddened
by hyperamia and inflammation is shown by the color,
the absence of lustre and by the location.
4. In the kidneys we find hypostases, principally at
the posterior half, in cases where the corpse has remained
on its back. They are, therefore, easily distinguished
from a general plethora of these organs. -
5. The hypostases of the medullary substance of the
spinal cord, has, up to the present time, been scarcely
noticed, and yet it is important, because it too, may
lead to errors of diagnosis. It is shown in the veins of
the pia mater, and is the more frequently mistaken
for meningitis as its occurrence is almost unknown to
those engaged in the examination of corpses, because
of the difficulty experienced in opening the spinal
cord and the consequent rarity of such an operation.
The novelty of the case easily misleads to the assump-
tion of inflammation especially when it is known that
the back has been subjected to acts of violence. The
truth of this assertion may be readily demonstrated by
examining a corpse that has lain on its back for some
days, with reference to this hypostasis.
Coagulation of the blood after death.
6. The heart is not subject to hypostasis. Still, the
heart, more than any other organ or vessel, presents in
the so-called polypi of the heart, a sign, which is of
great importance in forensic diagnosis. It is expedient,
therefore, to notice them here. These polypi are, as is
well known, simply coagulated blood. That this coagu-
lation in the heart sometimes takes place even before
death, we may admit in cases where the death agony
is of long duration, but certain it is that in the vast
majority of cases it does not occur until after death,
during the gradual escape of animal heat. Bockf and
Donnét even go so far as to fix the time when this co-
agulation commences at about four hours after death,
but this can, at most, be considered only as the average
time, for the tendency of the blood to coagulate varies
according to its concrete quality. Hoppet hästlemon-
strated that ceteris paribus, the coagulation of the
blood will be accelerated, when it is thin and watery
(hence the rapid coagulation after loss of blood and in
cases of hydraemia) and that it will be retarded wheti
it is deficient in oxygen and rich in carbon. Now,
since it must be admitted, that the blood does not co-
agulate all at once and simultaneously with death, but
that it requires a certain time to go through the pro-
cess of coagulation, it is clear that the doctrine that the
blood, after death, can no longer coagulate, which is so
often repeated, and was quite recently defended by
Tardieu, is not correct, and the assertion that, because
f Gerichtl, Sectionen, 4 Aufl. Leipzig, 1852, 5, 19.
I Donné, Cours de Microscopie, p. 52.
+ Hoppe Seyler, Hdbch. d. Chem. Analyse, Berlin, 1865, p. 300.
t Tardieu, Etude medico-legale sur l'infanticide, Paris, 1868, p. 71.
114
[MAR. 9, 1872.
T THI EH C T , T N T C .
the blood at the base of a wound is found to be coagu-
lated, therefore, this wound must necessarily have been
inflicted before death, cannot be maintained.
Cadaveric rigidity.
10. The last sign of the earliest period of death, and
which always precedes the first stages of decomposition,
is cadaveric rigidity; the well known shortening and
thickening of certain muscles, especially of the flexors |
and adductors of the extremities, including the fingers
and the lower jaw, which causes them to feel hard and
firm. It begins in the neck and lower jaw, extends,
subsequently, to the muscles of the face, throat, breast
and upper extremities, and finally, the lower. This
rigidity disappears in general, in the same manner, and
after it has once disappeared, it does not occur again,
but the corpse becomes flexible as before. Cadaveric
rigidity commences, as a rule, in from 8 or 10 to 20
hours after death; in rare cases, sooner. Caspart
says that in one case he noticed cadaveric rigidity
of the lower jaw in 24 hours after death, and of the arms
in 63 hours. It is necessary, therefore, to be cautious in
determining the time of death. This rigidity may con-
tinue much longer than from one to nine days which is
the usual time. It seems to be certain, that in cases of
narcotic poisoning it is either feeble or only of short
duration. Tourdes” who examined two persons, killed
by lightening, speaks of rapid and general rigidity, in
both cases. In the immature foetus, mature neo-
nati and small children it is comparatively feeble and of
short duration. Caspar denies the statement of Som-
mer that this is also the case in the aged. He considers it
an error to maintain, as is often done, that in cases of
death from suffocation, this rigidity does not occur at
all, or at a later period or only for a short-time; they do
not differ from ordinary cases. That a low temperature
and alcohol favor a longer duration of rigidity, cannot
be doubted. Caspar noticed it in several cases of death
during intoxication as late as the fourth, seventh, eighth,
and even ninth day, -
Where the rigor-mortis is of longer duration, it is not
uncommon to notice, in connection with it, discoloration
caused by decomposition. An advanced state of decom-
position alone does not, therefore, put an end to it.
That it is in no case ever entirely absent, seems to be
well established. The rigor mortis cannot well be con-
founded with the rigidity caused by freezing. A frozen
corpse is as stiff as a board, from head to foot, whilst in
rigor mortis the extremities are, especially in the joints
of the elbow and knee, still susceptible of some degree of
flexion.
A corpse that presents only the signs before enumerated
(1 to 10) may be taken to be that of a person who has been
dead at most two or three days.f
f Caspar, Hdbch. d. gerichtl, med. Berlin, 1871, p. 27.
*Tourdes, relation médicale de l'accident occasionné par le foidre,
8trasbourg, 1869.
#Caspar p. 30.
In order to accurately determine the time of death, it
is of course, necessary, to have a correct knowledge of
the various stages of the process of decomposition, but,
the present article being already of sufficient length,
and having, moreover, given an accout of all the signs
necessary to determine death itself, we will defer the
rest of the subject to a future time.
Cincinnati, March, 1872.
Henry Haacke
—-º-e-º-
G O A L ID U S T IN T H E L J N G S.
Anthracosis Pulmonum (Stratton), The Coal or
the Miner’s Lung.
EY
DR. LUDWIG HIRT, (Breslau).
A Chapter selected from the Author's work on “The Diseases of Labor-
ers from the Inhalation of the Manufactory Dusts” (Die Staubinhala-
tions Krankheiten, Breslau, 1871.)
Continued from No. 9.
Concerning, then, first, the relative frequency of
phthisis, we discover that of the 39.879 patients of Upper
Silesia, 345, i.e., 0.3 per cent. only were affected. Of
the 11,499 of Hörde, 129, i.e., 1.1 per cent. were patients
with phthisis, while of the 49 miners, patients of our
hospitals, only one was a sufferer from this disease. Of
the 23 cases treated by Vernois, three are registered with
phthisis. These results, with perhaps the single excep-
tion of the last, are in gratifying accord with each other
and establish the fact that of 100 patients among workers
in coal, one, at most, 1.5, suffer with pulmonary consump-
tion, a percentage as low as could have been hoped for.
This conclusion gains in value and interest when it is
remembered that it is confirmed by the observations
and statements of different authors; all doubt is thus.
relieved. Lewin, in his highly rational investigations
—though mostly from small numbers it is true—arrives
at the same result. Seltmann in his work on anthracosis
expresses himself in the same sense and in Lombard's
table, representing the frequency of phthisis in some 60
different trades, this disease falls among charbonniers to
the 58th place This remarkable fact only meets its
full appreciation when this percentage just given is
compared with that derived from other “dusty” avoca-
tion and from avocations free from dust. The frequency
in which the disease under discussion occurs in other
“dusty” avocations, whether the dust be organic or in-
organic in nature we have already exhibited in a pre-
vious page. A single glance at the table referred to
suffices to demonstrate that no comparison at all is ad-
missible as the frequency of the disease in the other
MAR, 9, 1872.]
“dusty” avocations surpasses that of the coal worker
ten to twenty fold and more. Further comparison
teaches us also that, even among laborers exposed to no
dust inhalation in their pursuits, this disease is much
more frequent, and now follows the most remarkable
fact in these observations to the effect that the per-
centage of phthisis is greater in entire populations than
in laborers exposed to coal dust inhalations. The entire
population of the Upper Silesian Verein is 148.429; of
these 345, were consumptive, i.e., 2.3 in every 1000;
we have seen alreadyi that it is only in a few selected
places (St. Helena, Algeria,) that the percentage is but
2.5 while every where else the number of deaths in a
thousand is three to four, almost double, thus the per-
centage of our list.
These facts from the Verein almost confirm to a cer-
tainty the hypothesis that coal dust is far from ever being
causative of consumption; that it is in this respect not to be
compared with other dusts; that it in all probability pos-
sesses the property of preventing the development of this dis-
ease, of restraining it, more especially, in its further course.
To illustrate these facts more clearly the following tables
have been prepared in exhibition of the percentage of
consumption among laborers, patients with internal dis-
eases, embracing those who have inhaled inorganic and
organic dusts, those from pursuits free from dust and
those, finally, subjected to the inhalation of the dust
of coal.
Of 100 Patients Affected with Phthisis.
Laborers inhaling inorganic dust about 26 per cent.
& 4 & 4 organic & 4 § { 17 & 4
& & i. Ilo & 8 & & Il & 4
& 6 & 4 coal 4 & 4 4. 1.3 & 4
The statement of Guillot that he always found tubercle
in the lungs of consumptive patients calcified, chalky
—in process, thus, of cure—when much coal had been
deposited (which chiefly takes place in the apices) affords
an anatomical explanation to the peculiarity, already
mentioned as pertaining to coal dust. In what manner
the calcification of tubercle is brought about as the result
of coal dust inhalation, whether coal acts as an antiseptic
or whether it prevents the development of the vessels,
which, according to Schröder van der Kolk, are always
observed about tuberculous deposits, is a question that
may not yet be answered. The fact that it was formerly
believed (and even now this belief if often encountered):
that coal dust develops consumption depended on the
confounding of this disease with the above described
anthracosis which in its latter stages sometimes runs a
Course common to consumption; that these affections,
however, are quite different from each other needs no
further emphasis than a reference to the first section of
our subject.
As to the frequency of anthracosis among workers in
TIEHI E C T , T N T C .
115
coal it is difficult, unfortunately, to make any definite
Statements, because it remains often enough entirely or
almost entirely without symptoms during life, when it is
revealed only on section. In all probability all coal
Workers suffer with it in light grade; grave cases are
rare or at least are only rarely observed. Statistics are
wholly wanting.
The following table exhibits the relative frequency
of chest affections among workers in coal.
Of 100 Patients Affected with Chest Dis.
Coal work- | Phthisis. | Chronic ] Emphy- Pneumo- || Total.
erg. | Bronch. I sema. Inia.
Upper Silesia.f 0.8 16.4 0.9 4.7 22.8 pr. ct.
Hörde.t 1.1 18.3 ? 3.6 23 “
Parist º 69 17. 2 7 7
Breslau.” 2.0 22.4 8.1 14.4 46.9
F-
While as we have seen in this portrayal that a large
quantity of the coal dust which impregnates the labor-
ers atmosphere is inhaled and penetrates the organs of
respiration there is still another quantity which takes
another course in the economy, being swallowed by the
laborer into the Organs of digestion upon which it exer-
cises an influence. That this influence, too, has been
over-estimated hitherto is now without doubt. Rama-
zinni, for instance, was Sorely afflicted with the belief
that coal dust excites in the stomach an afflux of
fluids and a preternatural sensibility, that it disturbed (?)
the function of digestion and , thus laid the foundation
for occlusion of the intestines, for the cachexia carbonica.
Though it may not be maintained that the influence of
coal dust upon the organs of digestion is entirely null
yet we are certainly not justified in accepting the grave
fears of the above mentioned observers. Coal dust in-
duces, when accumulated, in mass, in the stomach of
laborers, not accustomed to it, loss of appetite, light
gastric catarrh, constipation and black discoloration of
the feces. Long consuetude diminishes or dissipates the
first mentioned inconvenience, leaving only a chronic
obstinate constipation. Graver diseases of the abdom-
inal organs in consequence of coal dust, more especially
a cachexia from this cause are cases in rarest exception
and even then may be predicated to a series of other
predisposing and concurrent circumstances. As to the
frequency of the diseases of the text we discover from
the observations referred to that they occur among coal
workers neither more frequently nor more rarely than
among other laborers, since of the 39,879 patients of
Upper Silesia, 5,531, i. e., 13.8 per cent., and of the
11,499 patients of Hörde about 14 per cent. suffered
from gastric and intestinal catarrh. Similar, at least
foesterlrn, Handbuch, etc., p. 375.
#Total number examined 148.429. Total number patients with in-
ternal diseases 39,879.
tTotal number sick 11,499.
fTotal number examined 255, patients 23.
*Total number patients 49.
116
[MAR. 9, 1872.
TiE E C T.I. NI c.
but very little different, results are gleaned from the
statistics of laborers in avocations free from dust.
Though we may not, then, in conclusion, claim that a
few inconveniences and light abnormities may not re-
sult from the ingestion of coal dust, yet it can no
longer be admitted that serious life or even health
threatening diseases of any duration ever ensue from
this cause.
The relative frequency of disease in general, the aver-
age duration of life and the mortality of coal workers
will engage us when we come to speak of the different
avocations which coal affords. For a general view of
the influence of coal dust upon laborers the statistics
just tabulated suffice; they embrace the diseases of most
importance and of most frequent occurrence. They
teach us, what is confirmed by a glance at the tables of
other dusty avocations, that coal dust is not only the
least injurious of all the various dusts, but also that
there are conditions connected with its inhalation which
exercise an unmistakeably beneficent influence upon
the laborers health.
After these general considerations there remains only
to be considered the different trades which are worked
in coal ; as already stated our lists afford us but few
numbers from which to draw conclusions, embracing
only 49 workers in coal and 76 chimney sweeps. Con-
cerning first, the general frequency of disease—and here
coal cart-men, coal shovellers and workers are included
—it is to be remarked that this is extraordinarily low
notwithstanding the fact that the labor of the first
mentioned class is often extremely severe. According
to Lewin, of 160 cartmen, 108, i. e., 67.5 per cent. were
perfectly sound at the time of the examination; of 58
whose service had extended from 5-10 years, 34, i. e.,
58.6 per cent. were perfectly healthy; of 45 whose ser
vice had extended longer than 10 years, 51.5 per cent
were sound. Shovellers and workers showed an even
better condition, the results of examinations being ex-
tremely favorable. In full accord with these results
are those derived from the examination of chimney
sweeps. Here too, the frequency of disease, as we dis-
cover from Lewin, is extremely low. Of 45 boys exam-
ined, 39, i. e., 84.6 per cent. were sound. After a ser-
vice of 5-10 years 50 per cent. were sound, but after a
service of over 10 years 92.3 per cent. were sound.
This last statement, viz., that after 10 years almost all
were healthy, would go to prove that coal dust is not
only not injurious but is absolutely conducive to health;
the numbers concerned, however, (only 36 sweeps)
restrain us from further deductions.
Of other pursuits which have much to do with coal
dust, but which unfortunately do not occur in our lists,
we may mention the moulder, the influence of whose
labors has already been subject to such wide discussion
and strife. The strewing of the ready ſorms with coal
dust, the blowing away of the superfluous dust, these
are the manipulations which have been considered as of
such extreme danger to health. Yet, according to
quency of individual diseases.
Lewin, the frequency of disease is very slight among
these laborers. Of the men examined 81.4 per cent.
were healthy; after 5–10 years service 72.7 per cent.;
after more than ten years 51.5 per cent. These numbers
must certainly be discouraging to those who have been
crying so long and loud for protective measures for
moulders against the injurious effects of coal dust.
Let us pass now to the investigation of the relative fre-
The list for the workers
in coal has already been exhibited; it has been shown
that of 100 patients, 46.9 per cent. suffered with some
form or other of pulmonary affection; of these 22.4 per
cent, almost half, was bronchial catarrh, while phthisis
claimed only two per cent. In chimney sweeps, now,
We find that 41.8 per cent. of all diseases are chest affec-
tions; of these bronchial catarrh takes 22.2 per cent,
phthisis 6.5 percent. That this last disease occurs here
three times as often as among other workers in coal is
explicable not only by the fact that the labor is ex-
tremely, even exhaustingly severe, but that the con-
stant, unavoidable change from the warm chimney to
the icy roof exposes them to frequent colds. These same
circumstances may be evoked also in explanation of the
relatively greater percentage of pneumonia (10.5) and
of acute diseases in general (39.4) among this class of
laborers. Among the firemen in manufactories, lung
inflammations also frequently occur, not from the inha.
lation of dust, but from the frequent change of tempera-
ture. As to emphysema it plays but an insignificant
role (2.6 percent, of all diseases) among chimney sweeps,
While we find it noted at 8.1 per cent. among other coal
Workers. This is a difference of difficult explanation.
The last percentage given, 8.1, can hardly be considered
reliable as we find that in the lists of Upper Silesia,
emphysema holds a quite low place in percentage (0.9).
This, as will be observed, is more in unison with that
just given for chimney sweeps.
The condition of health of colliers (charcoal burners.)
was studied by the author in the neighborhood of Wal-
denburg, in Austrian Silesia. A large number
of kilns are built there whose presence is recognised at
a great distance in consequence of the peculiar odor which
they generate and diffuse. The colliers who are exposed
continually to the influence of charcoal dust complain
in general, but little. The effect of the dust is, of course,
considerably relieved by the fact that they work in the
open air where the wind is the ventilator. Even if
charcoal dust possessed a decidedly injurious influence
these laborers are still in a relatively favorable condition.
Any injurious consequences from this dust inhalation
is scarcely or not at all d e monstrable. Consumption
belongs to the rarities i Pneumonias are observed no
oftener among the laborers than among the other inhab-
i"ance of the place. These statements, it is true, are
j Concerning the relative frequency of anthracosis, there is as yet, but
little to state. Black expectoration is not rare, but it is usually only
temporary. Autopsies are strongly forbidden in the region visited by
the author.
MAR. 9, 1872.]
not deduced from strict statistics. How may, indeed,
such facts be established among a people who are not in
the least interested themselves? The above statements,
however, as to the frequency of consumption and pneu-
monia rest upon perfectly reliable communications. As
to other diseases, like the average mortality rate, but
little reliable could be gleaned. The average duration
of life is from 58–60 years. Compare Ramazzini, Patis-
sier's revision, p. 10. n
T As to the mortality rate we gather sufficient informa-
tion from the annual report of 1851. Of 10,628 workers
in coal, 160, i. e., 1.505 per cent. died ; of 9,741 shovel-
ers [händlern], 140, i. e., 1.520 per cent. died; of 4,146
chimney sweeps, 95, i. e., 2.291 per cent. died. The
least percentage was that from the cartmen busied in
open air with constantly changing work; less favorable
was that from those engaged in magazines, and most
unfavorable was that from the hard working, often ex-
posed, chimney sweeps.
LITERATURE.
Beddèes, An Essay on the Causes, Early Signs and Pre-
vention of Pulmonary Consumption, London,
1801.
Ramazzini, Patissier's Revision, p. 9, Ilmenau, 1823.
Marshall, Lancet, Phthisis melanotica, 1834.
Fuchs, tiber das Kohlenbrennen in Meilern in med-
polizeilich. Hinsicht. Henker's Zeitschr. f.
Staatsarzneikunde 17 Jahrg., 1837, Ergänzungs-
heft, p. 12, et seq. -
Schönfeld M., de l’état hygiènique et moral des
ouvriers-enfants, employés aux mines de char-
bon dans le district de Charleroi, Charleroi,
1843.
Küpper, Krankheiten und Gefahren, welche den
Bergmann in den Steinkohlengraben bedrohen,
^. Rhein und Westphal. Correspond. Bl, No. 17–23
1845. -
Holland, Inhalation of gritty and metallic particles,
Monthly Journ., Nov., 1843.
Holland, Diseases of the Lungs from mechanical ||
causes, London, 1843. e
Makettor, An Investigation into the Nature of the
Black Phthisis, Edinburg, 1846.
Brockmann, die Metalburgischen Krankheiten des
Oberharzes. Osterode, 1851.
Bartheleness, Diagnosis der Lungen
Erlangen, 1855.
Tardieu, Étude hygiènique sur la profession de mou-
leur en cuivre, Paris, 1855.
Cox J. W., Diseases of Coal workers and their causes,
Journ. Pub. Health, Mar., 1857.
François, Ueber Immanität der Steinkohlenarbeiter
gegen Lungen Phthise, Presse méd. 43 und
Bull. de l'Acad. de Belge, 1857.
Maggiorani, Sull' ingresso dellasubstanze pulverulente
nella via della respirazione, 1858.
Vernois, Ann, d'hyg. 2 sér. ix. p. 844, Août 1858,
melanosis
TIH. H. cI.I.INTI c.
117
Fossion, Bericht tiber die Krankheiten der Arbeiter
in der Steinkohlengruben, Bull. de l'Acad. de
méd. de Belge, 8, 1859.
Heszay, Krankheiten der Bergleute zu Hodritsch,
Ungar, Zeitschr. II, 33, 1859.
Schönfeld M, Recherches sur l'état sanitaire des
houilliers, etc. Mém. pub. par l'Acad. royale
de med. de Belgique, Tom. II. Bruxelles et
Charleroi, 1859.
Marten, die Schädlichkeiten and Krankheiten, denen
die Kohlengrubenarbeiter unterworfen sind.
Vierteljahrschr, f. ger. Med. XVI, Oct., 1860.
“ zur med. statist. Geschichte der Hermanns-
hütte zu Hörde, Pappenheim's Beiträge zur
exacten Forschung, etc. Heft I, 1860.
Reimbault, Hygiene des ouvriers mineurs, etc. Paris,
1861. -
Böens Bosseau, Traité pratique des maladies, etc.,
des houilleurs, Brux, 1862.
Villaret, Cas rare d’Anthracosis, etc. Paris, 1862.
Perroud, de l’état charbonneux du poumon, a propos
de quelque fait graves d'anthracosis. St.
Etienne, 1862.
Robers, C, De la phthisie charbonneuse et suivi de
quelques considérations Sur la pénétration des
corps pulverulentes et sur l'absoption des
matières solides, Paris, 1862.
Kuborn, Etude, Sur les maladies particulières aux
ouvriers mineurs. Paris, 1863.
Wilson, Customs and Diseases of the Miners of Dur-
ham and Northumberland—Med. Times and
Gaz., Oct., 17, p. 384, 1864.
Friedriech, Virchow's Archiv. xxx, p. 394, 1864.
Beaugrand, Sur la Santé des mineurs, Canstatts
Jahresber, 1865.
Lewin, Die Inhalations therapie, Berlin, 1865, p.
24, et seq.
Seltmann, Die anthracosis der Lungen bei der
Rohlenbergarbeitern, Deutsch. Arch. f. Klin.
med. Vol. ii, p. 300, 1865.
Zenker, tiber Staubinhalations Krankheiten, Deutsch.
Arch. f. IClin. Med. vol. ii, p. I16, 1867.
Vleminckx, Bulletin, etc., 1869. Tom. III, 12, p.
1249. º
Schönfeld, M. Nouvelles recherches sur l'état sanitaire,
moral et social des houilliers, Charleroi, 1860.
Rindfleisch, Lehrbuch der patholog. Gewebelehre,
2nd Ed., p. 375, et seq., Leipzig, 1871.
Merkel G. Zur Casuistik der Staubinhalations Irank-
heiten, Deutsch. Arch f. Klin. Med. Vol. viii,
p. 206, et seq.
LAUGHING.-Rausius Texter, a French writer who
flourished in the beginning of the Sixteenth century,
gives a list of persons who died laughing, but he seems
to doubt whether laughter ever causes death. It is
stated that prolonged tickling of the soles of the feet
is employed as a torture by the Chinese, the victim at
length dying from exhaustion; and there was a vague
Statement some forty or fifty years ago, of a man being
tried for murder by tickling three wives to death.
118
[MAR. 9, 1872.
TIEEE TED CT, ITN T C.
Books and Pamphlets Received.
NEUMANN's HAND Book of SKIN DISEASEs. Trans-
lated by Lucius D. Bulkley, A. M. M. D. 60 wood
cuts. New York, D. Appleton & Co., 1872—Geo. E.
Stevens & Co.
A PRACTICAL TREATISE ON THE DISEASES OF
WomeN. By T. Gaillard Thomas, M. D. Third
Edition Revised and Enlarged. Philadelphia, Henry
C. Lea, 1872. Robt. Clarke & Co. Price $600.
SEVENTEENTH ANNUAL REPORT of the Board of
Trustees of the Southern Ohio Lunatic Asylum at Day-
ton, for the year 1871, Columbus, 1872.
PEPSIN–New Practical and Reliable Method to Pre-
pare it, by E. Scheffer, Phila., 1872.
—sº- e-º---
Journal Changes, etc.
§
Reuben A. Vance, M. D., whose name lately appeared
as editor, is no longer connected with The Medical
World. The publishers, Wm. Baldwin and Co. have
issued the February number and propose to continue it
themselves.
THE NATIONAL MEDICAL JOURNAL.—On account
of a determination on the part of the publishers of this
Journal to insert an article, which in the shape presented,
was not deemed suitable by the editors, Drs. Busey and
Lee, these gentlemen have retired from the charge of
the Journal and the February No. will be issued under
the entire control of the publishers.
VERMONT MEDICAL Journ AL.-J. M. Currier,
M. D., of McIndoes Falls, Vermont, will commence
early in the year the publication of a Medical Journal
under the above title.
—º-O-ºsm--
CILINICAL MEMORAN IDA.
Treatment of Sick-Headache
Dr. Clifford Allbutt, of Leeds General Infirmary, be-
lieves it to be of the highest importance that sick-head-
ache, properly so-called, should be recognized as a neu-
ralgia, but he also believes that among physicians there
is no longer much ignorance on this point. These head-
aches may, and often do, occur in persons who present
every other indication of good health and vigor; but in
them or their family there is generally found a history
of some other neurosis, such as asthma, neuralgia of the
stomach, trunk or limbs, insanity, bed-wetting, eczema,
psoriasis, and the like.i. If this be absent, there is gen-
#There is no doubt a curious connection between sick-headache and
gout; but Dr. Allbutt thinks that this is not due to any common ground
in abdominal congestion or diphtheria, but rather in the curious neu-
rotic element which enters into the true conception of gout itself.
erally some history of great mental strain during the
earlier life of the sufferer. The only well-marked excep-
tion to this rule which Dr. Allbut has noted is the
occurence of sick-headache in connection with uterine
or ovarian disease, and in these cases bromide of potas-
sium is especially valuable. Generally speaking, how-
ever, sick-headaches are not due to peripheral causes,
though these may intensify them, as epilepsy may thus
be intensified. A coated tongue and a bad taste in the
mouth are often complained of by the patients, and by
these symptoms both patient and physician are often
tempted to a purgative treatment and to a lowering of
diet, which is very injurious. In the intervals of the
attacks a very liberal diet is required, together with
mental rest and wholesome conditions of routine and of
variety; and the disordered tongue and taste are, no
doubt, to be regarded as of nervous origin. In hemi-
crania, for example, both the bad taste and the coat are
often confined to the side on which the pain occurs.
If the attack set in violently and without warning,
little can be done, even by the hypodermic use of mor-
phia, to cut it short. If a stimulant, such as black
coffee, be given, it must be at the very commencement;
afterwards it will do harm. The patient must be placed
in a darkened and absolutely quiet room, and must ab-
stain from all but the very lightest food till about 5 P.M.,
when the attack generally relaxes, and a mutton-chop
may be taken with advantage. Dr. Allbutt thinks that
sick-headache is substantially the same affection as hem-
icrania, for every transition may be traced between the
two, hemicrania in the majority of cases wandering be-
yond its proper limits. Hemicrania he believes, with
Anstie, to be a neuralgia of the fifth nerve; hence the
injunction to avoid food during an attack is borne out
by the well-known experience of asthmatics, who find
that food in the stomaclu, probably by setting up irrita-
tion in the vagus root, intensifies the paroxysm; in the
same way the presence of food in the stomach during a
paroxysm of sick-headache seems by the intermediation
of the vagus to disturb the morbidly irritable root of the
fifth nerve, which lies near its own. In the same way,
Dr. Allbutt regards the vascular changes as secondary,
and due to a propagation of the irritation in the medulla
to the vaso-motor centre contained in that part; he be-
lieves that the vasal paresis described by other writers
on the subject is but partially true, and that this paresis
is preceded by a period of irritation shown by pallor,
coldness, small temporal pulse, and dilated pupil.
This stage is seldom observed, as it usually occurs be-
tween 5 and 8 o’clock A. M., and is succeeded by the
paresis of exhaustion, with its evidences in the flushing,
full and soft temporal pulse, and contracted pupil. The
tight handkerchief and the cool applications comfort, he
thinks, by their sedative influence upon the terminal
expansion of the fifth nerve, and not by affecting the
vascularity of the head. Many persons have more or
less warning of an approaching attack, such as a feeling
of dulness in the head, odd tinglings in limited regions,
MAR. 9, 1872.]
TEL H. cI.I.INI c.
119
—;
and the like. Such persons may avert an attack by the
use of five to ten cells of a continuous galvanic battery,
or by means of twenty to sixty grains of nitrate of
ammonia. In the intervals he relies, in addition to the
measures already mentioned, upon tonics, of which ar-
senic is the first in value and strychnine the second, and
upon the daily or tri-weekly use of the continuous cur-
rent. In uterine cases, of course, attention will be
given to the peripheral disorder.—Brit. Med. Journ.,
Jan., 13.
THE RELATIVE VALUE OF THE QUININE SALTS.—
The following are the points in a note read by Mialhe,
at the meeting of Jan. 30, '72, of the Paris Academy,
upon the relative therapeutic value of quinine
salts: -
1. Sulphate of quinine ought not to be used as a
basic sulphate, but as an acid sulphate;
2. Sulphate of quinine is one of the most active and
efficacious of all the quinine salts;
3. The efficacy of the valerianate of quinine depends
more upon the valerianic acid than upon the quinine.
4. The tannate of quinine is one of the least active
and least efficacious of the quinine salts, though it is
not entirely devoid of effect.
M. Chauffard remarked that he did not regard the
tannate of quinine entirely inert, but that it was much
less powerful, much less active than the sulphate, and
that the latter must always be employed in paludal
intermittent fevers. M. Jules Guérin could not agree
with Mialhe that the efficacy of the valerianate of qui-
nine depended upon the valerianic acid. It is a salt of -
equal energy to the Sulphate in affections other than ||
paludal fevers. For the latter he prefers the sulphate.
M. Piorry regards the efficacy of the salts of quinine
as being proportionate to their solubility.
He thinks in this respect no preparation equals the
alcoholized quinine, which is competent in forty seconds
to bring about considerable reduction in the kidney.
The sulphate of quinine, even when acid, acts much
slower.—Gazette des Hopitaux, Feb. 1, ’72.
—-º-º-º-
| HIOM IE NEWS.
Medical College of Ohio
Fifty-First Annual Commencement.
The exercises as announced were held in College Hall
Friday evening March 1st, in presence of perhaps the
largest and most select assembly ever gathered upon
such an occasion in the history of Cincinnati. Within
fifteen minutes after the beginning of the exercises there
was not even standing room in the lower half of the hall
and numbers were turned away at the door.
The exercises opened with an appropriate Prayer by
the Rev. S. M. Merril, which was followed by Remarks
by Prof. Jas. Graham, Dean of the Faculty. The Dean
Congratulated the Hon. Board of Trustees, his colleagues,
the profession and the public on the continued prosper-
ity of the college, a prosperity this session so far as the
number and character of the students were concerned
unprecedent in the history of the institution. The ma-
triculating list registered 226 names; the graduating
class numbered ninety. A handsome tribute to the
energy and enterprise of the younger members of the
Faculty followed which was all the more gracious in
that it had been predicted by some of the feeble in cir-
culation, that the transfusion of so much youthful blood
would be attended with disastrous results. Nearly
2000 alumini had been sent out from the old walls of
the college in her more than half a century’s existence,
and the eminence to which many of them had attained
was best exemplified by the fact that in this city alone,
no less than fifteen professors in colleges and lecturers
in hospitals held the diploma of the Medical College of
Ohio.
The degrees were conferred by the Hon. Flamen Ball,
Pres’t. of the Board of Trustees, according to the time
honored custom of the institution.
GRADUATES.
Wm. A. Adair, Ohio; J. B. Anderson, Ind. ; J. S.
Baughman, Ohio; Thos. L. Brown, Ohio; Joseph A.
Brumleve, Ills; Samual P. Brundige, Ohio; John Wm.
Burnett, Ills.; John Campbell, Ohio; C. D. Carpenter,
Ohio; John M. Carr, Ohio; Robert F. Carpenter, Ohio;
Geo. F. Cook, Ohio; S. Crumbaugh, Ohio; J. J. Dailey,
Ind.; G. D. Darnall, Iowa; John T. Davis, Ohio; R.
T. Dean, Ohio; J. D. Dougherty, Ohio; J. T. Drake,
Ohio; J. W. Duncan, Ind. ; Wm. T. Elder, Ohio;
Ephraim M. Fine, Ind, ; Robt. L. Finnell, Ky. ; C.
H. Foertmeyer, Ohio; John A. Frame, Ohio; Orville
Gaddy, Ind.; W. M. Goodlove, Ohio; David G. Grier,
Ohio; Wesley B. Guthrie, W. Va.; Wm. A. Hall,
John W. Hays, Ohio; Andrew J. Hazelwood, Ohio;
E. E. Hughes, Ohio.; Allen Hussy, Ohio; Frank
Hutchings, Ind. ; Chas. B. Johnson, Ills. ; Jas. John-
son, Ills.; E. King, Ky., John A. Kroeger, Ills.; Fred-
erick Langenbeck, Ohio; D. M, Lewis, Ohio; Samuel
J. Lisman, Ind. ; J. M. Lockhart, Ohio; John M.
Lyle, Ohio; A. A. Mannon, Ills.; R. Y. Martin, Ind. ;
Abijah P. Mendenhall, Ind.; Leonidas Mason, Ind.;
E. B. Miller, Ind.; Wm. E. Moore, Ohio; Winfield S.
Marshall, Ills.; H. G. McAllister, Ohio; John S.
McBean, Ohio; Josiah McKechnie, Ohio; B. B. Morgan,
Ind., T. Goodloe Morrison, Ky. ; Noah D. Myers, Ind;
John H. Nichols, Ohio; G. G. Parker, Ind., E. W.
Parker, Ohio; John W. Piper, Ohio; I. Nutt Plummer,
120
[MAR. 9, 1872.
T IEEE IET: C T , T INT I C -
Ind. ; U. C. Prather, Ind. ; Robt. C. Prewett, Ills.;
R. E. Pryor, Ohio; James B. Ray, Ohio; L. M. Reamy,
Ohio; B. S. Rice, Ky., J. V. Bichardson, Ohio; A. W. |
Ringer, Ohio; J. Thornton Robinson, Ohio; James H.
Roll, Ohio; J. B. Rosson, Ills. ; Darious Rowe, Ohio;
E. D. Snyder, Ohio; Willis E. Sutton, Ind. ;
Amos Taylor, Ohio; James L. Taylor, Ohio; J.
Smith Thomas, Ills.; Peter Thornton, Ky., M. W. B.
Vickrey, Ind.; T. G. Vaughters, Ohio; H. C. Vincent,
Ind., C. C. Walton, Ind. ; Amos H. Warner, Wis.;
Albert A. Wells, Ky., W. T. Wells, Ind.
Ad Eundem.
DR. F. P. ANDERSON, (Miami Med. Coll. Cinti.)
Ohio; DR. W. O. SMITH, (Transylvania Univ. Ky.)
In Honoriam.
E. S. Wayne, (College of Pharmacy, Philadelphia),
Ohio.
Total 90.
Hon. Judge Whitman delivered the address on be-
half of the Board of Trustees. The address was a half
hour's sparkle on regular irregularities exhibiting in the
language of a critic an intimate knowledge of the springs
and actions of the so-called black arts in medicine with,
at the same time, a hearty sympathy with all that is
honest and true.
Prof. Thad. A. Reamy closed the exercices with a
valedictory address from the faculty. After the flow,
the feast, at Dr. Dawson's until a late hour in the night.
The music was fine, the speeches in good taste, the ban-
quet worthy its host. The whole affair was a grand
Sll CCeSS.
The following gentlemen were elected internes to the
Good Samaritan Hospital for the ensuing year as the
result of the competive examination held last week:
Drs. A. W. Ringer, John M. Carr, A. M. Lockhart.
Service commenced this week.
AT the recent election at the Academy of Medicine
the following gentlemen were chosen officers for the en-
suing year. Jas. Graham M. D. President, F. P. Ander-
son M. D. Recording Secretary. Other officers, Vice
Presidents, etc., were also elected but their names were
not ascertained.
DIED.—At his residence in Avondale, at five o’clock
Friday morning March 1, of apoplexy, Israel S. Dodge,
M. D., in the sixty-fifth year of his age.
Dr. Dodge was a graduate of the Medical College of
Ohio early in its history and has been for a long time an
active member of its Board of Trustees.
In his death Cincinnati loses one of her oldest and
most respected citizens, and the medical profession a
faithful and devoted servant.
Medical College of ohio.
S PR IN G C 0 U R S E,
The regular eight weeks course of practical instruc.
tion for the Spring of 1872 commences March 15. Un-
usual advantages are offered this year in the fact that
the course will be conducted by the entire Faculty of the
College. •
The course will embrace the following topics:
Clinical Medicine—Bartholow. *
“ Surgery—Dawson. -
Anatomy Brain and Nervous System—Gobrecht.
Operative Surgery—Conner.
“ Obstetrics—Reamy.
(£ Ophthalmology—Seely.
Female Pelvic Surgery—Palmer.
Urinalysis—Nickles.
Physical Diagnosis—Cleveland.
Fractures and Dislocations—Kearns.
Genito-Urin. Dis.—Anderson.
Microscropy—Whittaker.
Prof. Graham will deliver occasional lectures on Clin-
ical Medicine and Diseases of the Chest during the pro
gress of the Course.
The design of the Course is to present instruction in
a thoroughly practical manner. Physical Diagnosis is
to be demonstrated in the hospital wards; Operative
Surgery, Operative Obstetrics, Operative Ophthalmology,
and Operative Gynaecology on the cadaver. -
The Dissecting Room will be under the supervision of
Dr. Brown, where abundant material will be provided.
Special attention will be paid to the chemical and mi-
croscopical analysis of morbid urine.
In order to render this course the most practical pos-
sible, an opportunity will be. afforded each individual of
the class to make the various examinations and opera-
tions on the living and dead subjects. Regular daily
Medical and Surgical Clinics will be held at the
Good Samaritan Hospital: Two Daily Clinics will be
regularly held in the Cincinnati Hospital, throughout the
entire course; and a Daily Clinic will be held at the
Dispensary of the Medical College of Ohio.
One hour each evening will be devoted to Recitations
on Anatomy, Physiology, Practice, Surgery, Obstetrics,
and Materia Medica. -
The eminently practical nature of this course, and its
shortness of duration, together with the great clinical
advantages presented in Cincinnati, can but commend
themselves favorably to the practitioner as well as the
student. . . . .
FEES FOR THE ENTIRE Course, $10
As this Course does not count towards graduation,
being considered supplemental to the regular winter
course, graduates of the College are not required to
matriculate. The matriculation of non-graduates is
deducted from the fees of the ensuing winter session.
Carriage Manufacturer,
Nos. g and il East sixth Street, bet. Main & Sycamore.
I MAKE NOTHING BUT
- CºA, 2A S.S. W’62 ſº M'.
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of -
LIGHT FAMILY CAFFIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very € X-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
- PHYSECHANs'
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose. * , -
) 6.
The superiority of my light gentlemen's
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
| to Dr. W. W. Dawson and all the leading
Physicians in the city and neighborhood. S
-msm-mate







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167 EAST 34 TEI-ST., NE W YO RIC,
By Special Appointment Electrical Instrument Makers tº
the New York State Hospital for Nervous Diseases,
MANUF ACTURERS OF PORTABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwamic Batteries,
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1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
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PERMANIENT EATTERIEs,
For Hospitals and General Practitioners,
IET ITECTIE, OTDIES.
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trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
JEXTRA (!TS FROM THE O PINIONS OF THE MOST
JEMIN ENT MEMBERS OF THIS PROFESSION.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Nothing CAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. Hammond to announce en-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
roved and re-modified lnstruments made by our Company.
* MEREDITH CLYMER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider their
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:—“In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. GARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.: |
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WAN NIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALD WILL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
FOSTER’s
IE'_ALTTE NTT
i
Are furnished to Officers and Soldiers on Government
account.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTEFr.
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnmati, Ohio, or 172 Jef-
ferson Avenue, Detroit, Mich.
a ſº * * *
SAML. P. THOMAS
T.A.. I I, OR,
N
D E A LEF IN
English, French and Scotch -
GO. O. D's,
34 VVest Fourth Street,
("Z.W’("A.W.Wºź 7"/.




IIRT S
Made to order of N. Y. M. Muslin and 2300
HEAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.0)
First three qualities have ALL LIN EN Cuffs |
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less.
Perfect satisfaction given or money cheerfully
refunded. -
Also import and Manufacture Men’s Furnish-
ing Goods. t -
Pike's opera-House, Fourth Street, Cincinnati; 931
Wabash Avenue, and 88 West Washington
- Street, Chicago.
CAMARGO
MANUFACTURING COMPANY,
MANUFACTURERS AND IMPORTERs of
AND
Window Shades, .
67 Wasz. Zºolºziz Szºnºr,
CINCINNXT, 0.
H. H. BRENEMAN, Proprietor,
M. A. F. P. T. VVAIN'S
- NIEVV E O O. Ex
IS NOVV READY FOR CA NVASSERS.
It contains over 600 pages of read ng matter, with 250
engravings, designed expressly for this work, by the best
artists in the country. Agents now at work upon it. are
meeting with unparalleled success. Agents at CircleVille,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re.
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 Elm Street, Cincinnati, O.
BASCOM & CARPENTER,
Stationers, Printers
Blank Book Manufacturers,
136 VINE s'TEREET,
&\\\\\\\\\\\e
E. D. ALBRO & BRO.
IMPORTERS AND MANUFACTURERS OF
FCREIGN and DONESTICwOCDS
In Veneers, Boards and Plank,
fºil-Millſ, (al-Bullier'ani air-Buitri'Wii,
The only house in the Western country that saws Spanish and Mexi;
can Cedar for cigar-Box Makers. We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also º keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 West Second Street,
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNAT1.



-º-º-º-º-º-º-º-º-º-º--
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The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence
It is handsomely furnished throughout, and is provided with all the necessary ap".
Portičoes, with commanding views, surround the whole house, and wide
of Sixth and Lock streets.
pointments of a First-class Hospital.
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MARITAN HOSEITAL.
overlooking the city, at the corner
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
systERs of CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford. - *,
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department.
of the city any physician of their choice. -
The GOOD SAMARITAN HOSPITAL presents extra inducements to
quiet asylum in any case of protracted illness, or
some stay is necessary in after treatment.
Patients may, however, select from the regular profession
Invalids throughout the State as a safe and
in cases, more particularly, requiring Surgical Operation, where
Rooms vary in price, according to the character of appointments necessary and service required, ranging, iº
general terms,
gº" Address, :
SISTEER ANTHONY,
between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
EHospital of the Good Samaritan,
corner of sixth and Lock ste., cincinnati.onio.
















































































































McGrew,
wo. 27 west rowarm screer,
PIKE's OPERA HOUSE BUILDING,
importer and Dealer
—” I N → ~~
Diamond and Gold J ewelry,
Watches for Ladies and Gentlemen,
Sterling Silver T ableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
-- Marble Statuary,
G E N E R A L L Y.




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CINCINN ATI.
IET A C U L T Y.
J AM ES G R A H. A. M., M. D., D E AN,
IProfessor of the Theory and Practice Of Medicine and Clinical IMedicine.
ROBERTS BARTHOLOW, M.D.,
Professor of Materia Medica and Therapeutics.
W. H. GOBRECHT, M.D.,
Professor of Anatomy.
P. S. CONNER, M.D.,
Professor of Surgical Anatomy.
W. W. SEELY, M.D.,
Professor of Diseases of the Eye and Ear.
SAMUEL NICKLES, M.D.,
Professor of Physics and Medical Chemistry
J. A. VI. HX S TI. .
W. W. DAWSON, M.D.,
Professor of Principles and Practice of Surgery and Clinical Surgery
C. D. PALMER, M.D.,
Professor of Medical and Surgical Diseases of Women.
T. A. REAMY, M.D.,
Professor of Obstetrics and Diseases of Children.
JOHN L. CLEVELAND, M.D.,
Demonstrator of Anatomy.
CHARLES KEARNS, M. D.,
Assistant to the Chair of Surgery.
W H ITT A. Ex E F, , g
Professor of IPhysiology and Secretary of the Faculty.
,--~~
T. LOU19 BRow N, Prosector of , natomy.
Janitor, College Building, Sixth St., bet. Vine and Race.
Printed and Published by Nohais & MURRY, Medical College of Ohio Building, Cincinnati,
*


























wº- •. *** - 24
~ : . . ….s º'º'; '
, , , , , , ; *… ". . . .
- • A. ** - -3.3% s'. . . . -
:**":
***
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* “.
TERMs—$2.00
׺
PUBLISHED EveRY SATURDAY.
per year, invariably in advance. All Communications relating to Publication must be addressed to the Editor;
. . . . . all Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
3. Aºr ==
- - • - *
--~~~~ • X , L- - ~ r- - F ºr
T++E sºrtriotºrwºr's sur
CINCIN IN ATI, M.A. R. C.H., 1872.
IPI IETMLIEENT*r-
—-w-
_* * *-
MEDICAL COLLEGE OF OHIO,
sixTH & VINE stEEIs. . .
SPRING COURSE of 1872. . .
*- - -
• *-* ~ * --~~3. Sº
-, * → ~ * *
DIRECTORY... .
HOSPITALs.
CINCINNATI, . . .
Twelfth and Plum Sts.
GooD SAMARITAN, ... is . . .
Sixth and Lock Sts.
.* * ... •
+----.
* *
HoFELs. . . . .
BURNIT ſous E, . . . ...
N. E. Cor. Third and Vine. .
GIBSON Hous E, “ . .
Walnut, bet. Fourth and Fifth.
WALNUT STREET Hòusī, - ***. . . . .
Walnut, bet. Sixth and
SPENCER HOUSE, . . . . - ? .
- Broadway and Public Landing.
GALT House, . . . . . .
Cór. Main and Sixth.
CRAwford Hous;.
Cor. Sixth and
BEV is Hous E,
Court and
HEYL House,
- Cor. Sixth and Elm.
IIENRIE Hous E, * -
Third, bet. Main and Sycamore.
St. JAMES Hotel,
Fourth, bet. Main and Sycamore.
MERCHANTS' HOTEL, -
Fifth and Main Sts.
INDIANA House,
163 West Fifth St.
CENTRAI, Avenue Hotel, -
Seventh.
Walnut. --
Walnut Sts.
Cor. Central Ave, and Longworth.
º -- -
AMUSEMENTs.
PIKE's OPERA House, -
Fourth, bet. Vine and Walnut.
WooD's THEATER, - .
Cor. Sixth and Vine Sts.
NATIONAL THEATER, " *.
Sycamore, bet. Third and Fourth.
MozART HALL, . . . , -
Cor. Vine and Longworth.
Wisweil's ART GALLERY,
No. 70 West Fourth St.
*-4–
*-
BANKs.
LAFAYETTE, . .
Third, bet. Main and Walnut.
FIRST NATIONAL, ‘. . .
- Third and Walnut Sts. . . . .
GILMoRE & DUNLAP,
Fourth St., bét. Vine and Race. .
, - ...” & -- ~
..** * *
.*
RESTAURANTs.
-
—ºur-
l _**-*-
CHURCHES.
* * - -º-º-º-º-º:
{
$
*
f
BUCKEYE DINING SAïooN,
218 Vine, near Sixth St.
HARDING's DINING SALoon,
259 West Sixth St.
| HUNT's DINING SALgoN,
172 & 174 Viñe St.
MERCHANTs', $
168 Race St. :
ºf Bowmas's, ..
99 West Third St.
ST. NiCHolAs, a
Cor. Fourth and Race Sts.
FARMERS AND MECHANICs,
i . . . . 192 West Sixth St. *
, , §
- No. 49 Longworth St. $4.50
-- ... BoARDING HousEs.
Room AND BOARD.
138 (t ºf 5.00
# 160. “. . . 4.50 & $5
161 “ 5.00.
110 West Sixth St., 5.00
i. 216 * : 5.00.
: 145 Elm St., , ; 5.00
105 West Fifth St., 5.00
109 {{ 4.50 & $5
125 f : 5.00
127 “. 4.50 & $5
206 º 5.00
227 {{ 5.00
Cor. Sixth and Race, 5.00
No. 10 Perry St., , 6.00
397 West Sixth St.
- FURNISHED Rooms.
No. 67 Longworth St.
87 “
107 “.
134 { { -
109 West Fifth St.
200 {{
294 Sixth St. -
319 Vine St. ... • .
338 “
99 John St.
BOARDING.
. 70 Laurel St.
51
110
110
37
Longworth St.
Central Avenue Hotel.
George St. -
Sixth St.
Longworth St.
per week.
{{
& 4
{{
't &
PARKs.
EDEN, East End.
|LINcoLN; Freeman and Clark.
WASHINGTON, Twelfth and Race.
TYLER DAVIDSON FountAIN,
Fifth, between Vine and Walnut.
t.*i- - -
METHODIST,
i Sixth St., bet. Vine and Race.
Seventh and Smith Sts.
Fifth, bet. Sycamore & Broadway.
CHRISTIAN, e
º Eighth, bet. Central Ave. & Plum.
CONGREGATIONAL,
Vine St., bet. Eighth and Ninth.
PRESBYTERIAN,
Broadway, bet. Fourth and Fifth.
Fourth, bet. Walnut and Main.
Fourth, bet. Vine and Race.
EPISCOPAL,
Seventh and Plum Sts.
Fourth, bet. Walnut and Main.
. Fourth, bet. Sycamore & Broadw'y.
UNITARIAN, -
4 Mound and Sixth Sts.
BAPTIST,
Ninth, bet. Vine and Race.
LUTHERAN (German), -
- Elm, bet. Court and Ninth.
Fifteenth and Liberty.
UNIVERSALIST,
Plum, bet. Fourth and Fifth.
SWEDENBoRGIAN,
Fourth and Smith.
CATHOLIC,
Cathedral, Plum and Eighth.
SYNAGOGUES,
Plum and Eighth Sts.
Mound and Eighth Sts.
FRIENDS,
Eighth and Mound Sts.
ExPREss of FICEs.
ADAMS, *
* No. 67 West Fourth St.
AMERICAN,
No. 118 West Fourth St.
UNITED STATES, -
No. 122 West Fourth St.
HARNDEN,
No. 67 West Fourth St.
LIBRARIES.
MEDICAL,
Medical College of Ohio.
PUBLIC (including Medical),
Vine st bet. Sixth and Seventh.
MERCANTILE,
Walnut, bet. Fourth and Fifth.
CATHolig INSTITUTE,
Cor. Vine and Longworth Sts.
THEOLOGICAL, t
Cor. Vine and Sixth Sts.
YoUNG MEN's CHRISTIAN Association
READING ROOMs,
Nos. 200 & 201 Vine St.



THE STUDENT's suPPLEMENT.
The Medical College of Ohio.
When Cincinnati was a mere village and the
Great West a wilderness—so long ago as 1818
—the Medical College of Ohio was founded by
Dr. Daniel Drake. Even the present genera-
tion of medical students need hardly be told
that Dr. Drake was not only one of the most
eminent citizens ever resident in Cincinnati,
but also one of the most able and distinguished
This
ambitious and sagacious physician early dis-
medical men this country has produced.
covered the fortunate position of Cincinnati
as a seat of medical education, and by perse-
vering effort he secured the necessary legisla-
tion and organized the Medical College of
Ohio. The first Faculty meeting of the pro-
fessors of the new college was held January
14th, 1820. The members present were Dr.
Daniel Drake, President, and Dr. Elijah Slack,
Registrar. Dr.
named in the act of incorporation, Professor
of Anatomy, and Dr. Coleman Rogers, Pro-
Samuel Brown had been
fessor of Surgery, but neither of these gentle-
men were present. Great difficulty had been
experienced in organizing a faculty which
should not occasion disappointment; for Cincin-
nati, then a frontier village, had not within its
borders the profusion of medical talent which
now exists in the metropolitan city. Owing to
some differences which already had arisen in
the new organization, Dr. Brown did not ac-
cept his position of Professor of Anatomy and
Dr. Coleman Rogers was dismissed by the
President and Registrar at this first recorded
meeting.
The first commencement of the infant col-
lege was held on the 4th of April, 1821, and
seven candidates were admitted to the degree
At this time the fac-
ulty was constituted as follows:
Daniel Drake, M. D., Prof. of Theory and
Practice of Medicine. º
Jesse Smith, M. D., Prof. of Anatomy and
Physiology. *
Benjamin S. Bohrer, M.D., Prof. of Materia
Medica, Botany and Clinical Medicine.
Elijah Slack, A. M., Prof. of Chemistry and
Pharmacy.
John D. Godman, M. D., Prof. of Surgery
and Demonstrative Obstetrics.
Two of them, Drs. Drake and Godman, had
a national reputation which, indeed, has con-
of Doctor of Medicine.
tinued to our own time.
The Cincinnati Hospital was formed also,
by the personal efforts of Dr. Drake, and was,
from its origin, the clinical department of the
College. This was really the first combina-
tion of clinical and didactic teaching in the
United States, whatever claim may be set up
in other quarters for the honor of priority in
this important movement. In the minutes of
a Faculty meeting held November 1st, 1821,
we find the following rule:
§ 1x. Resolved, that the matriculated stu-
defits shall be privileged to visit the Hospital
with the Medical and Surgical attendants
throughout the present year, and that it shall
be the duty of said attendants to render the
practice in that institution as instructive as
possible. g
This was a clear recognition of the value of
true clinical, or bedside instruction.
The difficulties which occurred in the first
organization of the Faculty, continued during
the first years of the struggling institution.
The internal dissensions arose from the powers
given by law to the Faculty, who regulated all
the affails of the college, even filling the va-
cancies in their own numbers. At a meeting
held March 7th, 1822, Dr. Drake presiding,
the following business, as appears by the min-
utes, was transacted:
“On motion of Dr. Smith, which was second-
ed by Prof. Slack, it was voted memine contra
dicente that Daniel Drake, M. D., be dismissed
from the Medical College of Ohio.”
Four days afterward this vote was canceled,
and Dr. Drake restored, in orderit subsequent-
ly appeared, to offer his resignation, which was
accepted. Four times this able, ambitious and
restless man entered the Faculty and quitted
it, but at last he ended his eventful career in
the institution which he had formed thirty-four
years previously. Dr. Drake died on the 5th
of November, 1852, just at the opening of the
winter session.
The Medical College of Ohio has heretofore
been famous for the dissensions in its Faculty.
The occupants of the Professorships have been
men of positive qualities who had opinions of
their own and did not hesitate to express them.
Differences were common, and were expressed
with energy, and fought with obstinacy. Not-
withstanding these differences, lectures have
been delivered for fifty years, and at least
1,900 graduates have gone forth with the di-
ploma of the College. Eminent men have
been connected with its Faculty, and men have
risen to eminence who received their medical
training within its walls. Drake, Cobb, More-
head, Godman, Mussey, Gross, Lawson, Harri-
son, Blackman and other distinguished physi-
cians have been connected with the Faculty.
Profs. Byford and Rea, of Chicago; Prince,
of Jacksonville; Waterman, of Indianapolis;
Murphy, Stevens, Taylor, Bramble, Thacker
and others, of Cincinnati, are numbered a-
mong its alumni. In the selection of profess-
ors the College has not been unmindful of its
own graduates, and in the present Faculty
there are several who hold its diploma.
As the Medical College of Ohio was for
years the only Medical School in Cincinnati,
its management was a fruitful source of dis-
content in the profession of the city. The
professorial positions were, of course, few in
number, and the aspirants for professional
The Trustees and
Faculty, moved by a sense of what was most
honors were numerous.
necessary for the College, frequently selected
eminent men from abroad to fill posts in the
College. Thus, Godman, Gross, Mussey,
Bläckman and others were, as the phrase goes,
imported. It might have been presumed, in-
deed, that the addition of eminent men to the
professional ranks of our city would be highly
considered; but it was far otherwise. Those
who aspired to places received with open dis-
trust, and even hostility, men who have con-T
ferred honor on the profession of the city.
Another bone of contention was the con-
nection of the Commercial—now Cincinnati-
Hospital with the College. For forty years
the Faculty of the Ohio College were the ex-
This ar-
rangement—an arbitrary and exclusive, and,
clusive attendants of the hospital.
therefore, offensive one, it must be confessed—
gave to the Ohio School an almost entire mo-
nopoly of medical teaching in this city and
prevented any successful rivalry. Professors
in esse and posse, not connected with the of-
ficial School of Medicine, were, therefore,
bitterly opposed to this arrangement, and left
no means untried to dissolve it. For forty
years the contests over the hospital control
raged with more or less violence, and have
finally culminated in severing the connection
of all college professors with this charity.
Notwithstanding the frequent and bitter con-
troversies which raged on these questions, a
medical millenium has constantly been looked
for by the profession of this city. A young
medical college which was instituted to provide
for “home talent” was organized out of these
professional elements most hostile to the Ohio
College. After a few years of precarious ex-
istence, this institution, under arrangements
termed the “coalition,” was swallowed up in
the Ohio College. At the commencement held
March 1st, 1858, the ad eundem degree of the
Medical College of Ohio was conferred on all
the graduates of the Miami College. The era
of good feeling—the millenium—inaugurated
by the union of the two Faculties did not long
continue. We find that in 1860, these antago-
nistic elements had burst asunder; the Miami
professors were sent adrift and the old Ohio
College professors united in a new organiza-
tion.
The semi-centennial exercises of last year
closed fifty years of eventful history. The
Medical College of Ohio entered on her 51st
year stronger than ever, and with a brightened
prospect of continued usefulness and renown.
The results of the last session surpassed even
the most sanguine expectations of success, and
the SPRING Course of ’72 bids fair to excel to
the same extent, all previous sessions of its
kind. With a comparatively young, energetic
and united Faculty to continue her 3areer—
with a past renown to incite to higher aims,
what shall prevent the future from becoming
more glorious than the past has been eventful!
*
CLINIC,
PUBLISHED EvKRY SATURDAY.
T E R M S-$2.00
- *-
a. Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
—dº
M A R C H 16, 1872. No. 11.
or N C IN N ATI,
JAS. T. whitTAKER, M. D. Editor.
No. 101 West Ninth Street, Cincinnati.
-A-SSOCIALTE EIDICTORS.
W. W. D.Awson, M. D. THAD. A. REAMY, M. D.
P. S. ConneR, M. D. . C. D. PALMER, M. D.
W. W. SEELY, M. D. SAMUEL NICKLEs, M. D.
CHAs. KEARNs, M. D. JNo. L. CLEVELAND, M. D.
RoBERTs BARTHollow, M. D. -
coars are ce.
|Fashionable Hatters,
IMPORTERS AND MANUFACTUBERS OF
£ABEES' Rººs,
92 wrest FOURTH ST.
- . . - - Opposite Post Office,
CINCINNATI.
saw-special Inducements to Medical Men-
ºbesign:sº
ENGRAVERSºWooDºº
W. W. SEFLY, M. D., - - - - - - - TREASUREE.
No. 118 west Seventh Street, Cincinnati.
C LU B R AT ES.
4 Copies to one address. $ 7.00
6 “. . . “ 10,00
12 44 && 18,00
G O N T E W T S.
- -* Page.
oric INAL ARTICLES
- Experiments in Epilepsy by Brown-Séquard, M. D., F. R. S............121|.
Valedictory Address by Thad. A. Reamy, M. D 123
- TRANS LATION
Cancroid, Impetigo, etc. Their Diagnosis and Therapy, by M. A.
Duvergie, [From the Bulletin Therapeutique, Nov. 30, 1871]......126
scIENTIFIC NOTES
spontaneous Hydrophobia—The Lacto-Phosphate of Lime in Fever
..127-129
* * * *.
and Conval
- NIE DIGALL NEWS.
Lessons from Sandringham—Marriage and Crime--A Successor to
the Zouave—Dogberry-cal—Honors to Dr. Gull....................129-130
- correspond ENCE
Syphilis corpuscles (From Bost. Med. Journ., Mar. 7, '72.)—
Anonymous—Not a Case of Conscience ...130-182
cLINICAL MEMORANDA
‘Digitalis an Antaphrodisiac. - 839
HOME NEWS 132
The spring Course of 1872. 132
THIS week's Clinic is of unusual interest in its original
matter in the novel treatment of epilepsy suggested by
its distinguished author. ... • -
The translation on cancroid and allied diseases takes
up to-day the therapy of these affections.
will be concluded in the next number.
The note on the lacto-phosphates in fever, etc., is of
practical value. And then, we have a glance “at the other
side” of the new discovery in syphilis.
- The
This subject
ºsºl & 2 WEST FOURTH Sºº-ºº:
i. Bºzº
SºGINCINNATIOHIo:
*~ww-
J. TAFT, w. TAFT.
J. & W. TAFT,
TENTTIsTs
17 WEST FOURTH STREET,
CINCINNATI, O.
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,


















*.
- * * *
COID T.I.VIEER, OIT,
O I DO ER, IL, IE S S A. IN ID IPA. I. A. T.A.. I E I L I E •
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more-extensively its merits
are tested by the medical profession the more highly will they be appreciated.
*
g
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

*—
William Autenrieth,
No. 71 west sixth sºrrºr,
BETWEEN WAINUT Añº VINE,
cincinnati, ohio,
MANUFACTURER OF AND DEALER IN
III III IIHRIII III,
Abdominal Supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETC
Keeps constantly on hand a full variety of
Metalic and ERubber Syringes,
Stomach. Pumps, IEtc.,
stockings For vamloose veins.
Special attention given to the fitting of Apparatus for Deformities.
~gº Agent-for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
-ALSO–
DR. AHL'S POROUS FELT SPLINTS,
- - -AISO- -
T) A. Y. * S S E LIN TS
ROBERT CLARKE & Co's.
LIST OF NEW
MHL iBTH in MBIII; inſ;
|GREEN’s PATHOLOGY AND MORBID ANATOMY, 8vo.
Cloth. $2 5o
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN’S DIS-
EASES. 12mo. $1 75
BENNETT ON PULMONORY CONSUMPTION. 8vo. $1 5o
FIRST HELP IN ACCIDENTS. 12nºo. $1 50
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 50
ECHEVERRIA ON EPILEPSY. 8vo. Cloth. '$5 oc
HOWE ON EMERGENCIES. 8vo. $3 oo -
HAMMOND ON NERVOUS DISEASES. 8vo. $; oo
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 od Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth.
TANNER'S HANDBOOK OF OBSTETRICS. 12mo.
WAN BUREN ON DISEASES OF THE RECTUM.
Cloth. $1 5o *
FLINT’S EXAMINATION OF URINE. 12mo. Cloth. $ 1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 5o
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRICITY. 8vo. Cloth. $4 50
ATTFIELD'S MEDICAL CHEMISTRY. Izmo. Cloth. $2.75
Leather. $3 25 *.
BARTHOLOW’S HYPODERMIC MEDICATION.
Cloth. $1 5o --
TURNBULL’S DISEASES OF THE EAR. 8vo. Cloth. $5 od
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 od
NEUMANN'S HAND-BOOK OF SKIN DISEASES.
Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 oo.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $1 o oo gº -
HOOD ON BONE SETTING. 12mo. $1 5o
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo
$2 5o
$2 oo
I 2 II, O.
I 2, III C),
8vo.
hoºks PARTURITION WITHOUT PAIN. 16mo.
I OO
PROCTER'S LIGHT SCIENCE FOR LEISURE HOURS.
12mo. . $1 75
BERNARD’S PHYSIOLOGY OF THE HEART. 50 cts.
BARNES’ OBSTETRICAL OPERATIONS. 8vo. $4 5o
NICHOL’s FIRESIDE SCIENCE. 12mo. $1 50.
WOHLER'S MINERAL ANALYSIS. 12mo. Cloth. $3 oo
PLATTNER'S MANUAL OF ANALYSIS WITH THE
BLOWPIPE: 8vo. Cloth. $7 50
JEFFRIES ON THE EYE. 8vo. Cloth. $1 oo
MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
JEFFRIES ON THE SKIN. 8vo. Cloth. $1 oo
GARDENING FOR PROFIT. 12mo. Cloth. $1 50
PRACTICAL FLORICULTURE. 12mo. Cloth. $1 5o
FULLER'S SMALL FRUIT CULTURE. Izmo. Cloth. $1
WOODWARD'S COUNTRY HOMES. 12mo. Cloth. $1 5o
DARWIN'S ORIGIN OF SPECIES. 12 mo. Cloth. $2 oo
ARTHUR'S TREATMENT AND PREVENTION OF DE-
CAY OF THE TEETH. 12mo. $1 5o
TYND ALL ON LIGHT AND ELECTRICITY.
THE AMATEUR MICROSCOPIST. Small 4to.
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMEN.
ROBERTS ON RENAL DISEASES.
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN.
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by mail or express, free of charge
on receipt of price-
5o
I 2. In O. $1 25
$1 75
s: w. miliott's saddle-bass
65 West 4th Street, Cincinnati, Ohio.
List of Pharmaceutical Preparations,
MAN &JFACT iſ RED EY
JøA.W WºZAZ & ZººZººZºº,
PHºrrº.4 ºr F.H.I.A.
—º-
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR, WALERIANATE OF AMMONIA, -
(Goddard?’s Formula,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF. IRON,
Hron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
*
*
ELIXIR OF CALISAYA BARK, -
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Hron, and Pergaviaen Bark,
FERRATED CORDIAL ELIXIR, -
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK, º
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH, - *
TASTELESS COD LIVER 9ſº at
TASTELESS COD LIVER OIL. FERRATED, *ē,
BEEF, IRON AND WINE,
Extraet of Beef, Citrate of Iron and sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA, WINE OF PEPSIN. -
SYRUP SUPERPHOSPHATE OF IRON. 9
ELIXIR OF BISMUTH,
COMP. FLUIDEXT. BUCHU AND PAREIRA BRAVA.
st JIEPE*Os][TOR.I.Es.
Bectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application. . -
SPONGE TENTS.—For the Urethra, of every size and Btyle made of finest quality of sponge.
* * * * * * * * ,
sº EFFEºle= }
JAMES FOSTER, JR., & Co.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
same. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in-
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Lenses, Spectacles, and the best models procurable, with pains-
taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopic Objects
and Microscopic Apparatus, Magnifiers and Readers in
great variety. edical Batteries, Barometers, Thermo-
meters, Hygrometers, Urinometers and Rain Gauges,
of the most approved constraction always on hand. All orders promptly
and accurately filled. -
JAS. FOSTER, JR. e
F. S. SHACKLEFORD, } *ing * JAs. FosTER, JR. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TER. S.IN.INMA ER.S.H.’s
- º:3°SS
*
*E=
*. - - No. 758 BROADWAY, NEw Yob R
HAVE been in the habit of applying and recommending the Truss
I manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. WIS A. SAY RE, M. D.
- - Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital,
BEG leave to state for the benefit of all concerned, that I have known
Jº Dr. S. N. Marsh the last fifteen years. Mºr am in the constant.
fiabit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a JRadical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to , the patient
that exist in many of the plans suggested and attempted to be cºrried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
: - Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure, Truss, and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical deformities, made and accurately fitted at the Radical
Cure Truss offices of S. N. MARSH & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
oppositE THE HIGH STEEPLE.
F. E. SUIRz. E. S. WAYNE
TT. THX. Suire & Co.,
WHOLESALE DRUGGDSTS,
M. A.IN U FA CTU. R.I.N. G.
£Hemists AND PHARMAceutists,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
S)6),) EC4)(*)6]O pagos ANYo WXYeoxc)(N)es,
C}{}(XSYYX)(CAX, Aeeaaarus,
TESTS, MEDICAI, grass WARE, &c., &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
alºne in accordance with the U. S. P. and other recognized authori-
risk ANID R.A.ER. HX CHEMICALs.
Of the popular class of preparations known as
II, T, TIXIII-R, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c.
AGENTS FOR BULLOCK & CRENSHAW'S
sugar-coated Pills and Granules.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.







Divided MEDICINES,
*—
The Divided Medicine Com’y,
CINCINNATI, OHIO.
Լ
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExCEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general. . . . . .
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. - * 4.
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every Square will consequently contain accurately measured quantities.
But not only SoluBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. . . . . .
This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; : *, *, *, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. ', . . . . . . . . . . .
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste... . . . . . . . . . - -
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own preseriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days. - - -
For Samples, Price Lists, and Agencies, address º
- Box 2ese,
Or FRFDERICK KRAUS, Chemist and Druggist,
. Walnut Hills, Cincinnati, O.
MR. FREDERICK KRAUs: . . . - CINGINNAT1, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: * , * + ... - - . . .
SU LP II: MOſ. PPſ II....................... % grain in each square. ARSEN:AgID..........................I-20 grain in each square.
“ GH IN IN I.......................] & 4 § { $6. CALOMEL... - 34 “ * : ; ; * * *
4 6 COPPER, ...“...............}% -- - $ & * - - - - ~ * r
Respectfully You Bs, • J & • .
E. S. WAYNE, Analytic Chemist.
/*


T IEEE THE C T , T TNT I C -
121
Vol. 2.] S A T U R D A Y, M A R C H 16, 1872. [No. 11.
O R. I G IN A L A R T I C L E S.
—se-e-a-—
Ex P ER IM ENT's R N E PHL EP sy.
BY
PROF. C. E. BROWN SEQUARD, M.D., F. R. S.
Professor of Comparative and Experimental Pathology, (Paris).
A Lecture delivered before thé Cincinnati Academy of Medicine
March 9th, 1872.
Among the researches of the past twenty years no in
vestigations are of greater importance and significance
than those concerning the phenomena of arrest of ner.
vous activity, the suspension, in other words, of the
nerve force generated in the cells of gray matter in the
brain and spinal cord. This phenomenon of arrest I
may perhaps best illustrate by that sudden cessation of
the heart's action which ensues upon a blow upon the
epigastrium. The shock is thence conveyed to the
brain whence it is reflected by the par vagum to the
heart. This arrest or suspension of activity of nerve
force thus engendered by peripheric irritation is full of
promise in explanation of the action of remedial agents
in the cure of disease. As you are all aware I have
some time ago discovered the possibility of inducing
epileptic convulsions in animals by injuring certain parts
of the spinal cord. In animals thus rendered epileptic
the least irritation, as that of tickling, of certain parts
of the neck or face invariably brings on an epileptic
attack. This irritation is of course transmitted through
the sensitive nerves to the cells of gray matter whence
it is reflected to the muscles through the motor nerves.
Knowing, now, the effects of carbonic acid gas in in
ducing collapse when brought to bear upon the larynx,
I was led to believe that such an arrest of activity might
be brought about by this agent as would interrupt a
convulsive seizure. I found then by experiment upon
these animals (guinea pigs) that when carbonic acid
gas was directed into the larynx, in quantity just
sufficient to permit recovery, that the fit would be in-
Variably interrupted in form from one second to one
second and a half. This interruption of the fit, more-
over, was permanent, and was followed by that tickling
of the nostrils with the forepaws which is always indica-
tive of the permanent cessation of the convulsion. This
result was verified in a great number of recently per-
formed experiments during my last sojourn in Paris.
It is essential, however, to secure this result, that the
gas be somewhat forcibly injected, as it is necessary that
the mechanical effects of a jet as well as its direct influ-
ence upon the nerves be also secured. I found, more-
over, that this immediate, or nearly so, cessation of the
fit followed when the gas was made to traverse the
trachea from below upwards by means of an opening in
the tracheal tube.
I now directed my attention towards the relief of an
attack of epilepsy in man. For this purpose I visited
the hospital for epileptics and paralytics in Paris where
I soon had the opportunity of performing my experi-
ments. -
My first patient was a female in whom the epilepsy
was complicated by a marked hysterical element, con-
stituting what is known as the hystero-epileptic spasm.
She had both tonic and clonic convulsions, bit her
tongue, etc., yet it was plain to see that there was a
decided hysterical element, as I have remarked, compli-
cating the attack. In this case my remedy had no per-
ceptible influence.
I was more fortunate in my second case. In this
patient the attack lasted usually 15-20 minutes. The
convulsions were confined principally to one side.
There was marked spasm of the muscles of the neck and
chest. At first vomiting was produced which assumed
a threatening aspect as I feared that strangulation might
ensue as has indeed occurred in some cases reported.
This fear however proved groundless. Over this attack
my remedy had the happiest effect. The spasm of the
muscles of the chest and neck relaxed in two minutes,
becoming perfectly soft and flabby; a stiffness of the
extremities lasted some eight minutes. The difference
in the duration in this attack from previous ones, how-
ever, proved conclusively the value of carbonic acid in
abbreviating the duration and diminishing the violence
of the seizure. Unfortunately my short stay in
Paris after this experiment gave no other opportunity
of confirming this discovery in man. Again: you are
aware that one attack of epilepsy implies or begets such
a condition of the nerve centres as will be followed by
a series of attacks. This I have generally combatted
with chloroform. When chloroform is promptly admin-
istered upon the first attack before organic lesions are
engendered the sequence of attack is interrupted. I
have also met with the same results in the use of car-
bonic acid. In three of the seven animals in which I
provoked the epilepsy there has been a stoppage of the
series of attacks after one had been treated in the
method described.
Moreover, I have observed that a certain number of
the animals have been apparently cured by five or six
applications of this agent, that is, epilepsy could no
longer be induced artificially. To be sure we often
have spontaneous cures of this disease in the guinea
pig, but these never ensue in less than 6-8 weeks time
and I have observed in these cases the following singular
phenomena: when this animal is recovering from
epilepsy the hair on those parts of the face and neck,
122 T H. H.
[MAR. 16, 1872.
C T , ITN. T.C.
which when irritated excite an attack, gradually fall
off and the animal is only cured of the disease when
the spots referred to have become perfectly denuded of
hair.
The point that I desire to bring into prominent notice
is the fact that peripheral irritation lowers, or tempo-
rarily suspends the activity of the gray cells of the base
of the brain and the spinal cord, and it is in this way
that all such remedial agencies act.
There are some cases, for instance, induced by
laryngismus. Now in these cases it is well known that
cauterisation of the larynx has been resorted to with
the best effects. In a case of this kind under my care I
adopted this expedient, cauterising with nitrate of
silver just before the attack, with the effect of prevent-
ing the paroxysm. In this case the paroxysm had
recurred every 49 days. This periodicity of recurrence
would seem strange were we not at all So familiar with
the peculiar oddities of this strange disease as not to be
astonished at any of its freaks. He had one attack in-
duced by allowing himself to become exasperated with
a servant at table after a full meal but, with this excep-
tion, he was free from epilepsy for three years afterwards
when he died from a fall, it may have been in an attack,
but as he was of intemperate habits it is possible that it
was during intoxication.
In what I term, now, spinal epilepsy where there is
congestion in a limited portion of the dorsal division of
the cord, the phenomena of arrest may be induced by
the lightest peripheral irritation. This is exemplified
in a case I had under care by the discovery, not my
own, an accidental one of a negro Servant, that a vigor-
ous pull upon the big toe averted the threatened attack.
This was effected of course by the transmission of the
peripheral irritation to the cells of gray matter where
an arrest or suspension of activity was brought about.
You may perhaps have heard of the fact that in
Corsica and some other countries they are in the habit
of treating and curing sciatica by burning the ear; this
is only another application of the same principle. I had
in my hands once the case of a young girl, a clergyman's
daughter, a patient with very severe epilepsy in whom
the convulsions were more marked on the left side of
the body which is, indeed, the rule. Here there was
a distinct aura epileptica. I directed the nurse to try
the effect of pinching the body, first the arm of the left
side then the leg, afterwards both members of the
opposite side and then various parts of the body. These
manipulations were attended with good results; in some
cases the attack was undoubtedly prevented. And so
in compressing a limb or in binding it with a ligature
—proceedures Sanctioned by long practice—we only
irritate certain nerves and this irritation is transmitted
to the cells of gray matter at the base of the brain and
in the spinal cord. We used to think that in adopting
these means we prevented something from passiug from
the periphery to the brain; now we know that we act
from the other direction, we prevent something from
passing from the centre to the periphery.
I had the opportunity while last in Paris of trying the
effects of carbonic acid gas in the convulsions of strych-
nia poisoning. Having induced the toxic effects of the
drug in Some animals, I proceeded to inject the gas into
the trachea and bronchi. The experiment succeeded
in arresting the convulsions in a very short time. By
this means it is hoped that the fatal effects of the poison
may be held in check, in man, until evacuants and an-
tidotal remedies may be administered
So also in convulsions from loss of blood, the same
cessation was brought about by the intralaryngeal in-
sufflation of carbonic acid gas. I tried this experiment
in three instances, two pigeons and one duck.
It was a matter of regret to the speaker that he had
not brought his animals with him. He did not expect
to lecture on this occasion but upon some subsequent
opportunity, and such would perhaps repeatedly occur,
he would take pleasure in demonstrating these investi-
gations. While it was a matter of indifference as to
whom should be credited with these discoveries, it was
nevertheless a great pleasure to the speaker to be able
to present them first to an American audience and more
especially to one in Cincinnati.
[We recall for the benefit of our readers, a few of the
important contributions made to science, by the distin-
guished physiologist Prof. C. E. Brown-Sequard, now
honoring our city with a visit. Both the physiology
and pathology of the nervous system have been enriched
by his discoveries. He first demonstrated that the
sensory fibres of the spinal cord decussated at all points.
By section of the lateral half of the cord he showed that
anaesthesia followed in the parts below on the same side,
and hyperaesthesia on the opposite side. The writer of
this note was fortunate enough to have seen Dr. Brown-
Sequard perform these vivisections and can testify to
his marvellous dexterity.
He enlarged the field of vaSO-motor physiology after
Bernard's great discovery of the effects produced by
division of the cervical sympathetic, by demonstrating
that contraction of the vessels ensued on galvanisation
of the divided extremity of the nerve.
He is the author of the modern doctrine of reflex
paralysis. -- -, *
He has shown that irritation of the skin over the
kidneys causes contraction of the vessels of these organs,
and that immersion of one extremity in cold water will
cause a fall of temperature in the other.
He was the first to demonstrate the power of ergot
to diminish the blood supply to the spinal cord.
He has lately been engaged in Some very curious re-
searches on the pathology of epilepsy; and has shown on
guinea pigs that section of the Sciatic, and of certain
parts of the spinal cord will be followed by gonvulsions
when certain “zones” are irritated. *
The lecture above given is on some points developed
in his recent investigations].
MAR. 16, 1872.]
T H H C T, ITNT c.
123
A D HD R E S S
Waledictory to the CIass of the Fifty-First Annual
Session of the Medical College of Ghio.
BY
PROF. THAD. A. REAMY.
GENTLEMEN:
I address you by appointment of my colleagues.
At no period in the history of the Medical College of
Ohio could it have been other than an honor to receive
such an appointment. This conclusion is legitimate
whether we consider the distinguished men who have
composed its faculties or the alumni who, during its
fifty years of continued success, have gone forth bear-
ing its honors. -
One year ago, on an occasion like this, an able and
elaborate historical account of the rise and progress of
this institution was given by one of her former most
distinguished teachers—also a member of her Board of
Trustees.i.
One session more has been added to her fifty; one
year more to her growth and strength. One class more
has assembled within her time-honored precincts—and
from that class, having passed successfully a rigid writ-
ten examination, stands before me to-night one of the
largest and most intelligent graduating classes which
she has ever sent out honored with her parchments.
The latter statement, gentlemen, is due to your in-
dustry, to the distinguished competency of my col-
leagues, their faithful and indefatigable labors in your
behalf during the session just closed; and to the fine
advantages which Cincinnati offers for medical educa-
tion. Last, but not least, to the increased facilities
which this college posesses over other schools.
A few words as to the truth of this last remark. The
proposition needs only to be stated, not argued, to obtain
the assent of all well-informed minds that the school,
which, other things equal, can afford most clinical in-
struction of the most practical and varied character to
its pupils, has at once established its claim to superiority
of advantages.
How is this with the Medical College of Ohio gentle-
men 2 First, you have had access, on equal footing,
with the pupils of other schools to the wards and amphi-
theatre of that great charity, justly the pride of our city,
the Cincinnati Hospital: an institution which in
architectural grandeur and beauty, in all its appoint-
ments, and in its noble mission is at once an honor to
our people, and to Christian civilization. You have
heard the clinical lectures, and witnessed the operations
of the gentlemen composing the staff of that charity.
So far, you are but equal with others, but; Secondly.
you have had access to the wards and amphitheatre of
f Prof. M. B. Wright.
another, no less noble private charity—the Good Samar-
itan Hospital, under the management of Sister Anthony,
aided by her corps of untiring nurses—women who de-
vote their lives to the welfare of others. This institu-
tion in proportion to its capacity, is unsurpassed in its
good work, its mission of mercy to the afflicted. More-
over, as to facilities for clinical teaching, it is now en-
dowed with scientific apparatus, electrical, etc., unsur-
passed in completeness by any on this continent.
Further, its staff is composed largely of the faculty of
the Medical College of Ohio. To the benches of this
hospital you, gentlemen, as matriculants of this college,
have eacclusive access.
Again; during the past session clinical lectures have
been delivered daily in the Dispensary of the college,
where the material has been not only ample, but the
diseases discussed and treated, have covered the widest
range. The value of this course can scarcely be esti-
mated, for in it you were permitted to auscultate, percuss
and often prescribe for the patient yourselves—advan-
tages which are. enjoyed in no hospital in the land.
Your appreciation of this means of instruction, was rec-
ognised by your teachers, as they found it difficult
sometimes to induce you to leave the dispensary room
when the hour had arrived for the hospital lectures.
When our dispensary material was abundant, it was
often quite difficult to dispose of it before the hour.
And I may add here, by way of parenthesis, that it is
to be hoped in the future such mutual arrangements
can be made between our college and the hospital, as
not to have clinical lectures in each at the same time,
for while it has been and will continue to be our duty
and policy tosurge all our students to take the hospital
tickets and attend the lectures and operations; still,
our dispensary clinical advantages have grown to such
magnitude, and are on such firm footing that we cannot
for a moment think of surrendering them. Such a
course would be an abandonment of one of our most
distinctive claims of superiority. &
A spring course, suplemental to the winter session
has been already announced, and what has heretofore
been unusual East or West, will be conducted by the
regular members of the faculty. This course is to be
eminently practical and operative. Moreover import-
ant additions are to be made to our cabinet, chemical
apparatus and other means for Scientific instruction.
But I must desist from this line of remark as I have no
time to pursue it. So much was considered proper to
be said in justification of my claim as to our advantages
for teaching, and so much was due to you, gentlemen,
as now our alumni; and to you our honorable board of
trustees, as an assurance that this institution which,
under your fostering care has become historic, is still
pushing forward with renewed energy and vigor, deter-
mined from year to year, not only to elevate the standard
of medical education, but to bear it herself in the first
ranks of progress. But, gentlemen, why have you en-
tered upon the study of medicine? Why subjected
124
[MAR. 16, 1872.
TIE-L E C T.I. N. T. C.
yourselves to a rigid course of mental discipline in pur-
suit of this special branch of human knowledge? True,
medicine has been acknowledged one of the learned pro-
fessions, but have you therefore been lured to seek it 2
can you endure the Herculean labor demanded of those
who win access to her inner courts and higher walks?
It is true, if you succeed in obtaining practice it will
yield you a competent support; but is not almost any
other field more promising in this regard? To-night
you go forth from us; our relations as teachers and pu-
pils close. You have been trained in the science of
medicine and just now commissioned to enter upon its
practice. Ere you go I would have you remember this
profession is not, mnst not, be mercenary. The precious
stones to be wrought into its temple must not be handled
by unskilled or defiled hands. Have you realized that
the mission of the physician is to relieve human pain?
A boon inestimable; to preserve that gift of the creator
which includes all other gifts—life? “All that a man
hath will he give for his life” is a wonderful truth,
though first formally announced by a character
not above suspicion. God has implanted a love of life
in the human breast commensurate with its far reach-
ing consequences. So far as we know either from rea-
son or revelation in it is man's only opportunity of
working out the objects of his creation, of preparing for
eternity.
Again, what are the ties of kindred ? Deeply as they
are implanted in the soul, life severed, and they are de-
stroyed. That committed to your keeping therefore, is
a sacred trust. Are you qualified in heart and head to
take it? If so, go forward to your posts of duty. If not,
I beg you abandon this and seek other avocations.
But, can human life be preserved ? Can disease be neu-,
tralized 2 Pain subdued 7 These questions press them-
selves upon you as you stand at the threshold of a pro-
fessSon of whose votaries so much is required—and the
voice of inquiry becomes louder and more imperative in
view of the skepticism which so much obtains in the
public mind on the subject, a skepticism, I grant, largely
due to ignorance, nevertheless to be met and all the
harder to meet because of the ignorance. Gentlemen, I
would have you enter the profession at whose door you
stand to-night with confidence in its resources and pow-
ers. The sickly cry of those who are in it against the
power of therapeutic agents over discase; a cry whose
language is “I have lost confidence in medicines” is gen-
erally irrefragable evidence of ignorance, and therefore
those who utter it should go out.
I can in the brief time alloted but name a few of the
answers which should give assurance. Most of them
modern in discovery and application. But first note
the absolute power of sulphate of quinia not only to
neutralize the force of malarial poison in the system
generally, but to wrest the victim of pernicious inter-
mittent from the very grasp of death and hand him
over to health.
The power of iron and bitter tonics to transform the
pale, nervous, anaemic girl, who is about to become the
victim of some inhaling quack because she has cough,
to all the health, vigor and beauty of young womanhood.
The power of iodide of potassium to disperse gummat-
ous tumors of the brain, heretofore in all cases incurable.
The power of bromide of potassium in the acute stages
of cerebral congestion to lessen the diameter of the ves-
sels, to remove pressure and thereby not only allay
pain, but in many instances, avert effusion and its
serious consequences, procuring tranquil and refreshing
sléep in cases where delirium and convulsions were im-
pending. In this connection I may say, that through
the door which recent histological research has opened
showing the influence of the vaso-motor nerves over
cerebral congestion and anaemia, a light is pouring which
is destined to illumine that mysterious disease epilepsy,
and others of kindred character, less formidable, but
heretofore equally inexplicable; moreover, there is to be
richer fruit than simply this knowledge affords; experi-
mental demonstration that there are certain drugs which
will so act upon these nerves as to dilate or constringe
the blood vessels to which they are supplied constitutes
at once an achievement in scientific therapeutics which
must mark the age in which it was made. * * *
Again, here is a patient suffering from paralysis, from
progressive muscular atrophy caused by disease at the
nerve roots. The intelligent practitioner employs elec-
tricity, the nerves are restored, and the muscles again
are creatures of life. That which in another age was
the subject of a miracle has become the legitimate work
of the physician. In the same community is another
paralytic, same members involved. The modern im-
proved tests of diagnosis are applied—the cause is dis-
covered to be hemorrhagic effusion within the cranium.
Will you apply electricity here, as in the former case?
No, that which cured the former will certainly make
this case worse by increasing the cerebral congestion.
But administer bromide and further along iodide of
potassium, gradually the cause is removed and the pa-
tient recovers. These cases are typical and prove the
power of our art over disease. But the sword is two-
edged. Here is proof–on the one hand that the bat-
tery so potent for good in the hands of the educated
medical man, may, nay often does become an engine of
death in the hands of the ignorant. Again, these two
cases which are not hypothetical, but real, at once burst
that dogmatic bubble, similia similibus curantur, which
treats symptoms alone. * + k 3&
Fibroid tumors, heretofore irremediable in regions
inaccessible with safety to the surgeons knife, are now
resolved by electrolysis. Hydatids of the liver often
disappear under similar treatment. Aneurismal tumors
are dissipated under the power of the same agent which
Franklin coyed from the clouds with his kite. * * *
Here is a man with an old and indolent ulcer which
has resisted treatment for twenty years. The surgeon.
snips a piece of healthy skin from a neighboring part
and plants it in the midst of the diseased mass, with
MAR. 16, 1872.]
TIH. H. cI, IISTI c.
125
what result? A perfect cure. The same process will
prevent those frightful cicatrices which so often deform
the features after severe burns. Ovarian tumors were
in former times a great source of mortality, and such
was the fearful mortality attendant upon their surgical
interference less than thirty years ago, that a most dis-
tinguished physician pronounced any man who would
attempt such interference a murderer. Now, however,
under improved surgical management the recoveries are
70 per cent. It is but little more than fifty years since
Laennec announced to the profession his discoveries in
physical diagnosis. Now the experienced auscultator
distinguishes the different forms of pulmonary consump-
tion, and separates the curable from the incurable. He
detects also incipient heart lesions, defines their ex-
act character, and gives such treatment as will ward off
fatal results. Precision in these cases is the diagnostic
law. * # * -
Liebreich’s discovery of crotonchloral, an agent which
produces anaesthesea of the entire body without sus-
pending consciousness, promises magnificent results.
The few therapeutic facts, gentlemen, to which your at-
tention has been called may suffice for my purpose.
The entire evening could be occupied in the citation of
others equally positive. But these answer the inquiries
with which we started out. I cannot close without call-
ing your attention to the crowning scientific triumph of
the age which comes to us from Vienna, authenticated
by such names as Skoda, Hebra and Stricker. I refer to
the discovery of Dr. Lostorfer of the characteristic cor-
puscle of that specific malady which has been the curse
of civilization, and which we suspect as tainting and
underlying many intractable forms of disease whose
origin could not heretofore be clearly made out. For
more than half a century trained eyes have in all parts
of the world been peering down into minute structures
for these corpuscles. It remained for Dr. Lostofer with a
Hartnack microscope, No. 3 eye piece and a No. 10
immersion lens to see them. This discovery will exert
an influence upon positive diagnosis, and thereby direct
therapeutics to results which cannot now be even esti
mated. Already it in part verifies and at once simpli-
fies the germ theory of disease. As already intimated’
most of the facts cited are of recent demonstration.
Think not therefore that they are the fruits of this gen-
eration. No ; they are the discoveries of the aggregate
experience and wisdom and work of medical men in all
countries for forty centuries. * * * Under the in-
fluence of this science human life is annually lengthen-
ing. It has been my purpose to-night to speak only of
things which should encourage—give you faith, hope
and zeal. There are many uncertainties and imperfec-
tions in our science and our art, of these you have been
well apprised during the course of instruction just
closed. - I speak now of triumphs not failures. We
hear occasionally from our legal brethren, politicians
and statesmen, and also from our theological teachers,
that medical men disagree, teach different systems, and
therefore the science must be unreliable. Let us take
no time to argue with these gentlemen, for who does
not know that the laws of every country differ, accord-
ing to the educated conscience of their makers. And
that lawyers seldom agree as to the construction of the
same law. Do statesmen even of the same political
party agree as to high-tariff and free trade? Even now is
not the parliament and cabinet of the two greatest nations
on the earth, disputing as to the gramatical construction
of a treaty ? And, of our theological brethren we would
inquire, have there not been 180 creeds since Constan-
tine 7 No truth is invalidated because men differ as to
its construction. Christ the saviour of sinners, and
faith in Him is the grand truth of Christianity—creeds
do not invalidate it. Neither can differences of opinion
among medical men destroy the truth of medical
science. The profession upon which you have entered
challenges your best powers, your loftiest ambition for
usefulness, for greatness. And now let me say the
difference in men as to what they accomplish, is not a
difference in genius—success is not due to friends or
fortuitous circumstances. Shall I give you the formula
for success. The foundation is faith, the superstructure
is work. I knew of a man who concluded to plant an
orchard—he transplanted from a native thicket, young
crab Scions. The soil was good—the trees grew. He
was a devout man and I imagine as he stood under his
trees, as he was wont, and looked up through their
branches he prayed, “O Lord give us this year nice
pippins, but his teeth were edged with sour crabapples;
notwithstanding his devotion—to get the pippins he must
graft and bud. Gentlemen, if you wish the richest fruits
of professionel success, you must graft and bud. What
more shall I say? In all your professional relations
with your patients, to those who place their own lives
or the lives and health of their friends in your hands
under God, indeed in your relations to all mankind, be
itrue to truth and honor, in heart and Soul, be pure.
Finally as a faculty we bid you God speed and an
affectionate farewell. -
— —s-e-a---— —
THE ANIMAL HospitaL.—We learn from the British
Medical Journal that the Brown institution for Sick
Animals is likely to commence at once a work of great
public utility. Aided by a handsome grant from the
Chambers of Agriculture, Profs. Sanderson and Klein,
and Mr. Duguid, will undertake an extended series of
observations on the treatment and comparitive pathology
of pleuro-pneumonia, an epizootic which commits the
most costly ravages among our herds.
PAYING A FINE.-A student in the University, says
the Edinburgh Courant, who was fined a guinea for dis-
turbing his class last week, paid the greater part of it
in halfpence, abóut a quarter of an hour being occupied
by him in counting over the amount. This singular
mode of “serving out” the Professor who inflicted the
fine was carried out amid the laughter of the class, by
whom the amount had been subscribed.
126
[MAR. 16, 1872.
TEEE CI ITTI c.
caneroid, Non-re-rangere, Ulcerous Impetigo
Rodens, and Non-Ulcerous Impetigo Rodems.
Their Differential Diagraosis and Therapy.
BY - -
M. A. DEVERGIE.
Member of the Academy of Medicine, Honorary Physician to the
St. Louis (Paris) Hospital,
-ſº
From the Bull. Therap., Ncy. 30, 1871.
Continued from No. 8.
This assemblage of facts seems to us to be sufficient
to enable the practitioner to make a differential diag-
nosis of these diverse affections, and to permit us to turn
our attention to the practical side of the question, that
is to say, its therapy. But as the disease is very obstin-
ate I must, in order to justify the employment of the
means that I shall suggest, declare what experience has
taught me as to the different causes of its forms.
I have never found any connection of effect and cause
between the two forms of non-ulcerous impetigo rodens
and syphilis, or scrofula, while to these two causes is
most often to be attributed ulcerous impetigo rodens; not
only syphilis acquired long before by the patient, but also
hereditary syphilis. Just as it happens that by hereditary
influence syphilis is changed into scrofula, or scrofulous
syphilitic diathesis, so ulcerous impetigo rodens may be a
consequence of hereditary syphilis. Not only is this
disease directly related to scrofula evidences of the ex-
istence of which have been manifested in early life, but
also to the lymphatic disposition which has not shown
itself by any morbid phenomena during youth. It has
often been impôssible for usin any given case to determ-
ine a priori which of these two causes existed. So
before proceeding to any local treatment I do not hesitate
to give patients a mixed medication, as I have called it,
which comprises medicinal agents proper to combat the
one and the other cause. This medication is composed
of the “tisane de noyer”f iodide of potassium, bichloride of
mercury, arsenic and cod-liver oil. In the way in which
these agents are prescribed they do not destroy or neutral-
ize each other, and they are given in small doses, incapable
of injuring the health yet capable of affecting a cure.
It is not in fact large powerful doses that produce the
best effect upon chronic diseases, but prolonged treat-
ment with small doses. It was this that Chomel
brought out so strongly and with so much reason. In
anti-syphilitic treatment, for example, large doses become
hurtful before complete cure is effected, so that patients
cannot continue the treatment more than a month or
fThis tisane de noyer is a preparation of the juglans regia; which lat-
ter is by the French highly esteemed in the treatment of scrofulous af.
fections. The tisane is probably the infusion of the leaves (2 parts to 100),
though I have not been able to ascertain the precise formula. [Trans.]
a cure and destroying the syphilitic poison.
opinion, held for a long time, is a cause of want of suc-
six weeks; a time sufficient for the dissipation of the ex-
ternal manifestations, but not sufficient for the destruc-
tion of the cause giving rise to them. In syphilitic
affections two agents seem to be able to destroy the
morbid cause; these are the preparations of mercury
and the iodide of potassium, the first employed for the
the relief of the earlier, and the second of the later
manifestations. It would however be an error to believe
that the two have indifferently the power of effecting
This
cess. It is sufficient to have treated, as has been done
for example at the St. Louis Hospital, a large number
of cases of secondary and tertiary syphilis, to prove the
incorrectness of this opinion, which has however
been accepted by all practitioners who have
paid but little attention to syphilis in its
various forms and on a large scale. Let us see to what
practitioners imbued with this false idea have been led.
Ricord brought in vogue the protiodide of mercury, in
the belief, probably, that it had a double action, that of
mercury and that of iodine, which enters into
the composition of the iodide of potassium. Gibert has
recommended a syrup of iodide of mercury and of potas-
sium, the composition of which is a little better, in that
it contains a proportion of iodide of potassium capable
of dissolving the iodide of mercury, and that is even in
excess. But it is sufficient to consider the chemical
constitution of these bodies to see that the physicians
were completely deluded as to the efficacy of the reme-
dies they proposed. In the first place, in the protiodide
of mercury the iodine is in a state of insoluble combina-
tion. The salt contains only so much iodine as is nec-
essary to combine with the mercury, an insignificant
quantity so far as any therapeutical effect is concerned;
on the other hand, when the iodide of potassium alone
is given as an anti-syphilitic there is prescribed for the
patient a dose of at least 15 grs. a day which is some-
times increased to 2, 3, or 4 times as much. With 3.j of
the iodide of potassium there may be made 105.6 grs. of
the protiodide of mercury. In the #, 3 or 1 gr. of the
protiodide of mercury given to patients there is taken
but 1–5th, 2–5ths or 3–5ths gr. of iodine in combination,
while in 30 grs. of the iodide of potassium there is given
about 23 grs. of iodine. The delusion is altogether in
the name, and if the protiodide of mercury bas been
adopted by the great majority of practitioners it is be-
cause it was brought into use by syphilographers who
have founded a school. For myself I do not hesitate to
say that the protiodide of mercury is a poor remedial
agent, and I have thus expressed myself for a long time,
however much I have esteemed M. Ricord and the
advances in the science that he has made. This agent
is a bad one because it is insoluble, and to combat
syphilis there must be daily given twenty or thirty
times as much of this mercurial as it is necessary to give
of the soluble bichloride of mercury; because again it
is not known how much of it is absorbed; because it
wº
MAR. 16, 1872.]
T EHI E3 CT, ITNTI C.
127
often salivates; and because its mode of administration
is in opposition to an established precept of the time;
to wit: that medicinal agents intended to be absorbed
act better the more soluble they are. The syrup of
Gibert is preferable because it contains a soluble salt
of mercury; its action does not correspond, however, to
that of the ordinary doses of the iodide of potassium
and bichloride of mercury given separately.
These various observations tend to justify the mixed or
compound treatment, the constituents of which I have
already stated, and which from the mode of its prepara-
tion will be seen to fulfill the requirements of a mixed
treatment while there is secured for each of its constitu-
ents its own mode of action and doses. I have the
patient take in the morning an hour and a half before
eating, and in the evening three hours after the last
meal, a tablespoonful of cod liver oil and follow it with
a tablespoonful of the following syrup. -
R.
Ferri Jodid; 38s.
Potassii Iodidi 3üss.
Pſydrarg. Chlor. Cor. gr. iss.
Syr. Simpl. 3aij.
M.
There is added to this, Fowler's solution, commencing
with one drop morning and evening and increasing by
a single drop daily, either in the morning or evening,
until the amount reaches ten or twelve drops, six in the
morning and six in the evening, continuing this dose
without increasing it further. In this syrup the
bichloride passes into the state of double iodide of potas-
sium and mercury. To effect this change an insignifi-
cant quantity only of the iodide of potassium is required,
so that the directed 3iiss of the iodide of potassium is
not found to be diminished to any appreciable amount.
The iodide of iron remains unchanged, and the arsenic
passes into the state of soluble iodide of arsenic. To
resume; the patient takes then (1;) to combat the scrofu-
lous element, the “tisane de noyer” cod liver oil and the
iodide of iron in about 3 gr. doses daily, the entire
amount of the syrup being taken up in about twelve
days. (2;) to combat the syphilitic element, about
14 grs. of the iodide of potassium daily, about 1–16th gr.
of the soluble mercurial salt and 10 drops of Fowler's
solution. It is well known that arsenic is rightly con-
sidered an anti-syphilitic agent in the treatment of the
tertiary manifestations. In using these different reme-
dies, the patient takes morning and evening a tablespoon-
ful of cod liver oil and a cup of “tisane de noyer” with
the addition of a tablespoonful of syrup and 10 drops
of Fowler'ssolution. The employment of these remedies
So varied in their nature and yet preserving in the mix-
ture all-the conditions for their mode of action just as
When taken separately, does not then present any diffi-
culty. I have called this medication mixed or compound
because it contains all the elements necessary for meet-
ing the two causes which give rise to ulcerous impetigo
rodens. It is in this form of the disease that a scrofulous
or syphilitic origin may be suspected. When after two
months trial of the treatment mentioned no improve-
ment in the condition of the diseased parts can be seen,
the treatment should be abandoned. Three, four or five
months will be required for the producing of a cure in
the successful cases. The improvement that takes place
or the absence of improvement must indicate the con-
tinuance or suspension of the treatment. When the
treatment is continued, after two or three months the
dose of the bichloride of mercury should be diminished
one-fourth and the Fowler's solution may be omitted.
It is very rarely that a complete cure of ulcerous impetigo
Todens can be secured by this mixed internal treatment.
Almost always recourse must be had to cauterization of
the indolent portions of tissue that remain, in order to
bring about perfect cicatrization. The disease having
always existed for many years before it comes under the
notice of a physician who knows how to cure it, the tis-
sues have become modified in their organization, having
been long nourished in a particular way. It is because
of this condition, common to all chronic ulcerations, that
they can never be cured without the employment of some
modifying agent more or less energetic.
[To be Concluded.]
–mº-º-º-
SČHENTIFIC NOTES.
Spontaneous Hydrophobia.
...From the London Medical Times and Gazette.
In the autumn of last year M. Guillery related an
interesting instance of “spontaneous hydrophobia” to
the Belgian Academy of Medicine, which is reported in
the eighth number of its Bulletin for that year.
A vigorous old man, 71 years of age, a tailor by trade,
who had always had the best of health, was attacked on
February 5, 1871, with pain in the head, neck and tem-
poral region, which he attributed to cold. He thought
little of it until he found, in the evening, on placing
his hands in water for the purpose of washing them,
that he was seized with a violent and painful spasm of
the throat, and a great repugnance to repeat the immer-
sion. Feeling thirsty, he tried to drink some water, tea,
and coffee, but at each attempt the spasm returned and
prevented him. This state of things continuing, M.
Guilery was called to him on the 7th, and found him
quite calm, speaking of his malady more as a curiosity
than a suffering. He swallowed some meat without
difficulty, but dared not appease his ardent thirst.
Introducing fluid into the mouth without seeing it, by
means of a tube, had also brought on the spasms.
Persuaded to try, he managed by an immense effort to
get down two teaspoonsful of coffee, but declared that
he preferred enduring the thirst to repeating the pain-
128
[MAR. 16, 1872.
THE CILITTI c.
ful attempt. The mere sight of liquid brought on the
spasms, accompanied by paroxysms of intense and pro
longed fear. The liquid once removed, he conversed-
calmly upon his strange malady. His pain in the head
had disappeared; there was no fever or acceleration of
pulse, and his tongue was only whitish. On the 8th,
the symptoms described were found persisting and ag-
gravated, cruel sufferings having been produced by
attempting to wash the hands. The only thing the
patient could take was a few morsels of bread dipped
in wine, which had to be conveyed from behind, so that.
he should not see them. Mere looking at a glass of
water produced a fearful spasm. . An hour after he died,
declaring that the attempt to do this had killed him.
No post-mortem was performed. It is quite certain that
he had not been bitten by any dog. *
—-ºº-o-º----
On the Use of the Hacto-Phosphate of Hime as ann
Analeptic MHedicamaeant in Ady Raahmaic
Fever agad Îla Cornwalescence.
BY
DR. R. BLACKE,
Laureate of the Medical School of Paris, &c, &c,
In a great number of acute diseases, especially in ty-
phoid fever, typhus, and certain forms of pneumonia,
we often notice a condition of considerable adynamia
which takes its origin either in the peculiar character
of the malady or in the constitution of the patient, and
is constantly attended by a marked rise of temperature.
This latter phenomenon may be rationally explained
by an unceasing and general process of denutrition of
the tissues. And, indeed, it is well known that all
molecular changes in the form or composition of the
constituent parts of the organism are attended with a
disengagement of heat, and that these physiological
manifestations are under the dependence of the gangli-
onic nervous system. -
I was led to the employment of this salt by the
physiological study of its action on all living organisms.
For it is not only in animals, but also in an equal meas-
ure in vegetables, that its action is powerful—since, a
long time ago, botanists had stated that the ligneous
skeleton of plants contained but insignificant propor-
tions of the lime phosphate, whilst this substance was
constantly found in the soft and nitrogenous parts of
the plants. They had shown that the very existence of
albuminoid substances was linked with the presence of
the phosphate, and was everywhere found in direct ratio
to the quantity of this agent, so that the more strongly
nitrogenated vegetable food was precisely that which
contained the more phosphates. .
They had found out this substance in great abundance
in the bud and growing leaves; they had seen it decrease
in the fully developed organ, and take its way to the
grain, where it became concentrated in view of the fu-
ture development of the embryo. It is furthermore
known that when a grain is deposited in a situation de-
prived of phosphate, it produces a plant the develop-
ment of which will continue only until the entire
quantity of lime salt primarily contained in the grain
shall have disappeared. Now, if we proceed to investi-
gate the action of the phosphate in the mineral kingdom,
We shall find identical phenomena. . .
I may recall the fact that in the pregnant woman we
See at the end of a few days the phosphates disappear
almost completely from the urine and excretions, where-
as in the pelvis and often in the cranium are formed os-
teophyta,destined to disappear towards the latter months
of pregnancy or the beginning of lactation. It can
scarcely be objected that these phosphates are uniquely
absorbed for the formation of the skeleton. Boussingault,
in a series of exact experiments, which can not be too
highly quoted, has shown that young animals take up
much more phosphates than is required by the develop-
ment of the bony tissues alone. Besides, Boussingault,
Lehmann, Mayer, and other chemists and physiologists
have shown in these cases also the strict correlation which
links the presence of phosphates with that of nitrogenous
substances, and the concentration of this salt in all
organs which are going through a process of develop-
ment, and they have enounced the opinion that phos-
phate of lime is indispensable to the organization of
albuminoid substances into cellules.* - -
In order to obtain a correct knowledge of the action
of the lime Salt upon nutrition, I carefully submitted a
pigeon to the test of taking food which was almost de-
prived of phosphate of lime. It soon lost all its liveli-
ness, its appetite, a notable portion of its flesh and
Weight, and it excreted more phosphate than it absorbed.
At the same time the muscular and fibrous tissues
diminished as rapidly as the skeleton. The addition of
the phospate to its ordinary food soon brought back the
normal condition from mineral inanition a fact which,
though well known, had not until now been elucidated;
that the vital activity of animals and temperature are
proportionate to the quantity of lime phosphate which
they contain; so that from the bird to man, and from
man to the mollusk, the quantity of this sait follows a
descending course.
The lime phosphate, as has been seen, plays an im-
portant part, after its absorption, and when it is carried
away with the albuminoid substances through the cir-
culatory torrent into the intimate recesses of our tissues.
But that is not its only action. It is found in abund-
ance in the stomach, forms an essential part of the gas-
tric juice, and its action on the digestion of food is such
that Blondlot considers the phosphate of lime to be the
truly active element of the gastric secretion. And I
may indeed even now state the fact that excitement of
* “It has been recognized,” says Lehmann, “that in the inferior
animals, in the organism of which carbonate of lime is yet the most
abundant mineral substance, the phosphate of lime accumulates in the
| situations where new cellules are undergoing a process of development.”
MAR. 16, 1872.]
appetite and facility of digestion constantly and quickly
result from the ingestion of lacto-phosphate of lime.
Such is, I believe, the uniform action of this sub-
stance investigated in the animal and vegetable king-
dom. It is scarcely needful here to refer to the use to
which agriculturists have turned these notions in com-
posing phosphated manures, and to the success
has justified their applications. -
How is it that, in man, the same favorable results have
not been seen to follow the employment of the phos-
phates even in such cases where they seemed to be most
clearly called for—I mean rickets, osteomalacia, and
fractures of bones? A great many physicians had been
led, indeed, to employ the substance in these cases, but
never with those marked and precise effects which had
been expected. . - - -
The failure of these attempts is satisfactorily ex-
plained when we observe that the preparation invariably
prescribed was the pulverulent phosphate of lime, of
which lactic acid is the natural solvent. Now, this
latter substance enters only for two thousandth parts in
the composition of the gastric juice. It could there-
fore transform and render absorbable only a very limit-
ed part of the ingested salt; whilst the remainder, dis-
sociated, reduced into an imperfect powder, passed with
the food into the intestines, and there produced con-
stipation, and consequently an arrest of all organic
functions, the ordinary result of this pathological con-
dition. - -
It was therefore necessary, in order to obtain the bene-
ficial effects of the substance, to introduce with certainty
into the economy, large quantities of perfectly dissolved
phosphate of lime.
It was in 1868 that Mr. Dusart and myself, after hav-
ing investigated with care the phenomena of the diges-
tion of phosphate in the stomach, were led to reproduce |
a substance representing exactly the composition of a
portion of bone, rendered soluble and easily absorbable.
I have thought it necessary to enter into all the above
details, because the facts which they involve, if they
were not unknown, had at least passed without much
engaging the notice of the profession, and because there
had been no explanation of these physiological results.
It seems to me that now it will be easy to understand
how in convalescence, and in acute affections of an
adynamic form, the functions of nutrition are restored;
how, after easy digestion, the assimilation of food is se-
cured, and fills up the gaps produced by disease, or ar-
rests denutrition caused by grave fevers, substituting in
its stead a contrary movement. - -
The lacto-phosphate of lime is at once an aliment and
an article of food, and a medicament of the highest
Value. Its administration cannot, like that of alcohol,
produce mischievous consequences, and it never de-
presses the nervous system charged with presiding over
the transformations which takes place in the nature or
form of the elements of our tissues—The Practitioner.
Feb., 1872. -
T TH. H. C. LINTI c.
which |
129
MEDICAL NEws
Lessons From Sandriangham.
[From the Medical Record, New York Mar. 7, 1872.]
It is not often that the management of any medical
case assumes the proportions of a public event. When
it does, besides the interest of the masses, and the repu-
tation of the attending physicians, there are at stake
the general standing of the profession, and the rank then
assignable to physic among the physical sciences. The
case of the Prince of Wales was of this class. gº
In order to avóid even the appearance of being in-
fluenced by popular and contradictory clamors in a
question whose scientific interest is hardly second to the
political, we have postponed the expression of some of
the remarks suggested by the character of the bulletins
of the physicians who attended this memorable case.
But now that the public has rendered its ordinary ver-
dict: “All is well that ends well,” let us say that all that
came from Sandringham was not as well as it could have
been for the eminent physicians themselves, nor for the
profession at large, nor for the fair name and promotion
of medical science.
We particularly refer to the sanitary bulletins as
not representing accurately the condition of the patient,
as virtually and wrongfully ignoring the new means of
clinical description whose veracity can not be impugned,
and as made up of the flabby expressions of alternate
fears and hopes. - -
We have simply heard that the Prince was better,
worse, recovering, sinking, rallying, convalescing, re-
lapsing, and finally recovering. For many weeks after
this was all the news given to an attentive world. The
prognosis was as wavering, and seemingly as uncertain,
as it might have been half a century ago, before ther-
mometry or sphygmography was dreamt of Naturally
these bulletins, very much resembling those issued from
Metz when France had the misfortune of not losing
Louis XV., alias le bien-aimé, were soon distrusted, and
accused of exaggeration, even of falsehood; and openly
said to be calculated in view of manufacturing loyalism,
or for the vile object of fostering gambling combina-
tions.
That men like Drs. Jenner, Gull, and Lowe, whose
scientific reputation is so high, could have exposed
themselves, and the medical profession as a body, to
such impossible imputations, shows that there was a
serious misconception of their duties to the science of
medicine, and that at a time when they had the whole
civilized world for an audience.
It seems that the cause of their mistake was the idea
that the majesty of the subject precluded the possi-
bility of publishing the true clinical record of his sick-
ness, as if the disease should behave differently in a
130
[MAR. 16, 1872.
TIED THE CIT, IT, INTIC .
Prince than in a simple hospital patient. This courtly
idea offers the only extenuation for the unscientific
character of these bulletins, but is far from finding its
justification even in courtly habits and traditions. For
these traditions and habits have always been, in case of
sickness of a Queen, King, or Crown-Prince, to issue
bulletins as complete as the science of the time could
afford, and to keep the royal patient constantly in view
of some of the high officers of State.
And why that publicity of sickness and death; why
can not a king agonize quietly ; why must people prey
upon his decomposing form by minute reports and by
de visu proxies? Evidently because a prince—whatever
could otherwise be his individual worth—is a cipher,
whose social value is borrowed from the millions stand-
ing by him, millions who have never been denied the
right to know what becomes of the zero.
Therefore we do not hesitate to affirm that, if the
physicians of the Prince of Wales in issuing their bulle-
tins have literally conformed themselves to courtly
traditions, in avoiding or neglecting to stamp these bul-
letins with the seal of modern positivism, they have
forfeited the confidence of the English nation; they
have left the door of their council chamber open to un-
true but deserved suspicions; they have neglected a
solemn occasion of impressing the people with the pre-
cision of the methods of observation which have been
substituted for guessing at the bedside; and thereby
these eminent physicians have, in no small degree, low-
ered, or at least prevented the legitimate rise of, the
standard of physic in public estimation.
On the contrary, let us for an instant suppose that
these eminent men, improving the opportunity actually
offered to them by the tradition of all the courts of Eu-
rope, would have clothed their bulletins in the scientific
form adopted by the medical institutions of London,
Paris, Vienna, Berlin, New York; these daily or hourly
reports would have been written in a few figures, and
summed up every septenary. They could also have
been accompanied by a few commentaries, such as es-
cape from the lips of a medical man looking at the table
of vital signs appended to the bed of an ordinary subject
of typhoid fever.
In the supposition that these popular and progressive
views had prevailed in the judgment of the physicians
in charge at Sandsingham, the world would have assisted
to a novel and dramatic spectacle. We do not mean the
spectacle of the pitiable youth slowly eaten up, then let
go by the ulceration of his Peyer's glands—we mean the
narration, by telegrams, of the phases of an almost ty-
pical case of complicated typhoid fever. Never before
would nations have listened to such a tale, mainly told
in advance, like a prophecy by the thermometer; never
such interest would have been attached to predictions
of better or worse, fore-shadowed on the stem of the in-
strument, and to the degrees of vitality infused in the
patient by tonics or food, and written in the pulse-wave
of the sphygmograph. Such a medical problem would
never before have been solved to a larger or more inter-
ested audience; no better opportunity could have been
found to prove to the civilized world how much of a
Science medicine has come to be. - .
If this mode of bulletins had been adopted—and we
firmly believe that Aitken, Sydney Ringer, Wunderlich,
or Jaccoud would have carried it out—what an impulse
would that lesson on positive diagnosis have given to
the profession; how higher would physic have instantly
ranked in the estimation of the public; and, to speak
but once, like courtiers, what a chance the Prince would
not have lost of being as useful and celebrated for his
sickness as his father was for his goodness! These are
some of the lessons we had, and had not, from Sand-
ringham. - E. S.
—New York, February 20, 1872. ~.
MARRIAGE AND CRIME.-The influence of marriage
on criminality is not less striking. Whilst the crimi-
nality of single men for crimes against the person is 100,
in married men it is only 49, and 45 for offences against
property. The criminality of widows and widowers ap-
proaches that of celibacy.” Relative to suicide, the
author (Bertillon) concludes that this cause of death is
reduced one-half by marriage. - -
SUCCESSOR. To ZOUAVE,--Mr. Strong an American,
has set up business in Marseilles for miraculous cures,
like the Zouave Jacob. Mr. Strong refuses payment,
and his curative mode consists in laying the hands, etc.
An interminable procession of invalids daily wend their
way to Mr. Strong’s villa on the sea-side, and the doctors
intend to petition against what they call the “thauma-
turgist.
DOGBERRY-CAL.—“Justices' Justice” has become a
proverb. Here is a sample of justices' science:—At
Chelmsford the county magistrates declined to grant
the use of the Shire-hall for a lecture on the sun, illus-
trated by experiments in spectrum analysis, on the
ground that the electric light might endanger the safety
of the building f
HoNORs To DR. GULL.-Sir Wm. Gull, Bart, has been
appointed physician extraordinary to her Majesty the
Queen. -
—-º-º-º-
CORRESPONDENCE.
*
syphilis-Corpuscles.”
VIENNA, February 9, 1872.
MESSRs. EDITORS: Every chair and every Square
inch of standing room were filled this evening at the
meeting of the “Gesellschaft der Aertze,” because of
the advertised review of Dr. Lostorfer's discovery by
Prof. Wedl. Prof. Hebra in the chair.
Prof. Wedl, having first recounted the results of the
* From the Boston Medical and Surgical Journal, March 7, 1872.
MAR, 16, 1872.]
T EL ED CT, ITNTI C.
131
examinations of Dr. Lostorfer, and the steps by which
they were said to have been reached, stated that he had
pursued the same method in his researches, but had
failed to discover any corpuscles in the blood of syphil-
itics which were not to be found equally in that of
healthy individuals. He had easily found bodies, simi-
lar to those described by Dr. L. as peculiar to syphilitic
blood, in almost every specimen of blood examined, both
healthy and diseased. They were round, shining bodies,
of less size than the blood corpuscles, and having a
slightly bluish-green shimmer. Prof. Gruber (aurist)
and Docent Dr. Neumann (dermatologist) saw these
specimens, and pronounced them to be precisely similar
to the bodies which they had seen in Dr. L.'s prepara-
tions. Prof. Wedl had then made a preparation of
mistura oleosa, in which the fat drops were finely broken
up, and in which, on comparison with the so-called
syphilis-corpuscles, the small fat drop could not be dis-
tinguished from the corpuscles. This applied only to
the perfectly symmetrical round bodies. Besides these,
bodies had been described of various forms and in many
cases supplied with one or more sprouts; these the Pro-
fessor asserted to be “torn-off pieces of protoplasm.” The
formation of vacuoles was nothing more than a process
of decomposition, in which carbonate of ammonia was
formed, and which could be demonstrated any day by
adding an alkalito fat, and watching their development
in the fat. As to the supposed growth of the corpuscles,
this the Professor asserted had not been proved, because
Dr. L. had not shown that he had followed one and the
same through its various stages of development; more-
over, that he himself had watched thes same bodies for
several weeks, and failed to note the slightest increase
in size. In order to remove the corpuscles which had
obscured the bodies in dispute, a stream of distilled
water had been passed over the slide, and by this means
the corpuscles left alone under the microscope. In con-
clusion, he suggested that the fat had been introduced
into the specimen by accident, as, for instance, in prick-
ing the finger to obtain a drop of blood, a few drops of
fat might be easily squeezed from out the sebaceous
follicles of the skin, and be brought upon the slide with
the blood.
Prof. Stricker then rose to combat the scepticism of
Prof. Wedl, with a reiteration of the extreme caution
used in the tests to which Dr. L. had been subjected,
and denied that the Professor could have seen the cor-
puscles in question; adding further, that he himself had
examined them many hundred times, and while unable
to judge of their true nature, was convinced that they
were neither molecules of fat nor protoplasmic bodies.
Dr. Lostorfer inferred that if, as asserted by Prof.
Wedl, the bodies had been observed on the first day
after the blood was drawn, they could not have been
those described by him, which never had appeared
within the first twenty-four hours. He further con-
cluded that if water had been added to the preparations,
his corpuscles must have been destroyed, because he had
proved them to be shrivelled up on the admixture of
water, especially in the earlier stages of their existence.
Prof. Stricker thought it likely that Prof. Wedl, by
his stream of water, had at all events washed away the
corpuscles together with the blood corpuscles, and had
probably by its medium brought many new microscopic
objects into the field.
Prof. Wedl replied that the “wet chamber” in which
the slides were placed would in any case admit water to
the preparation by the well-known principle of the
diffusion of fluids, and that the streams thereby pro-
duced would effect the same as his method of washing
the blood. He also thought that after twenty-four hours
the blood corpuscles would have lost their color and
might be taken for strange bodies.
Dr. Neumann recounted some of Hallier's discoveries
of spores indicative of various diseases, and his own ex-
periments with the specimens supplied him by Hallier.
The foreign and diagnostic bodies he had fully proved
to be nothing but decomposed blood corpuscles. He had
recently subjected syphilitic blood to constant observa-
tion for ten hours a day, and had invariably found the
same appearances as in his previous researches.
Dr. Geber, the newly appointed 1st assistant of Hebra,
had, at the request of the latter, examined a large num-
ber of paticnts in the small-pox wards, and found, with
the absence of syphilitic symptoms, many of these cor-
puscles, in part precisely similar to those shown him
by Lostorfer, and in part of a somewhat more bluish-
green tint. Moreover, in a dead subject he had found
them in great quantities. -
Prof. Gruber testified to the exact resemblance of
Prof. Wedl’s specimens to those of Dr. Lostorfer.
It was finally decided that the matter of testing the
possibility of a diagnosis of syphilis by means of these
corpuscles should be referred to a committee, and the
Chair appointed the following members of the Society,
omitting, in accordance with the wishes of those present,
all who had taken any part in the discussion of the
evening: Prof. Rokitansky (Chairman), Profs. Brücke,
Billroth, Reichert, Klob; Drs. Auspitz and Casche.
To these was added the name of Prof. Karsten, after
much excitement and opposition on the part of some
present. - .
The report of this committee I will send you as soon
as published, and in the meantime thought that an ac-
count of the ground taken by the opposing parties
would not be devoid of interest to your readers.
Iam very truly yours, .
JAMES R. CHADw1CK, M. D.
—-º-e-º-
- * —, MARCH, 9th, 1872.
PROF. W. W. DAWSON:
DEAR SIR:—I find myself indebted to the Medical
College of Ohio, the enclosed sum which please put in
your faculty fund. This is not a case of conscience; no
crime has been committed, only the writer feels his obli-
132
[MAR. 16, 1872.
T EEE C LINI c.
gation to this extent. Please acklowledge in Clinic.
Respectfully,
- R. S. M.
[If the writer of the above will send us his address he
will be furnished, without further question, with a copy
of THE CLINIC].
—-º-o-º-
CLRNHCAFL lºg(EMHORANIDA.
DIGITALIS AN ANAPHRODISIAC.—M. Gourvat, in the
course of a paper published in the Gaz. Méd. de Paris,
on the action of digitalis, says: “When digitalis, or
digitaline, is administered for some time to a man in full
possession of sexual powers, these become gradually
weakened, the propensities disappear, formation of the
liquor seminis diminishes, and may at-last cease alto-
gether. The anaphrodisiac properties of the drug are
the secret of its good effect in spermatorrhoea.
women, digitalis or digitaline excites strong, regular,
and intermittent uterine contractions, and controls
metorrhagia; hence digitalis is employed in producing
abortions (Tardieu), . It is probable that this drug
acts as an anaphrodisiac in women, inducing, by long-
continued use, impotence and sterility, appearing also,
in their cases, to interfere with the development of the
Graafian vesicles; the propagation of species being thus
doubly retarded.—N. Y. Med. Rec., Mar. 1, ’72.
—-º-º-º-
IHOMIE NEWS.
THE SPRING COURSE opened out yesterday with an
introductory by Prof. Conner.
THE ACADEMY bristles with new life. The valedic-
tory of the retiring President Dr. Comegys and the
salutatory of the President elect Dr. Graham were both
delivered at the last meeting. The evening was made
historic further by the lecture of Prof. Brown-Sequard |
which is presented in this issue.
THE LECTURE of Wednesday last at the City Hospital
before a crowded amphitheatre will appear in full in the
next Clinic. •
MARRIAGES OF THE DOCTORS.—Prof. Esmarch of Kiel
is to marry the Princess Henrietta of Schleswig–Hol-
stein. Dr. Frank formerly of the British army, now of
Nice has recently married an English Countess and now
Prof. Brown-Sequard of Paris has come to our city to
be united to Miss Carlisle, one of his former patients in ||
Paris.
THE OvARIOTOMY CASE operated on by Dr. Dunlap
of Springfield in the hospital last Monday week, as ex-
tensively reported in the daily papers, died on the fol-
lowing Friday of peritonitis. The patient had been
brought to the hospital from the country.
DIED AT HIs Post.—Doctor W. P. Elstun of Columbia,
was thrown from his buggy through the violence of an
unmanageable horse, in the Twenty-fourth Ward yester-
day forenoon, and killed. , Dr. Elstun was held in high
favor by the people of this county as a physician and
citizen for many years. He settled in Columbia in
1849, and has practiced there ever since. He leaves a
wife and child.
With ||
tions on the living and dead subjects.
Medical College of ohio. .*
sPRING cours E.
-*s
The regular eight weeks course of practical instruc-
|tion for the Spring of 1872 commences March 15. Un-
usual advantages are offered this year in the fact that
the course will be conducted by the entire Faculty of the
College. * - -
The course will embrace the following topics:
Clinical Medicine—Bartholow. -
“. . Surgery—Dawson. -
Anatomy Brain and Nervous System—Gobrecht.
Operative Surgery—Conner.
4 & Obstetrics—Reamy.
& 4 Ophthalmology—Seely.
Female Pelvic Surgery—Palmer.
Urinalysis—Nickles. -
Physical Diagnosis—Cleveland.
Fractures and Dislocations—Kearns.
Genito-Urin. Dis.—Anderson.
Microscropy—Whittaker. --
Prof. Graham will deliver occasional lectures on Clin-
ical Medicine and Diseases of the Chest during the pro
gress of the Course. - - -
The design of the Course is to present instruction in
a thoroughly practical manner. Physical Diagnosis is
to be demonstrated in the hospital wards; Operative
Surgery, Operative Obstetrics, Operative Ophthalmology,
and Operative Gynaecology on the cadaver.
The Dissecting Room will be under the supervision of
Dr. Brown, where abundant material will be provided.
Special attention will be paid to the chemical and mi-
croscopical analysis of morbid urine.
In order to render this course the most practical pos-
sible, an opportunity will be afforded each individual of
the class to make the various examinations and opera-
Regular daily
Medical and Surgical Clinics will be held at the
Good Samaritan Hospital: Two Daily Clinics will be
regularly held in the Cincinnati Hospital, throughout the
entire course; and a Daily Clinic will be held at the
|Dispensary of the Medical College of Ohio.
One hour each evening will be devoted to Recitations
on Anatomy, Physiology, Practice, Surgery, Obstetrics,
and Materia Medica. : .
The eminently practical nature of this course, and its
shortness of duration, together with the great clinical
advantages presented in Cincinnati, can but commend
themselves favorably to the practitioner as well as the
student. •
FEEs FoR THE ENTIRE Course, $10
As this Course does not count towards graduation,
being considered supplemental to the regular winter
course, graduates of the College are not required to
matriculate. The matriculation of non-graduates is
deducted from the fees of the ensuing winter session.
Carriage Manufacturer,
Nos. 9 and 11 East Sixth Street, bet. Main & Sycamore.
I MARE NOTHING BUT
PS 7" Cz & S.S.
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur.
J . .
passed. Of
LIGHT FAMILY CARRIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehićles especially
adapted to
PłºśAAS”
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen’s
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
Physicians in the city and fieighborhood.









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We are authorized by Prof. Hammond to announce ern-
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work on Nervous Diseases, has reference only to the im-
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* MEREDITH CLY MUER, M. D., Prof. of Diseases of the Neº-
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ALFRED C. G ARRATT, M. D., Boston :-"In cases of
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Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; , E. C. SEGUIN, MI. D.;
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WAN NIE,
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CALL OR SEND FOR CIRCULAR AND PRICE LIST.
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account.
I claim to have combined such improvements in ARTI-
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Medical profession, or to those wishing information con-
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full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
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wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
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All communications should be addressed to
JAMES A. FOSTEE.,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 172 Jef-
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Officers and Soldiers on Government
SAML. P. THOMAS
DE ALER IN
English, French and Scotch
GOODs,
34 west Fourth Street,
crwciww.wrſ.


*
WILSON BRO'S.
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Made to order of N. Y. M. Muslin and 2300
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First three qualities have ALL LINEN Cuffs
and Neckbands. At above prices Cuffs are
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Perfect satisfaçtion given or money cheerfully
refunded. -
Also import and Manufacture Men’s Furnish-
ing Goods. -
Pike's Opera-House, Fourth street, Cincinnati; 931
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CAMARGO
MANUFACTURING COMPANY,
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It contains over 600 pages of read ng matter, with 250
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meeting with unparalleled success. . A gents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re-
ports 250 in 12 days. Early applicants secure choice of
| territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 IElm Street, Cincinnati, O.
BASCOM & CARRENTER,
Stationers, Printers
Blank Book Manufacturers,
136 VINE sº DEREET,
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E. D. ALBRO & BRO.
IMPORTERS AND MANUFACTURSRs of
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In Veneers, Boards and Plank,
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Also saw and keep on hand a large stock of Poplar, White Walnut and
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office and Warerooms, 136 and 138 West Second Street,
Weneer Mill, 507, 509, 5ii, 513 & 515 W. Sixth St., CINCINNATI,


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GOOD sa MARITAN Hospit. AL.
The GOOD SAMARITAN IIOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of Sixth and Lock streets.
pointments of a First-class Hospital.
It is handsomely furnished throughout, and is provided with all the necessary ap-
Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department.
of the city any physician of their choice.
Patients may, however, select from the regular profession
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment. ;
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand ot
service.
63;" Address,
SISTER ANTHON.Y.,
Hospital Of the GOOd Samaritan,
Corner of Siacth and Lock Sts., Cincinnati, Ohio.















































































wo. 27 west Fovara scºrer,
PIKE's OPERA HOUSE BUILDING,
Importer and Dealer
- Diamond and Gold Jewelry,
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. Bronzes, Antique and Modern;
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CINCINNATI.
IF. A. C. TCſ L T Y -
J A M ES G R A H A M, M. D., DE AN,
IProfessor of the Theory and Practice Of Medicine and Clinical IMedicine.
W. W. DAWSON, M.D.,
ROBERTS BARTHOLOW, M. D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomy. Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D., T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
W. W. SEELY, M.D., JOHN L. CLEVELAND, M.D., -
Professor of Diseases of the Eye and Ear. Demonstrator of Anatomy.
SAMUEL NICKLES, M.D., CHARLES KEARNS, M. D.,
Assistant to the Chair of Surgery.
Professor of Physics and Medical Chemistry
J. A. M. E S T - W H ITU T. A. Ex E IR, ,
Frofessor of Physiology and Secretary of the H'aculty.
Janitor, College Building, Sixth St., bet. Vine and Race.
T. LOUIS BROWN, Prosector of Anatomy.
Printed and Published by Noh RIs & M URBY, Medical College of Ohio Building, Cincinnati,




* {i
$
+ºf
THE STUDENT'S SUPPLEMENT.
Practical Instruction.
“Is it advisable to attend the spring course?”
This question is frequently asked, and merits
careful consideration before sit is answered
either by the student himself or the physician
to whom, perhaps, the inquiry is addressed.
Every right-minded student and practitioner
recognizes that the period which custom has
established for the undergraduate’s training is
a very limited one, and the consequent neces-
sity of using all of that limited time to the best
advantage. It becomes, then, a question of
very great impurtance in which way will the
spring months of each year be most advantage-
ously spent: in reading in the preceptor's of:
fice, or in attending the “spring course.” At
best, if the preceptor has the time and inclu-
nation to do his lull duty by the student, the
latter can only receive the 1esults of the pro-
ſessional thought, study aud experience of a
single individual, and watch the cases occurring
in a practice limited to a district of a few miles
radious. Anatoin.cal study must, of necessi-
ty, in the vast majority of cases, be limited to
reading books and examning dry bones. In
almost as many cases, surgical study must be
limited to reading, and the occasional opening
of a boil or putting on a baldage. The conduct
of a case or two of obstetrics will probably
include all the practical midwifery training the
office student whll receive.
Now, if by this sort of training, valuable as
it is, necessary as it is in its place and to its
proper extent, the intervals between the win-
ter courses of lectures are filled up, the newly-
created M. D. will enter upon his professional
caneer almost, if not altogether, wholly igno-
rant of the mechanical part of his life-busines
which, if he is to succeed, he must learn, .
which, for his own good, and the good of his
patients, he ought to know considerable about
before he is pen mited to proclaim himself a
doctor. Will he be aided in acquiring this
most necessary knowledge by attending the
Spring course : What is the scope and inten-
tion of this spring course 2 Is it to give to the
Student a repetition of the winter course, and
that, too, a repetition limited, trite in the
number of subjects considered and the tho-
roughness with which they are considered
Not at all. Its object is the enabling of the
Student to learn for himself, under proper di-
rection, how to auscultate the chest and to
recognize and distinguish normal and abnor-
mal sounds; how to make the various gynae-
cological and obstetrical examinations, and to
use the instruments that may have to be em-
ployed in the treatment of cases in these de-
partments of practice; how to perform required
9perations in opthalmology and general sur-
§ery; how to examine tissues, healthy and
diseased, and excretions, physiological and
Pathological in character; in a word, to train
Practically the eye, the ear and the hand.
And while this training is going on the student
has the advantages of hospital and dispensary
clinics and the theoretical knowledge prev-
*sly or at the time acquired is fixed in mind
by º quizzes” and recitations. Is it not, then,
advisable to employ two months in the Spring
Of *h undergraduate year in attending the
Spring course ? *
ºmma---
The History of Anatomy,
In the Medical School of Alexandria, found-
ed by Ptolemy 1 (320 B.C.), human anatomy
seeins to have found its first asylum. Celsus
tells us that the reaction was so great that
Erasistratus even opened the bodies of living
meu condemned to death, that he might more
accurately study the uner workings of the
systein. This is, perhaps, about as true as the
remark that Herophilas was able to recognize
in the pulse of the king's son his love for his
stepmother. No opportunites were offered in
the rest of the world. Galen was compelled
to travel from 1'ergamus to Alexandria to see
a perfect skeleton. It is highly probable that
he never opened a human body, as his descrip-
tions of organs are only those of the ape and
dog. The age in which he lived, says the his—
torian, offered yearly thousands of human
lives to the caprice of the Roman people, and
their cruel eluperor cast them even as prey to
the wild beasts of the Collis.um, but would no.
grant one single dead body to the study of
science. f
Still as late as the seventh century the ex-
amination of the dead was made a penal offense
According to a passage in Cassivodorous, a
Benedictine Monk and physician of that time,
guards were placed in the different cemeteries
to prevent the desecration of graves and all
secret exhumations, and the Salisch law lor-
bade any intercourse with any one who had
even participated in robbing a tomb. With
Mundinus (1290), Professor at Bologna, anato-
my celebrated its second birth. He ventured
to use the human body, and dissected two fe-
males before his class. These he was coin-
pelled to preserve unitil every organ and mem-
ber was properly displayed To do this he
adopted the same expedient which is still le-
sorted to when material is scarce – he exhibited
the intestines and internal organs, brain, mus-
cles, bones, &c., in the order in which they
first decay.
But this happy inaugural to the science of
anatomy was destined to meet with a sudden
extinction. In the year 1300 Boniface III. pub-
lished that celebrated Papal bull, which pro-
nounced sentence of excommunication upon
any one who dared to dissect a human being
and boil asunder his bones.
The occupation of the Benedictii,e monks
with the science of medicine and its effect upon
their religious proclivities, as injurious to pro-
longed fasting, prayer, &c., seems to llave
been the occasion of this famous document.
The first dissection in Vienna, was held in
1404, by Galeatus of Padua. It was performed
in public, and lasted eight days. Female bod-
ies were not admitted until 1452. As a curios-
ity, it may be mentioned that the body of a
thief hung upon the gallows, was delivered
over to the doctors and was by them restored
to life. In 1492 this reanimation was repeated
in another case, when the law was passed that
bodies should hereafter be followed by the oi-
ficers of justice to see that these attempts
were not repeated. Sylvius soon after erected
an amphitheater at Paris, that students might
obtain a better view.
In Andreas Vesalius (1514) anatomy receiv-
ed its greatest reformer. His enemies, the
Catholics, called him the luther of Anatomy,
Such was his zeal for his study, that he was
the subject of most violent persecution. Ac-
cording to his own conſession, he did not hesi-
tate to invade the sanct ty of the graveyard,
and he habitually stole the bodies of criminals
executed on the gallows or at the wheel Fi-
nally he was connpelled to flee from his native
country (Belgium) and betake him, self to
Paris. His accurate acquaintance with even
the smallest bones of the Wrist and ankle (he
could distinguish them by touch with blinded
eyes) gave him a corresponding reputation,
and, as always occurs in such cases, excited in
others a corresponding envy and persecution.
He visited Italy, taught in all her universities,
and was finally appointed by the Republic of
Venice, Professor of the University of Padua,
at the unprecedented age of thirty-three. His
enthusiasm never ceased, and it finally awak-
enca for him such intense hatred at Rome that
he was ordered to make a pilgrimage to Jel u-
salem in expiation of alleged crime. Having
resigned his position and burned all his papers
under the same cruel order, he set out upon
his journey. On the return he was shipwrecked
on the coast of the Island of Zante, where his
body was alterwards found and recognized by
a goldsmith, and placed in the Chapel of the
Holy Virgill. The report that his punishment
was ordered because he had opened the body
of a lady of the Court at Maurid, while the
heart was still beating, is but one of the cabals
of his enemies. It is, however, true that his
great work on Anatomy was subjected to cell-
sorship of the linquisition by the older of
Charles W.; and the question whether it was
per missible to open dead bodies was asked dur-
ing his time of the theological faculty of Sala-
manca. The question was discussed with more
reason by these learned gentlemen than that
of the efficacy of baptisiu in the womb by
means of Syriuge by the profound theologians
of Sorbonne in 1733, for it was answered that
the Bible did not prevent dissections. The
portrait of Vesalius now hangs on the walls
among world-renowned collections of the
Pitti Palace at Florence, and his life has been
written by Burggraeve. His restless, zealous
spirit was inherited by lis pupil, Fallopla, who
even excelled h m in the correctness of his
drawings of anatomical subjects. But Fallopia
stained his reputation by experimeuting upon
criminals with diffel ent kinds of poison.
Prejudice and superst tion still held sway
during the follow ing hundi ed years. Nicko-
laus Stein was obliged to reliounce the Protes-
tant religion. Rolfinc of Jena excited such a
fear among the people that many a poor crim-
inal begged of lus Judges that he might not be
“Rolfincked” after his death.
Albrecht of Gottingen, who was obliged to
dissect in a dark cellar near the fol tress door,
was finally uenied even bread and water by
the people of the town. Everywhere oppon-
tunities were denied. How strange it now
seems to read the boast of Paaw, that he was
able to hold two or three dissectious every
year. On account of this lack of material,
wax preparations wel e made in great quanti-
ty, and at enol mous prices. Such collections
still exist at Florence and Vienna, and even
now there is a village in F1 auce where nearly
every inhabitant finds support in their prepa-
lation Women and girls an e likewise engaged
in numbers, and many specimens are wonder-
ful models of beauty and accuracy
Diffel ent organs and parts of the body were
also preserved in alcohol. Peter the Great
bought the collection of Ruysch (or 30,000 gul-
dens; but a great part of it was destroyed on
the voyage to St etersburg, as the sailors
drank up the liquor in which they were con-
tained. Quite recently a similiar accident de-
stroyed a fine collection en route for Russia,
and since this occasion, the precaution is al-
ways taken to add a little con losive sublimate
to the preserv lug fluid, which (\en the Scyth-
ian stomach will probably respect.
'I he finst dis-ection in America was made in
N. Y., in the year 1750. Very likely the first
public dissection in Cincinnat] was held in the
Amphitheater of the Medical College of Ohio,
over fiſty years ago.
GUIDE TO THE LECTURES IN THE COLLEGE AND HOSPITALS.*

MON DAY. TUICSDAY. WEDNIESI) AY. THURSDAY. FRIDAY. SATURDAY.
HOU R.
9 in * * -
º # Reamy. Seely. Cleveland. Whittaker. Conner. Palmer.
Dispens'y -
—w- ; - GOOD SAMARITAN
11–12 Kearns. Reamy. Kearns. Cleveland. Whittaker. HOSPITAL.
*----- - - -º-º- Tate.
12---1 Gobrecht. Conner. Palmer. Conner. Anderson.
Seely.
* GOOD SAMARITAN &
3—4 Nickles. Whittaker. HOSPITAL. Nickles. Seely.
pººr 7 1-, i. *-- --- Dawson.
5–6 Whittaker. Cleveland. Seely. Conner.
Recitat’n Reamy. Nickles. Bartholow. Palmer. Anderson.
8–10 Practical Anatomy.
* The Order of Lectures at the Cincinnati Hospital is not yet announced.
G2: Xo->=-
THE SPRING SESSION OF 1872. A Bird's Eye View of the Course.
Modern medicine is characterized by its positivism. The application of the various instruments of preci-
sion, as they are called, the microscope, ophthalmoscope, thermometer, etc., enable the physician skilled in
their use to make his diagnosis sure. The vague, indefinite, and unmeaning terms of even a decade or two
ago are rapidly becoming obsolete in medical vocabulary. In their place is substituted that more exact phrase-
ology which describes and locates with precision the organ affected and its disease. This is, of course, the
natural consequence of the more exact knowledge which is now possessed—the result of the more direct means
of investigation employed. Uncertain hypothesis, thus, has given way in great measure to actual demonstra-
tion. The great advance of medicine as a science, in modern times, is but the legitimate triumph of experi-
mental demonstration over what used to be called rational deduction.
This revolution in the method of the study of medicine calls for a like revolution in the method of instruc-
tion. Witness, now, the really wonderful effects which have followed the radical change in the manner of
teaching and studying the languages, both ancient and modern. But a few years ago the student was com-
pelled to pore over the dry rules of grammar and memorize pages of words; indeed, the grammar and the
dictionary were his only aid. Few, there were, who ever attained proficiency. Now the whole system of inn-
partation is different. At first but a few common, every-day words are learned; then follows a short practical
exercise for translation, which is to be written down; and then a still more practical effort at conversation.
To-day fluency in one, even several foreign languages, is common everywhere.
It must certainly surprise those not familiar with the fact, to learn that there has been until recently but
little, almost no change in the method of instruction in medicine for the past fifty years. There is offered to
the student the same round of didactic lectures from morning till night. In many cases there is not a single
demonstration made, not a point offered any where to address any other sense than that of the ear. The evils
of such a method are only too apparent to any board of examiners; and painfully apparent they become to the
student himself when he first attempts the execution of those precepts which his memory may still have pre-
served Long ago foreign schools became impressed with the necessity of this change. Long ago the prac-
tical method was adopted, and the benefits and attractiveness of such a system are at once evident in the crowds
of students from all parts of the world that throng the private courses of the foreign universities.
Two years ago this same plan was adopted in the Medical College of Ohio. Feeble as the effort may have
been at first, it was, nevertheless, the first course of practical instruction ever presented in the United States.
So successful it proved in the numbers of students attendant, and the enterprise and enthusiasm exhibited, that
it has now been adopted as a fixed feature of instruction supplementary to the regular winter course.
As already intimated, the distinctive feature of this course is its eminently practical nature; in detail, it is a
model of the short courses of private instruction in all the foreign schools. There is first every provision made
for clinical instruction. The large wards of the Good Samaritan and City Hospitals are constantly filled with
patients with every possible malady. The dispensary of the College abounds in that class of cases more par-
ticularly which first present themselves at the office of the young physician. The whole of Wednesday and
Saturday afternoons are to be devoted to the Good Samaritan Hospital, while daily clinics will be held in the
wards of the City Hospital. The dispensary is open from 9–11 every morning, and here more especially is
opportunity granted for the individual examinations of every kind of disease. In the various operative courses
every member of the class is to be permitted to make personal inspection, application, and manipulation of the
various proceedings taught. In operative surgery, for instance, every amputation, ligation or operation of
whatever nature, is to be thus repeated by each member of the class upon the dead body. In operative obstet-
rics the female cadaver is also employed with the dead foetus; and here, too, the student is to be personally
drilled in the detection of the various positions and presentations, as well as in all the operations of mid-wifery,
foiceps application, version, craniotary, cephalotripsy, etc., etc. In the course on urinalysis, specimens of
morbid urine are to be placed in the hands of each member of the class, and he is to be taught the method of
detection and recognition of the varions conditions of disease.
These are but a few points selected from the course in more specific illustration of its peculiar nature. In addition to these various
operative and demonstrative courses, recitations are to be held, one each evening, on the various departments of medicine. In this
way, and only by Home such means, may that drill and discipline be obtained which is an essential pre-requisite to accurate and fixed
knowledge. These, then, are the advantages in brief which are offered in what is known as the practical system of instruction. No
honest, earnest student will fail to embrace them; none but that will appreciate them in practice at their worth.
w
- THE CLINI C.
PUBLISHED EVERY SATUR DAY.
sº
*::::
***
*
T E R M S-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editer i
. . . . * *s-All Communications relating to Băsiness, Substriptions, Advertisements, etc., to the Treasurer.
—£4— † = & —º- º * .* ---.
Vol. 2.- * ~ * C IN C IN N A TI, M A R C H 23, 1872. ** - No. 12.
JAS. T. VV HITTA KER, M. D. tº º º Editor.
No. 101 West Ninth Street, Cincinnati.
JASSO cI.A.T.E. EºPITOER.S.- .
W. W. Dawson, M. D. THAD. A. REAMY, M. D.
P. S. Con NER, M. D. C. D. PALMER, M. D. !
W. W. SEELY. M. D. SAMUEL Nickles, M. D.
CHAs. KEARNs, M. D. JN6. L. CLEvel. AND, M. D.
Roberts BARthonow, M. D.
W. W. SEELY, M. D. - - - - - - - - - TREAsunza.
No. 118 West Seventh Street, Cincinnati.
C L U B R A T E S.
4 Copies to one address $ 7.00
6 66 & & : , 10,00
12 & 6 & & 18.00
C O N T E N T S. .
* * *-ºsmºs Page.
orticiNAL ARTICLEs
The Mechanism of the Production of the Symptoms of Brain Dis-
ease, by Prof. C. E. Brown-Séquard, M. D., F. R. S.................. 133. "
t TRANsi,ATRox
Cancroid, Impetigo, etc. Their Diagnosis and Therapy, by M. A.
Duvergie, [From the Bulletin Therapeutique, Nov. 30, 1871]......130
SCIEN" TIFIC NOTES
Convulsive Reflex Facial Neuralgia—vesico-Urethral Absorption—
Medical Jurisprudence of Insanity—Syphilis in the Ape—The
Action of Alcohol 138-141
MIE DICAL, NEWS.
A Generous Testatrice—Patriotic—Baby Farms—A Comfortable
Practice—Anecdote of Dupuytren—An Epidemic of Icterus—
. Cholera—Teaching and Practising....... 141-142
CORRESIPON DENCE
A Suit for Mal-practice—Charge of the Judge—A Fair Exchange—
A Little Thin * * * 142
C. L.INI ICAI. M. [EMIOLRANIDA
Chloral, Clinical and Experimental Researches—Arseniate of Qui-
nia in Tetanus—A Quinine Collyrium—Poisoning by Atropia—
j. TAFT,
The Treatment of Pleurisy 143-144
HOME NEWS T44
The spring course of 1872 Y44.
SEVERAL articles of original matter are crowded over
this week to give place in full to the lecture of the
distinguished stranger still within our gates.
The therapy of cancroid and its allied affections, as
detailed in the translation of to-day, is well worth a
transfer to the physician's note book.
The case of reflex glaucoma is in striking confirmation
to the views of Brown-Séquard.
The note on medical jurisprudence is likewise oppor-
tune, as a view in full accord with that so recently ex-
pressed in the Academy in a prolonged discussion on
The
this subject.
co.é.IN te CCP-
Fashionable *Hatters,
IMPoitter:S AND MANUFACTUREIts of
... E.A.B.E.E.S." Fºtºs,
92 WEST FOTTERTEL ST.
Opposite Post Officer
CINCINNATI.
t •wsreelal Inducements to Medical Men-
RAVERSoNWOOD
ºf Sãº.
º
- - gº
* * * * *=
W. TAFT.
Editor Derntal Register
J. & W. TAFT,
TYETNTTIsTs
117 WEST FOURTH STREET,
CINCIN NATI, O.
A Monthly Journal, :
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,

























Marvin's tºº

COID IT ITVTIEEE, OIL

O ID O E& L E S S A.N ID IP A. L. A. T. A. IB IL, IE •
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency.
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded. y
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c. *
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only. ~x.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.
List of Pharmaceutical Preparations,
Jonºv. Irrazºr & amozwan,
F.H.I.E.A.D.E.L.F.E.C.I.A.
—º-
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIRVALERIANATE OF AMMONIA,
(Goddard’s Formuła,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and calisésa,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron amud Peruvian Bark,
FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND SIRYCHNIA,
WINE OF WILD CHERRY BARK,
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUPSUPERPHOSPHATE OF IRON. 9
ELIXIR OF BISMUTH,
COMP. FLUIDEXT. BUCHU AND PAREIRA BRAWA.
STUIEPEPOSITOTE: II ES.
Rectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
care, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and style made of finest quality of sponge.
William Autenrieth,
ROBERT CLARKE & CD's. '
No. 71 WEST sIXTH STREET,
BETWEEN WALWUT A&E WIME,
Cinciſ INATi, OHIO,
#IANUFACTURER OF AND DEALER IN
\}}}|| || || ||||||||}
Abdominal Supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
IMetalic and Rubber syringes,
Storm.ach Pumps, Etc.
STOCKINGS FOR WABDCOSE WEBNS,
special attention given to the fitting of Apparatus for Deformities.
Bºy Agent for DR. L. A. BABCOOK'S
Silver Uterine Supporter,
-ALSO-
DR. APFL's POROUS FELT SPLINTS,
—Af,SO-
S E” T, IN T S
-ANI)—
T) A. Y. * S
LIST of NEW .
Mill, iTE. In Māllū; hiſ
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5o
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN'S DIS-
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BENNETT ON PULMONORY consumpTION. 8vo. $1 5o
FIRST HELP IN AcCIDENTS. 12mo. $1 5o
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 5o
ECHEVERRIA ON EPILEPSY. 8vo. Cloth, $5 oc
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASES. 8vo. $5 od
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo.
WARINGS PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 oc Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth. $2 5o
TANNER'S HANDBOOK OF OBSTETRIC.S. 12 mo. $2 oo
WAN BUREN ON DISEASES OF THE RECTUM. 12mo.
Cloth. $1 5o
FLINT’S EXAMINATION OF URINE. 12mo. Cloth. $r oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 5o
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
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ATTFIELD'S MEDICAL CHEMISTRY. 12mo. Cloth. $2.75
Leather. $3 25 was ºn.
BARTHOLOW'S HYPODERMIC MEDICATION.
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TURNBULL's DISEASES OF THE EAR. 8vo. Cloth. $5 oc
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 oc *
NEUMANN'S HAND-DOOK OF SKIN DISEASES.
Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 oo.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $1 o oo --
HOOD ON BONE SETTING. 12mo. $1 50
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo
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I OO .*
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PLATTNER'S MANUAL OF ANALYSIS WITH THE
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MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
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GARDENING FOR PROFIT. 12mo. Cloth. $1 50
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ARTHUR'S TREATMENT AND PREVENTION OF DE-
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TYND ALL ON LIGHT AND ELECTR1CITY.
THE AMATEUK MICROSCOPIST. Small, 4to.
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMEN.
ROBERTS ON RENAL DISEASES. * ~ *
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN.
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by maih or express, free of chargs,
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º
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izmo.si 25
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S. W. Elliott’s Saddle-bags
65 west 4th Street, Cincinnati, Ohio.
. N *.N
sº ŞNA .
ill
|
º-cº º
iº.'
JAMES Fostºn, JR., & Co.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
same. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in.
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Lenses, Spectacles, and the best models procurable, with pains-
taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopic Objects
and *rºcopiº Apparatus, Magnifiers and Readers in
great varietv. edical Batteries, Barometers, Thermo-
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of the most approved coustraction always on hand. All orders promptly
and accurately filled.
, JAS. FOSTER, JR. . deali
^ F. S SHACKLEFORD, } *** ** JAs. FostER, JR. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TXIEvº, S-INT. INAL_A_IEC/SIET’S
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»TRUSSES. <s
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&
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Sºlº
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E’. TC. Suire & Co.,
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WHOLESALE DBUGGEST3,
IM. A. INT TJ E A C T TJ F, IIST GF
£Hemists AND FHAR Maceutists,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
sex.xecºco ox{UGS ANYO TVX8xoxc)(N)es,
cx+xeryx)(cAM. Alºxe-ARA*Us,
TESTs, MEDICAL, GLASS WARE, &c., &c.,
f
And solicits the patronage of the trade and profession-
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Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordince with the U. S. P. and other recognized authori-
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E"INTRE ANTO ERA.R.H. CHEMICALS,
Of the popular class of preparations known as
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77




T H E c T.I.N.I.C.
Vol. 2..] S A T U R D A Y, M A R C H 23, 1872. [No. 12.
O RIG IN A L A R T I C L E S.
—-aº-e-Gº-
THE NIIECHANISMI OF THE PRODUCTION OF
SYN (PTO]] (S OF DISEASE OF THIE I BRAIN.
. . BY
PROF. C. E. B.Row N-SEQUARD, M.D., F. R. S.
Professor of Comparative and Experimental Pathology, (Paris),
A Lecture delivered at the Cincinnati Hospital, March 13, '72.
The questions which are to form the subject of our
discussion deserve the careful attention not only of the
medical profession, but as well of all thinking men.
Their pschychological aspects I shall have no time to
consider in this lecturé; you may be able to draw con-
clusions concerning them from the facts I am about to
present.
As regards the physiology and pathology of the brain
we find ourselves now is such a position as to be unable
to progress without retracing our steps, without turning
our backs on previous theories. To advance we must
only regard facts. If we admit the brain to be an organ
of the importance usually assigned to it, we encounter
many facts of difficult reconciliation with this view; if
we admit, further, that every symptom is the immediate
effect of brain lesion or disturbance of function we find
again many facts opposed to this view and thus we be-
come disgusted with results. We must then go back-
wards and look again for new views in explanation.
When we examine the various objections to the views
stated we find that the brain is not the only organ
which acts as a centre.
Take, for instance the sense of volition; we find it de-
stroyed or altered in diseases of the brain; yet cases are
not wanting in which certain parts of the brain have
been destroyed—as in diseases of the pons Varolii—
while volition was not lost. And this is true of all the
functions referred to the brain. At times alteration or
destruction of these functions attend lesions of the brain,
at times again these lesions are present while the symp-
toms are absent and at times an entirely different class
of symptoms may appear. Each alleged function of the
brain may remain after the destruction of what is con-
sidered its centre. The conclusion, then, to which these
facts alone would lead us would be that the brain had
no function at all. Of course such an opinion is absurd
and comes from reasoning only from separate facts.
It is a general opinion that one half of the brain serves
for the other half. This opinion, however, is contrary
133
to fact, as there are many facts which show that consid-
erable alteration and destruction may occur in one side
and yet there may be no symptom of affection of the
other. Abercrombie himself witnessed all the details
of a case in which the whole lateral half of the brain
was destroyed. The disease was of years duration, yet
throughout the whole malady, even on the night before
death, the patient complained of nothing but pains and
vague sensations. There was no symptom present which
would have evidenced the immense destruction of tissue.
This case, it is true, is almost unique, yet one such case is
decisive in proof that one-half of the brain may be de-
stroyed without serious symptoms. Upon this part of
my subject, however, I have no time to dwell.
There are many facts which go to establish the con-
clusion that the same brain lesion may give rise to dif-
ferent symptoms in different individuals or in the same
individual at different times. The whole anterior lobe
may be affected and there may present facial paralysis
of one or more muscles about the lips, there may be
loss of speech, may be insanity or convulsions or the
same lesion being present there may be none of these
symptoms whatever. Such facts as these would seem
inexplicable unless we should admit that one part of
the brain has one function in one individual and another
in another, a view which is in itself absurd.
Another proof of the fact that we may not refer symp-
toms to specific lesions is this; the same symptoms may
present from lesions in any part of the brain. If this
were not true we would have to admit that every small
part of the brain had its specific function. I have al-
ready intimated that we have symptoms without any
lesion. I may mention more in particular, now, cases
in which lesions were not marked by symptoms. Such
are some of the cases of abscess which we all know to be
often so insidious in their course. Years may elapse
without other symptoms than headache. These ab-
scesses may even be of the size of an orange. Thus a
case is reported where the right half of the brain was
destroyed with the exception of its anterior portion and
yet the only symptom was pain in the head. It is in
injuries of the right side more especially where the
greatest lesions may exist with the least amount of
symptoms and yet right sided injuries have often, as we
shall see, most marked symptoms.
For examples of symptoms without lesion take the
case of children with intestinal worms, wounds of nerves,
any kind of irritation of sensitive parts. If symptoms
located function we should have to conclude in these
cases of convulsions, etc., from worms, that the bowels
were the seat of intellect. This would be true, too, not
only of the bowels, but also of nerves. In a case which
I published in 1858, we would have to conclude that
the big toe was the seat of intelligence. It was the case
of a child who was seized with convulsions and mania
one morning whenever it would put its foot on the floor.
On being replaced in bed the mania would pass off and
the child would wonder why its attendants were gath:
134
[MAR. 23, 1872.
T TEI THE C T , T INTT C.
floor the convulsions returned and its mind was lost.
The surgeon who had been summoned discovered a
small piece of glass which had entered near the nail.
Pressure upon this at once elicited convulsions; its re-
moval was sufficient for cure.
Such facts as these are not frequent, but facts illus.
trative of the point that any kind of brain disease may
result from any accident abound. -
Another fact in opposition to the view first announced
is that disappearance of all symptoms which often oc-
curs just before death. Physicians in attendance at
lunatic asylums are fully familiar with this fact, and
this is true not only of insanity, but also of all brain
symptoms. The insane may recover, thus, and the
lesion still be present.
Again, the same lesion persisting, the symptoms may
vary considerably in the same individual. Symptoms
of brain disease, too—and this is especially true of paral-
ysis and insanity—may disappear suddenly from some
emotion, from a burn, a wound of a nerve, a fracture or
dislocation, even from a fracture of the cranium with loss
of brain substance. There is reported, thus, the case of
a lunatic whose skull was fractured while he was in a fit,
by another lunatic; the fracture was upon the right
side and much brain substance escaped, to be followed
by the cure of both the epilepsy and insanity with which
he was afflicted. Finally there is a case of an in-
dividual who was paralysed in one half of the body by a
stroke of lightening and was cured subsequently by a
second stroke. -
There is a fact of exceeding interest and which I have
studied with a good deal of care in connection with
hemiplegia. When a patient is attacked with com-
plete hemiplegia he is unable to stand on his sound leg
or use his sound arm. Complete hemiplegia always im-
plies injury to the other side of the brain. This is
exerted in some peculiar manner and is perhaps nowhere
so commonly observed as in the facts relating to amaurosis.
You are all familiar with Wollastons theories regarding
the decussation of the optic nerve fibres. This author
exhibits that the fibres pass from the right side of the
tubercula quadrigemina to the outer half of the right eye
and the inner half of the left; and the same is claimed
for the fibres from the left side, only, of course, conversely.
Now if this theory were true, disease of the right side of
the quadrigeminal bodies should produce hemiopia in
the outer half of the right eye and the inner half of the
left and I have myself seen two such cases which would
go to confirm this view. But there are also cases of
lesion of one whole tract, with loss of vision in the two
halves of one eye only or now of one half and again of
the other or again of the same or opposite halves of the
two eyes which defeat Wollaston's views, as upon his view
only their own districts of distribution should be involved.
Experiments on animals leave no doubt that amaurosis
does not depend on destruction of substance or if it does
the 8ame function must exist everywhere. The truth
ered about its bed. The moment its foot touched the ‘
is one optic tract is quite sufficient for vision in both
eyes. There are cases of destruction of one with vision
still preserved. One such instance is of course sufficient
in proof... We must admit, then, that amaurosis is due
to changes in the retina itself sufficient to destroy vision
and caused by the influence of distant affections. We
see this in disease of the cerebellum where such a variety
of symptoms may present. The amanrosis induced
may disappear from time to time or may be present on
the side corresponding with the disease or on the op-
posite side. Thus it happens also in cases of worms,
etc., the amaurosis is due to reflex influence.
I pass now to other facts. If we study what relates to
the facial and hypoglossal nerves we find again decided
objections to the location of lesion or function by symp-
toms. In some cases of hemiplegia the paralysis of the
face is limited to two or three small muscles about the
lips; and this occurs no matter where the lesion is lo-
cated. If these symptoms were due to the location of
the lesion we should have to conclude that all parts of
the brain received nerves from all parts of the face.
But we know it to be true that any part of the brain
may be destroyed in some instances without producing
these symptoms. -
The same may be said now of the hypoglossal, the
motor nerve of the tongue, for which the pons forms the
connecting link. There are cases in which the pons has
been destroyed without destruction of the function of
the hypoglossal nerve. If the symptom depended on
the lesion the paralysis of the tongue would imply an
affection of the pons.
I pass now to other demonstrations. If we study the
two sides of the brain comparatively we find an immense
difference between them. A lesion of the left side will
produce aphasia by far more frequently than a lesion of
the right side. Indeed, cases of aphasia following right
sided lesions—unless the individual be left handed—
are exceedingly rare. This fact led my friend Broca to
locate the faculty of speech in the third left frontal con-
volution and its vicinity. But it does not follow that a
lesion of this part of the brain always implies aphasia,
as cases are recorded in which this part of the brain was
destroyed and yet aphasia was not a symptom. Two
such cases were reported only a month ago in the N. Y.
Med. Record. These cases destroy the argument
Again, aphasia may appear from disease located any-
where, the third left convolution being perfectly healthy.
So that if the seat of the disease were proclaimed by the
symptom we would have to locate the faculty of lan-
guage everywhere in the brain or for the matter of that
in the bowels as cases are not wanting in which aphasia
was manifest as a symptom in consequence of worms in
the intestines. -
The conclusion is that aphasia is a reflex manifesta-
tion, a symptom dependent on an irritation exerted at a
distant point. It does not depend upon a direct lesion
but upon a loss of function from distant irritation.
Injuries and lesions of the left side induce greater
MAR 23, 1872.]
TIH. H. C. LINT c.
185
alterations of the mind, more especially in those faculties
connected with speech but not connected with aphasia.
Paralysis of the tongue is much more frequent and
extensive in left than in right-sided lesions. The left
side, then, is more intimately connected with all the
functions which relate to articulate language.
There are some facts regarding the right side which
are of extreme interest. Excepting the few researches
of my 'pupil Hughlings Jackson and of Callendorf of
London, there have been no other researches upon this
subject than my own.
These facts I will now proceed rapidly to mention.
In injuries to the right side we find nutrition in the
paralysed limbs disturbed much more frequently than
in lesions of the left, as manifest in oedema of the oppo-
site side. Charcot has discovered that bed-sores are more
frequent upon the side opposite the lesion, and I have
remarked that these occur chiefly in cases of lesion of
the right side of the brain. Callendorf and myself,
nearly at the same time, discovered that convulsions
occur by far more frequently in case of lesion upon the
right side and, as I have long ago shown, chiefly in lesions
of the anterior lobe. Prevost published a good paper on
the conjugated action of the globes of the eye showing
that both eyes were directed to the paralysed side, and
here again is this observed more frequently in lesion of
the rightside of the brain. So paralysis of the sphincters
is more common in right-sided affections.
Hysterical paralysis affects principally the left side of
the body, a fact which would go to show right-sided
affections of the brain, if the brain be at all concerned
in this affection which I do not believe.
There are some cases recorded in which the paralysis
is on the same side with the lesion. A man was shot
through the head from before backwards. Paralysis of
the corresponding side followed. There are a number
of cases published in which lesions of the corpora thalami
and striata were attended with paralysis of the same
side. In these cases almost always it is the right side
which is affected. -
In injuries to the right side of the brain, other things
being equal, there is much less chance of recovery. The
fatality of right-sided injuries preponderates markedly
over injuries to the left. This is in corroboration to a
statement made in my previous lecture.
I hasten now to consider the mechanism of the pro-
duction of brain symptoms. We remark now that we
have two very distinct phenomena resulting from
peripheral irritation. We observe that a distant organ
or part of the body is put into a state of activity in the
one instance and in the other the reverse takes place, its
activity is restrained or suspended. This latter fact is
of the most importance because the least known. Ex-
amples of stimulation are very frequent. Tickling the
sole of the foot, for instance, is followed by very differ-
ent effects in different individuals. Some are excited
to laughter with or without tears, others are convulsed
in the facial muscles, others still more excitable have
*
convulsions in other parts of the body and it is even
said—and the story is told of wives—that persons have
been tickled to death. These phenomena occur in a
state of health. I have recorded a large number of cases.
in disease. One most striking instance was that of a
student at St. Bartholomew's who stated to me after a
lecture upon this subject that he was himself attacked
with epilepsy whenever the back part of his head was
tickled. Some of his fellow students had discovered
this fact and he was often victimized in this way for
their amusement. He ended his own life, finally, by
suicide. - - -
I regret that I am unable to show these experiments
in the induction of epilepsy by the irritation of certain
zones in animals. I shall have the opportunity, how-
ever, again.
The instances mentioned hitherto are in proof of the
stimulation of activity by distant irritation. Now if
you act upon these animals while in their convulsions
you may observe the opposite conditions mentioned, the
suspension of activity, the cessation of the fit. This has
Sometimes occurred to me, to my dismay, in experi-
menting on my animals. There are many facts which
go to show this suspension of activity. You all know
how we can stop the acts of respiration; in this case we
restrain the activity of certain cells of gray matter. I
have just seen a case with Dr. Judkins in which a fit of
epilepsy could be stopped by drawing the head to the
shoulder opposite to that to which it was twisted in the
fit. Here the same effect is produced as in checking
respiration. What it is exactly we can not say, it is
similar, this inhibitory influence, to the action of a mag-
met on a piece of soft iron in motion; there is induced,
for a time, a cessation of activity. Many actions of the
system are in this way under the control of the will.
Flourens claimed to have found the centre of respira-
tion in the medulla oblongata. When this point, a sur-
face just above the calamus scriptorius, was irritated, life
was destroyed. Now, I have found that there are many
points other than this, in which death may be instantly
produced. By introducing a needle with certain pre-
cautions, suddenly and dextrously, at many other points,
all activity can be diminished or arrested for a time.
If consciousness be considered as the expression of activ-
ity of the brain, the activity of this organ may be sus-
pended altogether in this way. So there is an arrest of
that interchange between the blood and the tissues, as
the blood remains red in the veins, and the same influ-
ence is exerted on the temperature, the heat being
changed to some other form of force.
The direct prick of the needle, thus, arrests activity,
and paralysis may be so produced. Pricking the pos-
terior columns of the spinal cord produces the same.
symptoms as section of the lateral half of the cord pro-
ducing hyperaesthesia upon the opposite side. Many
symptoms we know to be produced by mere emotions.
These are points sufficient to prove that these phenomena.
result merely from a suspension of activity and I think,
136
[MAR. 28, 1872.
T H E CIT, ITNTI c.
*>
if you study carefully the phenomena of arrest of activ-
ity of the heart and intestines as first observed by Jaeger,
of arrest of respiration by galvanization of the par vagum
or after passing carbonic acid gas into the larynx or
after direct irritation of the larynx or, finally, after
pricking the cord with a pin, you will admit that this
cessation of activity starts from the point of irritation.
In cases of brain disease, then, we have every variety
of symptoms from any lesion, determined only by the
part upon which the influence may be exerted. Start-
ing, thus, with lesion of any part of the brain we may
have a cessation of activity of any of the senses or of
speech, or of one or more muscles according, as stated,
to the part upon which the influence is exerted.
Some time past I was led to believe that the loss of
consciousness in epilepsy depended on a local syncope of
the cerebral lobes from spasm of the blood-vessels. There
is no doubt but that the blood-vessels of the cerebral |
Robes do contract and there is no doubt but that such a
cause is sufficient to induce loss of consciousness. But
this syncope is too sudden to be attributed to the effects
of contraction of vessels and consequent diminution of
blood supply, hence I am compelled to retraet my for-
mer opinion and to admit that here too the loss of con-
sciousness is only a cessation of activity. It is demon-
strated in some of these cases that there is dilatation of
the vessels so that arterial blood flows from the sinuses,
proof that the syncope does not depend upon lack of
blood. It takes about 8–10 seconds for loss of conscious-
ness to supervene after the circulation has ceased. In
one case 12 seconds elapsed. In epilepsy this kºss of con-
sciousness is immediate, consequently it can not depend
upon this cause. -
But here I am compelled to stop. I would be glad to
continue this subject, may possibly have the opportu-
nity of doing so upon some future occasion. May what
I have remarked upon this most interesting subject
stimulate some younger member of our profession to
those further investigations which youth is more capable
to undertake.
—mº-O-º-
THE CAPTURED MEDICAL STUDENTS AT HAVANA.—
A correspondent writes that—“The Medical students
now undérgoing imprisonment for the desecration of the
tomb of Caslanon were removed about a fortnight ago
from the city prison, La Punta (the scene of the No-
vember massacre), to the villa of the Captain-General,
the Molivo del Rey, on the Pasco de Jacon. It is sat-
isfactory to know that the students are in excellent
health and spirits. Food and cigars are brought daily
to them by their friends. They wear the ordinary prison
dress, with their hair closely cut, and with their legs
chained. The most melancholy sight was to see the
fathers and mothers, brothers, and sisters of these boys,
who were sitting on rough benches under the Verandah,
distracted with grief and anxiety, and whose minds
must surely give way; in fact, some have already done
so under their cruel infliction. It is considered in
Havana that the removal of the students from the com-
mon prison is the first step towards their ultimate.
release.”—Times and Gazette, Mar. 2, '72.
Cancroid, Noli-Me-Tangere, Ulcerous Impetigo
Rodens, and Non-Ulcerous Impetigo Rođems.
Their HDifferential Diagnosis and Therapy.
BY
M. A. DEVERGIE.
Member of the Academy of Medicine, Honorary Physiclan to the
St. Louis (Paris) Hospital,
From the Bull. Therap., Nov. 30, 1871.
Continued from No. 11.
The compound treatment that we have mentioned
is only applicable to ulcerous impetigo rodens, especially
that of long standing. It should not be employed at
the commencement of the ulcerous form nor before
there is recognized in the patient certain proof of
antecedent syphilis or scrofula. Most often the ulcera-
tions in the early manifestations of the disease can be
cured by cauterizations; but if they are obstinate, there
should be no hesitation in employing the treatment in-
dicated. As to the non-ulcerous forms of impetigo rodens,
they always yield to cauterization, and do not require
any general medication. In my treatise on the diseases
of the skin I reported in detail the first case of impetigo
rodens that I diagnosed and cured. I will mention here
the principal circumstances. A lady acquaintance of
our illustrious printer M. Firmin Didot, consulted me
through him in 1845. She had in the neighborhood of
one of the eyes an ulceration that had resisted all treat-
ment. The lady had consulted the principal physi-
cians and surgeons of Paris. It is useless to enumerate
the various sorts of pommades, lotions and local applica-
tions of all kinds that had been prescribed for her, as
well as caustic and more or less superficial modifying
applications. She showed me a list of prescriptions of
diverse natures and origins. In the presence of such a
past I postponed the case on some pretext or other, and
reflected upon the means that I should make use of to
effect a cure. I had already commenced a comparative
study of caustics and their effects; I had come to have
a decided preference for the chloride of zinc as being
a powerful modifier, and one that could be regulated
at will by conforming to the mode of employment in-
dicated by Canquoin, who introduced it into therapeu-
tics; whence the name that it bears, that of Canquoin's
paste. The efforts that have been made since that time
to vary the use of this caustic, and the daily employ-
ment that I have made of it, have confirmed my early
preferences. It is a dry caustic, i. e., it causes a dry
eschar sometime after its application to the skin, one
that does not attract moisture from the atmosphere nor
give rise to any secretion or suppuration, at least not
generally. The eschar, drying upon the cauterized
MAR. 23, 1872.]
TEEE CI.INI c.
137
part, remains adherent for twelve or fifteen days with-
ont any dressing, and falls off leaving a very clean
cicatrix. This cauterization does not necessitate any
dressing; the applied caustic should be let alone. It
gives rise half an hour after its application to an inflam-
mation that increases for twelve hours, causing a
swelling more or less extensive of the surrounding parts,
the attending pain being very bearable and the sens: -
tion subsiding after the first two or three hours. These
painful sensations are so bearable that no patient has,
refused to be cauterized a second time when this has
become necessary. One remarkable thing is that the
swelling, whatever its extent, even when it shows itself
in an usually high degree, (and in this respect I may
say that I have seen some rare cases in which the
patients believed that they had taken erysipelas,) never
causes any disturbance of the general health of the
patient, and completely subsides in forty-eight hours,
without leaving any traces, or necessitating recourse
to emollient applications. These inconveniences that I
have described are the exceptions. In the generality of
cases the phenomena of cauterization are of no import.
ance. Finally when one well understands the manage-
ment of this caustic and the proportioning of the thick-
ness of the layer which is to be applied to the parts to
be destroyed, he is never obliged to reapply it to the
same point, so that he may proceed from one point to
another in such manner as to successively attack the
whole surface of the wound, multiplying the cauteriza-
tions and benefiting by them all the points attacked.
In employing this caustic two preliminary measures must
be attended to: 1. There must be procured chloride of
zinc that has deliquesced under the influence of the
humidity of the atmosphere. 2. There must be used
in making the paste excellent wheat flour. In the
shops chloride of zinc is found in two states fused in a
solid mass or crystallised. In either state it has a strong
affinity for the moisture of the air, and little by little
becomes liquified. But the fluid which is formed from
the fused chloride of zinc is of an oily consistence and
more active than that which results from the exposure
to the air of the crystallized chloride of zinc. The first
then should be preferred. When the physician does
not find this liquid layer fully formed in the bottle, he
must then procure it by making an opening in the cork
of the bottle which contains the solid chloride, and
placing the bottle in a damp place ; he will thus obtain
in the course of a week the liquid necessary for pre-
paring the paste. The same results will not be secured
by adding water to the solid chloride; the salt will be
in part decomposed, and there will never be obtained
the oleaginous liquid which I have before mentioned;
it will not then enjoy in the same degree its caustic
property. Nothing is simpler than the preparation of
the paste, which results from the mixing of good flour
with the chloride. Take a saucer or small cup; place
in it a drop of the deliquesced chloride of zine; near by
a little flour; then with a flat bladed instrument such
|as a spatula or better a sharp pointed knife, work up
together, little by little, the flour and chloride until a
mass is obtained of a consistence more or less thick ac-
cording to the intensity it is desired the caustic to have.
It is the density of the paste that gives a measure of its
mode of action. But in making this mixture, one
must not lose sight of the fact that the paste once
made afterwards becomes slightly more liquid and loses
a little of its consistence when applied to the diseased
part, and as it ought to keep in place without the use
of any retentive apparatus it is necessary that it should
be prepared a little thicker than it is desirable it should
be when in use. It is not solely the consistence of the
paste-that gives it its caustic power, but also the thick-
ness of the layer applied. This is a matter of habit and
practice. But the physician in using it should not lose
sight of two factors, the consistence of the paste and thick-
ness of the layer, if he would not have the effect exceed
what it is desired to produce. The application to the
affected part may be made by means of the instrument
used in mixing the paste. It is sufficient to spread
evenly the layer as well as to limit its circumference
with the point of the instrument to cause as strong a
cauterization at the circumference as in the centre. As
soon as the paste has been applied its surface will be
seen to become glistening from the little moisture that
is absorbed from the air. If the paste runs and spreads
it is because it is not sufficiently consistent. It should
be removed with a piece of linen and a new application
made. Then it should be left to itself; it sets in place,
little by little dries, in some hours becoming firmly
attached to the diseased tissue, which it attacks
in all parts. The chloride of zinc is one of the
least painful caustics. Applied as directed it adapts
itself to all the conditions of the skin, according to the
thickness of the layer. On this account and in the
majority of cases, particularly in the forms of disease
which we have described, where it penetrates to all parts,
it should be preferred not only to other caustics, but
filso to the solid preparations in the shape of stick or
otherwise as proposed by M. Filhos; not that we would
wish to disparage the advantages of these modes of using
it, which have their special uses, particularly when it is
desired to circumscribe tumors, and to remove them by
means of caustics in stick or layers introduced into the
depths of the tissues. It is important to add to the ad-
vantages of this paste and this caustic that it leaves
only very slightly apparent cicatrices, and those very
rarely attended with deformity when the caustic has
been properly applied. I recollect destroying in this
way seven or eight tumors of frambaesia seated upon the
face of a young girl of eighteen, without there resulting
any very noticeable cicatrices. This result will not
always be secured unless the patient never touches the
eschar before it has spontaneously fallen off. For this
reason I have several times had patients, even adults,
wear a mask of very flexible iron wire similar to those
sometimes placed on the arms, in order to protect the
$38
[MAR. 23, 1872.
*
face against the rubbings which may involuntarily occur
during sleep. It must be understood that Canquoin's
paste has no action upon those parts of tissue or of a
wound which are covered with a crust or the epidermis.
Care must consequently be taken before applying it to
secure the removal of such crusts. A small flaxseed
poultice on the diseased surface for an hour or
two will secure this result. I have entered into these
details in order that there may be secured the good
effects that may be obtained by the employment of this
agent. If however, one compares Canquoin’s paste with
other caustics, it will be seen that aside from the
chloride or butter of antimony all the others give rise to
eschärs more or less moist or causing secretion. Often
it is necessary to envelope them and keep them in place
by a layer of gauze Ör amadou or diachylon, etc. For
the chloride of zinc no retentive dressing is necessary.
As to the non-ulcerous impetigo rodens, a single applica-
tion of the paste is ordinarily sufficient to cure it. In
fifteen or eighteen days the patient is wholly rid of a
disease that has annoyed him for many years. - A
remarkable fact, and one that well shows the nature of
the affection, is the appearance in persons somewhat
lymphatic of a secretion around the cauterization which
resembles in all its characters ordinary impetigo. It is
almost painless, concrete and crystalline like impetigo,
the crust which it forms drops off with the eschar.
Such are the teachings of 3, thirty years practice
respecting these various forms of disease. I have
been led to bring together all the fruits of my
experience and impart them to my fellow workers,
convinced as I am that in taking notice of the facts pre-
sented in this article they will thence derive marked
advantages in their practice. The forms of disease that
I have described (the treatment of which I have
stated) are not rare. They are diseases most usually
but little understood by physicians; and it is this that
has led me to call their attention to this subject.
-- - - sº- c, -º---—
scIENTIFIC NotEs.
wº
t! O N V U L S I W E FA CIA L N E U R A L & H. A.
Followed by Glaucoma, its starting Point
being a “Peripheric Morbid zone.”
Entire Relief of the Pains and Convulsions by Division of
the Infra-orbital Nerve.
IBY --
PROF. CH. ABADIE, (PARIs).
An Abstract from the Journal d’Ophthalmologie, Feb., 1872.
The author claims that the case is one of the greatest
interest as regards the general pathology of the nervous
system as well as ocular pathology.
It is a clinical confirmation of the beautiful experi-
*
ments in physiologico-pathology of Hippel & Grünhagen
upon the production of glaucoma. The subject was a
woman who consulted the author in 1871 for a painful
affection of the face which had been followed by a comi-
plete loss of vision. *
The disease began in 1863 under the form of attacks
of pain in the left side of the face. -
- For the first two years the neuralgic attacks only
occurred at intervals of two or three days, later on, every
day, and for about a year, twenty or thirty times a
day. . .
The patient presented the appearance of an extremè
sufferer. -
The violent contractions of the muscles of the left
side of the face had produced large wrinkles in the skin,
deviation of the angle of the mouth and nose; giving
to the face the appearance of monolateral facial paralysis.
The left eye presented all the external signs of chronic
glaucoma. - - -
No perception of light. The right eye was atrophied.
The patient simply sought relief from the excruciating
pains, which had lasted for eight years. -
All the branches of the 5th pair seemed to be in-
volved. - . -
There were violent convulsions in the muscles of the
left side of the face and head. Sometimes, during the
more violent attacks, the muscles of the limbs were
contracted. So there were veritable general convulsions,
though no loss of consciousness. --
The patient presented all the characteristics of the
epilepti-form facial neuralgia as described by Trousseau.
A careful examination excluded the idea that the
origin of the trouble was glaucoma of the left eye.
The pains began before sight was affected, and were
wº
gº
located at first not in the eye, but in the skin of the
lips and of the malar region, afterwards in the upper
and lower jaw. - -
Later, ciliary pains, radiating to the brow, began in
the eye, then the sight began to fail and finally disap-
peared entirely. -
Three years later violent pains appeared in the right
eye, followed by ulceration and perforation of the cornea
and complete destruction of the eye in three days.
Numerous observations have established for a long
time that irritation of the branches of the 5th nerve
may produce glaucoma, and the articles by Hippel and
Grünhagen (in Graefe’s Archiv, 7, xiv. et t. xvi, 1st
part), recording their experiments in pathology, have
shown very strikingly the important rôle this nerve
plays in increasing intra-ocular tension.
It was highly probable, then, in the author's opinion,
that this case was one of glaucoma, the result of neural-
gia of the 5th pair. -
It was difficult to say what had caused the loss of the
right eye, possibly glaucoma fulminans.
Most of the teeth had been extracted, and pressure
on those that remained did not increase the pains.
On touching the skin of the brow, of the cheek, of the
MAR. 28, 1872.]
TIEEE C T.I. NI c.
139
ear, or of the inferior maxilla the patient experienced
nothing in particular, but when that of the upper lip
and of the angle of the nose on the left side was touched
the cries were increased, the muscles were violently
contracted and the pain so severe the patient could
scarcely endure the touch. The slightest touching with
the finger at these points sufficed to produce the most |
cruel attack. - - -
We have in these spots a perfect representation of
Brown-Sequard's epileptogenous zones.
[We refer the reader to Professor Brown-Sequard's
lecture before the Academy of Medicine as published
in the last number of THE CLINIC on these zones].
It is well known that cases analogous to those
artificially produced exist in man. Violent general
convulsions and veritable epileptic attacks occurr as |
medical and surgical treatment.
the result of a peripheric irritation of a small portion of
the skin often quite remote from the cerebro-spinal
axis. . . -
A similar order of things occurs in those cases of
irritation of the mucous membrane of the bowels, for
example, by ascarides and other worms, in children,
followed by general convulsions. -
This case without doubt must be regarded as of the
same class, and if the deductions are correct and the
point of departure of the disease is from this morbid
zone, operating upon it would produce a satisfactory
therapeutic result. * . -
A division of the infra-orbital nerve was made.
Immediate complete anesthesia followed in the region
where such intense pain had just been experienced, and |
the patient was entirely relieved.
No return after four months and a half, the time
of writing. -
The author proposes to collect and publish the cases
already recorded, which he thinks admit of a similar
interpretation. -
Conclusions.
The following conclusions are arrived at from this
C2SO - -
1. Irritation of the trigeminus can produce glaucoma,
as other clinical observations and the physiological ex-
periments of Hippel and Grünhagen have demonstrated.
2. There exists a form of facial neuralgia of serious
import from the intensity of the pains, their frequent
appearance and their long continuance, accompanied
by local and sometimes general muscular contractions.
whose starting point is peripheric and confined to a
small zone upon the skin.
3. This form of facial neuralgia presents itself with
an assemblage of symptoms altogether similar to those
attributed by authors to the classic disease known as
epileptiform or convulsive facial neuralgia, tic
douloureux of the face, etc., whose origin, instead o
being peripheric, is probably central. -
4. Probably the two diseases presenting the same
symptoms have been confounded, as the attention of
observers had not as yet been called to these painful
ZOI) eS. - - . - .
In the author's case, for example, several physicians
had already diagnosed the classic disease, so rebellious
to all medical and surgical treatment, and had therefore
been unable to render the patient any material aid.
5. To differentiate this new form from the old, I will
designate it as convulsive neuralgia with peripheric zone,
not using the word epileptogenous zone inasmuch as the
attacks are never accompanied by loss of consciousness
consequently not by the characteristic mark of epilepsy.
6. Convulsive neuralgia with peripheric zone may
be completely cured if the zone can be found, either by
dividing the nerves that pass to it, or perhaps by other
Iſle?AIlS.
The central form, on the contrary, resists as a rule all
VESICO-URETHRAL ABSORPTION.—A number of ex-
periments have been recently performed by Dr. Edward
Alling which prove absorption by the mucous membrane
of the urethra.
The mucous membrane of the bladder
in health absorbs almost nothing but in disease its ab-
sorptive powers are very much increased. Opiates
particularly were readily absorbed by the inflamed
membrane of the bladder.—Gaz. Med. de Paris, Feb.
3, '72.
—sº-º-º-
On the Aspects of Law and Medicine in Relation to
our Criminal Jurisprudence, with Special
Reference to Cases of Insanity.
BY
DR. GEORGE MAY,
President of the Reading Pathological Society,
Public attention has been drawn to this important
subject by the late trials of the Rev. John Selby Watson
and Christiana Edmunds, the results of which I cannot
but regard as a reproach to our legislation, too intol-
erable to be longersustained. The only plea of insanity
accepted by the judges in criminal cases, is the inability
of the prisoner to distinguish right from wrong at the
time when the crime was committed. The opinions of
many learned psychologists are in direct antagonism to
this legal dictum; and they declare it to be erroneous
and inconsistent with our knowledge of the manifesta-
tions of unsound mind. This conflict of opinion has
been so painfully developed in the trial, conviction, and
subsequent reprieve, of Miss Edmunds, that public feel-
ing has been shocked, and our laws have been brought
into general disrespect if not contempt. It is believed
that many persons of unsound mind retain the abstract
knowledge of right and wrong, although the judgment
and power of controlling the will may be diminished or
perverted, though not entirely lost. If this be true, it
140
[MAR. 23, 1872.
TiEEE ci. ITTI c.
must result that every alleged criminal act should be
held responsible to the law; extenuating circumstances
being admitted under the plea of insanity, and punish-
ment awarded according to the degree of proved mental
aberration. To admit the contrary, would be a direct
encouragement to crime and dangerous to the public
weal. Both law and medicine are concerned in the
solution of this important problem. Law deals with the
applicability of the penal statutes; and medicine, per-
sonified in the experienced physician, must be the best
exponent of psychological phenomena, since the struc-
tures and functions of man, and the physical and mental
derangements to which he is subject, are the objects of
the study and practice of his professional life. When
skilled in forensic investigations, who can be found bet-
ter qualified to detect the crafty malingerer and to
elucidate the truth? Now proving the offense to be the
act of an unfortunate aberrant, and now only the cul-
minating crime of a life of hardened villany. But to
give due weight to the judgment of such a man, he must
take an official position in the judicial inquiry. Trial
by jury, so dearly cherished by Englishmen as the
palladium of our civil rights, is sorely taxed in cases of
disputed insanity. If to define sanity and insanity be
a puzzle to the most acute metaphysician; if to fix the
boundary in many cases be simply impossible, is it rea-
sonable to expect a jury composed of men of ordinary
intelligence satisfactorily to dispose of cases involving
subtle distinctions, and replete with doubts and diffi-
culties even to the most accomplished medical jurist 2
We need not wonder that medical evidence is not
always complimentary to our profession, since all legally
qualified practitioners are not psychological experts,
and from the nature of their professional engagements
and the absence of special training they cannot be; and
yet they are called to give evidence and to express
opinions for the guidance of juries on the issue of which
hang life or death.
At the trial of Miss Edmunds, important medical evi-
dence in favor of her insanity was adducted; but it was
overruled, the unhappy prisoner was convicted and
condemned, and then submitted again to medical
inquiry and ultimately reprived. Surely this reproach
to our jurisprudence cannot endure. I venture to ask
the members of this society to concur with me in assert-
ing the time to have arrived when in the name of justice
and humanity, and for the honor and dignity of our
profession, we are called to urge the legislature to inves-
tigate and revise our laws in relation to criminal juris-
prudence, and , specially with regard to cases of
questionable sanity.—Brit. Med. Journ, Mar. 2, 72.
SYPHILIS IN THE APE.--Dr. Schmidt reports in his
zoological clinic that, according to a communication
from Edward Lund in Manchester, an ape had his penis
almost entirely destroyed by ulceration, that the hair fell
out in places and that the frontal bone as well as some
of the long bones were perfectly carious.
In the zoological garden of Bellevue at Manchester
where the animal died it was ascertained from the keeper
who had had charge of the apes for a number of years
that these animals had been previously subjects of a
disease which was characterized by ulceration of the
external organs of generation and which was extended
by sexual intercourse. In the same collection in which
the ape had lived there was a female ape diseased in like
manner; the vulva was surrounded by condylomatous
formations of considerable size and there was an abund-
ant sero-purulent vaginal discharge.—Schmidt's Jahrb.,
Feb. 14, '72. -
—-nº-O-ºsm--
or the Probabie Action of Alcohol in the Body.
BY
DR. LIONEL S. BEALE, F. R. S.
But we may now very briefly consider the influence of
alcohol upon the organism, and its probable operation as
an article of diet. What becomes of alcohol when it is"
taken into the stomach 7 There is no doubt that if the
spirit is strong when introduced, it is much diluted by
the pouring out of fluid from the vessels and glands of
the stomach, and that it is quickly absorbed, in its
diluted state, into the blood. That this is so is proved
by the familiar fact that the smell of alcohol is often
very perceptible in the breath. Moreover, as is well
known, alcohol has been detected by chemical tests in
the breath, in the sweat, in the urine, and in the other
secretions by a number of observers. Alcohol has also
been proved to exist in the blood. There is, therefore,
no doubt that alcohol, as alcohol, may not only be
taken up by the blood, but may circulate with the
nutrient fluid, and eventually pass away from it un-
changed. But it must not therefore be concluded that
all the alcohol every person takes is thus absorbed as
alcohol, caused to circulate through the body as alcohol,
and at last excreted unchanged; for such a conclusion
would be opposed to the facts of observation and ex-
periment. The truth seems to be, that some of the
alcohol taken, is unchanged in the system, but that a
considerable and very varying proportion of the total
quantity introduced is caused to disappear altogether
as alcohol, and to pass through most important changes,
escaping at last from the organism probably as carbonic
acid and water. -
A certain quantity of alcohol is digested and assimi-
lated; and it is quite certain that the capacity for the
digestion of alcohol varies very remarkably in different
individuals. It is most probable that the alcohol is
taken up by, and carried with, the portal blood to the
liver. It is then appropriated with other substances by
the bioplasm of the hepatic cells, and completely
changed. Its elements are arranged, and added to the
constituents which form the liver-cell, and which grad-
ually break up to form the ingredients of bile, the
liver-sugar, and the so-called amyloid matter.
MAR 28, 1872]
TIH. H. C. T.I. NTT c.
141
. . It is the living matter of the yeast-cell that splits up
to form alcohol and carbonic acid, water, and a form of
cellulose. We shall not be surprised to find that another
form of living matter—that of the liver-cell—has the
power of appropriating alcohol, rearranging its elements,
and causing them to combine with other elements to
form compounds having properties very different from
those of the materials out of which they were made.
And it seems probable that under certain circumstances
other forms of bioplasm of the body are able to take up
and appropriate alcohol; for it is certain that in some
prolonged cases of exhausting disease a large amount of
alcohol is readily assimilated, while ordinary foods can
only be taken in such infinitesimal amount that we
cannot attribute to them much influence in the main-l
tenance of life. In severe cases of fever, as I shall
again have occasion to state, the greater portion of the
alcohol introduced is probably not oxidised, as used to
be supposed, but appropriated. Its effect is to lower,
not to elevate, the temperature ; and, so far from in-
creasing the dyspnoea in bad cases of bronchitis, pneu-
monia, etc., by throwing increased work upon the lungs,
as used to be affirmed, it has a directly contrary effect.
Dr. Parkes has shown that diluted alcohol, given
daily in such proportions that not more than two ounces
of absolute alcohol are consumed in the twenty-four
hours, in most cases improves the appetite, and slightly
quickens the heart's action; but that larger amounts
have an opposite effect as regards the appetite, and
greatly increase the cardiac beats.
Anstie and Dupré showed that if doses of alcohol
sufficiently large to produce narcotic effects are taken,
alcohol escapes in the excretions, but when smaller
quantities are taken, alcohol escapes in the excretions,
but when smaller quantities are taken it is not to be
detected. This may be the true explanation of the
fact that alcohol in certain cases cannot be detected
in any of the secretions at all. It is certain that the
quantity required to produce narcosis varies greatly in
different individuals, and perhaps this may account for
the different results obtained in the course of different
experiments:
Dr. Dupré has quite recently proved that, of the
alcohol taken in moderate doses (48 to 68 grammes of
absolute alcohol), only a minute fraction is excreted as
alcohol, while by far the larger proportion is disposed of
in the system in some other manner.” Dupré's obser-
vations show that this alcohol is not stored up in the
system as alcohol, and slowly evolved in the form of
alcohol. He remarks that the amount of alcohol
eliminated per day does not increase with the continu-
ance of the alcohol diet, and that, therefore, all the
alcohol taken daily must be disposed of daily, and con-
verted into some other substance in the system.f
* Proceedings of the Royal Society, January 25, 1872.
f Dr. Dupré has discovered in the urine and in the breath a substance,
which, though not alcohol, gives the ordinary reactions relied upon
for detecting that substance. It yields acetic acid by oxidation, and
gives the emerald-green reaction with bichromate of potassium and
strong sulphdric acid. It yields iodoform. This body was found after
Bix weeks’ total abstinence from alcohol, and was detected in the case.
of a teetotaler.
We must therefore conclude that, of the alcohol
taken, only a small but very variable amount is ex-
creted as alcohol, but that the larger proportion, at
least in the case of most organisms, is changed in the
system; not simply acted upon by other things in a
state of change, as may be effected out of the body, but
actually taken up by the living matter or bioplasm,
appropriated and converted into other substances.
Though probably not applied to the nutrition of tissues,
its elements may perhaps assist to form some of the con-
stituents of bile, sugar, fatty and amyloid matter.—
Times and Gaz., Mar. 2, '72. -
—sº-º-º-
MEDICAL NEWS
A GENEROUs TESTATRICE.-Madame Reid, according
to the London Times, has left £110,000 sterling to the
consumption hospital at Brompton.
PATRIOTIC.—The society of Medicine of Paris unani-
mously voted to transfer the fund for the annual ban-
quet to the national subscription for the ransom of
France.
BABY FARMS.—The existence of a “baby farm” was
discovered a few days ago in Marseilles by a novel
species of detective. A mastiff was seen carrying the
arm of a newly born infant in his mouth, and his move-
ments being watched, led to the arrest of a woman who
confesses to have exercised this calling for thirty years.
THE LARGEST ConsulTING PRACTICE IN THE
WoRLD.—Dr. Gull, of Guy,s Hospital, London, is said
to have the largest consulting practice of any physician
in the world— worth not less than £25,000 a year
($125,000).
ANECDOTE OF DuPUYTREN.—The large class of re-
calcitrant patients Dupuytren used to circumvent by
means of a bell. When a patient who ought to pay
left his consulting room without bestowing the customary
honorarium, he touched a particular bell, whereupon the
porter, before opening the front door, said: “I believe
monsieur has forgotten his fee,” and thus forced the
would-be-dead-head to be honest. -
AN EPIDEMIC OF ICTERUS.—During the past three
months Paris and all its environs have been subjected
to an epidemic of icterus.
CHOLERA.—Cholera has completely disappeared from
Constantinople. The officer of health has removed all
naval restrictions since Jan. 22.
TEACHING AND PRACTISING.—There is a law in Bel-
gium which prevents professors in the University of the
state from exercising any other avocation, without
special permit from the government, than that of in-
struction. The minister of the interior Kervyn de
Letterhone has recently called the attention of the pro-
fessors of medicine to the fact that they are also subject
142
[MAR. 23, 1872.
TEEE CI.I.INI c.
to this law. It is the intention of the government to
grant the privilege of practice in only the most excep-
tional cases.
This law, comments the Paris Gazette, is exceedingly
wise. Professors of a state institution should devote
their whole time in their didactic lectures to the theory
and in their clinical to the practice of medicine. In
France everywhere position is aspired after as a means
of obtaining a clientèle which, when obtained is alike |
injurious to the education of students and to the pro-
gress of science which the professor has no longer time
to cultivate.
This subject should meet with our [France] most
serious consideration in the reorganization of our system
of medical instruction. It is, however, no more than
just that if our professors are to be deprived of the rev-
enue, often very lucrative, attending a large clientèle, the
state should assure them a large and fixed compensation,
at least should grant them the income from the inscrip-
tions of students attending their own lectures.
—º-e—sº-
CORRES) PONIDENCE.
CHILLICOTHE, O., March 11th, 1872.
EDS. CLINIC;
Last fall I was sued for mal-practice—in a case of
oblique fracture of the femur at the junction of the
middle third. The trial took place a few days since,
lasting 7 days. I was honorably aquitted of all charges.
Enclosed you will please find a synopsis of the judge's
charge to the jury. The profession is deeply interested
in all such trials, hence I forward you the enclosed for
publication.
Another physician has been sued for mal-practice
in a similar case. The trial will take place in a few
weeks.
Yours very truly.
B. F. Miesse, M. D.
synopsis of the Charge to the Jury by Judge
Samuel F. Steel.
J. W. Marys, Plaintiff.
2)S.
Benj. F. Miesse, M. D., Defendant.
In order to entitle plaintiff to recover in this action
he must satisfy the jury by a preponderance of the evi- |
ence: first, that defendant attended him in the char-
acter of a surgeon and undertook to treat his fractured
thigh. It is immaterial whether he was employed by
the plaintiff or by the township trustees; his liability
would be the same in both cases. Second, that from a
want of ordinary skill on the part of the defendant, or a
failure on his part to exercise ordinary care in the man-
ner of treating the plaintiff, the latter has been injured;
that is, that the leg is shorter or weaker than it would
have been if treated with such skill and care or that the
plaintiff was put to greater inconvenience or suffering
by reason of such want or failure on the part of the
defendant. What is meant by ordinary skill and
ordinary care is that reasonable degree of skill and care
which is ordinarily possessed and exercised by men who
practice the profession of surgeon and hold themselves
out to the public as qualified to practice that profession.
If the jury find from a preponderance of the evidence,
that in treating plaintiff's fractured thigh the defendant
did not exercise ordinary skill or care and that the
plaintiff was injured thereby, your duty will then be to -
determine the amount of damages the plaintiff ought to
recover. In estimating these you have the right to take
into consideration the plaintiff’s loss of time, his pain
and suffering, and expense occasioned by defendant’s
want of skill or care, and such injury to him and to his
business, as will in future probably result from the injury
he has received by reason of the defendant's negligence,
and to give the plaintiff such damages as will compen-
sate him for all these things. And if you should find
that the defendant was guilty of such gross negligence
as to show wantoness or to indicate intentional wrong
on his part, you may go beyond the rule of compensa-
tion and allow such damage as you may think proper by
way of punishment to the defendant. But the law does
not presume either a want of care or a want of skill on
the part of the defendant. One or both of these must
be made out by the plaintiff. It is not for the defendant
to prove his innocence but for the plaintiff to prove
defendant's guilt. In the absence of an express agree-
|ment to that effect the law does not imply an agreement
on the part of the surgeon to effect a cure, but it does
imply an agreement on his part to treat every case he
undertakes with ordinary skill and care, and that in
cases of doubt as to the best mode of treatment he will
use his best judgment in the matter.
—º-o-º-
OPPOSITE YALE COLLEGE.
NEW HAVEN, CONN., Mar. 16th, 1872.
EDs. CLINIC: Dear Sirs:—We mail you this day a
copy of the “College Courant” published by us. We de-
sire to obtain in every college one or two persons who,
during the year, shall send us items of news or articles.
We would propose to send you the paper for one year
for $2.00, one-half the subscription price, provided you
will occasionally send us an item of news from your
college. -
Very Truly Yours,
. Chas. C. Chatfield & Co.
MEDICAL COLLEGE OF OHIO,
F. CINCINNAT1, OHIo, Mar. 20th, 1872.
EDS :- CoLLEGE COURANT: Dear Sirs:—We mail
you this day a copy of “THE CLINIC” published by us.
MAR. 23, 1872.]
TIH. H. cIIISTI c.
143
We desire to obtain in every college one or two persons
to become subscribers. We would propose to send you
“THE CLINIC” for one year for $2.00, the regular sub-
scription price, provided you forward the item of
expense.
Very Truly Yours,
PUBLISHERS CLINIC.
—-tº-e-ºº-----
C. LINEICAI, MEMORANIDA,
Chloral, Clinical and Experimental Researches.
BY
DR. ZUBER, (Strasbourg).
Chloral was presented to materia medica by Drs.
Otto and Liebreich in 1860 before the Faculty of Med-
icine at Berlin. It was discovered in 1832 by M.
Liebig as the result of the long continued action of
chlorine upon alcohol.
The liquid chloral mixed with a little water combines
with it and presents then in the form of a crystalline
mass non-transparent, the hydrate of chloral :
C2 C13
k }co, no 2HO.
H
It is the hydrate of chloral that is employed in
therapy. -
In his most excellent work M. Zuber remarks tha
when it is given in small doses frequently repeated it
produces no good effect, as the action of the first
dose is lost before the remedy is repeated. It must
be given them in one dose. –
It is administered by the mouth, in applications and
in subcutaneous injections.
M. Zuber recommends the dose as follows:
For infants - - - - - 2-3 gr.
4-5 gr.
5 gr. and over.
For women gº º tº EE tº
For men - - • - - -
The ordinary formula is as follows:
R. -
Chloral hydrat. 4-6 gr.
Syrup
Syrup. Aurant, aa 15-20 gr.
-º-
If only a light sedative action is desired, it is obtained
by the formula of Liebreich . -
B.
Chloral hydrat, 2 gr.
Mucilaginis 15 gr.
Syrup 30 gr.
Aquae dist.
‘S. Spoonful doses every half hour.
The application of chloral should be concentrated.
It is not an advantageous method of administration.
|utes to the development of normal tissue.
In subcutaneous injection its absorption is easily
effected. This method, however, is liable to local
accidents, M. Zuber has had one abscess result, one
eschar. M. Liebreich has never observed an accident.
M. Zuber terminates his work with the following con-
| clusions:
1. Chloral hydrate, pure and in sufficient dose is a
powerful sedative to the nervous system.
2. As a hypnotic it induces sleep rapid, profound,
rarely preceded by a period of agitation and followed
by no malaise; a sleep preferable to that of opium.
As an anaesthetic it produces a light diminution of
sensibility, sufficient to permit explorations and minor
|operations; but it cannot substitute chloroform in the
great operations of surgery.—Gaz Med. de Paris, Feb.
10, '72.
ARSENIATE OF QUINLA IN TETANUS.—Dr. Pietro
Galli has employed this remedy in tetanus with most ex-
cellent results. It acts in two ways, against the nervous
element of the disease and against its intermittency. This
first action is secured by the arsenic, a reliable anti-
periodic and at the same time sedative in relieving the
partial alterations of the nerves; the second action is
secured by the quinia, a remedy whose sovereign power
in this direction is universally known. These two rem-
edies thus simultaneously employed and reinforced also
by opium to relieve the activity of the circulation and
facilitate absorption contributed much to the recovery
of the cases mentioned. The malady presented the
characters of a veritable intermittent fever accompanied
by tetanic pains. As it has its seat in the central por-
tion of the central hemispheres extending out along the
ramifications of the trigeminal nerve and involving the
spinal cord with the connections of the great sympa-
thetic, it demands a medication of such heroic action as
to combat at the same time its periodicity and the grava
concomitant symptoms.-L'Ippocratico–Gaz Med. d.
Paris, Jan. 29, '72.
A QUININE COLLYRIUM.–Dr. Vincenze Gotti lauds
the value of a solution of quinine as a collyrium accord-
ing to the method of Magni in his clinic at Bologna and
urgesstrongly its adoption in the therapy of ophthalmolgy
It has been recommended some time ago by Prof. Nagel
of Tübingen. It is to be used especially in cases of
kerato-conjunctivitis scrofulosa. It acts further—as the
four cases would seem to prove—in a most surprising way
in phlegmonous affections of the cornea and in corneal
wlceration, as it checks the formation of pus and contrib-
The quantity
used is 0. 25 [3. 3-4ths gr.] to 30 [450 gr.] distilled
water. The application which is not painful should be
made several times a day.—Riv. clin. iv. io, cii.-
Schmidts Jahrbücher, Feb. 14, '72.
PoſsONING BY ATROPIA.—What then in conclusion
| are the different means of therapy from time to time
introduced in cases of atropine poisoning.
The first indication consists, if the poison have been
144
[MAR. 23, 1872,
TIH. H. CLINI c.
ingested per stoma, in recourse to evacuants; emetics
and purgatives may in some cases remedy the dangers
and hasten the cessation of the toxic effects. With a
view of neutralising the action of the atropine certain
pharmaceutic preparations have been employed from
time to time, with greater or less success, as iodine, io-
dised water, iodide of potassium, tannin, caffein, thein,
etc. These various substances in combining with atro-
pia form insoluble compounds.
Of all the various medical agents opium is the remedy,
without doubt, which has played the chief role in therapy
in recent times. The fact of the myotic action of this
substance in contrast with the midriatic of atropine led
at once to the view of its specific antidotal power. 3.
This antagonism recognised between these two agents,
however, has been contested by most authors. For our
own part, notwithstanding the fact of its employment
in our case, we do not believe opium to be possessed of
the antidotal powers imputed to it, being persuaded that
most cases of atropine poisoning terminate favorably
spontaneously.—Prunac—Gazette des Hospitawa, Jan.
27, 72.
—-º-º-º-
On the Treatment of Pleuritis.
BY
DR. H. QUINCKE.
Private Docent in Bærlin.
The following are the eonclusions from an extensive
and most interesting article in the last number (Feb.
19, 1872), of the Berlin Klinische Wochenschrift:
The best method of removing serous exudations is by
ouncture with a small trocar and suction.
Except in cases in danger of apnoea the puncture is
to be undertaken in large as well as in small exudations
as soon as absorption is in any way delayed. Even
in those cases where a palliative effect only is to be
hoped for, puncture is still often indicated.
in purulent, exudations incision, and subsequent
cleansing out of the pleural cavity with fluid and air
is to be undertaken on all occasions and early for the
the reason that spontaneous absorption is improbable in
these cases, certainly is very tedious.
In many cases of pneumothorax also where purulent
exudation has taken place operative treatment is in-
dicated. º
——º-e-ºs-
| HOM IE NEWS.
THE SPRING CourSE opens with thirty students,
nearly double the number of this time last year. Full
particulars of the course with other matters of interest
to the student, will be found in the student's supple-
ment to be had in the college library.
PROF. BRown-SíquaRD still remains in our city.
It is rumored that he will permanently locate in either
New York or Cincinnati.
WE HOPE TO BE ABLE to make such arrangements
with the Secretary of the Academy of Medicine as to
secure us a weekly abstract of its proceedings.
Medical College of Ohio.
S P R | N G C 0 U R S E ,
The regular eight weeks course of practical instruc-
tion for the Spring of 1872 commenced March 15. Un-
usual advantages are offered this year in the fact that
the course will be conducted by the entire Faculty of the
College. -
The course embraces the following topics:
Clinical Medicine—Bartholow.
“ Surgery—Dawson.
Anatomy Brain and Nervous System—Gobrecht.
Operative Surgery—Conner.
{{ Obstetrics—Reamy.
{{ Ophthalmology—Seely.
Female Pelvic Surgery—Palmer.
Urinalysis—Nickles.
Physical Diagnosis—Cleveland.
Fractures and Dislocations—Kearns.
Genito-Urin. Dis.—Anderson.
Microscropy—Whittaker.
Prof. Graham will deliver occasional lectures on Clin-
ical Medicine and Diseases of the Chest during the pro
gress of the Course.
The design of the Course is to present instruction in
a thoroughly practical manner. Physical Diagnosis is
to be demonstrated in the hospital wards; Operative
Surgery, Operative Obstetrics, Operative Ophthalmology,
and Operative Gynaecology on the cadaver.
The Dissecting Room will be under the supervision of
Dr. Brown, where abundarit material will be provided.
Special attention will be paid to the chemical and mi-
croscopical analysis of morbid urine.
In order to render this course the most practical pos-
sible, an opportunity will be afforded each individual of
the class to make the various examinations and opera-
tions on the living and dead subjects. Regular daily
Medical and Surgical Clinics will be held at the
Good Samaritan Hospital: Two Daily Clinics will be
regularly held in the Cincinnati Hospital, throughout the
entire course; and a Daily Clinic will be held at the
Dispensary of the Medical College of Ohio.
One hour each evening will be devoted to Recitations
on Anatomy, Physiology, Practice, Surgery, Obstetrics,
and Materia Medica. -
The eminently practical nature of this course, and its
shortness of duration, together with the great clinical
advantages presented in Cincinnati, can but commend
themselves favorably to the practitioner as well as the
student. • * - -
FEES FOR THE ENTIRE Course, $10
As this Course does not count towards graduation,
being considered supplemental to the regular winter
course, graduates of the College are not required to
matriculate. The matriculation of non-graduates is
deducted from the fees of the ensuing winter session.
DIVIDED MEDICINES,
The Divided Medicine Com’y,
CINCINNAT1, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEw AND ExcEEDINGLY PRACTICAL
METHOD of dividing into doses. Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous"
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a mannér that the several squarEs must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MoRE. .. - -
-- The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities. -
But not only SolubLſſ, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. - -
- This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; : # *. iło, and even idbo part £f a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. - - - - -
Besides the peculiarity of THESE MEDIGINES, that they are NOT LIABLE To SPOIL BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calis with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares) within four days.
For Saxmpies, Price Lists, and Agencies, address
w
EOIX. 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
- Walnut Hills, Cincinnati, O.
MR. FREDERICK KRAUs: CINCINNAT1, February 15, 1871. -
- Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: -
SULPII:MI0 RPH II....................... % grain in each square. ARSEN: ACID.......................... 1-20 grain in each square.
“ CH IN.INI ....................... 1 as “ . “ CALOMEL % “ s * I
tº º COPPER ...“º § { -
ResPECTFULLY Yourts,
E. s. Waxse, Analytic Chemist

||||||||}|| MM|| ||M||
Fos"TER’s
~.
167 EAST, 34TH-St., NEW YORK,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANUFACTURERS OF PORTABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwanic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
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instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid. -
|M|| ||||—||f|| ||
PEERMANIENT BATTERIEs,
For Hospitals and General Practitioners,
IEET ITECTIER, OTDIES.
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FºxTRA tºt'S FRONT TH F O PINIONS OF THE WroST
JEMI NENT MEMBERS OF TLRI; PIE OFESS / ON.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Nothing CAN
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MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. Hammond to announce en-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
A MEREDITH CLYMER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider their
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.” -
LEWIS BAUER, Prof. of Surgery, St. Louis : —“In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. G ARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
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Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MUR RAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, MI. D.;
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, 0.; Dr. JOHN BECKER, Brighton, Iown;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
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• Electrical Instruinent for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
\\limlija
–28, LIMIB5 \\
=<-2 W
Are furnished to Officers and Soldiers on Government
account.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb – why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb. etc., etc.
All communications should be addressed to
-JAMES A. FOSTEE,
911 º'hestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cinginnati, Ohio, or 172 Jef-
ferson Avenue, Detroit, Mich.
SAML. P. THOMAS
DEA LEF IN
English, French and Scotch
GOOD's,
34 West Fourth Street,
& Z-W'6'' A.W.W.?? We







- *-
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The GooD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
It is handsomely furnished throughout, and is provided with all the necessary ap-
Porticoes, with commanding views, surround the whole house, and wide
ial to health and comfort.
of Sixth and Lock streets.
pointments of a First-class Hospital.
halls and abundant windows secure that full and free ventilation which is so essent
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
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The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
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Rooms vary in price, according to the character of appointments necessary and service required, ranging, jº
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service.
tº Address,
SISTEER ANTHONY,
Hospital of the Good Samaritan,
Corner of Stacth and Lock Sts., Cimoirºmatº. Ohio-
































































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D E A N ,
y
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SAMU
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ecretary of the Faculty.
XVI E S T .
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J. A.
sys; O r"
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Vol. 2. C IN C IN N A TI, M A R C H 30, 1872. No. 13.
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ORIGINAL ARTICLES Bº *A ºlº º Tll. LM
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Cases Illustrative of Treatment by Air-Exhausting Apparatus by § \ || -º-º-º-º-º: . . . . WITF
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Digitalis, Its Action on Circulation and Temperature by Prof. S. CINCINNATI, OHIO,
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SCIENTIFIC NOTIES * * *-*--
J. TAFT, W. TAFT.
Germs of Healthy Blood–Alcohol and Tobacco as Cause of Ambly-
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M IELDICAL NEWS.
International Medical Congress—Conquest of Alsace–Human Hair - J D & * W C TART N
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*
In calling the attention of Physicians and Druggists to the Cod, Liver). Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we're the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market. i
*
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. ,”
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable iºthe stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

List of Pharmaceutial Preparations,
MANUEFACTURED BY
Jozzy Wyżſzºg & Bºozºº,
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—º-
ELIX, PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA,
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Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
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COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
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TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
• BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIRVALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUP SUPERPHOSPHATE OF IRON, y
ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRABRAVA.
STUI PIPOSITOTE&II ES.
-- Bectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
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SPON GE TENTS.—For the Urethra, of every sise and style made of finest quality of spongº.
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CINCINNATi, OHIO,
MANU FACTURER OF AND DEALER IN
|| || || |||||||||
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reeps constantly on hand a full variety of
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STOCKINGS FOR WAR}}COSE WEDNS,
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t
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& Co.
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that our invariable rule is, to make or import none but the best in-
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TXTER, S.INT. TMI. A_IF/STEL’S
sº :- " R - y -
w - :2 5KS:º º
No. 758 BROADWAY, NEw Yohk
I HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAYRE, M. D.
Surgeon, Bellevue Hospital.
Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
BEG leave to state for the benefit of all concerned,
Dr. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution... I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
- Professor of Surgery, New York City
From Prof. Willard
that I have known
Br. S. N. Marsh's Patent Radical Cure Truss, and all other kinds of |.
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r
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tº gº, ſº *
º III,
º
WS-
AFS:
*----
*-
. . ."
==Q
º
Užs)
Carriage Manufacturer,
NOS. 9 and 11 East Sixth Street, bet. Main & Sycamore.
I MAKE NOTHING BUT
F/APS-77 Czz SS. Wºo Ar A-,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of g
LIGHT FAMILY CARRIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
PHYSECHANS” {jSE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose. -
adapted to
The superiority of my light gentlemen’s
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References















T TE-ITEH C T , T TNT I C .
:*TY
Vol. 2.) SAT U R DAY, M A R C H 30, 1872. [No. 13.
O RIGINAL ARTICLEs.
AMPUTATIon of THE CERVIx UTERI.
- By *
DR. J. C. McMECHAN,
Cincinnati, 0.
On October 8th, 1871, I saw Mrs. D.—for the first
time. - -
For eight years she had been suffering with an affec-
tion of the womb. She was sterile and had dysmenor-
rhea. She had been married nine years, and about one
year after that event had had a miscarriage, self induced
by the introduction of a knitting needle into the
literus.
On examination the cervix was found elongated at
least an inch and a quarter. The neck was conoidal
in shape. Intra-uterine measurement was three inches
and a half. The uterus was retroflected.
The next time I saw the patient, I called Dr. Whitta-
ker in consultation, and we proposed to amputate the
cervix. To this the patient consented, but on examin-
ation the neck was found so congested and enlarged,
(it was just after menstruation), that it was impossible
to draw it down sufficiently close to the vulva to oper-
ate. Another objection to the operation was that in
the then congested state of the organ hemorrhage would
probably have proved dangerous. It was considered
best, as a temporary expedient, to open the neck by a
bi-lateral incision. This operation Dr. Whittaker per-
formed, and tents were introduced for several weeks to
maintain the dilation so gained.
On November the 13th, the patient not feeling
sufficiently relieved, and there being no congestion of
the cervix I determined to amputate.
, Assisted by . Dr. Hancock, by means of the Sim's
speculum and a tenaculum the neck was brought down
to the vulva and amputated with the curved scissors.
Nearly an inch of the cervix was taken off. But little
hemorrhage followed, and the womb was kept well
dilated for three weeks following the amputation by
Sponge tents. . . .
|Up to the time of removing the cervix the pain at
each monthly period had been very intense for a
number of years, so much so that the patient generally
remained in bed during these periods.
At the present time the retroflection has almost dis-
appeared, having been treated simply by semi-weekly
reposition with the sound for six weeks.
Since the operation there has been no pain at the
.145
menstrual epoch and the patient feels entirely relieved.
She has never been pregnant since the miscarriage eight
years ago, and could not possibly have become so owing
to the mechanical impossibility of the passage of Semen
through the elongated and constricted cervix.
The patient being now so well, the menstrual flow
occurring so regularly, freely and painlessly, there is
every reason to believe that she will soon have her wish
of maternity fulfilled. -
This operation was first brought into prominence by
Lisfranc, who operated 99 times. He gave many favor-
able results from his operations, but his student Panby,”
who saw his numerous cases, states that the results were
not always so favorable, and that several of the cases
proved fatal. --
It is of undoubted utility in proper cases, and the
case related, as proven by the result, belongs to this
category.
—º-o-º-
Cases IIIustrative of the Value of the Air-Exhaust-
ing Apparatus in Acute Diseases.
BY
J. BRADLEY, M. D.
St. Marys, Ohio,
CASE 1.-Mr. M., aged 16, Pleurisy—was taken ill in
the evening and sat up all night in an arm chair. Called
the next morning, I found his temperature 1033°, pulse
112, respirations 50, with severe pain in the left side.
I applied six wet cups and ordered veratrium. On my
visit that evening I found him no better. Ithen applied
my exhausters as he sat ; in about five minutes he said
“I feel the pain going away,” and in a few minutes
more the pain was entirely gone. In about an hour I
took them off and laid him down—gave a Dover's pow-
der with hot bricks to his feet. This ended the treat-
ment—he was well the next day.
CASE 2.—Mr. B., a laborer in a spoke factory, aged
17, Pneumonia—was taken ill 10 o'clock A. M. I was
called the same evening; found his heat 104°, pulse
118, respirations 40, with dyspnoea that gave him much
alarm. I applied my exhausters at once. In a few
minutes he said “I can breathe easily.” After about
an hour I took them off, and administered a Dovers
powder; applied heat to the feet as before. The treat-
ment ended here—he resumed work at noon the next
day.
CASE 3.—Mrs. M., aged about 35, a country woman,
large and lax: Pneumonia—I was called the next morn-
ing. Found her temperature 104}*, pulse 120, respira-
tions 40, with deep seated pain in the right side, and
almost constant dry cough. I at once applied my ex-
hausters, which in about an hour relieved her of the
pain and cough entirely. They were again followed by
* Panby Maladies de l'Utérus, Paris, 1836.
146
[MAR. 30, 1872.
T TH THE CIT I INT I. C.
*-
Dover's powder and hot bricks as in the other cases.
On my morning visit I was told that the pains, cough,
and fever had returned in the evening, and she had had
a bad night. Temperature at visit 102},” pulse 112,
respirations 40, as before; pain severe and almost con-
stant. I again applied my exhausters at the same time
giving a little antimon. tart. which soon brought her
near a fainting condition. I kept her in this condition
about an hour and a half relieving her of all pain and
cough as before, but this time permanently. On leaving
I found her temperature 99°, pulse 112 as before, but
small and soft. The next day I found her sitting up
out of bed, pulse 80. She was well, except a little dry
cough.
Now I ask what other treatment could have been
used in the above cases with such favorable results?
And these are not isolated cases. Such resnlts have
followed in every instance where I have used the air-
exhausting apparatns, previously described, when it has
been applied on the first or second day of the attack.
—-º-º-º--—
DIGITALIS,
Its Action on Circulation and Temperature.
JBY
PROF. ACKERMANN.
From the Berlin. Klin. Wochenschrift, Jan. 15, 1872.
The physiological action of digitalis upon the circula-
tion has been subjected by Traube, as is well known, to
most searching and accurate investigation, and the chief
points established by a great number of experiments
beyond the shadow of doubt. Based on a short reca-
pitulation of the most essential results of his investiga-
tions, Traube formulises the theory of the physiological
action of digitalis on the circulation as follows:
Digitalis acts,
1. Exciting and in further course depressing on the
inhibitory nervous system.
2. Exciting and in further course depressing on the
vaSO-motor nervous system.
3. Depressing on the cardiac muscles.
Five years ago I made a tolerably long series of ex-
periments—with a defective kymographion, it is true—
on the effects of digitalis on dogs. Since the results of
these experiments agreed in all essential points with
Traube's and did not contain anything new of impor-
tance there was no justification for their publication.
Later experiments, however, undertaken with Sander-
wald's kymographion, made accurately after Traube's
description, have furnished further results, have led
Inore especially to a conclusion as to the connection
which seems to exist between the changes in the circu-
lation and the long known action of digitalis on animal
temperature.
1. Action on the Circulation.
Quite constantly is observed, immediately after the
injection of a large dose of digitalis (0.05) into the jug-
lar vein of the dog a diminution of the frequency of the
pulse which is always attended with an increase of the
individual pulse waves. Traube has already referred
this diminution of pulse frequency to an irritation of
the inhibitory nerves of the heart, without having been
able, however, to adduce any absolute proof for his view.
Retardation of the pulse ensues—as Traube himself con-
fesses—even where section of the vagi has been per-
formed before the digitalis has been administered, so that
Traube—in protection of his theory—was forced to the
belief that the retardation after division of the vagi was
effected from the peripheric extremities of the divided
nerve. That this view was correct is proven by means
of an agent which has the power of perfectly paralysing
the heart fibres of the vagus. Such a substance, as
Bezold has discovered, is atropine. If this substance be
injected in sufficient quantity (usually 0.010–0.015 suf.
fice) the pulse frequency is not at all retarded by
digitalis. - < ..
After this pulse retardation ensues, sometimes quite
suddenly, oftener gradually, an increase of pulse fre-
quency far above normal. This has been ascribed by
Traube, likewise correctly, to a paralysis of the vagi.
But it is only in part affected in this way; for this in-
crease in frequency is also observed when the vagi have
been perfectly paralyzed by the previous administration
of atropia. We must therefore conclude that this
frequency of the pulse under digitalis depends, besides
upon paralysis of the vagi, upon a stimulation of the
musculo-motor apparatus or the acceleratory nerves of
the heart. - *.
After this acceleration of pulse frequence follows,
then, quite frequently, yet not constantly, a second re-.
tardation usually associate with great irregularity.
This seems to depend upon a beginning paralysis of the
heart muscle, and, when it occurs, it usually passes away
suddenly into a complete arrest of the heart's action.
This arrest of the heart's activity which may ensue
upon the acceleration of the pulse, even, indeed, upon
the primary pulse retardation, is absolutely independent
of the action of digitatis upon the inhibitory nerves.
It seems to be favored by the direct contact of the drug
with the muscular substance of the heart and is with-
out doubt based on a paralysis of the musculo-motor
apparatus. Immediately upon its occurrence the heart
reacts no longer, as Stannius has long ago demonstrated,
to electric excitation. -
Regularly is observed, further, after the injection of
digitalin, an increase in the arterial pressure, usually
very marked. This phenomenon is entirely independent
of pulse frequency, as it may be present or absent with
every grade of frequency. It is caused, anyhow in part,
perhaps entirely, by vaso-motor excitation, for it is ob-
served in less degree where the cord in the region of
MAR. 30, 1872.]
TIEI IEH C T , T N T C .
147
the atlas has been previously divided. Whether it be
alone brought about by vaso-motor excitation or
whether the heart also does not take part in its produc-
tion could not hitherto be definitely determined.
This increase of pressure may pass, with every grade of
pulse frequency, into a diminution of pressure down to
or below the normal, in consequence, to great extent,
certainly, of paralysis of the heart muscle. In the
beginning of the primary retardation also, a diminution
of pressure below the normal may occur owing to the
fact that at the time of vagus excitation the vaso-motor
excitation is absent. The diminution of pressure, then,
is to be regarded as the direct consequence of vagus
irritation. -
As it is well known there are very often observed in
experiments in blood pressure regular, peculiar varia-
tions, much slower than the pulse, whose cause, accord-
ing to Hering's investigations, is to be sought in the con-
nection between respiration and cardiac action. These
variatioſis, which in antithesis to the primary pulse waves
may be denoted as secondary waves, are likewise retard-
ed by injections of digitalis and in the same relation as
the pulse, i.e., the number of the pulse waves following
a secondary wave remain the same before and after
retardation. -
2. Action on Temperature.
In my former investigations as to the effects of large
doses of digitalis upon animals I made a great number
of observations upon the temperature of the rectum in
the hope of discovering the connection between the
circulatory changes and the well known antipyretic
effect of digitalis. These attempts were utterly fruitless.
The reason of this failure, as I have since convinced
myself, was not because a reduction of temperature does
not follow after large doses of digitalis, but because, as
Heidenhain has already shown, the rectum is an un-
suitable place for the observation of temperature. It is
necessary to obtain the temperature of the blood in a
large blood vessel and I have lately made a number of
experiments in which I have observed the temperature
of the blood under the action of digitalis in the ascend-
ing cava by means of a Heidenhain thermometer.
These experiments have furnished positive results.
The temperature sinks with the increase and ascends
again with the diminution of pressure even above
the normal, beyond the pressure at the commencement.
So far as my experiments hitherto justify a conclusion it
seems that the loss of heat occurs most rapidly and
markedly when the pulse had been frequent and small
and the pressure low before the remedy was administered.
If, then, in consequence of the digitalis, a marked
retardation of the pulse occurs simultaneously with con-
siderable increase of pressure, the loss of heat is very
great. It is less when the pulse becomes frequent under
unchanged or even diminished pressure. These results,
however, need further experimental confirmation.
Heidenhain has already shown that the reason of the
temperature reduction in connection with increase of
arterial pressure depends, most probably, on an increased
rapidity of the motion of the blood in the capillaries.
This view does not by any means coincide with Weber's
theory of the motion of the blood ; for the greater the
difference in pressure between the arteries and veins
[i, e., the higher it is in the arteries] so much the more
rapidly must the blood pass from the arteries to the
veins. •
Traube, in his latest already mentioned communica-
tion, has attempted to explain the action of digitalis in
many heart affections by the physiological effects of this
agent upon the circulation. The effect of this drug, as
is well known, is most marked in insufficiencies and
stenoses of the left ostium venosum. Venous hyper-
‘aemiae with corresponding anaemia of the aortic system,
are natural to this condition and are, with their con-
sequences, diminished or allayed by a greater distension
of the aortic system with blood. Such a distension we
can induce by means of digitalis and when induced it
is mostly, perhaps solely, the effect of vaso-motor irrita-
tion. This causes increase of pressure in the arteries, a
more rapid motion of blood in the capillaries and diminu-
tion of the venous pressure. The consequence of all
this is that retreat of the transuded fluids into the
capillaries and veins so often a fact of clinical observa-
tion, a thinning of the blood and an increased secretion
of urine which is also immediately favored by the in-
creased pressure in the arteries. Traube has also dem-
onstrated that in consequence of this retardation of car-
diac contractions the nutrition of organs is favored.
The antipyretic action of digitalis finds a sufficient ex-
planation in the loss of heat connected with inerease of
pressure.
Finally, I have to mention with gratitude that my
honored colleague Prof. Aubert has favored me through-
out these investigations with his counsel and assistance.
–-nº-e-Qº---
SCIENTIFIC NOTES.
THE GERMS OE HEALTHY BLOOD.—The last number
of Stricker's Jahrb. contains an article “On the Presence
of Fungi in the Blood of Healthy Men,” by Adolph Lor-
storfer. Lorstorfer drew blood from the fingers of eleven
people who considered themselves in perfect health
with every precaution to avoid contamination with dirt,
and examined the specimens daily with a Hartnack
microscope, ocular 3, objective 10. During the first two
days he observed nothing remarkable, except in some
cases a few scattered groups of small granules. On the
third day similar groups were always found, though
still scattered. The granules were of equal size, consid-
erably larger that those of the colorless blood corpuscles,
but without any definite arrangement. On the fourth
day they had increased in size, and were arranged in
groups of four, so as to resemble the well known Sar-
cind ventriculi, On the fifth day the granules had slightly
148
[MAR, 30, 1872,
TIEI IE C T , I INTI C.
increased in number and size, but after this date no
change was observable up to the tenth day, when the
preparations became unserviceable. Lorstorfer thinks
his experiments render it probable that the germs of
Sarcina ventriculi exist in the blood as a natural condi-
tion.
THE ABUSE of ALcohol AND Tobacco As A CAUSE
OF AMBLYOPIA. By Dr. L. Hirschiller, of Pesth.—The
author appears to have had large experience among the
intemperate, and gives the following résumé of symp-
toms of amblyopia a potu : -
Objects appear as if under a veil, and this dimness
comes on suddenly. They are apt to swim and tremble;
persons faces seem to the patient to be bluish or yellow;
glistening, metallic surfaces are badly discriminated ;
only large print (Jaeger 14–20) can be read; at first it
seems clearer than it does after looking a short time;
objects soon grow hazy and utterly confused. Vision is
worst at mid-day, and best at twilight and by artificial
light.
To external inspection there is nothing abnormal, ex-
cept perhaps slight conjunctival catarrh. The pupil is
contractile, and is quite indisposed to expand. Visual
field is intact. Central Scotoma is rare. By the ophthal-
moscope the nerve may be normal, or slightly reddened,
or of a dirty gray; at the latter stages it may be white,
and indicate beginning atrophy. The amblyopia soon
reaches its maximum, and remains for a long time
unchanged. &
Amblyopia from tobacco differs little in symptoms
from the above. The proneness of the pupil to contract
is sometimes remarkable.
Amblyopia from other causes, as menstrual troubles or
rheumatic processes, etc., etc., may present precisely
similar symptoms. The pathology of the disease the
author is disposed to locate in the brain-tissue. For
treatment, the author relies on entire abstinence from
the use of alcohol and tobacco, and a general hygienic
method. Local depletion does little good. Attention
to digestion, exercise, and fresh air, are most essential.
—Archiv. für Oph., a vii., 1, 221.
———º-º-º--—
Experiments Demonstrating that the Hair of Man
may change rapidly from Black to White.
- BY
BROWN-SEQUARD.
From the Archives de Physiologie, May, 1860, p. 442.
It is still a question whether the hair of the head and
beard may change color rapidly, as many facts would
seem to show. It has even been affirmed that the change
from black to white may take place to greater or less
extent in the hair or beard in a manner almost suddenly.
I do not wish to discuss the question as to what faith
may be attached to the assertions, for the most part, of
persons of no scientific authority.* I propose only to re-
port some experience which leaves no doubt whatever
as to the possibility of a very rapid change of color in
the human hair. **
In the month of August I first observed the appear-
ance of a few white hairs in my beard in the midst of
both cheeks, anteriorly. The posterior portions had
already been sprinkled with white hairs for several years
but up to the period I am about to mention there had
been none upon the anterior part of the cheeks. On
awaking one morning I observed a few white hairs on
this anterior part where they had not before been seen.
I then conceived the idea of extirpating these hairs of
latest appearance (there were only five on one side and
seven on the other) to observe whether hairs of similar
color would reappear. I had not long to wait. In the
midst of the hairs of this part of my face, black or deep
brown in their entirelength and a few others white only
at the root, I found two days after the epilation men-
tioned three hairs on the right side and two on the left
white in their entire length.
The result of this experiment was not doubtful. But
in order to be more sure of the facts I had observed, I
repeated the experiment several times during the five or
six weeks following and on each occasion I had the
opportunity of observing the black hairs become white
in their whole length in from two to five days. I need
hardly say that the hairs commenced to whiten in the
neighborhood of their roots.
I was then in my ordinary condition of health and
was not under the influence of any mental disturbance.
Thus, without any appreciable cause other than that
incidental to a certain age there occurred in my case a
very rapid change of color from black to white in a
considerable number of hairs. So far as I could deter-
mine this change occurred, in every instance, in the
night. I made no microscopic examination of the
white hairs. •
These experiments leave no doubt whatever of the
possibility of a very rapid transformation (probably in
less than one night) of black into white hairs.
—-º-º-º--
MIEDICAL NEWS
AN INTERNATIONAL MEDICAL CONGRESS IN 1873.−
It is intended to hold an International Medical Congress
in Vienna in 1873, under the protectorate of the Arch-
duke Rainer. This will be the third assembly of the
kind; the first having been held in Paris in 1867, and
the second in Florence in 1869. The programme com-
prises several important subjects in public medicine;
viz., vaccination, quarantine (especially in cholera), the
regulation of prostitution, and the sanitation of large
towns. There will also be brought forward for discussion
*I would refer those who would learn existing knowledge on this
subject to the excellent treatise of my friend Charcot, published in 1861,
in the Gazette Hedomidaire, vol. viii p. 445. * * * * * ... . . . * ~ * ~ * *
MAR. 30, 1872.]
T EH. H. C. T.I. NI c.
149
proposals for an International Pharmacopoeia, and for
the establishment, as far as possible, of uniformity of
medical education in all countries, with consequent
reciprocity in the value of diplomas.
CONQUEST OF ALSACE.-The Germans who openly |
proclaim their universities as among the most effective
of their means of conquest, have made arrangements for
establishing an university at Strasbourg. An imperial
credit of 200,000 thalers will be opened for 1872; and to
this will of course be added the receipts from the
students and provincial subscriptions. It is intended
that there shall be forty-two ordinary and twenty extra-
ordinary professors in the university. Among the
ordinary professors are some names of European rep- |
utation; viz., Waldeyer (Anatomy); Hoppe-Seyler
(Physiological Chemistry); Von Recklinghausen (Path-
ological Anatomy); Schmiedeberg (Materia Medica);
Leyden (Medicine); Lücke (Surgery); Gusserow (Mid-
wifery); etc. It is openly proclaimed that the professors
appointed have accepted their perhaps not very enviable
posts as a patriotic duty. The organisation of the faculty
of medicine is not yet completed; but it is intended to
open the university at the commencement of next
sumnºr session.
“INDEx To PRICES” is responsible for the following.—
The demand for human hair is so great that it is im-
possible to supply it. Price has risen to 16s. a pound.
As much as 1,000 dols, has been offered for a “head of
hair” six feet long. Some ladies dress fifty to sixty
miles of hair every morning.
ST. PAUL AND ST. LUKE.-‘‘Honor a physician with
the honor due unto him for the uses which ye may have
of him; for of the Most High cometh healing, and he
shall receive honor of the king. The skill of the physi-
cian shall lift up his head, and in the sight of great men
he shall be admiration.”—In the new Lectionary, this
is the commencement of the evening lesson on the day
sacred to St. Luke, the evangelist and physician. But
the Lord Chamberlain is apparently of a different
opinion. . We counted about fifteen hundred clergy in
St. Paul’s cathedral at the public thanksgiving, some
hundreds of soldiers and lawyers, and about one dozen
invited members of the medical profession. There were
one hundred and four members of the London Board of
Works invited; but neither the Council of the College
of Surgeons, nor the General Council of Great Britain
and Ireland. Against the hundred and four tickets sent
to the Board of Works may be counted two sent to the
University of London, one to the College of Physicians,
and one to the College of Surgeons. In the official
statement by the Lord Chamberlain of the professions
represented, that of Medicine is not even mentioned.
Accipe dum dolet is a motto long ago recommended to the
profession by a shrewd observer. Lord Sydney gives a
new force to it, by excluding the profession from an
adequate representation on this occasion of public re-
joicing, to which they were not altogether foreign, and
in which their official representatives would not have
been misplaced.—Brit. Med. Journ., Mar. 2, 72.
American Medical Association.
*
The twenty-third Annual Session will be held in
Philadelphia, Pa., May, 1872, at 11 A. M. The follow-
ing Committees are expected to report:
On Cultivation of the Cinchona tree, Dr. Lemuel J.
Deal, Pennsylvania, Chairman.
On the Anatomy and Diseases of the Retina, Dr. R. F.
Mitchel, Alabama, Chairman.
On the Comparative Pathology and the Effects which
Diseases of Inferior Animals have upon the Human
System, Dr. Geo. Sutton, Indiana, Chairman.
On the Structure of the White Blood Corpuscles, Dr.
J. G. Richardson, Pa., Chairman.
On Vaccination, Dr. T. N. Wise, Kentucky, Chairman.
On Skin Transplantation, Dr. J. Ford Thompson, D.
C., Chairman.
. On the Nature and Process of the Restoration of Bone,
Dr. A. L. McArthur, Illinois, Chairman.
On Some Diseases peculiar to Colorado, Dr. John
Elsner, Colorado, Chairman.
On Correspondence with State Medical Societies, Dr.
N. S. Davis, Illinois, Chairman.
On National Health Council, Dr. Thomas M. Logan,
California, Chairman.
On Nomenclature of Diseases, Dr. Francis Gurney
Smith, Pa., Chairman.
On What, if any, Legislative means are Expedient and
Advisable, to Prevent the Spread of Contagious Diseases,
Dr. M. H. Henry, New York, Chairman.
On American Medical Necrology, Dr. J. D. Jackson,
Kentucky, Chairman.
On Medical Education, Dr. J. S. Weatherly, Alabama,
Chairman. 4-
On Medical Literature, Dr. Theoph. Parvin, Indiana,
Chairman.
On Prize Essays, Dr. Alfred Stille, Pa., Chairman.
On the Climatology and Epidemics of New Hamp-
shire, Dr. G. R. Crosby; Vermont, Dr. G. B. Bullard;
Massachusetts, Dr. E. Cutter; Rhode Island, Dr. Edw.
T. Caswell; Connecticut, Dr. J. C. Jackson; New York,
Dr. W. F. Thoms; New Jersey, Dr. E. W. Hunt; Penn-
sylvania, Dr. W. R. Wells; Maryland, Dr. C. H. Ohr;
Georgia, Dr. A. J. Semmes; Missouri, Dr. W. S. Edgar;
Alabama, Dr. R. F. Mitchel; Texas, Dr. S. M. Welsh;
Illinois, Dr. David Prinoe; Indiana, Dr. Dugan Clark;
District of Columbia, Dr. J. W. H. Lovejoy; Iowa, Dr.
J. Williamson; Michigan, Dr. S. H. Douglas; Ohio, Dr.
J. A. Murphy; California, Dr. F. W. Hatch; Tennessee,
Dr. W. K. Bowling; West Virginia, Dr. E. A. Hil-
dreth; Minnesota, Dr, Chas. N. Hewitt; Virginia, Dr.
A. G. Wortham; Delaware, Dr. L. B. Bush; Kansas,
Dr. Tiffin Sinks; Mississippi, Dr. J. P. Moore; Louisi-
ana, Dr. S. M. Bemiss; Wisconsin, Dr. J. K. Bartlett;
150
[MAR. 30, 1872.
-T H E C T.I. N. T. C.
Kentucky, Dr. L. P. Yandell, Sr.; Colorado, Dr. R.
G. Buckingham; Oregon, Dr. E. R, Fiske; North Car-|.
olina, Dr. J. F. Haywood; South Carolina, Dr. M.
Simmons.
Physicians desiring to present papers before the Asso-
ciation should observe the following rule: “Papers
appropriate to the several sections, in order to secure
consideration and action, must be sent to the Secretary
of the appropriate section at least one month before the
meeting which is to act upon them. It shall be the duty
of the Secretary to whom such papers are sent, to ex-
amine them with care, and, with the advice of the
Chairman of his Section, to determine the time and
order of their presentation, and give due notice of the
same.”
OFFICERS OF SECTIONS.—Chemistry and Materia
Medica.--Drs. R. E. Rogers, Philadelphia, Pa., Chair-
man; Ephraim Cutter, Boston, Mass., Secretary.
Practice of Medicine and Obstetrics.--Drs. D. A. O’Don-
nell, Baltimore, Md., Chairman; Benj. F. Dawson, New
York, N. Y., Secretary.
Surgery and Anatomy.—Drs. John T. Hodgen, St. Louis
Mo., Chairman ; W. F. Peck, Davenport, Iowa, Sec-
retary.
Medical Jurisprudence, Hygiene, and Physiology.—Drs.
S. C. Busey, Washington, D.C., Chairman; E. L. How-
ard, Baltimore, Md., Secretary.
Psychology.—Drs. Isaac Ray, Philadelphia, Pa., Chair-
man; John Curwen, Harrisburg, Pa., Secretary.
Secretaries of all medical organizations are requested
to forward lists of their Delegates, as soon as elected, to
the Permanent Secretary. Railroad and hotel arrange-
ments will be announced at an early date.
Address W. B. Atkinson, Permanent Secretary, 1,400
Pine Street Southwest corner Broad, Philadelphia.
—sº-º-º-
Bogus Medical Colleges.
REPEAL OF THE CHARTERs of the Philadelphia
University of Medicine and Surgery and Eclectic Med-
ical College of Philadelphia.-The unblushing effrontery
with which Paine, of the Ninth Street concern, and
Buchanan, Hylton & Bissell, of the Pine-Street shop,
have conducted their nefarious business has at last re-
ceived a permanent quietus by the joint action of the
Senate and Assembly of Pennsylvania.
In November last the Herald and general press made
a combined attack on the nuisance, and the sweeping
erpose then made reached even the ears of the law-
makers at Harrisburg, and an investigation was at once
ordered. The Committee of the Senate had one or two
sessions here and others in Harrisburg, and, so over-
whelming was the evidence against these individuals,
that the Senate on hearing the report of the Committee,
voted unanimously to repeal their charters. Senator
Bandall, Chairman of the Committee, was satisfied
from the first that the .. made by the press were
genuine, yet he gave the professors (?) every opportunity
to prove their innocence.
Death of a Well Known Physician. :
NORTH LEWISBURG, CHAMPAIGN Co., O., Mar. 26,-
Dr. H. C. Foster of this place, who was thrown from
his buggy several weeks ago and suffered a broken leg
just one inch below the hip, died from his injuries this
morning.
A strange feature of this case is, that after he found
he could not get well, he telegraphed for his brother to
come and see him, who immediately started, but taking
the ill-fated train on the Pan-handle road, which was
thrown from the track near Altoona, Pennsylvania, last
Friday, he also received a broken leg similar to that of
the Doctor’s.
THE SYPHILIs CoMMITTEE.—The committe appointed
by the Vienna Medical Society to examine and report
on Dr. Lostorfer's researches on syphilitic blood has been
dissolved, the members nominated having declined to
accept the duty assigned to them.
—-º-o-º-
CORRESPONIDENCE.
NASHVILLE, IND., March 18tlı, 1872.
EDS. CLINIC : : -
I submit herewith a brief report of a case of foetal
deformity that has come under my notice since my
return from your city.
It is not the peculiarity of deformity that has arrested
my attention so much, as we find almost every grade
of deformity mentioned in our literature upon this
subject, but it is the cause, which appears most certainly
to have produced it in this case; one that I have not
seen alluded to in any medical work, nor heard men-
tioned as being productive of this particular type of
malformation.
Mrs. H., American aged 23, medium stature, was
delivered unaided of her third child, a female, on the
6th inst., after a somewhat tedious and severe labor,
Dr. J. S. Arwine of Columbus, Ind., attending her.
The child was well formed in every way as far as could
be observed except that the parietal bones, occipital
bone and frontal bone, were but partially developed.
The bones forming the nose were almost entirely want-
ing; a small tubercular eminence representing the
point of the nose, pierced on either side by exceedingly
small openings, the external nasal orifices. The eyes
appeared to be well developed, but the lids coalesced so
they could not be separated without surgical interfer-
ence. The bridge of the nose was depressed below the
level of the eyes. - 1 *
This case occurring in the family where I had been
making my home, I was immediately shown the child
which was still alive, and presented the deformities
above alluded to. It was deeply cyanosed, respiration
being quite feeble and irregular. It made frequent
attempts to cry, but seemed unable to utter an audible
sound. I was informed by the nurse that it had only
made similar efforts since its birth. I administered
some milk and water prepared for the purpose, a small
‘MAR. 30, 1872.]
TIEEI IEL, C T , I INTI C.
1.51
quantity of which it swallowed with great difficulty.
Respiration was almost entirely performed by the mouth
in consequence of the minuteness of the nasal orifices. |.
It lingered about three hours after my arrival when it
was attacked with a light convulsion and expired.
The child’s head presented the evidences of a con-
striction by a substance corresponding in size to an or-
dinary umbilical cord. I wrote to Dr. Arwine in ref.
erence to the condition of the child at birth and received
the following reply: “The child was wound up in the
cord in the following manner. The funis passed around
the right side of the child, under the left axilla and
twice around the neck, and I am fully convinced by its
shortness interfered very materially with the expulsive
efforts of labor and protracted the case very much. My
opinion is that the cord was originally around the head
and was forced from its imbedded position during the
progress of labor down around the neck. The cord
constricted the head, I think, and arrested the full de-
velopment of the particular bones misshapen or absent,
and occasioned the deformity in question.”
I may state that Dr. Arwine is an old practitioner of
undoubted ability, a graduate of the Medical College of
Ohio in ’52 or ’53 and a reliable man in every respect.
Now we have as a proof of the cord having been the
prime cause of the deformity, a hollow depression ex-
tending around the occipital bone about the region of
the superior curved line, also an indenture in the mid-
dle of the helix of each ear, a depression at the external
margin of each orbit and the obliteration of the bridge
of the nose ; a line corresponding, thus, quite well to a
circle drawn around the head in those regions. These
furrows bore evidence of having been produced by a
cord of the size of the navel-string. Beneath and above
this apparent constriction was the want of development
spoken of The integument was perfect and there was
a sufficient growth of hair over the scalp. Is it not
very probable that in this case the cord was looped
about the foetal head during the early months of gesta-
tion, and as the development progressed the cord became
constricted about the head, produced these marks, de-
pressed the nose, caused the adhesion of the eyelids, and
by the constriction arrested the nutrition and develop-
ment of the parts found absent.
I attended this lady in her two former confinements,
both the children were males, Small but well formed.
The labors were short and characterized by less pain
than is the rule. I would like to have the opinion of
THE CLINIC upon this matter.
Yours, etc.,
J. W. Duncan, M. D.
There is no ground for any other theory in explana-
tion. It certainly was not an anencephalic foetus for
mention is made of the presence of the scalp in situ.
The furrow and agenesis of bones described, might have
been produced, it is true, by a false band from the
membranes which escaped observation, but as it is ex-
pressly stated that the cord was exceedingly anomalous
in its course the view expressed is far more plausible.
From any of the works of reference at hand we do not
discover an exactly similar case. A case of absence of
the frontal bone and superciliary arch is reported in the
Revue Méd. vol. xi, p. 146, 1821. It was a case, how-
ever, in which the placenta was adherent to the scalp.
The following extracts elucidate other points of
interest in the case:
The usual length of the cord is about that of the
foetus 18–20 in. It is far oftener longer than the
normal than shorter. Baudelocque mentions a length of
58 in. ; Morlame of 60; L'Heritier and Schneider have
reported a length of over 9 feet! (3 mêtres).” This
excess of length favors (1) the accident of twisting of
the cord around the neck or limbs of the child; (2) the
formation of knots; (3) prolapse of the cord. All these
may become causes of dystocia. (1) The encircling of
the neck, which is by far the most frequent form, was
formerly thought to have been due to active motions of
the child. Sieboldt attributed it to the fact that the
arm left the body and carried the cord with it. Simp-
son, having noticed that the circles generally passed
over the right shoulder towards the left, attributed the
cause to a greater force of the right umbilical artery;
this was strengthed by a future observation, in which
the cord passed from the left shoulder towards the
right, when an opposite version was also found in the
cord. Generally the cord forms but one circle.
Schneider has seen 6; Baudelocque, 7; Credé, 8; and
Gray, 9.
They occur, too, more frequently than is generally
supposed; thus Devilliers has observed them 3 times in
a hundred cases, Churchill between 9 and 10. Weid-
man's proportion ran 123 to 100; Verrier, 18.3; Mayer,
19; and Beale, 20, in the same number. Walcher con-
sidered that it was only in the rarest case that they
proved dangerous to the life of the foetus, because the
placental insertion of the cord descended with each con-
traction of the uterus. Veit has shown, however, that
partial and total asphyxia not infrequently results from
constriction of the trachea. “The infant literally com-
mits suicide,” says Monro. Gardien was the first to
prove that death is induced more frequently by the
interruption of the circulation. Velpeau is scarcely
disposed to admit this, but Monod, Taxil, and Hillairet
have placed it beyond doubt, by showing that the neck
may be so compressed as to leave deep grooves upon its
surface; in the case of Taxil, the neck was reduced to
4 millimetres (?) in thickness. In these cases death
occurs, of course, before labor; in the rule, however,
death only supervenes in labor when the grasp of the
halter is tightened.
* Manuel, Pratique De L’Art des Accouchements.
1867.
f Siebold, De Circumvolutione Funiculi Umbilicalis.
1834.
I Klob (Path. Anat.).
Verrier, Paris,
Göttlingen,
152
[MAR. 30, 1872.
T EC H C T I IN TC.
The cord may encircle the neck or limbs, moreover,
when its length is perfectly normal, or even shorter than
normal; thus, Spaeth observed the cervical circle once
in a cord measuring but 13% in, length.
That the cord, when entwined about the limbs of a
child, may amputate the limb, is a fact with which we
have long since been made acquainted by Montgomery,
who has reported a number of interesting cases in the
essay on “Spontaneous Amputation in Utero.” Schwabe
has also reported a case of amputation of the leg of an
embryo of three months just above the ankle-joint.
Braun thinks this impossible, as death would result
sooner by obliteration of the calibre of the vessels in the
cord, whereupon Klob pertinently remarks that it is
questionable whether even the pulsation of the cord
might not be sufficient to divide the delicate structures
of an embryo at this period.
Finally, cases are not wanting in which the cord has
passed down between the limbs, traversed the length of
the back, and then encircled the neck.
Streeter* has demonstrated that many cases of pre-
ternatural presentation may arise from abnormal length
of the cord, particularly when twisted about the neck
or limbs.
—sº-C-º-
C. L. (NICAL VIEN (OIRAN IDA.
SUB-CUTANEOUS ASPIRATION IN STRANGULATED
HERNIA.—To the facts pertaining to this subject which
we have already registered we add the following taken
from the inaugural dissertation of M. Dr. Autun. It
adds additional lustre to the happy results already ob-
tained by the instrument of Dieulafoy.
Some time ago Dr. Dugue, physician at Mans wrote
to M. Collin (Charrière) that in a case of strangulated
hernia Dieulafoy's aspirator had furnished remarkable
results.
The facts, as related, are as follows: My confrère and
friend Dr. Bourdy came a few days ago to take me to
assist him in an operation for strangulated hernia which
he was about to perform on a woman in the suburbs of
Mans.
It was a case of left inguinal hernia, strangulated for
four days. It was an enterocele. The intestine greatly
distended and resistant contained gas and fluid. Before
operating we wished to try the aspirator. The needle
(No. 1) being plunged into the intestine, the body of
the pump very rapidly filled itself with gas and liquid
and the tumor subsided very rapidly, becoming soft and
flaccid. We believed then that the reduction would be
easily effected ; this was unfortunately not the case, the
hernia remained adherent. M. Bourdy proceeded to
operate immediately. The intestine having been
exposed, it was impossible to find the point of puncture
and during the operation and at the moment of reduc-
tion there escaped from the intestine neither a drop of
liquid nor a bubble of gas. The adhesions having been
*w- ºr ~ *
* Lee's Midwifery, p. 122.
broken up, the intestine was returned with the greatest
facility. Some hours after the operation, under the
influence of a purgative (30 grim. ol. ricini) fecal dis-
charge was reestablished, and on the next morning we
found our patient in the most Satisfactory condition.
There was no fever, pain nor cramp, the abdomen was
flaccid and supple. This fact, although the success was
incomplete on account of adhesions, would seem to
demonstrate conclusively the impunity with which the
intestine may be punctured and the absence of all
danger in reduction after this puncture—These de
Paris–Bull. Therap., Jan. 30, 72.
—-º-º-º-
Aethylidenchloride.
BY
A STEFFEN, (Stettin).
From the Berliner Klinische Wocheuschrift, Feb. 5, 1872.
At the congress of German physicians and physicists
held at Rostock in September last the wish was ex-
pressed that I should publish my experience with
athylidenchloride in the children's hospital at Stettin.
I do this now the more readily because the employment
of this agent seems to me to have been hitherto very
limited. -
We have used the remedy during the past few months
Some twenty times in children and once in the adult.
Its inhalation is effected just as simply as the inhalation
of chloroform. Since aethylidenchloride has a pleasanter
and milder odor than chloroform and does not irritate
the skin to the same degree, children resist it much less,
older children almost not at all. To attain the most
rapid effect, as much as possible must be inhaled in the
beginning.
Its effect is as follows: Children are rendered perfectly
unconscious in two, at most in three minutes. On two
occasions in which I cut through a number of lupus
facei papules there occurred no loss of consciousness but
there was perfect anaesthesia in the diseased parts so
that the sections were entirely void of pain. If the
patients are not restless before inhalation no accelera-
tion of the heart's action manifests, and as little is
respiration affected. Patients present the appearance
of a quiet sleep. The effect of aethylidenchloride is of
shorter duration than that of chloroform. In operations,
therefore, requiring considerable time, the anaesthetic
must be reinhaled as soon as signs of consciousness
manifest. In childhood, for operations of short duration
an average of three or four grammes [45-60 grs.] is fully
sufficient. In the case of a woman, on the other hand,
operated on for carcinoma mammae by a physician of
this city, where the extirpation could not be effected at
once but only in piece-meal manner, about thirty
grammes were employed.
MAR. 30, 1872.]
T IEET THE C T , T INTI C.
153
So soon as the effect of the agent subsides the patient
recovers rapidly without experiencing any inconve-
niences whatever. Children, in the rule, as soon as
they recover consciousness call for their dinner. In
adults also all effects disappear quickly and without any
inconvenient consequences. Vomiting during or after
inhalation occurs in children only in exceptional cases.
If we compare the action of aethylidenchloride and
chloroform we must admit that the former is to be pre-
ferred on account of its prompt effect, further, because
it seems to be less dangerous as the heart's action and
respiration are not influenced, both of which are
decidedly, often dangerously, affected by chloroform.
Finally, aethylidenchloride deserves the preference
because patients recover from it so speedily and without
subsequent disagreeable sequelae. The objection that
aethylidenchloride is more evanescent in its action is
overcome by the more frequent repetition or the longer
continuance of its inhalation. An essential objection
to it at present is its high price. This, it is to be hoped,
will soon alter itself. -
With this experience, I do not hesitate to give
aethylidenchloride the decided preference over chloro-
form and to recommend its use most warmly.
—-º-e—sº-
Intermittent Blepharospasm.
BY
DR. A. SEELIGMULLER (Halle).
From the IClinische Monatsbl. f. Augenkeilkrande, Aug. Ó Sept., 1871.
(Schmidt's Jahrb., Feb. 4th, 1872).
We make an abstract of the following case on account
of its rarity, as a contribution to nerve pathology of
such extraordinary interest.
A countrywoman, aged 57, suffered for 30 years from
a peculiar spasm of the lid. During her time of service
she suffered many times from rheumatic tooth-ache by
which the most of her teeth had dropped out. During
such an attack she spent a night in a cold room so she
was obliged to be taken home stiff and paralysed.
The cold disappeared after sweating, but soon after at
times in sewing and knitting dimness of vision came on
which imperceptibly became changed into a convulsive
spasm of the lids.
Different therapeutic measures were resorted to, among
others, division of both supraorbital nerves, without
effect.
Pregnancy, etc., had produced no change. During
the climacteric period other nervous troubles had come
and gone.
Pure hysterical attacks, however, were never present.
Periodic spasm of the lids appeared as follows; some-
times the lids involuntarily closed two or three times
an hour, sometimes as high as ten times, and remained
closed one or two minutes without the patient being
able to open them without the help of the hand.
If the lids were forcibly opened there was violent
gasping or drawing back of the head by jerks. The
spasm came on especially when the patient looked
down, on turning the head, chewing solid food, walking
or reading, working in a bent position, deep thinking,
listening to frightful stories, even from loud talking in
the room. It came on oftener if the patient carried
anything in both hands than if one was free.
Objective examination gave, beyond numerous wrink-
les in the skin about the eye, no disease of the lids or
eyes.
At the height of the attacks the physicians in attend-
ance were unable to open the lids perceptibly. The
rest of the senses were normal, excepting the sense of
Smell which had been lost for two years. From examina-
tions made from time to time by various physicians dif-
ferent pressure points were revealed, which were painful
on the slightest pressure, on an irritation of which
the lids immediately came open, like the lid of a box
by pressure on its spring. These points were the back
teeth of the lower jaw; both supra-orbital notches; both
parietal protubrances especially the left; the temporal
ridge itself, the transyerse process of the upper cervical
Vertebra especially the left; the upper sympathetic cer-
vical ganglion ; the brachial plexuses above the clavicle
and the spinous processes from the 1–8 dorsal vertebrae.
Strong pressure upon the radial and ulnar processes at
wrist joint produced no pain but gradual opening of
lids. Other points, painful on pressure in healthy per-
Sons, e. g., the sternum, the skin over the shin, had no
effect on the spasm of the lids. The patient was experi-
mentally subjected to treatment by electricity.
The negative pole of 6 or 8 elements was placed upon
the breast, the positive upon the above named pressure
points. The result of the first sitting was favorable.
Not only did the susceptibility to pain in the pressure
points disappear, but also the spasm of the lids became
much more seldom so the patient could read a long
time, which was formerly impossible. A complete cure,
however, was not effected, as the trouble returned in its
former severity after the treatment.
Cutting the gums about the teeth had already been
done in Berlin without effect, and was not again resorted
to. Prof. Arlt in his book has recorded four cases of
this extraordinary disease, Wrecker and Mackenzie
each one.
Handfield Jones of London, (Studies on Functional
Disorders) mentions a similar case. A very peculiar case
of the same nature is given by Broadburt (Med. Times
and Gaz.), where the patient’s head was drawn back
and the lids were closed when he talked, the patient
being free from attacks so long as he kept quiet. Alfred
Graefe also saw a case in his clinic in Halle. In none
of these cases was there the so-called hysterical or ner-
vous temperament. This periodic spasm of the lids is
not to be confounded with the continuous spasm gener-
ally to be relieved by division of the supra-orbital nerve.
154
[MAR. 30, 1872.
T EI IEH C T , T: N T C .
Preputial Calculi.”
BY
J. G. KERR, M. D.
Canton, China,
Phymosis is not an uncommon deformity among the
Chinese, and it is, of course, only in cases where this
abnormal condition existed that preputial calculi could
form.
The cases included in this table were operated on in
the Medical Missionary Society’s Hospital in Canton,
and I need but refer to the simplicity and entire free-
dom from danger of the operation, required for the
relief of these cases, to show how utterly destitute of
surgical skill the physicians of the oldest nation on
the earth are, and how much need there is of giving
them the knowledge and appliances of western science
and art.
A reference to the table will show that in every case
except one the calculi were multiple. In two cases the
number exceeded one hundred ; in one there were
forty, and in three others there were between twenty
and thirty. In one or two cases the calculi were
uniform in size and shape, but, in most of those where
they were numerous, there were a few large and many
small ones. Some had smooth, even surfaces, while
others were angular, with facets.
The most remarkable of the cases was No. 7, operated
on in 1862. The patient was thirty-eight years old.
The prepuce was much thickened and enlarged, and the
presence of calculi was easily discovered by a probe.
A crucial incision was made in order to remove the
stones, and the superfluous thickened skin was removed
by circumcision. The calculi were two in number, and
the weight one ounce and a quarter. The diameters of
one were one and five-eighth by one and one-eighth
inch. It had two concave facets, on opposite sides.
One facet which received the second stone was smooth
and polished. The concave facet on the other side was
precisely like the first, except that it was slightly
roughened by recent deposit. The second stone was
one and a half inch in diameter, and was almost a per-
fect double convex lens in shape. One of its sides,
where it rested on the other stone, was worn quite
smooth, and it had evidently been shifted from one
side of the first stone to the other, thus maintaining the
completeness of the two concave facets. The calculi
from case No. 2 are in the possession of Prof. S. D. Gross,
of Jefferson Medical College, Philadelphia.
I will add an account of two more cases, not included
in the table, because neither of them is strictly either
preputial, urethral, or urinary calculus:
Yip Akwong, aged twenty-one, was admitted into
the Medical Missionary Society's Hospital, July 27,
1867 (then in charge of F. Wong, M. D.,) with an accu-
* From the N. Y. Med. Joura., Mar., '72.
mulation of calculi, in a sac half the size of a walnut,
on the underside of the penis, about its middle, and
communicating by a small opening with the urethra.
It had existed since his childhood, but had given rise
to no difficulty in passing water until recently. The
sac was laid open by a free incision, and a large number
of calculi removed. They were of various sizes, whitish,
Smooth, and shining. Four of them were about the
size of a pigeons'-eggs, with irregular surface and angles.
Six were smaller, oval in shape, and angular. There
were two hundred and eighty-one small pieces, varying -
in size from that of a pea to a millet seed. Total num-
ber, two hundred and ninety-one.
The other case is, strictly speaking, one of lithotomy,
but the stone was in an unusual situation:
A patient, aged fifty years, from Hoi-ping District,
was admitted with stricture of long standing and urinary
fistulas, which he persistently asserted had existed only
about one year, but the appearance of the parts indicated
a much longer duration. On probing the fistulas, a .
stone was discovered, located on the right side of the
contracted scrotum, near the groin. The fistula was
enlarged toward the perinaeum, and the stone extracted.
It weighed two and a half drachms, and its diameters
measured one and a half by three-quarters of an inch.
Its appearance indicated that it was composed of uric.
acid.
Cases of Preputial Calculi.


No. of Age | Date of No. of Weight. IREMARKS.
Case, years. Operation | Calculi
Oz. I dr. Sc.
1. 58 1856 2
2 { { 103 2 All smooth.
3 .. 24 2 I. Smooth and angular.
g -
# | | | | | | | | *%
6 63 1860 40 1 || 2 ||Uniform in size, shape.
7 38 1862 2" | 1 || 2 || 2 |One had two facets in
* which the other (being
double convex) fitted.
8 47 { { 4
9 1863 6 1
10 & 4 6
II. 1866 4 Surface rough.
I2 72 1867 116 1. { { & C
I3 42 1869 6 1 || 1
14 56 1871 5 Also had stone in bladder
15 8 & & 22 T 6 (; € $
I6 39 { { 28 11.
17 | 75 { { 2 §
18 39 § { 11. 2 3 large and 8 small.
ACUTE SPASM OF ACCOMMODATION, ACCOMPANIED
BY SPASMODIC NEUROSIS OF THE FACIAL NERVE.-
An anaemic girl aged 11 who had been much engaged in
sewing, was attacked with photophobia and continuous
spasm of the upper half of the left side of the face.
Beyond a somewhat narrowed pupil there was nothing
to be observed in the diseased eye. The lids could only
be slowly opened when the sound eye was closed.
The left globe was painful on pressure, could not fix,
objects seemed enlarged.
Accommodation was only possible between 5% inches
and 7 inches. The right eye was hypermetropic 1-24,
left 1-13.
MAR. 30, 1872.]
T H. H. C.I., ITNTI c.
155
Instillation of atropia produced an improvement in a
few days. -
Iodine and morphine were used endermically, in-
ternally iron with quinine and valerian. In six days
there was a relapse. Later a blister was applied and
the atropine solution continued for four-weeks.
A cure was brought about and the patient could work
again with the aid of convex glasses No. 24.—Dr. Gos-
Sctti—Ann, d'Oculistique, Mar. Avril., 1872.
—º-º-º-ºm-
&
Alcohol at Different Periods of Life.
BY
LIONEL S. BEALE, M. D., F. R. S.
My conclusions as regards giving alcohol to the young
are in the main not at variance with the opinions of
those who advocate extreme temperance. My own ex-
perience leads me to believe that the majority of young
healthy people would do well without alcohol, and I
believe the habitual daily consumption by young persons
—even of a moderate quantity—of wine or beer, is quite
unnecessary, and mere waste, while in some instances it
is positively injurious to health. At the same time,
there can be no doubt that in certain cases where the
health fails in children, and even in infants, great benefit
results from giving small quantities of wine daily for a
short time. Hard-working people, students, professional
men, and people actively engagéd have been advised to
take stimulants, as a general rule—and some, no doubt,
require them; but I believe many would enjoy very
good health without any alcohol at all, while the recom-
mendation that they should take plenty of claret or
other light wine is bad advice for several reasons. Not
only is a bottle of light wine not required, but in many
cases it is actually injurious. That people who can get
it will often take a bottle of light wine, and more, is
quite certain; but that they require it, or that it is good
for their health, will not bear discussion.
Up to the age of 40 very little stimulant is, as a gen-
eral rule, really desirable for healthy persons, and I ex-
pect most people of average health would get on better
without any. My own personal experience is this:–I
was never very strong, though always able to get through
a very considerable amount of physical exertion without
suffering from fatigue. Up to the age of 40 I hardly
ever touched stimulants of any kind, and when I did
take a little I not unfrequently experienced an attack
of sick headache before my ordinary condition of health
was restored. Lately, however, I have found the ad-
vantage of half a tumbler of ale daily; and I can bear
half an ounce, and sometimes three or four ounces, of
wine without suffering. I dare say, as I grow older, I
may, like most persons, require a little more; but when
in the country, and taking plenty of exercise, I feel very
well and contented without any stimulants whatever.
The experience of some members of my family who have
lived to be old, and that of many persons of whom I
have inquired, accords with my own. In old age, I be-
lieve, stimulants are really necessary, and sometimes
are even more important than food itself. I feel sure
the life of many old people is prolonged by the judicious
use of alcohol, and I think that some, who have been
very careful all through life, take far too little stimulant
when they grow old—Times and Gaz, Mar, 2, '72.
--º-º-º: ==Cº-O-º-
JBIOMIE NEWS.
I S R A E L S. ID O D G E , MI.
ID .
Born Oct. 6, 1807. Died Mar. 1, 1872.
When death takes from our midst one of our oldest
and best known associates, “it is very meet, right, and
our bounden duty” to pay a tribute of respect to his
memory. Especially is it So, when as now in the death
of HDr. Dodge, we mourn a personal friend and one sus-
taining to us important official relations. More than
forty years ago Dr. Dodge came from his early home
near Marietta to attend lectures in the Medical Col-
lege of Ohio. When the cholera broke out in 1832-3, the
Dr. though an undergraduate commenced practice,
being urged to do so by the necessities of the time and
the advice of his friend and preceptor Dr. Drake.
Graduating in 1834 he selected Cincinnati as the field
of his life-work and from that time till his death was a
patient hard-working physician, up early and down late,
doing with all his might what he had to do, interrupting
his labors only when by ill health compelled to do so.
His judgment was good, his reading extensive, his prac-
tice honest and successful. His memory will be long
cherished, not so much because of professional knowl-
edge and skill as on account of his kindliness of heart
and readiness to help by deeds rather than words. He
was in an unusual degree the friend of the poor, and in
a forty years professional life spent many a day and
many a night caring for those who could make him no
pecuniary return. He knew the weaknesses of human
nature and was ready to make excuses for those whom
others censured. Personally, I never knew a man more
free from “envy, hatred, malice and all uncharitableness”
To the Medical College of Ohio he was a constant firm
friend, even in days when many turned against the In-
stitution that had nurtured and developed them. Time
and again have I heard him speak of the dark days, the
crises through which the College has passed, when her
strongest defenders hardly dared hope that she would
struggle through and beat down the opposition of ene-
mies within and enemies without. He most heartily
rejoiced in the successes of her present and the hopeful-
ness of her future, and grew enthusiastic as he remem-
bered the glories shed upon her and the profession at
large by her long list, from Drake to Blackman, of

156
[MAR. 30, 1872.
T E H C T, ITN I C.
&
eminent Professors now deceased. In the discharge of
his duties as Trustee he had no individual ends to
subserve, no personal animosities to gratify. Whatever
measure seemed to be for the best interests of the College
was sure to have his hearty support, and knowing him
as I did, I know that his official errors, if there were
such, were sins of the head and not of the heart.
His death though sudden was not unexpected, for
there had been apparent to his medical friends for very
many months a progressive impairment of nervous
power that taken in connection with evident arterial
degenerations could be interpreted in but one way.
Within a few months on at least four different occasions
the Dr. had attacks, that in their loss of consciousness,
facial and lingual paralysis, intense cephalalgia. etc.,
gave warning of the ultimate result. His last illness
was of less than twenty-four hours duration. The good
physician, the faithful friend, the honest man, the
devout Christian “rests from his labors and his works do
follow him.” - P. S. C. .
The following preamble and resolutions presented by
the committee appointed at the last meeting of the
Academy of Medicine were adopted on perusal,
“ WHEREAs, Death, has so often approached our
ranks in the selection of victims, that his presence has
almost ceased to be appalling. To-day he may claim one
whose industry, energy, attainments and aspiration have
given promise of an early opening into full manhood;
to-morrow he may select another, who, in advanced age,
had reached the summit of his ambition and usefulness;
and
“Whereas, Our familiarity with human weakness and
its suffering, and man’s earthly destiny, does not allay
our regrets when one dies who, for many long years, had
sustained an honorable and praisewothy relation to the
profession; and by his tenderness, attention and symp-
athy had secured the confidence and affections of his
patients; and
“Whereas, It has become our duty to reiterate that
Dr. Israel Dodge is dead, and to say in the sincerity of
our hearts that we shall miss his presence here, that we
shall miss him in our Social gatherings, in our anxious
consultations, in our efforts to mitigate disease and
prolong life; therefore
“Resolved, That as we held him in high esteem dur-
ing life, so will we cherish a recollection of his useful-
ness and goodness although dead.
“Resolved, That his devotion to the profession, his
freedom from guile, his conciliatory disposition and
the tenderness and frankness of his naturé are worthy
our constant imitation.
“Resolved, That we tender the family and friends of
our deceased brother our heartfelt sympathies.”
After the report and resolutions were read, Dr.
Carson was called upon and said that he was called to
see Dr. Dodge upon the day of his attack. He
ascertained that at 2 P. M. of that day, the doctor
while dressing, suddenly fell back unconscious, remain-
ing in that condition about twenty minutes. When
he recovered consciousness he complained of much pain
in the forepart of his head and was found to be hemiple-
gic in the left side. He remained conscious for 2 or 3
hours when he again became comatose and continued so
until his death, which occurred at 5 A. M. the follow-
ing day. gs
The autopsy was made 30 hours after death—on re-
moving the Scalp a considerable extravasation of blood
was found beneath it, probably occasioned by his fall.
On removing the calvarium a large extravasation of
blood was found between it and the meninges. The
membranes were quite firmly attached in places to the
superior portion of the skull. The basilar arteries were
found degenerated, especially that of the right side.
A large cavity was found in the anterior part of the
right hemisphere, filled with blood; the extravasation
exerting pressure upon the corpus striatum. On the
walls of the cavity was found a small artery, ruptured,
from whence the extravasation came. There was some
softening of the right hemisphere. No old clots found.
The examination of the liver was of especial interest in
view Óf the fact. that the doctor had suffered a number
of years ago from hepatic abscess, which had discharged
into the lung.
On opening the abdomen the liver was found firmly
adherent to all the surrounding structures by old
adhesions. The gall bladder was so firmly attached to
the duodenum, that it was torn off in removing the
liver, though but slight force was used. The substance
of the liver was a little soft but otherwise healthy.
There were no cicatrices in it, and none in the diaphragm
or lung. -
The speaker stated that he had seen two cases of
hepatic abscess before in which there were no cicatrices :
in the liver on post mortem examination.
* CINCINNATI, Mar. 24, '72.
EDS. CLINIC : k
I have asked some of the members of the Academy
if they would object to my giving a weekly abstract of
the proceedings for publication in THE CLINIC. They
do not wish to have their remarks in print until after
the minutes have been read at the Academy and cor-
rected if need be. This explains why I have not left a
copy with you. If I do as you request my course will
certainly be severely criticised.
Yours Truly,
L. Wolfe, Sec. Academy.
The above note explains itself. We have often been
solicited by members of the Academy to publish just
such an abstract as the Secretary cheerfully promised
to furnish. “Several members object to the publication
of their remarks until they are read before the Academy
and corrected.” This would give us the minutes of the
Academy just two weeks after date. In the days when
canal boats and post chaises were our only means of ob-
taining information, we might have been content to fill
the pages of THE CLINIC with the stale news of a dis-
tant city at this interval. As we can readily report the
proceedings of the Academies of Paris, London, Berlin,
Vienna or St. Petersburg—do it, indeed, all the time—
at this interval, we shall hardly inflict upon that portion
of the profession which prefers a weekly paper to a
monthly or quarterly in order to keep themselves posted,
the remarks made right here where our paper is published,
a fortnight after date. If THE CLINIC, then, continues
to present to its readers the proceedings of the medical
societies of Europe and Asia in lieu of those of Cincin-
nati, they will understand and appreciate the chief rea-
son for its course.

DIVIDED MEDICINES,
PREPARED BY
Divided Medicine Com'y,
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEw AND ExCEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general. -
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MoR.E. - - -
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities.
But not only SoluRLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINEs. . -
This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; : *, *, *, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of prepaiing medicines. -
Besides the peculiarity of THESE MEDIGINES, that they are NOT LIABLE TO SPori, BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For Samples, Price Lists, and Agencies, address +.
The IDivide º -
- - IECDX 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O. -
MR. FREDERICK KRAUS: CINCINNAT1, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: -
SULPH:MORPHII.......................}6 grain in each square. I ARSEN:ACID.......................... 1-20 grain in each square.
“ CH IN INI ....................... 1 * * * * * * CALOMEL.............................. 34 “ “ $ 4
& 6 COPPER ....................... .3% § { -
- - - ResPECTFULLY YoUBs,
E. S. WAYNE, Analytic Chemist.



||||||}|| || ||M||
Fosºrrºrt's
167 EAST 34TH-ST., NEW YORK,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANUFACTURERS OF PORTABLE -
ELECTRO-MAGNETIC MACHINES,
Portable Galwanic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871. -
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
|M|| ||||||—|| |||||}
PEERMAN ENT BATTERIEs,
For Hospitals and General Practitioners,
ELECTROIDEs.
For Eye, Ear, Larynx, Nose, Uterus, Wagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Eleo-
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
EXTRA (4TS FROM THE OPINIONS OF THE TWOST
JEMIN ENT MEMBERS OF THIS PROFESS / O N.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “No THING CAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.” -
We are authorized by Prof. Hammond to announce eun-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
* MEREDITH CLYMER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider their
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:—“In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. GARR, ATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;
ALLEN MAYNARD, M. D., Cleveland, 0.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOIIN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
m|ritia
Are furnished to Officers and Soldiers on Government
account. -
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I’
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb—why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTEER,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 172 Jef.
ferson Avenue, Detroit, Mich-
SAML. P. THOMAS
TAIL or,
IDEALER IN
English, French and Scotch
. GOOD's,
34 West Fourth Street,
CA.W.C.A.W.W.? TA.

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sAMARITAN HOSPITAL.
GOOD
The GooD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of Sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
pointments of a First-class Hospital. Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The Good SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, "
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
service.
gas-Address,
SISTER ANTHONY,
Hospital of the Good Samaritan,
Corner of Stacth and Lock Ste., Otºtoºººººº- Ohio.































































WILson BRD's.
M A R K TVA IN'S
S HIRT S
Made to order of N. Y. M. Muslin and 2300
HEAVY Linen, per dozen - - - $36 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.00
First three qualities have ALL LIN EN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less.
Perfect satisfaction given or money cheerfully
refunded.
Also import and Manufacture Men’s Furnish-
ing Goods.
Pike's Opera-House, Fourth Street, Cincinnati; 931
Wabash Avenue, and 88 West Washington
Street, Chicago.
CALMA R.G.O.
MANUFACTURING COMPANY.,
MANUFACTURERS AND IMPORTERS OF
AND
Window Shades,
67 WºSzº Motºziz Szºzºz',
CINCINNXTI, O,
H. H. BRENEMAN, Proprietor,
NEW E O O. Ex.
IS NOVV READY FOR CA NVASSERS.
It contains over 600 pages of reading matter, with 250
engravings, designed expressly for this work, by the best
artists in the country. Agents now at work upon, it are
meeting with unparalleled success. Agents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re.
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 Elm Street, Cincinnati, O.
BASCOM & CARPENTER,
Stationers, Printer
-AND- • * : ***
Blank Book Manufacturers,
136 VINE sº CEREET,
&\\\\\\\\\e
E. D. ALBRO & BRO.
IMPORTERS AND MANUFACTURESRS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
frºnt-Miº','!-Birčani al-Bilº,
The only house in the Western country that saws Spanish and Mexie
C8-T1 §.º. Cigar-Box Makers. We . ºw" wood direct, and
ll at prices to compete with any and everybody, -
*. º keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
office and Warerooms, 136 and 138 West Second Street,
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCIMNAT1-
*... --


Wm. Wilson McGrew,
* wo. zz masr Fovara sºrrºr.
f PIP3E'S OPERA, HOUSE BUILDING,
Importer and Dealer
Diamond and Gold Jewelry,
watches for Ladies and Gentlemen,
Sterling Silver Tableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
Marble Statuary,
FAN cy. Coons,
G E N E R A LLY.

f
Rºº |
Fº . -> f W
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[… º M º:
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CINCINN ATI.
E" A C TU T., T Y.
J A M E S G FR A H A M, M. D., D E A N,
Professor of the Theory and I?ractice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M. D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomy. Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D., T. A. REAMY, M.D.,
I’rofessor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
W. W. SEELY, M.D., JOHN L. CLEVELAND, M.D.,
Professor of Diseases of the Eye and Ear. Lemonstrator of Anatomy.
SAMUEL NICKLES, M. D., CHARLES KEARNS, M.D.,
Professor of Physics and Medical Chemistry Assistant to the Chair of Surgery.
J. A. M. E S T . W H ITT Al IX E R ,
Professor of Physiology and Secretary of the Faculty.
*~
T. Louis BBown, Prosector of Anatomy. Janitor, College Building, Sixth St., bet. Vine and Rae,
-
Printed and Published by Noah is & M URBY, Medical College of Ohio Building, Cincinnati,




















HE CLINIC,
PluſBLISHED EVERY SATURDAY.
TER MS-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
Vol. 2. C IN C IN N A TI,
A PRIL 6, 1872. No. 14.
JAS. T. VVHITTAKER, M. D.
No. 101 West Ninth Street, Cincinnati.
_ASSOCIALTE EIDITOR,S.
W. W. D.Awson, M. D. THAD. A. REAMY, M. D.
P. S. ConnKR, M. D. C. D. PALMER, M. D.
W. W. Sārīy, M. D. SAMUEL NIGKLEs, M. D.
CHAs. KEARNs, M. D. JNo. L. CLEvELAND, M. D.
RoBERTs BARTHoLow, M. D.
w. W. SEELY, M. D., .
No. 118 West.Seventh Street, Cincinnati.
—A
F.TRT-Tº
* C L U B R A TES,
*-*.
Editor.
º •º *º
TREAsuaza.
co-Ary we ces
Fashionable Hatters,
IMPORTERS AND MANUFACTURERS OF
FºES” FöRS,
92 wrisT FOURTH ST.
Opposite Post Office,
*
:**** ‘. . . CINCININATI.
12 & 6 & & sº lºav"Special Inducements to Medical Men.
C O N T E N T S. - ==
—, Page. §§§liºn
ORIGINALL ARTICLES
The Mode of Production and the Treatment of Nervous Diseases by
Prof. C. E. Brown-Séquard M. D., F. R. S I57
* TRANSLATION
The Process of Decomposition (An Abstract from Caspar's Gerichtl.
Medicin. Berlin 1871) T 60
SCIENTIFIC NOTES
Sea Sickness, the Means of Relieving it—Sympathetic Ophthalmia...160
ME DIGALL NEWS.
The “Milah” and the “Mohel”—The Significance of Diagnosis—A
Vaccination Martyr-The Libéral{Party in Prussia–Trepan-
ning the Sternum—A Knighthood for Cormack—A Cross for
Virchow
s • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ee e s - e is e e s - e. e. e. a
CLINICAL MEMORANIDA
Constriction of the Penis by a Wedding Ring—Hernia Reduced by
Digital Dilitation—The Chlorohydrate of Narceine—Treatment
of Enuresis—Electricity in Trachoma—Xylol in Small-Pox 1ſ;8
* * * * * * *
-º-sº ºn wºº -- * - * *
We are put in possession, now, of all the facts beating
upon the much vexed and perplexed reflex action by
the distinguished author of this doctrine himself.
A full abstract of the chapter from Caspar's “Legal
Medicine” on the process of decomposition follows. A
perusal of this chapter in any other work on medical%
jurisprudence will exhibit how great was our need of
more positive and definite information on this subject.
Some of us at least, can confirm by personal expe-
-rience the value of the expedient suggested in relief of
sea-sickness whether we subscribe to the theory in ex-
planation ºf not.
We have an entertaining letter to-day with some ed-
120
º ERS AN
| -
*:
J. TAFT,
Editor Dental Register
J. & W. TAFT,
TXTENTISTS
117 WEST FOURTH STREET,
CHN CIN N ATI,
O.
A Monthly Journal,
CONTAINING 48 PAGES,
tailed information as to exactly how it is done in Israel.
*~~
Devoted to the Interests of the Dental Profession,















List of Pharmaceutical Preparations,
Jonºv wrºzºn dº anoznan,
FIFILADELPHIA.
—dº-
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR, WALERIANATE OF AMMONIA,
(Goddard’s Formula,)
ELIXIR. VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK, -
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
BEEF, IRON AND WINE,
Extract or Beer, Citrate of Iron and Sherry Wine,
ELIXIR, WALERIANATE OF STRYCHNIA, • *
WINE OF PEPSIN,
SYRUP SUPERPHOSPHATE OF IRON,
ELIXIR OF BISMUTH,
COMP. FLUIDEXT. BUCHU AND PAREIRA BRAWA.
sTJE*E*O's ITOER MEs.
Rectum, Vaginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
care, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and style, made of finest quality of sponge.
WILSON BRO'S.
S HIRT S
Made to order of N. Y. M. Muslin and 2300
HEAVY Linen, per dozen - - - $26 00
Wamsutta. Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.0)
First three qualities have ALL LIN EN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less.
Perfect satisfaction given or money cheerfully
refunded.
Also import and Manufacture Men's Furnish-
ing Goods.
Pike's opera-House, Fourth street, Cincinnati; 931
Wabash Avenue, and SS West Washington
Street, Chicago.
CAM'ſ A.I.R.G.O
MANUFACTURING COMPANY.,
MANUFACTURERS AND IMPORTERS OF
Window Shades,
&? Wasr Fovarw Szºzº,
CINCINNXT, O,
B. H. BRENEMAN, Proprietor.
M A F P& T VVA. I. N'S
NEW E O O. Ex
IS NOVV READY FOR CA N VASSE FRS.
It contains over 600 pages of read ng matter, with 250
engravings, designed expressly for this work, by the best
artists in the country. Agents now at work upon, it are
meeting with unparalleled success. Agents at Circleville,
O., reports 25 orders in 2 days; one at Louisville, Ky.,
reports 175 orders in 8 days; one at Middletown, Conn.,
reports 200 orders in 12 days; one at Cincinnati, O., re-
ports 250 in 12 days. Early applicants secure choice of
territory. For circulars, terms, &c., address
NETTLETON & CO.,
161 Elm Street, Cincinnati, O.
*A
BASCOM & CARPENTER,
Stationers, Printers
*
Blank Book Manufacturers,
136 VINE sºl{REET,
&NWASNN\\\\e
E. De ALBIRO & BRO.
IMPORTERS AND MANUFACTURER8 OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
fºr ſaint-Maºri', 'al-Bullier'ani Star-Bitri'Wii,
The only house in the Western country that saws Spanish and Mexi-
can Cedar for Cigar-Box Makers. We import ºn wood direct, aſid
n sell at prices to compete with any and everybody.
**. º keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 West Second Street, *
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATi,


Wm. Wilson McGrew,
wo. 2% WºSzº Fovara. srazºr.
PIKE'S OPERA HOUSE BUILDING,
Importer and Dealer

—r-ºwe I N were.”—
Diamond and Gold Jewelry,
Watches for Ladies and Gentlemen,
w" Sterling Silver Tableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
Marble Statuary,
FAN cºr Coons,
G E N E R A LLY.
|||||}|| MM|| ||M||
167 EAST 34TH-ST., NEW YORK,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANUFACTURERS OF POP TABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwanic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
|M|| ||||||—|| ||||||}
PEERMANIENT BATTERIEs,
For Hospitals and General Practitioners,
IET IIECTIER, OTDIEHS.
For Eye, Ear, Larynx, Nose, Uterus, Vagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Eleo-
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
IEXTRA (!TS FROM THE OPINIONS OF THE MOST
IEIHINENT IMEMBERS OF THIS PROFESSION.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Not HING CAN
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TIH. H. cI.INTI c.
157
[No. 14.
Vol. 2..] S A T U-R D A Y, A P R I L 6, 1872.
O R. I. G. I. N. A. L. A. R. TI C L E S.
T H II E MO DE OF ORIGIN AND THIE TREATMENT
O F NERVOLUS DISEASES.
BY
PROF. C. E. Brown-SEQUARD, M. D., F. R. S.
Prof. of Comparative and Experimental Pathology (Paris),
A Lecture Delivered at the Cincinnati Hospital, March 28, '72.
Gentlemen and Ladies:
In my lecture ten or twelve days ago, I dwelt upon
the modes of production of certain brain diseases. I at-
tempted to show you that the views of former belief can
now be held no longer. The proofs I brought forward
are perfectly convincing of this fact and I do not intend
to return to speak of them again to-day. There is one
point, however, in the mode of the production of brain
disease which my limited time did not permit me to
fully explain, and I wish to speak of this before I take
up the subject for to-day.
Those present at my last lecture will remember that
I said that symptoms arise not as the direct but as an
indirect effect, an influence originating at a distance
and propagated to other parts so as to disturb their
functions. I stated that there were two sets of phenom-
ena produced at a distance from the seat of irritation.
These two effects are absolutely distinct from each other.
The one consists in the production of morbid phenomena,
the other in the induction of a cessation of activity giv-
ing rise to paralytic symptoms. Take the case of an
individual struck on the left side of the head. There
may ensue the loss of the power of expressing his ideas
by speech. In this case there is an arrest, an interrup-
tion or a stoppage of activity. If the same individual
under other circumstances happen to be struck in the
same part there might other symptoms manifest quite
different in character, as epilepsy, for instance. In this
case, I remarked, there would be the production of mor-
bid phenomena. There are, thus, these two great classes
of symptoms from the same lesion, the arrest of activity
on the one hand and the production of morbid phenom-
ena on the other. There are many other ways to ex-
plain the production of these symptoms besides the one
to be mentioned. The view that the function of that
part of the nervous system in which disease exists, is lost
or destroyed, is false. Pressure, for instance, exerted
upon a part may produce a set of symptoms or may in-
duce a cessation of activity of various faculties of the
mind. I do not here by any means intend to say that
destruction of a part is not followed by certain symp-
toms, only that it is not followed by the same symptoms.
Dr. Tuerck, a physician of Vienna, was the first to
point out a fact to which some friends of mine, Charcot
and Vulpian and others contributed largely. It is that
when disease exists in certain parts its propagation is
along the nerve fibres extending from it. Thus, disease
may reach the extremity of the body from the head to
the foot. In that case an active disorganization of some
fibres in their entire length takes place. This secondary
degeneration occurs very frequently. It is certainly to
be looked upon as a cause of symptoms, but can not be
regarded as the principal cause for the very manifest
reason that these symptoms only appear after a long
time, one month or more being required sometimes from
the head to the foot, or arm, or from the liver to the
brain, etc. So that we are not to look upon symptoms
that appear immediately as caused in that way.
In most instances, symptoms of brain disease arise by
a mechanism entirely different. There are many ways
in which they can be explained but their explanation
requires such a knowledge of physiology and pathology
that I can not enter into them now. &r
It is perfectly well known that the nervous system
can act upon parts so as to affect their blood supply, to
produce in them a diminution of their blood. But this
view although it has no share in the production of brain
symptoms can not explain more than a few phenomena.
It is now perfectly well known, and I have contributed
to its establishment, that an irritation starting from dis-
ease in the tissue of the brain or spinal cord may pro-
duce an attraction of blood to, or increase in its amount
in, many other parts. This is by a peculiar chemical
influence exerted on the tissue so that blood is attracted
to it and its nutrition is increased. Indeed inflamma-
tion may be so produced. Many of the inflammations
of the lungs and other viscera of the chest are brought
about by this mechanism. But this is not the legitimate
way. The general mode of production of symptoms is
simply by the arrest of activity in certain parts. We
know, now, well that certain cells of gray matter may
be so acted upon that their action will be stopped just
as a piece of soft iron is stopped by a magnet. It is a
matter of indifference by what means this arrest of ac-
tivity is produced. It is only essential that we recog-
nise that any function may be arrested by distant
irritation,
When we take an animal and prick quickly certain
parts of the cord or medulla oblongata, even by a mere
prick Scarcely below the surface with the thinnest
needle, we find very frequently that the action of those
cells which serve for mentality in man as well as in an-
imals ceases. They become unconscious for a time,
sometimes permanently.
Besides the cessation of the activity of the cells of
mental action there may be an arrest of activity of the
cells serving to respiration and besides' the arrest of
158
[APR. 6, 1872.
TIH. H. C.LINTI c.
activity of the cells of the nervous system there may be
an arrest of the activity of the cells which serve for the
interchange between the blood and the tissues so that
the blood remains red in the veins. In health the
blood becomes black because it surrenders its oxygen
to the tissues and takes up carbonic acid gas. In dis-
ease there is an arrest of the activity of the cells of the
tissues so that this interchange does not take place and
the color of the blood remains unchanged. In many in-
stances also there is a diminution in the force of the cir-
culation so far as it depends upon the heart. There are
other manifestations of like interest regarding this sub-
ject but I have no time to dwell upon them now. I
may mention merely the phenomena of the arrest of
putrefaction. In one case a dog exhibited no signs of
putrefaction in two or three weeks and muscles have
been preserved as long as seven or eight weeks, facts
which go to show how great an influence is exerted by
a mere prick of the needle. If we consider the greatness
of the effects from such a trifling cause we observe that
we have results that are similar to those from severe
lesions as hemorrhage from the brain. Death even will
occur very frequently. But it is not death which I am
to consider but symptoms.
In cases of sudden alterations at the base of the brain
we have symptoms such as paralysis produced suddenly.
In some cases it disappears, also, suddenly, though the
cause may be continous.
I have collected, now, more than fifty cases of disease
of the base of the brain at the level of the crura cerebelli
and in the neghborhood of the pons Varolii and corpora
restiformia in which there was paralysis on the side of
the body corresponding with the disease. These cases
cannot possibly be explained by the conduction of
nerve fibres. They are only explicable by the indirect
influence of distant points of irritation. -
To the medical gentlemen here present I will say that
of the fifty cases of same-sided lesion and paralysis—
cases not all seen by myself but collected from reliable
sources—that when the lesion is deeper, when it en-
croaches upon the tissue to such extent as to destroy
one-half of its substance, the mechanism of the produc-
tion of symptoms may appear to be different.
A lasting paralysis may ensue upon an irritation con-
fined to the nerves of one side of the chest. A paralysis
of the corresponding side thus may be of weeks duration
even of months. Dr. August Waller who assisted in
the examination of these cases showed that these nerves
were in no connection with the paralysed limbs. The
paralysis so induced is by an indirect influence, that
is, an irritation originating at one point induces these
phenomena at a distant point.
If we take other facts, such as those that occur in
animals after division of one nerve only, as the sciatic,
we find many different symptoms, indeed, from the same
lesion. A great variety of effects is thus induced which
may persist for months and months. In certain animals
we notice an increase in the temperature of the ear.
Sensibility to pinching, burns and great irritation
diminishes: later new symptoms appear, epilepsy may
manifest and still later, changes occur in the skin, the
hair may fall or parasites may be found in places pre-
viously free, facts showing the alteration which has
taken place. When the hair has all fallen, the fits cease,
sensibility to pain returns, the animal has recovered.
Other interesting facts in this connection are the in-
crease in milk in the mammary gland in the female
animal on the side corresponding to the lesion, the limb
in which the nerve has been divided has increased in
sensibility, the belly hangs loose and paralysis may
ensue. There are many other facts that might be men-
tioned but enough has been stated to show the prop-
agation of irritation to distant points.
If we pass to another series of proofs in man as well
as in the lower animals resting upon experiments of
injuring the auditory nerve, a nerve of special sense, we
observe here again that a great variety of effects will
be produced. I may only mention them briefly; cold,
toppling gait but full possession of the mind and in
gome cases, without irritation of the skin, great sensi-
bility to pain. In the case of a large bull-frog which I
experimented upon first in this country pricking the
bag which contains it caused the most different effects.
When the nerve on the opposite side was injured the
animal moved in a circle like a horse in a circus. After
a while it regains the power of going straight showing
that this effect is only temporary. Another phenomena
of interest was the hyperaesthesia observed everywhere.
In the case of the frog on one occasion the animal gave
vent to an audible sound of pain, a phenomenon of most
rare occurrence. These are all direct proofs that an
irritation will give rise to the most diverse effects. I
was once called to see a patient in great suffering who
had symptoms of an abscess in the mastoid portion of
the temporal bone with irritation of the auditory nerve.
An opening into the mastoid process and the discharge
of the abscess relieved him. In children not infre-
quently convulsions are due to an irritation of the
auditory nerve. This has been shown to be true by a
medical friend of mine in London.
And now I must pass to other considerations discon-
nected with this part of my subject. I should like to
be able to speak further upon the phenomena dependent
upon an excitation or arrest of nervous activity but I
am warned by my limited time to enter upon the
second part of my programme as announced.
I am now to speak of the mode of treatment more
especially of functional nervous disorders. It is quite
essential that we still hold in view this phenomena of
arrest of activity in considering the treatment
of nervous disorders. It is in this way that convulsions
are checked. I have already remarked in the Academy
of Medicine how convulsions are checked by peripheric
irritation some in one place, others in another. Even
the most violent and lasting convulsions, those of half
an hour's duration, those in wnich violent jerking follows,
APR. 6, 1872.]
T H E CI, IISTI c.
159
as after strychnia, may be arrested by pulling the big
toe, etc. It is in this way that we stop the action of
the cord and complete relaxation follows. In epilepsy
we may have the opportunity in the use of these means
to detect cases of feigned affection. It is not necessary
that pricking be resorted to, galvanisation or any irrita-
tion may be sufficient to check the paroxysm. More
than this, all kinds of convulsion may be checked in this
way and, what sounds strange, by the same means as
those which produced them.
My friend Bernard found that when chloroform was
applied to the frog, circulation in the capillaries ceased.
Bernard did not explain this but it is certainly due to
reflex action, the bloodvessels are acted upon just as
after galvanisation of certain nerves. In one woman in
whom a recurrence of the paroxysm was especially to be
dreaded, as she had fractured the humerus and dislocated
the shoulder by the mere force of muscular effort in the
last attack, I administered chloroform and kept her
under it continuously for a number of days. Hibbardon
of London, kept a patient under chloroform three days
permitting her to recover only sufficiently to take liquid
food. This might seem a dangerous practice, but Simp-
son has found that patients may be kept under chloro-
form for many days. I was not aware of this fact at the
time but have since ascertained it. If no vomiting nor
depression of pulse occurs, chloroform may be adminis-
tered with impunity for a long time. In my case the
patient passed over the threatened attacks safely and
was afterwards free for a fortnight when another convul-
sion occurred. Callus had already formed, however, so
that there was no further damage. -
You will ask why is it not legitimate to employ chlor-
oform in every case. It is a practice I would not hesitate
to adopt in every case where I could administer it my. ||
self. Unfortunately the physician is so busy—having
more than one case to attend to, at least after a certain
age—that he has not the time to so employ it. But
there are cases in which epilepsy is followed by coma or
dangerous hemorrhage or threatening suffocation from
spasm of the larynx in which the physician is not to
hesitate but is to give it a whole day at a time. In my
practice I have not had more than eight or ten such
cases, and I have always succeeded in shortening the
fit and the coma, in some instances when the coma had
lasted previously from one to three days. Chloroform
produces these effects in these cases by reflex action.
There are many cases of nervous affection in which a
peripheric irritation effects a cure or at least a preven-
tion of the disease.
What, now, are the best means to be employed? In
organic disease of the base of the brain or in any part
of the brain or cord the most powerful means of changing
the state of the circulation is the heated iron. In all
applications pain is to be avoided. If I had again to
treat the eminent patient who was under my care in
Paris in '57 I would not again use the six moxas of
Previous employment. Moxas indeed are to be rejected
altogether as pain is really an obstacle to cure. Of all
means the actual cautery brought to a white heat and
applied in parallel lines upon the surface is the
best, least painful, and most potent counter-irritant.
The great mistake, by which this remedy of old employ-
ment in England and here was brought into disrepute,
consisted in the application of the iron at a red heat
when the pain induced is very severe Heated to white-
ness it not only gives less pain but the resulting eschar
heals more rapidly. I may say here that physicians in
the rule are too yielding to the feelings of their patients.
They are not bold enough in this regard dreading to be
called barbarians. It is unfortunate that there is a
tendency towards the abandonment of this agency as its
pain is hardly felt and its after effects are of very short
duration. I have myself used the heated iron in almost
all cases of nervous affection. I have applied it freely
even to the faces of young ladies who have then gone
out among their friends flattered with the belief that
they had exhibited an astonishing courage in withstand-
ing it. Permanent disfiguration is very rare, the mark
generally disappears in 3-5 weeks and the full beauty of
the skin returns. It should be passed over the surface
with some pressure and with speed in parallel lines.
It hardly produces any pain only a sensation of dryness.
The resulting eschar has but very little discharge and
soon disappears. This means is best adapted to cases in
which there is congestion somewhere. It is not neces-
sary, however, that there shall be congestion as it is the
best means of treatment of simple neuralgia where there
is no congestion. I have now in memory but very few
cases that have resisted it. Jobert and Valleix say they
have never seen it fail. I do'nt go so far as that. I have
had failures.
Another means extremely potential is ice. This
agent ranks next to the actual cautery. It is to be ap-
plied, not by Chapman's ice bag, but bare or crushed
finely and folded in a towel. It is not to remain upon
the surface more than 10 or 12 minutes. In any kind
of nervous affection it offers a good chance of cure. It
looses its efficacy, however, after a time. The idea was
put forth that ice diminished the temperature of the
brain by reducing the size of the blood-vessels. I doubt
if it do not rather dilate the vessels as after galvanisation
of the nerve in the neck. After this my friend Dr.
Waller a celebrated German physician, untimely dead,
as he had published very little, conceived the idea that
he could produce changes in nutrition in the head
by pressing upon the nerves in the neck. Many
physicians had had this idea before but they
thought the changes were effected by pressure upon
the carotid. Now it is known that they depend
upon pressure of the par vagum and sympathetic.
When it was found that we could produce changes in
the blood vessels by pressure upon these nerves I one
day tried the influence of galvanism. Of course I was
unaware of the great risks of such a proceedure. We
went on boldly with the intention of stopping a terrible
160
[APR. 6, 1872.
TIEEE c1.TISTI c.
—r-
head-ache. Well, we stopped the head-ache but we
almost stopped life too. The patient became pulseless
and lost consciousness for two or three minntes. It
proved a rather dangerous remedy and we did not re-
apply it. The method of Waller was to press upon the
nerves near the angle of the jaw, that is, over the carotid
and whenever the carotid is pressed, the nerves are also
pressed. The result of my experiment made me un-
willing to employ this means. My friend Dr. Waller
used to relieve epilepsy in this way on a large scale.
He used it with great advantage in cases of disease of
the cells of gray matter of the brain. In this way also
in that group of affections in which we desire to bring.
about a diminution of the force and frequency of the
heart's action, as in the acute fever of articular rheu-
matism, this means may be employed with benefit.
As my time is now becoming short I shall content
myself with the remark that if we keep in view the dis-
coveries and teachings of the last ten years regarding
the suspension of activity by peripheric irritation we
shall he led to a better mode of treatment of nervous
affections.
I should say something with reference to the points of
election in making this irritation. If we act on a sur-
face which receives nerves from a centre we act upon
the centre itself; thus in epilepsy as the disease usually
affects the medulla oblongata we select parts in connec-
tion with nerves from this centre. In cases of congestion
of the spine we select the skin of the leg or thigh. These
facts have been very little known or developed.
Lastly we are to remember to avoid pain as a coun-
ter-irritant as pain interferes with the desired effect.
A good agent in this regard is the nitrate of silver whose
application is void of pain. It possesses great power in
neuralgias and other nervous affections. It rapidly
changes the color of the skin to a dark chestnut color
but it produces no sensation. Collodion applied to a
large surface or oil answers pretty much the same pur-
pose as a means of peripheric irritation of the nerves of
the skin though their action is not perceived. In some
cases of inflammation of the throat such simple means
as these afford excellent results.
I should be glad to continue this subject further but
I have already passed the limits of my time. I have
in conclusion to thank you, ladies and gentlemen, for
your kind attention.
—sº-O-ºsm-
A SUIT FOR FORGERY.—At a late meeting of the
British General Medical Council (Mar. 1, ’72,), Dr. Ben-
nett moved, Dr. Aquilla Smith seconded him, and it was
resolved: “That the Registrar be directed to write to
the Solicitor authorising him to take the necessary steps
to prosecute the student alleged to have been guilty of
forging a certificate of having passed his preliminary
examination at the Hall of the Society of Apothecaries,
by which he obtained admission on the Students' Reg-
ister.”
T H E PR o o Ess o F D Eco M P os IT I o N.
An Abstract from Caspar's Handbuch der Gerichtlichen
Medicin. Berlin, 1871.
sº.
In No. 10 of “THE CLINIC” we endeavored to lay
before its readers, concisely, the views of Caspar on the
signs of death, as developed in his exhaustive work on
medical jurisprudence, leaving the consideration of the
process of decomposition, with reference to the time of
death, for a separate article. We will now turn our
attention to this subject. Caspar says it is surrounded
with many difficulties. It is not easy to describe, by
mere words, the various changes in color and consistency
of organs which the corpse undergoes, and in view of
the many agents that affect the process of decomposition
anything like a general rule can be laid down only with
great caution. He thinks it is scarcely an exaggeration
when Orfila says that “it is beyond the powers of man,”
to determine the time of death in corpses that have
undergone decomposition. And yet, Devergie says of
his subordinates in the Paris Morgue, and Caspar has
noticed the fact himself in Berlin, that men without any
culture whatever, acquire, by mere routine, a judgment
in this matter, which, in general, is quite correct;
whence our author argues it must be possible to do it still
more accurately by employing scientific means. Whilst
appreciatings the labors of Orfila, Lesueur, Güntz and
Devergie”, he censures them for devoting too much
attention to trifling details, making their works prac-
tically worthless for the medical jurist.
Interior Conditions of Decomposition.
The causes which modify the process of decomposition,
by either hastening or retarding it, so that the corpse of
A may in from 24 to 36 hours present the same appear-
ance as the corpse of B in from 3 to 4 weeks, must be
sought in the individual, or externally. As a matter of
course, decomposition itself is possible only through ex-
terior influences. Fresh flesh, hermetically sealed, does
not decompose.
Individually, the progress of decomposition is mod-
ified,
1. By Age. Caspar admits what all authors main-
tain, that neo-nati, cet, par., undergo decomposition
more rapidly than other corpses. Still, we have to take
into consideration the fact not noticed by any other
writer, that they are nearly all found naked immedi-
ately after birth, or at most, enveloped in a few rags,
having been exposed, or thrown into the water, into
vaults, or hidden in manure or rubbish; whilst naked
corpses of a greater age are almost exclusively only
* Orfila (). Ilesuer, Handb. z. , Gebr. f. Gerichtl.
Leipzig, 1832-35.
Güntz, der Leichnam des Nengeborenen, Leipzig, 1827.
Devergie I, p. 88-253,
Ausgrabungen,
APR. 6, 1872.]
TIH. H. cIIISTI c.
161
those of persons drowned. But the influence of clothing
on retarding the process of decomposition is very
essential.
2. Sea, according to Caspar, has no influence. But
he has noticed that the corpses of women, who died
immediately after parturition, decomposed very rapidly,
no matter what was the cause of death. -
3. The Constitution has a very decided influence.
Fat, spongy and lymphatic bodies undergo decomposi-
tion far more rapidly than bodies lean and dry, because
an abundance of liquids favors the process. In the
corpses of the aged this process is retarded, probably,
because they are generally lean and dry.
4. The mode of death has a marked effect on the pro-
cess of decomposition. It occurs much later after the
sudden death of healthy persons than in persons dead of
diseases which exhaust the system ; such as typhus,
dropsy following organic lesions, or tuberculosis.
Mutilated bodies, and those of persons killed by repeated
acts of violence, by mechanical force, on railroads, etc.,
decompose rapidly. Excepted from this rule are the
bodies of persons that were killed by the falling of
walls; the stones, rubbish, or sand with which they re-
main covered, preventing a direct contact with the air.
Persons suffocated by smoke, . carbonic oxide gas, or
sulphuretted hydrogen, decompose rapidly. After death
from narcotic poisons, decomposition is accelerated.
This is much less the case after other poisons, and
especially phosphorus. Where the blood was poisoned
by alcohol, i. e., in cases of drunkards who died of
apoplexy, in a state of intoxication, Caspar observed
that the corpses retained their freshness for a remark-
ably long time. -
It is worthy of notice, finally, that after poisoning by
sulphuric acid the process of decomposition is decidedly
retarded, probably because the acid prevents the forma-
tion of ammonia, or continues to neutralise the ammonia
formed by decomposition. After poisoning by arsenic
decomposition occurs according to the ordinary laws,
but it is well known thºt it is interrupted in its course
by the process of mummification, of which more here-
after. # -
We ought to remember, however, that, although the
foregoing statements are generally correct, there must
be still other causes, as yet unknown, which hasten or
retard decomposition. •
As cases in point, the following are cited by Caspar.
On March 18th, 1848, two men suffered the same death,
by º wounds, at the same time on the barricades
in Berlin. Nevertheless, the signs of decomposition
were dissimilar. At another time, a man and a woman,
both aged between 50 and 60 years, died the same night
from suffocation by carbonic oxide gas. Four days
after, the man's corpse was quite green on the abdomen
and back, whilst that of the woman, though remarkably
fat, was, internally as well as externally, quite fresh.
Eacterior Conditions of Decomposition.
The exterior conditions have a more decided effect on
decomposition than the interior. They are air, water
and heat. -
a. Atmospherie air. Everything that favros or hinders
its access to dead animal (as well as vegetable) sub-
stances, hastens or retards the process of decomposition.
Helmholz” has shown that no decomposition takes place
in flesh that is in contact with water cleared by boiling
and air conducted through red-hot tubes, until all
| organic germs are destroyed. The oxygea of the atmos-
pheric air is, consequently, the chief condition of de-
composition. Corpses remaining in the open air decom-
pose much more rapidly than those that were buried,
and even than those lying in water. Decomposition
sets in sooner in naked or lightly clothed corpses than
in those that are completely dressed, especially if the
clothes are tight and but little permeable.
The access of air may be obstructed or favored by the
composition of the earth. If it is light and porous, de-
composition will commence sooner than if it is moist
and dense. But here a great deal must be ascribed to
the action of water because light earth (sand) is at the
same time dry, whilst moist earth (clay) is naturally
damp. So, too, corpses decompose sooner in shallow
graves than in those of great depth. It is further im-
portant to consider the cover that surrounds the corpses
is the earth, which is well shown by Orfila. Everybody
knows how soon coffins of common pine are destroyed,
and, with them, the corpses; whilst the great men of
of former times, buried in coffins of hard wood, tin or
stone, were preserved for an uncommonly long period.
On the contrary, corpses that were buried in an entirely
nude state decompose very rapidly.
b. Water. Without water and watery vapor no de-
composition takes place. But the water of the corpse
itself is sufficient. It gradually evaporates, and, event-
ually, bursts the walls of the abdomen, of the thorax
and, finally, even the bones of the skull, and the corpse
macerates in its own liquids. Before this time, however,
maggots and larvae make their appearance on the surface
at first on the eyelids, ears, vulva and groins, until their
number is increased to myriads and the complete and
total destruction of all the soft parts follows.
But in proportion as water without has access to the
corpse, decomposition will be more rapid, and vice versa.
c. Heat. A high degree of heat, alone, causes the
liquids of the body to evaporate and favors the very op.
posite of the process of decomposition, i.e., the drying
up, if not roasting of the corpse, as we see it in com-
bustion. Ordinary heat, however, when combined with
air and humidity, favors decomposition. It is well
known that a corpse will decompose more rapidly in
summer than in winter. Bodies that at a summer tem-
perature of 16 to 20° R. are still in a good state of pre-
servation, may, in the course of 24 hours, become en-
tirely unfit for dissection, whilst in water, at a tempera-
ature of from 5 to 8° R. this will not be the case for 10
or 12 days. The difference of temperature is exceed-
ingly remarkable in the case of water. If the corpse
freezes in water (or humid earth) it will be preserrved
*Erdmann d. Marchner, Journal d. Pract. Chemi., Bd. 31, s.420.
162
[APR. 6, 1872.
TIEEE IEH C T LI INTIL C.
by the mammoth, exhumed in Siberia, and now to be
seen in the Museum of the University at Moscow, though
the remains of the tissues are partly saponified. In
winter, a corpse taken from water showing a tempera-
ture of from 2 to 6°. R. 10 to 12 days after death, may
still be so well preserved as to enable an examiner to
demonstrate the signs of death from suffocation, which
in summer, at a temperature of from 18 to 20° R. is
often impossible after 5 to 7 days; and here, another
circumstance must be considered. It is well known,
that the temperature of the water is lower, under its
surface, than on it and in the superior strata, because
the rays of the sun strike only these. Decomposition
will, therefore, be accelerated when the corpse is on the
surface, and retarded when it remained at the bottom.
Another point that must not be overlooked is this, that
a corpse taken from the water and exposed to the air,
will decompose with exceeding rapidity. The progress
will be greater in one day than it would have been in 3
or 4 days, had the corpse remained in the water. So,
too, a higher or lower degree of the temperature of the
earth affects decomposition. Corpses buried in shallow
graves will, therefore, (as also for the reason given above
under atmospheric air) decompose more rapidly than
those in deep graves,
Comparison of the Signs of Decomposition according
to the Media,
Caspar says it is perplexing for the practitioner to di-
vide the process of decomposition into stages according
to the different media, as has been done by Orfila, De-
vergie and Güntz, and he thinks it is superfluous, be-
cause this process is, in all cases, one and the same from
the first moment to the last, modified only by the media
and all the various conditions heretofore enumerated.
It appears, to him, more judicious to set up a general
criterion regarding all three media, i.e., air, water and
earth, leaving the effect of the other conditions to be
considered in each given case. Aware of the difficulty
of setting up such criterion, yet from his large experience
he does not believe to depart from the truth in announc-
ing the following doctrine: the average degree of temper-
ature being about equal, a corpse eago&cd to the open air
for one week (or month), exhibits the same degree of decom-
position as a corpse that remained in water two weeks (or
months) amd one that was buried in the earth in the usual
way, for eight weeks (or months).
The same degree of decomposition will therefore, cet.
par., be shown by three corpses of which a has been
exposed to the air, e. g., on the ground, for a month;
b was drowned two months ago; and c has been dead
and buried in an ordinary coffin for eight months. A
due regard for this rule and a proper intimation of the
circumstances of each specific case, will avoid essential
€rrorS.
for a long time, even for thousands of years, as is shown |
Successive Changes of the Corpse, Externally.
1. The first sign is the well known greenish color of
the walls of the abdomen, on the appearance of which
the odor of decomposition is noticed. It occurs in from
24 to 36 hours. (The exception in the case of persons
found drowned will be referred to hereafter). •
2. In the same time, the eye-balls soften, and yield to
the pressure of the finger. . • .
3. In from 3 to 5 days after death this green color
becomes more marked and covers the entire abdomen,
including the exterior sexual organs. In the latter, it
assumes, in both sexes, a rather brownish-green, dirty
appearance from the start. In a great many corpses,
especially in cases of suffocation, sanguineous, frothy
liquids, with air-bubbles, ooze from nostrils and mouth.
At the same time, green spots appear, with great topical
irregularity, on other places, especially on the back, the
lower extremities, the neck and lateral portions of the
thorax. -
4. In from 8 to 12 days after death this discoloration,
with which the odor keeps even pace, has covered the
entire body and become darker. In Some places,
especially in the face and on the entire neck down to the
breast, the color even at this stage, is reddish-green, the
decomposed blood having extravasated into the cellular
tissue. Putrid gases are developed and inflate the
abdomen. These are (but not in all cases) combustible
gases, sulphurretted and phosphuretted hydrogen. On
making an incision in the walls of the abdomen, the gas
which escapes, will, on lighting it, burn for a considera-
ble time, with a small flame. This takes place, almost
without exception, with the gas proceeding from the
scrotum. The cornea has become concave, but the
color of the eyes may still be recognized, whilst it is no
longer possible, in all cases, to determine whether the
pupils of the immature foetus are open or not. The
sphincter ani is open. In some places of the corpse,
especially on the extremities, on the neck and breast,
cutaneous veins of a dirty red may be seen through
patches of skin of a lighter color. The nails are still
firm.
5. In from 14 to 20 days after death, the color of decom-
position has everywhere become green, like the color of
the frog, and bloodred-brown. The cuticle, in some
places, is raised in blisters of the size of a walnut ; in
others, patches as large as a plate, and still larger, are
entirely detached. Innumerable maggots cover the
body, seeking especially the folds of the skin and the
natural cavities. The evolution of gas has increased to
such an extent, that the abdomen looks like a large
ball, the thorax is artificially rasied, and the entire
cellular tissue presents the appearance of inflation. The
corpse resembles that of a giant. The features can no
longer be distinguished, and even intimate friends find
it difficult to recognize the body; for the lids, the lips,
the nose and the cheeks appearing much swelled, the
physiognomy is naturally entirely different. The color
APR. 6, 1872.]
T H. H. C. T., T N T C .
163
of the eyes can no longer be distinguished, because the
eye-ball (iris and pupil being obliterated) shows in all
such corpses, without exception, a uniform dirty-red
color in the entire extent of the sclerotica. In men,
the penis has become enormously large, and the scrotum
may reach the size of a child’s head. The nails are
detached with their roots, and may be easily pulled
from the limbs. The scalp comes off readily.
Temperature is an important condition in bringing
about this high degree of decomposition. Taking the
extremes of temperature, it may be said, that 16 to 20°
R. in summer, will have the same effect in from 8 to 10
days as 0 to 8° R. in winter in from 20 to 30 days. We
mentioned that at this stage of decomposition the corpse
is covered with maggots. But where it was exposed to
the open air or had lain in the water, it is not uncom-
mon to find that it has been a prey to other animals,
especially rats, but also dogs, cats, birds of prey, foxes
and wolves. The evidences of such voracity are found
on the chest and abdomen which frequently have been
opened; and on the extremities, which, in many places
appear as if dissected down to the bones. A little atten-
tion will prevent us from confounding such lesions with
traumatic effects. Finding a corpse in the condition just
described, we may affirm with some degree of certainty,
that the individual has been dead at least as long as
above stated, but not that it could not have been dead
longer, for this stage of decomposition differing thus
from former stages, continues, generally, many weeks,
even a few months, and but very gradually proceeds to
the following stage: Corpses in a state of putrescence, of
a green color, inflated and eacoriated, found one month after
death, cannot well, cet, par., be distinguished from similar
corpses found in from 3 to 5 months after death.
6. The stage of putrid colliquation begins in from 4
to 6 months after death; in corpses lying in warm and
humid media, even sooner. The constant evolution of
gas has opened the cavities of the chest and abdomen.
Often the bones of the skull, too, have yielded in the
sutures and the brain has escaped. All the soft parts
are in a state of pap-like solution, or have been partly
dissolved and consumed. Entire bones, especially those
of the skull and extremities, are bare. Those of the
extremities are often, even at this stage, detached at the
joints; the fasciae and ligaments being destroyed. No
trace of the physiognomy can be recognised. The ex-
istence of mammae can no longer be determined, and
since the external sexual organs have also disappeared,
the sex of the individual can be known from the exterior
habitus only in case the hair of the pudenda is still
visible, which is often the case. As is well known, in a
female, this hair is strictly confined to the mons veneris,
in the male it extends to the umbilicus. According to
Schulze, exceptions to this rule are not rare.” It is also
still possible to determine the sex by searching for a
ºtterus. -
[To be Concluded.]
* Jenaische Zeitschrift, Bd. iv. Heft 2, s. 312.
SCIENTIFIC NOTES.
S E A-S I C K N E S S .
The Means of Relieving it.
BY
SIR. JAMES ALDERSON, M. D., D. C. L., F. R. S.
Consulting Physician to St. Mary's Hospital,
From the British Med. Journal, Mar. 9, 1872.
The cause of sea-sickness and its possible amelioration
is a subject particularly appropriate at the present time.
It is more agreeable to offer suggestions for relief than to
comment on the Sybaritic weakness which is generally
displayed in impatience of the evils usually to be en-
countered in a passage across the Channel. When we
remember that not half a century ago, people, waiting
days or perhaps weeks for fair wind and weather, were
glad to consider a voyage of six hours of tossing and
sickness as a very favorable one, one can hardly under-
stand how the present generation feel it unendurable to
submit to a single hour and a half after having started
at a given time. Though, however, we must admit the
fact that we are less brave in meeting discomforts than
our predecessors, there is still satisfaction in diminishing
those discomforts to the utmost in our power.
We have seen the futility of various childish devices,
such as stimulants, globules, ice-bags, etc., all of which,
not being based on any true knowledge of the evils to be
met, are merely empirical. Rejecting all of these, there-
fore, it will be well to invite attention to a scientific ex-
planation of the cause of sea-sickness, and to base on
that explanation a proposal for a remedy.
A suggestion was made sixty years ago by Dr. Wollas-
ton, that sea-sickness proceeds from pressure of blood
upon the brain; and this view is supported by patholog-
ical observations, since injury or pressure on the brain
is almost invariably attended by vomiting, which is its
earliest symptom. Dr. Wollaston explains the way in
which pressure is induced upon the brain during the
motion of a ship at Sea, by reference to the action of
mercury in the tube of a barometer. He says “that if
a barometer be carried out to sea in a calm, the mercury
will rest at the same height as when on shore; but when
the ship falls by the subsidence of the waves, the
mercury is seen apparently to rise in the tube which
contains it.” I may add to this, that anyone who has
carried a mountain-barometer, and has happened to let
it descend suddenly, must have been sensible of a concus-
sion of the mercury against the top of the tube, and
must have both heard and felt the blow. In fact, the
mere action of walking is sufficient, by the alternate rise
and fall of the hand, to produce this effect. Dr. Wollas-
164
[APR. 6, 1872,
TIH. H. C.T.I. NI c.
ton considers that the action of the blood on the brain,
at the moment of the descent of the ship, is identical
with that of the mercury on the top of the barometer,
and that there is an actual pressure, and even a blow,
which, by frequent repetition, produces nausea and
vomiting. Now it is to be regretted that Dr. Wollaston
does not state the true scientific explanation of the
apparent rise of the mercury in the barometrical
tube, to which inaccuracy may possibly be referred
the reason why so little notice has been taken of
this valuable suggestion. It is not necessary here to
analyse his statement with a view to refute it. The
fact is undeniable, that contact does take place
between the mercury and the upper part of the tube
with more or less violence, and the proper explanation
of the apparent rise of the mercury when the tube de-
scends is this: that when the rigid tube falls, the
mercury, having its own inertia, and not being attached
to, or a part of, the tube, remains stationary—at least
for a time; thus the tube is pushed down upon or over
the mercury, and the concussion takes place. Exactly
the same occurs between the brain and vessels on the
one part and the blood on the other. The approximately
rigid brain and vessels are carried downwards, the blood
remains by its own inertia, and the consequence is to
crowd blood into the vessels of the brain, and so press
with increased force, producing a certain shock; this
shock and the attendant pressure produce sickness and
vomiting. The vomiting induced is of a peculiar char-
acter—very different from that proceeding from a
common disordered stomach; it occurs in a spasmodic
manner, and violent retching remains after the contents
of the stomach have been ejected. This continuous
retching seems to indicate the repeated action of the in-
creased pressure. *
Referring to the experience of sufferers from sea-sick-
ness, it is admitted by all that they are most sensible of
the miserable feeling at the moment of the descent of
the ship. They are also conscious at that particular
time of an instinctive effort to sigh or take a deep in-
spiration, the meaning of which is manifest. During
deep inspiration, the chest is dilated for the reception of
air, and its vessels become more open to admit blood,
so that a return of blood from the head is then more free
than at any other period of complete respiration; whilst
on the contrary, by the act of expelling air from the
lungs, the ingress of blood is obstructed. This obstruc-
tion is proved by observation when the surface of the
brain is exposed by the operation of trephing; a succes-
sive turgescence and subsidence of the brain is then seen
in alternate motion with different states of the chest.
A deep inspiration, therefore, at the time of the descent
of the ship tends to counteract the turgescence of the
brain.
Sickness is sometimes produced by waltzing. In this
case the same theory of pressure on the brain holds good;
but during rapid gyration in waltzing the blood is acted
on differently: it is centrifugal force which causes the
blood to rise in the vessels supplied to the brain. There
is an additional cause of cerebral disturbance from the
confusion of objects rapidly presented to the eye; from
this comes giddiness.
In reference to sickness brought on by swinging, I
cannot do better than quote Dr. Wollaston: “Sickness,
by swinging, is evidently from the same cause as sea-
sickness, and that direction of the motion, which occa-
ions the most piercing sensation of uneasiness, is con-
formable to the same explanation already given. It is
in descending forwards that this sensation is perceived,
for then the blood has the greatest tendency to move
from the feet towards the head, since the line joining
them is in the direction of the motion; but when, in
the descent backwards, the motion is transverse to the
line of the body, it occasions but little inconvenience,
because the tendency to propel the blood towards the
head is then inconsiderable.” -
This last observation of Dr. Wollaston, quite accurate
as to the result, plainly suggests the practical bearing
of the subject. Knowing the mode in which the ship's
movement acts on the brain, we are at once furnished
with the only rational way of averting sea-sickness.
The first point is wholly to avoid the upright posture.
Every one knows that it is a common practice to lie
down, and this is done almost instinctively, but it is also
known that to do so, though frequently successful, it is
not invariably so. The way in which the motion in a
swing effects the brain affords the proper explanation
why lying down is not invariably successful; and shows
that it is necessary, not only to take a recumbent posi-
tion, but to lie in the right direction. A person lying
down with the feet towards the bows of a ship is, whilst
it descends in pitching, in the same position as a person
in a swing descending forwards, in which case we have
seen that sickness is produced by blood being forced
upon the brain. On the contrary, a person lying down
with his head towards the bows is, during the descent
of the ship, in the position of one descending backwards
in a swing, in which case the pressure by the blood will
be towards the feet, and, therefore, relief rather than
an inconvenience will be experienced, the tendency be-
ing to reduce the natural supply of blood to the brain.
It is necessary, therefore, not only to lie down, but to do
so with the head to the bows; and it is highly desirable
that this position should be assumed before the ship be-
gins to move. There is a secondary advantage to be
gained by closing the eyes, and so shutting out the con-
fusion arising from the movement of surrounding
objects.
If the philosophical explanation here given be the
correct one, which there is no reason to doubt, it adds
one more to many unanswerable objections to the device
of taking passengers in railway carriages on board gigan-
tic vessels. No relief would be afforded by that plan to
the miseries of sea-sickness, since, except in a perfect calm,
nothing can prevent the rising and falling of the ship,
and the consequent action of the blood upon the brain
APR. 6, 1872.]
TIEEI IEH C T II INT I. C.
165
The sitting posture would be equally unfavorable with
the upright, and there would be, in addition, the com-
mon motion of a carriage, which alone, with some per-
sons, produces sickness.
It is well to forbear imagining the miseries of sitting,
shut up, face to face, with fellow sufferers, and, at the
end of the voyage, of missing the one consolation of
leaving the scene of your sickness, with all its disgust- ||
ing evidences behind, and getting into a clean and pure
conveyance free from late contaminations,
It is beside the subject of this paper to discuss the
danger of unstable equilibrium from deck-loading, which
must raise the centre of gravity and depress the meta-
centre; also to hint that engineers may promise immu-
nity from danger, whilst the melancholy fate of the
Captain forbids us to trust in their scientific calculations.
One thing is more than probable, that, in rough weather,
deck-loading will produce heavy rolling motion.
Short of the wild idea which goes by the name of the
“Ferry scheme,” with all its doubtful experiments and
certain tremendous outlay, much might be done to
alleviate the discomforts of the passage across the Chan-
nel. There might be larger vessels, with increased
steam-power; better means for embarkation; shorter
passages might be ensured, and comfortable arrange-
ments might be made, so that every passenger could
recline with the head to the bows of the vessel, whether
on the deck or in the cabin. All these points might be
ensured without any dangerous experiment, and there
can be little doubt that the testimony of passengers
would soon prove the efficacy of the plan.
—sº-o-º--—
sympathetic ophthalmia.
From the Klin. Monatsbl. f. Augenh., Oct., Nov., Dec., '71.
At the lastophthalmological meeting in 1871 (Heidel-
burg). Dr. Cohn reported two cases of sympathetic
ophthalmia the result of gunshot injury that are of in-
terest from the peculiar form of the exciting cause.
The first patient was struck by a chassepot ball at the
outer angle of the left eye which fractured the orbital
border. The eye was entirely blind. The ophthalmo-
scope revealed a white spot bordered with pigment,
eight or ten times the size of the papilla, it being impos-
sible to tell whether it belonged to the retina or choroid,
The Dr. decided, however, that it was an exudative |
mass. The papilla could not be seen nor were vessels
visible over the patch. It was in the outer portion of
the fundus, corresponding with the part of the eyeball
that was injured. -
At the first examination the vision of the other eye
(to right) was 50–70ths. There was no trace of iritis,
cyclitis (inflammation of the ciliary body) or irido-
cyclitis in the injured eye, simply total blindness; a
magnesium light even not being recognised. Conse-
of the latter with atrophy of choroid.”
quently none of the usual conditions that produce sym-
pathetic trouble. -
All forms of treatment failed to produce any effect.
An examination after five months showed the vision to
be 40–70ths in the right eye.
The patient could now only continue to use his eye
for four or five minutes at a time.
Enucleation of the left globe was practiced. An ex-
amination of the extirpated eyeball by Prof. Waldeyer
showed “chronic chorio-retinitis with plastic exudation
on the inner surface of the retina and fibrous hardening
Four weeks af-
ter the enucleation the vision of the right was 50–50ths, a
complete restitution.
The second patient was injured on the upper lid of
the right eye by a bomb, that scarcely left any trace on the
skin. The sight soon became defective, and an ophthal-
moscopic examination revealed a little brownish-red
spot on the macula lutea of the size of a pin head sur-
rounded by a yellowish-red zone from which extended
a few small horizontal white lines. There was a central
scotoma corresponding exactly with the macula lutea.
By eccentric vision letters No. 20 of Senellen could still
be made out.
After some weeks the left eye, which at first was per-
fect, could only read No. 3 Senellen. Enucleation was
practiced on the 22nd April, and when the patient was
seen last, 22nd August, the vision was perfect.
Prof. Walkyer made the examination of the eyeball
and found nd trouble in the iris, ciliary bodies, or media.
In the macula lutea there was a small elevation that
corresponded with the ophthalmoscopic picture.
The author concludes that sympathetic trouble may
arise without there being any affection of the iris or
ciliary body. -
Donders, eight years ago in one of the meetings stated
that a peculiar form of sympathetic trouble may appear
without any subjective appearances, which must be dis-
tinguished from irido-cyclitis and irido-choroiditis. ' Also
von Gräfe at the same time stated that such cases must
not be confounded, as those not dependent upon affec-
tions of the uveal tract usually afforded a favorable
prognosis.
—sº-º-º-
MHEDICAL NEWS
The **M) ſillain” and the **MIonel”
A Letter from Dr. Epstein to the Cincinnati Israelite, Mar. 29, '72.
CINCINNATI, O., March 20, 1872.
ED. ISRAELITE.-A severe and almost fatal case of
bleeding after the rite of “Milah” having recently occur-
red in my medical practice, I am induced, by a regard
for the welfare of the Israel of our country, to ask your
favor of publishing in your widely circulated paper a
few hints on the prevention and management of exces-
sive bleeding after “Milah.”
166
[APR. 6, 1872.
T ET H. c T.I.N.T.c.
1. “Hitooch” alone, performed with ordinary care,
could hardly ever give rise to excessive bleeding, owing
to the great contractility of the external skin. A little
cold water—or still better, mixed with an equal part of
vinegar—would be all that were necessary to stop the
bleeding in ordinary cases. This part of the rite is a
trifling affair, and devoid of any danger,
2. The skill and coolness of the “Mohel” shows itself
in the delicate and apparently violent second act of
“Priah,” which, as we all know, is essential to the com-
pleteness of the rite as prescribed. It is well that the
“Mohel” be not over-hurried at the performance of it.
One cannot but admire the good tact of the usual ritual
arrangement, making the father say his “B'racha” at
the stage before the “Priah.” It would be even well to
enjoin the father to pronounce his Hebrew clear and
distinct (rather troublesome in certain regions of the
world), and thus afford the “Moheſ” sufficient leisure to
survey the wound, and prepare for a successful “Priah”
I am not intending to presume to instruct the “Mohlim”
in Israel any where; but as they are mostly not physi-
cians (a fact greatly to be regretted), I merely wish to
supplement their ritual knowledge by a consideration of
the anatomical nature and arrangement of the tissue to
be operated upon at this stage. This is the inner mem-
brane of the “Orlah”—“Or Hapnimi.” It is far less
contractile than the external skin, to “Or Hahitson,”
and on that account remains, after the “Hitooch,” closely
covering most of the “Atarah,” by which, I mean the
entire head, and not only its lower projecting rim.
This membrane is thin, translucent, and usually deli-
cate, so that the color of the “Ataroh” is seen through
it. Tracing the course of this membrane at this stage of
the rite, we would follow it down to the groove, behind
the projecting lower rim of the “Ataroh,” and there we
would find the important fact, that it is more firmly at-
tached to the “Guid,” thence it is reflected upon, and
loosely attached to, the inner surface of the now partly
amputated external skin—“Or Hahitson.” Tracing now
again this delicate inner membrane—“Or Hopnimi”—
around the “Guid” and in the groove, behind the pro-
jecting rim of the “Ataroh,” we will find that it term-
inates on either side, in one fold, on the lower surface of
the “Ataroh,” at a little distance from the aperture of
it. Here the delicate membrane, and the tissues
underneath it, form what is anatomically called “the
Frenulum,” or “Bridle,” which is very sensitive and
vascular, i. e., more abundantly provided with nerves
and blood-vessels than that membrane is elsewhere.
The same vascularity exists, only in a less degree, at its
attachment in the groove, behind the “Ataroh.” The
skill of the “Mohel,” in performing “Priah,” consists in
tearing this delicate membrane just sufficiently, and no
more, so as to enable him to push it back with ease from
the “Ataroh,” So as to expose it and its projecting rim
completely all around.
When well performed, the “Priah” is in itself a means
of stopping the bleeding, for a torn wound bleeds less
“Mohel” hastens away to his daily task of life.
than an incised one; and the crowding of the folds of
this membrane into the retracted remaining portion of
the “Orlah” prevents the bleeding, and both speedily
form a healthy soft cicatrix. In ordinary cases, there-
fore, the usual cold water dressing of the wound is all
that is necessary. But it may happen that this mem-
brane is unusually tough, and when the “Mohel” is a
little excited, he may overdo the performance of “Priah”
and detach the membrane on either side from its attach-
ment in the groove, behind the “Ataroh,” nay, may
even tear it completely off all around the “Guid,” and
reach violently into the “Frenulum” (above named),
and lacerate it so that the membrane hangs in one or
more shreds about or underneath the “Ataroh.”
Here the good “Mohel” gets even more excited, and
in the usual, but very unnecessary over-haste in per-
forming the third part of the rite, viz., “M’tsitsah,”
while he spurts about with blood, wine and water, like a
small fire-engine, the good “Mohel” may entirely over-
look the damage done and the danger induced. He
vainly believes, that having pushed back the membrane
in the groove, behind the “Ataroh,” or not, and having
temporarily, by the “M’tsitsah,” staunched the bleeding,
and adjusted his first cold water dressing, that all is
done. The diaper is pinned on, the baby quieted, the
rest of the ceremony gone through with, the “Mazel
Tov” resounds all around, the congratulatory glasses
clink to the good cheer of all present, and soon the good
But,
perhaps, before he reaches his business place, the careful
nurse, or anxious mother, notices that the baby is
unusually quiet, and examining it, finds the diaper
bloody. In haste the Good “Mohel” is recalled ; and
his perplexity and the parents' perturbation begin.
What is to be done?
[Here follow directions (Gentile) for checking hemor-
rhage, the treatment of complications, etc. The whole
article concludes with an editorial suggestion that “No
Mohel should be employed unless well known to be an
expert in the operation or a practical physician.”]
THE SIGNIFICANCE OF DIAGNOSIS.—A man who was
told by a physician that his wife had a cancer, borrowed
a book in order to read upon the subject himself; after
which he remarked to the physician that he did not
think his wife had cancer: “her symptoms were more
those of diagnosis, and if she had that it would kill her ſ”
A VACCINATION MARTYR.—“Example is better
than precept.” Acting upon this wholesome maxim,
a Medical Practitioner stated during the progress of a
case in the Court of Queen's Bench the other day, that
he had been vaccinated 477 times. It was his practice
to vaccinate himself when parents objected, to prove
there was no harm in it.
THE LIBERAL PARTY IN PRUSSIA.—It has been
widely rumored and publicly stated that the eminent
leader of the Liberal party in Prussia, and equally emi-
nent pathologist and physician, Professor Virchow, was
APR. 6, 1872.]
TEEE CI.I.INI c.
167
about to quit Berlin, under circumstances of political
discouragement, and to take up his residence in London.
We understand that this statement is without founda-
tion: in truth, Virchow's activity in parliament this
winter has bºen crowned with very considerable success,
the ministry having adopted some of the important
principles for which his party contends. His position
and influence as an uncompromising Liberal in Parlia-
ment is probably as great now as ever it was, in spite
of all the prestige that the ministry have acquried from
the late war.—Brit. Med. Journ., Mar. 9, '72. -
TREPANNING THE STERNUM.—This operation was
performed upon a certain divine at Amsterdam who was
by this means, freed from a great quantity of matter;
and the heart was thus left so naked that, by applying a
looking-glass opposite the wound, he could see his own
heart beating, which he seemed to take some pleasure in.
This was the noted Becker, who has written against the
existence of devils.-Boerhaave's Institutes, English
edition, 1746.—Brit. Med. Journ., Mar. 9, '72
A KNIGHTHooD FOR CORMACK.—The honor of
Knighthood was formally conferred by the Queen on
Dr. (now Sir) John Rose Cormack at the levée on Thurs-
day. -
A CROSS FOR VIRCHOW.-Professor Virchow has re-
ceived the cross of Commander of the Italian order of
the Crown from King Victor Emmanuel.
—sº-o-º-
CLINICAL, MIEM [O] RANIDA.
Constriction of the Penis by a Wedding Ring.
- BY
DR. M. DUMAREST (Lyons).
Interne des Hopitaux,
From the Lyon Médicale, March 3, '72.
G—, married, aged 59. Entry Sept. 27, '71. Eight
days before entry, with a design at least original, he in-
troduced his penis into his wedding ring. The ring was
imbedded behind the glans and prepuce. The prepuce
was in the condition of paraphymosis and the constric-
tion of the ring had produced an ulceration of unequal
depth: it was very deep on the upper surface of the
penis, superficial over the urethra on the under surface.
Micturition was difficult but still possible.
The ring was divided in three segments, subsequent
cicatrisation was rapid; two days afterwards he left the
hospital almost cured.
In this patient notwithstanding the violence and long
duration of the constriction, though there was ulceration,
there was no gangrene. Gangrene of the penis from
mechanical cause is very rare, whether the cause be |
artificial constriction or by paraphymosis. In truth
ulcerations from a ligature of the penis, ulceration not
only of the dorsum but of the much more resistant under
surface, ulceration so extensive as to produce urethral
fistula may exist and yet gangrene will not ensue. M.
Laroyenne, notably, has seen two cases of ulceration of
this kind in children fearful of punishment who tied the
penis to avoid wetting the bed. Our patient is a proof
that sphacelus does not present as easily as most of the
authors claim.
It is useless to add that fatal mortification of the
penis may ensue if the constriction be of long duration
and excessively violent. As to paraphymosis it is gen-
erally admitted that it may be easily complicated with
gangrene; far from being true, this complication is ex-
tremely rare. M. Laroyenne has never observed it. In
all cases it easily produces ulcerations of the prepuce
and furrow. This ulceration may cause the most serious
dangers on the under surface, if it involve the urethral
canal. It may be the point of departure of an urethral
fistula or indeed of an immediate urinary infiltration or
finally of a future stricture. But the circulation is ex-
tremely rarely sufficiently arrested at the outset to in-
duce, by the sole fact of constriction, mortification of
the glans or the cavernous body. M. Demarquay” and
many others with him are wrong, then, in admitting its
frequency, with either phymosis or paraphymosis.
Cases of ligation or constriction of the penis by foreign
bodies are not rare. A few are encountered everywhere.
We cite a few as follows: e
M. Demarquay has reported two; the first was pub-
lished by M. Leteinturier, of Havre. The introduction
of the penis into a ring was followed by mortification of
the skin of the entire penis and the anterior part of the
scrotum. The patient was a peasant who had used this
token of love from his mistress in this way as a charm.
The second was that of Bourgeoist who did not hesi-
tate to remove a portion of the corona glandis to facili-
tate the detachment of the constricting ring. It was a
radical proceedure: the patient was released from it
with a few eschars upon the prepuce and the dorsum.
penis from which he recovered in two months.
Nat. Guillot reported the case of a baker who in the
first months of marriage permitted his wife to pass over
the penis the bond which she had carried on her finger.
This ring was gold and a pharmaceutist conceived the
ingenious idea which released the patient. He dissolved
it in a bath of mercury. - .
M. Guibout, in 1868, communicated to the Société
des Hôpitaux the case of a man of more than 60 years
of age who had introduced his penis up to the root in
seven rings of copper, very small and very strong, “to
procure,” as he said, “a few moments of pleasure.”
These rings remained in place eleven hours. The penis
had become hard; cyanosed, extremely turgid and of
ganrenous hue. After a thousand efforts the seven rings
e-
*Archives de Méd., 1870.
f Mém. de l'Acad. Roy, de Chirurg., vol. I.
168
[APR. 6, 1872.
TIEEE CI, IISTI c.
were successively divided. In eight days every local
trace had disappeared.
Two well known cases we finally cite; the one of a
soldier in whom Larrey found the penis fastened in the
socket of his bayonet, and the other that of the bather
found suspended by the penis from the cock of his bath
tub.
STRANGULATED HERNIA REDUCED BY DIGITAL
DILATATION.—Dr. Acaldo da Savigliano reports that
he was called to a patient aged 63 years, with an in-
guinal hernia of forty years standing. -
In consequence of a gastronomic excess this patient
was attacked with intense colic and incessant fecal
emesis. Futile essays at reduction by taxis had been
made by two physicians. Ice had been applied, blood
had been let, the patient had been put into a hot bath.
On the following day, the patient being in the same
condition, a renewed attempt at taxis was made and
then, 18 hours after strangulation, an operation, was
performed. This operation consisted in an incision
parallel to the long axis of the tumor, division of the
sac and exposure of the intestine which was found livid
but still warm. The operator then introduced his
finger beneath the ring as a guide to the bistoury, but
perceiving that after having insinuated the little finger
he was able to introduce the middle finger, he dispensed
with the incision and succeeded in returning the intes-
tine into the cavity of the abdomen.—Gazetta Med. di
Torino–Bull. de Therap., Feb. 15, '72.
CHLOROHYDRATE OF NARCEINE by Hypodermic
Injection.—M. Paul Pétrini reports, in his dissertation
on this subject fourteen cases in the additional experience
of Prof. Béhier (Hôtel-Dieu) and in the different depart-
ments of this hospital with the following conclusions:
1. In a dose very minute, the chlorohydrate of
narceine possesses an action decidedly sedative.
2. It is much superior in sedative action to the salts
of atropia. -
3. Its anti-emetic action is equal if not superior to the
chlorohydrate of morphia.
4. As a hypnotic, even after morphia and the other
preparations of opium have failed, the chlorohydrate of
narceine in dose most minute produces Soporific effects.
5. The chlorohydrate of narceine acts with the same
efficacy and with the same rapidity in whatever part
of the body injected. -
6. Even in minimum dose the chlorohydrate of
narceine produces a transitory elevation of temperature
and a momentary augmentation of pulse and respira-
tion.
There is observed at the same time a reduction of
arterial tension.—Bull. de Therap., Feb. 15, '72.
TREATMENT OF ENURESIS.—Cases of enuresis are, as
a rule, very troublesome to deal with ; and, therefore |
though I have nothing new to recommend, I think it
may be worth while to record a very successful case.
Emily B., 6% years, healthy, and of healthy parents,
had from infancy up to November last, been used to wet
the bed nightly. All sorts of treatment had been tried
in vain. I ordered the lower part of the spine to be
sponged nightly before she was put to bed. This has
been continued every since, and she has only once wet
the bed. This speaks for itself. I shall continue the
treatment for some months longer, and have no doubt a
permanent cure will have been effected.—Savage—Brit.
Med. Journ., Mar. 9, '72.
GRANULATIONs of THE Conjunctiva TREATED BY
ELECTRICITY.--Dr. Arcoleo of Palermo has already
employed this remedy with success in these cases
(Eléments d'electrothérapie oculaire in Gazetta Clinica
di Palermo 1870). Shortly after Dr. Kohn of Berlin
obtained satisfactory results in seventeen cases; this
physician employed a battery of only one element.
Having protected the eye with Jaeger's plates he placed
the heated platinum wire on the eyelid. Dr. Kohn, thus
had recourse to thermal galvano-cautery, while Drs.
Arcoleo and Rodolfi secured the chemical galvano-
cautery. Dr. Schivardi's method is thus described:
The negative pole of the battery composed of two ele-
ments of Bunsen is applied by means of a buttoned
sound to the inverted surface of the upper lid. The
positive pole is applied to the nucha by a sponge sat-
urated in salt water. The first session is of ten minutes
duration. Dr. Schivardi publishes three observations
of old granulations lasting respectively, in duration, two,
three and eight years. The first case was cured in five
sessions; the second was decidedly improved in two
sessions; the third, aftected also with concomitant
blepharitis and pannus, not only recovered from these
affections, but also regained sight in nine sessions. To
practice electrisation three assistants are required, one
to hold the positive pole, the other the negative, the
third holds the lid reversed and the head fixed.
This application of electricity is now to be taken into
serious consideration in the medical world, for the dis-
cussion of the therapeutic value of electricity in ocular
maladies is made the order of the day for the next con-
gress of the Italian ophthalmological association.—
Il Morgagni—Bull. Therap., Jan. 30, 72.
XYLOI, IN SMALL-POX.—I have during the last few
of the prevailing epidemic of small-pox here, used xylol
with most satisfactory results. I do not, however, agree
with giving it in capsules, as recommended, simply on
account of the great difficulty generally experienced by
patients in Swallowing during the severe stages of the
disease; nor is it miscible with water alone, as stated.
I have given it in doses to adults of 20 minims every
three or four hours, either in milk or mixture of almonds;
the latter I prefer. I should be glad to hear of its ex-
tensive use, as I believe in its efficacy, although I can-
not define its specific action.—H. B. Hurman, Bridge-
Water.—Brit. Med. Journ., Mar. 9, '72.
ºmmºn-
The Divided Medicine Com’y,
CINCINNAT1, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEw AND ExCEEDINGLY PRACTICAI,
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. - - .e.
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities.
But not only SOLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINEs. - ۼ -
* This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain;
# *, *, *, *, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. •', - -
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE To SPOIL BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For Samples, Price Lists, and Agencies, address
Hoºese,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O. -
MR. FREDERICK KRAUs: . CINCINNAT1, February 15, 1871.
. Dear Sir—The specimens of your “Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: ſº-
SULPH:MORPHII......................3% grain in each square. ARSEN:ACID......................... .1-20 * tº
*ś::::::::::::::::::::Aerºn inºch Tºrº. §º: lºsiºn mºnº
é & COPPER * * * * * * * * * * * * * * * * * * * a see wº}% & ſº . :,
RESPECTFULLY YoUBs,
E. S. WAYNE, Analytic Chemist.

Carriage Manufacturer,
re 9 and 11 East Sixth Street, bet. Main & wana,
I MARE NOTHING BUT
Frasz, czass work,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages, .
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passed. Of ---
LIGHT FAMILY CARRIAGEs
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to
PHYSKEFANS” {|SE.
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
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The superiority of my light gentlemen’s
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to Dr. W. W. Dawson and all the leadin v/
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LXZ Physicians in the city and fieighborhood. .N.
83 - 77
K
G
Nº.






O' D C R LE s s AN ID PA. L.A.T A. B. L. E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency.
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c. * -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent. *
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated. -
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.


William Autenrieth,
ROBERT CLARKE & Co's.
No. 71 wrest sIxTH stre+GET,
BETWERN WAINUT AND WINK,
cincinnati, OHio,
MANUFACTURER OF AND DEALER IN
III III IIHRIII III,
Abdominal Supporters, Trusses,
j
CTUB-F00T SHOES,
SPINAL APPARATUS, ETC
Keeps constantly on hand a full variety of
Metalic and ERubber syringes,
Storm.ach Pumps, Etc.
STOCKINGS FOB WABDGOSE WEDNS,
} - i
Special attention given to the fitting of Apparatus for Deformities.
pay-Agent for DR. L. A. BABCOCK's
silver uterine supporter,
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• º:
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GooD s AMARITAN HOSPITAL.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished throughout * * provided with all the necessary ap-
pointments of a First-class Hospital, Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the -
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
Theºregular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
service. -
Gº" Address,
SISTEE ANTHONY,
- Hospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio-







CINCINN ATI.
E" A G U L T Y.
J A M E S G R A H A M, M. D., D E AN,
Professor of the The Ory and Practice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomy. Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D., - T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
JAMES T. WHITTAKER, M.D., JOHN L. CLEVELAND, M.D.,
Professor of Physiology. Demonstrator of Anatomy.
SAMUEL NICKLY'S, M.D., - CHARLES KEARNS, M. D.,
Professor of Physics and Medical Chemistry Assistant to the Chair of Surgery. ©
VVT. VV . SFXEI.Y. , N.I. D.,
IP 1"ofesso of ID is e º uses of the Iºye arid IHEar, andl Secretary of the Faculty.
---
$
T. LOU18 BRow N. M. I.). I'rosecutor of Anatomy. F. NoHLE, Janitor, College Building, Sixth St., bet. Vine and Race.
- - y } ge 12. g y
-*
Printed and Published by Non R1s & MURRY, Medical College of Ohio Building, Cincinnati,

THE CLINIC,
19t.JBLISHED EVERY SATUR DAY.
*... ... ?"
*
*
"Ya
Vol. 2.
HITTAKER, M. D.
No. 101 West Ninth Street, Cincinnati.
JAS. T. VV
_A_SSOCIALTIE, ETXITOR,S.
W. W. D.Awson, M. D. THAD. A. REAMY, M. D.
P. S. ConneR, M. D. C. D. PALMER, M. D.
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C O N T E N T S.
*-*-*. • Page.
ORIGINALL ARTICLES
A Review of Some of Prof. C. E. Brown-Séquard’s
JRoberts Bartholow, M. D...
TRANSI LATION
The Process of Decomposition (An Abstract from Caspar’s Gerichtl.
Medicin. Berlin, 1871)
scIENTIFIC NoTEs
Extracts from Quetelet’s Science of Man—Sea-Sickness—Prof.
Laycock on Ears—Wentral Body Heat 174-177
M IELDICAL NEWS.
American Medical Association—Kentucky State Medical Society—
Signs of the Times—Medical Science in Quito—Salaries of Phys-
icians B. C.—A Munificent Donation—A Heavily Backed
Journal–French Patriotism—The Oldest Medical College in
the West—Graduates in Medicine in 1872............................
CLINICAL MEMORANDA
Opinions, by
T80
º .180
Ergot in Varices—Management of Epilepsy
HOME NEWS.
THE curious processes of saponification and mummifi-
cation meet with full discussion in the exhaustive
chapter on the process of decomposition concluded to-day.
Quetelet's recent developments from his continued
statistical researches are an extension of those investi-
gations which have long ago made this method of de-
duction famous. Buckle, it will be seen, is only his ex-
ponent in political economy.
No one can fail to be interested with the chapter on
the conformation of the ear as an indication of cerebral
development.
The discovery of the effects of ergot on varicose veins
as detailed under Clinical Memoranda, is another of
those happy results now becoming so frequent, from the
scientific study of the action of medicines,
C IN C IN N A TI, A PRIL 13, 1872.
Editor. .
92 wres
J. TAFT,
TERM s—$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
• * : * All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
.*
No. 15.
coArs e co-
Fashionable Hatters,
IMPORTERS AND MANUFAUTURERS OF
EABEES” FºrS,
T ENOTTERTEL ST.
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º
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TXETNTTIST's
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CINCINNATI, O.
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,


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PIKE's OPERA HOUSE BUILDING,
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GooD s AMARITAN HOSPITAT.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
-
pointments of a First-class Hospital. Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
sistºns or citamrty, *
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice. -
. The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
service.
8&" Address, - - -
sISTER ANTHONY,
Hospital of the GOOd Samaritan,
Corner of Siacth and Lock Sts., Cincinnati, Ohio-























































































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Made to order of N. Y. M. Muslin and 2300
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Wamsutta Muslin and 2100 HEAVY Lin- -
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Perfect satisfaction given or money cheerfully
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Also import and Manufacture Men's Furnish-
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Pike's opera-House, Fourth Street, Cincinnati; 931
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CALMA R.G.O
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Also saw and keep on hand a large stock of Poplar, White Walnut and
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Office and Warerooms, 136 and 13s West second Street, *.
veneer Mill, 507, 509, 5ii, 513 & 545 W. Sixth St., CINCINNATi,

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ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
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Are furnished to Officers and Soldiers on Government
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Medical profession, or to those wishing information con-
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was called to artificial limbs—my choice in a limb–why I
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... a =
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crºwcz.w.y.z rz.


DIVIDED MEDICINES,
The Divided Medicine Com’y,
CINCINNATI, OHIO.
, ºr
The Company have the honor of bringing to the notice of the Profession, this NEw AND ExcEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general. . -
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. . . -
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities. •
But not only SoLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. - ... --
* This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
ł, , , , ºo, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. . - g - -
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE To spori, BY ANY LENGTH OF TIME they may
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the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
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For samples, Price Lists, and Agencies, address
* Divided M.
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Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
MR. FREDERICK KRAUs: - CINCINNATI, February 15, 1871.
Dear Sir—The specimens of your “Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: : - . * -
SULPH:MORPH II.......................% grain in each square. ARSEN:ACID...................... ...1-20 grain in each square,
§ { CH IN INI ....................... I & 6 & 8 $6. CALOMEL * % § { •6 $6
* * COPPER • . . . . . . . . . . . ***** tº e º is ſº gº tº % 6 & -
Respectfully YoUBs,
E. S. WAYNE, Analytic Chemist.



*-*.
vol. 2..] s A T U R D A Y, A P R I L 13, 1872. [No. 15.
O R. I G IN A I, A R T I C L E S.
A Review or some or prior. C. E. anows.
. seouard's opinions.
By
RoBERTS BARTHOLOW, M. D.
The lectures of Dr. Brown-Séquard published in the
three preceding numbers of THE CLINIC, furnish us
much material for reflection. If his views are not always
tenable, at least, they are interesting and suggestive,
and exhibit that fertility in invention and independence
in statement characteristic of the pioneer. Few of our
readers need be told how numerous and important have
been Dr. Brown-Séquard's contributions to knowledge.
Many of his discoveries have taken.permanent place in
science. But the very qualities of mind which are
most necessary to the successful prosecution of discov-
eries often unfit the investigator for a patient and
candid examination of the views of others. Hence, his
opinions and the observations on which the opinions are
based, are apt to be one-sided. It requires the work of
many investigators to develop the whole truth.
In illustration of this narrowness of perception which
comes of devotion to a special line of investigation, I
may take Dr. Brown-Séquard's views on the importance
of reflex action from peripheral irritation in the causa-
tion of various convulsive and other morbid phenomena.
It is undoubtedly true that he has admirably shown by
vivisections how injuries of the spinal cord and of cer-
tain nerve trunks, may result in such an exaltation of
the reflex faculty that irritation of the epileptogenic
zones, will be followed by epileptic seizures. This
happy demonstration has led him to a generalization of
the influence of reflex action so sweeping, as to prac-
tically exclude from consideration the large body of
facts demanding a very different interpretation. His
central idea is that peripheral irritation causes an in-
crease of .the activity of some, and a suspension of
the activity of other parts of the nervous system, and
the symptoms of disordered function which ensue are
thus produced. Irritation of the epileptogenic zone
causes a suspension of activity of the cerebral hemis-
pheres (loss of consciousness), and an increase of activity
of the “spasm centre” (convulsive seizures). He thus
for the time being ignores the influence of local brain
lesions in causing definite symptoms, and indeed he
affirms “that we may not refer symptoms to specific
lesions.” He also failed to advert to the now well-estab-
lished fact, that peripheral injuries cause changes in the
T H E CI, IISTI c.
169
nervous centres with which the points of irritation are
connected. In the space and time at my disposal, I
cannot do more than examine into these two questions
and make some observations on the points of practice
"evolved by Brown-Séquard from his theories.
1. Are there special centres of function in the brain, and
do injuries of them cause definite symptoms ? Dr. Brown-
Séquard assumes the negative and brings forward the
various and contradictory symptoms, and sometimes the
absence of symptoms in brain diseases in support of his
side of the question. I think it can hardly be denied
that the present tendency of medical belief is to con-
sider the brain a compound organ made up of many
parts having different functions. This is partly ad-
|mitted by Dr. Brown-Séquard when he states that the
left hemisphere is more immediately concerned in the
function of language. “Indeed” he says “cases of
aphasia following right sided lesions—unless the indi-
vidual be left handed—are exceedingly rare.” It is
true Broca's localization of articulate language in the
third left frontal convolution, although supported by
many observations, has been opposed by many and
cannot now be considered as established, but further
investigations will hereafter, no doubt, as former obser-
vations have, more conclusively, limit the seat of this
faculty in the left hemisphere. That extensive de-
struction of brain tissue should occur in the right hem-
isphere without any pronounced symptoms need not
occasion surprise, when we reflect that the left hemis-
phere is the first developed, and as the facts show, first
and chiefly educated in the performance of functions.
That lesions in various parts of the brain should occur
without producing characteristic objective evidences,
and that the symptoms of a certain form of brain dis-
ease may vary in different cases, is a condition of things
not unparalleled indeed, in the diseasesofother organs the
physiological functions and morbid changes of which
are better understood. It is not uncommon for a latent
pneumonia to exist without the usual signs, or for a
hepatalgia to be confounded with hepatic colic. Will
we therefore ignore physical diagnosis in diseases of the
lungs, or rational signs, in determining the character
of hepatic diseases? If it be shown in numberless
instances that a hemorrhagic extravasation in the left
corpus striatum, will cause right hemiplegia, what will
be the value of some rare instances in which paralysis
followed on the same side as the injury 2 Such excep-
tional instances would rather indicate a deviation from
the true structural type. Although alternating hemi-
plegia may occur from disease of the corpora striała, yet
who does not admit that it is a most significant symptom
of disease of the pons Varolii. Paralysis of the extremi-
ties on one side and of the third nerve on the opposite
side most surely indicates disease of a crus cerebri.
Paresis of muscles to which the 7th nerve is distributed
is also alluded to by Dr. Brown-Séquard as due to widely
different lesions and as therefore wanting in significance
as a symptom, but is it not perfectly well known that
170
[APR. 13, t&72.
TIEHE TER C T , T N T C .
we may fix with great accuracy on the position of a
lesion of this nerve, whether in its trunk or in the centre
from which it takes its origin? Paralytic affections of
the various cranial nerves, enable us to locate with the
greatest certainty the position of adventitious products
in the brain, notwithstanding exceptional instances may
occur due to causes which we cannot now well explain.
To deny the value of these signs and to exaggerate the
importance of exceptional instances, is to discourage all
attempts at accuracy in the diagnosis of brain lesions
and to relegate the study of these affections to the ob-
scurity of a century ago. This is all the more sur-
prising in Dr. Brown-Séquard who has been celebrated
for his diagnostic acumen. His discouraging observa-
tions may, however, have their inspiration in the desire
of the specialist to exaggerate to ordinary professional
minds the difficulties, and the special skill and knowl-
edge necessary for success, in his special field of prac-
tice.
Dr. Brown-Séquard does not always, however, dis-
courage diagnostic refinements in nervous diseases. He
has indeed, distinguished himself by subdividing the
functions of the organs concerned in his favorite doctrine
of reflex action. Thus he makes no less than “eleven
kinds of nerve fibres” having “distinct functions”
(Lectures on the Diagnosis and Treatment of Functional
Nervous Affections Part 1. p. 11). He has carried this
subdivision to the utmost limit of plausability, for, in a
recent publication he affirms “that the conductors capa-
ble of causing convulsions are distinct from those which
serve for the voluntary movements” (Archive de Phy-|
siologie Vol. 2, p. 776). Vulpian and Philipeux have
shown, however, by transplantation of nerve fibres, that
the nerves merely conduct nerve force, and indifferently
whether it be of motion or sensation. If there be so
many kinds of nerve fibres, there must be special nerve
cells capable of reacting definitely to the impressions
received. Hence, it follows, these nerve cells must con-
stitute centres, the disturbance of which by disease,
must cause definite reactions, or symptoms. Our ina-
bility in any case to locate the seat of the alterations as
manifest by the symptoms (anaesthesia, hyperasthesia, etc.)
is due of course to the imperfection of our knowledge.
Examples showing contrary to Brown-Séquard’s views,
that symptoms indicate lesions, might be greatly multi-
plied, but I pass for want of space from these general
considerations to the special question of centres of func-
tion in the brain. The one-sidedness of Brown-Séquard's
opinions may be best shown by bringing forward some of
the more modern views regarding functions of certain
parts of the cerebra! mass. The facts of comparative
anatomy show that intellectual power is determined by
the development of the cerebral hemispheres. In the
gray matter of the brain, it is now held, resides those
complex functions included in the term, intellection,
and hence upon the depth and complexity of the convo-
lutions, depends the mental power of the individual.
This well known fact has been illustrated by the re-
searches of Lockhart Clarke and Meynert, on the differ-
ent layers of the cortical substance. Modern investiga-
tions more and more tend to establish the connection of
the faculty of language with the left hemisphere of the
brain, although it may not be limited to the third fron-
tal convolution as maintained by Broca, or to the walls
of the Sylvian fissure as held by Meynert. Dr. Brown-
Séquard entirely ignores the observations of Meynert in
regard to the changes in the cornu ammonis which occur
in epilepsy and other motor diseases. Careful micro-
scopic researches have demonstrated the constancy of
organic alterations of the cortical periphery (MESCHEDE,
Virchow's Archiv., 1865. LOCKHART CLARK, Lancet, &c.)
in cases of general paralysis of the insane. The facts
showing the connection of the tubercula quadrigemina.
with the function of sight are too numerous and direct
to be overcome in significance by the contradictory ex-
amples brought forward by Brown-Séquard—many of
which may have arisen in errors of observation.
Although denying the existence of centres of function
Brown-Séquard admits the importance of the medulla
oblongata as the seat of convulsive movements in epi-
lepsy, yet he is silent in regard to the “spasm centre”
of Nothnagel and the “inhibiting centre” of Setschenow.
(Virchow's Archiv für Pathologische Anat. and Phys.
Band xliv. Hft. 1).
Four systems of inhibitory nerves are now pretty gen-
erally admitted by physiologists: the cardiac, the respi-
ratory, the intestinal, and those which restrain the reflex
actions. We are more particularly indebted to Weber
and Budge for the demonstration of the first, to Rosen-
thal for explaining the second and to Pflüger chiefly, for
pointing out , the third, the inhibiting centre of
Setschenow being the fourth. To these must be added
the “cilio-spinal region” of Budge and Waller. The ex-
istence of all these centres rests upon the same basis of
proof as Brown-Séquard’s discoveries—upon experiments
on animals and the results of disease in man, and are
just as much entitled to credence.
2. Are the symptoms caused by peripheral irritation,
solely due to reflea action ? Dr. Brown-Séquard answers
this question in the affirmative, In assuming this posi-
tion he ignores numerous facts which require a different
interpretation. Especially from the point of view of
the therapeutical application of counter irritation, does
this question demand our most earnest attention. It
is certainly true—and it is a demonstration the impor-
tance of which it would be difficult to overestimate—
that injuries of the spinal cord and of nerve trunks is
followed by epilepsy on irritation of certain zones Sup-
plied by the fifth and the spinal accessory. But we
should not be so dazzled by the brilliancy of this dem-
onstration as to lose sight of a fact which we obtain from
Dr. Brown-Séquard, himself, that these epileptic attacks
do not follow immediately on receipt of the injury, but
appear after a period of three weeks. By this time the
influence of the injury has been sufficiently exerted to
induce changes in the “spasm centre.” Peripheral irri-
APR. 13, 1872.]
171
tation—for example counter irritation—is too commonly
supposed to produce effects merely through reflex action
—the irritation of the surface being reflected from the
centre to the vaso-motor nerves. For this very partial
and incomplete view of the modus operandi of counter
irritants Dr. Brown-Séquard is largely responsible.
His famous experiment of irritation of the skin over the
lumbar region causing contraction of the vessels of the
kidney has exercised an undue influence in shaping
opinion on this subject. Peripheral irritation does more
than simply excite reflex action : it induces, if long con-
tinued, structural changes in the centres of reflex action.
A variety of facts go to prove this. In the blister treat-
ment of acute rheumatism the reaction of the urine is
changed from acid to neutral or alkaline. Sometime
ago Waller, and afterwards Turck, demonstrated that
section of the roots of a spinal nerve will be followed
by atrophy and degeneration of the posterior root and
of its connections upward in the spinal cord. Vulpian
has shown that after section of the nerves of a limb no-
table atrophy takes place in that part of the spinal cord
from which these nerves take their origin. Duchenne
de Boulogne and Joffroy, have apparently established
the existence of two sets of cells in the cord—trophic
and motor. Numerous clinical observations have ren-
dered it highly probable that trophic centres exist in
the cerebro-spinal axis. It follows from these facts that
peripheral irritation not only excites actions of a reflex
Kind, but induces changes in the cells of the trophic
centres. This latter fact, Dr. Brown-Séquard admits in
his last lecture when alluding to the observations of
Turck. If changes take place in the centres from per-
ipheric irritation, shall we not refer the morbid phenom-
ena which result rather to these centric lesions? So in
Dr. Brown-Séquard's epileptic guinea pigs shall we not
refer the convulsive siezures to centric lesions—for is it
not admitted that the convulsions occur not at once,
but some weeks after the peripheric injuries?
In fact Westphal has very recently shown that min-
ute hemorrhagic extravasations occur in the medulla
of these guinea pigs, and that the convulsions do not
begin until this process has taken place.
There is one other fact relating to counter irritation |
in regard to which Brown-Séquard is unaccountably
silent. I now refer to the difference in effects which fol-
low slight and temporary irritation, and the deeper and
more enduring injuries. Especially when he came to
discuss the influence of his theories on his therapy, we
should have had some light thrown on this important
question. It is now well understood that whilst slight
irritation of the terminal filaments of the sensory nerves
-as the action of a mustard plaster—causes reflex con-
traction of the organic muscular fibre of the arterioles,
deep injuries by exhausting the irritability of the sym-
pathetic, induce paralysis and hence dilatation of the
vessels. This last mentioned result is illustrated by the
ulceration of the duodenum which ensues after deep
burns of external parts. Finally, Dr. Brown-Séquard
the range of utility of which is so much wider.
argues ill, indeed, for the therapeutical skill of a special-
does not allude, except in the most indefinite way, to.
the changes in the trophic centres wrought by severe or
long continued peripheral irritation.
3. Dr. Brown-Séquard's therapeutical maxims. In read-
ing his lectures on “The Treatment of Functional Ner-
vous Diseases,” and his most recent utterance in the
last number of THE CLINIC, it must appear evident to
any practical mind, that an experimental physiologist,
devoted to a theory of the truth of which he is thor-
oughly persuaded, is a poor guide in therapeutics. His
special views constantly intervene to bias his opinions
and his practice. This fact is conspicuously shown in
his last lecture. Recognising the all-sufficient influence
of peripheric irritation in the production of morbid
phenomena, his remedies are comprised in two classes;
those that cause, and those that allay peripheric irrita-
tion. “It is a matter of indifference by what means this
arrest of activity is produced. It is only essential that
we recognise that any function may be arrested by dis-
tant irritation,”—in this language Dr. Brown-Séquard
formulates his theory. The practical outcome of his
therapeutical speculations is seen in his suggestion to
stop an epileptic paroxysm—“to arrest activity”—by
injecting carbonic acid into the larynx His favorite
measures are the cautery to a white heat, and ice. “The
most powerful means of changing the state of the circu-
lation is the heated iron,” and “ice ranks next to the
cautery.” He thus comprehends all morbid processes
in the blood supply of the affected part—all therapy, in
the means of acting on the vessels. • -
Whilst Dr. Brown-Séquard makes much use of on
of the physical forces—heat—it is a matter of extreme
surprise that he utterly ignores another—electricity—
It
ist in nervous diseases, that he has not yet adopted the
applications of the constant and induced currents, either
in diagnosis or in treatment. It is impossible for him to
ignore electricity. The literature of the subject is too
vast, the names of its advocates too influential, the
claims for its therapeutical efficiency too strongly urged,
to permit him to pass it over in silence.
Finally weshould not fail to note that Dr. Brown-Séquard
offers us nothing new in the treatment of nervous diseases,
except his very extraordinary and impracticable sugges-
tion to arrest the epileptic paroxysm by injecting car-
bonic acid into the larynx. The observations which he
has made in his lectures in Cincinnati were before per-
fectly familiar to the medical profession. But we should
not expect much in the direction of practical therapy.
Dr. Brown-Séquard's strengh lies, of course, in origi-
mal investigations—in evolving theories from a basis of
experimental inquiry—a much higher plane for intel-
lectual effort, it is true, than drug-giving. To practical
physicians belong the humbler task of applying to the
treatment of disease the new views of normal and disor-
dered function which are disclosed in his researches.
The very bias which he has in favor of his own opinions
and his apparent indifference to the researches and dis-
coveries of others, by narrowing his breadth of view,
reduce his therapeutical resources to the level of any
ordinary medical practitioner. -
172
[APR. 13, 1872.
TIEEE C T.I. NI c.
T H E P R o o Ess o F D Eco M P os IT I o N.
An Abstract from Caspar's Handbuch der Gerichtlichen
Medicin. Berlin, 1871.
Continued from No. 14.
Saponification.
The constant effect of water on a corpse in a state of
colliquative decomposition, arrests that process, whether
the corpse lies actually in water, or only in very
damp earth. By the union of margaric acid and ammo-
nia, in many corpses, a process of saponification sets in,
and a peculiar fat, known as adipocire (Leichenfett,
Fettwachs) is formed. This occurs more readily in fat
bodies; hence the corpses of children saponify more
easily than those of adults. Caspar says it is difficult
to determine the time when this process first begins.
Referring to Devergie's opinion that it takes the body of
a person drowned, one year, and that of a person buried
in the earth three years, to entirely saponify, he cites
the case of a newly born child, buried in very damp
earth, one-third of whose body he found saponified only
13 months after death; and the case of a foetus which
he found entirely imbedded in adipocire 64 months after
burial. He thinks the formation of adipocire will hardly
assume any considerable dimensions until after 3 or 4
months in water, and 6 months in damp earth. The
fat itself cannot be mistaken, even by the most unskill-
ful. It is homogeneous in its formation, white, or with
a slightly yellowish tint, soft under the knife and fusible
in a flame. Its odor is not very disagreeable, and
rather resembles that of musty cheese. The muscles,
with their tendons and aponeuroses are first attacked,
but there is no organ in the body that does not succumb
to the process. According to Güntz's experiments, the
adipocire of a corpse is of greater volume than all the
fat the body posessed. This is important when we wish
to determine the weight of the corpse of a newly born
child for the purpose of calculating its age. Caspar, like
Devergie, has never seen an entire corpse completely
Saponified, but he observed the complete saponification
of a foetus in utero.
Mummification.
This is the well known, remarkable and complete dry-
ing up of the body, in which it retains, generally, its
form, and even its features, (though the latter may be
distorted), and assumes the brown color of rust. The
skin of a mummified corpse is dry; it feels like parch-
ment and lies close to the bones. Its odor is not at all
like the odor of decomposed bodies but resembles that of
old cheese. The interior organs have either entirely
disappeared, or they have been changed into a dark
brown, dry mass, the organic parts of which cannot be
formed, may last thousands of years.
distinguished by the naked eye. Artificial mummifica-
tion, by the injection of arsenic, and the various methods
of embalming was known already to the Egyptians.
But the general conditions of natural mummification
are but little known. It occurs as well in corpses that
are exposed to a continuous desiccating draught of air,
in vaults for instance, as in those to which the air has
scarcely any access at all, e. g., corpses buried in leaden
coffins. Caspar thinks it cannot be doubted that corpses
| readily mummify in dry, hot places, and that the tales
of mummified entire caravans, in the Arabian deserts,
are not incredible. Certain it is, that a mnmmy, once
We could not,
therefore, determine the time of death in the case of a
corpse found mummified, with any degree of probability.
Successive Changes of the Corpse, Interiorly.
Caspar says that the interior organs are never and
under no conditions subject to a uniform effect of the
process of decomposition. From his long experience
and independent of the assertions of Bichat, Orfila,
Devergie, Güntz and Hébread, he feels justified in giving
the following data as reliable: -
1. The trachea, including the larynx, is attacked first.
As long as the discoloration on the abdomen is confined
to separate green spots, the mucous membrane of the
entire trachea, down to the bronchi, is a pale color, ex-
cept when death was caused by suffocation or laryngitis.
But as decomposition progresses and the green spots on
the abdomen become confluent (though the corpse, ex-
teriorly, may otherwise appear fresh) the mucous mem-
brane assumes a uniform dirty green, greenish-brown,
cherry-red, or brown-red, no vascular injections being
visible in this discoloration. This takes place, in sum-
mer, in from 3 to 5, in winter, in from 6 to 8 days.
Caspar warns us not to mistake a simple and early
phenomena of decomposition for capillary injection and
the result of death from suffocation or drowning. Age,
constitution and mode of death make here no difference.
In the further course of decomposition the mucous
membrane becomes olive-green, the different parts of
the cartilage separate, but months pass before they en-
tirely disappear.
2. The substance of the brain of neo-nati and children
up to one year of age follows next. -
3. No organ is found in so many different forms as
the stomach. We find it of various sizes, inflated with
gas or collapsed, partly or entirely filled with the re-
mains of food, or empty. As it imbibes coloring matter
freely, the mucous membrane will look yellowish from
the contents of the gall bladder, bloody and black from
medicines and dark juices of fruit, red from red wine
and so on, to say nothing of the dangers brought about
by sickness, catarrh, inflammation, corrosive poisons or
the jelly-like softening of the process of decomposition.
The stomach decomposes early. The first traces of de-
composition appear in from 4 to 6 days in the fundus,
in the shape of detached, dirty red spots, which are not
APR. 18, 1872.]
T H E c T, IISTI c.
173
circumscribed, very irregular in form, of various sizes,
some as large as a dinner plate. The reddish patches
are, generally, traversed by blood-red diffused venous
strands. These spots are mostly caused by the imbibi-
tion of serum, which has taken up the coloring matter
of the red corpuscles of the blood, into the walls of the
vessels, and, through these, immediately into the sur-
rounding cellular tissue. All these signs become first
visible on the posterior wall, where they are, in part,
caused by hypostasis; soon, however, they appear also
on the anterior wall. At the same time, similar blood-
red venous strands are formed at the lesser curvature.
These alterations are of great importance in doubtful
cases of poisoning. Caspar says that the signs which
many writers have described as blood stases, and even
as traces of inflammation, and which they have desig-
nated as the signs of death from suffocation by hanging
or drowning, are nothing but the signs of early decom-
position here enumerated. As the process of decompos-
ition continues, the discoloration of the stomach changes
from dirty red to greyish-black and the membranes
gradually succumb to the softening process, which, how-
ever, progresses at the same rate in all other membranes.
In not a single case has Caspar noticed, as a mere pro-
duct of decomposition, the detachment of the mucous
membrane from the muscular tissue, which occurs as
the effect of corrosive poisons which must not be confound
ed with the merely emphysematic loosening of the
mucosa. Still, in a very few cases, an excoriation of the
mucous membrane may be caused by the bursting of a
blister of decomposition, but then the base of the blister
and its surroundings will be colored, and the existence
of other blisters of decomposition, not ruptured, will
insure a correct diagnosis. - &
4. Next in order are the intestines, and all that has
been said with regard to the stomach, applies to the re-
maining portion of the alimentary canal. The coloring
caused by exosmosis, in the intestines near the gall blad-
der, known even to those who have made but few autop-
sies, can deceive no one. But the hypostatic coloring
of the intestinal loops, which occurs early, and is espec-
ially visible in the loops taken up from the small pelvis,
may easily give rise to mistakes. During the course of
decomposition the intestines become dark brown, they
burst, pour out their contents, become greasy, and are,
finally, converted into a shapeless dark paste. In one
case, where a corpse had been exhumed, that showed no
trace of any of the organs of the thorax, Caspar found
fresh feces in what appeared to be an intestinal loop
which had preserved the distinctive odor of human
faces, -
5. In the majority of cases, the spleen is preserved
longer than the stomach and alimentary canal. Still it
belongs to the class of organs that are attacked at an
early date. It becomes soft and, gradually, jelly-like,
may be readily crushed, and after decomposition has
progressed still further it becomes of a steel blue green
º ; Soft, that it can be scraped off with the handle of
8, KIllie.
6. The omenta and mesenteries withstand decomposi-
tion a little longer. If they are very lean, they may be
in a good state of preservation for several weeks after
death; but if full of fat they decompose early. They
become of a greyish-green color, and dry. These organs
do not readily occasion errors.
7. In ordinary cases, the liver is found solid and firm
for a few weeks after death. In neo-nati, however, it is
attacked sooner than in adults. Decomposition appears
first on the convex side, in a glittering green color which
subsequently covers the entire organ, until it is changed
into a coal black. As in all organs, a portion of its blood
evaporates at the same rate, and the parenchyma is
gradually turned into a jelly-like mass. But if the gall
bladder contains no bile (which exudes or evaporates),
it collapses.
8. The substance of the brain of adults is the last in
order of the series of organs that decompose early. The
brain collapses immediately after death, and this con-
tinues as decomposition progress. Remarkable as it is
the first traces of decomposition do not appear on the
surface, but at the base of the cerebrum, in a light green
color which extends from below upwards, and, gradually,
over the entire brain. It visibly progresses from the
grey substance to the white. In a moderate tempera-
ture the brain softens in from 2 to 3 weeks, but it takes
months before the brain of adults becomes that reddish
mass, into which the brain of neo-nati is so very soon
converted. A wounded brain, like all wounded organs,
owing to the increased access of air decomposes much
more rapidly. This circumstance may impede a thor-
ough examination of penetrating injuries to the head,
9. The heart is the first of the series of organs that
decompose at a later date. When the stomach, intestines,
liver, etc., have for weeks been in a state of decomposi-
tion, the heart is still fresh and distinct in all its parts,
though flat and collapsed, containing at that time, gen-
erally no blood at all, or only a few remnants of greasy
blood. Generally the heart softens: its color is at first
greenish, subsequently greyish-green, and finally black.
The little quantity of liquor pericardii evaporates after
decomposition has progressed but very little, and the
pericardium becomes quite dry. Still, the heart does
not show this high degree of decomposition until several
months after death. -
10. The lungs show the effects of decomposition about
simultaneously with the heart, sometimes sooner. In
corpses that exteriorly present the higher degrees of de-
composition, such as a green color, excoriation of the
epidermis, etc., the lungs are frequently still so well pre-
served that their structure may be distinctly recognised.
This indisputable fact says Caspar, is an important
answer to the objections made by theorists, to the hy-
drostatic test. For if the lungs of a new born child,
whose corpse is still fresh, or shows only the first signs
of decomposition, such as a greenish color of the walls of
the abdomen, floats on water, we cannot, in the light of
experience, assume, that they do so because gases of
174
[APR. 13, 1872.
T EH. H. CT, IISTIC.
decomposition have developed and made them specifi-
cally lighter than water. The lungs do not decompose
Bo soon after death, extremely rare cases only excepted.
Moreover, decomposition of the lungs cannot be mis-
taken. Its first traces appear in the shape of circum-
scribed spots of a pale red color and the size of a pin's
head up to that of a millet-seed on the surface of the
lungs. They are caused by a circumscrihed raising of
the pleura, or the filling of one or more peripheric lung
cells with gas. An incision shows at once the fact that
this accumulation of gas does not penetrate to the par-
enchyma. These early traces of decomposition of the
lungs, in corpses otherwise still fresh, are not at all rare,
whilst the higher degrees of decomposition of the lungs
in such corpses are, as before stated, extremely rare.
In such cases, too, decomposition shows itself in blis-
ters varying in size from a millet-seed to a bean caused
by an accumulation of a gas below the pleura and can
be so easily recognised, that they are in themselves a
very plain diagnostic sign of decomposition leading us
without difficulty to ascribe the floating of the lungs to
their putrescent condition. These blisters are first single
and in the most different portions of the lungs. Subse-
sequently they increase in number so as to closely cover
entire portions, especially the inferior surface of both
lungs. -
Notwithstanding the development of these blisters the
lungs do not, at first, change their color. In the course
of decomposition the color becomes darker, dark green
and finally black, and the destruction of the parenchyma
keeps even pace with this discoloration. The lungs|
soften, the evaporation of the liquids causes them to
collapse, and at last, they are entirely destroyed.
11. The kidneys follow next. Their color turns brown;
afterwards they begin to soften, whilst their granulated
texture can still be recognised, and not until long after
death are they found greasy, of little consistency, and
of a black and green color. -
12. The bladder, whether empty, or partly or entirely
filled, shows no signs of decomposition until all the
organs enumerated have been attacked.
13. The aesophagus does not, in the process of decom-
position, keep even pace with the rest of the alimentary
canal. When stomach and intestines can no longer be
critically examined, it will be found for months, still
pretty tense, though of a dirty greenish color.
14. A pancreas, showing signs of decomposition, can
be found only in a corpse entirely deeomposed. Its
color turns a dirty red, until it finally suecumbs to gen-
eral destruction.
15. The diaphragm decomposes very late. Though
in the first weeks after death green spots make their
appearance, still its muscular and aponeurotic structures
may be clearly distinguished in corpses four to six
months after death.
16. Small bloodvessels running into putrescent organs
are withdrawn from observation; but the larger vessels,
especially the arteries, are of all the soft parts among
the very last to succumb to destruction.
17. To the uterus, Caspar vindicates (against Orfila)
the greatest resistance to decomposition of all the soft
parts. When not a single other organ ean any longer
be examined it is still found entire in its position pretty
fresh and dense, of a dirty red color, and so well pre-
served that we may cut it open and examine its interior.
To show the importance of this fact; Caspar” cites at
great length, a case in point from which we abstract the
principal items. A young servant girl suddenly disap-
peared. Rumor would have it that she was enceinte, as
the result of a liaison with a married man of previously
unsullied reputation. Nine months later her body was
found in the privy of the house where she had lived.
Skull, lower jaw and the greater portion of the lower
extremities had by maceration been deprived of the soft
parts; the joints were partly loosened, and whatever
there was left of the soft parts was nothing but stinking
black remnants. The muscles of the abdomen had
changed to adipocire; the intestines, liver, spleen and
kidneys had become a black greasy mass. And yet
Caspar found the uterus entire, of a light red color, hard
and firm to the touch and under the knife, of normal
virginal size; its cavity empty. He concluded, of course,
that the deceased at the time of her death could not
have been enceinte. - -
Cincinnati, March, 1872. HENRY HAACKE.
—-º-º-º-
screNTIFIC NoTEs.
Extracts from Quetelet’s Contributions to
the science of Mºſarn.
To Quetelet is due the argument from the astonish-
ing regularity from year to year in the recurrences of
murders and Suicides, a regularity extending even to
the means or instruments by which these violent acts
are committed; his inference being broadly “that it is
society which prepares the crime, the criminal being
only the instrument which executes it.” To quote a
luminous instance of this regularity of action, M.
Quetelet gives a table of the ages of marriage in
Belgium (Phys. Soc. i. p. 275). Here the numbers of
what may be called normal marriages, those between
men under 45 with women under 30, as well as of the
less usual unions where the women are between 30 and
45, show the sort of general regularity which no one would
expect from mere consideration of the circumstances.
The astonishing feature of the table is the regularity of
the unusual marriages. Disregarding decimals, and
calculating the approximate whole numbers in their
proportion to 10,000 marriages, the table shows in each
of five five-year periods from 1841 to 1865, 6 men aged
from 30 to 45 who married women aged 60 or more, and
1 to 2 men aged 30 or less who married women aged 60
or more. M. Quetelet may well speak of this as the
* Caspar's Gerichtl. Med. 5. Aufl. II. Berlin, 1871.
APR. 18, 1872.]
T EH. H. C. T., T N T C -
175
most curious and suggestive statistical document he has
met with. These young husbands had their liberty of
choice, yet their sexagenarian brides brought them up
one after the other in periodical succession, as sacrifices
to the occult tendencies of the social system. The
statistician’s comment is, “It is curious to see man,
proudly entitling himself King of Nature and fancying
himself controlling all things by his free will, yet sub-
mitting unknown to himself, more rigorously than any
other being in creation, to the laws he is under subjec-
tion to. These laws are co-ordained with such wisdom
that they even escape his attention.” “ * *
It is well known in current opinion that more children
are born in the night than in the day; in fact, there
are about five night-born against four day-born, the
maximum being about mid-night, the minimum a little
before noon (i. p. 208). Why this is no one yet knows;
it is a case of unexplained law. But another not less
curious law relating to births seems to have been at last
successfully unravelled. In Europe about 106 boys are
born to every 100 girls. The explanation appears to
depend on the husband being older than the wife; which
difference again is regulated by prudential considera-
tions, a man not marrying till he can maintain a wife.
In connection with this argument it must be noticed
that illegitimate births show a much less excess of male
children (p. 168).
be accepted), it appears that a law which has been
supposed to be due to purely physiological causes is
traceable to an ultimate origin in political economy.
The examples brought forward by Quetelet, which
thus show the intimate relation between biological and
ethical phenomena, should be pondered by all who take
an interest in that great agent of our time—the intoduc-
tion of scientific evidence into problems over which
theologians and moralists have long claimed exclusive
jurisdiction. This scientific invasion consists mainly in
application of exact evidence, in place of inexact evidence
and of proof in place of sentiment and authority.
Already the result of introduction of statistics into in-
quiries of this kind appears in new adjustments of the
frontier line between right and wrong, as measured
under our modern social conditions. Take, for instance,
the case of foundling hospitals, which provide a “tour,”
or other means for the secret reception of infants aban-
doned by their parents. It has seemed and still seems
to many estimable persons an act of benevolence to found
and maintain such institutions. But when their opera.
tion comes to be studied by statisticians, they are fonnd
to produce an énormous increase in the number of ex-
posed illegitimate children (Phys. Soc. i. 384). In fact,
thus to faciliate the safe, the secret abandonment of
children is to set a powerful engine at work to demoral-
ise society. Here, then, a particular class of charitable
actions has been removed, by the statistical study of its
effects, from the category of virtuous into that of vicious
actions. And even more important transition of the
same is taking place in the estimation of almsgiving
Here, then (if this explanation may
from the ethical point of view. Until modern ages,
through all the countries of higher civilisation, men have
been urged by their teachers of morality to give to the
poor, worthy or unworthy; the state of public opinion
being well exemplified by the narrowing of the word
“charity” from its original sense to denote the distribu-
tion of doles. Yet, when the statistics of pauperism
were collected and studied, it was shown that indiscrim-
inate almsgiving is an action rather evil than good, its
tendency being not only to maintain, but actually to
produce idle and miserable paupers. In our time a
large proportion of the public and private funds distrib-
uted among the poor is spent in actually diminishing
their industry, frugality, and self reliance. Yet the evil
of indiscriminate almsgiving is diminishing under the
influence of sounder knowledge of social laws, and
genuine charity is more and more directed by careful
study of the means by which wealth may be spent for
the distinct benefit of Society. Such examples as these
show clearly the imperfection and untrustworthiness of
traditional, or what is called intuitive morality, in
deciding on questions of right and wrong, and the neces-
sity of appealing in all cases to the best attainable in-
formation of social Science to decide what actions are
really for or against the general good, and are therefore
to be classed as virtuous or vicious.--Nature, Mar. 7, '72.
—º-º-º-
Sea-Sickness.
Sir, Recent, though not large, experience emboldens
me to make one or two comments on the ingenious
theory of sea-sickness, supported by Sir James Alderson
in your last number.
Mechanical theories succeed completely or not at all.
If sea-sickness were due to the impact of the mass of
blood within the body on the brain in its quasi-rigid
coverings, or rather, as Sir James Alderson rightly says,
of the brain and its coverings on the mass of blood, then
every person who lay down flat with his head to the
bows would escape sea-sickness; which, so far as my ex-
perience goes, is not the case. Undoubtedly the hori-
zontal position, with the head low and the eyes shut,
offers the best prospect of escape from the malady; but
I have never seen any reason to attribute the result to
the direction of the head.
The feeling of dissociation between one’s solid and
fluid component parts—as if they found a difficulty in
keeping pace with one another in the race of floating up
and down with the ship—must be only too familiar to
landsmen. The focus of discomfort appears to be not
the brain but the Solar plexus. A feeling of distress at
this point is the instantaneous accompaniment of every
lurch, whether vomiting occur or not. That no such
sensation follows a degree of concussion of the brain
sufficient to produce violent vomiting, I can personally
testify; if, indeed, recollection in such a case be worth
anything.
176
[APR. 13, 1872.
T EH. H. c T.I.N.T. c.
Again, if the cause were so purely mechanical and
simple, all persons ought to suffer in proportion to the
patency of their vascular systems, which I have not
observed to be the case. And the remedy ought to be
equally simple, namely, pressure by a pair of pads on
the carotids during the descent of the portion of deck
occupied by the traveler. A lever attached to a small
parachute would easily effect this. The same plan
might be applied to waltzers, by an adaptation of the
arrangement called the governor of a steam-engine.
Landsmen who repeat their voyages only at consider-
able intervals ought not, if this explanation be the right
one, to gain any immunity from the repetition ; whereas,
in most cases, they do gain a certain degree of immu-
nity. And the recovery of all on board, after two or
three days at Sea, ought to be due to an alteration in
the mechanical conditions of their cerebral circulation ;
a proposition which it would be difficult to prove.
I need hardly say that these remarks are not prompted
by want of respect for the authority of the accomplished
writer to whose paper they refer. I merely suggest that
the demonstration would be more complete if these
points were noticed.
If a channel ferry scheme had occurred to Dante, he
would doubtless have added another depth to his Inferno,
in which the offender, immured in a railway carriage
lined with frowzy cloth padding, with closed windows,
should make perpetually the sea and land journey be-
tween London and Paris in the company of five of our
volatile neighbors.-Mayo, Brit. Med. Journ., Mar. the crown.
23, '72.
—º-e—º-
|PROF. LAY COCIR ON EARS :
H, obed and Lobeless Ears; Monkey Ears; Roger
Tichborne's and “The Claimant’s” Ears.
From the London Med. Times and Gazette, Mar 16, ’71"
In the Medical Times and Gazette for Mar. 22,
1862, appears a lecture by Professor Laycock
on the coexistence of weakness or defective organ-
isation of the brain, with certain peculiarities of
formation of the face, and especially of the parts
answering to the “ribs” of the cranial vertebrae. For
instance, congenital defect of the brain and tendency to
tubercular or other tissue-degeneration are so often associ-
ated with a defective and receding chin that artists and
novelists, when they wish to describe aperson of unusual
strength of character, are sure to give him a well developed
square-cut chin. An upper jaw contracted from side to
side, with a very narrow and highly arched palate; the
“rabbit jaws” with upper teeth projecting so that they
cannot be covered by the lips; peg-like deformity of the
upper lateral incisors; imperfect development of the
* *
• *
, s • * .
• ‘’ s • . . "
upper lip, and going so far as hair lip and cleft palate;
and noses, either snubbed and turned up, showing the
cavities of the nostrils, or preternaturally big and saus-
age-like, as in the Aztecs, are all familiar examples,
But we wish to recall attention especially to Professor
Laycock's remarks on the ears, for they refer by antici-
pation to the difference between the ears of Roger
Tichbourn and those of the “Claimant” who is now
awaiting his trial for perjury. - r
“The form,” says Professor Laycock, “of the external
ear depends upon two fundamental elements—namely,
first, the cartilage with its muscles; secondly, the helix
and lobule. In man the cartilage of the perfect ear is
comprised within an ellipse or ellipsoid proportionate to
the head, and to this is attached a geometrically-formed
helix and a pendent ellipsoid lobule. In proportion as
these parts are defective, or as the ear is monstrous,
triangular, Square, or of irregular form, it indicates a ten-
| dency to cerebral degeneration or defect. Monstrous
ears, with defective helix or lobules, are very common
in idiots and imbeciles. You will note the defective
form and absence of lobule in the female Aztec and in
the case of dementia. The ear of the male Aztec cretin
is also defective, but it more nearly resembles the ear of
the chimpanzee. *
“Angle of Position of the Ear.—You will find that the
|ears of persons differ much as to the angle of position on
the head. The ear points either backwards towards the
vertex of the head, as in the chimpanzee, or upwards to
Ears pointing backwards are usually defec-
tive in form and development of parts, as the helix or
lobule. ę
“Modifications of the Helia, and Lobule.—Race has, I
think, an influence on the development of the external
ear, although I speak with reserve, not having had nu-
merous opportunities for observing and comparing.
But, so far as I have had them, I conclude that the ear
in colored races more nearly approximates that of the
chimpanzee than in our Anglo-Saxon race, in which the
helix is full and the lobule large and pendent as com-
pared with men of the darker races that I have seen,
whether African or Malay. Sea, has certainly an in-
fluence, for it appears to me that women generally have
not only the whole ear smaller than men, but the helix
and lobule smaller in proportion to the ear. And Ithink
I may venture to say, as the result of numerous examin-
ations of the ears of female lunatics and imbeciles, that
from one-third to one-fourth are below the standard of
development as to the lobule. In men somewhat feminine
in form, and compartively defective in force of character,
the ears are often feminine as to the helia and lobule. You
may have such men manifesting great refinement and
sensibility, and perhaps considerable intellectual power;
but, at the same time, even with marks of genius, there
is often seen less capability of endurance mentally, less
force of character, less tenacity of purpose, and even less
clearness of ideas than in standard men. t
“Men of high intellectual attainments, great capacit
APR. 18, 1872.]
TIH. H. C.L.INI c.
177
for mental labor, and great force of character, have a full
perfectly ovoid ear, the helix well developed, the lobule
plump, pendent, and unattached to the cheek at its an=
terior margin. These characteristics are seen in all the
portraits of great men which Lavater gives, and are
easily observed in living celebrities. I was much struck
with the highly characteristic ear in these respects of
the Prince Consort, as he stood without his hat when
laying the foundation-stone of our Industrial Museum in
October. . . - *
“Activity of the instincts and appetites, and perhaps
of vegetative or nutrient force in general, seems also to
coincide with a well-developed lobule. It is worthy of
remembrance that these parts are not constituted wholly
of cartilage; the helix is cartilage covered with a layer
of condensed cellular and adipose tissue, but the lobule
is made up wholly ofcondensed cellular and adipose tissue
without any cartilage whatever. This layer and the skin ||
covering it are highly vascular. Now, in proportion as
the helix is simply cartilaginous and the lobule defective,
or, in other words, as this vascular elastic tissue is want"
ing, you seem to have imperfect encephalic action and
development. And with certain reservations, the plump-
ness and vascularity of the lobules may be considered to
coincide with common activities within the encephalaon.
I say within the encephalon because I am satisfied
we must not restrict our consideration of the
question to intellectual activity alone, for that implies
only activity of a certain kind. You may have great
volitional activity, as in the day laborer, or great sensual
activity as in the sensualist, who seeks only the indul-
gence of his appetites, whether sexual or others. But
it is further to be noted that this vascular activity may
be wholly local and due to exclusively local causes, as
constant exposure to the atmosphere.
“Defective and Adherent Lobule.—In a perfect ear the
ovoid lobule hangs from the cartilage with a rounded
lower margin, which at its inner border is not confluent |
with the face. Now, if this inner margin be adherent to
the cheek, and at the same time the lobule be only a
segment of an ellipse, there is more or less tendency to
imperfect cerebral action. A more important form is
seen when the lobe is not only soldered to the dheek,
but its posterior half cut away, as it were, and the helix
defective.” t - -
The significance of Professor Laycock's remarks is
obvious. Roger. Tichbourn had a soldered and ill-
developed lobule. This was quite consistent with his
whole character and person—overbred, not well-
developed, and, undersized. On the other hand, the
well-developed lobule of the Wagga-Wagga slaughter-
man seems consistent with his audacity, strength of
purpose, and power of will. That one condition can be
changed into the other we hold to be incredible.
VENTRAL BODY HEAT—Animals preserve their tem-
perature best in abdominal decubitus or in crouched
positions in which the belly is covered by the ground or
by the extremities. If rabbits be left bound upon their
backs with extended limbs, as in the position for experi-
mentation, in a room of usual temperature (13–15 C.)
they continue to cool off to such extent that death en-
sues in from one-half to one day. This loss of heat is
not caused by the fastenings for if the animal be
abundantly covered with wool or some such protection
it does not occur. Man, too, gives off a much greater
quantity of heat from the ventral than from the dorsal
surface as is easily verified by the more marked chilliness
experienced in a cold room in bed under light covers
when decubitus is on the back than when partly or en-
tirely on the belly or even with flexed limbs. The
reason of this greater radiation from the ventral surface
is certainly due to the fact that the viscera are covered
anteriorly with a much lighter layer of muscle, etc.—
Ackerman,—Berlin. Klin. Wochenschr, Jan. 15, 72.
—-º-e—sº-
MEDICAL NEws
AMERICAN MEDICAL Association.
WM. B. ATKINSON, M. D.,
Permanent Secretary,
1400 Pine Street, Southwest cor. Broad, Philadelphia.
The Twenty-third Annual Session will be held in
HoRTICULTURAL HALL, Philadelphia, Broad Street
above Spruce, on Tuesday, May 7, 1872, at 11 A. M.
HOTEL ARRANGEMENTS.
Continental, Chestnut and 9th, $4 a day
Girard, Chestnut and 9th, $3 a day.
La Pierre, Broad below Chestnut, $3 a day.
Colonnade, Chestnut and 15th, $3 a day.
St. Cloud, Arch below 8th, $3 a day.
St. Elmo, Arch above 3d, $2 50 a day.
American, Chestnut below 6th, $2.50 a day.
Merchants, 4th above Market, $2.50 a day.
St. Lawrence, Chestnut below 12th, $2 a day.
Alleghany, Market below 9th, $1.75 a day.
St. Charles, 3d bel. Arch, lodging only, 50 cts. a day.
Miller's, 7th and Chestnut, lodging only, $150 a day.
Meals at restaurant of Horticultural Hall, and
Petry’s, N.W. cor. Broad and Walnut, each 50 cts.
RAILROADS.
All the Railroads have agreed to issue half fare, excur-
sion or return free tickets.
Bay All who desire to avail themselves of the above
rates, must send to the Secretary their full names, and
the names of all the railroads over which they must
travel in coming to the session, with stamp for postage.
- WM. B. ATKINSON.
SPECIAL.
Camden and Amboy, excursion tickets at $4 from
New York to Philadelphia and return, if fifty tickets
178 *
[APR. 13, 1872.
TIEEE E C T.I. N. T. C.
are taken. For this ticket, send money to Dr. A. E. M.
Purdy, 123 East Thirteenth Street, New York.
From Washington to Philadelphia and return, $6 if|P
fifty tickets are taken.
Central Pacific, half local rates,
—-º-c-ºn-
KENTUCKY STATE MIEDICAL SOCHETY
Transactions of the Annual Congress of ’72.
The Kentucky State Society closed its sessions April 4,
at Louisville where it had convened for the annual con-
vention of ’72. - -
The first part of the session was occupied by a question
of medical ethics; Dr. E. S. Gaillard having preferred a
number of charges against the private and professional
character of Dr. David W. Yandell. After considerable
debate the subject was decided out of order. An ap-
peal from this decision not having been sustained, the
charges were withdrawn.
Dr. T. N. Wise, (Covington), the President of the
association then delivered the annual address. The
subjects upon which the speaker dwelt were the necessi-
ties of the legalisation of dissection, of enactments to
secure efficiency in the dispensation of medicines, the
registration of births, marriages and deaths, and quite
extensively upon medical education. As the speakers
views are somewhat at variance with those usually pro-
pounded on such occasions we take the liberty of
making the following extracts:
“There is, gentlemen, an undeniable connection
between the age of a government—between the popular
character and genius of the people—and all of the pub-
lic, literary and scientific, institutions which such a peo-
may originate, develop and support. Illustration is
useless. History, with her magic pen, has given us
endless illustrations.
of the Government and the genius of the people are
chiefly scientific and military; in France they are
characterized by self devotion, impulse and enthusiasm:
in England they are conservative, aristocratic and
thorough; in Scotland, Scholastic, accurate and analytical,
in America, practical, rapidly changing, strongly marked
by an easy and swift adaptation of forces to the results
which are to be accomplished. These undeniable facts
are due to the wonderful construction of the human
mind, which, among its endless glories, numbers that
special glory which is beyond all description and praise
—the faculty of adapting the individual to the sphere
in which he is to move, to the habits, customs and the
necessities of those who surround him ; to those great
differences of thought, perception and action which
characterize each and all of the nations of the earth, and
which in the aggregate have given them individuality |
and a separate history. All institutions, then, of every
people, in order to be permanent, must be adapted to the
people who surround such institutions, and who are to
give it its permanency, success and glory. If this be the
case—if the lessons of history be not pointless—foolish
fables—how vain, how foolish it is to expect that the
medical institutions of America are to be conformed to
those of other nations, rather than to the genius of the
people, who are to give to each institution a local habi-
Thus in Germany, the character |
tation, a reputation and a name? How illogical is it,
therefore, for us to expect that our medical institutions,
eculiar to a peculiar people, should conform to institu-
tions which have originated and been sustained by na-
tions differing entirely from our own in age, genius,
demands and characteristics. • .
Let us not, therefore, seek after strange gods—let us
venerate and protect our own.” -
We have space but to notice a few of the papers pre-
sented. - -
Dr. Fraze read a paper on the
Kentucky. - -
Dr. L. P. Yandell, Jr., reported cases of epilepsy in
which blueness of the skin, resulting from the use of
nitrate of silver, was removed by the use of nitrate of
potash. He also reported a case of parasitic disease,
known as favus, the parasites being the effect and not
the cause of the disease. Also, a singular case of vesi-
cular disease. - - - - -
A paper of Dr. J. W. Clemens on apparatus for trans-
verse fracture was referred to the Committee on Publi-
cation. - -
Dr. J. J. Speed read a paper on Phthisis, which was
referred to the Committee on Publication with direc-
tions to publish it. - º
Dr. D. W. Yandell read a paper on epilepsy treated
with bromide of potassium and sulphate of atropia.
Papers by Dr. D. T. Smith and Dr. C. T. Ulrich were
referred to the Committee on Publication.
Mineral Waters of
3. -
The following special committees were appointed:
Registration—Dr. Jno. D. Jackson, Danville, Chair-
man. -
Publication—Drs. Jno. Goodman, T. P. Satterwhite,
and S. Brandeis. - - -
Medical Electricity—Prof. J. W. Holland. -
Recent Improvements in Ophthalmic Surgery—Dr. D. S.
Reynolds. - - - -
The President was chosen a delegate to the American
Medical Association, which meets in Philadelphia next
month, and was authorized to appoint the other dele-
gates. - . . .
The following honorary members were elected, and
the Corresponding Secretary was requested to notify
them of the fact: Drs. J. J. Woodward, Washington
City, D. C.; E. Williams and Wm. Carter, Cincinnati.
The Committee on Nominations reported the follow-
ing officers, who were duly elected: -
For President—Dr.Lewis Rogers, Louisville.
Senior Vice President—Dr. Jas. W. Thompson, Pa-
ducah. - - -
Junior Vice President—Dr. Joseph Smith, Lexington.
Recording Secretary—Dr. J. A. Larrabee, Louisville.
Treasurer–Dr. L. B. Tood, Lexington. -
Corresponding. Secretary—Dr. W. T. Humphreys,
Louisville. - -
Committee on . Publication—Drs. John Goodman, S.
Brandeis and T. P. Satterwhite, Louisville.
Librarian—Dr. R. H. Thornton, Newport.
On motion, the thanks of the Society were tendered
APR. 13, 1872.]
179
to the President, Dr. T. N. Wise, for the efficient and
impartial manner in which he had fulfilled the duties
of his office. - . -
The usual thanks to the railroads, physicians of
Louisville and others for courtesies extended were then
passed, and the meeting adjourned.
The next session of the society will be held in Paducah
on the first Tuesday in April, 1873.
SIGNS OF THE TIMES.–The last number of the N.
Y. Medical Record contains as its leading paper a ten-
paged article on the “Pathogeny of Pyaamia and Septi-
caemia” by Mary C. Putnam, M. D. -
PROMOTION of TRAUBE.—Privy Counciller Traube
of Berlin has been promoted to the position of professor
in ordinary at the University of Berlin. The prejudice
of the minister of education against Jews alone preven-
ted this promotion long since. Prof. Traube is the first
individual of Jewish faith ever promoted to this position
in Berlin. -
Dr. Rosenthal, also an Israelite, has accepted the
proferred chair of Physiology at Erlangen.
MEDICAL SCIENCE IN QUITO.-One of the last trav-
ellers to the Andes, Mr. Orton, whose notes on the phys-
ical structure of that part of the world are exceedingly
valuable, and whose observations on the Social status of
the people are reliable, mentions the curious fact that
there are only three drug stores in the great city of the
Incas, and the sign which indicates the business is a
serpent. Physicians there have no offices, and rarely
visit patients at their dwellings. When a sick person |
is too sick to call upon the doctor, it is considered a
hopeless case. - - -
Yellow fever and consumption are unknown in Quito.
Catarrhal affections and typhoid fevers are common.
Asthma, however, is exceedingly prevalent, and there-
fore such altitudes as are made the abodes of moun-
taineers in Peru should be carefully avoided.
CUSTOMS AND SALARIES OF PHYSICIANS BEFORE THE
CHRISTIAN ERA.—Boerhaave observes that before there
were any professed physicians, it was the custom
among the ancient Egyptians, when any one was sick,
to inquire of neighbors and passengers if they knew of
any proper remedies for the patient. But eyer since
the study of physic became a profession, it has been
both honorable and lucrative. The customary yearly
salary which princes paid their physicians, about the
time of Christ's birth, was 250 sestertia, or above
2018!, sterling. Stertenius complained that he had
only a salary of 500 sestertia, or 4036!. 9s. 2d. Sterling,
when he had by his private practice 600 sestertia, or
4848l. 158.--Dr. Arbuthnot's Book on Coin, and Mr.
William Smith's Book of Remarks on the same subject.
MUNIFICENT DONATION.—The Middlesex Hospital
has received another sum of £20,000. It may be re-
membered that a like sum was given by an anonymous
donor to the Hospital two or three years ago. Last year
the name of the munificent benefactor—Mr. Francis
Brodrip—was made public. The second sufn of £20,000
now handed over to the authorities of the Hospital, is
the proceeds of the sale of Mr. Brodrip's pictures and
other works of art, which he directed to be disposed of
|after his death for the benefit of the Middlesex Hospital.
—Brit. Med. Journ., Mar. 23, '72.
A HEAVILY BACKED JOURNAL.—A New Journal of
Ophthalmology has been started in Paris. Its cover
bears the names and titles in full of two directors,
fifteen editors in chief, including the directors, and
thirteen corresponding editors.
FRENCH PATRIOTISM.–A committee of women, all
wives of physicians, has been organized in Paris to assist
in the liquidation of the national debt. The internes
of the Lyons Hospitals have all given up a months
salary for the same purpose.
THE OLDEST MEDICAL COLLEGE IN THE WEST.-The
last number of the St. Louis Medical and Surgical Jour-
nal, (April, '72), prefaces the report of the commence-
ment exercises of the Missouri Medical College with the
statement that this Institution is the oldest Medical
College in the West. !
We have before us the U. S. official table of statistics
of all the “Medical, Dental and Pharmaceutical Institu-
tions in the United States.” Western medical colleges
take place in the order of age as follows:
Medical College of Ohio, tº tº 1819.
“ “ “ S. Carolina, - - 1824.
“ Dept. Univ. Virginia, - - 1825.
“ Coll. Georgia, tº- - - 1832.
“ Dept. Univ. Louisana, - 1836.
{{ & C “ Louisville, - - 1837.
Missouri Medical College, - - IS40.
As our friend Dr. McIlvaine used to say, “There's
nothing like having your dates correct.”
—º-º-º-
Graduates in Medicine in 1872.
Bellevue Hospital Medical College 129
Jefferson Medical College ... 114
Ohio Medical College 90
Medical College of Nashville 84
University of Pennsylvania a 83
College of Physicians and Surgeons, N. Y. 78
Rush Medical College (Chicago) 77
University of the City of New York . - 75
Miami Medical College * - 67
Med. Dep. University of Buffalo . 34
Cleveland Medical College, Ohio 34
Med. Dep. of Georgetown College 20
Medical College of Virginia . º & 12'
National Medical College (Washington) . . 7
—News and Library, Ppril, '72.
180
[APR. 13, 1872.
TEEE CI.INI c.
CLINICAL MEMORANIDA,
The Treatment of Variees by the Subcutaneous
Injection of Ergot.
BY
DR. PAUL Vogt (Griefswald).
Assistant at the Surgical Clinic and Private Docent at the
University of Griefswald.
From the Berlin. Klin. Wochenschr., Mar. 4, '72.
The observations of W. Langenbeck on the cure of
two cases of aneurism by the subcutaneous injection of
ergotin (Berl. Klin. Wochenschr., 1860, No. 12, p. 117)
and the further report of cure in a case of aneurism of
the femoral artery by Schneider (Session of the Society
of Scientific Medicine, Königsberg, May 25th, 1869) and
finally the cure of an aneurism of the subclavian by
Dutoit (v. Langenbeck's Archiv. Bd. xii) would seem
to have established the effects of ergot preparations upon
the blood-vessels. Dresche of Vienna, moreover, was
the first to adopt this principle in the treatment of
hemoptysis by the subcutaneous injection of ergotin
(Centralblatt f. Med. Wissenschaft., 1868, No. 52).
Last summer I commenced some experiments with a
view of determining the effects of ergotin in other dis-
eases of the vessels, examining more especially into its
influence upon that affection which in the existing
state of our knowledge, so far as radical cure is con-
cerned, is almost hopeless. I refer to varicosities of the
veins of the leg. Since the principle of radical cure
of these varices hitherto—the obliteration of the veins
by one method or another in a greater or less extent of
surface—involved such dangers and discomforts as to be
out of all proportion to the original disease, we have
been limited essentially in our Selection of innocuous
methods of treatment, to a therapy only palliative.
With a view of regulating the circulation and of re-
lieving the stasis and ectasia I made some experiments
with ergotin. In the case of a man aged 60 who had
suffered for years with extensive varcies of the right
leg I injected beneath the skin of the leg an aqueous
solution of extr Secal. cornut. 2.0 grm. with spirit vini
and glycerin. aa 7.5, selecting two particularly marked
dilatations as the seat of injection. An enlarged vein
6 ctm. long, running diagonally over the tibia was
marked on its borders with a pencil of lunar caustic and
over it was injected subcutaneously a whole syringe full
of the solution (0.12 ergotine). This was repeated every
2 days. After eight days there was nothing to be seen
of the varix and after six weeks, during which time the
patient walked about as usual, there was no trace of it
to be seen or felt. A second varix of haselnut size on
the outside of the calf disappeared in like manner after
a single injection of ergotine. At the points of injection
by it in the pulse.
there appeared a hard somewhat circumscribed infiltra-
tion which, however, in the thin and atrophic skin of the
Senile individual mentioned gave rise to no inflammation
nor gangrene, disappeared gradually, on the contrary,
without having excited any marked pain.
For the further examination into the effect of ergotine
upon the vessels I induced Dr. Potel to undertake two
investigation. 1, to examine into the action of ergotine
| upon the vessels of the mesentery of the frog. 2, to in-
yestigate with the sphygmograph, the changes induced
- Under the direction of Prof. Lan-
dois the microscopic and sphymographic effects of ergot
upon the muscular coat of the vessels, both arterial and
venous, were demonstrated (see his Inaugural Disserta-
tion, Griefswald, 1871.). Thereupon the subcutaneous
injection of ergotin in the manner mentioned was re-
peated upon different patients with varices of the leg in
our surgical clinic and dispensary and even in the cases
of ºl ectasias was the happy effect surprisingly
rapid.
MANAGEMENT OF EPILEPSY-Dr. Brown-Séquard
recommends, in the treatment of epilepsy, the following
combination of the bromides of ammonium and potas.
Slti DOl
Potassi iodidi. dr. j.
Potass. bicarb, scr. iſ.
Potassi bromidi, oz. j.
Ammonii bromidi, dr. iiss.
Inf columbaº, oz. ºff. .
S.—A teaspoonful before each of the three meals, and
three teaspoonsful at bedtime, with a little water.
Dr. Roberts Bartholow's (Fisk Fund Prize Essay)
plan of treatment consists in giving a powder, contain-
ing two scruples of bromide of potassium dissolved in
water, three times a day, and after the cessation of the
paroxysms a drachm dose at bed time only. It is now
well known that a patient cannot omit his dose for a
single day without danger of having the attacks return,
and he cannot be considered exempt until he has passed
two years without a convulsive seizure.
To prevent the development of bromism Brown-
Séquard is in the habit of combining arsenic with the
bromide of potassium. Since using this combination,
he has not observed so much the debility caused by its
prolonged administration. The use of iron, strychnia,
the hypophosphites, is also indicated to maintain the
health of epileptics during a course of bromide of potas-
sium. The hygienical means consists of abundant food,
wine, out-door employment, and a careful regulation of
the moral life.—N. Y. Medical Record.—Georgia Med.
Companion, Mar., '72. -
—º-e-C*-
IHIOM IE NEWS.
PROF. BROWN-SíquaRD will enjoy his lune de miel
in Paris whither groom and bride have already departed.
Cambridge, Mass., it is stated, will be his new and per-
manent field of labor on his return.
THE ACADEMY has reconsidered its previous vote so
as to permit an abstract of the proceedings of the pre-
vious session to appear regularly in every issue of THE
CLINIC. As our home subscription and foreign exchange
lists are now quite extensive, the passage of the present
law is a subject of mutual congratulation.
& Sº
& sº Yº
- S. 2". "...sº Sºzº
º Sº T. . . ºº Sº
º ſº º-º $º
. . . . § sº
jº º
. . º. . . **
Ille,
JAMES FOSTER, JR., & Co.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
game. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in.
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Lenses, Spectacles, and the best models procurable, with pains-
taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopic Objects
and Microscopic Apparatus, Magnifiers and Readers in
great variety. Medical Batteries, Barometers, Thermo-
meters, Hygrometers, Urinometers and Rain Gauges,
of the most approved constraction always on hand. All orders promptly t
and accurately filled.
JAS. FOSTER, JR. &
F. S. SHAößEroRD, : ** JAs. Foster, J.R. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TR.s.IN.INMARSH's
‘gº) TRUSSES
sº-º:
No. 758 BRoadway, New Yoak
I HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAYRE, M. D.
Surgeon, Bellevue Hospital.
Q.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
BRG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient,
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder Braces. Supporters, Elastic stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Gure Truss Offices of S.N. MARSH & CO., No. 2 Vesey St. (Astor House),
ow York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
opPOSITE THE HIGH STEEPLE,
Kºšº Agents for Clement's Patent Artificial Legs.
|
F. E. SUIRE.
IF. E. Suire & Co.,
E. S. WAYNE
wholesale dauggists,
IMI AL INT TJ E" A C T TJT TER, I INT GF
£Hemists AND PHAR Maceutists,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
sye), EcºEd O'RUGS ANYO IVX)ex))(c)(N)es,
ck{}eryxxcAY, APPARAºcus,
TESTS, MEDICAL, GLASS WARE, &c., &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate. Principles of Plants,
Made in accordance with the U. S. P. and other recognized authori-
ties.
FINE AND RARE CHEMICALs,
Of the popular class of preparations known as
H. T., IDX IIHR, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take. *
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c.
AGENTS FOR BULLOCK & CRENSHAW'S
Sugar-coated Pills and Granules.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.























º->
&=
U-7Ns)
|N|RTS,
Carriage Manufacturer,
NOS, 9 and 11 East Sixth Street, bet. Main & samº.
I MAKE NOTHING BUT
runsz, czar'ss work,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of ºs-
LIGHT FAMILY CARRIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
PHYSKEFANS” （SE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
adapted to
The superiority of my light gentlemen’s
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price ;
lists furnished on application. References K.
to Dr. W. W. Dawson and all the leading wº
Physicians in the city and heighborhood. * * *












william Autenrieth,
No. 71 WEST sIXTH sº IEEET,
-*
BETWEEN WAINUT Aſs WINE,
cincinnati, ohio,
MANUEACTURER • OF AND DEALER IN
|||||| || || || |||||||||
Abdominal Supporters; Trusses,
CLUB-F00T SHOES, -
SPINAL APPARATUS, ETC
Keeps constantly on hand a full variety of
Metalic and Rubber syringes,
Storm.ach Purmps, Etc.
STOCKINGS FOR WARICOSE WEINS,
Special attention given to the fitting of Apparatus for Deformities.
say-Agent for Dr. L. A. BABCOCK's
Silver Uterine Supporter,
* - . —º- -
DR AHL's Porous FELT splints,
- —air-
T) A. Y. * S S E L IN T S
-AND-
ROBERT CLARKE & Co's.
IIST OF NEW
MHL iBTH in Mºulis find
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5o
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN’S DIS-
EASES. 12mo. $1 75
BENNETT ON PULMONORY CONSUMPTION. 8vo. $1 5o
FIRST HELP IN ACCIDENTS. 12mo. $1 50
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 5o
ECHEVERRIA ON EPILEPSY. 8vo. Cloth. $5 od
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASES. 8vo. $5 oc
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 od Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth.
TANNER'S HANDBOOK OF OBSTETRICS. I 2 mo.
WAN BUREN ON DISEASES OF THE RECTUM.
Cloth. $1 5o
FLINT’S EXAMINATION OF URINE. Izmo. Cloth. $ 1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 5o
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRICITY. 8vo. Cloth. $4 5o
ATTFIELD'S MEDICAL CHEMISTRY. 12mo. Cloth. $2.75
Leather. $3 25
BARTHOLOW’S HYPODERMIC MEDICATION.
Cloth. $1 5o
TURNBULL’S DISEASES OF THE EAR. 8vo. Cloth. $5 od
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 od
NEUMANN’S HAND-BOOK OF SKIN DISEASES.
Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 oo.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $1 o oo
HOOD ON BONE SETTING. 12mo. $1 50
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo
$2 5o
$2 oo
I 2.Ill O.
I 2 IIl Oe
8vo.
HOLBROOK’S PARTURITION WITHOUT PAIN. I 6mo.
$1 oo
PROCTER’S LIGHT SCIENCE FOR LEISURE HOURS.
12mo. $1 75
BERNARD’S PHYSIOLOGY OF THE HEART, 5octs.
BARNES’ OBSTETRICAL OPERATIONS. 8vo. $4 5o
NICHOL’S FIRESIDE SCIENCE. 12mo. $1 5o.
WOHLER'S MINERAL ANALYSIS. 12mo. Cloth. $3 oo
PLATTNER'S MANUAL OF ANALYSIS WITH THE
BLOWPIPE. 8vo. Cloth. $7 50
JEFFRIES ON THE EYE. 8vo. Cloth. $1 oo
MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
JEFFRIES ON THE SKIN. 8vo. Cloth. $1 oo
GARDENING FOR PROFIT. 12mo. Cloth. $1 5o
PRACTICAL FLORICULTURE. 12mo. Cloth. $1 5o
FULLER'S SMALL FRUIT CULTURE. 12mo. Cloth. $ I
WOOD WARD'S COUNTRY HOMES. 12mo. Cloth. $1
DARWIN'S ORIGIN OF SPECIES. I2mo. Cloth. $2 oo
ARTHUR's TREATMENT AND PREVENTION OF DE-
CAY OF THE TEETH. 12mo. $1 50°
TYND ALL ON LIGHT AND ELECTRICITY.
THE AMATEUR MICROSCOPIST. Small 4to.
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMEN.
ROBERTS ON RENAL DISEASES.
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN.
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by mail or express, free of charge
on receipt of price-
5o
5o
12mo. $1 25
$1 75
S. W. Elliott’s Saddle-bags
65 West 4th Street, Cincinnati, Ohio.
List of Pharmaceutical Preparations,
MANUEFACTURE O BY
Jozºv" Wºzºr & Bºozººn,
FECIL.A.D.E.L.F.H.I.A.
—º-
ELIX PHOS. IRON, QUININE AND STRYCHNIA, -
ELIXIR OF GENTIAN FERRATED,
ELTXIR, WALERIANATE OF AMMONIA, -
(Goddard’s Formuła,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON, -
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES, *
.-- COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER win E OF IRON,
Citrate of Iron and Peruvian Bark,
FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH, *
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK,
- FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH, -
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and Sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA, *
- . • WINE OF PEPSIN,
SYRUP SUPERPHOSPHATE OF IRON. -
ELIXIR OF BISMUTH,
COMP. FLUIDEXT. BUCHU AND PAREIRA BRAVA.
STUTE"I POSITOTE, IES.
Bectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and Btyle, made of finest quality of sponge.
O Do R. L.E. s.s A.N D F A LATA H. L. E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market. -
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded. - -
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c. - - -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent. .
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

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CINCINN ATI.
—-º-
IF. A. C. TCſ IL T Y.
J A M E S G. F. A. H. A. M., M. D., D E A N,
Professor of the Theory and EPractice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D.,
Professor of Materia Medica and Therapeutics.
W. H. GOBRECHT, M.D.,
Professor of Anatomy.
P.'s, CONNER, M.D.,
Professor of Surgical Anatomy.
JAMES T. WHITTAKER, M.D.,
I’rofessor of Physiology.
SAMſ JEL NICKLES, M.D.,
Professor of Physics and Medical Chemistry
W. W. DAWSON, M.D.,
Professor of Principles and Practice of Surgery and Clinical Surgery
C. D. PALMER, M.D.,
Professor of Medical and Surgical Diseases of Women.
T. A. REAMY, M.D., -
Professor of Obstetrics and Diseases of Children.
JOHN L. CLEVELAND, M.D.,
Demonstrator of Anatomy.
CHARLES KEARNS, M.D.,
Assistant to the Chair of Surgery
W. W. S.H.E.L.Y., M. D.,
Professor of ID is eases of the IEye and HXar, and Secretary of the Faculty-
**-
T. LOUIS BRow N, M. D., Prosecutor of Anatomy.
*_º
E. Noble, Janitor, College Building, Sixth St., bet. Vine and Race
Priuted and Published by Noan Is & M Unny, Medical College of Ohio Building, Cincinnati.






























LINIC.
IPTUELISPHIED EVERY SATURDAY.
TERMS-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
C IN C IN N ATI, A P R IL 20, 1872.
—º
No. 16.
Vol. 2.
JAS. T. whitTAKER, M. D. - - - Editor.
No. 101 West Ninth Street, Cincinnati.
-A-SSOCIALTIEH FRIDITOR,S.
W. W. D.Awson, M. D. THAD. A. REAMy, M. D.
P. S. ConnºR, M. D. C. D. PALMER, M. D.
W. W. SEELY, M. D. SAMUEL NICKLEs, M. D.
CHAs. KEARNs, M. D. JNo. L. CLEvKLAND, M. D.
RoBERTs BARTHollow, M. D. 3.
W. W. SEELY, M. D., gº º ºs º º º
No. 118 West Seventh Street, Cincinnati.
CLU B R AT Es,
*=e
TREASURER."
4 Copies to one address...................................................... $ 7.00
6 é & & 4 - 10,00
12 & £ & & ~ * 18,00
C O N T E W T S.
º Tºmº Page
ORIGINAL ARTICLES
Chronic Catarrh of the Middle Ear by W. W. Seely, M.D................
Surgical Notes by P. S. Conner, M. D. - - 183
TRANSILATION
The Diagnosis of the First Stage of Carcinoma Colli Uteri (From
the Archiv. f. Gynaekologie vol. iii Sect. 2. 1872.)........................ 185
ACAIDEMIY OF MIE DICINE
Transactions April 13, '72.
Dr. Kearney on Syphilis—Dr. Carson on Anti-pyretic Action of Qui-
- nia 187
MIE DICAI, NEWS.
American Medical Association—The Emperor of Brazil—The Med-
licott Case—Bound in Human Skin—Bellevue Hosp. Med. Col-
lege—N. Y. Univ. Med. College—Blockley Hospital; Phil.
Closure of the Paris School—Lostorfer's Syphilis Discovery..188-189
CO RRESPONDENCE
Letter fron Dr. Wright—Jackson's Cough Syrup
CLINICAL, MIENIORANIDA
Menstruation from the Mammae—Removal of Foreign Bodies from
189
the Ear by Agglutination—Uterine Intermittent Polypus—Cold
Applications in Hyperperexia—Morphia and Chloroform Com-
bined 190-192
The early recognition of carcinoma uteri, of highest
importance in therapy, is made easy by the points estab-
lished in our translation of to-day.
Wedl was on time as will be seen by the date of his
letter but he was not quick enough to prevent the dis-
semination of Lostorfer's views all over the civilized
globe. •.
The discussion on hyperperexia contains the points
on this subject which is now exciting so much interest.
Morphia and Chloroform combined is a valuable
|J. TAFT,
co-Arr se ces
|Fashionable Hatters,
IMPORTERS AND MANUFACTURERS OF
Hºs’ FºxS,
loo wrisT FOURTH ST.
Opposite Post Office,
cINCINNATI.
sarspecial Inducements to Medical Men-
*ENGRAVERSonwooD.
SCINCINNATIOHIO:
- Bº * Still Y º
Editor Dental Register
J. & W. TAFT,
TXIEHINTTISTS
117 WEST FOURTH STREET,
CINCININATI, O.
A Monthly Journal,
CONTAINING 48 PAGES,
*tion to materia medica, again from, scientific Devoted to the Interests of the Dental Profession,
experimentation,




















List of Pharmaceutical Preparations,
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ELIX PHOS. IRON, QUININE AND STRYCHNIA,
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COTD TLTTV FIF, GDIT_
O' D C E L E S s A.N ID PA. L. A.T.A. B. L. E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency.
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufact
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.
HMHiſ MF; tıWºr
167 EAST 34TH-ST., NEW YORK,
By Special Appointment Electrical Instrument Makers to
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MANUFACTURERS OF PoETABLE
ELECTRO-MAGNETIC MACHINES,
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Continuous Current, Stöhrer's Improved, patented June 1st,
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These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid. -
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PEERMANIENT BATTERIEs,
For Hospitals and General Practitioners,
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EXTRA (!TS FROM THE OPINIONS OF THE MOST
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WM. A. HAMMOND, Prof. of Diseases of the Mind and
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ExCEED THE EFFICIENCY AND convKNIENCE of THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. Hammond to announce em-
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Portable Electro-Magnetic Machines, published in his recent
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MEREDITH CLYMER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider the ºr
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neSS, compactness and efficacy, they can not be excelled.”
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local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A, MURRAY, M. D.;
QHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;
ALLEN MAYNARD, M.D., Cleveland, O.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes.
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mºny ºther prominent Physicians who are using our Appa-
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IF_A_TIERINTT
WA)
Are furnished to Officers and Soldiers on Government
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I claim to have combined such improvements in ARTI-
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in use. For the truth of this assertion, I would respectfully
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Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
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All communications should be addressed to
JAMES A. EOSTEER,
9II Chestnut Street, Philadelphia, Pa. No. 60 West
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ferson Avenue, Detroit, Mich.
SAML. P. THOMAS
T.A.. I I, OR,
DEALER IN
%23
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º º:
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22.
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English, French and Scotch
GOOIDs,
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& M.W.C.A.W.W.?? /.


F. E. Surke. E. S. WAYNE
mü.
JR, & Co.
---
|TER,
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through ||
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
same. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in-
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Leruses, Spectacles, and the best models procurable, with pains- ||
taking 8 kill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopic Objects
and ** Apparatus, Magnifiers and Readers in
great variety. edical Batteries, Barometers, Thermo-
meters, Hygrometers, Urinometers and Rain Gauges,
of the most approved constraction always on hand. All orders promptly
and accurately filled. - - - - .
JAS. FOSTER, JR.
F. S. SHACKLEFORD, }
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
S
&º
No. 758 BROADWAY, New Yons
HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
I
** JAs. Foster, J.R. & co. |
F • E. Suire & Co.,
wholesale Daugatsts,
|M. A. N. UE A cru IRIN G
£HEMists AND PHARMAceutists,
CINCINNATI, Ohio.
Have constantly on hand a full assortment of
sex ecºeo xºgos ANo moeoxexses,
cºewear areawards,
TESTS, MEDICAL GLAss wARE, &c, &c.,
And solicits the patronage of the trade and profession.
we would call attention to our select preparations, such §§
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordance with the U. S. P. and other recognized authori-
ties.
EINE AND EARH, CHEMICALS,
of the popular class of preparations known as -
IF. T., ILXII IF, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take. -
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c
AGENTS FOR BULLock & CRENSHAw's
Sugar-coated Pills and Granules.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and wideb known repu-
clusion of all others, and have found it to give general Satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS" A. SAYRE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
BEG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever Seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried.
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Trugs Offices of S. N. MARSH & CO., No. 2 Vesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
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OPPOSITE THE HIGH STEEPLE,
Jº Agonts for Clement's Patent Artificial Legg.
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.










T EL EL C. T., T N T C.
181
wº-
Vol. 2..] S A T U R D A Y, A P R I L 20, 1872. [No. 16.
O R. I. G. I. N A L A R T I C L E S.
*- —º-e-Cº-
CHRONIC CATALRR. H I OF THE MII DI DI LE EAR.
BY
PROFESSOR: , SEELY.
A Clinical Lecture delivered at the Dispensary of the Medical
College of Ohio.
GENTLEMEN:
Unquestionably the form of ear trouble represented
in the cases before us is the one aural surgeons meet
most frequently. It is the greatest source of deafness.
I have had a field so rich in typical cases that you
have already become somewhat familiar with the
various forms of ear trouble, and your personal exami-
nations will be invaluable to you. I have shown you
the form of trouble in question, in children, the middle
aged and the old. º
So you will infer at once that it is a disease not con-
fined to any age.
Some of you perhaps will recall my remarks made
from time to time on the acute or sub-acute catarrh of
children, when we had a redness of the membrana
tympani, with haziness and concavity, and ear-ache.
In speaking of the significance of ear-ache in children,
I called especial attention to the necessity of always
"making a speculum eacamination in order not only to assure
3/0urselves that ear-ache in children is not “nervous,” as a
cule, but inflammatory, that the proper remedies may be
ºresorted to for destroying the seeds that are being sown for
the chronic trouble that I have presented yaw in older chil-
dren, some of whom had suffered from ear-ache as children.
We may have then the chronic form of inflammation of
the middle ear resulting from the acute or sub-acute.
It is not a little instructive to see how many persons
With impairment of hearing have as children suffered
with ear-ache.
You may be surprised, gentlemen, when I tell you
that it is not an easy matter to find perfect membranae
tympanorum for illustration, that probably not more
than one-half between the ages of 20 and 40 have per-
fect hearing, and that after 50 or 60 the percentage is
reduced almost to 0. Undoubtedly this percentage will
be Very much altered by the spreading of the advances
in aural science. It was not till quite lately that an
aurist could see a case of “ear-ache” in a child. As a
rule those cases have passed over into the chronic stage
and increasing deafness is the alarming symptom.
The mother is surprised that the child has not “out-
grown it.” I trust, gentlemen, none of you will present
the uncouth spectacle of “ignoring a serious trouble,”
when science points out such a sure way of overcoming
it.
I am frequently asked if I believe in an “hereditary
deafness,” and if any thing can be done. Undoubtedly
there is an hereditary tendency to inflammation
of the mucous membrane of the middle ear—for
that is the trouble—and just as undoubtedly can that
inflammation be combatted.
We combat successfully bad inheritances in other
parts of the system. Why not in the ear? The con-
dition of ear patients is no longer a standing reproach
to the science of medicine, for at the present day aural
science is on a level with the other departments of
medicine and surgery.
The great difficulty yet in the way of a more popular
recognition of this department, is the fear that damage
may be done, a fear made popular by the profession,
and only really to be perfectly overcome by the influ-
ence of the profession.
Another difficulty, is the length of time required to,
even, in many cases, produce any improvement.
Many times these cases of chronic catarrh of the
middle ear require long months even before any signs of
improvement appear. Some of your most satisfactory
results will be had in cases that require treatment
more or less continuous for one or two years. You can
see that nowhere will your patience and powers of per-
severance be more severely taxed than in such cases.
In fact, gentlemen, let me tell you that there is no
quality a physician should be so wanting in as impa-
tience, with it many a man has lost some of his rarest
opportunities for success.
How is chronic otitis media recognized?
The membrana tympani forming as it does the
boundary between the middle and external ear with its
inner surface lined with mucous membrane, continuous
with that of the middle ear, would certainly commend
itself as the first part upon which we are to seek our
knowledge of the cavity of the drum.
We find the changes in this membrane affecting
direction, color and the light spot. All are usually
found, but are not necessarily pathognomonic of chronic
catarrh.
As our time is limited I will simply call your atten-
tion to some of the appearances more usually presented,
remarking simply in passing, that what the membrane
reveals in regard to a prognosis is as yet exceedingly
uncertain, as also the exact location and extent of the
trouble.
Frequently the color of the membrane varies little
from normal, though the epidermic and the cuticular
layer may be so affected that the membrane is dull,
hazy, the triangular light spot being not only altered in
shape, but even entirely absent.
Such facts in the absence of all external trouble
would readily lead us to infer trouble in the cavum
tympani.
182
[APR. 20, 1872.
TIEEE THE CIT, I. TST I. C.
You will be liable to err in your diagnosis, if you ex-
pect to find redness as a symptom of inflammation, for
only when you have more or less acute or sub-acute
forms do you find any redness or congestion of the vessels
along the handle of the malleus.
It is always difficult to persuade patients that any-
thing like inflammation has been going on in the ear,
for they think that pain should be present.
In this chronic form, the handle of the malleus is
frequently, (usually) very prominent, and the short
process, in particular, presents as a prominent white'
point.
The membrane is concave sometimes regularly on
both sides of the malleus, sometimes irregularly, owing
to various kinds and positions of the adhesive pro-
CeSSéS.
As the changes in the middle ear go on, these changes
in the color and position of the membrane alter. I
have presented you a case where the membrana tympani
was much thicker than normal so that the attachment
of the malleus could not be discovered. Again a case
of almost pearly whiteness of the membrane. Not un-
frequently we find calcareous deposits in the membrane.
Bear in mind that these spots are not evidences of
long continued trouble, for they are found in the mem-
branes of children. Again, you will find too, that they
are not incompatible with good hearing power.
I have already remarked that the examination of the
membrane alone is not sufficient to tell you either of the
hearing power, or of the possibilities of the effects of
treatment. Many times, even when the changes in the
membrane are few and slight, the hearing is not only
bad, but the possibilities for improvement are few. I
shall have an opportunity of referring to a special form
of trouble in the ear to illustrate this allusion more
forcibly. Our second means of diagnosis is catheteri-
sation of the Eustachian tube.
This brings me to the still further explanation of the
position of the membrana tympani. I have spoken of
the formation of adhesive bands.
In cases of what is called catarrh of the Eustachian
tube, we have the membrane abnormally concave, very
slightly changed in color. So that we are able now and
then to see the parts of the middle ear, e.g., the pro-
montory, the vertical process of the incus, etc., ; a very
marked case of which occurred in my wards in the
Cincinnati hospital some time ago.
The concavity in these cases, as well as in catarrh of
the middle ear, occurs probably as a consequence of the
atmospheric pressure from without. You are aware
that the middle ear normally is filled with air, kept in
equilibrium with the outer air by means of the Eusta-
chian tubes. Now if these tubes become closed, the air
in the middle ear becomes absorbed by the circulation
and the metamorphic processes, and the pressure from
without drives the membrane in against the promon-
tory.
By means of the Eustachian catheter we are enabled
to inform ourselves still more of, not only the condition
of the tubes, but of the state of the middle ear. We
are informed of the more or less permeability of the tube,
of the elasticity of the membrane, as to whether it is
more or less fixed by adhesions, of the moistness or dry-
ness of the mucous lining of the tympanic cavity.
While both of these diagnostic means should always be
resorted to, can we rely implicitly on this evidence, that
we are in the presence of chronic catarrhº. At some
future time I will endeavor to show you a little more
in extenso that we cannot. There are then other points
that come in either to modify or rather to assist in our
diagnosis.
One of the favorable points usually mentioned in
catheterization is, that the patient after the process hears
better and the noises are less. This cannot be relied
upon always. I have spoken of the so-called “dry
catarrh” in which this process while it may produce
some immediate improvement may be followed by a
rapid diminution in the hearing.
A large majority of patients with middle ear trouble,
combined or not with tubal trouble, will tell you that
changes in the weather affect their hearing. The more
marked and sudden the changes, the more the Eustachian
tube is involved.
The mucous membrane of the tube is more exposed
to the air consequently more rapidly thickens, absorbs
water, which along with the usual increased
secretion of such a membrane, rapidly blocks up the
tube.
We find cases where the sounds on catheterization are
good and yet the hearing power is very much reduced.
Probably I need scarcely call your attention to the
fact, that the parts that convey the sound to and through
the middle ear are of far less consequence than those
that transfer it to the inner ear, to the nerve.
You will also readily understand that a catarrhal pro-
cess, while the general law is, that mucous membranes
continue a morbid process by continuity of surface,
may be confined to localities, and such localities have
been demonstrated in the ear to be the two fenestrae,
those membranes that cover the openings leading into
the internal ear.
To resume, if the variations in the hearing are sudden
and marked, we infer that the tubes are the chief seat
of the difficulty; if the changes are not so rapid and
great, we infer trouble in the middle ear; if the diminu-
tion in the hearing power is great, the strong probability
is that the cause lies in an affection of the membranes
covering the fenestrae.
The exact value of the mastoid processes as accessory
structures is not accurately determined. Of course, in-
creasing the quantity of air to be set into vibration, they
act somewhat as a resonator, and knowing the tendency
of mucuous membranes to propagate an inflammatory
process per continuitatem, we must suppose in all long
continued troubles of the middle ear, more or less affec-
tion of the mastoid cells.
APR. 20, 1872.]
TIEEE EIH C T III INTI C.
183
Prognosis.
Certain points admitted, the prognosis is very favor-
able. Time and perseverance given, treatment will, if
inot cure, at least decidedly improve a large majority of
the cases. º
Many times it is impossible to give an opinion until
the case has been seen even four or five weeks. Espec-
ially in patients that come from a distance subjected to
the changes of leaving home. Do not be discouraged,
if after weeks of trial you.have brought about little or
no improvement. You will see by this that the treat-
ment is to be regarded as part of the examination,
the test by treatment, for I have already remarked that
we are unable to tell exactly where the trouble lies,
and exactly what its nature is. Then do not be too
hasty in forming your conclusions.
Treatment.
The treatment is as a rule both constitutional and
local. If the patient complains of taking cold very
easily, perhaps almost every day, there is nothing prob-
ably that will so effectually prevent it as the iodide of
iron, continued for months.
You could scarcely expect much permanency in the
improvement so long as the constitutional tendency to
taking cold continued. Locally, the air douche to
the middle ear, medicated or pure, and remedies to the
throat if there seems to be a good deal of irritation. I
am always in the habit of beginning the treatment of
my cases with the air douche to see what the effect will
be of so simple a remedy. If there is a considerable
Secretion I inject some astringent solution through the
catheter into the ear. Making use generally of a weak
solution of zinc, (3–3 grs. ad 3i aq).
If I wish to cause irritation or absorption I use muriate
of ammonia, (2-5 grs. ad. 3i aq).
If the tubes are so closed that but little air enters, I
dilate mechanically, as we dilate strictures of the nasal
duct, making use of an ordinary fiddle string, about
letter E.
Do not be too ambitious to inject vapors or fluids into
the ear, for very frequently the simple mechanical
effect of the air douche will be sufficient.
Unquestionably, if we could know our case, the ex-
citement of an intense acute inflammation in the middle
ear and the proper treatment of it, would accomplish an
immense amount of good, a plan of treatment that corres-
ponds with “inoculation,” of the conjunctiva for
Pannus, or what it means, to the excitement of an
intense conjunctival inflammation to carry off the neo-
plastic matter. I feel confident that such a plan of
treatment for some of the old obstinate middle ear
troubles would be attended with less risk than the excite-
ment of a violent blemorrhagia to the eye. Every one
probably has seen the marked results of idiopathic sub-
*ºute attacksin otitis media chronica. This air douche
should be made use of every day, provided no irritation
of the throat is caused by the “catheter. If ice or
*mmonia is used, a sitting of once a week will frequently
be sufficient.
If stimulating remedies "are used, it is well to allow
-the ears periods of rest. Treating them regularly for a
few weeks then desisting for a few weeks.
In closing my remarks I must caution you against
not only not giving your patient pain, but also not pro-
ducing irritation of the throat by the catheter. Cather-
terization is a comparatively simple operation, and yet
I am continually seeing patients in whom the only bar
to improvement was the awkward manipulation of the
operation. The catheter is introduced, but the irritation
produced prevents any favorable result.
—-º-º-º-
S U R G I C A L N 0 T E S .
BY
P. S. Con NER, M. D.
Prof. Surgical Anatomy Medical College of Ohio.
Lyell’s “Displacement of the Radius.”
Case 1. F. N., aet. 2 years. Some hours before hurt by
nurse swinging her by the hands; afterwards very
fretful, complaining of pain when left arm was
touched. When seen the left forearm was partially
flexed on arm, the hand about three-fourths fully
pronated, the motions of shoulder elbow and wrist
unimpaired and painless, the slightest attempt at
Supination caused pain, (though gentle motion
showed that the head of the radius moved with the
shaft), no tenderness on pressure upon any part of the
forearm and hand except over the upper sixth of radius.
Not being able to determine the nature of the injury,
but from the tenderness suspecting incomplete fracture
somewhere in the upper fourth of the radius, I put the
forearm in a state of complete supination and secured
it by adhesive straps to a dorsal splint. The child very
quickly became quiet and was sent to her home a short
distance in the country. On the fourth day afterwards
(as I learned from the physician in charge), upon tak-
ing off the splint it was found that the difficulty what-
ever it had been had entirely disappeared, all motions
of forearm and hand being painless and complete.
Further treatment was consequently discontinued. A
few days afterwards Isaw a paper by Dr. Lyell, originally
published in the Glasgow Quarterly Journal, calling atten-
tion to a “curious displacement of the radius,” previously
undescribed by surgical writers, so far as known occur-
ing only in children under five years of age, generally
in girls, apt to be frequently reproduced. The
described symptoms of this displacement agreed
So well with those observed in the case above
mentioned, that I was satisfied of the nature
of the latter. Fortunately for my patient I had adopted
the very treatment recommended by Lyell, viz., forced
supination, though the application of the splint was an
unnecessary annoyance to the child.
Case 2. S. B., ast, 23 years, hurt her right arm
184
[APR. 20, 1872.
TIEI H. C. T., T N T C.
in some way unknown. Symptoms identical with
those of Case 1, given. Recognising now the na-
ture of the accident I supinated the forearm, making
at the same time slight pressure over the head of the
radius. All pain and deformity were at once relieved,
the child began laughing and playing around the room.
Up to the present writing there has been no recurrence
of the displacement. A j
“Lyell’s displacement,” (as I thinkinjustice to the descri-
ber the injury should be denominated), is not to my
knowledge referred to in any surgical work. I
have never seen but the two cases mentioned, yet
these cases were met with within three weeks
of each other. The relief is easy and immediate
when the character of the injury is recognised.
Of the exact nature of the injury I have been unable to
satisfy myself. Very probably Lyell is correct in his
belief that “the radius somehow catches on the adjacent
ulna and is there retained,” whether or not from over-
supination, as he thinks, is perhaps questionable.
Backward Dislocation of the Wrist.
F. S., aet. 22 years, brakeman. Dec. 12, 1871, fell
or was thrown from a freight car, the brake of which he
grasped with his right hand in an attempt to save him-
self. When picked up was found to have received some
injury about the right wrist. Through the kindness of
my friend Dr. J. L. Cleveland, I saw the patient
soon after he was hurt. There was a very well
marked prominence on the dorsum of the forearm
just above the normal line of the wrist, the
upper margin of which was smoother and more rounded
than in any case of Colles fracture I had ever seen.
Upon making extension the deformity was relieved and
showed no disposition to reproduce itself. Immediately
afterwards it was found that lateral motion of the wrist
upon the forearm could be readily made to the extent
of at least one-fourth to one-third inch to either side.
No crepitus at any point could be elicited either before
or after reduction was made. Palmar and dorsal splints
were applied and the wrist kept at rest. In a private
note to me Dr. Cleveland writes, “The dressing was re-
moved four weeks after the accident at which time it
was found that mobility existed in wrist-joint though it
was restricted and painful on account of the long fixed
position. There was no deformity except slight swelling.
Passive motion was ordered and a hydrant douche twice
or thrice daily. It was thought advisable to still support
the wrist by a roller bandage. Two weeks afterwards
(six weeks after the accident), motion had much im-
proved and the patient felt so well that he commenced
light work on the road (flagging), though he could not
use his right hand. The last time I saw him, Feb. 10th,
he was continuing to improve and the only deformity
apparent was slight thickening of the wrist. But he
could not grasp anything with his right hand. Yester-
day (April 5,) heard that he was beginning to use his
hand somewhat.” The case was, I am certain, one of
backward dislocation of the carpal-bones accompanied
with extensive laceration of the ligāments of the wrist-
joint. Every one knows how very rare such dislocations
are, and I feel under many obligations to my friend
Dr. Cleveland for giving me the opportunity of seeing
and making the first examination of this case, the only
one of the kind I have met with.
Undescended . Testes.
E., aet, 35, married 10 years, no children. A tall robust
heavily-bearded man, hair upon and above pubes abünd-
ant, penis normally developed, scrotum exceedingly
Small scarcely more than a slight fold of skin, testicles
absent, one to be felt behind right internal abdominal
ring, the other perhaps, just external to and slightly
above left internal ring. Venereal desirès stated to be
very strong, erections vigorous, emissions complete and
abundant, not followed by any sense of exhaustion.
The microscopical évaminations that I made of the ejacu-
lated fluid did not reveal a single spermatozoid. Cases of
monorchidism (non-descent of one testicle) are not so
very uncommon, but those of cryptorchidism, where
both testes are retained, are very much rarer. The case
mentioned above is the third that I have met with, the
other two being discovered. in examining about 5,000
'recruits. Amomg 10,800 recruits for the British army,
Marshall found but a single case. Very possibly many
may exist of which nothing is known, for every care is
generally taken to conceal such a deformity, and as it is
irremediable, only accident or the determining of the
question of fruitfulness will bring about a discovery of
its existence.
To the cryptorchid and to medical men the
question of the functional value of retained testes
is a very intereting one. John Hunter wrote,
“when one or both testicles remain through life
in the belly I believe that they are exceedingly
imperfect; ” and in this, as in many other respects,
his views were as correct as they were in advance
of those of his own and immediately succeeding years.
However much we may at first be inclined to believe
with Owen that “there is nothing in such a situation
which necessarily tends to impair their efficiency, (i.e.,
that of the retained testes), and that their continuance
in the abdomen º * may influence the quantity but
not necessarily the quality of the secretion;” yet when
we ask what has been the result of microscopical exam-
inations, the universal answer is no spermatozoids present.
The presence or absence of these is the sole thing to
be determined. Virility even to an unusual degree may
be present and yet the fructifying elements be wanting
in the seminal discharge.
Curling declares that “spermatozoids have not been
discovered after death in the spermatic ways of a detained
testicle in any one instance that I know of.” It will not
do to accept such a report of post-mortem examinations
as that given by Sir Astley Cooper, “testicles of nearly
the normal size and seminal tubes full of semen;” as is
.APR. 20, 1872.]
T H. H. C.L.I INTI C.
185
well known there may be apparently an abundance of
to-the-eye-healthy semen with entire absence of the
fructifying elements. In the seminal discharges of living
cryptorchids no microscopist so far as I can find has ever
discovered spermatozoids. To such evidence of necessary
infertility presented among others by Godard,
Goubaux, Follin, Liegois and Curling, it is neither
scientific nor just to oppose a statement like Casper's
that “experience proves that cryptorchids are per-
fectly capable of procreation,” even though supported
by such cases as have been reported by Reigel, Valette,
Poland, Coulsen, Curling and others, in which cryptor-
chids have married and had children. The maxim
“Pater est quem nuptia, demonstrant,” however good in
Law will not alwayshold good in fact. How can alleged
paternity of six children be reconciled with post-mortem
evidence that the retained testicles were apparently un-
developed (not "atrophied), and no spermatozoids were
discoverable, as was the case in Curling's patient. Most
generally neither the volume nor consistence of retained
testes have been found to equal those of normally placed
organs. Very commonly they have undergone fatty
degeneration especially affecting the tubuli seminiferi.
That occasionally a cryptorchid may be found whose
testicles are in all respects healthy is possible perhaps, but
thus far, a case is not to my knowledge on record.
—-º-º-º-
THE DIAGNosis of THE FIRST stage of
CARGINoMA colºr UTERI.
With Observations on its Pathology and Therapy.
BY
PROF. OTTo SPIEGELBERG, (Breslau).
º
From the Archiv. fir Gynalkologie vol. iii, sect. 2, Berlin, 1872.
The recognition of the first local beginning of cancer
of the uterine cervix is attended, as is well known, with
difficulties; indeed, so far as an absolute certainty is
concerned, it has been considered—except in those cases
where the disease has opened out with exuberations—
impossible, more especially when it occurs as circum-
scribed (papular) or more diffuse infiltration, with the
mucous membrane intact.
“Diagnostic difficulties in all the forms of uterine
cancer are only encountered in those cases in which the
mucous membranes remains intact, otherwise expressed,
in that stage of the so-called carcinoma in which there
is as yet no destruction of tissue. Here, however, the
difficulties are so great that it is only in the rarest cases
that a positive diagnosis may be established. It is still
relatively simple and easy if one or more hard, nodulated
masses may be felt beneath the smooth mucous mem-
brane of the cervix but it is out of our power to differ-
entiate those cases characterised by an enlarged, smooth,
hard and markedly swollen cervix from simple benign
hypertrophy or from chronic metritis. Seductively
thorough as the rules for differential diagnosis given in
the various text books seem to be, in practice, with re-
liance gnly on the sense of touch, the so-called tactus
eruditus, diagnosis is always dubious and uncertain.
It would be of the highest importance in therapy if we
could early recognise those cases in which a portion of
the cervix is still apparently sound.”
With this portrayal, Gusserow in his else so excellent
essay on “Carcinoma Uteri” (p. 22) characterises our
knowledge, and it is this and more especially the state-
ment at the close which prompts me thus early to a
communication which I had reserved for a more
pretentious article.
From an extensive field of observation and from con-
siderable reflection as to its pathology I believe myself
justified in giving the following as perfectly certain
evidences of cancerous infiltration, viz., a peculiar indu-
ration of the cervix, the disposition of its mucous membrane
and its reaction to dilatation under Sponge tents. Ever
since I have learned these signs they have never left
me in doubt as to the differentiation between carcinoma,
with the mucous membrane entire, and simple diffuse
or circumscribed hyperplasia, the so-called benign in-
duration, though the decision, it is true, in considera-
tion of the rarity of carcinoma, was almost always in
favor of the simple induration.
The hardness of the cancerous deposit in comparison
with the consistency of a simple induration, be it never
so dense and cicatrical like, is well known ; still the
judgment in such a case is altogether subjective, and
the bounds between the two diseases are always hard to
determine. I will therefore not place this characteristic
in the foreground, though for me it has always been very
reliable.
The other two symptoms, on the contrary, are une.
quivocal, and briefly expressed are as follows:—first, the
mucous membrane in a cancerous growth is firmly con-
nected with the underlying induration and immovable
over it, which is not the case in mere hyperplastic thick-
ening and induration; and, second, while the latter,
under the pressure of compressed sponge in the cervical
canal, becomes regularly (even though at times incon-
siderably) looser, softer and thinner, the cancerous infil-
tration remains unalterably hard and rigid, and cannot
be stretched.
What clinical experience has thus taught is clearly
explained by a consideration of the microscopic anatomy
of the disease; and this compels me to make a short di-
gression upon the development of cancer, which is the
more in place as all accounts of the origin of the disease
labor under the objection of indecision and incomplete-
ness, referring, for the most part, to the manner in which
it develops itself externally and other matters of only
secondary importance; thus Förster's distinction of
papillary and parenchymatous epithelial cancer"; the
* Handb. der. Pathol. Anatomie, ii. Bd., Aufl. 2.
186
[APR. 20, £872:
T. E. H. C. T., T N T. C.
division by Blau into cancroid, as villous papillary tu-
mor, and carcinoma as uniform infiltration of the deeper
layers of the cervix;* and Gusserow’s omission of any
decided opinion upon the subject.f
The results of Waldeyer's investigations, which my
colleague has kindly permitted me here to anticipate,
help us to a clear and satisfactory explanation of the
observed phenomena. He shows that cancer of the
cervix uteri is developed from the rete Malpighi of the
mucous membrane, or, in extremely rare cases, from the
glands of the cervical canal. The latter form of devel-
opment gives rise to the alveolar or colloid carcinoma,
and is, as remarked, so extremely rare that Waldeyer
has had but one opportunity of examining a case of the
kind. I also have seen but one. He can, there-
fore, accept the form originating from the rete Malpighi
as the type of carcinoma uteri. As a rule, the disease
is developed from the interpapillary depressions of the
epithelium, and accordingly originates oftenest on or
close by the lips of the os, but may, of course, appear in
other places free from papillae.
According as the growth of the epithelium into the
tissues below is or is not attended by a simultaneous
growth of the papillae, two forms of cancer may be dis-
tinguished—the papillary villous (commonly called
cauliflower excrescence) and the simple infiltrated form.
In every case, however, the irregular epithelial growth
remains the essential part of the disease.
+ * % •k *
Since the development of cancer always begins with
the abnormally rapid growth of the deeper layers of epi-
thelium, it is very possible that the disease may be far
advanced, even though the superficial epithelial layers
remain entirely unchanged. Hence the frequent men-
tion of the primary deep development of uterine cancer
with an outwardly healthy mucous surface. It is a
mistake, however, to fancy the epithelium entirely un-
concerned in the process. In many cases, to be sure,
and even at an early stage of the disease, the outer layers
of epithelium are thrown off, and the beginning cancer
is presented in the form of an erosion, as well as an epi-
thelial infiltration of the subcutaneous layers of connec-
tive tissue.
Farther, it is to be remarked that in the uterus, just
as on the skin, the cancerous development may start
from a small, circumscribed collection of epithelial cells
and penetrate hence inwards into the tissue, or extend
outwards towards the surface.
In the first case, the disease must appear as a small,
circumscribed induration (Knoten), lying deep down
in the substance of the uterus; in the Second, as the
so-called corroding ulcer, ulcus phagedænicum or gorro-
dens of authors.
If the disease has advanced to marked papillary
growths or ulcerous disintegration, the diagnosis is com-
paratively easy, but even in the cases in which there is
* Eiringer's Pathologische Anatomisches uborder Gobārmutterkrebs.
i Loc. c it.
externally no disease, the immobility of the mucous
membrane must be recognised as a condition in perfect
conformity with the established facts in regard to the
development of carcinoma.
Since the carcinomatous indurations and infiltrations
owe their origin directly to the most important constitu-
ent of the mucous membrane, namely, its epithelium,
and are thus intimately connected with its superficial
layers, any motion of the latter upon the new growth is
prevented.
The different effect of compressed sponge upon car-
cinoma and homoplastic induration will be understood
if we consider that in the first case the diseased tissues,
as if injected with wax, are filled with an inflexible
mass, which deprives them of all elasticity and renders
them incapable either of being stretched without rup-
ture by the mechanical pressure of the swelling sponge,
or of being softened by the fluid fluxion and exudation
which the sponge indirectly incites in other conditions
of structure.
In fact, these two effects of compressed sponge corres-
pond exactly with the two conditions accompanying
labor, viz., the pressure of the advancing foetus and the
attending hyperaemia; and it was, in fact, this last com-
parison which led me to the idea of using the sponge in
the way indicated. |
My first case was that of a patient whose irregularly
indurated, enlarged, fissured cervix uteri had frequently
been held for cancerous and its extirpation recommended,
The absence of carcinomatous hardness, however, and a
mucous membrane entirely normal, and easily movable.
except at the fissured points, arroused in my mind a
doubt of the correctness of the diagnosis; and every
idea of carcinoma disappeared when, the next day, after
the introduction of a compressed sponge, I found the
indurated and thickened portion much softer and thinner.
The latter history of the case confirmed the correctness
of my diagnosis.
I have very often since argued in this way the absence
of cancerous disease, and subsequently proved the justice
of my conclusions by microscopic examination after
removal of the inflamed and hyperplastic vaginal por-
tion (an operation which is attended with immediate
benefit, and is in itself without danger). If, as is true,
the opposite cannot be so often proved, the difficulty
lies only in the frequency with which cases of primary
parenchymatous cancerous disease without papillary
hypertrophy of the mucous membrane are observed in
the beginning of their course. I have met with but two
cases of the sort in all, but in both, the signs in question
proved their reliableness as criteria for the differential
diagnosis.
It may be objected to the use of the compressed
sponge as an aid in diagnosis, that by its means the de-
generation of the neoplasm, the exulceration of the
cancer, will be hastened. That I allow; but, still, there
is no harm done, for the extirpation must follow imme-
diately if the disease is ſound to be carcinoma. It is
APR, 20, 1872.]
only when done very early that the operation can be at-
tended with any success; and whether a perfect cure
ever results, I still very much doubt. For, even in the
two above-mentioned cases, in which I recognized the
disease in the first stage and -operated, so far as the
finger could judge, in healthy tissue, the operation was
useless. The disease returned almost immediately.
The result was the same in three other cases with
ulcerations and superficial growths, in which I applied
the galváno-caustic wire upon a ring of apparently yet.
healthy tissue close up to the vaginal attachment, where,
to be sure, the burned cut surface did not allow micro-
scropical proof of transition to healthy tissue. In the
first case, the wound healed well and showed no change
for nearly a year, when suddenly a papillary cancerous
growth developed itself with surprising rapidity from
the cicatrix. In the second, new papilloma showed itself
immediately upon the falling off of the slough. In the
third case, after long suppuration and repeated slough-
ing, a tunnel-shaped cicatrix was formed in the base of
the vagina, with which the cervix uteri was closely con-
nected, and I considered the case cured. Upon exami-
nation, a year and a half after the operation, I found
the cicatrix unchanged; but at present, three months
later, there is developed upon the site of the old disease
a superficial cancerous induration larger than a pea.
Nevertheless, I must still allow the possibility of a
radical cure by early amputation. It is confirmed by
the reports of perfectly reliable authors, although there
are among those reported many cases of only apparent
cure. Certain it is that cures are very rare, and the
reason for it is probably to be found in the rapidity with
which the lymphatic vessels in the neighborhood of:
cancer, in contrast to sarcoma, are invaded by the dis-
©a.Se.
In the very great majority, however, of cases of carci-
noma of the cervix, amputation is inadmissible. On
this point I differ completely from Gusserow's too gen-
eral advice” for operation.
The loss of blood upon the application of instruments
and the removal of the diseased portion, is so considera-
ble that it injures the patient more than the temporary
retardation of the growth and ulceration can benefit
her.
It has always seemed to me that the disease made
more rapid advance after the bloody operation, and that
the degeneration and disintegration became only more
rapid.
If the disease is locally far advanced, the removal of
the diseased portion must be accomplished with scalpel
and Scissors, if there is to be any prospect of a respite of
even a few months. For it is with these instruments
alone that it is possible to extirpate a pyramidal-shaped
piecet whose apex shall extend above the base of the
Vagina, which level in a case anyways far advanced is
*—
—º
TIEEE TH} C.T.I.N.I.C.
of authority favored the latter.
* Loc. Cit.
t Hegar-Werhand. der Gynäkol. Section der Naturforscher-Vers-
ammlung zu Innsbruck. Mon. für Geburtsk 34 Band, S. 394-95.
187
always overstepped in the vicinity of the cervical canal.
Loop and chain cannot be operated above this level,
must cut, therefore, through the midst of the disease,
and the following development from the cut surface is
all the more luxuriant.
For a while, I deceived myself with the idea that, in
cases where the vaginal walls were not yet attacked, it
would be possible to remove a portion of the corpus
uteri by means of a wedge-shaped incision, but the
difficulty of the undertaking became evident upon the
first attempt at its execution. The enormous haemor-
rhage, the impossibility, in the gushing blood, of con-
trolling the instrument by the eye; the necessity of di-
recting scalpel and Scissors in the narrow space with the
fingers alone; the danger of injury to the neighboring
parts (bladder and especially peritoneum); the repeated
tearing out of the hooks fixed in the brittle mass; then,
too, the threatening danger of serous inflammation which
would attend the tamponning or cauterization of the
bleeding wound—all caused me to regard the comple-
tion of the operation, without imminent danger to the
life of the patient, as impossible.
My advice, therefore, is: very early operation, or,
where this is not possible, mere treatment of symptoms.
—-º-O-º-
A C A D E M Y O F MIE DI C IN E.
JAS. GRAHAM, M. D., PREST., L. WOLF, M. D., SECTY.
Transactions April 13, 1872.
Reported by Joseph Ransohoff.
*-*-*s-
Regular session; the President, Dr. Graham in the
chair.
Dr. Thomas Kearney presented a paper on syphilis.
He opened by reviewing the theories of the unicists and
dualists, stating at the same time that the weight
The essayist then di-
rected the atteneion of the Academy to Morgan's views,
viz., “That the soft, non-infecting sore in the male is
produced by inoculation from a secondary syphilitic
lesion, and particularly from the vaginal Secretions of
infected females.” The author objected to these views,
because Morgan's experiments were made exclusively
upon prostitutes, and hence the fallacy of some of his
conclusions. He then briefly referred to the difficulty
of diagnosis by physical appearances alone between the
infecting and non-infecting sores, and then quoted from
the report of the committee appointed by the Parliament
to investigate venereal disease in the British army.
The report stated that “It could not be known with
certainty whether or not a local sore would produce con-
stitutional syphilis until the constitution is actually in-
volved.” Dr. Kearney then referred to the practice of
syphilisation which corrected the belief in the non-inoc-
188
[APR. 20, 1872.
TIEEE IH, C T I INT I. C.
ulability of syphilitic sores upon the persons bearing
them. In the treatment of syphilis, authorities differ
but little. Mercury is almost universally given in the
earlier stages, and certain salts of Iodine in the tertiary
stage. The author thinks that mercury should not be
given until some constitutional manifestations of the
virus appear. Lee says “that the insufficient use of
mercury renders the subsequent developments more
difficult of control, than if no mercury had been given.”
The essayist concluded with the report of a case of
syphilitic dementia, treated succesfully by Dr. Henry
of New York. In this case from 90–300 grs, of Potass.
Iod. were given in the course of twenty-four hours.
Dr. Carson presented a pathological specimen to the.
Academy. It was a lung, removed from a patient who
had been suffering with phthisis of four years duration.
According to the patient's statement, it had originated
in a severe cold. The case was interesting because it
presented some peculiar physical signs. A year previous
to his death, the patient exhibited a very marked con-
traction of the right side of his chest. By percussion a
dull sound was elicited, expansion was diminished and
respiration in the anterior region of the right side was
tubular. At no period were there any evidences of the
existence of cavities. The patient died suddenly, the
cause of his death being pericarditis with effusion. The
apex of the right lung presented a very large and ragged
cavity in which the remains of a vessel were to be ob-
served. Cavities varying in size and bounded by fibroid
tissue are dispersed throughout the entire right lung.
The pleura is everywhere thickened and especially at
the base where it is fully half an inch thick. The left
lung presents no cavities but is thickly studded with
granulations, and also shows a tendency to fibroid de-
generation. In this case the speaker had experimented
upon the anti-pyretic effects of quinia. His average
temperature in the morning was 98.3°F. The evening
temperature ranged from 99%% to 101°. He was then
ordered xx grs. Quin. Sulph., every morning. Although
he continued this treatment for 11 days, accurate ther-
mometric observations showed but little alteration from
the average temperature previous to the administration
of the agent. The speaker had also given quinia in a
similar manner in another case of advanced phthisis,
whose average temperatures were 98}* and 103}” in the
morning and evening respectively. In this case the re-
duction was also very slight. He had also given 120
grs, of quinia in two days in a case of typhoid fever.
In this instance the fever was considerably reduced but
the speaker attributed the reduction to a natural decline
of the fever. These experiments, though not con-
clusive, showed in the speaker's opinion that the anti-
pyretic power of quinia was greatly over-estimated,
especially when given in 1 or 2 gr. doses, and at longer
intervals.
—º-e-ºn-
THE world is moved by the men of uneasy soul.—
Hawthorne.
MEDICAL NEWS
AMIERICAN MEDICAL Association.
Active measures are being taken by the medical pro-
fession of Philadelphia to insure a pleasant visit to their
guests at the ensuing meeting of the American Medical
Association. The programme, as now arranged, com-
prises a reception similar in character to the one given
in May, 1870 (see Med. News, June, 1870, p. 90), by the
Biological Section of the Academy of Natural Sciences,
and a promenade concert at Horticultural Hall on Tues-
day evening, May 7th. On Wednesday and Thursday
evenings, in addition to the usual private entertainments
by citizens, there will be given very interesting lectures
on the spectroscope, gas microscope, the recent discov-
eries in electricity and galvanism, etc. And on Friday
the members of the Association, with their ladies, will
make an excursion to Fairmount Park, and along the
banks of the Schuylkill.
A visit to the iron-clads at Leagué Island is proposed.
The Alumni of the University of Pennsylvania and
of the Jefferson Medical College will each avail them-
selves of the meeting being held in Philadelphia to have
a reunion.
During the sessions of the Association there will be
held in the Hall of the College of Physicians an exhibi-
tion of objects of interest and instruction, such as recent
inventions and improvements in surgical and obstetrical
apparatus and appliances, optical, ophthalmological and
other instruments of precision, philosophical and elec-
trical instruments and apparatus, new chemical and
pharmaceutical preparations, anatomical and pathologi-
cal specimens, models and other means of illustrations,
and new books, prints, and other publications. The
chief design of this exhibition, which it is hoped will be
held annually hereafter, is to show the recent progress
in, and present status of, these respective branches of
knowledge and industry. We earnestly hope that gen-
tlemen who have objects of especial interest or recent
origin, in these different classes, at their disposal will at
once avail themselves of this opportunity to bring them
forward, not only for their own benefit, but for that of
the profession generally. Contributions are invited
from all parts of the country. Any information wished
by gentlemen desiring to exhibit may be obtained by
addressing Dr. Wm. Pepper, 1215 Walnut Street, Dr.
F. F. Maury, 1218 Walnut Street, Philadelphia.-News
and Library, April, '72.
THE EMPEROR OF BRAZIL.-The Emperor of Brazil
while at Paris visited Dr. Wecker's ophthalmic clinic,
which he has recently established in his new and mag-
nificent quarters in Rue du Churchemidi. He was
present at Some operations and ophthalmoscopic demon-
strations and complimented the Doctor very highly on
the excellent appointment of this house.
APR. 20, 1872.]
TIEI IEI, CT I INTI C.
i89
w— —r-
• THE MEDLICOTT CASE,--The Supreme Court set aside
the verdict in the Medlicott case, , and ordered a
new trial, mainly on the ground of the lower court
admitting, as testimony, the dying statement of Ruth,
the murdered, man,—Leavenworth Med. Herald, April,
1872. & t
BoDND IN HUMAN SKIN.—A copy of the “Constitu-
tion of the French Republic of 1794,” bound in human
skin, is about to be sold in Paris. The binding, however
is said not to be unique. The public library in Bury
St. Edmunds contains an octavo volume, consisting of a
full report of the trial and execution of Corder—who, it
may be remembered, murdered a young woman named
Martin, at the red barn, in a neighboring village, about
forty years ago—together with an account of his life and
other matter. This volume is bound in the murderer's
skin, which was tanned for the purpose by a Surgeon in
the town. The skeleton was prepared for the Suffolk
General Hospital, and is still to be seen there. The
human leather is darker and more mottled than vellum,
of a rather course texture, with holes in it like those in
a pig's skin, but smaller and more sparse. English books
with this kind of binding are at the same time much
less rare than is generally supposed. In the Bristol
Law Library are several books bound in human skin,
specially tanned for the purpose, and some curious de-
tails might be furnished of several local culprits execu-
ted in that city who were flayed after execution to
furnish the leather for binding together some contem-
porary legal lore. w
BELLEVUE HOSPITAL MEDICAL COLLEGE.—The fol-
lowing changes have lately been made in the Faculty:
—Prof. Stephen Smith has resigned the chair of
Descriptive and Comparative Anatomy, and Clinical
Surgery, Prof. B. W. McCready has resigned the chair
of Materia Medica and Therapeutics and Clinical
Medicine, and has been appointed Emeritus Professor of
Materia Medica and Therapeutics and Professor of Clin-
ical Medicine. Prof. A. B. Crosby has been appointed
Professor of General, Descriptive, and Surgical Anatomy.
Prof. Wm. A. Hammond has been appointed Professor
of Materia Medica and Therapeutics, Diseases of the
Mind and Nervous System, and Clinical Medicine.
Prof. Hammond will continue his lectures and clinics on
Diseases of the Mind and Nervous System as heretofore,
lecturing also upon Materia Medica and Therapeutics.
Dr. E. G. Janeway has been appointed Prof. of Path-
ological and Practical Anatomy. As Prof. of Patholo-
gical Anatomy, he will deliver in the regular session a
course of lectures on that subject. As Prof of Practical
Anatomy, he will perform the duties of Demonstrator
of Anatomy, Dr. E. L. Keyes, formerly Lecturer on
Permatology, has been appointed Prof. of Dermatology.
Prof. A. B. Mott has been transferred from the chair of
Surgical Anatomy, with Operative and Clinical Snrgery
tº the chair of Clinical and Operative Surgery. Prof.
Mott will relinquish his didactic lectures on Surgical
Anatomy to the Prof. of Anatomy, and will hold a Sur.
gical Clinic at the college throughout the year.
UNIVERSITY MEDICAL COLLEGE N. Y.-Dr. Joseph
W. Howe has been appointed clinical Professor of
Surgery; Dr. Henry S. Hewit, Professor of Clinical
Surgery; Dr. Arnold, Professor of Pathological Anatomy
and Dr. Kammerer, Professor of Diseases of Women and
Children, vice Dr. F. D. Lente, resigned.
PHILADELPHIA HospitaL, BLOCKLEY.—Prof. A.
Stillé has resigned his office as visiting physician to this
hospital, and the managers have passed a resolution
thanking him for the efficient services rendered while
connected with the institution.
Dr. J. Tyson has been elected visiting physician in
place of Dr. Stillé.
CLOSURE OF THE PARIS SCHOOL.—The Paris Medical
Students have again made use of political motives in
demonstration against one of their professors, Dr. Dol-
beau, professor of surgical pathology. To put an end to
such scandalous scenes the faculty have concluded to
entirely close the medical school of Paris for one month,
that is, to the 'énd of April.
LostORFER's SYPHILIS DISCOVERY.—The discovery
of germs in the blood peculiar to syphilis was published,
as is well known, in the Vienna Medical Press, Jan. 28,
1872. In the very next number, Feb. 4, 1872 the fol-
lowing letter appeared in large type.
LOSTORI FER2S SYPHILHILIS BOLDIES.
To the Editor of the Vienna Medical Press.
The importance and significance of the preliminary
communication on the alleged syphilis bodies published
in your valuable paper (Jan., 1872, No. 4) determine
me to request you to accept the following lines in ex-
pression of my views upon this subject.
The so-called syphilis bodies occur in normal as well
as in syphilitic blood and are, so far as my observations
hitherto extend, nothing else than protoplasm and fat
particles which obtain their so-called vacuolae from
the escape of the water of the process of decomposition
developed in the water chamber. They are, therefore,
by no means to be regarded as a specific characteristic
of syphilis.
Most Respectfully,
Prof. C. Wed].
Vienna, Jan. 30, '72.
—º-º-º-
CORRESPONDENCE.
CINCINNATI, APRIL 11, ’72.
EDS. CLINIC:
I notice in a late number of one of the Journals
what purports to be the formula of “Dr. Jackson's Cough
Syrup,” as adopted by the Cincinnati College of Phar-
macy. As it does not answer the original prescription,
190
T. EEIL TED CT, ITNT.I. C.
... ---------- * *-*****
[APR. 20, 1872.
I send it to you, as I find it among my father's papers
and as furnished by Dr. Jackson.
R. Syrup. Morphiae, 3ij.
“ Ipecac et Senekae,
“ Rhei Simplicis, & 3i.
M. S. A Tablespoonful three times a day.
The Syrups of Morphia, of Ipecac and Senekae are pre-
pared thus.
1st. R. Mur. Morphide, gr.
Syrup. Simpl., 37.
Ol. Sassafras, 9ii.
R. Rad. Senekae, 3ij.
Ipecacuauhae, 3i.
Aquae Font., gal. #.
2nd.
Boil the snake root in the water until half consumed,
then add the Ipecac and from one to two pounds of
Sugar.
Respectfully,
C. O. WRIGHT, M. D.
——sº- ©
CLINICAL MEMORANDA.
MIenstruation from the Mammae.
BY
Dr. P. MYNET.
Physician to the Charite,
From the Lyon Médicale, Mar. 17, ”2.
Henriette M–, aged 17, well formed, though of
lymphatic temperament entered the Hotel Dieu (Lyons),
Salle St. Charles, Feb. 24, 1862, with the statement that
for the past eight months her menses had escaped every
month through a fissure in the nipple sometimes of one
side, sometimes of the other. The loss of blood was
sufficiently abundant and continued for two or three
days. This hemorrhage is preceded each time for a day
or two by pain and swelling of the breast. When it
ceased the fissures of the nipple closed, the breast soft-
ened and in every way she was well. She had never
had her courses, but during the time of hemorrhage
from the breasts she experienced slight pain with a
sense of fullness in the abdomen and lassitude in the
loins.
Her general condition was excellent. We had the
opportunity of observing the phenomena mentioned on
three separate occasions. The hemorrhage occurred and
passed with the greatest irregularity. The breasts were
manifestly swollen and painful, the nipple was sur-
rounded with a small black circle and at its extremity
from a rough, anſractuous surface there oozed a few
drops of perfectly red blood. The daily quantity lost
was about 30–40grammes. The duration varied between
two and three days.
Subjected to a tonic treatment of iron and bitters
during her stay at the Hôtel Dieu with at the same time
an attempt at restoration of the hemorrhage per vias
naturales by cutaneous and intestinal revulsives, sinap-
isms and purgatives and cups over the loins repeated
two or three times, she left the hospital in unchanged
condition. Two months after exit the menses appeared
naturally and there has been since this time no return
at the breasts. t
I have again, quite recently seen this young woman
and this is the occasion of the present memoire. She is
now 27 years of age, robust and vigorous, but menstrates
irregularly, every two or three months, with much
pain about the abdomen and kidneys. She has
an intercostal neuralgia which manifests quite frequently
and occasional palpitations. In a word, she presents
numerous signs of chlorosis but without the bruit of vas-
cular souffle. Married for three years, she has never
borne a child.
[The author then appends another somewhat similar
case in a woman of 44 years, robust and of sanguine
temperament, the mother of two children. It terminated
in an active inflammation of the right breast which is
increased at every epoch and which has hitherto resisted
medication. So far there is no indication of cancer from
this manifestation which is regarded by some authors as
one of its first signs. He cites in conclusion the two ob-
servations of M. Duchaussory, communicated to the
Society of Practical Medicine, November, 1871; cases of
hemorrhage from the nipple, in neither of which did
carcinoma appear. In one of these cases the injection
of tincture of iodine into the galactophorous ducts suf-
ficed for cure].
REMOVAL OF FOREIGN BODIES FROM THE EAR BY
AGGLUTINATION.—Löwenberg, of Paris, calls attention
in a long article (in the Berliner Klin., Woch., Mar. 4,
’72,) to his “agglutinative method” for extracting for-
eign bodies from the ear, giving illustrative cases. He
objects to the use of syringing with warm water both
when the foreign substance completely fills the ear, and
also when there is a perforation of the membrana tym-
pani. In the latter condition one runs the risk of
driving the foreign body into the cavity of the drum.
He uses ordinary glue, dropping it upon the foreign
body and waiting fifteen minutes for it to cool and
harden.
[The subject of foreign bodies in the ear is one that
under some circumstances may become of vital interest.
It is surprising what difficulties various operators get
themselves into, and remarkable to relate, the only
serious cases, in fact the only difficult cases that have
come under my care, have been made such by previous
manipulations. A curious chapter of expedients might
be given, showing the difficulties in the way of removal
of foreign bodies among the older practitioners and some
among the more recentl.
APR. 20, 1872.]
Tº H. H. C. T., T N T C.
191
AN INTRA-UTERINE INTERMITTENT POLYPUS.—
Certain intra-uterine polypipresent the remarkable pe-
culiarity of engaging at the os during menstruation and
protruding thence into the vagina. After a variable
time they withdraw themselves again into the body of
the uterus and reoccupy their first position. Their
presence in the vagina, thus, is transitory and intermit-
tent. Such a case recently presented at the Maison
Princip. de Santé in the service of M. Demarquay.
Bernardeau and several English surgeons have published
facts of this kind. In France, Sabatier, Marjolin and
Lisfrance have already signalized the influence of men-
struation on this class of tumors. M. Demarquay has
observed three cases in his practice published in the
memoire of M. Larcher in the Archives de Médicine.
This paper includes several original observations and
existing knowledge on this subject.
In the case of the text the os was dilated with sponge
tents and the polypus was secured and removed.—Gaz.
des. Hopitaua, Feb. 24, '72.
—-º-º-º-
Cold Applications in Hyperpyrexia.
Clinical Society of London.
From the Brit. Med. Journ., Mar. 30, 1872.
Dr. Hermann Weber read a paper on a case of hyper-
pyrexia in rheumatic fever, successfully treated by cool
baths and affusions. The patient was a youth aged 16,
who had rheumatic fever (first attack) in August 1871.
The affection of the joints was well marked, but not
excessive. The temperature of the body varied between
the ninth and twelfth days of the disease from 101.6 to
102.2 deg. Fahr.; the pulse between 98 and 118; the
respiration between 20 and 24. The lungs were free,
and there was only the slightest indication of a murmur
with the first sound near the apex. The medicinal
treatment consisted of three grains of quinine three times
a day. On the morning of the thirteenth day, great
restlessness, vomiting, excessive micturition, involuntary
motions, delirium, tendency to coma, and lividity of face,
Supervened, simultaneously with a rise of temperature
from 101.6 deg. on the previous evening to 108.2 deg., of
the frequency of pulse from 118 to 148, and of respira-
tion from 22 to 56. The patient was then placed in a
bath of 71 deg. E.; and affusions of water of the same
temperature were made. The mental condition and the
appearance of the patient rapidly improved already
during the first ten minutes; and at the termination of
thirty minutes, when he was removed from the bath?
the temperature in the cavity of the mouth was only
101.8 deg, while the patient fell asleep, and began to
perspire freely. In the course of the same afternoon,
the temperature again began to rise rapidly—i. e. from
100.8 deg, at 8 P. M. to 105.8 deg. at 6.40 P. M. Pulse
148; respirations 38; slight delirium. The patient had
then another bath with affusion, as in the morning,
when the temperature further arose during the first
five minutes of the bath to 106,2 deg., but afterwards fell
rapidly, the mercury receding within twenty-five
minutes (the duration of the bath) to 101 deg. After
the second bath. without any medicinal or hydro-
therapeutic treatment, the disease took the course of a
usual mild form of rheumatic fever, leading to perfect
recovery, leaving only a rather too long first sound. Dr.
Weber repeated the view stated in a former communca-
tion to the Society: that the nature of these attacks
was the same as in common heat-stroke or insolatio; and
he thonght the term hyperpyrexia, as employed by Dr.
Wilson Fox, more appropriate than heat-stroke, which
conveyed the idea of causation by external heat.
Acknowledging that hyperpyrexia was an accident which
could occur in all febrile diseases, he maintained that it
occurred infinitely more often in rheumatic fever than
in any other disease; and, regarding the peculiarities of
rheumatic fever, he was inclined to ascribe it to the
tendency to endocarditis and fibrinous deposits existing
in this disease. He suggested that it might have a sim-
ilar origin with chorea, and might possibly be due to
minute embolism or to plugging of some small vessels
in a certain portion of the nervous system, as the hypo-
thetical centre of animal heat and chemical changes.
As to prognosis and treatment, he pointed out that all
cases formerly had a fatal termination when Once the
temperature had reached 108 deg. Fahr.; but that the
hydrotherapeutic plan, ifearly and energetically pursued
and with watchfulness as to the possibility of several
attacks, gave great promise of a speedy cure, as
had been shown by the two complicated and yet suc-
cessful cases published by Dr. Wilson Fox, the one by
Dr. Medling, and the one by the author. Dr. Hermann
Weber alluded also to a difference in the action of the
cold baths in this class of cases (hyperpyrexia) and in
the pyrexia of typhoid or enteric fever, typhus, and
other fevers of longer duration. While in the latter the
baths, when given during the height of the disease, pro-
duced only a transitory reduction of temperature, which
was followed sooner or later by a fresh rise, so that three,
four, or even five baths might be required on each of
several successive days, in the hyperpyrexias one or two
baths might be sufficient entirely and finally to remove
the complex of symptoms within less than twenty-four
hours. He thought that this difference in the action of
the plan in question pointed to a difference in the un-
derlying pathological causes.—Dr. Greenhow gave
details of a case which had been under his care in the
Middlesex Hospital, and in which the cold application
did marked good, although the patient ultimately died,
the treatment not having been, by some unforeseen
accident, continued. The result of the treatment in
this case, and in another under his care of high tem-
perature in typhoid fever, had led him to entertain a
high opinion of its therapeutic value.--Dr. Andrew
192
[APR. 20, 1872.
In IEEE IEH C T I I INT I C -
asked Dr. Greenhow what treatment had been adopted
before the high temperature supervened, as the condition
might be due to the remedies.—Dr. Greenhow, in reply,
stated that the treatment had been by alkalies, and that
he believed the patient was ordered one large dose of
quinine on the morning on which the high temperature
was first observed.—Dr. Wilson Fox observed that the
high temperature had nothing to do with the treatment,
and brought forward facts which had occurred under his
own observation to prove what he said. From his ex-
perience of the cold treatment in hyperpyrexia, he was
able to speak strongly of the good results to be obtained
from it, and earnestly urged its being carried out in
private practice. It was a matter of life and death,
and medical men should not hesitate to carry it out.
No case, except one of relapsing fever, had been recor-
ded in which a patient with a temperature of 108 deg.
had recovered, unless by the cold treatment. He did
not think that cooling of the skin could unload plugged
capillaries.—Dr. Anstie observed that hyperpyrexia
might occur in any complaint, and alluded to a case of
delirium tremens under his care in which the tempera-
ture was 109 deg., and the pulse was shown by the
sphygmograph to be undulatory in its character, Dr.
Southey said that, without accepting the theory of
plugging of arteries, stasis in the vessels might be present
and be removed by the cold applied to the skin.—Dr.
A. P. Stewart was of opinion that these cases were not
dependent on plugging of the minute vessels. In one
case which had been under his care, the temperature
had risen to 109.5 deg., and the blood was found more
completely fluid than in any case of typhoid or typhus
fever he had ever seen. This militated against the view
of plugging of the vessels. This class of cases presented
a typhoid type from the commencement: in fact, some
people would say, from the appearance presented by the
patients, that they were laboring under typhus fever.
All the cases he had seen were given colored water, so
that remedies could not have caused the hyperpyrexia.
He considered the plan advocated by Dr. Weber to be
a very admirable one,—Dr. C. J. B. Williams thought
that, in these cases of hyperpyrexia, there must be some
affection of the nervous system from the commencement
something affecting the heat-making process in the body,
causing it to rise to a fatal height. He doubted the
safety of hastily adopting a form of treatment like this.
In continued fever, it was useful; but in rheumatic
fever there was inflamation of the joint, and this might
be repelled from one part to the other. He, in his long
experience, had never met with a case of hyperpyrexia;
and he had only two deaths from acute rheumatism
during the ten years he was physician at University
College Hospital—one from double pneumonia, and one
from valvular heart disease. After offering some re-
marks on some of the modes of treatment of rheumatic
fever, he expressed his opinion that the hyperpyrexia
might perhaps be due to treatment.—Dr. Weber in
reply, said that he would not usually treat acute rheu-
matism with cold water; but the examples of high
temperature were cases of life and death; and by its
means the duration of the disease was shortened, and
also its mortality. *~~ *~.
~.
MORPHIA AND CHLOROFORM CoMBINED.—M.M.
Labbé and Guyon recently read a paper at the Acadé-
mie des Science, in which they gave an account of the
results obtained in four cases in which they had tried
the combined effect of hypodermic injection of morphia
and the inhalation of chloroform. They were induced
to enter on the investigation by having observed numer-
ous experiments of M. Claude Bernard at the College de
France, which demonstrated that, by such combination,
very complete anaesthesia may be obtained by means of
a much less quantity of chloroform than when this
substance is employed alone. About the same time that
M. Bernard was pursuing these researches, Professor
Nussbaum, of Munich, with a view to the prevention of
the pain consecutive to operations, injected in several
cases the acetate of morphia while the patient was
under the influence of chloroform. In all his cases pain
continued suppressed, and Sound sleep was prolonged
for several hours after the operation.
While Professor Nussbaum, however, employed the
morphia during the anaesthesia, MM. Labbé and Guyon
injected it before this was produced, their object being
also different—not the prevention of consecutive pain,
but facilitating the production of anaesthesia and ren-
dering it less dangerous by reason of the smaller quantity
of chloroform employed. At present they have only
resorted to the means in the four cases, abstracts of
which they now lay before the Academy. In the first
of these, twenty minutes before the performance of an
amputation, two centigrammes of muriate of morphia
were injected into the thigh, and then chloroform was
administered. In seven minutes anaesthesia was com-
plete, and was prolonged for a long time after the
operation, which lasted seventeen minutes. The quan-
tity of chloroform employed was twenty-eight grammes.
In the case of ovariotomy, occurring in a girl of 20, the
chloroform was given twenty minutes after the injection,
and complete anaesthesia was produced in six minutes.
The operation lasted an hour and forty-five minutes, and
the expenditure of chloroform during all this time was
only forty-eight grammes. The patient continued in a
state of complete relaxation, and after the operation, was
entirely calm, having felt no pain whatever. Incomplete
as are their researches at present, the authors feel entitled
to conclude: first, we can in man—as M. Claude Bernard
has shown can be done in animals—obtain anaesthesia
much more rapidly by combining the action of chloro-
form and morphia; secondly, that this anaesthesia is of
longer duration, and may be kept up by smaller doses
of chloroform, the risks of fatal accidents being thereby
considerably diminished. They suggest also that the
quantity of morphia injected may be somewhat larger
than that which they employed, and that the injection
might be conveniently practised a longer time before
the operation.—Times and Gaz., Mar. 23, '72.
. ‘s • * * J. "
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The Company have the honor of bringing to the notice of the Profession, this New AND ExcLEDINGLY PRACTICAL
METHod of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general. d
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. -
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities. . ..
But not only SoLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINEs. - -- -- *. *.
. .2 This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
# , , , º, and even ideo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. - . . .
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH OF TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these médicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days. . .
For samples, Price Lists, and Agencies, address -
The Di
TECIX 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
. . . . . Walnut Hills, Cincinnati, O.
§
—tº *
– w
Mr. FREDERick Kraus: CINCINNATI, February 15, 1871.
- - Dear Sir—The specimens of your “Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: - - > -
SULPH:MORPHII....................... * … . quare. Arsenacio… .1-20 grain i
*śºstºn inºchºre. # - §: grain in each square.
46 COPPER w is º ºs º is e e * * * * * * * * * * * * * * g. .3% - te - - - - -
- - ResPEGTFULLY YoUBs,
E. S. WAYNE, Analytic Chemist.






*a
Carriage Manufacturer,
NOS, 9 and 11 East Sixth Street, bet. Main & Sycamore.
82
. I MAKE NOTHING BUT:
First czass wronx.
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of
LIGHT FAMILY CARRIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
PHYSEEFANS” {{SE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
adapted to
The superiority of my light gentlemen’s
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
£hysicians in the city and fielghborhood.
83 77
ſ\}.Sk





Wm. Wilson McGrew,
JW2, 2% WºSA" Aſozºzºz Szºz,
PIKE'S OFERA, HOUSE BUILDING,

In porter and Dealer
Diamond and Gold Jewelry, >
Watches for Ladies and Gentlemen,
Sterling Silver Tableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
Marble Statuary,
FAN cºr Coops,
G E N E R A L L Y.
WILson BRD's.
"VV"AN" ºr )—AGENTºš.
S HIRTS
Made to order of N. Y. M. Muslin and 2300
HEAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.00
First three qualities have ALL LINEN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less.
Perfect satisfaction given or money cheerfully
refunded. -
Also import and Manufacture Men’s Furnish-
ing Goods.
Pike's Opera-House, Fourth Street, Cincinnati; 931
Wabash Avenue, and SS West Washington
Street, Chicago.
CAM.A. R.G.O
MANUFACTURING COMPANY.,
MANUFAOTURERS AND IMPORTERS OF
AND
Window Shades,
67 Wasz Kotºzº Szºzzº,
CINCINNXT, O,
} %.
H. H. answevas, Proprietor. -
School Teachers, Students
AND OTHERS,
Can find light and healthful employment for the Summer, by
engaging in the sale of our valuable and very popular works.
One lady teacher just commencing work for us, reports her
net profits for last week at FoETY DOLLARs—many others doing
equally well. Large commissions or liberal salary as preferred.
For particulars, address
NETTLETON & CO.,
161 Elm Street, CINCINNATI, OHIO:
P. S.—We will make “SPECIAL TERMs” to medical stu-
dents, who are “working their own way through college.”
º
BASEM & CARTENTER,
Stationers, Printers
-AND-,
Blank Book Manufacturers,
136 VINE sºlſ|[REET,
&\\\\\\\\\e
IE. De ALBIRO & BRO.
IMPORTERS AND MANUFACTURERS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
frtaint-Maºri','l'-Büller'anishi-BiºWº.
The only house in the Western country that saws Spanish and Mexi;
can Cedar for Cigar-Box Makers. We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 West Second Street, tº:
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI,

---------->
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GooD s AMARITAN HOSPITAL.
The GooD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished througho", and is provided with all the necessary ap"
pointments of a First-class Hospital. Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The GooDSAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
§eRW1C0.
B&" Address,
SISTEE, ANTHONY,
EIospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati, Ohio-



















































































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jºys ºsºft Kº jº. yº.
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CINCINN ATI.
E" A C TU T., T Y.
* J A M E S G FR A H A M, M. D., DE AN,
IProfessor of the Theory and EPractice of IMCedicine and Clinical IMedicine.
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomy. Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D., | * . T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
JAMES T. WHITTAKER, M.D., JOHN L. CLEVELAND, M.D.,
I’rofessor of Physiology. Demonstrator of Anatomy.
SAMUEL NICKLES, M.D., CHARLES KEARNS, M. D.,
Professor of Physics and Medical Chemistry . º Assistant to the Chair of Surgery
W. W. SEELY, MI. D.,
IProfessor oſ I) is eases of the Eye and Hjar, and Secretary of the Faculty.
**
T. LOUIS BROWN, M. D., Prosecutor of Anatomy. E. No BLE, Janitor, College Building, Sixth St., bet. Vine and Race.
*
Printed and Published by Norn Is & MURRY, Medical College of Ohio Building, Cincinnati.














LINIC,
PUIBLISHED EVERY SATURDAY.
tº RMS-82.00 a Year, Invariably in Advance. An Communications relating to Publications must be addressed to the Editor
*
*
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
Vol. 2. C IN C IN N AT I,
A PR, IL 27, 1872. No. 17.
º *Lºs *
JAS. T. whitTAKER, M. D.
- No. 101 West Ninth Street, Cincinnati,
-A-SSOCIALT1: E.DITOER.S.
W. W. Dawson, M. D. THAD. A. REAMy, M.
P. S. Conner, M. D. C. D. PALMER, M. B.
W. W. SEELY. M. D. SAMUEL NickLEs, M. D.
CHAs. KEARNs, M. B. JNo. L. CLEVELA
Roberts BARTHolow, M. D.
W. W. SEELY, M. D., .
No. 118 West Seventh Street, Cincinnati.
D.
- - - - - - TREAsvagh.
Editor. }
j.
---
§
* * * *
, ºr
ND, M. D.
co-Ary tº ce.
hionable Hatters,
. HMPQRTERS AND MANUFACTURERS OF
EABEES' Fújº S,
club RATEs. '92 WEST FOURTH ST.
... • — ` ! : Opposite Post Office,
4 Copies to one address...................................................... $ 7.00
:**** 10.00 CINCININATI.
#2 § { * $$ *". sarspecial Inducements to Medical Men.
C O N T E N T S - * * • .
* - Page. ºf T. Tºp N. ſº. sº, º, . . .
. . . . . • , ºr ARIºriºn
oRIGINAL ARTICLES ſº iſ ==ºkº º
Pibrous Polypus of the Uterus by J. C. Reeve, M.D.........................193 - * ( sº T ſºlº. AN º 3. &
Abscess of the Spleen by Philo E. Jones, M. D................................196 º 2. \\
TRANSLArrows -
Scurvy, A Report on the Epidemic of Scorbutus in Paris during the
Siege (From Schmidt's Jahrb., Mar, 12, 72) -
Disease of the Gray Matter of the Cord by Dr. Rosenthal (Front the
Wiener Med. Presse, Mar. 31, ’71)
* * * *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Jº CADEMIY OF WIEIDICINE
Transactions April 24, '72.
- $
Tic Doloureux by. Dr. Bartholow—Cerebro-Spinal Meningitis Speci-
mens by Dr. Dandridge—Reports of Cases by Drs. Dawson,
Carson, Grahama
SCIENTIFIC NOTES
The Production of Epilepsy in Guinea-Pigs—Influence of Rheuma-
tism on the Character—Spasm of the Levator Ani during Coition
-The Force of Uterine Contraction 200-202
199
* * * * * * *
ME DIGA) A NEWS.
High Science—The “Toner Lectures”—Salaries of Germau Profes-
Sors—Annottr de la Patrie—The Strasbourg School—The First
Med, Journalist—Deaths of Profs, Jackson and Dickson.,..., 202-203
CORRESPON IDENCE -
©hio State Med. Soc.—To the Committees on Special Reports........... 203
CLINHCAI, NIEMI® RANIPA
An Important Symptom in Traumatic Paralyses—Treatment of
Tetanus by the Chinese–Physiology and Therapy of Alcohol,
Coffee, Tea, etc.—Bromide of Potassium in Epilepsy—Benzine
in Whooping Cough—Re-implantation of Teeth
HOME NEWS
*=
* * * * * * * * * * * * * * * * * *
ſº
****** * * ************ *** *** *** - - - - - - - - - - - ---------- . . . . . . ............ ......
WE have Some new light to-
field of spinal patholo g
tions of disease of the
day over the obscure
* gray substance of the cord.
The experiments and observations of Westphal leave
no doubt as to the existence of central lesions in the so-
called reflexe ileptic phenomena of artificial induction.
The proceedings of the Academy will be found of
especial interest as indicating the presence in our city
of cerebro-spinal meningitis.
196].
gy in the recent direct demonstra-
* * * *
W. T.A.F.T. -
Editor, Dental Register
a w. TAFT,
IDENTTIsTs
17 WEST FOURTH STREET,
CHN CIN NATI, O.
The Dental Register,
A Monthly Journal,
al
&S
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,



**.
* * * * * * * * * *.*. --~~~~~~ *
William Autenrieth,
No. 71 wrest sixTH sTREET,
BETWEEN WAINUT Añº WIME,
CINCINNATi, OHIO,
MANUFACTURER OF AND DEALER IN
Siſſl Mill iſſºlſ|| ||||||||||
Abdominal Supporters, Trusses,
3.
CLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
Metalic and Rubber syringes,
Stommºach Puanmps, Etc. '
stockings FoR VARIcose veins.
Special attention given to the fitting of Apparatus for Deformities.
Bay Agent for DR. L. A. BABCOCK'S
silver Uterine Supporter,
-ALSO–
DR AHL's POROUS FELT SPLINTS,
--A 12SO–
ID A. Y. * S S P T, IN T S
—A N T-
| ECHEVERRIA ON EPILEPSY.
... • *
ROBERT CLARKE & Co's.
List of New
Mill, iTºm Mātūn; inſ;
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5o
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN’S DIS-.
EASES. 12mo. $1 75
|BENNETT ON PULMonoRY consumpTION. 8vo. $1 50
FIRST HELP IN ACCIDENTS. 1 amo. $1 5o
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 go
* * * * 8vo. Cloth. $5 oe
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASEs. 8vo. $5 od
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 oc Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth. $2 56
TANNER'S HANDBOOK OF OBSTETRICS. 12 mo. $2 oo
WAN BUREN ON DISEASES OF THE RECTU M. 12mo.
- Cloth. $1 5o
FLINT'S EXAMINATION OF URINE. 1zmo. Cloth. $1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 5o
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRICITY. 8vo. Cloth. $4 50
ATTFIELD'S MEDICAL CHEMISTRY. 12mo. Cloth. $2. 75
Leather. $3 25
BARTHOLOW'S HYPODERMIC MEDICATION.
- Cloth. $1 5o
TURNBULL’S DISEASES OF THE EAR. 8vo. Cloth. $5 oa
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 od
NEUMANN'S HAND-BOOK OF SKIN DISEASES.
- Cloth. $4 oo &
ANSTIE ON NEURALGIA. 8vo. Cloth.
PAN COAST'S OPERATIVE SURGERY.
plates. $10 oo
HOOD ON BONE SETTING. 12mo. $1 5o -
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo.
I 2 II] O.
8vo.
$3 oo.
4to., with many
HOLBROOK’S PARTURITION WITHOUT PAIN. I 6mo.
. . $1 oo -
PROCTER'S LIGHT SCIENCE FOR LEISURE HOURS.
12mo. $1 75
|BERNARD's PHYSIOLOGY OF THE HEART. 50 cts.
BARNES’ OBSTETRICAL OPERATIONS. 8vo. $4 5o
NICHOL’S FIRESIDE SCIENCE. 12mo. $1 5o. -
WOHLER'S MINERAL ANALYSIS. 12mo. Cloth. $3 oo
PLATTNER'S MANUAL OF ANALYSIS WITH THE
BLOWPIPE. 8vo. Cloth. $7 5o -
JEFFRIES ON THE EYE. 8vo. Cloth. $1 oo
MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
JEFFRIES ON THE SKIN, 8vo. Cloth. $1 oo
GARDENING FOR PROFIT. 12mo. Cloth. $1.5o.
PRACTICAL FLORICULTURE. 12mo. Cloth. $, $o
FULLER's SMALL FRUIT CULTURE. 12mo. Cloth. $1 5o
WOODWARD'S COUNTRY HOMES. 12mo. Cloth. $1 50
DAR WIN'S ORIGIN OF SPECIES. 12 mo. Cloth. $2 oo
ARTHUR'S TREATMENT AND PREVENTION OF DE-,
CAY OF THE TEETH. 12mo. $1 50
TYND ALL ON LIGHT AND ELECTR1CITY.
THE AMATEUK MICROSCOPIST. Small 4to.
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMEN.
ROBERTS ON RENAL DISEASES. * * -
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN. & -
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by mail or express, free of charge
on receipt of price-
12mo, $1 25
$1 75
S. W. Elliott’s Saddle-bags
65 West 4th Street, Cincinnati, Ohio.
—-sº
.vo. 22. Wasr Fovazz Srrºr,
º
- * &
**
.." º º
W
:* , - - ...
3. •. - º
&. - - * *
; ,
k • * , º
º
O . tº
PIPSCE’S opera House automo,
In porter and Dealer
Diamond and Gold Jewelry,
Watches for Ladies and Gentlemen,
• Sterling Silver Tableware,
Bronzes, Antique and Modern;
* Marble and Bronze Clocks,
Marble Statuary,
FAN cºr Coons,
GENER ALLY.

F. E. SUIR -.
E. S. WAYNE
ºš
|
my.
JAMES Fosºr, Jr., sco.
Instrument Makers and Practical Opticians,
Beg leave to return thanks for the patronage extended to them through
a long series of years (having been established since 1836), and in the
reorganization of their firm will endeavor to merit a continuation of the
*ame. We wish it understood by the Profession and the Public generally
that our invariable rule is, to make or import none but the best in.
struments. Those in want of any of the acknowledged good aids of
vision to imperfect eyes, will always find the best and largest stock of
Lenses, Spectacles, and the best models procurable, with pains.
taking skill to adjust them to all conditions of sight, at our house.
Special attention paid to orders for Fine Microscopie Objects
and Microscopic Apparatus, Magnifiers and Readers in
great variety. edical Batteries, Barometers, Thermo-
naeters, Hygrometers, Urinometers and Rain Gauges,
of the most approved construction always on hand. All orders promptly
and accurately filled.
JAS. FOSTER, JR. deali
F. S SHACKLEFORD, ! *** ** JAs. Fost ER, JR. & Co.
S. W. Cor. Fifth & Race Sts., Cincinnati, 0.
TXTER, S.INT. TN/I_A_TER,STEI’S
Ǻ
º
Sº
No. 758 BRoadway, New Yoak
HAVE been in the habit of applying and recommending the Truss
I manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend . M. D., Surgeon to the
Massachusetts General IIospital.
B EG leave to state for the benefit of all coucerned, that I have known
1)r. S. N. Marsh the last fifteen years. I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have over Been,
and his treatment is unattended with an v of the risks to the patient
that exist in many of the plans suggested and atteuxpted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
aud integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
Professor of Surgery, New York City
Dr. 8. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & CO., No. 2 Vesey St. (Astor House),
New York, and S. N. MARSE, CORLISS & CO., No. 3 West Fourth St.,
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TIEI IEE C T , T N T C .
193
Wol. 2.] S A T U R D A Y, A P R I L 27, 1872.
[No. 17.
O RIG IN A L A R T I C L ES.
—-º-º-º-
FIEROUS POI.YPUS OF THIE UTERUS.
SRemarks upon a Case presented to the Montgomery
County Medical Society.
BY
J. C. REEve, M. D.
dayton, Ohio.
GENTLEMEN: . .
The specimen presented to you this evening is a
fibrous polypus of the uterus, therefore neither very
singular in character nor rare in occurrence. Neverthe-
Hess, as the subject has never been before this
society, and as many points connected with the dise as
are of very considerable practical interest and import-
ance, I will occupy your time with some remarks which,
if they add nothing to the knowledge of the older mem.
bers may possibly be of interest to those who have had
less experience with the class of diseases to which this
belongs. In one respect the specimen merits attention,
I allude to its size. Somewhat smaller now, since its
immersion in alcohol, it measured when first removed
5% inches in length, in circumference 10 inches, and
weighed 17 oz. avordupois. The pedicle measures two
inches in its shortest diameter. Since writers speak of
these tumors as sometimes reaching “even the size of a
child’s head” this must be considered a large one of its
kind, much larger than generally met with. .
I will read you a brief sketch of the case. Mrs. B.-
41 years of age, a tall and spare woman, of very pale
complexion. She has generally enjoyed good health ;
has had three living children and two miscarriages;
the last confinement twelve years ago; menstruation
generally regular but always too free. About three
years ago she was taken with flooding, and since then it
has occurred as often as every two weeks and has some-
times been severe; at times the flow has been so great
as to place her in a dangerous condition. It has not
occurred for three months except once, four weeks ago
When it followed an examination. She has had consid-
erable, but not excessive, leucorrhea; has not had
offensive discharges, has not suffered severe pain in the
pelvic region, nor had expulsive pains like labor pains.
Her appetite is excellent. The pulse indicates no febrile
disturbance, but it is feeble. There has been difficulty
of defecation, and the bladder is disturbed in its func-
tions, micturition is frequent, and to accomplish it the
Patient is obliged to push something out of the way.
thrown in with a syringe.
This obstructing body has been called the uterus, by a
physician who treated her a year for prolapsus. By Dr.
Shuler, under whose care she has more recently been, who
has treated her very judiciously for the attacks of hem-
orrhage, it was immediately recognized as a fibrous
tumor. Since then, however, it has been pro-
nounced by another physician to be a cancer. An ex-
amination revealed the rounded, smooth and hard end of
| this tumor, filling the vagina down to the outlet and
extending up beyond reach ; it was slightly movable,
and not tender to the touch. Externally, a round,
smooth body smaller than this, could be felt just above
the pubes, believed to be the fundus of the uterus. A
uterine probe, well bent, passed over the body of the
tumor and the point could be carried all around it ex-
cept at one point where it met with obstruction. An
examination by the rectum revealed nothing more and
the speculum was not used.
The operation for its removal was deferred for a week
to allow the supposed time of the next menstrual period
to pass. The patient was then placed in Sim's position,
and anaesthetised by Dr. Conklin with the mixture of
chloroform, alcohol and ether, while Dr. Shuler assisted
me. I had determined to first pass my whole band into
the vagina and after learning the size of the pedicle
and mobility of the tumor, decide upon the other
steps of the operation. As I could not, even in this
manner, reach the pedicle satisfactorily, I of course
selected the ecraseur. A wire rope of fifteen strands
was pushed up over the tumor and the staff of the in-
strument passed up anteriorly, the screw was tightened
and there was every prospect of Špeedy success, but no
great progress had been made before the rope gave way.
A single strand of annealed wire was now carried around
the tumor, pushed high up and tightened as before. The
pedicle was not divided before this gave way a second
time, the first break having been external and easily
remedied. I now determined to attempt delivery of the
tumor rather than lose more time in dividing the
pedicle, and fixing a strong Mueaux forceps in it found
it came down much more readily than before ; with a
second forceps opposite, and aided too, by a finger in the
rectum, as first advised by Ould for assisting the head
of the child to clear the perineum, delivery was effected.
The remainder of the pedicle was then divided by the
scissors. Sims' speculum was immediately introduced
and the vagina Sponged out; there was a pretty free
flow of blood and a solution of sub-sulphate of iron was
Pledgets of cotton, the first
few dipped in the solution, were then introduced and
the vagina effectually plugged with dry cotton, no
ordinary quantity being required to fill up the enormously
dilated canal. After a short time the patient was placed
in bed, a hypodermic injection of morphia administered
and at the end of a few hours left comfortable. Her
convalescence followed without serious disturbance.
The pathology of polypi of the uterus is well under-
stood, so well that it is surprising what a multiplicity
194
[APR. 27, 1872.
T H E CI.I. NI c.
of names they have received and how much confusion
of terms has resulted. It is not necessary upon this
occasion to go into this labyrinth of nomenclature or to
attempt an explanation of the classification of different
authors. Let it suffice to say that they are all formed
by an over-growth of some one of the normal tissues of
the uterus, and that, in my humble judgment, the
simplest, and therefore the best classification is that
which recognizes this fact and is the one adopted by
Courty, [Traité Pratique des Maladies de l’Uterus, Paris,
1866], a classification which divides these growths into,
1, vascular; 2, mucous; 3, fibrous; the latter by far
the most frequent of all. Either of these tissues may
be excessively developed and yet no polypus result; to
render this term appropriate the tumor must be con-
stricted at its base into a narrower portion or stem.
Hence Thomas' definition of polypus, “a tumor covered
by mucous membrane and attached to the uterus by a
pedicle or stem”; and the statement of Courty that
“the existence of a pedicle characterizes the polypus”
and is the distinguishing mark which prevents con-
founding them with fibrous tumors and other growths
“from which they do not fundamentally differ and of
which they are often only a consequence or a more ad-
vanced degree of development.” The steps by which a
fibrous tumor of the uterus, intra-mural at first, becomes
by degrees extruded and pediculated are detailed in the
text books and I will not occupy your time with them,
however interesting this part of the subject may be.
The symptoms of the presence of a polypus have been
well illustrated in the history of the case before you.
Hemmorrhage—either as menorrhagia or metrorrhagia,
or both ; leucorrhoea, sometimes pain, or pains such as
that to which the term uterine colic is applied; and, if
the tumor be large, the difficulties resulting from pressure
upon the pelvic organs. Loss of blood at irregular
periods and in irregular quantities is, however, the one
prominent symptom of polypus and ought always to
lead us to suspect its presence. But it should be borne
in mind, in regard to this and all other symptoms that
their severity bears no relation to the size of the morbid
growth. It is well known that very small polypi may
cause profuse and exhausting hemorrhages. Courty
says, “I have seen them only the size of a pea give rise
to very severe uterine pains and hysterical phenomena
such as I would never have believed to depend upon
their presence, had I not seen them entirely disappear
after ablation of the polypus while they had resisted
until then the best directed treatment. Scanzoni [Kran-
kheiten der Weiblichen Sexual Organe; Wien, 1857]
says he has discovered by examination polypi as large
as a goose egg or a man's fist and the patients have de-
nied, in the most explicit manner, suffering any pain.
The presence of these symptoms then should lead to a
physical examination.
case to-night does no more than to impress upon the
junior members of the profession present, the absolute
uecessity of this step, it will have done no insignificant
And if the prseentation of this.
amount of good. The lesson is not perhaps necessary to
them on account of want of experience or want of
knowledge; but because it is for them particularly
difficult to obtain an examination. What is readily
accorded to their older brethren is often denied to them
or only permitted upon the strongest representations of
its necessity. To them, therefore, is the temptation par-
ticularly strong to pass these cases over and give them
the go-by with some such loose diagnosis as “change of
life” or “falling of the womb.” If the unscientific
method of this course does not strike you I need only
allude to the different effect upon your reputation
should a tumor be afterwards found by another practi.
tioner in a case where you had followed it, or your
better position had you insisted upon an examination
and been refused. To assist in obtaining permission to
make an examination you may state to your patient
that the day is certainly past when any one pretends
to treat uterine hemorrhages without it.
An examination having been made and a tumor found
vou have next to decide upon its eharacter. Cystocele
vaginal hernia may be immediately distinguished from
fibrous polypus by their totally different consistence
and feel. Neither hypertrophy of the neck of the uterus
nor pregnancy could certainly be confounded with it.
Nor would it seem likely that there could be a mistake
about prolapsus. There was, in this case, it is true, but
it is only charitable to believe that an examination
was not made and that the error arose from that careless
mode of procedure already alluded to. Nevertheless, I
must call your attention to the fact that Scanzoni (op.
cit. p. 214), states that he was once deceived by a pecu-
liar separation of the fibres at the lower segment of a
uterine polypus which formed an opening so exactly
similar to the os uteri that not until he had found the
true os higher up and surrounding the pedicle was he
undeceived. The rarity, however, of this condition of
things may be judged of from the fact that it stands
alone, not only in his own, but in all the recorded expe-
rience of others so far, he states, as he can discover.
It does not seem as if there ought to be any difficulty
in distinguishing such a growth as this from Schirrus.
It has but two symptoms of the latter disease, the hard-
ness and the hemorrhages. The pain of polypus, where
there is pain at all, is not so severe or so constant and is
of an entirely different character, while the offensive dis-
charges of cancer are entirely lacking. In regard to the
constitutional symptoms there may be difficulty of dis-
tinguishing between them, for the patient in this case
presented such an appearance as might easily have been
held to be cachectic and certainly excited my suspicion
before examination. But the mobility of such a tumor
as this, its smoothness, the ready passage of the finger
around it in every direction, the absence of any sem-
blance of an os, ought certainly to enable one to dis-
tinguish it from a disease, the peculiar characteristic
of which, is to implicate all neighboring organs, to pay
no regard to natural boundary lines, and to run all tissues
APR. 27, 1872.]
together into a common mass. But although generally
the differential diagnosis between polypus and cancer is
easily made, and in the individual instance before us
there was no excuse for the error, exceptions occasionally
present themselves and should be borne in mind. Thus,
Sims gives a case, with a diagram, ( Uterine Surgery, p. 73,)
in which a hard knobby growth occupied the position
of the os and cervix in a woman 48 years of age presenting
“almost exactly the cachectic physiognomy of carcinoma”
It proved to be a fibrous polypus of mushroom shape,
fitting closely over the os and with so short a pedicle as
to be scarcely movable. Scanzoni, too, (p. 213) calls
attention to a condition of things which may deceive a
superficial examiner; the lower segment of a polypus
having suppurated and ulcerated, a ragged opening is
produced which may bear a very close resemblance to
an os broken down and eaten by cancerous ulceration.
The detection of the real os higher up would dissipate
all the doubt of such a case. *
It may serve to indicate to you the progress made in
this branch of medicine to state that in the first work
upon diseases of women read by me after commencing
practice, these tumors were confounded with cancer, and
that it is only within this recent period that a differential
diagnosis has been cleverly taught and made possible to
all of us.
A tumor of this kind in the vagina may be but the
projecting portion, and but a relatively small portion of
a fibrous tumor of the uterus. An interesting case of
this kind I have had recently under my care. To the
touch exactly similar, because in nature identical, and
accompanied by the same symptoms, the error would
not be so great except as regards treatment. The recog-
nition of a pedicle would be alone necessary to dis-
tinguish the two; this is a fact only difficult when the
vagina is blocked up by the size of the mass, and to
effect it the sound may be used or it may be necessary
to introduce the whole hand into the vagina.
Inversion of the uterus is the condition presenting
very great similarity to a uterine polypus both in its
symptoms and its physicial signs, and numerous instances
are on record where the error has been made with most
disastrous results to the patient, and some, too, where
the patient has escaped the perils of an operation. Upon
this point of diagnosis the history of the case is of the
greatest importance and should always be carefully con-
sidered. Inversion is generally an accident to parturition
and the symptoms should therefore date from that pro-
cess. The discovery and recognition of the body of the
uterus is an important step; if the patient be too cor-
pulent to permit this to be done through the abdominal
walls it may be effected by rectal or combined recto-vesi-
cal exploration. Again, upon passing a probe up by
the side of the vaginal tumor, it passes in inversion, only
to a certain and nearly equable depth all around. By
attention to these points the diagnosis an generally be
made; mistakes have occurred, however, over and over
again, and to men of the highest standing in this depart-
T ET H C T , T N T C.
cordance with general experience.
195
ment of practice; almost every author gives instances,
The want of sensibility of the tumor may, at first
thought, seem to be a distinguishing feature of polypus
as compared with the inverted uterus, but this symptom
is not reliable and its absence is only presumptive.
It is a fortunate circumstance for much-suffering wo-
men that these growths are very amenable to treatment.
Their removal is easily effected and accompanied by
very little danger. Probably in few diseases can we
give so great and so permanent relief with so little risk,
rescuing the patient from frequently-recurring and dan-
gerous hemorrhage, and placing her at once in a condi-
tion of"comfort and safety. Very few more striking in-
stances of improvement in our art can be adduced than
has been made in the treatment of uterine polypi. The
necessity of their removal and its practicability have
long been recognised, but in the mode of effecting it the
advance has been made. Formerly, these growths
were removed by ligation; a ligature was carried around
the pedicle, gradually tightened, and sloughing of the
tumor thus occasioned. Now, their immediate removal
either by the ecraseur or scissors is the plan followed,
and I should not occupy yomr attention with remarks
upon this part of the subject if I did not know that the
older, more dangerous and abandoned plan is still followed
by some in spite of the teachings of all recent authorities.
Of course it is the fear of hemorrhage which has caused
and causes the use of the ligature, a fear not altogether
groundless it is true, for Sims states that he has known
fatal hemorrhage to follow removal by the scissors, That,
however, was before we had the styptic preparations of
iron to rely upon ; with these at hand there need be
little fear of serious loss of blood. Yet even without
these styptics it is impossible that the mortality should
reach that which follows the use of the ligature. Dr.
Routh says, [Lettsomnian Lectures 1863] “when it was the
common practice to tie a uterine polypus and allow it
to slough off, the mortality of the operation was forty
per cent,” which is simply enormous! This is in ac-
Scanzoni says that
he has treated but three cases with the ligature and all
had dangerous symptoms while in twenty-eight other
operations convalescence was speedy and uninterrupted in
every single instance. In these cases he used the ligature
only because the pedicle was implanted towards the
fundus of the uterus, a circumstance which we now
know does not prevent the use of the ecraseur, West's
presentation of the dangers of the ligature are perhaps
too well known to you to need quotation; he refers to
Lee's twenty cases with nine deaths—“a mortality more
than double that of the operation of lithotomy, as high
as that which occurs in placenta praevia, and higher than
the mortality from malignant cholera.” So Langenbeck,
McClintock and many others have shown the gravity of
the proceeding, and, latest of all, our countryman Sims
denounces it as an operation “fraught with great danger”
and “not only hazardous but culpable!” Had he lived
in this Section, however, he would not have written that
196
[APR. 27, 1872,
TIH. H. cI, IISTrc.
the day for the use of the ligature had “gone by never
to return.”
On the other hand, all authorities testify to the slight
amount of danger attending excision. To Dupuytren,
I believe, is due the credit of first demonstrating this
fact; his experience, extending to two hundred cases |
with only two instances of severe hemorrhage gave the
profession confidence in an operation which is now
almost universally adopted, and considered as the only
accepted method of treatment.
Under certain circumstances, when the pedicſe is very
thick, when, as in the case before you, the size of the
tumor is such as to prevent access to the pedicle, the
mode of excision must be by the ecraseur.
I will close with a few words upon this instrument
as possibly my experienee may be of some service to you.
You will have remarked that the cord or wire of the
instrument broke three times during the removal of this
tumor, an occurrence I need not say, both unpleasant ||
and embarrassing. But had this been the only occasion
upon which the accident had happened it would be less
worthy of remark, but it has occurred to me in every
operation but one in which I have used the instrument
and in that one the pedicle was not very thick. The
instrument I have used is Braxton Hick's wire rope |
ecraseur, an instrument which has been very highly
praised, and held to be especially adapted to such cases |
as these from the greater facility with which a wire or
wire rope can be carried to its position as compared
with the chain of the ordinary ecraseur. I should be
disposed to ſay the blame of my iſlfortunes with it upon
the instrument maker had it not been that I obtained
mine directly from London, which precludes this view of
the case. But whatever may be the explanation I have
given you my experience; it is certainly not assuring in
regard to this instrument, nor such as would lead one to |
reject for it the chain ecraseur. At the same time it
should be stated that it is not in accordanee with high
authority. Hewitt, for instance, speaks highly of Brax- |
ton Hick's ecraseur and especially recommends it for ||
polypi having a very thick pedicle. There must be |
however something faulty in the construction of the
instrument, and I believe the cause of the giving way
of the wires is to be found in the actite angle at which
they are drawn into the staff and over its edges when
the tumor is large or the instrument has to be passed
$igh up.
* - ——º-O-º------—
ABSCESS OF THE SPLEEN.
BY
PHILO. E. Jon E3, Mſ. Tº.
Wauseon, Ohio.
Nellie ſ—, ±t. 15 months, was brought to me for
treatment February 15, 1872. T’arents state she had
intermittent fever last fall and fore part of the winter.
At present she has slight fewer every afternoon with
bilious diarrhoea. She is very anaemic. The spleen is:
slightly enlarged. She was ordered quinine, iron and
sub. nit. bismuth. - -
February 25. By request of parents Dr. Wm. Hyrd,
of this place, visited the patient with me. Diarrhoea:
has been arrested. She has but very ſittle fever after-
noons. Appetite and digestion very much improved.
Spleen so much cnlarged as to produce some bulging of
the abdominal walls; tenderness to pressure.
Treatment.-Quinine, iron, and cod liver oil with
unguent. potass iodid. applied to the surface of the
tūmor. - •
March 15. Condition of generaſ system about the
same; tumor increased to nearly the size of an inverted:
teacup ; no discoloration of skin, fluctuation perceptible.
The quinine, iron and cod liver oil were continued and
now warm pouſtices were applied to the tumor.
March 22. Tumor one-third larger than at last date;
fluctuation still more distinct, me diseoloration of
integument. M-
Supposing perſtoneal adhesions to have taken place
over the abscess, a free incision was made allowing the
discharge of over one pint of pus. General and loeak
treatment continued.
April 8. The child is making a good recovery.
—-º-º-º-
§ C U R V Y -
A Report on the Epidemic of Scorbutus in Paris.
during the Siege in the Winter of *70-71.
Compiled from Various French Anthors.
|BY
É)r. O. BERGER, (Breslau).
Arn, Abstract from Scnmidt’s Jahrbücher, Mar. 12, 1872.
wº -
During the siege of Paris in the winter of 1870–71.
numerous cases of scorbutus occurred in the different
hospitals, jails and other public institutions of the
besieged city which gave rise to a series of works of more
or less value by French authors from which the follow-
ing abstracts are made.
We commence our report with the work of H. Delpech
(Ann. d’Hyg., 2 sér. xxxv, p. 297, Apr., 1871) whose
studies were directed principally to a critical explana-
tion of the still obscure points in etiology of this dis-
€3.Se. - -
The author made his first observations in the house
of correction, Rue de la Santé whither he had been
called to investigate into the causes of the recent out-
break of scurvy as an epidemic. He found at first only
six patients with pronounced manifestations of scorbutus
and these had all been affected for but a short time.
*
APR. 27, 1872.]
TIEH E CIT, IT INTI C.
197
At a later period, up to Feb. 15, '71, the disease had
attacked 65 of the inmates whose total number was an
average of 250. All patients uniformly exhibited con-
siderāble swelling and bluish spongy appearance of the
gums, most intense stench from the mouth, hemorrhagic
tendencies and cutaneous spots of purpura. In the
majority of cases he observed broad, subcutaneous
ecchymoses, rheumatoid joint pains, extreme debility,
palpitations of the heart, habitual depression and Oedema
in various grades. The correction house mentioned is
situated in the south-western part of Paris in one of the
healthiest regions of the city, in the midst of wide
garden rich terrains. The internal construction of the
house fulfills the same demands of hygiene. Since the
first appearance of the epidemic all the prisoners have
been permitted to remain in the open air the entire day.
Of 850 German prisoners brought in from the 12-31
January, no single one became affected, while on the
other hand those who were brought in since the begin-
ning of the war and were subjected to the prison regime
furnished a very important contingent of the sick,
Some of the patients were brought into the house
already attacked with the first symptoms of the disease
and others had shortly before suffered from other dis-
eases so as to be in condition [as e. g., after mercurial
treatment] to offer but little resistance to the real
causative agency prevailing in the house.
Concering now the etiology of this affection, the
author thinks that the depressing psychical causes, empha-
sized by different authors as the most essential agent in
its production, play really only the role of a predispos-
ing cause to which other, entirely different and particu-
lar causes must be added to develop the disease. That
psyschical causes alone are not sufficient is proven by
the fact that no case of scurvy ever showed itself in the
house previous to the epidemic. Other alleged causes
are extreme bodily exertion on the one hand and lack of
eacercise on the other. Neither of these factors were con-
cerned in the existing organisation of the house. Nor
could over-crowding be brought into consideration as
during the time of the seige the number of inhabitants
was less than usual. Long continued cold is said to be
of special importance for the development of scurvy
(Rouppe, Borchardat). Lind, however, (A Treatise on
Scurvy, 1752) combats this view and remarks that
Sailors are affected just as often in the tropical as in the
arctic seas. So too, Leon, a marine physician emphasizes
the fact that according to his observations epidemics of
Scurvy are not influenced by the variations of the ther-
mometer or change of temperature. On the other hand,
reliable investigators (Wyatt, John Hall, Scrive, Gerrier)
have declared that an excessively high temperature may
develop scorbutus. In our epidemic the influence of
cold can not enter into consideration as the house was
properly warmed from October 12, on. The author
illustrates these facts by three cases from which it is
evident that the change in nutrition, especially the
absence of vegetable food, is the cause of the affection.
As to the influence of cold it is annulled in causation by
the fact that the German prisoners though they were
long exposed to the most intense frost, yet escaped
attack. Next to cold, moisture is alleged to be an im-
portant cause of scurvy as particularly remarked by
Lind, who presented a series of more or less strong argu-
ments in proof. In the production of this epidemic,
however, moisture could not have participated, as the
patients were not at all exposed to its influence.
From time immemorial, insufficient nutrition, both
quantitative and qualitative, has been cited by most
authors as the cause of scurvy. In this consideration the
prisoners of the house had much to suffer during the
siege. The good diet of the house was forcibly changed
when from September 23, on, meats, green vegetables
and potatoes were suddenly withdrawn. Since there
was no other change in the hygiene of the house than
the manner of nutrition, the cause of the epidemic is to
be attributed to this agency alone. As to the ques-
tion whether it was a simple insufficiency in the quantity
of food the author decides from facts observed outside
of the house than insufficiency only plays the role of
many other depressing agencies, i.e., predisposing, but
is able by no means, without the concurrence of other
quite special causes (withdrawal of fresh vegetables) to
develop the disease. As proof in párticular that scurvy
may develop under the most favorable conditions, if
there be lack of vegetable food, the author cites the case of
a patient affected with rheumatism and scorbutus in
marked degree who had had an abundance of fresh horse
flesh during the whole winter, having eaten no salt meat
Fresh vegetables and sour fruits soon restored him to
health.
As to the quality of the food, the author is of the
view that the alleged injurious influence of salt meats
and the abnormal increase of common salt in the blood
resulting therefrom, is by no means proven, and he sup-
ports this view by the report of a case of scurvy in a
lady who had lived in the most favorable circumstances,
who had always had fresh meats but who had been
denied all vegetable diet since the beginning of the
siege. In the prison there can be no question concern-
ing the influence of Salt meat because absolutely no
meat of this kind had been furnished the inmates.
The lack of fresh meat, which also followed in the prison,
exercised only a secondary, predisposing influence, and
experience teaches that total abstinence from all meats
cannot be the cause of scurvy. Whole populations,
certain religious sects entirely abstain from flesh diet
and yet among these people scurvy is rare or entirely
unknown. The different patients in the house received
at all times a certain quantity of fresh meat and yet
some of them were attacked with scurvy.
. It is otherwise, however with the withdrawal of fresh
vegetables. Common belief, the instinct of sailors, from
time immemorial have attributed scurvy to this cause; .
and Scientific facts prove, moreover, that in the absence
whatever, but had been entirely deprived of vegetables.
198
[APR. 27, 1872.
TIH. H. cI, IISTI c.
of every other agency, the absolute suspension of vegetable
diet is a sufficient cause of scurvy. The author believes
that the withdrawal of vegetable food is the most potent,
if not the only essential cause in the development of this
disease. An epidemic of scorbutus broke out in the
French army before Sebastopol and reached a colossal
extent in consequence of the fact that all vegetation in
the vicinity of the camp was parched by the increasing
heat. Scrive, also, (in his “Relation méd-chir. de la
campagne d'Orient,” Paris, 1857) expresses it as his
opinion, that the withdrawal of fresh vegetables is the
sole causa efficiens of scorbutus. Leon (“Contribution
à l'étiologie du scorbut,” Arch. de méd. nav. ix. 1868)
is of the same opinion. This author states that of all
the ships ordered to Mexico in 1867 to return the
troops, only the Castiglione, a vessel abundantly pro-
vided with fresh meat, whose crew was subjected to
neither cold nor wet, was attacked with scurvy because
of the deprivation of vegetable diet, while all the others
having had the opportunity of storing in vegetables,
were spared. From the moment of landing at the
Azores islands where opportunity was afforded the
Castiglione to lay in a stock of fresh vegetables all the
scurvy patients on board rapidly recovered.
Delpech bases his view of the paramount importance
of vegetable diet, so far as scurvy is concerned, on a series
of cases where it is seen that abstinence from this kind
of food is the sole and only cause in its development, and
the exhibition of fresh vegetables and sour fruits (oranges,
apples, lemons, celery, lettuce, dandelion) was attended
with the happiest results. In the hospital “Du Gros
Caillou,” from the time that the vegetables began to
diminish in the hospital economy to complete absence
Hater, the author began to observe in numerous patients,
purpura spots, disease of the gums and epistaxis—a clear
proof of the influence of the change of nutrition. It
was ascertained further, by eommunication, from Dr.
de Fornel, marine physician, that the crews of the ves-
sels which watched over the shipping interests on the
island coasts protected themselves from scurvy only by
adding to their daily food the fresh dandelion gathered
every morning, the only vegetable that grows in that
rough climate. The author then cites from Lind's clas-
sical work on scurvy, numerous proofs to the effect that
these facts have been known for more than one hundred
years.
In reference to the treatment of scurvy Delpech ex-
hibits in a series of observations, partly his own, partly
other physicians,’ during the siege, that the treatment
by fresh vegetables and Sour fruits is the treatment
proper for the disease. When the disease manifested at
the house of correction, the dietetic regimen was changed
so as to allow five kilogrammes of red beets in the soup
of every one hundred persons. Notwithstanding this
change the disease extended itself further and of sixty-
five patients, eleven died, more than one-sixth. Of the
sixty-five cases two occurred in Oct., nine in Nov.,
thirty-five in Dec., fourteen in Jan., and five in the first
half of Feb. The largest number of deaths thas oceurred
in December. These figures correspond to the times
when fresh vegetables were allowed or denied respec-
tively. The duration of the disease lasted from fifteen
to seventy-one days. The conclusion to be drawn from
this work is that every where contained in its text
that the true cause of 8curvy is the withdrawal of vegetable
food. .
[To be Continued.]
—º-º-º-
D Is E As E of T H E G R A Y MIAT r E R or
* T H E co R D .
Trainsactions of the Vienna Medical Society.
Session March 6, 1872.
From the Wiener Med. Presse, March 31, 1872.
Docent Dr. Rosenthal delivered a lecture on the
“Forms of Disease of the Gray Substance of the Spinai
Cord.”
The gray substance of the cord has hitherto not re-
ceived that pathological consideration which its physio-
logical dignity merits. It was reserved for the very
latest investigations to assist in supplying the deficiencies
in our knowledge of this subject and to cast a few
illuminating rays over the dark field of spinakpathology.
It cannot fail to be interesting then to communicate
the most essential of these discoveries of modern med-
icine worked out both at home and abroad.
As a point of departure is selected the nucleus at the
first station of the spinal tract, the gray substance of the
glosso-pharyngeal nerve. The Hesion of the cerebral
nerves imbedded here figures under the name, paralysis
glosso-pharyngo-labialis, more properly it should be de-
noted as a paralysis of many nerve nuclei. Dumésnil,
Huber, Wedl, Gerhardt, Leyden all referred this affec-
tion to atropy of the cerebral nerves or of the medulla.
oblongata, atheroma of the basilar arteries and fat cell
formations in the spinal cord. Charcot and Joffroy were
the first to give an anatomical explanation for the
significance of the symptoms as inductively ascertained.
They demonstrated progressive atrophy of the cells of the
nerve ganglia. This atrophy in the rule—as sections of
the atrophied cells of the hypoglossal ganglion showed
—reached its maximum in the region of the calamus
scriptorius while the vicinity of the pneumogastric
ganglion showed the least changes. -
By this progressive atropy of the ganglia of the corres-
ponding nerves, the closely contiguous centres of articu-
lation, phonation, deglutition and respiration become
disorganizsd ; lesion of the vagus ganglion arrests the
action of the heart.
Lesion of the gray substance of the anterior half of the
cord exhibits the well known forms of infantile spinal
APR. 27, 1872.]
TIH. E. cI, IISTI c.
199
paralysis, progressive muscular atrophy and the fatty
muscular atrophy, vulgo muscular hypertrophy.
In the spinal paralysis of children, Prevost and Vulpian,
Charcot, Joffroy and Parot and most recently Reckling-
hausen have demonstrated absence and malformation of
the anterior horns, with portial loss af nerve cells and
atrophy of the anterior roots and the anterior lateral
columns. . The speaker, also, had the opportunity of
confirming this condition which is in opposition to the
view of the French authors, the primary acute atrophy
of the cells of the anterior horns.
The marked vascularisation of the altered anterior
horns, the dilatation and thickening of the vessels, the
occurrence of nuclei about the vessels and in the lymph
spaces speak rather for an active participation of the
vessels in the pathological process whereby the nutrition
of the nerve cells is altered and thus is the impulse
imparted for secondary exuberations and malforma-
tions. - w
In progressive muscular atrophy was found by
Cruveillier, Valentiner, Leubuscher, and more recently
by Bamberger, Grimm, the speaker and others, atrophy
of the anterior roots and of the anterior lateral columns. |
Degeneration of the gray substance was claimed in
these cases by Luys, Gull and L. Clarke but it was re-
served for Charcot and Joffroy to demonstrate in two
cases chronic atrophy of the nerve cells of the anterior
horns, with atrophy of the anterior lateral colums as
the true pathogenetic condition of the disease.
Only in most recent tim,es have Barth, Müller and
Martini exhibited microscopically that cases of fatty
muscular atrophy, vulgo muscular hypertrophy likewise
depended upon atrophy of the nerve cells of the anterior
horns. -
As may be seen from the three forms of disease of the
gray substance of the cord given, they depend upon a
degeneration of the highly important motor and trophic
centres of the muscles of the trunk and extremities in
the anterior eolumns; the further connecting tracts
run into the anterior lateral columns and in the
anterior roots. ‘s *
Degeneration of the posterior columns may sometimes
be combined with a partial disease of the cells of the an-
terior horns. Charcot demonstrated an hitherto unpub-
lished case of tabes with muscular atrophy of simul-
taneous origin in a lecture with most istructive micro-
scopic preparations. In this case besides the wedge
shaped degeneration of the posterior columns, the rare-
faction or partial disappearance of the cells of one anter-
ior horn (in comparison with the other) was quite
remarkable. , -
In diffuse parenchymatous myelitis from pressure (in
consequence of vertebral caries), the speaker in connec-
tion with Meynert (1869) was able, during life, to refer
the analgesia with unaffected sense of touch [Kontakt-
gefühle]—as subsequently microscopically demonstrated—
to amyloid degeneration of a part of the gray nerve cells of the
$pinal cord. Joffe has also remarked a similar condition
in a case of analgesia in an insane patient. These are
conditions which confirm and support the experimental
results of Schiff (analgesia from simple division of the
gray substance of the cord).
In the Sclerosis of nerve centres which occurs at different
parts [herdweise], Schule has observed that the degen-
ation extends by preference to the anterior horns, and
Joffroy has seen a destruction of the ganglions of the
hypoglossal and facial nerves (with symptoms of a glosso-
pharyngo-labial paralysis).
In contagious diseases also is the gray substance of
the cord co-affected. Thus Oertel in his handsome
work on diphtheria has described an immense granule
infiltration of the gray substance of the cord, partieularly
in the anterior horns which were strewn with micro-
scopic hemorrhages. It remains yet for further investi-
gations to examine more closely into the spinal centres
concerned in all the various motor and trophic dis.
turbances occuring in life. A thorough appreciation of
these facts will tend to illuminate more fully many
phenomena hitherto obscure.
—-º-o-º-
A C A D E M Y O F M E D H C IN E .
***
JAS. GRAHAM, MI. D., PREST., L. WoLF, M. D., secry.
\ Transactions April 24, IS72.
Reported by Tom. O. Edwards, Jr.
DR. BARTHOLOW read a report of a case of epileptiform
Tic Doloureux of six years duration cured by the hypo-
dermic injection of morphia and the iodide of potassium.
[A full report of this interesting case will appear in a
future CLINIC].
Cerebro-Spinal Meningitis.
DR. N. P. DANDRIDGE presented the specimens of the
spinal cord and brain of two cases of cerebro-spinal
meningitis. One case was admitted to the Hospital in
a delirious condition, and soon became comatose; no
history could be obtained. The other was a negro boy
who said he was 16 years of age, but was thought to be
about 18 years old; lais history could not be fully taken
but he stated that he had a chill every other day for the
last two years, which statement is considered doubtful.
On admission, April 2d, his temperature was 101° and
remained so for 2 or 3 days, it then fell to 100° and re-
mained so until the 12th inst. Upon the supposition
that his disease was intermittant fever, he was given
quinia. After he was in the Hospital 8 or 10 days his head
became very painful and the muscles of his neck became
rigid, also much pain was experienced along the spine.
On the 12th his temperature rose to 103°. Cerebro-
spinal meningitis was now suspected. Dr. Ayers ex-
200
[APR. 27, 1872.
T ET. H. C. T., T N T c.
amined his eyes and found incoordination in their
movements, and from their appearances suspected brain
disease. On the 13th his temperature fell to 98°, on the
18th he was paralysed on both sides, the face was
paralysed on one side, the tongue was deflected to the
paralysed side; his urine was passed in bed; he was un-
conscious, and remained so until his death on the 20th.
The treatment after the first few days was quinia, after
4 or 5 days he was cupped on the back of the neck and
blistered. Calomel and ipecac were given in small
doses, latterly iodide of potassium. The man was Sane,
conversed well until he was paralysed. Dr. Dandridge
said the case was remarkable, 1st, in the insidiousness
of the attack; 2nd, in the complete paralysis, which was
not usual. He said he was called to see a child about
ten days ago, and found its head drawn back, pulse 100,
temperature normal, eyes half closed; the child had felt
unwell in the evening and vomited, it complained of
much pain in the back, and could not lie in the dorsal
position, it died in a few days. It was apparently con-
scious but could not speak, and had much difficulty in
swallowing, it could not protrude its tongue, but made
an effort to do so, its bowels were obstinately constipated.
Quinia was given, and calomel to move its bowels with-
out effect, bromide of potassium was freely given.
DR. D.Awson reported a case that he had seen with
Dr. Brent; it was a bright child of 6 years. Opis-
thotonos was well marked, skin hot, pulse 100 and feeble,
it was placed upon quinia and sometimes potass, bromid.
or chloral was given to procure sleep and relieve pain.
Dr. Brent remained in charge. He was again called in
about two weeks ago, found the child worse, the opis-
thotonos had continued during his absence, pulse fre-
quent; the child had, however, been bright and playful,
it was now stupid and had paroxysms of screaming very
violent. In a day or two it became paralysed on the
right side and died. He saw another case to-day with
Dr. Rosenfelt. In this case the pulse was small and
feeble, and the child was restless and nervous, screaming
out every little while, opisthotonos well marked. It
was put upon quinia.
DR. CARSON reported four cases of this disease. One
of a lady who had been subject to asthma for years.
She was 30 years old and had been free from asthma for
some time. Previous to this attack which occcurred
about five weeks ago, she was delirious, had hallucina-
tions of vision, much pain in the head, tenderness along
the spine, more in the upper part, she was very wakeful
and sensitive to exposure to light; he had regarded
these nervous symptoms as an alternative expression of
the neurotic element in her asthma, but since the pre-
valence of cerebro-spinal meningitis, thinks that there
was probably more organic than functional trouble.
She was put upon potass. bromid. and iodid. with exter-
nal applications to the neck and spine and chloral at
night. She recovered in two weeks.
Another case was in a child of 7 years old, which he
had scen in consultation, with convulsions, opisthtonos
well marked, paralysis of right side, intense hyperesthesia
of the surface. It has since improved. He saw another
case yesterday of a young man 18 years of age, who had
been in bed two weeks; he had complained of pain in
his head for ten days previously, had been at times de-
lirious with obstinate head-ache, constipation and vomit-
ing; last night his pulse was 84, temperature 101, surface
cool, rigidity, subsultus-tendinum, more hyperesthesia,
he was delirious, there was no paralysis, pupils normal,
he was very restless; quinia had been given. He is now
taking iod. and brom, potass, in large doses with blister
to neck. The Doctor with whom he had seen this case
had three well marked cases under treatment, one had
become deaf, the other cases were still doubtful.
DR. GRAHAM said he had seen two cases with Dr.
Fishburn last week. One a child of 5 years and the
other of 8. They were attacked suddenly while coming
from school, became pale and exhausted, and com-
plained of pain in the head. The head of one was
drawn back, he was called to see them again a few days
ago; the head of the other child had just begun to draw
back. At no time in either case was there elevation of
temperature, there was intense hyperesthésia of the
surface, they were very restless, and soon become stupid;
when aroused, complained of much pain; they were put
upon opium and quinine. In 4 or 5 days both seemed to
recover and regained their appetite; he did not see them
for some time but they continued to improve; yesterday,
however, one of them became paralysed in the right
side and died last evening. The other is now worse,
and presents an unfavorable aspect.
In these cases potass, brom. and chlor. were given
but disagreed, Laudanum was substituted and modi-
fied some of the symptoms.
—º-o-º--
SCIENTIFIC NOTES
The Artificial Production of Epilepsy in
Guinnea-pigs.
BY
PROF. C. WESTPHAL.
First is given a review of Brown-Séquard's experi-
ments, that, by dividing one-half the cord in Guinea-
pigs, after some weeks, irritation of the cheek causes
epileptiform convulsions. The epileptogenous zone is
the side of the face below the eye, the skin on the lower
border of the lower jaw, on the anterior border of the
shoulder-blade, and also a part of the skin of the neck.
In this zone there is a diminution of sensibility. Divis-
ion of the sciatic nerve causes the same phenomena;
When both sides of the cord or both sciatics are divided,
the epileptogenous zones are found on both sides. The
author has found the above to be true. He has also
found that when he gives a Guinea-pig a blow, or several
blows, on the head with a small hammer, holding the
APR. 27, 1872.]
TIEEI IET: C T , T N T C .
201
head firmly on a support, or when the animal's head is
beaten against a hard substance, there follows an attack
of convulsions of exactly the same character. The
attack occurs immediately, or from a few seconds to a
minute after; then the animal jumps up as lively as
ever, or it may lie on its side without making any
voluntary movement after coming to. Then it walks
with its body curved. in a bow shape; there may also
be weakness of the anterior legs, lasting a few minutes.
If the blows are too strong, death follows from cessation
of respiration, the heart continuing to beat some four or
five minutes longer. Artificial respiration may restore
life. There is then exalted reflex irritability, and the
animal, while lying on its side, makes the motion of
running. Some times, after a few seconds, the respira-
tion returns spontaneously, and sometimes it is only
lengthened, and after a while recovers its ordinary
condition. -
After a few weeks, the animal having meanwhile
entirely recovered its activity, upon pinching the epilep-
togenous zone of either side, especially the lower surface
of the angle of the lower jaw, there occurs an attack
perfectly analogous to those produced in animals oper
ated upon according to Brown-Séquard’s method.
Before the complete establishment of this condition, a
pinch on the above-mentioned zone will cause a partial
attack, as will also a series of scratching motions applied
to the cheek and neck.
If the irritation is applied repeatedly, the attacks be-
come less and less severe, and, finally, are scarcely to be
noticed. - - -
The epileptic condition may set in when the blows are
so light as not to cause convulsions immediately. Four
or five weeks are necessary for the development of the
full epileptiform attacks, though the difference in differ-
ent animals is very great. The conditions giving rise
to epileptic attack continues from six or eight week to
six month or more, then gradually subsides and is lost
By one female Guinea-pig the epileptic tendency was.
transmitted to her young, which could be thrown into
an imperfect attack by irritating the epileptogenous
2OI!62, -
As to the cause of this condition, it could not be by
reflex action of the injured skin or periosteum, for when
he removed both and struck the exposed bone, the at-
tacks followed in the same manner as in uninjured
animals. Autopsies, made immedfately after experi-
ments which had succeeded in exciting convulsions,
showed a moderate amount of effusion under the skin
without injury to the skull; the cerebrum and cerebel-
Hum, the crura cerebri, pons, hippocampus major, and
ventricles, were without any constant lesion. There
were, however, constantly found in the medulla oblon-
gata, or the upper cervical portion of the cord, very fine,
Small haemorrhages, from the size of a fine point to the
size of a pin's-head irregularly scattered through the grey
and white substance. Sometimes these lesions were
found lower in the cord, even as far as the dorsal region.
Usually there was also blood in the sac of the dura-mater
spinalis, and more rarely at the base of the brain.—Allg.
Med. Cent. Zeit.—Journ. Psycholog. Med., Apr., '72.
INFLUENCE OF RHEUMATISM ON THE CHARACTER.
Dr. Faure. (Archives Générales, September, 1871).
Rheumatism is manifested under such variable forms
that we may inquire, on meeting any thing unusual in
a patient subject to its attacks, whether rheumatism
may not be concerned therein. Why may it not attack
the organs of the cerebral functions on which character
depends, as well as the heart, etc.? &
Cerebral rheumatism has been long recognized, with
its attendant febrile and inflammatory phenomena. It
is not of that I wish to speak, but rather of cases where
it acts on the whole assemblage of mental faculties. It
is a change in the individual, which for a time separates
him from his normal habit of thought and feeling; they
seem as usual, but are themselves aware of a change.
A man who is subject to rheumatism will very often
tell you, if you ask him—for he has no reason to refer
what passes in his mind to the sensations in his arms or
legs, elsewhere in his muscular system—that he has
moments of despondency without cause, of inquietude,
of forlornness, inexplicable to himself. Then he is dis-
couraged without cause, and sees every thing in the
shade; that which ought scarcely to be the object of a
slight care, becomes the cause of a cruel torment, he is
without force, his thoughts can be fixed on nothing, all
intellectual work is impossible; if he wishes to solve a
problem, he soon experiences fatigue and heaviness of
his head, which often turn into a violent headache; then
his sensations are altered, his affections cease, he is in-
different to every thing; that which has the most right
or power over his mind, remembrances which are most
dear or most painful, have no interest for him. His
character has changed. He is conscious of his condition,
and can for a few minutes rouse himself out of it. A
crisis may follow, his head is congested, he feels quite
giddy. Finally, all these symptoms disappear, and his
mind recovers its tone and clearness. The attacks vary
much with individual disposition.
Sometimes the rheumatic attacks are very slight,
or are altogether wanting, or the above-mentioned
attacks may occur during the interval between the
rheumatic attacks.
These attacks follow the same causes as true rheumatic
attacks, are variable like the latter, and remittent or
intermittent.
The particulars of the cases of three physicians and
several other persons thus affected are given.—Journ,
Psycholog. Med., Apr., '72.
SPASM OF THE LEVATOR ANI DURING COITION.—The
last number of the Archiv. f. Gynaekologie, contains an
article by Prof. Hildebrandt on spasm of the levator ani
during copulation. It is a form of spasm of sudden oc-
" . . º © as º & to *
currence which retains the intromitted organ with pain-
202
[APR. 27, 1872,
Tº H. H., C T , T N T C .
ful force for a few minutes until relaxation as suddenly
takes place.
The author details three cases in somewhat graphic
description, referring at the close to the little mention
made of the affection in the various works of gynaecology.
This spasm depends upon no special abnormity of the
generative organs simply upon an extreme excitability,
being present generally in individuals of erotic tempera-
ment. Scanzoni is of the opinion that the constrictor
cunni is the muscle affected. The author considers this
muscle too feeble to exert such power, acknowledging
at the same time that the spasm of the constrictor may
prove an obstacle to intromission as occursin vaginismus.
The obstacle in these cases, however, is not alone due to
the constrictor, but also to the distended glands of
Bartholine, which, as Luschka has shown, are pressed
against each other during erethism. In explanation of
the penis captivus condition, another group of muscles
must be sought for, a group which is stronger and deeper
in the pelvic cavity than the constrictor. The only
muscle which could act in this way, as the author
exhibits from anatomical considerations, is the levator
ani and what lends support to this view is the resem-
blance which cases of tetanus of this muscle bear to this
condition. In all these cases the speculum is retained
after introduction by forcible contraction.
Vaginismus with contraction at the orifice is then
due to spasm of the constrictor muscle but vaginismus
of deeper seat is due to spasm of the levator ani.
The treatment of internal does not differ from that of
external vaginismus. Painful surfaces, abrasions, ulcers,
enlarged and inflamed carnuculae are to be subjected to
local treatment. The general condition is to be improved
and the influence of pscychical impressions is not to be
forgotten.
THE FORCE OF UTERINE CONTRACTION.—The ex-
treme force of uterine contraction produces a pressure
of 3,402 pounds per square inch, which is equivalent to
a pressure of 54,106 pounds acting upon a circle of nine
and a half inches in diameter, which is assumed as the
average area of the pelvic canal. The maximum force
used to expel the foetus, by both uterine and abdominal
muscles combined, is estimated by Soulin, by forceps
experiments made on a dead body, at 110.23 pounds, a
result as regarded by Dr. Duncan as too large. Dr.
Duncan considers 80 pounds as the maximum force
ever employed in difficult cases. This would correspond
with a hydrostatical pressure inside the uterus of 5,05
pounds per square inch, which is greater than the uterine
muscles, unaided are capable of producing.—Dublin
Quarterly Journal Medical Sciences.
- —sº- e -º---—
M[E])}{CALL NEWS
HIGH SCIENCE.-Along side of the double decompo-
sition formulas in chemistry, the mathematics which
have struggled in among the flaps in surgery and the
trigonometrical synclitism of the foetal head in obstet-
rics is to be ranged now a contribution from ophthal-
mology, the optics of art. º
Mr. Liebreich's lecture at the Royal Institution on
Triday (March 8th) was a great success. It attracted a
very brilliant audience, numbering the most eminent
artists and physicists of the metropolis, and a crowded
assemblage of the cultivated classes, who find in the
Friday evening meetings of the Royal Institution one
of the most agreeable of intellectual relaxations and the
most instructive of mental dissipations. He shöwed
very conclusively as to Turner, that subsequently to
1830 the great artist suffered from a diffused cloudiness
of the lens, afterwards passing into defined opacity,
which at first altered for him the face of nature, and
subsequently that of his pictures, which were finally de-
faced by vertical streakiness, due to irregular vertical
diffusion of light. Another kind of defect, which he
illustrated by examples, was astigmatism, which became
more serious as the accommodation of the eye suffered
from advancing years, producing then a vertical en-
largement of the objects painted from a distance, and
a horizontal enlargement of the lines of the picture, which
ended in palpable distortion. In the case of Mulready, he
showed yet another kind of optical defect occuring with
age, an increasing yellowness of the lens, leading to ex-
cess of purple tints in his pictures. He pointed out that
such defects as those of Turner's sight might be partially
corrected by stenopoeic glasses; the astigmatic errors by
cylindrical lenses; and, to some extent, the discoloration
of the lens last described by appropriate blue glasses.
As may be readily understood these sermons on
the physical Sciences, threatening, as they do, the dem-
olition of the altars to the unknown gods awaken a most
intense feeling among the votaries of art. -
A NEW EDUCATIONAL FEATURE FOR WASHINGTON.
—Dr. Joseph M. Toner of Washington city has organ-
ized a series of lectures “The Toner Lectures” to be
delivered in Washington city on the plan of the popular
scientific lectures of Great Britain. The Surg, Gems. U.
S. A. and U. S. N. and the Prest. of the Med. Soc. of
Columbia are made trustees of the funds donated for
the necessary expenditure by the following indenture
legally signed and sealed. *
Whereas the said party of the first part, believing that the
advancement of science—that is, a knowledge of the laws
of nature in any part of her domain, and particularly
such discoveries as contribute to the advancement of
medicine—tend to ameliorate the condition of mankind,
hath determined to convey and transfer to the said
parties of the second part, and their successors forever,
in their several official positions as aforesaid, the herein-
after described real and personal property, amounting
in value to about $3,000, 90 per cent. of the interest of
which is to be applied for at least two annual memoirs
or essays by different individuals, and as the fund in-
creases, as many more as the interest of the trust and
revenue will in the judgment of the trustees justify,
relative to some branch of medical science, to be read at
the city of Washington at such time and place as the
said parties of the second part and their successors as
trustees may designate, under the name of “The Toner
Lectures;” each of these memoirs or lectures to contain
some new truth fully established by experiment or ob-
APR. 27, 1872.]
TIEEE THE CIT, IT INT I. C.
203
servation, and no such memoir or lecture to be given to |
the world under the name of “The Toner Lectures”
without having first been critically examined and ap-
proved by competent persons selected by said trustees
for that purpose. -
SALARIES OF GERMAN PROFESSORS.—The Mercure
de Sonable announces that Gusserow, professor of obstet-
rics at Zurich accepts the same chair at Strasbourg with
a salary of 15,000 francs. The salaries of the German
professors consist of two elements, the one furnished by
the university or the state constituting the fixed salary,
the other arises from the proportionate division of the
fees of the students in attendance. This last sum in
certain cases is very large forming a revenue, at times,
of more than 25,000 francs per year. It is a recompense
for their talent, labor and zeal in instruction.—Paris
Med. Gaz. -
AMOUR DE LA PATRIE.-The society of physicians of
the hospitals of Paris decided in the session of Feb. 23, to
take from the treasury the sum of ten thousand francs
for the liberation of the land. This was to be indepen-
dent of individual contributions.
THE STRASBOURG SCHOOL-M. Schimper, the
celebrated botanist and palaeontologist, is the only one
of the old professors in the French University of Stras-
burg who has consented to hold his post under the
German rule. M. Schimper is a Frenchman by birth
and descent, and had been offered a superior position
elsewhere by the French Government.
THE FIRST MEDICAL Journ ALIST.-The Medical
and Surgical Reporter of March 23, in an editorial with
this heading, assigns the honor of being the first medical
journalist to Dr. Nicolas de Blegny, who edited the
200iacus Medico-Gallicus from 1680, when it was started,
until 1684. Born in a humble station in life, Dr. de
Blegny does not seem to have had the advantages of a |
learned education: he, however, was possessed of un-
usual energy, and at the early age of twenty-five was
appointed Surgeon to the Queen. Five years after-
wards he became Surgeon-in-Ordinary to the Duke of
Orleans, and, four years later, 1687,-Physician to the
King, Louis XIV. During these years he was busily
engaged in writing and lecturing on various medical
topics. None of his works, it is said, indicate much
ability; and they are known only through the criticisms
of his enemies. The comments of the journal upon Some
medical books embittered their authors, who succeeded
in procuring its prohibition in 1684. It was then
transferred to a Dr. Niort, a French physician prac-
tising in Amsterdam, who determined to render it less
medical and more literary. With this object he named
it Mercure Galant. -
The enemies of De Blegny were not satisfied with
causing the suppression of his journal, but continued
their persecutions until they procured his imprisonment
in the castle of Antwerp, where he remained seven
years. He spent the rest of his days at Avignon, dying
in 1722, at the age of seventy.—Phil. Times, Apr. 15, '72.
of restoration of the function of the motor nerves,
DEATH OF PROFESSOR: JACKSON.—Samuel Jackson,
M. D., Emeritus Professor of the Institutes of Medicine
in the University of Pennsylvania, died at his residence
in Philadelphia, aged 85 years.
DEATH OF PROFESSOR DICKSON.—William Henry
Dickson, M. D., Professor of the Theory and Practice of
Medicine in the Jefferson Medical College of Philadel-
phia, died at his residence in Philadelphia on Sunday,
March 31.
–-º-º-º-
CORRESPONIDENCE.
OHIHO STATE MEDICAL SOCIETY.
To the Committees on Special Reports,
It is the earnest wish of the officers of the Ohio State
Medical Society that you make a report on the subject
assigned you at the next meeting of the Society. And
that you have your paper completed—ready to leave
with the Secretary immediatsly after having been read
to the Society.
The Publication Committee has heretofore experienced
great difficulty and been delayed not a little in its work
of getting out the Transactions, by members with-hold-
ing papers from the Committe, to rewrite them, after
their having been read to the society. The object of
this note is to obviate that difficulty in the future.
J. HADLOCK, M. D.
Asst. Secretary,
O. S. M. S.
—-º-o-º---
CL FINICAL MEMRO RAN IDA.
AN IMPORTANT SYMPTOM IN TRAUMATIC PARAL-
YSEs. By Dr. Fr. Bärwinkel (Leipsic).-The author
believes, and his belief is based upon several observa-
tions, that he has found a certain sign of differentation
between total solution of continuity of mixed nerve
trunks and their simple injury ſquetschung, compression]
in high degree, in the different reaction to pressure below
the point of injury. If sensation at the periphery re-
main, it is a sign that the connection of the sensi-
tive nerves with the centre still persists, the motor fibres,
therefore, running in the same nerve trunk are not sep-
arated. Should this reaction to pressure be absent, a
solution of continuity is still not a necessary conclusion,
as experience has shown, and especially is this true if
reflex symptoms still remain in the nerves concerned.
In the first case the prognosis of restitution of sensi-
tive conduction is favorable. There is a probability also
On
the other hand the prognosis is unfavorable in cases in
which peripheric reaction is absent while reflex mani-
festations still remain.
Of course what has been said avails only during the
204
[APR. 27, 1872.
TIEH THE CIT I I IN T C .
first months after the injury when reproduction of the
injured fibres can not have occurred.—Arch. d. Heilk.
acii. 4–5. p. 336.-Schmidt’s Jahrb., Mar. 12, 272.
TREATMENT OF TETANUs AMONG THE CHINESE.-
This mode of treatment of tetanus has been seen by
English physicians in China and India to be successful:
the patient smokes in a pipe a mixture of from twenty
to twenty-five centigrammes of crude opium and tea or
rose-leaves, which are worked up with a small quantity
of molasses. When smoking, he must inspire as deeply
as possible, and continue this operation until the nar-
cotic influenee is noticed. This continues then, as a
rule, three or four hours. The smoking is repeated as
soon as the tetanic symptoms reappear. In the mean
time, as much nourishment as possible is given. In
using opium thus, it must be remembered that its nar-
cotic effect is somewhat neutralized by tobacco.—
Psychol. Journ., Apr., '72.
PHYSIOLOGICAL AND THERAPEUTICAL EFFECTS OF
THE ANTI-DESTRUCTIVE AGENTS, Alcohol, Coffee, Tea,
Cacao, Maté, etc., Bourdeaux prize essay by Dr. Angel
Marvaud.—The conclusions are first, that alcohol is a
stimulant to the nervous system ; second, that it is an
aliment which retards the retrograde metamorphosis
[anti-déperditeur).
Coffee and tea have the same properties and further
furnish a certain quantity of nitrogen to the organism.
This is ordinarily, however, not their most important
role. -
Marvaud experimented on himself as to the effects of
coffee, tea, maté and cacao on the nervous system. These
substances were ingested in cold infusions. Coffee pro-
duces a desire for active life stimulating the exercise of
the intellectual faculties, while tea induces a taste for a
contemplative and quiet life. Maté, which contains
the same alcoloid as the preceding, cafeine or theine,
has an action analogous to tea but more pronounced,
something like the intoxication of the lively wines.
Cacao finally with its alcaloid cocaine is a convulsive
substance imparting a desire to walk or run, inducing
even tremulousness in the extremities. It is an agent
causative of muscular activity.
The action of these substances on the circulation was
studied in several young and healthy individuals, and is
illustrated in the essay by a number of sphygmographic
oscillations. Coffee and cacao on one hand and tea and
maté on the other act entirely differently on the circu- |
lation and the pulse. The first of these drinks diminish
the amplitude of the oscillations, the others augment
them to the degree of alcohol. From the characters of
the traces, Marvaud makes the following deductions:
“Coffee and cacao increase the arterial tension; tea and
maté diminish them.” The author believes with reason
that these conclusions are of great importance, though
they are not by any means entirely new. Coffeine has
already entered into the therapy of cardiac maladies
(8ée Jacond, Traité de Pathologie Interne: Dosond and
Huchard, Des Complications Cardiaques dans la Variole,
etc.). Like digitalis, caffeine, also, in therapeutic doses
immediately increases the arterial and diminishes the
venous tension whence follow abatement of respiratory
frequency, of the hemopoietic functions, reduction of
temperature, diminution of the cutaneous and increase
of the urinary Secretions, etc. ~ *-
The conclusions are thus, that these substances are
aliments favorable to vigil and to intellectual and mus-
cular activity.—Gaz Med. de Paris, Mar. 9, '72.
BROMIDE OF POTASSIUM IN EPILEPsy.—M. Legrand
du Saulle gives a resume of the use of bromide of potas-
sium in 207 cases of epilepsy, including the advantages
and inconveniences of this method with its conditions of
success, concluding as follows: En résumé, the
bromide of potassium may completely and absolutely
suspend all the phenomena of epilepsy: but it is indis-
pensable that this medication be rigorously prescribed,
followed and watched for several years.-Gaz. des Hop.,
Feb. 22, '72.
BENZINE IN WHOOPING CouGH.—The author, Dr.
Rottari, ends his paper with the following conclusions.
1. Asoiration of the gases developed in the depuration
of coal gas has a certain influence in the cure of whoop-
ing-cough without complications.
2. Very probably this beneficial influence is due to
the benzine produced in the distillation of coal.
3. This remedy may be employed with the greatest
ease, in the house of the patient and without any danger,
if its quantity be varied according to the intensity of
the disease. - -
4. Benzine internally administered is at present the
best remedy for whooping cough. It may be given in
doses of 10-20 drops with mucilage or syrup either alone
or accompanied also by aspiration of the same substance
prepared in the patients room.—Lo Sperimentale—Gaz.
Méd. de Paris, Mar. 2, '72.
RE-IMPLANTATION OF TEETH.-At a recent meeting
of the Odontological Society, Mr. Steele called the
Society’s attention to this subject, and stated that he
recently had a tooth of his own extracted with great
care. The tooth was in an exquisitely sensitive condi-
tion from the exposure of the pulp, and gave pain on
the least change of temperature. It was taken out un-
der the influence of nitrous oxide gas, the dental canal
was cleansed; and caries removed from the crown. It
was stopped in the usual way, and the tooth at once
replaced in the socket. The operation lasted about half
an hour.—Brit. Med. Journ., Mar. 9, '72.
IH [OM IE NEWS.
THE number of cases of cerebro-spinal meningitis re-
ported at the last meeting of the Academy indicate an
extent sufficient for consideration as a prevailing disease.
The next CLINIC therefore will be a CEREBRO-
SPINAL MENINGITIS NUMBER. It is earnestly hoped
that all gentlemen who have had any experience in
the treatment of this affection will report it in the
Academy on Monday evening; a full abstract of the
proceedings, so far as relates to this subject, will
take the place of original matter.
List ºf Pharmaceutical Preparations,
MANUFACTURED BY
Jø/ZW WyżZVZ & Bºozºº,
FRILADELPHIA.
—-º-
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ELIXIR OF THE PYROPHOSPHATE OF IRON,
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FERRATED ELIXIR OF CINCHONA,
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w ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
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ELIXIR OF PEPSIN AND BISMUTH, -
TASTELESS COD LIVER OIL,
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wº
77










WILSON BRO's.
S HIRT S
Made to order of N. Y. M. Muslin and 2300
HIEAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.0)
First three qualities have ALL LIN EN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
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Perfect satisfaction given or money cheerfully
refunded.
Also import and Manufacture Men’s Furnish-
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Pike's Opera-House, Fourth Street, Cincinnati; 931
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CAMARGO
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coPI Ivº R. CIL
o I O R LEs s AN ID PA. LATA H LE.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market. - -
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency.
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c. -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains ; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated. -
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.
*

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GooD sa MARITAN HOSPITAL.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of Sixth and Lock streets.
pointments of a First-class Hospital. Porticoes,
halls and abundant windows secure that full
It is handsomely furnished throughout, and is provided with all the necessary ap-
with commanding views, surround the whole house, and wide
and free ventilation which is so essential to health and comfort.
Service is furnished by the
Under the Superintendence of the well-
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Med
Professor presiding over his own especial department.
SISTERS OF CHARITY,
known SISTER ANTHONY, with that care and attention which only they who
ical College of Ohio, each
Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in c
ases, more particularly, requiring Surgical Operation, where
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Rooms vary in price,
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service.
according to the character of appointments necessary and service required, ranging, in
between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand ot
w
gºy" Address,
3.
SISTEF, ANTHONY,
FHospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio.




































































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CINCINNATI.
~~~~
H' A C U L T Y -
J A M E S G R A H A M , M. D., D E A N ,
Professor of the Theory and I’ractice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M. D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomy. Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M.D., T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
JAMES T. WHITTAKER, M.D., JOHN L. CLEVELAND, M.D.,
Professor of Physiology. e Demonstrator of Anatomy.
SAMUEL NICKLES, M.D., º CHARLES KEARNS, M. D., .
Professor of Physics and Medical Chemistry Assistant to the Chair of Surgery
WV. W. SEELY, M. D.,
Professor of Diseases of the Eye and HDar, and Secretary of the Faculty
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T. Louis Brown, M. D., Prosecutor of Anatomy. E. NoPI.E, Janitor, College Building, Sixth St., bet. Vine and Race,
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Vol. 2. M A Y 4, 1872, No. 18.
JAS. T. WFHITTAKER, M. D.
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-A-SSOCIALTE, IEEDITOER.S.
W. W. DAwson, M. D. THAD. A. REAMY, M. D.
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W. W. SEELY, M. D. SAMUEL. NICKLEs, M. D.
CHAs. KEARNs, M. D. JNo. L. CLEvKLAND, M. D.
RobHRTs BARTHorow, M. D.
Editor.
C IN C IN N A TI,
colá. Fºr te Co-
Fashionable Hatters,
IMPORTERS AND MANUFACTURERS OF
Sº
W. W. SEELY, M. D., - - - - º º TREASUREE,
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r x CLU B R AT Es. 92 WEST FOURTH ST.
+copiº one widºw'....…~~~~~ *}} - Opposite Post Office,
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o o y T E N T S. ſº
tº-º-º-º-º-º-º- ... •- - Page.
A CEREBR.o-SPINAL MENINGITIs NUMBER. N. -- -
- - ſmºs aſ N. ºr nº
The History of Cerebro-Spinal Meningitis... • * * * * * * * * * * * * * * * * * * g ee e s ∈ e º e º 'º e .....205 Rºriºſa Ni
ACA DEMY OF MIE DICRINE SIGNER S ANPº l
Transactions April 29, 272. * * º-ºº: Ty S.
Cerebro-Spinal Meningitis—Reports of Čases by Drs. --- ENGRAVE RSoNWOOD ;"
Brown, Muscroft, Orr, Reamy, Carson. Remarks by Drs. issºl. 3 2 WEST FO UR7. H. ST sº º:
Gobrecht, Comegys, Graham. History by Dr. Whittaker......207-209 - ºc INGINNATI. of iro.
* TRANSIATIONs — w ~ : -
A General Survey of the Disease by Prof. Hirsch 209 - - * -ºr wº
The Pathology of the Disease by Prof. Klebs 211|
General Conclusions by Dr. Meissner - 213|J. TAFT, W. TAFT.
M IELDIGA. I. NEWS- Editor Dental Register .
Cerebro-Spinal Meningitis in New York, Buffalo and Brooklyn........ 214 -
CORRESPONIDENCE J | & W T AFT
fetter from Dr. Darnaji. Spotted Fever in Iowa........................... 214 y
C LINICAL, M I EMIORAN DA
The Temperature of Cerebro-Spinal Meningitis—Treatment by Qui-
nine and Opium—By Morphia Hypodermically—By Phy-
sostigma Venemosa—Recommendations of the Amer. Med.
Association -
* * g e is a s a s º e s is e is a tº 4 * * * * * * * * * * * * * * * * * * * e º s is sº a º is e º se tº e s ∈ n. * * * * * * * * * * * e º s sº e <
College Announcement
, THE CLINIC of to-day contains all the available in-
formation of recent date upon the subject of cerebro-
spinal meningitis, which is now present in our city,
though hardly as yet, at least, in the proportions of an
epidemic. - *.
As will be seen, liberal use has been made of Meiss-
ner's almost exhaustive collation of its medical literature,
214-21C
IDENTISTs
17 WEST FOURTH STREET,
CINCINNATI, O.
in that vast storehouse of medical knowledge, Schmidt's § 6
Jahrbücher der Gesammten Medicin. .
A careful perusal of the few facts established and the
many theories propounded leaves us, still, it must be
Confessed, in profound ignorance as to its nature, doubt
as to its course and perplexity as to its treatment.
Cerebro-spinal meningitis remains, in truth, as in-
scrutable in its origin as it is lawless and capricious in
its development and signs. Lastly, it is so little govern-
able by treatment as to show, according to Hirsch, an
average, from all epidemics recorded, of 37 per cent.
mortality under whatever method of treatment pursued.
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,

















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wo. 27 mºsr Fovern scºrer,
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§ im
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meters, Hygrometers, Urinometers and Baian Gauges,
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TXTER, S-INT. TML. ALTER,STEI’S
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No. 758 BROADwAY, NEw York
HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined." LEWIS A. SAYRE, M. D.
Surgeon, Bellevue Hospital.
Readers in
Ø
• *-
º
º
sº ºr
ºf r: ſº º
ſº yº
SS &Sº
sº
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
BEG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * I am in the coustant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKEB, M. D.
Professor of Sürgery, New York City
• *-*
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
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between Main and Walnut, Cincinnati.
OPPOSITE THE HIGH STER PLE,
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- !. Those in want of any of the acknowledged good aids of
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Have constantly on hand a full assortment of
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An excellent Chalybeate and tonic, Wine of Iron, &c.
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AND
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By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
ELECTRO-MAGNETIC MACHINES,
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Continuous Current, Stöhrer's Improved, patented June 1st,
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These Instruments are the most Elegant, Powerful, Effica-
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instantly set to work or stopped. Will remain in operation
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For Hospitals and General Practitioners,
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For Eye, Ear, Larynx, Nose, Uterus, Wagina, Bladder, Ree-
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EXTRA (4TS FROM THE OPINIONS OF THE MOST
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EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
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We are authorized by Prof. Hammond to announce em-
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vous System and of the Mind, &c., &c.—“I consider theºr
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ness, compactness and efficacy, they can not be excelled.”
ALFRED C. GARRATT, M.D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
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ALLEN MAYNARD, M. D., Cleveland, 0.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
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Fourth street. Cincinnati, onio, or 172 Jef-
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DIVIDED MEDICINES,
PREPARED BY
The Divided Medicine Com’y,
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExcFEDINGLY Practical
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in, general. -
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. -
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities. -
But not only SoLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. . .
2 This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain;
#. 3. #. 3, 1.0, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. -
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
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the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste. -
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days. -
For Samples, Price Lists, and Agencies, address -
2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
- Walnut Hills, Cincinnati, O.
MR. FREDERYCK KRAUs: - CINCINNATI, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz:
SULPH:MORPHII....................... % grain in each square. ARSEN:ACID..........................1-20 grain in each square:
** CH IN INI .......................1 ** ** $6 CALOMEL *.......}4 “ ** 44
$ 4 COPPER -----------------0 * * * tº ſº % 66
BESPECTFULLY YoUBs,
E. S. WAYNE, Analytic Chemist.


TIEEE IFI} C T , T NT I. C.
205
Vol. 2.] [No. 18.
*—
S A T U R D A Y, M A Y 4, 1872.
O R. I.G IN A L A R T I C L E S.
—-º-º-º-
“T H E H H S T © R. Y O F C E R E E R O-S P H N A L.
NH E N IN G H 'H' I S. . .
Compiled from Various Sources.
the chapter from Stillé and including extracts
Incorporating part of
- from Köhler and Hunt.
SYNoNYMs: Spotted Fever (Gallup), Typhus Petechialis
(North), Malignant Purpuric Fever (Stokes), Cerebro-
Spinal Fever with Cerebro-Spinal Meningitis (Gordon),
JFebris Nigra (Lyons), Malignant Purpura (McSwin-
ney), Pestilential Purpura (Banks), Black Death
(A. Smith), Cerebro-Spinal Meningitis (Hughes, Law,
Banks, Hayden, Moore and others), Epidemic Men-
àngitis.
Other less common synonyms are Typhus Syncopalis
and Winter Epidemic; Fièvre Cérébrale, Céphalalgie
Epidémique (Fr.); Nacken Staare, Gehirn á.
Rückenmarks Entzündung (Gr.).
The term Cerebro-Spinal Menigitis is, however, the
only classical name, the only one which designates
the seat and pathology of the disease.
The medical historian takes peculiar pleasure in
tracing back the recognition of every disease to the
most ancient times. It is his delight, indeed, to dis-
cover a lucid description of every malady in the
works of Hippocrates. Passages whose obscurity per-
mit as many interpretations as those over which theolo-
gians continue to wrangle are translated with the
fertility of imagination into indisputable evidences of
the diagnostic acumen of the first great physician.
Notwithstanding the fact that our knowledge of all
diseases of the nervous system is even in our day de-
plorably defective yet the most distinguished of the
older medical historians claimed to have discovered the
first portrayal of these affections in the writings of
Hippocrates and Galen. Neither the old physicians of
Coe, however, from their ignorance of the anatomy and
physiology, to say nothing of the pathology of the parts
concerned, nor their immediate or even more remote
successors could have had any but the faintest concep-
tions of the seat and essence of nervous diseases.
The statement of Frank, then, that the first accurate
descriptions of spinal meningitis are to be found in those
- chapters of Hippocrates, Galen, Ballonius and Allenius
which treat of the so-called pleuritis dorsalis is based—
as unprejudiced examination of the passages cited
clearly shows—upon that stasis of the spinal meningeal
vessels which is the frequent, almost constant attendant
upon inflammation of the posterior portion of the
diaphragmatic pleura. -
In the days of Hippocrates and Galen the dissection
of man was considered a crime of such enormity as
would invoke the direst anger of the gods; accurate
anatomical or pathological knowledge of any disease,
thus, was of impossible attainment. That any informa-
tion, however faint, could have been possessed at that
time upon the obscure affections of the spinal cord is
negatived at once by the acknowledgement of the great
physician of Pergamus himself who confesses how great
was his joy to have been able on one occasion to See a
human skeleton at Alexandria, by the study of which
and by its comparison with the facts he had ascertained
from dissections of the lower animals he had been able
to increase his knowledge of and correct his mistakes
in the anatomy of man. Indeed, it has been fully de-
termined by reliable investigators who have thoroughly
and laboriously worked over the barren fields of ancient
medicine that the first section of the spinal column, as
is seen in the writings of Nic. le Pois, Fernelius and
Felix Pater, was made as late as the fifteenth century
and then only in the most defective manner.
Our knowledge of spinal meningitis dates from a
period as late as the middle of the last century. Mor-
gagni and Bonet described the disease with full histories
of cases and reports of post-mortem sections in a manner
so accurate and trustworthy as to serve as illuminated
portraitures for the physicians of all times.
It was the celebrated essay of Peter Frank, however,
(De vertebralis columnae in morbis dignitate: Delect.
Opuc. Tom. xi, Ticini 1792) which first promulgated the
different inflammations of the spinal cord. He
developed the origin of spinal meningitis as an inflam-
mation of the membranes of the cord and contributed
in his description of the various processes of inflammation
ten fold more knowledge upon this subject than all
observers before him. The first decade, then, of our
own century furnished us more literature on spinal
meningitis than all time previous to this date.
Dr. Sanford B. Hunt (U. S. Sanitary Commission
memoirs, 1867), quotes from Simon to the effect in 1837
when its importance first began to be recognised in
France, few previous epidemics of the disease were on
record. Yet it had been more or less known, he con-
tinues, before that time. In Geneva in 1805, it killed
thirty-three persons and from that time on it has been
occasionally described. Yet there can be no doubt,
that as an epidemic—and in that respect to be dis-
tinguished from ordinary meningeal inflammations—it
has existed from the earlist periods of medical record,
Dr. S. G. Webber, of Boston, in the erudite essay to which
was awarded the Boylston prize for the year 1866, thinks
to very clearly establish its identity with epidemics
206 T IEEE IET:
[MAY 4, 1872.
C T , T TXT T. C.
chronicled in Europe as far back as 1840. A close ex-
amination of the various passages cited, however, still
leave it doubtful as to the nature of the disease described.
With the increase of medical publications we find this
disease, or something which does not much vary from it
in the prominent symptoms, recorded frequently; and
it would encroach too much upon our space to specify
the particular epidemics. In all of them we find no
contradiction to the continuous statement of a disease,
distinctly, but not extensively epidemic ; suddenly
appearing and as suddenly passing away having its
habitat in malarial localities, or where crowd poison was
present; attracting attention and exciting profound
alarm by the violence of its cerebral symptoms; and
finally, presenting at all times—and not less now than
in former years—a frightful percentage of mortality.
No country in Europe or in N. America, open to in-
telligent medical observation, has escaped this infliction.
The localities that have been distinguished by its most
severe invasions, during the present century, are Geneva
in 1805; among the Spanish prisoners at Briançon in
1807; in the sick of the French army at Grenable in
1814, after the hardships of crossing the Alps in winter;
and in the Parisian hospitals at the same time; during
the winters of several years (1813–14–15) in Ireland;
in Milbank penitentiary near London in 1823; among
the galley slaves at Toulon in the winter of 1829–30;
in numerous barracks in France in 1837 and continuing
for several years to be confined mostly to the military;
extending its ravages to civil life at Strasbourg in 1841;
from which time its appearances are too numerous to
quote, it having become a well recognized disease,
although by far the best study of it that has met our
eye is that made in 1865 by Dr. John Burdon Sanderson
on the lower Vistula, in Northern Germany, whither
he was dispatched on a tour of investigation by Dr.
John Simon the distinguished medical officer of the
Privy Council of Great Britain.
Restricting our historical review of the disease to the
epidemics of it which have occurred since the beginning
of the present century, and, rising for a moment above
its individual and local outbreaks, our attention is at
once arrested by a circumstance which removes it from
the category of endemic, and even of epidemic diseases,
in the ordinary sense of the latter word, and entitles it
to the name pandemic. Unlike typhus, and typhoid
and yellow fevers, its rise and progress are connected
with no antecedents of animal or other putrefaction; nor
with any miasmatic, cryptogamic or analogous agent,
like periodical fevers; nor with any telluric or aqueous
emanation like dysentery; nor with a special poison like
cholera, small-pox, or measles. All of these diseases
have, moreover, a distinctly ascertainable starting point
from which they widely extend ; or else their ravages
are confined within comparatively narrow limits; but
with epidemic meningitis the case is very different. Its
outbreaks have occurred almost simultaneously in
regions as widely separated as Europe is from America,
and annually it has made a mid-winter attack upon
towns and rural districts, the salubrious and unhealthy
alike, completing the cycle of its progress in a period
varying between ten and fifteen years. Three such
periods, at least, have occurred during the present
century. The first, of eleven years, began in 1805 and
terminated in 1816; the second, of thirteen years, oc-
curred between 1837 and 1850; and the third extends
from 1856 to the present time, and has already lasted
for eleven years, during which the disease has been
almost constantly present in Europe, but absent during
four years from the United States. These two condi-
tions, of simultaneous appearance in widely remote
places, and of annual recurrence for a series of years,
characterize no other disease whatever. The first,
indeed, is fulfilled by influenza; and it was perhaps a
dim preception of the analogy we have pointed out
which led one writer, at least, (Wilson), to imagine the
two diseases to be identical, a proposition which at the
present day may provoke a Smile, but hardly calls for
refutation. But no other disease than influenza affords
an example of the former condition singly, and none but
epidemic meningitis of both combined.
The first account of epidemic meningitis within the
period we have referred to was published in 1805, by
Vieusseux, who at once declared that neither he nor
any of his colleagues had ever seen a similar disease. It
is also worthy of remark, that in this particular epidemic
a petechial eruption was a prominent symptom, that
engorgement of the brain existed in most of the fatal
cases, and that its historian describes it as “a malignant
non-contagious fever.” If any doubts should be enter-
tained respecting the identity of this disease with epi-
demic meningitis, they will perhaps be dispelled by the
account which Mathey furnishes of a dissection made
in one of the fatal cases. He describes a gelatinous
exudation as covering the convex surface of the brain,
and a yellow puriform matter upon its posterior aspect,
upon the optic commissure, the inferior surface of the
cerebellum, and the medulla oblongata.”
In every one of the following years, until 1816, the
same disease prevailed either in Prussia, Holland,
Rheinish Germany, Bavaria, or the east of France, but
no where else in Europe; while in the United States it
began its course in 1806, at Midfield, in Massachusetts,
and between that time and 1816 it extended throughout
New England and into Canada, the State of New York,
Pennsylvania, and other States to the South and
West, precisely as it has done during the recent
epidemic.
We possess no record of its occurrence between 1816
and 1822; but in the last named year, a local and
* Bascombe, in his “History of Epidemic Pestilences,” speaks of *
local epidemic at Roettingen, in Franconia, in the autumn of 1802, in
which the young and strong were suddenly seized with pain and
anguish at the heart and lacerating pains in the nape of the neck. In
the worst cases the patient fainted, the limbs became rigid, and death
closed the scene frequently within twenty-four hours from the com"
mencement of the attack.
MAY 4, 1872.]
TIEEE E CIT, ITNTIC.
207
temporary appearance of the disease was observed at
Vesoul, in France; in 1823 at Middletown, Connecticut;
in 1828 in Trumbull county, Ohio; in 1830 at Sunder-
land, England, and in 1833 at Naples.
After four years of quiescence it entered again upon
a wide and destructive career, which lasted from 1837
to 1850. During the first two years of its recurrence in
Europe, it was confined almost entirely to France; but
during the third and fourth years it appeared also in
Italy and Algeria and at Gibraltar, without, however,
retreating from its original territory, where it continued
to prevail until 1849, breaking out meanwhile at various
points of the north of England and in Dublin, and from
1845 to 1848 in Denmark. While the epidemic was
thus spreading through Europe, it again appeared in
the United States at places as remote as possible from
trans-atlantic communication, and hundreds of miles
distant from one another; in Louisville, Kentucky, in
Rutherford county, Tennessee, and in Montgomery,
Alabama. This took place in 1842; and in the follow-
ing years, the disease appeared in Arkansas, Mississippi
and Illinois. In 1848 it occurred again at Montgomery,
Alabama, and simultaneously in Beaver county Pennsyl-
vania; in 1849 it existed in Massachusetts and in Cayuga
county New York, and finally at New Orleans, in 1850.
It appears, therefore, that although the American epi-
demic began later than the European, it reached its
period of extinction very nearly at the same time.
Between 1850 and 1854 epidemic meningitis had
ceased to be heard of, when suddenly it broke out with
destructive violence in Sweden, a country which had
hitherto entirely escaped its ravages, and there it con-
tinued to prevail during the six years from 1854 to 1860.
During this period localepidemics of very limited extent
or sporadic cases occurred in Dublin, London and in
Stafford, England; and simultaneously the disease pre-
wailed in several parts of the United States. On this,
as on previous occasions, its starting points were remote
from one another, as in North Carolina, where it ap-
peared for the first time in March, 1856, and in the cen-
tral portions of New York and Massachusetts at the
commencement of 1857.
To return once more to Europe, we find that hardly
had the epidemic ceased in Sweden, than it reappeared
in Holland during the winter of 1860–61; and in the
following year, at the same season, it spread over a large
extent of the Portugese territory. Germany, which
had remained almost entirely exempt from the attacks
of the disease since the first and very partial outbreak
of 1806, was now the seat of an epidemic as widespread
as that which had prevaded France. Beginning slightly
in the summer of 1863, it acquired new vigor during
the next winter, and for the two following years devas-
tated almost every part of northern Germany, but, so
far as we are informed, penetrated but slightly into the
Austrian empire. Simultaneously (1865) a local epi-
demic of the disease occurred in Dublin.
The counterpart of this epidemic, as on former oc-
casions, appeared in the United States. The first point
at which it broke out was Livingston county, Missouri,
in the winter of 1861–62; and during the same season
it invaded Indiana, Kentucky and Connecticut. From
1860 to 1864 it prevailed in Ohio, and during the last
named year in Illinois. Cases of the disease occurred
at Newport, Rhode Island, in 1863, and in Vermont in
1864. In 1863 the epidemic began in Philadelphia, and
has renewed its appearance annually until the present
time. During the same period it prevailed in Maryland,
Virginia, North Carolina, Alabama, and other Southern
States.
The coincidences which have now been pointed out
are among the most striking occurrences in the history
of this singular disease, and they are, as before remarked,
characteristic of it alone. If there had been anything
common in the origin of its epidemics, as climate, soil,
or water, or the Social condition, age, sex, occupation or
habits of the patients, a plausible, although even then
an untenable, explanation of their simultaneous occur-
rence might be suggested; but, in point of fact, no single
circumstance was common to all, or nearly all of them,
except their outbreak in mid-winter. It follows, there-
fore, that, even at this stage of our inquiry, epidemic
meningitis must be regarded as an exceptional affection,
and, as before intimated, a true pandemic disease. Along
with the more or less wide spread epidemics which have
now been considered, several instances are on record of
this disease occurring in groups of two, three of four
cases, in localities where it never at any time assumed
the epidemic form. Not to cite instances of doubtful
import, we shall refer only to those observed in England,
where epidemic meningitis has never yet been known
to prevail. In 1807, Dr. Gerwis, of Ashburton, reported
four such cases; in 1859, Dr. Day met with two such at
Stafford; and in 1865, three cases were observed in
London by Dr. Wilks, three by Dr. Orgle, and one by
Dr. Martin.
At the present time it is again prevailing as an epi-
demic, not extended, but of considerable severity, in
New York, Illinois, Iowa, and Ohio.
-—sº-º-º-----
A. C. A. D. E. E. Y O F M I E D I C I N E .
JAS. GRAHAM, M. D., PREST., L. WOLF, M. D., Secry.
Transactions April 29, 1872.
Reported by Joseph Ransohoff.
**=sºme
Cerebro-Spinal Meningitis.
DR. A. BRown reported the following case. L. H.,
aet. 6 years, American. Had been in delicate health for
two months, complaining of pain in the right hip joint.
Thursday, April 19th, the patient was attacked with
nausea and vomiting, complaining at the same time of
208
EMAY 4, 1872.
T H E CI, IISTIC.
pain in the head and posterior cervical region. Sunday
morning was apparently much better, but in the even-
ing of the same day, the nervous excitement became
intense, and attended with frequent shudderings and
shrill outcries. The bowels having been unmoved for
thirty-six hours, an enema of assafoetida and ol. ricini
was ordered, which had the desired effect in a short
time. Ordered also bromide of potassium in 5 gr, doses
every two hours. Monday morning the patient was
more quiet, pulse 72, temperature 99°. Hyperaesthesia
well marked, and a twitching of the muscles occasionally
noticed. The pupils contracted, and the tongue was
readily protruded, but coated with a brownish fur.
Sordes on the lips and teeth. Intellect sluggish.
Ordered iodide and bromide of potassium, wine and
beef tea and frequent sponging with mustard water,
Tuesday, same as day previous. Rested part of the
night. Again ordered an enema, which had no effect.
Wednesday, the patient was worn, making no response
to questions. Opisthotonos presented itself, and the
patient frequently carried her hand to the back part of
the head and neck. No tenderness of abdomen.
petechia. Temperature 99°, pulse 90, respiration irreg-
ular. The urine contained a slight trace of albumen.
The bowels being confined, a mercurial purgative was
administered. Thursday, no improvement, though
bowels had been freely moved. The pupils well dilated,
the right more so than the left. She was unable to pro-
trude her tongue. Partial paralysis was rapidly super-
vening. -
The patient remained in this condition until this
morning, [April 29th] at 9 o'clock when she expired.
No
DR. CARSON presented the pathological specimens of
the case. The lesions in this case are not very well de-
veloped, the amount of exudation being not so great as
in the specimen presented by the speaker at the last
meeting. There was, however, some opacity of the
arachnoid membrane and a decided congestion of the
superior and inferior surfaces of the brain. In this in-
stance the spinal cord was not examined.
DR. MUSCROFT stated that within the last few months
he had seen several cases of brain disease which were
unlike any that he had seen before. The first case was
that of a girl, aet. 5 years. She complained of severe
pain in head and back. She was partially unconscious,
but intelligent when aroused. She had been attacked
one day before the visit. There was a tendency to
opisthotonos. Supposing this to be a disease of the brain
and spinal cord, a mercurial purge, bromide of potassium
and hydrate of chloral were ordered. The case however
terminated fatally. The second case, was that of a girl,
aged 9 years. Found the child vomiting. She had
vomited for forty-eight hours previous to my visit.
There was also a great tendency to sleep, as in the first
case, I here also made but one visit, three days after
which the patient expired. The third case was being
treated for hooping cough. I saw the child about 8 P. M.
when it was making desperate efforts to speak. There
was also great disposition to extend the fingers; especially
those of the right hand. The child died next
morning at 2 o’clock. No post-mortem was obtained.
The next case reported by Dr. Muscroft was that of a
boy, aged 14 years. He was seized by an attack while
crossing the street. While so doing, he found great dif-
ficulty in controlling his muscles. When I saw him he
was in a straight position in bed; the pupils of natural
size but insensible to light. There was also a twitching
of the muscles of the face and some opisthotonos. He
lived one day after the visit. The Dr. added that all
the cases of cerebro-spinal meningitis which he had seen
terminated fatally. - s . -
DR. ORR also reported a case of this disease, The
patient was a girl one year old. The first thing noticed
upon entering the room, was the position of the child.
There was considerable opisthotonos. The next symp-
tom manifesting itself was paralysis of the upper and
lower extremity of the right side. The child was almost
constantly sleeping and its eyelids continually drooping.
Great sensitiveness along the spine, and upon the
slightest pressure there, the child would scream. The
pulse in this case was 148. Prescribed quin. Sulph. gr. ij.
and sodii. brom. gr. Vij. every 4 hours. Ordered also
mustard to be applied to the spine and cold to the head.
At present the child is very much improved but not
yet out of danger. -
DR. REAMY also related two cases. The first was
that of a child 16 months old. The little patient was
attacked with vomiting in the night. The bowels were
constipated. Pulse very rapid; there was a marked
tendency to opisthotonos, the head being constantly
thrown backward; the muscles, however, were not rigid.
There was also a disposition to convulsions. Ordered
potas, brom. gr. viij every two hours, after which potas.
iod. and quinia were administered. The child made a.
good recovery.
The second case was also attacked by vomiting. The
pulse rate was very rapid, and breathing rather difficult.
Gave potass, bromid. gr. vij, every two hours. The sub-
sequent treatment was similar to that given in the first
case reported. This patient also recovered.
DR, GOBRECHT stated that at present he had under
his charge a case which at first he thought to be one of
cerebro-spinal menigitis, but which turned out to be
one of an entirely different nature. The patient was a
boy seven years old. When first seen he was very stu-
pid and entirely insensible. Head and skin were hot
and dry; the pupils were neither dilated nor contracted
but insensible to light. The pulse rate was 140 per
minute. Slight tendency to opisthotonos also manifested
itself. Supposing this to be a case of the disease under
consideration, I put the child upon hydrarg. chlor. mit.
gr. 4 every two hours, and ordered ice cloths to be ap-
plied to the head. Saw the child again at 8 P. M., when
it had a general spasmodic action. Then ordered a warm.
bath and half teaspoonful of black assafoetida. The
next morning the boy was able to recognise his parents,
MAY 4, 1872.]
TIH. H. C.I.INTI c.
209
but upon close inspection a fine varioloid eruption was
seen on the body. The preliminary symptoms certainly
resembled those of cerebro-spinal menigitis.
DR. COMEGYS stated that he had no case to report,
but that he had an opportunity of seeing numerous
cases of this disease in the epidemic which prevailed in
and about Oxford several years ago. He spoke of the
great value of opium in these cases, and expressed his
intention of treating all those cases which might come
under his care, by the use of morphia hypodermically.
He also considered ice bags applied to the spine of the
greatest efficacy.
DR. CARSON reports as follows: Within the last two
days I was called to see a child in a very serious condi-
tion. The child had been vomiting profusely. It was
quite intelligent, and denied having any head ache.
Took the hazard of diagnosing this case one of stomach
trouble and treated it accordingly. Next morning the
patient was improved. I was informed by the mother
that it had cried out, and complained of violent pain in
the head. I then put the child upon bromide of potas-
sium. The next morning I found it nervous and occas-
ionally starting out of bed, but no further vomiting.
At present I have placed it upon the opium treatment.
As yet in this case I do not risk a diagnosis. I also saw
a boy (aet. 8 years) last Thursday who had been taken
suddenly with a very violent headache. The principal
symptom of this case was the behavior of the patient.
He would frequently become maniacal and then he would
attack the male members of the family only. There
was no rigidity of the muscles and no tenderness along
the spine. There was no vomiting and the pulse was
50 or 60.
Isaw another boy in the same locality. This patient's
symptoms were somewhat similar to those related of the
preceding case. There was the same reduction in the
pulse rate and there were also occasional paroxysms of
laughing. -
I have at present another case, in my ward at the
Hospital. The patient is a vigorous young man aged
18. In this instance there is well marked rigidity, the
skin is hot and the temperature 100°–102°. In this
patient no brain symptoms have developed, the intellect
being clear. At present the symptoms look more favor-
able. This case is one of very slow development.
DR. GRAHAM made a statement concerning the case
he had reported at the previous meeting to the effect
that the untoward symptoms had subsequently subsided
and the child was now out of danger.
DR. WHITTAKER read a short compilation of the
history of epidemic cerebro-spinal meningitis.
DR. ROSENFELT reserves a report upon four cases now
in his care until results have manifested.
DR WALKER reported a case of confluent small-pox
after vaccination and D.R.CARson presented a patient
with well marked progressive muscular atrophy. [The
description of this most interesting case with the
remarks of the speaker are deferred to the next number.]
A GENERAL SURVEY OF • THE DEISEASE.
Being Meissner's Abstract from Prof. Hirsch’s “Meningitis Cerebro-
Spinalis Epidemica,” from its historico-geographical and pathogico-
therapeutical standpoints, [Schmidt’s Jahrb., No. 136, 1, 1867, p. 89,
et seq. -
ºsmºmºsºmeºs
In many cases the disease was quite isolated occurring
at different places, in regions that had hitherto been
unvisited by attack, and extended itself to distant
regions overleaping the intervening places [sprungweise].
Only rarely did it manifest itself suddenly in great,
devastating epidemics, to disappear as suddenly as it oc-
curred.
The duration of epidemics and their extent varies
most remarkably, to such degree, indeed, that no
average can be struck.
The proportion of the number of cases to the number
of inhabitants ranged from 0.3–20.5 per cent. In like
degree the proportion of fatal cases varied, according as
lighter cases were included or not, from 20–75 per cent.
An average of 37 per cent is perhaps closest on truth.
Mortality is greatest at the beginning of epidemics, it
is at this time, too, that the duration of the disease is
shortest. §
Any relation to other epidemics cannot be established.
In Sweden and Thüringen, scarlet fever was observed
in conjunction, with it; in Montgomery 1848, and
in Niessethal 1863–64, measles; much more frequently
elsewhere typhoid and malarial fevers though Hirsch
has observed, concerning the latter of these affections,
that meningitis to a certain degree excludes malaria.
The form and course of the disease are so varied that
it is exceedingly difficult to sketch a portrait common
to the greatest number of cases. It is just as difficult,
too, to establish definite stages or forms of the disease.
The portrayal of Hirsch, notwithstanding its truth to
nature, exhibits only in general the form of the disease
in a minority of cases from which most cases differ in
numerous exceptions.
A stage of prodromata does not by any means always
exist, but when it does present the symptoms indicate
partly an affection of the cerebro-spinal system and
partly a general infection of the organism. Among the
manifestations of the first class is vomiting, with at
times perfect appetite and more especially cardialgic or
colicy pains. This last symptom is only mentioned by
Schillizi and Mayne ; according to Hirsch it is observed
in certain epidemics almost constantly. The symptoms
of the attack proper are well known. It is worthy of
note that, instead of the usual constipation which charac-
terises some epidemics (e. g., that of Sweden), a regular
diarrhea may be present. Swelling of the spleen was
never observed by Hirsh, by other observers as Mann-
kopff, always. The skin is usually strikingly pale, paler
than in any other acute disease. Hirsch does not con-
210
[MAY 4, 1872,
TEEE CI ITTIc.
sider the different eruptions, which are not infrequently
observed, of critical significance. The ranges of pulse
and temperature furnish no definite law; shortly before
death, however, a considerable increase of both was ob-
2erved and this increase continues even a short time
after death. In hyperacute cases with immediate
collapse, no reaction occurs. The speedy emaciation
and depression, present in even lighter cases and not
seldom terminating in fatal marasmus, is most remark-
able. -
The disease manifests itself in the following forms of
distinct type:
A. According to the Gravity of the Symptoms :
a. Grave Cases.
1.—Intensely acute cases in the form of meningitis
foudroyante (meningitis siderans); -
2.—Grave cases with acute course and termination in
death or most tedious recovery. g
3.—Grave cases with manifold complications which
have a protracted course and finally terminate in
death with typhoid manifestations, secondary accidents
(especially hydrocephalus), sequelae or marasmus.
b. Lighter Cases.
1.—With perfect development of symptoms attaining,
however, only a moderate grade of intensity without,
or with in only light degree, depression and terminating
in recovery, or in rare cases, with sudden aggravation of
of symptoms, in sudden death.
2.—With the characteristic symptoms but less
marked, almost without fever, running usually a quick
and always favorable course.
c. Lightest Cases.
1.—With prominence of individual characteristic
manifestations, the so-called abortive forms.
B. According to the Type of the Disease:
a. Cases with continuous or remittent type, the, by
far, most frequent form of the disease.
b. Cases with intermittent type.
Certain modifications of epidemic cerebro-spinal men-
ingitis are described more thoroughly, especially the
abortive form which occurs more frequently towards
the close of an epidemic and extends itself occasionally
over a whole population ; at times to assume the
fulminant form, which is else usually confined to the
beginning of an epidemic, and which causes the great
mortality at first. Further the intermittent form with
quotidian or tertian intermissions which may manifest
as well in the prodromatous stage as in its full develop-
ment or during convalescence and which Ziemssen refers
to an irregular [saccardirt) progression of the disease from
the start or to a resorption of the exudation during
resolution or convalescence. Hirsch subscribes to the
first of the views propounded, discrediting the last.
The prognosis in general is unfavoraple. It is de-
termined in special cases by the rapidity of the course
of the disease (stormy attack, absent or short pro-
dromata give an unfavorable, cases of meningitis siderans
an absolutely fatal prognosis), by the extent of the
affection (prominence of symptoms of cord affection,
trismus especially, is unfavorable), by the occurrence
of signs of depression (coma, respirations above 60, very
high pulse are very unfavorable), by the stage of the
epidemic (at first more favorable than later), by the
age of the patient (childhood and advanced age, above
40 is particularly unfavorable), by its complications
(pneumonia is unfavorable, stomach symptoms are not
of importance, exanthemata (except the petechiae of the
later stages), parotiditis, epistaxis, as well as the variety
of type of the disease are without special prognostic im-
portance.) -
The cause of the disease and its pathogenesis are as yet.
but little known. Climate exercises only a very limited,
perhaps no influenée at all. It occurs among the in-
habitants of the Atlas mountains up to and above the
60th degree of latitude and from the Gulf to the states
of New England. The season of the year, however, has
a most decided influence as by far the greatest number
of epidemics prevailed in cold seasons. The reason of
this, however, is obscure: neither temperature, nor
moisture nor conditions of soil showed anything definite.
Of all circumstances, concerning the individual, age
takes the first rank. In the rule childhood is most
frequently attacked, and in the so-called military epi-
demics the younger individuals, 18-24 years, suffered
most while the advanced in age were seldom attacked
in any of the epidemics. In Carthaus and Behrent, of
779 persons dead with the disease, 696, i. e., nearly 88
per cent. were under the tenth year. Of the 1297 dead
in Sweden between 1855-1860, 889, i. e., 70 per cent
were under 15 years of age. In the Bromberger epidemic
(1864) of 141 patients 132, i. e., 93 per cent. were under
| 7 years. In Zellin (1865) of 54 very sick, 47 i. e., 87
per cent. were under fifteen. -
Sex has less importance. In general, the male sex
is somewhat more subject to the affection than the
female and there have been epidemics in which only
boys have been attacked: yet there have been also
others in which girls were preferably seized.
Race and Social Differences seem to be of significance
only when the social-hygienic circumstances were bad.
Thus Hirsch cites numerous epidemics in which only
negroes or only military or only civilians or only
the inhabitants of certain places (garrisons, barracks,
manufactories, blocks of houses) were attacked. In
these close and crowded places the atmosphere becomes
poisoned by animal effluvia and products of decompo-
sition and in these factors Hirsch finds the chief element,
not in the production of the disease, but in its occurrence
and extension. Gasté in the epidemic in Metz 1839-40
first called attention to these facts and really succeeded,
by enlarging and ventilating the garrisons, in diminish-
ing the number of attacks. Still the proper cause of
the disease is not to be found in these conditions. Its
real cause remains unknown and is to be sought in Some
peculiar poison. Epidemic cerebro-spinal meningitis,
thus, is an infectious disease, which like dysentery,
MAY 4, 1872.]
T IEEE THE C T , ITNT I C -
211
diphtheria, etc., runs its course under manifestations of
a local disease and in this way differentiates itself from
malaria, typhoid diseases, acute exanthemata, etc. The
contagiousness of the disease is denied by many authors,
because there is no diseased product from the secretory
organs or from the surface of the body; yet cases of
transmission of the disease to other places are so
numerous as to leave the question of contagion at least
sub judice; from a practical standpoint affirmed.
The diagnosis is only difficult of differentiation with
cases of the sporadic disease and with tuberculous basi-
lar meningitis. It is distinguished by the different
symptoms showing a general disease, as, particularly,
herpes and petechiae, by the absence of any injury.
Fulminant cases exclude the idea of sporadic nature as
the sporadic disease never occurs in this form. The
tuberculous form is differentiated by the previous
tuberculosis or scrofulosis, its longer stadium prodrom-
orum and its more protracted course. Typhoid fever is
recognised by its much longer prodromata, its very high
temperature from the start, its pronounced gastric
symptoms with seldom vomiting and especially in the
beginning by its diminished secretion of urine and
absence of spinal symptoms, later by its typical course,
regular diarrhea and the peculiar typhomania resembling
narcosis. The diagnosis, therefore, presents difficulties
only when the genius epidemics of meningitis is com-
plicated with typhus or when later in its course a
typhoid condition is intercurrent. Lastly the inter-
mittent form might be mistaken for intermittent fever
but meningitis is recognised among other considerations
by the absence of other malarial attacks and of an
interval of pure apyrexia as well as by the inefficacy of
lllllla,
Q The therapy of different authors is so different and
often so contradictory that Hirsch contents himself
with merely detailing the various methods of treatment
by means of which or rather after which improvement
has been observed. The average mortality of 30–40 per
cent. remains the same in all epidemics under the most
diverse methods of treatment and it is very questionable
whether venesection, cold, derivatives or narcotics exert
any particular influence on the epidemic form of the
disease. Of special importance, however, is a regulation
of the diet and a regard to hygienic conditions. If the
case demand it, suspected houses must be purified,
Schools closed, etc.
—mº-o-º-
THE PATHIOLOGY OF EPIDEM IIC, CERE BRO-
s|PINAL MIENINGITIS.
An Abstract from Klebs (Berlin) “Beiträge zur Pathologie der Epid-
misohen Meningitis (Virchow's Archiv., xxxiv. 3. p. 327) in
Schmidt's Jahrb., vol. 136, No. 1. p. 103, 1867.
1. Pathological Alterations of the Nervous System.
a. The Cerebral and Spinal Meninges.
Purulent meningitis has its seat in the brain almost
exclusively in the arachnoid and pia mater, particularly
in the subarachnoid spaces at the base between the
infundibulum and pons, at the cerebellum and in the
fossa Sylvii, further in the temporal region over the
convolutions and in the course of the veins. As a proof,
however, that the inflammation is general, those parts of
the pia mater which are not covered with pus are cloudy
and dull, and exhibit a rich proliferation of cells. In
the spinal cord pus is found more especially on the pos-
terior surface, less in front, most abundant in the lower
cervical and the lumbar regions while the cauda equina
is sometimes free. Where the purulent deposition is
rich the pia is smooth and shining, where it is less it is
strewn with small purulent deposits often connected
together in reticulae. These purulent accumulations do
not by any means correspond in quantity with the
anatomical alterations of tissue; this indicates a change
of position in obedience to the laws of gravity. Where
this change of position is easy as in the relatively large
canal of the cervical region, where there is at the same
time greatest mobility, but little pus is encountered,
while in the upper dorsal region where the canal is
relatively narrow, pus accumulates. This change of
position, again, is favored by the so-called spontaneous
motion of the pus cells (Recklinghausen). The dura
mater of the cord participates in the disease rather
oftener than this membrane in the brain. At the upper
cervical and lower dorsal regions, patches of easily
Separable adhesions are sometimes encountered between
the pia and dura mater without any marked alterations
in the structure of the latter. These patches are associ-
ate with cloudiness and thickening of the apposed sur-
faces or with thin pachymeningitic deposits. They are
not to be confounded with the thread-like, linear ad-
hesions which occur in health and depend upon
anomalies in development. These latter are quite regu-
larly arranged and are to be considered as medianaccessory
ligaments to the anterior and transverse accessory liga-
ments of the posterior surface. The quantity of the
purulent deposit in the arachnoid spaces varies, often it
is so insignificant as to be scarcely perceptible. Espec-
ially in the older cases is an absence of pus deposits ob-
served with secondary hydrorrhachitis or hydrops ex-
vacuo and cloudy punctated or thread-like streaks
upon the pia of a pale greyish hue. Sometimes fresh
exudations are found at the base (Fischer and Hoffman)
without any extension of the disease from the base
upwards and this in those cases even where brain symp-
toms were only observed subsequent to spinal symptoms.
These circumstances meet with easy explanation by the
fact that brain symptoms only manifest themselves when
the accumulation of pus can no longer sink into
the araclinoid cavities. It is hemmed in, then, by the
limitation of spinal space and accumulates in the cranial
cavity to induce first symptoms of irritation subsequently
symptoms of depressions; we are not necessitated there-
fore with Fisher and Hoffman to regard this condition
as an exception to the rule that the primary inflamma-
tion always begins in the brain.
In the most recent cases, tough, thready, yellowish or
greenish-yellow masses are found deposited in the
212
[MAY 4, 1872.
TIEEE IED C T , T N T C - ".
arachnoid spaces resembling in appearance many forms
of catarrhal nasal mucus and thickly crowded, round
granulated cells usually with a single nucleus contain-
ing mucin (Virchow) and sodium albuminates. These
mucous contents in which the usual elements of pus are
absent, but which have been recognized by Hoppe
Seyler in the ventricular purulent fluid of hydrocephalus
internus, causes the reticulated arachnoid to resemble
the mucous tissue of the umbilical cord. In the
ventricles Klebs found the same tough, yellowish, puru-
lent masses only exceptionally; generally only a Some-
what increased, easily troubled [i. e., made cloudy]
fluid with occasional fibrinous clots but without pus
corpuscles. The origin of the arachnoid pus is to be
sought unquestionably in the few cells which the arach-
noid in normal conditions contains in the connective
tissue reticulae of the subarachnoid spaces. The epithe-
lial lining of these cavities claimed by Luschka, Klebs
has not been able to discover although the free, rounded
or angular cells, floating in the fluid resemble epithelial
cells in appearance. The rare occurrence of pus in the
ventricles is explicable, according to the author, by
the fact that the ependyma is as little inclined to sup-
puration as is the epithelium of the choroid plexus and
a de novo development of pus cells from other immigrated
cells is as little credible as is equivocal generation else-
where. This immigration is possible, however, along the
tract of the velum chorioides and in the further course
of the lateral plexuses or from the plexus chorioides
cerebelli as the arachnoid spaces seem to be in commu-
nication with the fourth ventricle.
b. Alterations in the Substance of the Brain and Cord.
The changes of substanoe consist in an often very ex-
tensive softening, or in a real purulent encephalitis or
myelitis. The softening so particularly emphasized by
Rollet is encountered more especially in the older retro-
grade cases and consists in an Oedematous Saturation of
tissue. The white substance has a gelatinous promi-
nence on section and even when hardened in chromic
acid is not capable of being divided in sections, falling
apart in numerous radiated fissures from the filling of
the perivascular lymph spaces (His) with serum. Any
increase of cells or division of their nuclei is nowhere
perceptible. By the imbibition of this fluid the nerve
fibres become varicose and the nervous substance
loosened in this way separates often large plates of
cholesterime while else only very small crystals are formed
The extensive motor disturbances which are occasionally
observed with only an insignificant accumulation of
pus in the arachnoid cavities would seem to stand
in connection with this process of softening. Still
we are not justified in regarding this condition
with Rollett as a special form of disease. The cause of
the occlema lies in the local formation of pus or its accu-
mulation, to the degree of which it corresponds quite
closely. It is not to be regarded, however as a simple
maceration from the contact of the pus, as just at the
base of the brain where the largest accumulations of pus
exist, no softening is observed. Moreover, contact of
the brain substance with pus for several days does not
induce more extensive softening than when this contact
does not exist. Different from this oedemations softening
is the so-called granular softening in the course of the ‘’
smaller blood-vessels, in the white substance of the
cerebrum as intimated by Lévy and Corbin and more
accurately described by Tholozan. This is a yellow or
white softening and is associated with the development
of granulated cells. Just as different from this condi-
tion is that appearance of disseminated purulent
infiltration which depends upon embolic processes, is
thus a true encephalitis granularis. These embolic pro-
cesses are to be regarded as products of a complicating
endocarditis which is, however, of rare occurrence as is
any participation of the heart in meningitis though it
has been mentioned by different authors, especially the
French. In 71 cases of brain disease, Klebs found only
two cases of this class. In the one case there were
numerous abscesses in the white substance, the conse-
quence of a gangrenous pneumonia, in the other
abundant sclerotic patches were observed which consisted
of very homogeneous, resistent, areolated connective tis-
sue without a trace of nervous elements.
(This individual suffered with chorea, a disease whose
connexion with heart affections Addison and Kerkes
more particularly have demonstrated. This fact may
be of significance in explanation of the symptoms of
chorea. The products of inflammation of the valves, de-
tached and carried off into the blood current, would
plug the capillaries of the middle layer of the cortical
substance and entail in this manner disturbances in the
connexion between the cortical substance and the motor
centres).
2. Pathological Alteraticns of Other Organs.
Changes in other organs are scarcely mentioned at all
in the older reports although they are constantly present
and are of the greatest importance in the interpretation
of the process of the disease.
In several rapidly fatal cases Klébs found small, scarce
pin-head sized, bluish extravasations in the upper-
most layer of the Corium and generally in the course of
a sudoriparous gland. The connective tissue at these
places showed a [no 71 process of proliferation, very like
the most recent formations of similar character in the
brain. How much the changed condition of the blood,
how much the condition of the vessel walls contributed
to the formation of these petechiae is still a question of
doubt. The French, it is true, lay the most stress upon
the first of these conditions as they found usually an in-
creased quantity of fibrin in the blood [due to their
copious venesections?]; but in the most of the rapidly
fatal cases the blood is found dark, fluid and poor in
fibrin as in typhus and other so-called infectious dis-
€3SeS.
Of much greater importance are the changes in the
MAY 4, 1872.]
TIEEE IEH C T , ITN. T. C.
213
great glands of the abdomen and in the muscles.
The Spleen is usually tolerably small, very lax, the
pulp a dark grayish-red, the follicles small and scant
or rather numerous and enlarged. It was only in the
perfectly recent cases that a soft fresh spleen tumor of
any size was encountered, and it is questionable, there-
fore, if the lax forms were not already in process of
retrogression, if there was not a spleen tumor present
before the manifestation of meningitic symptoms.
The kidneys are rarely enlarged, somewhat more relaxed
than usual, the capsule is easily separable, the surface
smooth, gray or grayish-red with darkly injected venous
stars (in recent cases); the cortical substance, on Section,
is of cloudy, grayish-red hue, sometimes (even as Soon
as the fifth day) pale, grayish-yellow, translucent; the
medullary substance is sharply distinct, usually mark-
edly congested. The tubuli uriniferi often contain very
many fine fat cells so that they are dark by transmitted,
bright by reflected light. Degenerated in like manner
are the thicker coils in the medullary substance border-
ing on the cortical, while the finer loops and the straight
tubules remain free or contain only fibrin cylinders or
casts. In many cases, moreover, marked catarrh of the
papillae is observable, but nowhere is any increase of
the cells demonstrable. -
The liver shows a similar parenchymatous degenera-
tion with granular, albuminous or fatty cloudiness of
the cells. This organ is not at all or only but little en-
larged, very lax, on section of a uniform dirty grayish-
yellow or grayish-brown color, dry as if boiled, showing
a great similarity to the liver of typhus abdominalis.
The voluntary muscles early show affection extremely
extensive in character. In recent cases their fibres
exhibit fine granular deposits so that they would seem
to be strewed or filled with an extremely fine dust.
This fineness of the fat molecules differentiates this dis-
ease from the muscle changes in other toxic affections
and seems to influence also their gross [macroscopic,
naked eye] appearance. While in phosphorus poison-
ing, the muscles are of a dirty grayish-red pale color; in
carbonic acid poisoning, cherry-red; in typhoid fever,
dry and dark violet-red, in epidemic cerebro-spinal
meningitis, they are less characteristically colored being
somewhat dry, lax and brownish-red. In consequence
of this degeneration, the contractile substance seems to
disappear, and such a degree of emaciation ensues as
Scarcely occurs in long continued and exhausting dis-
eases. In protracted cases this atrophy is attended with
an exuberation of the cells of the connective tissue
leading to suppuration and abscess formation similar
to that of poisoning by carbonic acid gas but
Without the subsequent necrosis of muscle snbstance.
The muscles of the heart show a similar, but altogether
much less degree of fat infiltration; the heart is usually
lax, its substance is grayish-red.
The changes of other organs are much less constant.
The lungs in recent cases usually show a marked
hyperamia, even splenisation of the deeper portions;
in later stages often patches of broncho-pneumonic
inflammation.
The lymph glands are usually reddened, else normal;
the solitary glands of the intestine are often moderately
swollen.
Disturbances of sight and hearing seem to occur more
in the later stages and as sequelae. They fall rather into
the department of the clinician than in that of the
anatomist. Only in one case, where deafness developed as
early as in the course of the first few weeks did the oppor-
tunity present of investigating its cause. In this case both
auditory nerves were extremely soft, Oedematous and of
a white color. Under the microscope these nerves and
their terminal apparatus, in which Gerhardt thinks to
find the cause of deafness, were perfectly normal. The
cavity of the drum, however, exhibited the remains of
an extensive otitis interna in the shape of numerous,
firm, vascularised, tensely stretched bands of connective
tissue extending out from the bones of the ear in every
direction, to the walls of the cavity and rendering the
bones immobile. Such a condition as this, according to
Lucae, is of itself sufficient to produce deafness of high
degree.
-—sº-o-º-
G E N E R A L C O N C L J S H O N S .
&
After a Thorough Review of all the Works on the
Subject of Cerebro-Spinal Meningitis up to 1867.
IBY
DR. H. MEISSNER, (Leipsic).
Trom Schmidt’s Jahrbücher, Vol. 167, 1867, p. 123.
From all the observations hitherto recorded, it follows
that epidemic cerebro-spinal meningitis shows in the
different places of its occurrence an extraordinarily
different form. While in places, as in the orphan
asylum at Vienna, it occurred in considerable extension
but with little violence and in other places as in
Einbeck extended over a whole population, it presented
itself in still other places in scattered or perfectly isolated
cases so that an epidemic basis could be recognized
simultaneously in distant regions. An individual pre-
disposition is, in general, not to be denied. Preferably,
in many instances almost exclusively, it attacked
children; yet there have been epidemics in which only
adults, soldiers, etc., have suffered. Most authors ob-
served the disease in individuals else perfectly sound; a
few on the other hand more especially in weak and
sickly persons. The general sanitary condition of popu-
lations attacked, according to some was unusually
good, according to others there prevailed at the same
time other epidemics, measles, scarlet fever, diphtheria,
rheumatism, intermittent, typhoid even recurrent fever
in such manner that they seemed to stand in more or
less intimate connection with each other.
214
[MAY 4, 1872.
TIEI IEH C T , T INT I. C.
Climatic and other telluric influences are, in general,
denied; yet the cold season exercises usually a definite
influence on the outbreak of the disease, and Dr. Karg
believes that by maintaining the temperature of children
and by preventing the influence of certain changes that
he allayed the epidemic in Vienna.
Of most significance in influencing an outbreak if not
in inducing the disease are unfavorable hygienic circum-
stances of every kind, over-crowding in badly ventilated
places, the circumstances of poverty; the prevalence of
the epidemic in winter, in certain institutions, among
the lower classes, the military, etc., is to be partially
explained in this way. *
The symptoms and anatomical changes in other
organs are referred by some [Klebs and others] without
exception to the local disease of the envelops of the
nerve centres, by others, on the contrary, in part, at
least, to a general cause. With such a difference in
the facts and views cited, it is not strange that there.
should be such difference of opinion as to the entity of
the disease. Klebs believes in a local disease of the
brain and cord caused by atmospheric and hygienic con-
ditions as in pneumonia which sometimes assumes an
epidemic character, while most authors certainly hold
fast to the originally constitutional origin of the disease
and its development by infection.
As a symptom of constant observation in Neuter-
shausen, not yet observed elsewhere, Baur emphasizes
pain along the tensely stretched carotids. Further,
attention is called by many authors [Mannkopff, Klebs
and others) in opposition to Niemeyer, to a constant
enlargement of the spleen, subsequently followed by its
relaxation and atrophy. Finally we may mention here
the polyuria observed by Ziemssen and Hess, and the
gyclosuria noted by Mannkopff as signs of an alteration
of the fourth ventricle and its vicinity.
In the pathological anatomy of this disease, numerous
new and notable results have been furnished by micro-
scopic investigation.
The pus in the meninges which collects in the
arachnoidspaces in the form of a thready, yellowish-green,
mucous mass is characterised according to Virchow
(Klebs) by containing mucin which is not usually pres-
ent in pus and has only been detected by Hoppe-Seyler
in the fluid of the ventricles. In the organizing exuda-
tion Orth has observed granule formations which might
confound the appearances with tuberculous meningitis.
Klebs explains the presence of pus in the ventricles by
immigration from other places as no pus can be devel-
oped from the ventricle walls. Mannkopff found pus in
the central canal. Of particular value in connexion
with the extreme hyperaesthesia of the whole surface
are the changes in the neighborhood of the posterior
nerve roots Rabus observed pus in them and in the
spinal ganglia: Ziemssen, once, a cheesy exudation in
the same places: Orth, new formations of connective
tissue in the dura-mater spinalis about the posterior
nerve roots. Orth always observed considerable fluid
in the spinal Sac and hydrorrachis is also noted by Klebs.
Mende mentions fatty degeneration of the brain itself
and granular destruction of many parts of the brain;
Köllner, amyloid degeneration and pus cells with fibres
of connective tissue occurring in masses.
As to the condition of other organs the parenchym-
atous degeneration of the liver and kidneys, the
granular degeneration of the muscles (Klebs) and the
cloudiness of the heart muscle fibres are to be specially
noted. Finally concerning diagnosis, it is to be remarked
that the sporadic form cannot by any means always be
certainly differentiated from the epidemic form, that
mistakes with tuberculous or meningitis from caries are
easily made and that the supervention of the disease
upon a previous injury may be of forensic importance.
– sº-º-º-
MEDICAL NEws
MENINGITIS IN NEw York.-Cerebro Spinal-Men-
ingitis is now quite prevalent in New York and vicinity,
and threatens to become epidemic. Cases are also re-
ported in Buffalo.
SPOTTED FEVER IN BROOKLYN.—There were fifteen
deaths from spotted fever, in Brooklyn, week before
last.
—sº- ©-º-
CORRESIPON OPENCE.
SoLON, IoWA, APR. 24.
EDS. CLINIC:
We are having a fatal epidemic of “Cerebro-Spinal
Meningitis.” Our efforts are of little avail in its treat-
ment. Please give usan article on this subject in “THE
CLINIC.” It will be hailed with joy by all its readers,
especially where this fearful disease prevails.
I am very respectfully yours.
G. D. Darnall, M. D.
—e---
CLINICAL MEMORANDA.
The Temperature of Cerebro-Spinal Meningitis.
BY
EDWARD LoNG Fox, M. D.
From the Med. Times and Gaz., April 2, 1870.
In this disease we lose the general regularity of ther-
mometric phenomena met with in the maladies pre-
viously mentioned. In the three cases tabulated with
this paper, and given me by my friend Dr. Edward
Collins, of Dublin, the variations of temperature are
exceedingly striking. In Case 25, Ellen D., aged 16,
MAY 4, 1872.]
215
admitted on the fourth day with a temperature exceed-
ing 104°, the thermometer seemed to show a descending
course from the sixth day to the thirty-fifth, when she
left Medical observation, having lost the left eye, and
having become totally deaf. But, during this course of
thirty-one days, the temperature had, on several oc-
casions, manifested considerable exacerbation for the
space of twenty-four hours at a time. In Case 26, John
D., aged 10, not admitted until the twelfth day, the
disease throughout assumed an irregular remittent type,
differing very much from the former case, and death
ensued with a temperature of collapse 94, 2–5ths”; whilst,
in Case 27, W. H., aged 22, death occurred at the end
of the first week, with a temperature above the normal,
but not higher than is usually seen in tuberculous men-
ingitis. This case bears out Dr. Sanderson's observa-
tion that the temperature is elevated even in the early
stages. The temperature was noticed by Dr. Sanderson
as constantly elevated at all stages of the disease, seldom
falling below 100°Fahr. The highest point was just at,
or immediately after, the close of the symptoms of in-
vasion—viz., 103° to 104°, or higher in children. Sub-
sidence of pains and general improvement were always
coincident with lower temperature, and vice versá. This
point was especially marked in Case 26, where the con-
stantly occurring remissions coincident with temporary
general comfort and relief of all distressing symptoms
were very remarkable.
Niemeyer, who, with Dotzauer and Lindrum, holds
strongly the local theory of the disease, states that, in
his experience, the temperature on the first and second
days was often but slightly raised. It was only a little
while before death that it rose as high as 104° or more.
It is impossible to speak definitely of an ascending, a
stationary, and a descending period in a disease that
not only varies exceedingly in duration (from a few
hours to many weeks), but also in its tendency to remis-
sion and exacerbation. The only point that, with some
exceptions, seems generally to have been observed, is
that the acme is not reached until after the symptoms
of invasion are over. An irregular defervescence may
commence immediately, or may be delayed for several
weeks, during which interval a middle period, that can
scarcely be called stationary, is met with, with a ten-
dency in the temperature to remit to the extent of four
or five degrees, but to rise again to the maxim point, or
Very near it.
Wünderlich distinguishes three chief varieties of this
disease—one rapidly fatal, and showing a very high
temperature shortly after the commencement of the ill-
ness, which is maintained for several days, and is still
further raised at the moment of death, even to 108°.
Post-mortem elevations may also occur in this form.
Secondly, a light form, with fever of short duration,
though often of considerable intensity, and with very
irregular course. Defervescence occurs more or less by
crisis, but with some exacerbation. Thirdly, a more or
less protracted variety, in which the height of tempera-
TIE-ITEH C T , I INT T. C.
ture varys considerably. This irregularity is considered
by Wünderlich to depend on successive complications
of disease of the bronchi, the lungs, the intestines, the
serous membranes, etc.
The distinguishing phenomena, therefore, as regards
temperature, will be (first) its great irregularity; (sec-
ondly) its maximum point being in most cases below
that of typhus, enteric fever, and scarlatina; and
(thirdly) its relation to the pulse.
Ziemssen says that the temperature is so irregular
that few of the curves resemble each other, and Dr.
Bäumler has made a similar observation. The experi-
ence of the Philadelphia epidemic was that the tempera-
ture was lower than in any other typhoid condition;
and in the Irish epidemic of 1867–8 it was comparatively
low, and in one case mentioned by Dr. Stokes the high-
est temperature recorded was 98.8°.
Dr. Sanderson found that, with high temperature in
this disease, the pulse assumed the character of less
arterial tension, but there was no discernible relation
between its frequency and the stages of the disease,
though the pulse rate fluctuated from time to time.
Wünderlich observes that during the pyrexial periods
of the disease the pulse is at or below the normal fre-
quency, and only becomes quicker when the tempera-
ture has become normal, and similar observations were
made in many cases in the Irish epidemic of 1867; but
the opposite condition is often met with. Indeed, Dr.
Collins found its frequency in almost every case greater
than natural, and he states that its frequency, its force,
its volume, its regularity, and other qualities are subject
to repeated and often inexplicable changes. In the
three cases noted with this paper the frequency of the
pulse bore a general relation to the height of the tem-
perature, with occasional exceptions.
Death, which occurs most usually from apnoea, is ac-
companied by a high temperature in the majority of
cases; but instances do occur in which the fatal event
is ushered in by the temperature of collapse.
The irregularity of temperature alone will serve for
the diagnosis of this disease; but with the additional
symptoms of cerebral respiration, vomiting, the peculiar
position in which the patient lies, the delirium, and in
some epidemics the eruption, a mistake will seldom be
made, except in those very rare instances in which the
temperature Somewhat simulates that of enteric fever.
The general irregularity will help to distinguish it from
typhus, of which disease Dr. Murchison considers
cerebro-spinal menigitis only a form. The main diffi-
culty is between this disease and some forms of acute
tuberculosis; but patients suffering from the latter
malady do not often experience that relief from distress-
ing symptoms during the remissions of temperature that
is so remarkable in cerebro-spinal menigitis. It must
be confessed, however, that, in rapidly fatal cases, neither
the temperature nor any aggregation of symptoms will
suffice to distinguish this disease from some examples of
tuberculous meningitis,
216
[MAY 4, 1872.
T IEEE TEE C T , T INT I C.
QUININE AND OPIUM IN SPINAL MENINGITIS.—Dr.
C. W. Packard details the clinical history of several
cases concluding with the follwfng remarks:
The diagnosis of this case presented some points of
difficulty. In many respects the symptoms resembled
those met with in remittent fever occuring in a person
of strong hysterical tendencies. Throughout the disease
she had a fixed and placid expression of face, and looked
as if she would get well. On the other hand, she had
only one decided perspiration during her sickness, and
quinine in large doses had no effect in checking the ex-
acerbations of fever. For example, on February 15th,
the morning temperature had fallen to 98°; twenty
grains of quinine were given and retained, and the
evening temperature rose to 105°. On the following
morning the temperature was 100°; the quinine was re-
peated, and the evening temperature was 104.”
After this no medication was attempted beyond the
exhibition of an opiate at night when the patient was
very restless or delirious, the opium having been found
to act more efficiently than any of the ordinary Substi-
tutes.
The quieting effect of opium was still more marked in
the case of the boy above reported. Here the tr. Opii
was given in five-drop doses every hour, and its effects
carefully watched. There is no doubt in my mind that
for twenty-four hours it so far steadied the nervous sys-
tem as to stop the convulsions, and control the irregular
action of the pupils and of the heart. Full narcotism
was not produced at any time, the pupils being only
moderately contracted, and the respiration even less
than 30 in a minute.—N. Y. Med. Rec., Apr. 15, '72.
MORPHIA HYPODERMICALLY IN CEREBRO-SPINAL
MENINGITIS.–Morphia has been used in this way in the
treatment of cerebro-spinal meningitis by Traube, Bois,
Lorent, Niemeyer, Ziemssen and Hess, Thomas, and
Neynaber.
In one case characterized by pains in the sacral region
and in the lower extremities, the injections were made
by Traube into the nates. Pain was silenced instantly.
The general condition, however, was always worse after
the injections; there was a still greater increase of the
sensibility. The intervals between pains were longer
and easier without it than with it. According to Traube
this depends upon the effect which opium always exer-
cises in acute inflammatory diseases, on which account
the use of this agent in this way is, in the rule, to be
discarded.
Bois, on the other hand cites a case in which an injec-
tion of 8 ctgr. morph... muriat. immediately checked the
extremely painful convulsions and brought the patient
into a deep sleep. Lorent saw the eccentric pains in
chronic spinal menigitis disappear transitorily.
According to Niemeyer subcutaneous injections of
morphia were made in the epidemic of Rastadt and
Carlsruhe as a palliative for the great restlessness and
jactitation. “In many cases the desired result seemed
to be obtained for a short time.” Ziemssen and Hess
used morphia both subcutaneously and per stoma; the
first more especially in the violent exacerbations and in
which a speedy effect was obtained. They never observed
any disadvantages resultant, on the contrary, such
marked palliative effects that it seemed, next to the
applications of cold, the most indispensable agent in
treatment. In the last session of the Society of Phys-
icians and Physicists, Thomas expressed himself in its
favor, Neynaber against it.—Die Hypoderm. Injection,
etc., Eulenburg, Berlin, 1867.
TREATMENT BY PHYSOSTIGMA.—Dr. N. S. Davis
(Chicago Med. Eacaminer, Apr. 1,) gives notes of treat-
ment in forty cases under his observation since Feb. 1.
From this paper we clip the following:
Recollecting that the Calabar bean had been used
with apparent success in tetanus, and that I had used it
with benefit in several cases of muscular rigidity from
irritation of the nervous centres, I made the following
prescription: -
JR.
Tinct Calabar Bean, 3f.
Fl. Eact. Ergot, 3.jss.
Mix. Gave half a teaspoonful every two hours, and
omitted all other medicines. At the end of twenty-
four hours the patient was found simply more quiet, the
pulse a little slower, and the respiration more regular.
The treatment was continued without change. At the
end of the second day the patient had ceased to com-
plain of pain in her head, had slept several times for
half an hour to an hour; the retraction of the head was
decidedly less; mind was clear; the mouth moist; and
the urine free; but she seemed feeble. More simple
nourishment was ordered, and the medicine continued
at intervals of three hours. The case continued to steadily
improve; and on the fifth day after the commencement
of the use of the Calabar bean and ergot, the muscular
rigidity had entirely ceased, and the patient was con-
valescent, though emaciated and feeble. The
medicine was continued three times a day several days
longer, and a combination of extract of malt and the
compound syrup of hypophosphites, in addition to nour-
ishment, were given to aid in restoring nutrition and
strength. Since that time I have used the Calabar
bean, either alone or in combination with ergot, in
nearly all the cases that have under my care, and cer-
tainly with more apparent effect in controlling the dis-
ease than by any other remedies I have tried.
RECOMMENDATIONS OF THE AMER. MED. Assoc.
COMMITTEE.—A Committee of the American Medical
Association reported favorably on the sulphate of quinia
in large doses, given at the very beginning of the
disease. In some instances the drug seemed to abort
the attack. The committee speaks also of the favorable
results reported from the combined use of ergot and
chloride of iron. Some American physicians have given
ergot in combination with belladonna, and belladonna in
combination with quinine, but with equivocal benefit.
Mercurials have been freely used, particularly in the
form of calomel, but their effect has been most question-
able, except as purgatives. Their indiscriminate use is
to be utterly condemned, and their use at all to be dis-
countenanced. A host of other medicaments have been
made use of, of which it is requisite to note only iodide
of potassium, bromide of potassium, and arsenite of potash.
The circumstances under which the two former drugs
have been used, and are most likely to prove beneficial,
will suggest themselves to the practitioner. It does not
appear that any decided good has arisen from their
administration. In protracted cases of convalescence the
arsenite of potash may prove a valuable remedy.
COLLEGE ANNOUNCEMENT.
THE SPRING COURSE closes Friday, May 10. The regular
attendance of the class [85 in numberl throughout the entire
term is the best evidence of the appreciation of the practical system
af instruction. A fine lot of most beautiful microscopic preparations
from abroad—again the private munificence of a citizen of our city—
is gratefully acknowledged as having contributed no little towards the
interest of this part of the course, and as constituting a valuable
addition to the College Museum.
THE DISPENSARY SERVICE will be continued throughout the
summer at 9–11 A. iſ, to which medical vior. to the city
are at all times cordially invited, and on sp. 1, -'72, A
SPECIAL COURSE on Microscopy, Electrotherapy, Bandaging, etc.,
will precede the regular winter session which commences on the
first Monday in October newt.
J||NF||RTS,
\P/
Carriage Manufacturer,
Nos. 9 and 11 East Sixth Street, bet. Main & Sycamore.
I MAKE NOTHING BUT
First czass wronx,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of -
LIGHT FAMILY CARRIAGEs
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to
PHYSECHANS” GSE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose. -
The superiority of my light gentlemen's
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price s
tº g lication. Ref S &s // * - F
lists furnished on app º € * <\º
Ny to Dr. W. W. Dawson and all the leading º s
Physicians in the city and heighborhood.








List of Pharmaceutical Preparations,
NiANUFACTURED BY
Jonºv wrºzºr & arozzºn,
FHILADELPHIA.
- º,
ELIX PHOS. IRON, QUININE AND STRYCHNIA,
- ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA,
(Goddard’s Formula,) ... --
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Hron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
- ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Liime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
e º FERRATED CORDIAL ELIXIR,
ELIXIR, CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK, *
- FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
* - TASTELESS COD LIVER OIL,
TASTELESS CODLIVER OIL. FERRATED,
- * BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIE VALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUP SUPERPHOSPHATE OF IRON, y
* ELIXIR OF BISMUTH,
COMP. FLUIDEXT, EUCHU AND PAREIRABRAVA.
sIJIPE*Os][TOE&LEs.
Bectum, Vaginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and style, made of finest quality of sponge.
William Autenrieth,
ROBERT CLARKE & GO’S.
No. 71 wrest sIxTH strºr,
BETWEEN WAINUT AND WINE,
CINCINNATI, OHIO,
MANUEACTURER OF AND DEALER IN
III || || |||||III,
Abdominal Supporters, Trusses,
CTUB-FOOT SHOES,
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
Metalic and Eubber Syringes,
Storm.ach Purm ps, Etc.
STOCKINGS FOR WABDCOSE WEDNS,
Scoeial attention given to the fitting of Apparatus for Deformities.
gº Agent for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
-ALSO–
DR. AHL'S POROUS FELT SPLINTS,
—A LSO–
DAY's spi, INTs
-AND-
THE AMATEUR MICROSCOPIST. Small 4to.
LIST of New . . .
- - º
MHL iBTH in Mºulis inſ;
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5o
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN'S DIS-
EASES. 12mo. $1 75 •
BENNETT ON PULMONORY CONSUMPTION. 8vo. $1 5o
FIRST HELP IN ACCIDENTS. 12-mo. $1 5o
BEASLEY'S DRUGGIST RECEIPT Book. 8vo. $3 50
ECHEVERRIA ON EPILEPSY. 8vo. Cloth. $5 oc -
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASES. 8vo. $5 bo
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 od Leather. $6 oo --
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth. $2. 5o
TANNER'S HANDBOOK OF OBSTETRICS. 12mo. $2 oo
WAN BUREN ON DISEASES OF THE RECTUM. 12mo.
Cloth. $1 5o
FLINT’S EXAMINATION OF URINE. 12mo, Cloth. $1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 5o
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRICITY. 8vo. Cloth. $4 50
ATTFIELD'S MEDICAL CHEMISTRY... 12mo. Cloth. $2. 75
Leather. $3 25
BARTHOLOW’S HYPODERMIC MEDICATION.
Cloth. $1 5o
TURNBULL's DISEASES OF THE EAR. 8vo. Cloth. $5 od
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 od
NEUMANN'S HAND-BOOK OF SKIN DISEASES.
. Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 oo.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $10 oo
HOOD ON BONE SETTING. 12mo. $1 50
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo
HOLBROOK's PARTURITION witHouT PAIN. 16mo.
I 2, IITO,
8vo.
- $1 oo gº
PROCTER'S LIGHT SCIENCE FOR LEISURE HOURS.
12mo. $1 75
BERNARD's PHYSIOLOGY OF THE HEART: 50 cts.
BARNES’ OBSTETRICAL OPERATIONS. 8vo. $4 50
NICHOL’S FIRESIDE SCIENCE. 12mo. $1 50.
WOHLER'S MINERAL ANALYSIS. 12mo. Cloth. $3 oo
PLATTNER'S MANUAL OF ANALYSIS WITH THE
BLOWPIPE. 8vo. Cloth. $7 50
JEFFRIES ON THE EYE. 8vo. Cloth. $1 oo
MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
JEFFRIES ON THE SKIN. 8vo. Cloth. $1 oo
GARDENING FOR PROFIT. 12mo. Cloth. $1 5o
PRACTICAL FLORICULTURE. 12mo. Cloth. $1 5o .
FULLER'S SMALL FRUIT CULTURE. 12mo. Cloth. $1 5o
WOODWARD'S COUNTRY HOMES. 12mo. Cloth. $1 50
DARWIN'S ORIGIN OF SPECIES. 12 mo. Cloth. $2 oo
ARTHUR'S TREATMENT AND PREVENTION OF DE-
CAY OF THE TEETH. 12mo. $1 50
TYNDALL ON LIGHT AND ELECTRICITY. 12mo. $1, 25
$1 75
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMEN.
ROBERTS ON RENAL DISEASES.
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN. -
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by mail or express, free of charge
on receipt of price.
*
S. W. EHiott’s Saddle=bags
65 West 4th Street, Cincinnati, Ohio.
O. D. O. R. L.E. s.s A.N. D. P. A. L.A.T A. B. L. E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLWTT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. - -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded. -
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
Volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c. *
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only. &
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

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CINCINN ATI.
--~~~
E" A. C. TCſ L T Y .
J A M E S G. F. A. H. A. M., M. D., DE AN,
Professor of the Theory and IPractice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomy. Professor of Medical and Surgical Liseases of Women.
P. S. CONNER, M.D., | - T. A. REAMY, M.D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
JAMES T. WHITTAKER, M.D., JOHN L, CLEVELAND, M.D.,
I’rofessor of Physiology. Demonstrator of Anatomy.
SAMUEL NICKLES, M.D., CHARLES KEARNS, M.D.,
Paofessor of Physics and Medical Chemistry Assistant to the Chair of Surgery
* W. VV. SEELY, MI. D.,
IProfessor of IDiseases of the Eye and Flar, and Secretary of the Faculty
,--~
E. NoblE, Janitor, College Building, Sixth St., bet. Vine and Race
—ms.
T. Louis Brows, M.D., Prosecutor of Anatomy.
-ms-
Printed and Published by Non R1s & M URRY, Medical College of Ohio Building, Cincinnati.


HE CLINI C.
PUBLISHED EveRY SATURDAY.
T E R MS-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editof $
w All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer,
vol. 2. C IN C IN N A TI,
tº º ºs Editor.
JAS. T. WHITTAKER, M. D.
No. 101 West Ninth Street, Cincinnati,
_A_SSO C.I.A.T.E. EIDITOIF.S. -
W. W. D.Awson, M. D. THAD. A. REAMY, M. D.
P. S. ConneR, M. D. . C. D. PALMER, M. D.
W. W. SEELY, M. D. SAMUEL NICKLEs, M. D.
CHAs. KEARNs, M. D. JNo. L. CLEVELAND, M. D.
RoberTS BARTHoLow, MI. D.
W. W. SEELY, M. D., - * ~ * sº tº * > TREASURER.
No. 118 West Seventh Street, Cincinnati.
C L J B R A T E S,
4 Copies to one address * * * * * * * * * * * * * * * * * * $ 7.00
6 & 4 & & 10,00
12 § { “ -------------------------------------................. 18.00
C O N T E N T S.
*== Page,
or IGINAL ARTICLEs
Surgical Clinic of Prof. Dawson............ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ......217
Progressive Muscular Atrophy by Wm. Carson, M. D....... tº a tº e º s e º ºs e º ſº e 218
ACA DEMY OF : M IEEEDICHN. E. .
Transactions May 6, ’72.
Cerebro-Spinal Meningitis.-Corrections—Cases by Drs,
Thornton and Muscroft.—Specimen by Dr. Reamy.................. 219
TRANS LATION
Torticollis, Clinical Lectures at “La Pitie” by Prof. M. Broca,
Paris. (From the Revue Photographique Mars, '72.)......'........220
SC HENTIFIC NOTES
So-Called Tobacco Amaurosis—Iostorfer's Syphilis Corpuscles—
Changes in the Cord after Amputation................................. 222-225
MEDICAL NEws.
Brown-Séquard—Life Insurance Fees—Circumcision in The-
ology—The Importation of Opium—A Turkish Medical Journal
-Virchow Peripatetic—The Jugulated Colleges—An Oppor-
tunity—Medical Senators—Professional Prerequisites—The
Promotion of Medioricty................................ * = e s = * * * * * * * * tº a s 4 & a º 225-226
- CORRESPONDENCE
Letter from Dr. Reeve—A Point in the Diagnosis of Uterine Polypus,.226
CLINICAL MEMORANDA .
Guarana in Sick-Headache—The Condition of the Labyrinth in
Cerebro-Spinal Meningitis—Chloral in Venereal Ulcers—The
Treatment of Croup—Opacities Tattooed—Treatment of Impo-
tence—The Significance of Womiting in Hernia—Cheiroplasty–
The Diagnosis of Hysteria.................................................. 226-28
HOME NEWS......,................ • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 238
American Medical Association
Dr.
I
* * * * * * * * * =s===
-—º-—-s—s. &
The singular cerebral, etc., changes wrought by that
štrºnge...condition of the cervical muscles, known as
tortigollis (wry-neck), are discussed in full in our chief
translation to-day. * .
...Friends to medical progress will be gratified to read
9f the continued and success promising investigations
*º the syphilitic corpuscles of the blood.
The changes in the cord incident to the destruction
of the nerves are of highest scientific interest. #
Under clinical memoranda we would call special
attention to the notes on sick-headache and on the
*gnificance of vomiting in hernia.
&
~&
11, No. 19.
M A Y 1872,
co.,&xº te Co-
Fashionable Hatters,
IMPORTERS AND MANUFACTUREHS 0F
E.ABEES” Eºs,
92 WEST FOURTH ST.
Opposite Post Office,
* CINCINNATI.
ºf Special Inducements to Medical Men-
J. TAFT, W. T.A.F.T.
Editor Dental Fregister
J. & W. TAFT,
TIENTISTS
117 WEST FOURTH STREET,
CHN CIN NATI, O.
The Dental Registers
A. Monthly Journal,
* Tº
e
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,



List of Pharmaceutical Preparations,
MANUIFACTURED BY
Jø/ZW WºZAZ & ZººZººZºº,
Flººr. Arººrºº’EHCIA-
_ºf_h-
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA,
(Goddard’s Formula,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK, *
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
FERRATED CORDIAL ELIXIR,
ELIXIR, CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK,
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
º BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry Wine,
ELIXIR WALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUP SUPERPHOSPHATE OF IRON. 9
ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRA BRAVA.
sū PEPO's ITOERIEs.
Rectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TENTS,-For the Urethra, of every size and 8tyle, made of finest quality of sponge.
William Autenrieth,
No. 71 WEst, sIXTH st"EREET,
BETWERN WALWUT AND WINE,
CINCINNATi, OHIO,
MANUFACTURER OF AND DEALER IN
|||}|| || || ||||||||
Abdominal supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
Motalic and ERubber syringes,
Storm.ach Pumps, Etc.
STQCKINGS FOR WARD (COSE WEDNS,
Special attention given to the fitting of Apparatus for Deformities.
B& Agent for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
-ALSO–
DR. AHL's POROUS FELT SPLINTS,
- ALSO–
D A. Y. * S S E LIN T S
-AND-
ROBERT CLARKE & G0°S,
I,IST OF NEW
Mill, #III: | MBHull; Hill;
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5o
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN'S DIS-
EASES. 12mo. $1 75
BENNETT ON PULMONORY consumpTION. 8vo. $1 50
FIRST HELP IN ACCIDENTS. 12mo. $1 50
BEASLEY'S DRUGGIST RECEIPT Book. 8vo. $3 go
BCHEVERRIA ON EPILEPSY. 8vo. cloth. $5 od
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASEs. 8vo. $5 od
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 od Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth. $2 5o
TANNER'S HANDBOOK OF OBSTETRICS. 12mo. $2 oo
WAN BUREN ON DISEASES OF THE RECTUM. 12mo.
Cloth. $1 5o e
FLINT’S EXAMINATION OF URINE. 12mo, Cloth, $1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth, $4 5o
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRICITY. 8vo. Cloth. $4 50
ATTFIELD'S MEDICAL CHEMISTRY. 12mo. Cloth. $2.75
Leather. $3 25
BARTHOLOW’S HYPODERMIC MEDICATION. I 2 mo.
Cloth. $1 5o
TURNBULL's DISEASES OF THE EAR. 8vo. Cloth. $5 od
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 od
NEUMANN'S HAND-BOOK OF SKIN DISEASES. 8vo,
Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 oo.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $1 o oo
HOOD ON BONE SETTING. 12mo. $1 5o
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo
HOLBROOK’S PARTURITION WITHOUT PAIN. 16mo.
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RESPECTFULLY You Bs, g
E. S. WAYNE, Analytic Chemist.


T TH TET:
C T , ITNT I C .
217
S A T U R D A Y, M. A. Y 11, 1872. [No. 19.
Vol. 2.]
O R. I G IN A L A R T I C L E S.
S U R G H C A L C L IN II () .
OF
PROF. W. W. DAWSON.
Good Samaritan Hospital,
Castration—Hemorrhoids—Fistula in Ano–Excision of
Tonsils,
Castration—Indications for the Operation.
Reported by Tom. O. Edwards, Jr.
The patient presented to you has as you see disease of
the right scrotum—it is enlarged, and has on its front
aspect a fistulous opening from which exudes purulent
matter. A closer inspection shows you that this en-
largement is due to hypertrophy of the testicle, and
when I make pressure upon the gland there is an in-
creased flow of pus. What is the nature of this dis-
ease? He has a syphilitic history. Some months after
the disappearance of a chancre upon the penis he noticed
a change in the right testicle, it was not painful but
gave him rather a sensation of weight and uneasiness.
it was slightly enlarged and irregular in outline
These symptoms gradually and steadily increased, and
after a time the mere uneasiness gave place to positive
pain; suppuration was soon pronounced. The gland is
now enlarged, nodular, irregular in density and dis-
charging a thin vicious pus. The history of this man,
the course of the disease and the character of the tumor
leave but little doubt of the syphilitic nature of the
affection. It is difficult to distinguish between a scrofu-
lous and syphilitic degeneration of the testicle, so closely
are they allied in symptoms and tendencies; true, it
may be said that the primary seat of the syphilitic de-
Posit is in the testicle, and of the scrofulous in the
epididymus and was deferens, yet as the latter so soon
involves the gland we are left at last but the history of
the patient to guide us.
The disease here has not only destroyed the function
°f the testicle, but has rendered it an incumbrance,
filthy and unendurable. Medicine is powerless, Con-
*Vative surgery is worse than useless. Castration is
* only justifiable remedy; it is an operation easily
performed and unattended with danger. I make, as
you see, an incision over the front of the gland, first
rendering the skin tense by grasping the tumor from
behind; a few touches with the knife expose the testicle
and the cord. You may tie the cord in mass or isolate
its vessels and apply ligatures to them. Your incision
should extend well up towards the external ring that
you may have the cord completely in hand.
As the repair here is by granulation, sutures are not
generally used, but in this case I propose to try the
effect of carbolic acid in preventing suppuration and
in promoting an early union. I wash the wound with
a solution of equal parts of carbolic acid and water, and
bring the edges together by a few interrupted sutures.
Castration is such an abridgement of a man that it
should not be resorted to until all other means have
been fairly and faithfully tried, and here in connection
with this case I may briefly enumerate the conditions
which indicate the operation :
1st. Syphilitic disease, not where you have one or both
testicles involved in constitutional syphilis by a mere
| deposit of fibrinous matter in the connective tissue, but
where, like in this man before you, the degeneration of
the gland by the specific infection is complete, render-
ing its longer stay not only useless, but damaging to the
general health.
2nd. Scrofulous degeneration, those cases in which sup-
puration has destroyed the function of the organ.
3rd. Malignant disease, this when attacking the testicle
is usually of an encephaloid character. After you have
decided that the case is malignant, do not delay the op-
eration until the neighboring glands are involved, for
then your efforts will be as unsatisfactory as in other
regions where interference is postponed until the disease
is no longer local. The knife in malignant disease is
but poorly successful at best, the earlier however you
resort to it the more promising will be the prospects of
your patient.
4th. Non-malignat tumors of the testicle, cystic, fibrous,
fibro-cystic, enchondroma. In these non-malignant affec-
tions of the testicle, castration should only be resorted to
when the tumor interferes with health, comfort or con-
venience.
Hemorrhoids,
The patient before you has a large hemorrhoidal
tumor at the verge of the anus—it may be called a
mixed pile—partly external and partly internal. For
internal piles the ligature is used; external piles are re-
moved by the knife, but what is the proper treatment
of a case like this, involving or rather partaking of the
nature of both ? The ligature is advisable in this case,
for here, as in internal piles, hemorrhage is liable to
occur, and if it should, it would be difficult to manage.
I take as you see a needle armed with a long and strong
ligature, and after transfixing the tumor, strangulate its
two divisions. Remember these two points; you must
have your ligatures long enough to be wound around each
218
[MAY 11, 1872.
T THE EIB C T , I INT I.C.
hand and strong enough to allow of sufficient force to
strangulate the tumor completely.
Fºstula in Ano with Easternal Piles.
You see in this man a fistulous opening about one
inch from the anus. The anus is surrounded by small
external hemorrhoids. In examining this case I find a
sinus extending downward and towards the rectum—it
reaches to, but does not enter the bowel. This is what is
known in your books as incomplete fistula; it is the
sequela generally of ischio-rectal abscess. What is the
treatment 7 The division of the sphincter is the only
remedy. You may apply lotions, caustics, and stimulat-
ing injections to such a case for weeks and months with-
out avail—the constant contraction of the anal sphincter
thwarts you. In operating you convert this incomplete
into a complete fistula. I insert into the anus a piece
of soft wood—then introduce a grooved director through
the sinus down to the rectum, along this groove I pass
a narrow bladed knife and thrust it through the rectum
into the piece of wood—the withdrawal of both divides
the sphincter. The wound should be dressed with dry
lint. After thus dividing the sphincter I excise as you
see with these scissors the external hemorrhoids. The
scissors should be blunt pointed and curved on the flat
surface.
Eaccision of Tonsils.
This little patient, between two and three years of
age, has enlarged tonsils—with this exception the child
presents every appearance of vigorous health. The
hypertrophy of the tonsils is very great—the glands
almost meet in the median line, and whilst the general
health is not compromised, the presence of these large
bodies seriously interferes with the comfort of the child.
The hypertrophy of the tonsil is a kind of fibroid degen-
eration, the soft and delicate structure of the gland is
replaced by a deposit of more consistence, and through
this mass bands of fibrous materal interlace. A few
years ago it was the fashion to remove tonsils—then the
operation was performed scores of times where it is now
resorted to once—however slight the enlargement, the
knife was applied. No good but much evil followed
this liberal sacrifice of tonsils. A better surgery now
prevails. Where the enlargement is not so great as to
embarrass deglutition or respiration, the surgeon should
not interfere, but where, as in this case, the diseased
glands so encroach upon the isthmus of the fauces as
to amount to a positive obstruction, they should be
excised. º
The operation may be performed by seizing the tonsil
with the vulsellum forceps and dividing it with a
curved bistoury. I use to-day the guillotine. I depress
the tongue—place the instrument over the tonsil, trans-
fix the gland with a needle and by withdrawing the
concealed knife the operation is concluded.
I PROGRESSIVE IN ITUSCULAR ATROIP H (Y.
BY
WM. CARSON, M. D.
The History of and Remarks upon the Case of a Patient presented
to the Academy of Medicine, April 29, '72.
Morris O'Donnell, aet. 69, Ireland, widower, laborer.
Father died of an injury caused by lifting a weight.
Cause of death of mother and two brothers unknown.
One sister living and two dead of old age. Has been a
drinker during his life. Never had syphilis. Has had
measles, small-pox and remittent fever.
States that he took sick in September last with a pain
in both shoulders and arms, which came on after having
exposed himself by hard work, mowing grass and sleep-
ing outdoors on the new mown hay. After this, during
the winter, his fingers and hands became crippled, and
he felt a general weakness all over his body.
Present Condition. Of average frame, gray hair and
beard, and wrinkled condition of face. Skin warm and
moist. Flabby condition of muscles of arms, but no
pain. Flattening of ball of thumb of right hand and
also between thumb and first finger. Interosseous spaces
deepened. Forearm flattened, skin over outer side loose.
Circumference just above wrist 6 inches; middle of
forearm 7 inches; below elbow 7 and 7–8th inches;
lower end of humerus 7% inches, with elbow bent 8
inches over biceps; 84 inches at margin of axilla.
Biceps not apparent on bending the elbow, flattening
about the shoulder, acromion process well marked, flat-
tening and wasting of scapular muscles; palm of hand
and flexor muscles not so much atrophied.
Left arm above wrist 6 inches; middle of forearm 6%
inches; upper part just below elbow 7% inches; lower
end of humerus with arm extended 7 inches; flexed 7%
inches; at margin of axilla 8 inches. Some flattening
of shoulder and posterior aspect of joint; acromion pro-
cess prominent; abduction and adduction of thumb
imperfectly performed. First three fingers can not be
straightened from contractions of tendons of the atro-
phied muscles. The skin over 2nd–3d phalanges very
smooth. Dynamometer moved by right hand to 10° on
the outside scale, and to 22° by the left hand.
Pain about attachment of occipital muscles. Tactile
sensibility on left side greater than on right; no sensations
of pain, or needles, etc., in arms or legs. Electric con-
tractility imperfect.
Fibrillar movement apparent over upper part of
body. Skin over pectoral muscles and over abdomen
hanging very loose. Good muscular movement over
frontal portion of head; facial muscles and their move.
ments on both sides about the same. In the effort of
throwing shoulders back, the right shoulder moves
better than the left. Puts his right hand on top of his
MAY 11, 1872.]
TIE-L ED CT I I INTI C .
219
ºs-—
head awkwardly, but unable to do the same act with his
left hand. Tongue coated with a yellowish fur; de-
flected to the left. Pulse 78 and tolerably full. Arteries
more or less degenerated. Appetite good. Bowels in-
clined to be costive. With no expectation of arrest or
improvement of his disease, we have ordered the appli-
cation of the constant current to the spinal column and
the interrupted current to the muscles. The recent in-
vestigations of Charcot and Hayem” into the morbid
anatomy of this disease though interesting do not offer
any more encouragement as to the therapeutical control
of it. They believe that the essential origin of it is in
atrophy and destruction of certain cells in the gray
matter of the anterior cornua of the spinal column. It
is probable that the degeneration in this case extends
high up, as is evident from the deflected tongue which
shows some paralysis of that organ.
—-º-º-º-º-
A C A D E M I Y O F M E D 1 c 1 N E.
*-*-*
JAS. GRAHAM, M. D., PREST., L. WOLF, M. D., SECTY.
Transactions May 6, 1872.
Reported by Joseph Ransohoff.
*-sº
Correctºons.
DR. WALKER corrects the report of his case as one of
confluent small-pox after vaccination as follows:
“The case referred to was to show the effect of vac-
cinia as a protective agency. Also as an exhibition of
“Royce's test,” and to offer any one the opportunity
who wished to try vaccine virus taken from a patient
who had the eruption of varioloid at the same time with
the vaccine pustule. The first child, aged 3 years, died
of confluent small-pox: the father having refused to
have it vaccinated for fear of injurious effects. The
Second child I vaccinated on the second day of eruption
of the first, and I again vaccinated it on the other arm
three days later. The ninth day of the first vaccination
the little girl aged 13 years had a slight eruption of
Varioloid, though distinctly marked.”
Yours,
J. P. Walker.
DR. THORNTON, according to a request made by DR.
CoMEGYs, stated that the remarks made by the latter
ºn the previous evening were misapprehended. Judg-
ing from the report in The Clinic, it would be thought
that Dr. Comegys would treat all his cases of cerebro-
spinal meningitis by the use of morphia hypodermically,
which was a misconception of his views. The Dr.
Would treat only the most severe cases of this disease in
the manner Specified in his remarks on that occasion.
Cerebro-Spinal Meningitis.
PR. THORNTON reported two cases of cerebro-spinal
*—
*Archives de Physiologie, 1869, vol. 2. '
meningitis. He saw both for the first time Friday,
April 26th. The first case was that of a child aet. 2 yr.
It had been seized by a convulsion on the night pre-
ceding the first visit. On the following day it was
attacked by severe vomiting, spells of which alternated
with convulsions. The head was thrown back, but the
muscles were not rigid. The temperature in this case
varied from 100°–1003°. Pulse 100. Applied one leech
behind each ear, which seemed to prevent the recurrence
of the convulsive paroxysms. Ordered a mercurial
purge, which was followed by potass, iodidum. Also
applied ice bags to the posterior part of the head and
neck. Under this treatment the patient was apparently
improving, being quite conscious, and the intellect re-
maining unimpaired. Convalescence was apparent
until yesterday (May 5th), when the child was again
seized by a convulsion. To-day both pupils were
dilated, and the patient was in a semi-conscious condi-
tion. No petechiae present. The second case was that
of a girl aet. 6 yr. Some of the family having had in-
termittent fever, the disease was supposed to be of
malarial complication, and was treated accordingly,
The patient however, soon complained of severe headache,
and extreme tenderness in the posterior part of the
head. There was also some rigidity of the muscles of
the neck. As in the first case, ordered a mercurial
purge and applied leeches (4), and ice bags to the head.
An apparent improvement was manifest until last Sat-
urday night when the severity of the symptoms increased.
She complained of severe headache, and there was a
decided tendency to opisthotonos. No petechiae were
observed. Prognosis unfavorable. Ordered quin. Sulph.
and potas, iod., and ice bags to the head and neck.
DR. REAMY presented a specimen which was removed
from a patient under the care of a medical friend. The
patient was a robust man aet. 21.-April 26. Found
him in a stupid and delirious condition from which he
was with difficulty roused. Complained of intense
cephalalgia and unquenchable thirst. Opisthotonos
well marked. There was manifestly a partial paralysis
of the lower extremities. The pupils were dilated and
insensible to light. Respirations 48, pulse 50 per minute.
Great irritability of the stomach and obstinate constipa-
tion. Cold clammy perspiration covered the body and
petechiae were visible. Ordered ol, tiglii gtt, ss, every
hour until an operation from the bowels was procured.
Ordered also quin. sulph. gr. iij, and hydrarg. chlor, mit.
gr. j. every three hours. Several hours later applied a
cantharidal plaster to abdomen, continuing the ol. tiglii
and administering full doses of bromide of potassium.
April 27. Vomiting ceased and other symptoms indi-
cate an improvement. Body warm and perspiration
profuse. Respirations 40, pulse 80. One stool. Blister
effectual. Continued full doses of bromide of potassium
and citrate of magnesia. 5 P.M. symptoms worse. No
stool. Resumed ol. tiglii and ordered beef tea.
April 28. No stool and no further vomiting. Respi;
rations 48, pulse 140. Pupils contracted; skin dry and
hot. Delirium greatly increased.
220
[MAY 11, 1872
TiEEE C I.I. NI c.
April 29. The symptoms being the same as those of
the previous day, the same treatment was continued.
April 30. The patient died having had increased de-
lirium up to within five minutes of death.
Dr. Reamy called the attention of the Academy to
the great discrepancy between the pulse rate and the
frequency of the respiration; as to the accuracy of the
observations ther could be no question. He then pre-
sented the cerebellum and the superior portion of the
spinal cord. A superficial congestion was everywhere
noticeable. The anterior subarachnoid space and the
fourth ventricle contained a considerable quantity of a
muco-purulent deposit. The vessels of the pia-mater
were also deeply congested. The meninges of the brain
were injected while those of the spinal cord presented
a normal condition. The substance of the brain and
cord was normal.
DR. MUSCROFT spoke of two cases which had occurred
in his practice, the symptoms of which closely resembled
those of cerebro-spinal meningitis. He then spoke of
the various and different pathological conditions found
in different cases.
—-º-º-º-
Tortroom.Lis.
Clinical Lectures Delivered at “Ila Pitie” Hospital
Jan. 8–10, 1872.
BY
Prof. M. BROCA (Paris).
From the Revue Photographique des Hôpitaux de Paris, Mar., '72.
GENTLEMEN:
The patient in bed 18, St. Louis ward, is affected
with torticollis of long standing, the commencement of
the disease dating back to the time when he was 10
years old, he being to-day in his 31st year. As surgery
can in this case interfere beneficially, notwithstanding
the long continuance of the deformity, I think it an
opportunity of establishing in your presence with all
possible certainty the diagnosis of this deformity. You
know that torticollis may be primarily osseous or muscular.
In case of disease of the vertebrae, the osseous levers
being at the outset altered, the equilibrium of the forces
that move these levers is destroyed. From the vicious
position of the bony framework there results a disturb-
ance of the muscular force. The muscle whose function
is impaired soon loses its proper structure; at first pale
and diminished in size, it finally undergoes granulo-
fatty degeneration. I will not enumerate to you the
various diseases of the vertebral column that may give
rise to these disorders, rheumatic arthritis, scrofulous
abscesses, etc. At other times the origin of the de-
formity is in the muscle itself or the nerve distributed
to it; and in the latter case there may be an excess or
deficiency of nervous action. Consequently we have
two species of muscular deformities—the direct, by con-
traction, the antagonistic, by paralysis. The diagnosis
between the two is easily made. In the case of our
patient there is evidently no paralysis. The head is
turned to the left, the right sterno-mastoid is healthy,
the patient can contract it and slightly carry the head
to the right side, although this movement is very limited.
The same result can be obtained by the application of
electricity. I would call your attention in this connec-
tion to a good characteristic of torticollis by paralysis;
the patient cannot bring the head straight; the surgeon
on the contrary, can easily bring it to its normal posi-
tion, so long as consecutive contracture of the muscle of
the sound side has not fixed the head in its abnormal
position. We have then in the man under observation
a torticollis by contraction. But what is the cause of
this contraction ? We shall find it in the muscle itself
or in the central nervous system. Is it in the nervous
system 7 . It is most often in children during the pro-
gress of a disease accompanied by convulsions, meningitis
for example, that torticollis of nervous origin is devel-
oped. Is it in the muscle? We shall upon this hypo-
thesis have to do with a rheumatic affection developed
in adult life. I should here remark to you that in my
opinion the muscular pains called rheumatic are with-
out doubt accompanied by a tissue lesion, which is noth-
ing else than a very slight degree of inflammation; that
on the one hand produces the functional phenomena with
which you are familiar, (vicious position in torticollis
and muscular coxalgia), on the other hand diminishes
the resistance of the fibres and causes ruptures such as
have been observed in lumbago.
The rheumatic affection of a muscle may last suffi-
ciently long to cause in its tissue a disturbance of
nutrition. The elements that compose it, fibres, con-
nective tissue, sheath, then shorten themselves. The
neighboring muscles that are nourished in a vicious po-
sition equally become shortened; the same is true of
tle ligaments; the bones themselves become deformed
by the settling together of their molecules. And if the
deformity dates from infancy it may attain an extreme
degree, for growth takes place freely on the convex side,
while it is impeded on the concave side. The patient
who is in our ward has probably had in infancy a febrile
affection with convulsions. We put aside muscular
rheumatism as much less probable, on account of the
age at which the disease commenced. For you know
that in children muscular is infinitely less frequent
than articular rheumatism. But before stating our
diagnosis in an absolute manner, let us say that a pri-
mary osseous affection appears to us very improbable.
The deformity of the skeleton is considerable it is true.
The vertebral column is convex to the right in the cer-
vical region, and to the left in the dorsal region (com-
pensatory curvature). But this deviation of the column
is not necessarily primary, it is the natural consequence
of the deviation of the head. Moreover if I examine
MAY 11, 1872.]
TIEEE CI.IISTI c.
221
the patient attentively Isee that the sterno-mastoid is the
only agent that I can fix upon as at fault. When an osseous
deformity produces consecutive muscular retraction
this does not affect solely the sterno-mastoid. The
neighboring muscles are deformed also, and contribute
to the maintaining of the vicious position. Here the
sterno-mastoid alone sets its seal upon the deviation.
A torticollis which has not this muscle for its producer
may be even more exaggerated, but has not this form.
We conclude then that our patient is affected with
muscular torticollis by contraction of the sterno-mastoid.
Now what is to be done? The indication for tenotomy
here naturally presents itself. I may say to you to
begin with, that the section of the inferior attachments
of the sterno-mastoid is one of the most benign opera-
tions of surgery. But what shall we gain by this opera-
tion? The first obstacle that presents itself to us is the
sterno-mastoid with its two inferior insertions. But is this
the only one 7 When the section has been made
will the other muscles that have for a long time been
accommodating themselves to the deformity be
more yielding than the sterno-mastoid 2 And the
ligaments? And the bones especially? Shall we be
able by mechanical means to overcome their resistance?
To sum up gentlemen, in making the tenotomy we shall
perform a harmless operation certainly. Shall we ob-
tain an amelioration ? Yes without doubt. Shall we
entirely correct this deformity? I expect not. Never-
theless we shall proceed to divide the muscle, and by
the aid of an orthopaedic apparatus we shall oppose as
best we may the other obstacles.
GENTLEMEN:
The operation that we made day before yesterday
upon our patient with torticollis, has given an immedi-
ate result much more favorable than I anticipated.
The head as you saw straightened itself almost com-
pletely after section of the sterno-mastoid. Although
the head and face are still deformed as they should be,
(and I shall directly call your attention to this fact), we
are permitted to hope that the deformity will be
better corrected than we hoped at the outset. I will re-
mind you also, that immediately after the operation and
the straightening of the head, the patient was seized
with clonic convulsions which lasted only a few
minutes, and which presented to us the spectacle of a
genuine attack of hysteria. At the first, seeing the
number of inspirations suddenly doubled, I thought of
the phrenic nerve and asked myself at the moment if
my tenotome could have touched it. But this thing
was very little probable, and the true nature of the
passing convulsions could not long remain doubtful.
The patient is nervous, cowardly and his intellect is but
little developed The emotion caused in him by the oper-
ation and the sudden change of position of the head,
gave us a sufficient explanation of the phenomena we
had observed. There remains now under the skin a
tendon-like cord occupying the place of the clavicular
attachments of the sterno-mastoid, which gives the
idea that we did not divide the entire thickness of the
fibres at this level. Nevertheless, and this is the essen-
tial thing, the head is completely free, and the presence
of this cord does not prevent our inclining it over upon
the shoulder of the opposite side. I do not think that
the Section of this fibrous band will later become neces-
sary. We have covered the little wound made by the
tenotome with a piece of diachylon plaster. It is not
needful to say to you that it will not suppurate. We
shall apply the apparatus that you have known under
the name of minerva. I have now to say a few words
to you respecting certain physiological phenomena pro-
duced by this torticollis. There has resulted from the
faulty position a profound change in the nutrition and
development of the head. You can observe without
difficulty the inequality in the two halves of the face.
This is a well known result of torticollis, especially of
that dating from childhood; it may be produced
nevertheless, although in a less degree, by torticollis de-
veloped in adult life. Notice carefully the patient; the
nose is not vertical, the line of the eyebrows is not
horizontal. The angle of the jaw on the affected side is
much more approximated to the eyebrow than that
of the sound side. And that you may not be deceived,
compare the direction of the superciliary line with that
of the other transverse diameters of the face; you will
see that when the head is not kept in place by the ap-
paratus all are deviated in consequence of the vicious
inclination, but that the obliquity of the Superciliary
line notably exceeds that of the other
diameters. But it is not the face only that has been
affected by the deformity. A priori the cranium ought
to participate; and this is in fact what does take place
although authors do not speak of it. I have had the
scalp shaved and there is apparent a notable deformity
of the cranium. The left parietal eminence is sensibly
less convex than the right. You can without difficulty
recognize this inequality upon the cast that I had made
by M. Stahl, and which will be deposited in the
anthropological section of the museum. The brain and
organs of sense ought to have suffered with the cranium.
Let us continue then our examination with reference to
this point. The patient has little intelligence, is
whimsical and hysterical, as I have already said to you.
His body is but slightly developed, his height not ex-
ceeding 5 feet. This ought not to astonish us for we
cannot deny the influence of the brain upon the devel-
opment of the entire organism. The microcephalics re-
main small; all true dwarfs are microcephalous. We
have tested with the dynamometer the condition of the
muscles. Here again we obtain results worthy of atten-
tion; the left side at each examination is not shown to
be feebler than the right; oftentimes the difference is
nothing; generally the right side is shown to be feebler
by several kilogrammes, and yet the patient is not left-
handed. You see then that in this man it is the right
half of the brain that predominates, while in the normal
condition it is the left half that overpowers the other,
222
[MAY 11, t&72.
TIEEL H. C. T.I. NT I. C.
not only in man but in birds which as you know almost
always perch on the right foot. This relative feebleness
of the left half of the brain in our patient is well in ac-
cordance with the atrophy of that half of the head,
The examination of the organs of sense shows that one eye
is not as good as the other; and the same with regard to
the ears. But this time it is on the side corresponding to
the torticollis that the impairment is found. And this
result is just as readily explained as the preceding. The
eye in fact is under the control of the two hemispheres,
but especially of the corresponding one. The ear evidently
is dependent upon the corresponding hemisphere; for
there is no chiasm of the auditory nerves. Lastly, gen-
tlemen, we tested the cutaneous sensibility. But here
we obtained only contradictory results, thanks to the
patient's lack of intelligence. I hear the name of Bichat
whispered. Bichat had the cranial sutures displaced,
but do not doubt, gentlemen, that the two halves of his
brain were equal. The cranium and the brain are it is
true correlative in their development, but independent
nevertheless within certain limits, and if they are not
reciprocally under restraint, the one may in certain re-
spects be irregularly developed without the other
ceasing to be properly developed. By what mechanism
can a torticollis give rise to these anomalies of develop-
ment? The head, say some is inclined to the ground
while it was intended to look upward. Os
homini sublime dedit; and this explanation satisfies
them. Too poetical for us, it does not come within the
domain of science. We must seek for a more tangible
cause, one especially that will account to us for the
whole aggregation of phenomena, a mechanism appli-
cable to the whole head. We shall find it in the arterial
system. The exaggerated curvature of the carotid, the
result of the faulty position, increases the friction of the
blood against the vessel-walls; and diminishes the force of
the circulation in the entire half of the head. Doubtless
the carotid of the sound side undergoes an increase of
curvature but this deviation is much less considerable,
and does not occasion anything like the same circu-
latory disturbance.
Such is, gentlemen, the most rational mechanism that
we can suggest to explain the phenomena of atrophy
resulting from torticollis.
§CIENTIFIC NOTES.
SO-CALLED TOBACCO AMAUROSIS.–The last series of
Jonathan Hutchinson's cases of tobacco amaurosis has
just appeared. They embrace those cases that have
come under his observation from '67 to ’70.
Mr. Hutchinson has already published two series, but
this last has been more carefully analyzed.
The first series contained 37 men and 3 women, the
second contained 34 men and 5 women, the third con-
tained 28 men and 1 women. It will be seen, the
author remarks, that there is a general disproportion
between the two sexes, indicated in each series, thus the
last two confirm in a striking manner the conclusions
of the first. . The author believes that we have to do
with a “formidable type of symmetrical amaurosis
which is almost exclusively confined to the male sex.”
The author refers to an interesting fact of a mother,
son and nephew all having the same form of amaurosis,
and adds, “the lesion of these facts seems to me to Sup-
port the opinion I have long held, that when tobacco
causes blindness it does so in virtue of an idiosyncracy.
It is by no means improbable that such idiosyncracy
will be found occasionally in several members of the
same family, and further that it may involve liability
to suffer from other influences besides tobacco Smoking.
The two cousins above alluded to were affected with
amaurosis by virtue of an idiosyncracy rendering them
liable to special poisoning by tobacco; the mother (and
aunt) who never smoked was the subject of a similar
form of nerve disorder by virtue of the same diathesis,
acted upon by a different excitiug cause, probably the
cessation of menstruation.
Not unfrequently has the author found that these
patients have learned to smoke with difficulty, and have
always displayed unusual susceptibility to its influence
and have been more than ordinarily liable to suffer from
Sea-sickness.
Shag, in the authors opinion is the most deleterious
form of tobacco.
Cessation of the habit of smoking almost invariably
allows the vision to improve.
No case seen early and when the patient has ceased
smoking entirely has gone on to blindness.
—l-e-e—º-
Lostorfer's Syphilis CorpuscIes.
Letter from
PROF. FREEMAN J. BUMSrPAD, M. D.
From the N. Y. Med. Record, May 2, "72.
VIENNA, APRIL 5, 1872.
MY DEAR DOCTOR,-Before this reaches you I pre-
sume you will have received and published a letter from
my friend Dr. Bronson, with regard to the so-called
“syphilitic corpuscles,” which Dr. Lostorfer claims to
have discovered in syphilitic blood, and which as he
asserts, are an unfailing sign of syphilitic infection.
With this letter already before your readers, it is an-
necessary for me to describe the method of examination
adopted by Dr. Lostorfer, nor to speak of the excite-
ment which ensned upon the announcement of the dis-
covery in the K. K. Gesellschaft in Wien, nor of the
violent or personal character of the discussion which
has since followed among the disputants pro and con. ;
MAY 11, 1872.]
TIEEI IEH C T I I INTI C.
223
but I hear that the subject has excited quite as much,
if not more, interest in America than here, and your
readers may like to know the further progress of the
matter in Vienna.
Dr. Lostorfer's investigations were commenced in |.
Prof. Stricker's laboratory, aud Prof. S., after subjecting
Dr. L. to the successful test of an examination of a
number of specimens from syphilitic and non-syphilitic
persons, gave his permission to Dr. L. for the publica-
tion of the latter's paper. In the discussion which en-
sued, the chief opponent of Dr L.’s views was Prof.
Wedl, who asserted that the “corpuscles” were only
fat, or particles of protoplasma, which had accidently
gained entrance into the blood at the time it was drawn.
Prof. Wedl also severely criticised Dr. Lostorfer's
method of examination, and was himself as severely
criticised by Prof. Stricker in return.
Profs. Gruber and Neumann took sides with Prof.
Wedl; while Prof. Hebra, and especially Prof. Stricker,
have stood up for Dr. Lostorfer to this extent, that he
was successful in recognizing syphilitic from non-syphi-
litic bloodin a certain number of tests to which he was
subjected; and Prof. Stricker was induced, if not com-
pelled, both by the scientific interest of the subject
itself and by the personal manner in which he had
been attacked, to follow out a series of investigations
for himself.
Prof. S. kindly invited me to witness what he was
doing, telling me at the same time that his object was
not so much to settle the question of the dependence
of the corpuscles exclusively upon syphilitic infection,
as to ascertain the best method for their examina-
tion, and the manner of their growth, so that others
might be better prepared to carry on the investigation
as to their origin; and I propose chiefly to relate what
he has thus far accomplished.
The first time I visited Prof. S.’s laboratory I found
the temperature of the room raised to an uncomfortable
degree of heat, and was told that this was done ex-
pressly in order to hasten the appearance and favor the
growth of “the corpuscles.” A few days before, the
fire had been allowed to go out, and the corpuscles
were very slow in making their appearance, and in
their subsequent development.
Prof. S. has since accomplished the same object by
using the warming apparatus [heitzbarer Objecträger]
invented by him, and described in the introduction to
his Handbuch der microscopischen Anatomie, p. 14, or
again by setting the moist chamber, in which the speci-
mens are kept when not undergoing examination, in
the sun, which at this season of the year is not too
warm. Of course the former mode is emyloyed when
it is desired to keep the same specimen under the
microscope for any length of time, and watch it every
few minutes; and the mercury in the thermometer
attached to the apparatus should indicate twenty-nine
degrees of Celsius, when the temperature of the glass
slide is supposed to be about twenty-four or twenty-
*
five. A greater degree of heat is injurious; for exam-
ple, yesterday the mercury was allowed to rise to
thirty-five degrees of Celsius, when the corpuscles en-
tirely disappeared.
In order to keep the air moist around the specimen,
and prevent the evaporation of the fluid contents, four
folded pieces of bibulous paper are thoroughly wet and
laid one on each of the four sides of the object glass.
Care must be taken that the water does not flow over
the glass to the specimen, and, on the other hand,
the wads must be moistened as fast as they become
dry.
At the time of collecting the specimen of blood, it is
desirable to lay two exceedingly fine shreds of silk
across it (parallel). These serve a double purpose;
that of collecting a portion of the plasma of the blood,
and that of serving as landmarks by which the position
of any single corpuscle or set of corpuscles can be fixed
in the memory, or by the aid of a drawing, from one
examination to another. The ends of the slide should
also be marked right hand and left.
Prof. Stricker has found one difficulty attending the
preservation of the slides in the moist chamber, viz.:
the vapor collects to some extent upon the glass, and a
small, but still an appreciable, amount of water gains
entrance beneath the covering glass, and this, as I
shall presently mention, has an injurious effect upon
the corpuscles when young, causing them, if the
amount of fluid be sufficient, to shrink. Thus far, how-
ever, the moist chamber cannot be dispensed with.
Prof. Stricker is trying to find some way to obviate
the difficulty, and meanwhile recommends that the
slides, after being charged with blood, should be ex-
posed to the air long enough to allow a narrow rim
of the specimen to dry, before they are placed in the
chamber.
With regard to the magnifying power requisite for
the examination, I presume Dr. Bronson’s paper in-
formed you. Prof. S. uses, as Dr. Lostorfer did, Hart-
nack’s immersion lens No. 10, and occulaire No. 3.
The corpuscles first make their appearance towards
the periphery of the specimen, or in the neighbor-
hood of an air-bubble, in other words, towards the
part nearest the external air. This would show either
that their germs are derived from the air, or, more prob-
ably, that the air is more favorable to their develop-
ment.
The first morning that I witnessed Prof. Stricker's
examinations, some blood was under the microscope,
which had been drawn only twenty minutes before.
Blood from the same patient had previously been
tested and found to be unusually rich in corpuscles.
At my entrance Prof. S. told me he thought he could
see the commencement of corpuscles, but was not
certain. I looked in and, on moving the fine adjust-
ment, could see a number of exceedingly minute
points, of a dark color, scattered over the field. While
I Was Watching them, one of these points gradually
224
[MAY 11, 1872.
TIH. H. cI, IISTI c.
increased in size, and assumed the light-breaking ap-
pearance of a corpuscle, with which I was already
familiar. In the course of half an hour, five or six
were to be seen, and after the lapse of another hour
there were twenty to thirty in the field, and several of
them had attained four or five times the diameter
they had at first. I must repeat, however, that this
degree or rapidity in the time of appearing and in
growth is extremely rare, and, as Prof. S. remarked,
may not be met with again in a long period. To one
who has carefully studied these bodies it makes but
little difference whether their growth takes place in a
few days or in a few hours; but such a case as this af-
fords an admirable opportunity for demonstrating the
fact to others.
With regard to the sprouting of the corpuscles de-
scribed by Dr. Lostorfer, Professor S. has observed
nothing more than what appeared to be a ripe-like
projection on the side of one of the larger corpuscles
[this too, if I am not mistaken, is all that Dr. Bronson
ever observed], and he is not certain that this is a sprout,
because he has repeatedly seen a small corpuscle come
in contact with a larger one, and subsequently in ap-
pearance coalesce with it. -
The addition of water or of acetic acid causes the
younger corpuscles to shrink and shrivel up, but has
little or no effect upon the older ones.
Iodine also causes them to shrivel, but does not
change their color to blue. .
Osmic acid does not turn them black, and hence they
cannot be fat, as Prof. Wedl asserts.
Prof. Stricker is not prepared to state positively what
the nature of these bodies is, but he regards them as,
probably, organisms, and judging from the action of
reagents upon them, not of a vegetable character.
Prof. Stricker has examined the blood from many
cases of healthy persons, from five cases of lupus, from
five cases of variola, from three cases of typhus, and
from one case of typhus abdominalis, and in none of
these was he able to discover the bodies in question,
except in one case of lupus, in which they existed to
perfection; but here the question comes in, whether
lupus is a form of spyhilis or not.
The number of syphilitic persons whose blood he has
thus far examined is twelve; in nine he found these
bodies and in three he did not; but he is not sure that
their apparent absence in the latter was not due to de-
fective examination. -
I have also had several opportunities of conversing
with Dr. Lostorfer. He has told me, what I had heard
from several other sources, that he had been making a
special study of the blood a long time before he hit upon
his supposed discovery. The first time that he happen-
ed to examine the blood of a syphilitic person he recog-
nized these bodies as something which he had never
seen before. Regarding them as doubtless due to syphi-
litic infection, he has now abandoned the study of
healthy blood.
blood will resemble a syphilitic corpuscle.
I asked him if there was nothing in healthy blood
which could be mistaken for them. He replied, “Yes,
to an inexperienced observer,” and that even the most
experienced observer, if allowed only a single examina-
tion, might, in some instances, be in doubt, but that
this doubt would be removed by repeated inspections
of the specimen. - ... •
The most liable sources of error are the following:
Sometimes a nucleus of a colorless corpuscle of healthy
Usually a
fine outline, at least, of its cell-wall may be seen and
will show what it is. But even if it be separated from
its cell and stand alone, it does not so sharply break the
light as a syphilitic corpuscle, and its outline is broader
and darker. -
Fragments of torn red corpuscles may also give rise
to deception, but they show no tendency to increase of
size and soon disappear.
In this statement, I presume Dr Lostorfer took it for
granted that no one would mistake an undeveloped red
corpuscle for one of these bodies, for this error certainly
might occur to a novice. I would also add that both
Dr. L. and Prof. Stricker evidently attach much import-
ance to a prolonged or repeated examination of the
same specimen, by which the conduct, whether pro-
gressive or retrograde, of suspected bodies can be ascer-
tained. -
I am not aware that the opponents of Dr. Lostorfer
are carrying on any serious investigations to demonstrate
their fallacy, if such exist. They appear to be satisfied
with the assertion that his corpuscles can be found in
any blood, and that they are fat or protoplasma, or
something else, but not an evidence of syphilis. The
controversy has unfortunately assumed a personal char-
acter, and I hear the words, “unloyal,” “swindel,”
“ass,” and (without fear of wounding an American's
feelings), “Barnum-humbug,” oftener than is either
dignified or gentlemanly. I have no idea that the
question is to be settled in a hurry; and, perhaps, I
shall have a chance to write you of its further progress
during my stay here. .
I cannot close without a few words in justice to Prof.
Salisbury, of Cleveland, Ohio, who published his paper
on the “crypta syphilicica,” and “crypta gonorrhoica,”
in 1868, a copy of which, I am sorry to say, I have not
been able to find in Vienna for reference.
Within a short time of its publication, Prof. Salis-
bury was so kind as to send me some blood which he
said contained the syphilitic crypta upon a slide: and
my impression is that the bodies were very similar
to those that I, now see in Vienna, but I cannot be
positive, after so long a time, that they had the same
essential characters.
With the aid of the able microscopist, Dr. Ed. Curtis,
I examined the blood from a number of syphilitic
atients in my wards at Blackwell's Island, and we
ound the same bodies as in the specimen sent by Prof.
Salisbury, but we also found what appeared to be the
same in the blood of several healthy persons.
*
MAY. 11, 1872.]
Now the bodies that Dr. Curtis and myself saw
were to be seen in the blood immediately after it was
drawn from the body; and, if I am not mistaken, Prof.
Salisbury insisted that they should be sought for at
this time; whereas the corpuscles of Dr. Lostorfer are
rarely to be seen (except in some extraordinary instance
as the one I have mentioned, or except when hastened
by heat), until after the lapse of at least twenty-four
hours. -
For this and other reasons I do not feel at all sure
that Prof. Salisbury’s “crypta” and Dr. Löstorfer's cor-
puscles are one and the same thing; but should this
prove to be the case, the honor of priority in this dis-
covery will undoubtedly belong to Prof. Salisbury, and
no American will more heartily rejoice at it than
- Yours very truly,
F. J. BUMSTEAD.
Changes produced in the Spinal Cord after Ampu-
tation of a Limb or section of the Nerves
of the Limb.
BY
M. VULPIAN.
The amputation of a part or the whole of a limb in
man causes remarkable changes in that portion of the
spinal cord which furnishes the nerves supplied to the
part which has been amputated. These modifications
consist essentially in a general diminution of the size of
the corresponding half of the cord in that region. Con-
trary to what I had noticed in the earlier cases that I
examined, and in accordance with what Dickinson has
indicated, it is the posterior part of the cord, that is to
say the posterior horns and the posterior column, that
in the greatest degree undergoes these changes. This
diminution in every respect of the dimensions of the
modified parts is not due to any actual alteration of
structure; there is no interstitial myelitis nor granulo-
fatty atrophy of the constituent elements of the cord.
In certain cases, although exceptional, the interstitial
tissue of the altered posterior column is a little hyper-
trophied. Perhaps in these cases there had been for a
long time violent pain in the stump. As a general rule,
there is produced simple atrophy, that is to say, a re-
duction of the diameter of the elements, principally the
nerve-tubules. The changes in the spinal cord follow-
ing amputations, have been observed not only when the
amputation was made before the period of cessation of
body-growth, but also when made in adult life, and even
in the senile period. They are, however, the more
rapid and more strongly marked as the age is less ad-
vanced. In order that very manifest changes shall have
taken place in the case of adults, there must have elapsed
an interval of Several months at least between the time of
operation and that of death. It may be asked if the
TIH. H. C.I.I.INI c.
that observed in man after amputations.
225
local atrophy of the spinal cord in these cases of ampu-
tation is due chiefly to the section of nerves in the opera-
tion. To clear up this point, the nerves of a limb must
be divided by themselves, the other parts being duly
preserved. I have made a section of the great sciatic on
one side, and sometimes also of the crural on the same
side, in a number of animals (dogs, rabbits, Guinea-pigs).
After varying intervals of time I have examined the
dorsal and lumbar regions of the cord in these animals.
Two or three months after the operation and even after
thirty-six days in young rabbits, I have observed an
atrophy of the corresponding half of the cord in the
region in relation with the roots of the divided nerves,
and this atrophy presents the same characteristics as
It is then
principally if not solely in consequence of the section
of the nerves of an amputated limb that local atrophy
of the corresponding half of the spinal cord takes place.
|—Arch. Gen., April, '72.
—º-e—sºm-
M IELDICAL NEWS
Dr. BROWN-SEQUARD.—Dr. C. E. Brown-Sequard,
who has been on a short visit to this country, will soon
return to France. He remains abroad until September,
when he will return to give his course of lectures at the
Harvard Medical School. He gave a characteristic
lecture on brain diseases before the Medical Library
and Journal Association on the evening of April 12th,
to a large and appreciative audience.—N. Y. Med. Rec.
May 2, 272.
LIFE INS. FEES.—The Canada Lancet, in speaking of
the fees for life insurance, says that the fee differs with
the amount insured, from $2.50 to $5.00. In London,
twenty-five years ago, it was decided that the companies
should, in all such cases, pay a uniform fee of one guinea.
CIRCUMCISION IN THEOLOGY..—Peritomy, (Circum-
cision) was made an obligatory study in the rabbinical
seminary of Paris.
THE IMPORTATION OF OPIUM.–The money value of
opium imported through the Custom House of New
York City, in the Year 1871, was $1,299,091.
A TURKISH MEDICAL Journal.—The first number
of a Medical Gazette in Turkish has made its appearance.
The new periodical is printed at the Haïdar-Pasha Hos-
pital—Practical School of Medicine.
VIRCHow PERIPATETIC-According to a letter from
Berlin, Virchow has journeyed to Barmen to deliver a
lecture to the citizens union on “The Development of
the European Nationalities.” In a few days thereafter
he is advertised to address the scientific society at Elber-
feld on “The Boundaries between Instinct and Reason.”
Thence he betakes himself to the Rhine to institute
Some investigations into the cultivation of fish.
226
[MAY 11, 1872.
TIEEI IED CT, I. N. T. C.
THE JUGULATED CoILEGES.—The foreign journals
(London, Vienna) notice with pleasure the suppression
of the pseudo medical colleges in Philadelphia.
AN OPPORTUNITY. —M. Gustave Ambert chief of the
expedition to the North Pole wishes to find a young
doctor of solid and varied (physical and natural sciences)
attainments who would like to join the polar expedition,
Address M. Ambert, rue de Verneuil 38, Paris.
MEDICAL SENATORS.—Four Italian Physicians have
been chosen to be senators of the kingdom; viz., Pro-
fessors Stanilaus, Cannizzaro, and Maggiorani, of Rome,
and Porta, of Padua.
PROFESSORIAL PREREQUISITES.—It may be of inter-
est to learn how professorial positions are filled abroad.
The chair of clinical surgery being vacant, the minis-
ter of public instruction advertises for candidates in the
Gazette des Hôpitaux, Mar. 23, '72, as follows:—
1. Certificate of Birth.
2. Diploma in Medicine.
3. A note specifying the titles which may have been
received and including a statement of all services in
medical instruction with an enumeration of all the
papers and works of which the candidate is an author.
Having filled these necessary prerequisites to inscrip-
tion as candidates they are then subjected to impartial
competitive examination.
THE PROMOTION OF MEDIOCRITY.-London is having
the same trouble it seems in chemistry that Cincinnati
is so sorely afflicted with in some other departments.
The Brit. Med. Journal (Apr. 20, '72) descants as fol-
lows:
“The fact is, we believe that cliqueism has become of
late years so rampant in chemical circles in this country,
that independent ability is rather discouraged than
promoted, and obsequious mediocrity has been studiously
pushed into all the prominent posts in the country. In
that dearth of useful and creditable work, which Dr.
Frankland deplored, we are partly reaping the result of
this system.”
—º-º-º-
CORRESPONIDENCE.
A Point in the Diagnosis of Uterine Polypus.
DAYTON, OHIO, May 1, 1872.
EDS. CLINIC: *
In my remarks on uterine polypus published in
your journal last week, I mention a certain condition
of the lower portion of the tumor, an opening betwen its
fibres, causing it to closely resemble the os uteri, as
having been once found by Scanzoni, and quote his
statement that he has but once met with it in his own
experience and has been unable to find any similar case
recorded in the earperience of others / Scanzoni is certainly
| tincae and cervical canal.
high authority and I may be pardoned for relying upon
his testimony as to the very great variety of this condi-
tion of things. Yet, within a few days, in casting my
eye over the pages of ARAN's* works on Diseases of the
Uterus, I met with the following paragraph which cer-
tainly seems worth quoting in connexion with this
subject: -
“One circumstance worthy of attention in connection
with diagnosis is that the base, or free extremity of the
polypus, sometimes presents an infundibuliform de-
pression, or even an excavation, into which the finger
or sound can penetrate, and which resembled the OS
Examples of this kind have
been reported by Levret, Richerand, Velpeau and
Clogvret; but the most curious cases are those presented
by M. M. Marcé, Boscredon and Dolbeau to the ana-
tomical society. In Marcé's case “the polypus was not
only elongated and conical, like the neck of the uterus,
but it also presented, in the middle of its extremity,
which was slightly flattened, a transverse opening; this
opening was the entrance to a cavity communicating
with the interior of the cervical canal and by this open-
ing the menstrual flow found exit.”
Yours, etc.
J. C. Reeve.
—-º-º-º-
C. LIN (CAI, MEMORANIDA.
GUARANA A REMEDY FOR SICK-HEADACHE. By
Samuel Wilks, M. D., F. R. C. P., Physician to Guy's
Hospital.-I wish to draw the attention of the profession
to guarana as a remedy for sick-headache, and at the
same time to ask for the experience of those who may
already have some acquaintance with the drug. My
own knowledge of it dates about two years back, when,
after the appearance of a lecture of mine upon sick-head-
ache, I received a letter from Mr. Helmcken, of British
Columbia, enclosing two powders which he recom-
mended to me with much confidence as able to cure the
complaint. He said that, having heard much of the
remedy, “I resolved to try the medicine upon one of
my patients who was always coming to me with sick-
headache; and sure enongh it acted like a charm; and
in place of suffering for twenty hours or so, the headache
had disappeared in a couple. This accords with what
others have told me.” Upon my first headache after
the receipt of Mr. Helmcken’s letter, I took the powder
but with only doubtful effect. I therefore did no more
than casually mention the medicine to my friends, but
did not recommend it. A few weeks ago, after the ap-
pearance of a second communication of mine in the
Journ AL upon the same complaint, I received a letter
from Dr. Wood, of Montreal, in which he also recom-
mended “guarana” as a remedy for headache, and gave
*Traité pratique des Maladies de l’Uterus deuxième ed; avec la
collaboration du docteur A. Linas. Paris, 1869.
MAY 11, 1872.]
T+H: H] c LINI c.
227
a history of his own personal sufferings and the relief
which he had obtained. He says: “By taking one of
these powders and remaining quiet when I have felt
premonitory symptoms by a beginning of pain always
in the right temple (headache on the other side, or in
any other part of the head, I never mind), I have
carried off the attack; and, with the first box, absolutely
put it off for two months—something which had never
occurred in my life before.” Upon so good an authority,
I determined to try the remedy in a more systematic
manner, and requested my neighbor, Mr. Hooper, the
chemist, to procure me a packet of the powders. These
I have recommended to several patients and friends;
and the result is so encouraging, that I have hastened
to suggest their trial to my professional brethren. One
lady speaks most enthusiastically of their power, as she
has now, on two seperate occasions, had her headache
arrested by their use. The drug has long been known,
for mention is made of it in English and French phar-
macologies but appears never to have come into general
use. It consists of the seeds of a tree growing in Brazil
called Paullinia Sorbilis;and these, according to Johnstone
in his Chemistry of Common Life, are used as we do cocoa.
The seeds are ground into powder, and contain an
alkaloid which is said to be identical with that found
in tea and coffee. The medicine is manufactured by
Grimault and Co., No. 7, Rue de la Feuillade, Paris.-
Brit. Med. Journ. Apr. 20, '72.
THE CONDITION OF THE LABYRINTH IN CEREBRO-
SPINAL MENINGITIS.—The cases of disease of the Semi-
circular canals described by Menière as well as those of
deafness after cerebro-spinal meningitis by Moos (Klinik
der Ohren-Krankheiten p. 325), Voltolini explains as
resulting from inflammations of the labyrinth. As
regards treatment the most different means produce no
result.
Heller examined the ears in two cases of purulent
cerebro-spinal meningitis. In one, the cavity of the
drum on both sides contained fluid pus as did also the
ampulla and the strongly congested cochlea in its
lamina spiralis membranacea. The auditory and facial
nerves on both sides were imbedded in pus. In the
other case an almost similar condition was observed.
In both instances there was a purulent affection of the
external and middle ear. The inflammation may have
extended out from the meninges through the internal
auditory canal and thence extended itself to the
labyrinth for which the condition of the auditory nerve
is evidence in proof or it may have developed in the
tympanic cavity and labyrinth simultaneously with the
meninges.—Schmidt's Jahrbücher, Bd. 148. 2, 1870, p. 252.
CHLORAL IN THE TREATMENT OF WENEREAL UL-
CERs.--Dr. F. Accettella has employed very strong
solutions of chloral as topical applications to chronic
ulcers that had resisted treatment by the acid nitrate of
mercury, the carbo-sulphuric paste and other very active
caustics. The result surpassed his expectations. After
the first applications the bottoms of the ulcers cleaned
off, healthy granulations sprung up and the ulcers were
converted into simple sores. The author employed a
Solution one part to four,
(R. -
Chloral Hydrat., gr. a-v.
Aquae Destil., 37.
M.).
brushed lightly over the surface of the ulcer. For
erosions and simple ulcerations he employs a more dilute
solution.—Bull. Gen. de Ther., Mar. 30, 1872.
THE TREATMENT OF CROUP.—Dr. Daguilon recom-
mends (Gazette Hebdomadaire, 1871) the following treat-
ment when symptoms of suffocation from croup are
imminent: A sponge, after being dipped in pure liquor
ammoniae, is to be squeezed until no more liquid drops
from it, and is then to be passed, by means of a whale-
bone probang, down the throat. The child should be
compelled to inhale the vapor of ammonia as long as it
possibly can. The immediate result of this treatment
is an abundant Secretion from the respiratory mucous
membrane and the expectoration of false membrane;
the dyspnoea diminishes, the cough is less hollow, and
the voice is less muffled. Often, in cases where death
seemed imminent, the lives of children have been saved.
—Phil. Times, Apr. 15, '72.
OPACITIES TATTOOED.—In 1868, Mons. de Wecker
introduced the operation of tattooing with India ink,
with a grooved paracentitis needle, in those unsightly
and disfiguring cases of opacities of the cornea, which
very successfully and happily ameliorates and dispels
those great deformities. He has operated upon forty
cases, and every one has been greatly improved. Each
case usually requires from six to eight tattooings, and
they can be repeated at intervals of about eight days.
The result is permanent. We have watched, with much
interest, the case of a young lady who had been tattooed
a number of times during the last six months, and who,
for three months, has been under our observation. It
is impossible to tell which is the tattooed eye at a
distance of three feet, it so closely resembles the sound
one. In fact, so successful has been the result, that it
is necessary to raise the upper lid, and make a close in-
spection, to perceive that the eye has been tattooed.—
Paris Letter to Nashville Journ. Med, and Surg., April, '72.
IMPOTENCY.—Prof. D. Hayes Agnew, of Philadelphia,
Pa. (Med. and Surg. Reporter), in a clinical lecture on
impotency, after stating that the treatment must be
largely moral, and urging the abandonment of onanism
or excessive yenery, says that there is no better internal
treatment than phosphorus and strychnia—1–50 grain
of the former, and 1–30 of the latter—made into a pill,
and administered three times daily,
THE SIGNIFICANCE OF Wom ITING IN HERNI.A.-If I
were asked which of the signs of strangulation I would
228
[MAYH 11, 1872,
THE CI.INI c.
most rely on as commanding the operation, I should
certainly say the vomiting. Time after time, when the
other signs were feebly, if at all, marked, the vomiting
has been a sufficient guide to a timely operation.
times, when all else was so quiet it seemed rash to
operate, the vomiting proved it would have been much
more rash to wait; and not one instance can I find in
my notes in which neglect of the import of vomiting
was not proved to be unwise. You had better hold the
rule complete, that, when a patient has a hernia, recently
become irreducible, and, with this, vomiting which,
cannot be clearly assigned to something independent of
the hernia, you shall operate. I am obliged to Say
recently become irreducible, because a patient with an
old irreducible hernia may vomit, as any one else may
without any reason for suspecting strangulation; though
in even these old cases you must be very watchful lest
the vomiting be an early sign of strangulation. But
the rule is safe that recent irreducibility and vomiting
are enough to justify the operation, even be there no
other signs of strangulation present. Much more must
the operation be deemed necessary when with these the
other signs of strangulation, in even slight degrees,
coincide. -
And in this judging of the vomiting, do not be too
scrupulous as to its manner or its products. There are
indeed some notable modes of vomiting when the intestine
is strangulated. The patient vomits all he drinks, and
that soon after taking it; and besides, he vomits fluids
of his own secreting; and this vomiting is commonly (at
least in the later stages), with gushes of large quantities
of fluid, without much retching or violence, as if the
stomach slowly become full of its own Secretions and of
those of the upper part of the intestine, aud then, without
any preceding nausea, suddenly emptied itself.
When you see these kinds of vomiting with a hernia
lately become irreducible, or even with any swelling
that may be a hernia, you may be sure that you must
operate. But do not wait for any characteristic mode
of vomiting; do not be misguided by the absence of
some peculiar fluid ; nay, do not be misguided by the
absence of all vomiting; for I have known it absent in
the case of a very large hernia, which was certainly
strangulated, and on which I operated successfully.
And do not be misguided by an apparant diminution
in the severity or in the frequency of vomiting, or by
the vomiting having begun as soon as the hermia
descended; for this it often does. Any kind of vomiting
if it be repeated, is enough to justify operation in a
hernia recently become irreducible.—Paget–Brit. Med.
Journ., Apr. 13, '72.
AUTOPLASTY ON THE HAND WITH SKIN FROM THE
ABDOMEN.—Dr. Delore, surgeon at the Charité (Lyons),
recommends the transplantation of skin from distant
places in relief of vicious cicatrices, etc., as follows:
There is a method of cheiroplasty which is susceptible
of useful applications. It is the method of the Italians
which consists in removing a surface far from the place
Many
to be applied. I have not found, he continues, traces
even of its adoption in the various treatises on surgery,
Tagliacozzi did use this means for the nose, whose
restoration, however important, is not of the necessity
of that of the hand. He dissected skin from the upper
arm and permitted it to suppurate before applying the
suture. The article concludes with the report of a case
of transplantation from the abdomen for the relief of a
vicious cicatrix of the little finger.—Lyon Médicale,
April 14, '72.
THE DIAGNOSIS OF HYSTERIA.—Dr. Chairon insists
upon it still that his symptom of hysteria as described in
his work (Etudes cliniques sur l'hysterie, Paris, 1870) is
characteristic. This constant and pathognomomic sign
is insensibility of the epiglottis to reflex action.
And how is this constant reflex insensibility to be
ascertained ? -
In the beginning of the malady, he observes, in the
absence of every other phenomenon, if the finger be
carried to the base of the tongue it will be seen that the
epiglottis, which is raised, is insensible. One may irri-
tate it with a feather or any other light body, carry the
finger even over the superior orifice of the larynx al-
most to degree sufficient to jprevent the passage of air
and produce a light degree of asphyxia and still there
will be no effort at vomiting. -
The author insists, further, on the extreme caution
with which this operation is to be undertaken. He
recommends the introduction of the finger over the
tongue and gliding it down gently to its base. In this
way it quickly comes in contact with the epiglottis
which may be titillated, touched, even scraped with
the nail without exciting the least effort at regurgita-
tion. . -
This single sign has often permitted a certain diag-
nosis of hysterical affection in cases in which the disease
manifested a few days thereafter in complete attack.--
Gaz, des Hôpitaux, Mar. 16, ’72. .
—-º-º-º-
THE RIGHT MAN.—Just on going to press we learn
that Dr. J M. DaCosta has been elected to the chair of
Practice in the Jefferson Medical College, vacated by
the death of Prof. Dickson.
IHOMIE NEWS.
SMALL-Pox lingers as if loth to leave us. Deaths
during the past month have averaged about ten per
month. The disease is almost exclusively confined to
the unprotected by vaccination or previous attack.
CEREBRO-SPINAL MENINGITIS, our new and equally
unwelcome guest has rather retreated than advanced
since our last report.
Mr. George Boone, now on his travels, is the only author-
ized agent and canvasser for THE CLINIC for the South
and West, -
MAY 11, 1872.]
TIEEI IEH C T , T INTT C.
A M ER Ic AN ºr ED 1 o AL As so or A Tro N.
28th Annual congress. º :
PHILADELPHIA, MAY 7, 1872.
EDS. CLINIC,
The “National American Medical Association”
held its 25th annual meeting here to day. This is the
third time that the “Quaker City” has been honored by
its sittings; and it certainly deserves that honor, for
here was the birth place of the association and here it
was that the science of medicine in America received
its first impetus. The glory of Philadelphia's medical
history will never grow dim, associated, as it is, with
reminiscences of the “University” and “Jefferson” and
of the many great minds that from the days of Rush and
Physic up to the present time, held, and still hold by
the charms of their medical teachings countless aspir-
ants for the title of “M.D.” spell bound. **,
The convention was promptly called to order at 11
o'clock A. M. this morning. Its place of meeting is at
“Horticultural Hall.”
judging from present appearances will be none too large
The hall is a large one, but
for the accommodation of the numerous delegates who
still continue to throng in from all parts of the country,
every state and territory being represented from Maine to
California. , 519 names had been enrolled up to 11
o'clock, and “the cry was still they come.” -
After a short prayer by “Bishop Stephens,” President
The ad-
Possessing the charms of
Yandell, of Louisville, delivered his address.
dress was a magnificent one.
a fine personal appearance, a loud and clear voice, and
the language of action to a most graceful degree. Dr.
Yandell held the delighted attention of the convention
throughout. ' + . . . -
The first part of his address was devoted to the past
medical history of Philadelphia, and he paid a most de-
serving tribute to the memory of the great men, who,
though they have quitted this sphere of worldly nation,
left behind them lasting monuments of genius. By far
the greater portion of the address was on the subject of
medical education. He was opposed to the present
Utopian scheme of founding so-called “National Med-
ical Universities.” He criticised the present system of
medical teaching as practiced in Germany; conceding
to the Germans the highest place in medicine, as regards
their labor, researches, and literature in the fields of
pathology, microscopical anatomy, and medical chem-
istry; and paying a high compliment to their obstetrical
. contributions to the science. He was opposed to their
| “practice,” it seemed to him that their therapeutics
|were a mere “reflection on death.”
He touched lightly on the subject of the admission of
women to the association, was rather opposed to female
physicians, still, if a woman would study medicine, so
be it.
He spoke of the harmony that had heretofore existed
in the organization, and hoped it would always continue
to exist. He was very careful not to allude to the dis-
turbance created at Washington sometime since by the
attempt of colored delegates to gain admission to the
convention. The address is said to be the best ever de-
livered before the association ; at its conclusion came
the bomb-shell which threw the convention into an
uproar. It was darkly hinted several days before the
convention that an attempt would be made by the
friends of the colored delegates to force them into the
association. Dr. Yandell had hardly concluded, before
a communication in the form of a resolution was pre-
sented by a Dr. Askell of Del. This brought Dr. Mussey
of Cincinnati to his feet; to cut matters short, it was a
repetition of the scene that is said to have occurred at
Dr. M. offered a substi-
tute to the resolution which was rejected, and the whole
Washington sometime since.
matter was referred to the committee on ethics; what
its fate will be remains to be seen. Should a majority
of the association vote in favor of admitting colored men
to membership, I predict a disturbance, and a probable
bolt of the southern delegation from the convention.
Drs. Carson, Mendenhall, Gobrecht, Comegys, Koen-
ner, Norton, Heighway, Henry Richmond, Rasching,
Walker and other Cincinnati delegates arrived this
morning. -
The programme So far arranged for the amusement of
| the delegates is extensive. Promenade concerts, recep-
tions, excursions, exibitions, and visits to Hospitals, etc.
Weather fine and all seeming to enjoy themselves.
M
P. S. No Banquet.
[This letter came to hand after our forms were locked
for press, consequently too late for insertion in its proper
place.
However excellent and able the address of the Presi-
dent in other respects it is a matter of regret that the
occasion was used to strike that old and worn out cord,
the popular twaddle about German “practice.” The
readers of The Clinic have had abundant opportunity of
deciding this matter for themselves, and no jingle of
American rhetoric will be likely to mislead them].
gº
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Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Lºen, &c.
AGENTS FOR BULLOCK & CRENSHAW'S
Sugar-coated Pills and Granules.
No. 758 BROADWAY, NEw York
I HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital.
B EG leave to state for the benefit of all concerned,
Dr. S. N. Marsh the last fifteen years. * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with anv of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honol
and integrity, and as such recommend him to the members of the medi.
cal profession generally. WILLARD PARKER, M. I.).
Professor of Surgery, New York City
that I have known
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & CO., No. 2 Wesey St. (Astor House).
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.
between Main and Walnut, Cincinnati.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
OPPOSITE THE IIIGH STEEPLE,
lºº Agents for Clement's Patent Artificial Legs.
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.



















OTD TLITVTIEER, OIT
o Do R. L.E. ss A N D P A LATA H. L. E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. . . . . . -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded. -
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c. -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains ; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN wVETH & BROTHER, 1412 Walnut Street, Philadelphia.


CINCINN ATI.
--> -e-E- - * =
E" A C Uſ I, T Y.
J AM ES G R A H A M, M. D., DE AN,
Professor of the The ory and Practice Of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery
W. H. GOBRECHT, M.D., C. D. PALMER, M.D.,
Professor of Anatomſ). Professor of Medical and Surgical Diseases of Women.
P. S. CONNER, M. D., T. A. REAMY, M. D.,
Professor of Surgical Anatomy. Professor of Obstetrics and Diseases of Children.
JAMES T. WHITTAKER, M.D., - JOHN L. CLEVELAND, M. D.,
J’rofessor of I’hysiology. Demonstrator of Anatomy.
SAMUEL NICKLES, M. D., CHARLES KEARNS, M. D.,
Professor of Physics and Medical Chemistry Assistant to the Chair of Surgery
WV . VV - SICEL'Y', MI. D.,
E*rofesson, o ſº I) i. easses of" ( H. G. Tºye an Čt HJar, and di Secre (a tºy of the Faculty
** *-
T. Lot' is I3 ſtow N. M. ()., ſºrosecutor of Aſ naſotny, E. No BLE, Janitor, College JSuilding, Sixth St., bet. Vine and Race
~s --------- - -
Printed and I'm blished jºy Noſ. It is & M tº Hity, Medical College of Ohio Building, Cincinnati.

THE
XLINI C.
PUBLISHED EYERY SATURDAY.
TERMS-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editors
3- S
vol. 2. '
*:
CIN cIN N ATI,
All Communications relating to Business, Subscriptions, Advertis
ements, etc., to the Treasurer.
~&-
—º
—º
20.
—º-2 —ºxº~.
M A Y 18, 1872. No.
JAS. T. VVHITTAKER, M. D.
No. 101 West Ninth Street, Cincinnati.
...A-SSOCI.A.T.E. Hi-DITOR.S.
W. W. D.Awson, M. D. Thad. A. REAMY, M. D.
P. S. Conn ER, M. D. C. D. PALMER, M. D. .
W. W. SEELY, M. D. SAMUEL NICKLEs, M. D.
CHAs. KEARNs, M. D.
- . . . . . RoHERTs BARTHollow, M. D
W. W. SEELY, M. D.,
* No. 118 West Seventh Street, Cincinnati.
C L U B R A T E S, .
Editor,
•
:
g-
JNo. L. CLEvKIAND, M. D. :
TREAsukeR, .
f
#
&
4 Copies to one address............….................................... $ 7.00
6 {{ “ .............................................a....... 10.00.
I2 44. {{ : * 18.00
C O N T E N T S.
sºmºmºmºsº Page.
A NIE R 1 C A N M E D 1 C A L. A SS-O C.1. A T 1 0. Nº
Twenty-third Annual Congress.
The Transactions in Full
TUESDAY-Morning Preliminaries—Exércises Commence—After-
noon Reports—Evening Entertainments
* * * * * * * * * * * * * * * g is e º a tº e º e º 'º e s e º º te e º is º
Wednesday—A Change of Base—Publication and Funds—The
—º-º-º:
coaxN se ce.
hionable Hatters,
IMPORTERS AND MANUFACTURERS OF
*Anºsº Furts,
Fas
# , -
* *
92 wrest FOURTH st'.
opposite Post office,
CINCININATI.
§sirspecial Inducements to Medical Men.
<
*
f
* - .#
RogaRºgrillman
|ENGRAVERSºwooD
º
Prize Essay—Medical Literature—Essays and Reports—The
Contract System—Evêning Entertainments—The Receptions....230
TirursDAY--Animal Disease—-Poison Labels—Alcohol—-Officers
Elect—The Health of the Sphere—A Warning—The Various
Committees—Officers of Sections—Ethics, Exit Bliss—The Ine-
vitable Contest * * s • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 232
FRIDAx–Resolutions of Regret—Medical Experts—Votes of Thanks
—A Last Effort—Adjournment--Thé Pavillion Collation—The
Departure ---...--.......... * * * * : * tº s ſº e º ........,235
- - ORIGINALL ARTEq} . ES *
Sub-Involution of the Uterus by Prof. Thad. A. Reamy........~. 236
Dysmenorrhoea by C. D. Palmer, M. D............................................ 238
ACADEMY OF MEDRCINE
Transactions May 13, ”72.
Paracentesis Thoracis, Paper by Dr. Bartholow—Remarks by Dr.
Graham—-Purpura Hemorrhagica, Specimens by Dr. Miller,
Cases by Drs. Muscroft, Reamy, Cleveland, Judkins, Ludlow---
Specimen by Dr. Maley---Procidentia. Vesicae, Case by Dr.
Ludlow---Morphia Hypodermically in Cholers, Paper by Dr.
* * tº w 24()
* * * * * * * * * * * * * * * * * * * * * * * g º $ tº gº tº wº
We are indebted to Drs. F. B. Morris of Hamilton,
T. C. Minor and M. L. Nardyz of this city for com-
plete and early reports, letters and papers from which
the full transactions of the association have been com-g
piled.
While acknowledging this debt of gratitude, however,
we take this occasion, to state that we publish the
transactions of the association only because it is expected
of us by the profession. Had we been able to secure
short abstracts of the papers read,&esults of experiments
performed, etc., we could have º our columns
with better grace. ¥
Meanwhile, however, valuable information is accu-
mulating both in original matter, and selections
and, the present digression over, THE CLINIC will be
Continued as heretofore.
ºf SºfºgFiºsº
CINCINNATECHIO:
§
*-
*** ****
J. TAFT, W. TAFT.
J. & W. TAFT,
TIENTTIST's
117 WEST FOURTH STREET,
CINCIN NATI, O.
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interest. ':e Dental Profession,





















MARVIN's
coL LIVER, OIL
o B C R. L.E. s.s A.N D PALATA H. L.E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTIETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market. R
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c. - -
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

----------
JAMES FOSTER
[ESTABLISHED, 1836.]
Importers and Manufacturers of
Optical and Physical Instruments,
Keep constantly on hand first-class
English and French Microscopes,
and Microscopical Apparatus of every descrip-
tion, Medical Baiteries, Thermometers,
Hydrometers, Urinometers and *
Chemical Glass Ware.
Fºl attention given to adapting the best spectacles to all conditions
OI Signt. - • , -
We take pleasure in showing the latest novelties from the best Euro-
pean and American manufacturers. - - -
JAMES FOSTER, Jr. & Co.,
S. W. cor. 5th & Race Sts., Cincinnati, O.
First-class Objects|
TER.S.N.M AIR's Hºs
F. E. SUIRE. E. S. WAYNE
IF. T.C. Suire & Co.,
|
WHOLESALE DRUGGISTS,
IN/[ _AL INT TJ ET A C T TJ IER, IT INT G-
£Hemists AND PHARM aceutists,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
sex. Ecºexºd ox{UGS ANYO IVX)expxcxxxes,
cºeryxxcAX, APPARAºcus,
TESTS, MEDICAL, GLASS WARE, &c, &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordance with the U. S. P. and other recognized authori-
ties.
FINR, ANT) ERAEHL CHEMICALs,
Of the popular class of preparations known as
IE T IDX IIR, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take. -
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Isen, &c.
AGENTS FOR BULLOCK & CRENSHAW's
Sugar-coated Pills and Granules.
Price Lists of preparations and of Sugar-coated Pills sent by Mall
upon application. The long standing and well and widely known repu-
* - - No. 758 BROADwAY, NEw York
I HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAYRE, M. D.
Surgeon, Bellevue Hospital.
*
From Prof. Willard Parker to S. D. Townsend, M.D., Surgeon to the
Massachusetts General Hospital,
BEG leave to state for the benefit of all concerned, that I have known
l)r. S. N. Marsh the last fifteen years. * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that ēxist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. ILLARD PARKER, M. D.
- Professor of Surgery, New York City-
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other. Physical Deformities; made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & Co., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
oppositE THE HIGH STEEPLE,
R&’ Agents for Clement’s Patent Artificial Legs.
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.






List ºf Pharmaceutical Preparations,
MANUFACTURED BY
Jonºv ryaznº anorman,
FEHirº AIDELIFECIA-
,”
—-º-
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
- ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA, - -
(Goddard’s Formula,) - -
EitzińvaLERIANATEAMMORIA AND QUININE,
ELIXIR OF THE FYROPHOSFHATE OF IRON,
Iron, with Phosphorous amd Calisaya,
FERATEDELIXIE OF CINCHONA,
ELIXIR OF CALISAYA BARK, - ,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES, -
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
- FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH, * *
ELIXIE CALISAYABARE, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK,
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH, - - *
TASTELESS COD LIVER OIL,
TASTELESS CODLIVER OIL. FERRATED, -
- BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA, wing OF PEPSIN
SYRUPSUPERPHOSPHATE OF IRON, ---------,
- ELIXIR OF BISMUTH,
COMP. FLUIDEXT, BUCHU AND PAREIRA BRAVA.
STUTEPIEPOSITOTERITES.
Rectum, Vaginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TIENTS.—For the Urethra, of every size and Btyle, made of finest quality of sponge.
Carriage Manufacturer,
Nos. 9 and 11 East Sixth Street, bet. Main & Sycamore.
!
I MAKE NOTHING BUT
rzwsz, czzz'ss ºro wr,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of
LIGHT FAMILY CAFFIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to §
, PHYSECHANS” （SE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen’s
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
: º
º
Ni
e-Sº
Z_\
\ ^
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
Physicians in the city and heighborhood.
83




DIVIDED MEDICINES,
PREPAIRED BY
The Divided Medicine Com’y,
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExcEEDINGLY PRACTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE. $º.
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every Square will consequently contain accurately measured quantities.
But not only SOLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. *
2. This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; , , , ºo, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines.
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For samples, Price Lists, and Agencies, address
The Divided Me § Nº N3
JEO 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
MR. FREDERrck KRAUs: CINCINNATI, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz:
SULPH:MORPHII....................... % grain in each square. ARSEN:ACID.......................... 1-20 grain in each square.
** CH IN INI .......................1 ** * * 66 CALOMEL 34 “ -- {{
“. COPPER ........................ % 6&
ResPECTFULLY YoUBs,
E. S. WAYNE, Analytic Chemist.

T TH. H. C. T., T N T C .
229
Vol. 2.] S A T U R D A Y, M A. Y. 18, 1872,
A M E R II Cº. A N M E 10 I (; A L A S S O C I AT I O N .
TWENTY-THIRD ANNUAL CONGRESS.
The Transactions in Full.
::
PHILADELPHIA, PA., MAY 7–10, 1872.
Special Correspondence of TITF CLINIC.
TULESHPAY.
Morning Preliminaries.
At eleven o’clock this morning there was opened the
first session of the meetings of the American Medical
Association. A very large number of gentlemen are in
attendance, as well as many of the softer sex, all come
to take part in or listen to the proceedings of the Asso-
ciation, as these should gradually unfold themselves.
The number present exceeds that of any previous con-
vention ever held. During the morning the delegates
assembled in Horticultural Hall, and there for a consid-
erable time occupied themselves in the courteous inter-
change of friendly greetings with brother professionals,
with whom they had not associated for many years.
The association is composed of delegates from local so-
cieties over the whole United States and from colleges,
hospitals, lunatic asylums, and other permanently
organized medical institutions of good standing in the
United States, from the army and navy and from the
American Medical Society of Paris. Prof. Wm. H.
Gobrecht is registered as the delegate from the Medical
College of Ohio, Drs. Comegys and Carson from the
hospital and Drs. Walker, Nardyz and others from the
Academy of Medicine. The large number of delegates
present, occupy about two-thirds of the floor of the hall
which had been railed off for their use. The remainder
of the floor and gallery was at the disposal of spectators,
among whom were a large number of ladies. Every
arrangement was made for the convenience of the body
in transacting its business.
The attendance is nearly one thousand in number, of
men of more than ordinary talent and appear-
ance of intelligence.
The Evercises Commence.
Shortly after eleven o’clock the association was called
to order by the president, Dr. T. W. Yandell, of Louis-
ville, Kentucky.
[No. 20.
The proceedings were opened with an appropriate and
impressive prayer by the Right Rev. Wm. Bacon
Stevens, M. D., D. D., D. C. L., Protestant Episcopal
Bishop of Pennsylvania.
The address of welcome on behalf of the medical pro-
fession of Philadelphia was delivered by Professor R. E.
Rogers, M. D., chairman of the Committee of Recep-
tion.
The greeting in behalf of the Committee of Arrange-
ments was delivered by TEdward Hartshorne, M. D.,
of that committee, who then recited the programme of
entertainments arranged for the strangers during their
stay in the city.
Dr. William B. Atkinson, of Philadelphia, permanent
secretary, read a list of the delegates whose credentials
have been approved.
President Yandell read the annual address, which
was a very long and erudite paper, pleasantly relieved
with dashes of anecdote and humor.
[An abstract of this address has already been pre-
sented to the readers of THE CLINIC by a former cor-
respondent].
A vote of thanks was passed for the address of the
President.
The report of the Committee on Credentials was pre-
sented as far as read.
Drs. Morris J. Ash, U. S. A., M. W. Junker, of
Bellaire, O., and David D. Mahan, of Mifflin county,
Pa., were elected members by invitation.
Dr. H. F. Askew, of Delaware, offered a resolution
that all questions of a personal character, including com-
plaints and protests, and all questions on credentials, be
referred at once to the Committee on Ethics, and with-
out discussion.
Dr. Mussey, of Ohio, asked that the motion be di-
vided, referring questions of personal character only to
..he Committee on Ethics. *
Br. Askew declinol to accept the amendment for a
division of the question.
Dr. Mussey asked if the question did not concern the
rights of societies to be admitted in convention, and if
so he denied the right of the committee to decide upon
such questions. He proposed, also, reflrring th second
branch of the subject to the convention.
The Chair said that such a course had never been
pursued. Hitherto the Counºnittee on Ethics reported
to the convention on both subjects, their action being
open to the approval of the convention.
Dr. Hartshorne said that the course of the Committee
of Arrangements was plain and defined by law, and the
original resolution was framed in accordance there-
with.
The previous question being ordered by the house,
Dr. Askew's motion was put and carried without a dis-
senting voice.
Various reports were next announced on the subject
of papers to be read at the sections held in the after-
IłOOIl.
230
[MAY 18, 1872.
T EITH C T , T: TNT I C.
The following gentlemen were appointed the Com-
mittee on Ethics:
Dr. Askew, of Delaware; N. J.Davis, of Illinois;
Calvin Slavy, of Maine; I. K. Bastette, of Delaware;
and S. D. Gross, of Philadelphia. The session then ad-
journed.
In the afternoon, the various sections of Practice and
Obstetrics, Surgery, Anatomy and other medical and
scientific branches met in different portions of the hall
as designated on the delegates tickets, for the purpose
of hearing reports of Special Committees on Climatology,
Epidemics, Surgical Operations, Ophthalmology, &c.
Evening Entertainments.
In the evening, a reception was given at Horticul-
tural Hall, by the Biological Society. In the foyer were
arranged two long tables, on which were placed over
one hundred powerful microscopes, containing specimens
of pathology, anatomy, microscopic photography, etc.
|Upon the platform at the end of the room were
arranged five spectroscopes, in charge of Professor B. H.
Rand, of the Jefferson Medical College, who exhibited
the spectra of the different mineral and other substances,
and of the electrical light.
During the evening a promenade concert was given
in the main hall by Hassler's Orchestra. The visitors
were greatly interested in the display and pleased with
the entertainment. Among the specimens examined
under the microscope were fleas, beetles, fang of a rattle-
Snake; human, insect, and animal blood; Egyptian
mummy hair, the human nerve trunk, sections of the
eye, lungs, heart, kidneys, cancer of the mammary glands;
photographs of Nobert's test plates, ninth and nineteenth
bands, from the Surgeon General’s office at Washington,
etc.
The following is the committee of arrangements ap-
pointed by the Association:
E. Hartshorne, M. D., Chairman; Richard H. Town-
send, M. D., John H. Rackard, M. D., William Pepper,
M. D., F. F. Maury, M. D., James Tyson, M.D., S. W.
Gross, M. D., D. Murray Cheston, M.D., Secretary.
&
WELONESPDAY.
The delegates to the American Medical Association
assembled in Horticultural Hall at 10 o’clock this
morning. The attendance was even larger than on the
day previous.
Shortly after 10 o’clock the association was called to
order by Dr Thomas M. Logan, of California, first vice
president, who stated that a recess of fifteen minutes
would be taken for the purpose of organizing State
delegations and electing members of a general committee
of one from each delegation to nominate officers for the en-
8uing year, and name the city for the next annual
meeting.
A Change of Hall.
At the close of the recess the association proceeded
to Dr. Wylie's church, Broad street, below Spruce,
where the session was resumed. This move was rendered
necessary owing to the difficulty of hearing in Horti-
cultural Hall. Nearly seven hundred delegates took
seats in the church at 11 o’clock, and the work of the
convention proceeded with much less confusion than
was reasonably anticipated as the result of the sudden
change of base.
At the church, Dr. Yandell, president, of Louisville,
took the chair, and the secretary read the list of members
selected as the Nominating Committee, when they re-
tired for consultation.
Dr. W. H. Pancoast announced through the commit-
tee of arrangements, that the ladies were also invited to
be present at his reception in the evening. It was
subsequently announced that Dr. Hugh L. Hodge had
also made arrangements to provide for the ladies
accompaning the delegates to his reception.
Dr. R. E. Rogers offered a resolution inviting Dr. J.
Edgar Chancellor, of the University of Virginia, to a
seat on the floor of the house, which was adopted.
Dr. R. Bronson, of Massachusetts, offered a resolution
providing that the committee on Ethics, to consist of
seven members, shall be chosen hereafter by the com-
mittee, on Nominations instead of by the président, as
heretofore.
The President thought this was virtually an amend-
ment to the by-laws, and should lay over under the
rules.
Dr. Bronson replied that the resolution might be
passed at this session to take effect at the next session
of the association. This idea was entertained by the
Chair, and after an explanation by Dr. Bronson, that
his resolution was offered for the sole purpose of Securing
harmony, a vote was taken, resulting in the defeat of
the resolution by a vote of 163 yeas and 187 nays.
Mr. Van Bibber, of Baltimore, moved that a special
committee be appointed to investigate the merits of a
certain nameless substitute for quinine.
The Chair stated that under the rules the matter
must be referred to the section on materia medica.
Dr. Davis, of Chicago, read a preamble and resolution
endorsing the efforts of the Massachusetts State Society
in crowding out quacks, charlatans, and pretenders
from the profession, which subject was referred to the
Committee on Ethics.
The secretary asked that Dr. Edward Seguin, of New
York, be permitted to exhibit his method of examining
patients with a thermometer.
Dr. Davis opposed this violation of the rules as estab:
lishing a troublesome precedent.
The president remarked that he was accused the day
before of being discourteous, and he was now disposed
to exercise all the courtesy he could.
Dr. Seguin was told to present his method to the
proper section.
The regular business of the association was then
resumed.
MAY 18, 1872.]
TIEEI IEH C T II INTI C.
231
Reports on Publication and Funds.
Dr. Francis Gurney Smith, of this city, chairman of
the committee on publication, presented his report. It
set forth that 750 copies of the transactions of the society
had been published, at a cost of $1,549.39. Of these 475
volumes were distributed to members, including 23 to
various medical journals, and 88 copies are still due to
members. The work was completed and issued early
in November. The report concluded by reminding the
members of a resolution passed in 1870 that all members
who failed to comply with the rules of the association
within one year forfeited their right to a copy. º
Dr. Caspar Wistar, of Philadelphia, treasurer of the
association, reported that the association last year exer-
cised a praiseworthy discrimination in the selection of the
material furnished for publication, and consequently
the volume of transactions was smaller, more compact,
cheaper and more desirable to the profession than here-
tofore. The edition was published at a price which
leaves a balance on hand for the use of the association
when it may hereafter become forgetful of its prudênce,
and refer a great mass of manuscript for publication.
The treasurer counselled care in the adoption of prize
essays, for out of this has arisen a considerable expense.
The treasury is depleted annually to the extent of $200
which it can ill afford. The account current shows a
balance in hand of $1,005, being about $300 more than
was in hand last year. The expenditures during the
year were $3,680. The treasurer asks the association to
bear in mind that there are no discretionary powers
vested in the committee on publication. They must
publish everything which is referred to them by the
sections. Referred to the publication committee.
Dr. J. S. Weatherly, of Alabama, chairman of the
committee on medical education, read the report of that
committee. It urges the immediate suppression of the
cheap medical colleges, through a petition to the State
Legislatures asking for the withdrawal of all charters
of institutions of a doubtful character. The committee
recommended the adoption of a badge or medal, to be
given to all physicians in the country who are deemed
eligible for membership in the American Medical As-
sociation. It is also recommended that the association
shall establish a high standard for medical education
and members, to be arranged by a congress of professors
and practicing physicians and surgeons, all of whom are
members of the American Medical Association.
The Prize Essay.
Dr. Francis G. Smith, of Philadelphia—In the absence
of the chairman of the committee on prize essays, who
is detained at home by a sad bereavement in his family
—the death of his son Louis—and who has commissioned
me, as the second member of his committee, to act in
his place, I will present the report to the association.
Four essays were submitted to the committee; of these,
one was withdrawn by its author, and the remaining
three were carefully examined by the committee. Two
of them did not fulfill the conditions which are to de-
termine the disposition of the prize. The third one did
—that is, it presented the condition of original research,
The title of that essay is, “What Physiological Value
has Phosphorus as an Organismal Element,” and it bears
a Latin motto—“Ne tentis, aut perfice.” The name of
the author is Samuel R. Percy, of New York city.
Medical Literature.
Dr. T. Parvin, of Indiana, chairman of the committee
on medical literature, reported that he had addressed a
letter to each of his four associates—Drs. J. P. Whitney,
of California; G. Mendenhall, of Ohio; H. Carpenter,
of Oregon, and L., P. C. Garvin, of Rhode Island. He
received replies from the two last named only. Dr.
Carpenter said he had nothing to communicate. Dr.
Garvin sent a long letter, which was read, and which
contained observations in reference to the national
literature and suggestions for its improvement. The
writer asserted that we have an American medical lit-
egature of which every one should be proud. This very
city has produced works which would make quite a
library of themselves, and without which no medical
library, however vast and various its volumes, would be
complete. The names of four of the living authors of
Philadelphia who specially deserved mention are Geo.
B. Wood, Hugh L. Hodge, Isaac Hayes, and Samuel D.
Gross. Our literature, he says, is practical in character.
Although we may boast of the grace and beauty with
which Dr. Chapman clothed his thoughts; of the flash-
ing declarations of the late Dr. Meigs; of the calm dig-
nity and ornate periods of Dr. Wood, yet generally, our
American authors give less heed to language than to
ideas. If an author wishes to catch the ear of an Amer-
ican physician, he must have something useful to say,
and must say it quickly. The committee favored the
idea of offering a triennial prize of $600 for the best
essay, instead of the present plan of giving $200 to be
divided between two each year. They suggest that the
chairman of each Section deliver an address to his sec-
tion, as likely to relieve Some of the irksomeness of
listening to dry essays. A large portion of this report
was devoted to advocating the publication of a national
monthly journal, under the auspices of the American
Medical Association. Referred to the publication com-
mittee.
Dr. J. D. Jackson, of Kentucky, chairman of the
committee on American necrology, Submitted his report,
which was referred to the committee on publication
without being read.
Essays and Reports.
The secretary announced that Dr. J. G. Richardson,
of Philadelphia, would read, before one of the sections,
a paper on the structure of the white blood corpuscles.
Also, that Dr. Hartshorne would read one on the
physiology of the vaso motor nerves.
232
[MAY 18, 1872.
TIH. H. C.L.INI c.
Also, that Dr. Pancoast would present to one of the
sections, through Dr. S. Bonaparte Merkel, the case of
George Thomas. This is a colored man, a native of
England, now a resident of Frederick city, Md., thirty-
six years old, who makes a living by exhibiting his
ability to roll his abdomen with an undulatory motion,
like a huge ball, around the umbilicus, and also to move
his heart from side to side.
Also, that Dr. J. S. Packard, of Philadelphia, would
exhibit to the surgical section a suspension apparatus
for fracture of the leg.
Also, that Dr. Hunt had sent in his report on the
climatology of New Jersey. Referred.
Also, that Dr. George M. Beard would read a paper
on the recent researches in electro-therapeutics, with a
demonstration of some of the methods of application.
Also, that Dr. John P. Garrish would read a paper
on “The use of instruments in obstetrics.”
Also, that Dr. W. H. Mussey would read a volunteer
paper on “A case of vesical calculus.”
Also, that Dr. Harrison Allen would read a paper on
“The soft palate in health and disease. *
Also, that Dr. William F. Peck, of Iowa, would read
his report of an operation on the hip joint, with details
of the case.
The Contract System.
Dr. William R. Findley, of Pennsylvania, presented a
resolution which declared that as the association, at its
meeting in 1869, unanimously adopted a resolution
classing all who practiced medicine on the “contract
system” with “irregular practitioners,” and as this ac-
tion has excited considerable controversy in many of
the county Societies, the members of which have mis-
understood the meaning of that resolution, it is therefore
important that the committee on ethics decide whether
such physicians are really “irregular.” Referred to the
committee on ethics.
Dr. George Sutton, of Indiana, read a report on “Com-
parative Pathology,” in which it is urged that a national
medical library should be established.
Dr. Woodward, of the United States Army, observed
that such a library is now in existence in the Surgeon
General's office at Washington, and contains eighteen
thousand volumes. -
Dr. Pollock, of Pennsylvania, offered a resolution
creating a special committee to consider the propriety
of adopting the suggestions made in the report of the
Committee on Medical Education, which was postponed
for the present. t
A long discussion ensued upon the matter of allow-
ing the Committee on Publications to publish papers
in the annual report at their discretion. The subject
was finally postponed indefinitely. Adjourned. -
In the afternoon the various sections and Committee
on Ethics held meetings, at which a vast number of
subjects were discussed, and among them the question
of admitting the representative of the Howard Univer-
sity (colored) and several colored physicians from
Washington.
Evening Entertainments.
In the evening a lecture was delivered at the Univer-
sity of Pennsylvania by Dr. Noyes, of New York, on
“The relation of diseases of the inner structure of the
eye to other affections of the body.” There was a large
audience present, composed of the delegates, their fami-
lies and friends. The lecturer showed the analogy
between the diseases of the eye and those of other por-
tions of the body, illustrating his remarks by means of
ophthalmoscopic pictures projected upon screens by
means of the magic lantern.
At the close of this address the audience passed into
the chemical lecture room, where Prof. R. E. Rogers
delivered a short lecture on the two subjects of Spec-
troscopy and Electricity. He first explained the action
of the spectroscope in analyzing the light of the sun and
other heavenly bodies, and also that produced by the
combustion of minerals and gases, and in illustration he
projected upon a screen the spectra of several of the
substances alluded to. - -
During the evening receptions were given to the
delegates and their ladies at the residences of Dr. Wm.
Pancoast and Dr. H. L. Hodge.
TH [UIRSHDAY.
The association re-assembled this morning at the ap-
pointed hour in Dr. Wylie's church; President Yandell
in the chair.
A large number of physicians were on motion, invited
to seats on the floor of the convention *
After some preliminary business, Dr. Stein, of New
‘York, offered a resolution that a committee be appointed
to examine and report upon the transmission of diseases
from animals to man, and to report what measures may
best be adopted to prevent and arrest disease in animals.
Agreed to. - -
A preamble and resolutions adopted by the College
of Physicians of this city, the preamble reciting the
frequency of cases of accidental poisoning by druggists
and the resolution recommending that all bottles con-
taing poison should not only be labeled poison, but
should be roughed on one side So as to indicate their
poisoning contents to the Sence of touch, and also be
labeled with the most ready and efficient antidote, was
upon motion, adopted by the convention. -
A resolution offered by Dr. Horner, of Virginia, that
the members of the association should discourage the
use of alcoholic stimulants in their remedies, was
adopted. There was one “No,” the enunciation of
which produced considerable merriment.
Dr. Walker of Brooklyn, presented a resolution that
so much of the report of the Committee on Literature
as relates to the establishment of a national medical
journal be referred to a committee, to report at the
present session. Agreed to.
MAY 18, 1872.]
committee on nominations.
+
TIH. H. C.T.I. NI c.
233
Dr. Francis Gurney Smith, of Philadelphia, chairman
of the Committee on Medical Nomenclature, made a
report with a resolution attached creating a special
committee to prepare the classification and lists of
names of diseases for publication and adoption by the
asSociation. -
Dr. Woodward, of the United States army, read a
minority report, with a resolution appended, “that the
classification and nomenclature proposed by the majority
of the committee be printed in pamphlet form, and
spread broadcast throughout the profession, and that
the report be postponed for one year.”
After a protracted discussion, Dr. Woodward's resolti-
tion was adopted. -
Dr. Keller, of Kentucky, then presented the following:
Resolved, That so much of the report of the committee
on education as refers to the establishment of a medical
congress, consisting of an equal number of represen-
tatives from each state, is of immediate importance, and,
in order to further the views thus expressed, that a
committee be appointed at once to take the preliminary
steps necessary to organization with instructions to
report before the adjournment of this convention.
Before acting upon this Dr. William O. Baldwin, of
Alabama, asked leave to make a partial report from the
This was granted, and he
announced that the committee had agreed upon the
following officers to serve during the ensuing year:
OFFICERS ELECT.
President—Dr. Thomas L. Logan, Cal.
First Vice-President—Dr. Catlin, Conn.
Second Vice-President—Dr. McPheeters, Mo.
Third Vice-President—Dr. Pollock, Pa.
Fourth Vice-President—Dr. Briggs, Tenn.
Treasurer—Dr. Caspar Wistar, Pa.
Librarian—Dr. William Lee, D. C.
Assistant Secretary—Dr. M. A. Fallon, Mo.
Next place of meeting—St. Louis.
The report was accepted.
Dr. Baldwin requested further time for his committee
to complete their report. -
Dr. Keller's resolution was then voted upon and not
agreed to. - *
Dr. Palmer, in behalf of the delegation from Missouri,
thanked the association for selecting St. Louis for the
next place of meeting.
Dr. Palmer then presented a proposition for the estab-
lishment of a national medical academy, for the purpose
of elevating the standard of medical attainments and
the moral worth of its members.
The association refused to adopt this scheme.
The Health of the Mundane Sphere.
Dr. T. M. Logan, of California, chairman of the com-
mittee on “a national health council,” made a long re-
port. The conclusions of this committee can be gath-
ered from the following extract from the report:
Diffuse the discovery of the means of protection
against these and many other diseases which have been
perfected under the vigilant outlook and investigation
of combined chemical and microscopic detectives; ex-
tend what has been successfully applied in circumscribed
communities to states and to nations; let facilities for
concerted action be established internationally through
the instrumentality of governments, and the people will
no more be decimated by those pandemic waves which
have so often swept with cumulative impetuosity over
the face of the earth. Utopian as the idea may at first
sight appear of stamping out the great anti-Sanitary
evils which beget disease, still it would be taking a very
limited view of the power of the human mind, and
argue a strange obliquity of vision as to the lessons its
triumphs in other fields are every day teaching us, to
doubt our ultimate ability to do so. “That man, who
is rapidly subduing all the most Titanic forces of the
universe to his commonest uses, should always remain
at the mercy of these ignoble things is an antithesis too
extreme to be permanent.” The government of the
United States has already done something in the direc-
tion toward which these suggestions tend, by the estab-
lishment of a bureau connected with the war depart-
ment, which makes constant synopses of the weather,
storm currents and other meteorological phenomena
occurring in some of the most prominent parts of the
Union. Let the operations of the “signal service” be so
extended as to reach the remotest expansions of the
republic; and while there shall be sent from the capital
of every state and territory full telegrams of the daily
travail of nature in all her parts to the federal head, let
the respondent wire report back simultaneously every-
thing of scientific interest to the physician as well as to
physicist. -
The committee asked to be continued and to be con-
stituted a special section on state medicine and public
hygiene, to which all subjects cognate thereto may be
referred; also that they be empowered to take such ac-
tion, in connection with the authorities at Washington,
as in their judgment may be deemed expedient in carry-
ing out the objects of the resolutions.
Dr. J. C. Tucker, of California, offered a resolution
appealing to congress to establish a national sanitary
bureau, in charge of competent medical men, to be ap-
pointed by the United States treasurer, from physicians
nominated by this association.
The bureau was to have charge of all govermental
hospitals, and was to secure the proper supply of bovine
virus, besides performing many other national duties.
The plan of Dr. Tucker was very elaborate and con-
tained an act bearing upon this subject to be presented
to congress.
Dr. Gallagher moved that the report of Dr. Tucker be
laid upon the table. Agreed to.
A Warning.
Dr. Tyler, of Washington, D.C., insisted upon the
234 dºſ
[MAY 18, 1872.
T H H C T.I.N.I.C.
members exercising great care in submitting questions
to congress, as all such subjects were likely to be
governed by a ring for their personal advantage.
That portion of the report of the committee which
referred to taking action in connection with the authori-
ties in Washington was stricken out, and the report
was then agreed to.
The Various Committees.
The Committee on Nominations presented a final re-
port, as follows:–
Committee on Arrangements—Dr. J. B. Johnston, Dr.
J. T. Hodges, Dr. J. S. Moore, Dr. Robinson, Dr. Ken-
nard, Dr. Teste, Dr. Brokay, Dr. J. M. Scott, all of St.
Louis. -
Committee on Publication.—Dr. Atkinson, chairman,
Pa.; Dr. D. Murray, Chester, Pa.; Dr. Wm. Lee, Dis-
trict of Columbia; Dr. Caspar Wistar, Pa.; Dr. H. F.
Askew, Delaware; Dr. A. Meigs, Pa.
Committee on Prize Essays.--Dr. Moore, chairman,
Missouri; Dr. Gregory, Missouri; Dr. Davis, Illinois;
Dr. Parvin, Indiana; Dr. Mendenhall, Ohio. *
Committee on Medical Education.—Dr. Carson, chair-
man, Ohio; Dr. Tojan, Ga.; Dr. Howard, Md.; Dr.
Steel, Col. ; Dr. Vanderpool, N. Y.; Dr. Johnson, Dis-
trict of Columbia; Dr. Stout, Ga.; Dr. Welsh, Texas;
Dr. Scott, Ark. ; Dr. Bailey, N. Y.; Dr. Jones, Ala.;
Dr. McRuor, Me. ; Dr. Tally, S. C.; Dr. Blaine, N. J.;
Dr. Shattuck, Mo.; Dr. Jasques, Va.
Committee on Medical Literature.—Dr. Flint, chair-
man, N.Y.; Dr. Yandell, Sr., Ky. ; Dr. Henderson,
Ala.; Dr. Thrall, Ga.; Dr. Leary, Me. .
Committee on Medical Necrology.—Dr. Jackson,
chairman, Ky. ; Dr. Parsons, R. I. ; Dr. Hildreth, W.
Va.; Dr. Johnson, D. C.; Dr. Simmons, Cal.; Dr.
Wariner, Oregon; Dr. Stevens, Ohio; Dr. Agnew, Pa.,
and others. . - -
OFFICERS OF SECTIONS.
Chemistry and Materia Medica.--Dr. R. E. Rogers,
chairman, Philadelphia; Dr. Ephraim, Cutter, Secre-
tary, Boston.
Practice of Medicine and Obstetrics.--Dr. D. A.
O'Donnell, chairman, Baltimore; Dr. Benjamin F.
Dawson, secretary, New York,
Surgery and Anatomy.--Dr. Warner, chairman, Bal-
timore; Dr. W. Peck, secretary, Iowa.
Climatology and Epidemics.--Dr. George Sutton,
chairman, Indiana; Dr. Elisha Harris, secretary, New
York. g :
Medical Jurisprudence, Hygiene and Physiology.—
Dr. R. C. Busey, chairman, Washington; Dr. H. B.
Arnold, secretary, Baltimore. :
Psychology.—Dr. Isaac Ray, chairman, Philadelphia;
Dr. John Curwin, secretary, Harrisburg. -
The reported was accepted.
A preamble and resolutions were presented and
adopted declaring the Massachusetts Medical Society in
full accord with the American Medical Association,
upon which Dr. Bronson, in behalf of that society,
tendered its thanks for the unanimity with which the
preamble and resolutions were carried.
Ethics—Exit Dr. Bliss.
The Committee on Ethics presented their report, in
which, among other things, the names of certain mem-
bers were mentioned for exclusion for non-payment of
dues; and also the same action in regard to Dr. D. W.
Bliss, who is under sentence of expulsion from the
society of D. C.; also, that alumni associations of med-
ical colleges were not entitled to be represented in the
association. The subject of the contracting for the sup-
plying of medical attention by the year to every one
other than charitable institutions was laid over.
The Inevitable Contest.
The question of the admission of females to positions
as students and professors, in various medical institutions,
was then referred to, and after a recital of the past
action of the conventions on the subject, mention was
made of the names of the Academy of Medi-
|cine, of Washington, D. C.; the Freedmen’s Hos-
pital, of Washington, D.C., and the medical depart-
ment of the Howard Institution, as associations which
had females among their practitioners, and had among
their members unlicensed practitioners. The com-
mittee recommended that the delegations from these in-
stitutions be not, therefore, received in the present
body.
Dr. Rayburn, of the District of Columbia, one of the
professors of Howard University, took the floor against
the recommendation of the committee. He alleged
that if the delegates referred to were kept out, they
would be kept out because they were not in good stand-
ing with the Washington Medical Association, and that
that association licensed irregular practitioners, and also
charged a fee for its license, against the legality of which
there had been several judicial decisions.
The Howard university, he said, received all who ap-
plied for medical education, without distinction of color
or of sex.' If the association see fit that institutions of
that class shall not be represented, of course they have
the power so to act, but, at the same time, it should
consider well what it was doing before taking such a
step. He thought that every human being should be
allowed the right to the very highest development that
God has made him capable of. -
Dr. Busey, of Washington, followed him in the defense
of the medical society of that city, and in favor of the .
recommendation of the committee. He asserted that
the society had never licensed irregular practitioners,
or homeopathists, or any practitioner that had not pre-
sented a diploma from some regular medical school, or
passed an examination before the society's board. Dr.
Rayburn, on the contrary, was a member of an institu-
tion which did receive irregular practitioners.
Dr. Parmer, of Washington, from the Howard Uni-
versity, spoke on behalf of that institution. He denied
MAY 18, 1872.]
T EH. H. C. T.I.N.I c. ;
235
that there was a lady member of the faculty, but that a
lady had been employed as ophthalmologist. He ac-
knowledged, however, that the lady spoken of was
ophthalmic surgeon of an institution in which certain
members of the faculty of Howard University are in
daily consultation. -
At the conclusion of this address, a great deal of con-
fusion was occasioned by crys of “question,” and by
hisses from those who were anxious to vote without
further discussion. .
Dr. Parmer explained his position as professor in the
Howard University. He said he had not practiced
medicine in that city, and, therefore, had not procured
a license, as the law requires. He did not understand
why he should be excluded from this association on ac-
count of his connection with that institution. .
A very rambling and animated discussion followed,
and the president had great difficulty in preserving
order. Motions were made in rapid succession, but they
were not noticed by the chairman. - *
Dr. Sayre, of New York, moved that the resolution
of the committee be adopted. -
Dr. Todd seconded the motion, and, under the call of
the previous question, it was finally carried by an over-
whelming majority, whereupon the convention ad-
journed. - -
In the afternoon the various sections met as on the
two previous days, for the consideration of medical and
scientific subjects. - ,
The members subsequently repaired to the University |.
of Pennsylvania to partake of an entertainment tendered
them by the professors and graduates of that institution.
In the evening, a lecture on Sound was given by Dr.
F. Solis Cohen, at the Jefferson Medical College. The
doctor illustrated his remärks by the use of various in-
genious and delicate apparatus, showing in one case the
waves of sound through the intervention of light thrown
upon a mirror. The lecture room was crowded with
the delegates and invited guests. After the lecture, a
handsome entertainment was given to the members of
the convention and their ladies by Col. Thomas A.
Scott at his residence.
- FRIDAY.
The association convened in the same church and was
called to order at the same hour by the President Dr.
Yandell in the chair. - . . . .
: Resolutions of regret were offered for the death of Dr.
Zeno Pitcher of Detroit; Dr. W. W. Gerhard, Dr.
Henry M. Dickson and Dr. Samuel Jackson, of Phila-
delphia. - - - - -
Dr. Porter, of Delaware, spoke on the resolutions,
paying a high tribute to the memory of Dr. Gerhard.
The resolutions were unanimously adopted by a standing
VOte.
A resolution providing that the Marine Hospital
Service be placed upon the same footing as the medical
department of the U. S. Army, was laid over until the
next meeting.
The reports of the various sections were presented,
and without being read were referred to the Committee
on Publication. -
Reports were received from the following Special
Committees, and referred without reading, to the
Committee on Publication; On the Cultivation of the
Cinchona Tree, Dr. L. J. Deal of Philadelphia, Chair-
man; On the Structure of the White Blood Corpuscles,
Dr. J. G. Richardson, Pa., Chairman; On Correspon-
dence with State Medical Societies, Dr. N. S. Davis,
Illinois, Chairman. - -
Professor Gross offered an amendment to the by-laws,
modifying the third section, so that instead of a report
on Medical Education, or Medical Literature, or Cli-
matology and epidemic diseases, there shall be annually
delivered before the association, at its general meetings,
an address on Medicine, one on Surgery, one on Mid-
wifery, or the Diseases of Children, the lecturers to be
appointed by the Committee on Nominations.
Laid upon the table till the next annual meeting.
Dr. Hartshorne offered a resolution, which among
other things, recommended the appointment of a com-
mission of experts by the Courts in all capital criminal
cases where medical testimony is needed, instead of the
present system of employing physicians as witnesses on
opposite sides. Adopted.
Dr. Askew, of Deleware, was appointed to prepare a
series of resolutions expressing the feelings of the associ-
ation upon the death of Professor Samuel Jackson.
Resolutions of thanks were passed to the officers of
public institutions, of the naval Station, and to the
authorities and congregation of the First Reformed
Presbyterian Church Association. Also, to the Com-
mittee of Arrangements, medical profession, faculties
and officers of the colleges, Colonel Thos. A. Scott,
Dr. Wm. Pancoast and Dr. Hugh L. Hodge, and to the
retiring President, Dr. D. W. Yandell. - -
Dr. John Morris, of Baltimore, also moved that a vote
of thanks be returned to the members of the press of
Philadelphia, for their faithful attendance during the
sessions. Adopted. - * -
A resolution was introduced setting forth that the
Association acknowledges the right of women to study
and practice medicine and surgery in all the branches,
but comdemns the public association of the sexes in
mixed classes and clinics as subversive of true modesty
and delicacy in both sexes. The consideration of the
resolution was indefinitely postponed.
The formal business of the Association being gone
through with, the Chair addressed the convention in
words of thanks for their support of him and his decis-
ions during the sessions of the Association. He closed
by hoping to meet all the members of the Association
again on the other side of the Mississippi, at the next
annual gathering. He then declared the Convention
adjourned sine die. . -
By the many trains which left the Reading Railroad
| Depot during the afternoon, hundreds of the members
236
[MAY 18, 1872.
T TH. H. cI.T. N. I c.
of the Convention visited the Park, and amused and
entertained themselves by driving to various parts of
that section of the city, in lounging beneath the trees of
the Belmont Mansion, and in partaking of temporary
refreshments, preliminary to a collation which had been
prepared for them in the pavillion.
This part of the ceremonies of the day came off at
4 o'clock, and the delegates, their ladies and invited
guests, passed a most delightful hour in the pleasurable
business of partaking of the luxuries of the season—a
fitting termination to a professional business reunion.
At the close of the entertainment, addresses were made
by John C. Cresson and John Welsh, Esqs.
—-º-º-º-
O R. I. G. I N A I, A R T I C L E S.
sun-INvoluTroN of THE UTERUs witH.
I DISP [, ACEMENT.
BY
PROF. THAD. A. REAMY.
Clinical Lecture delivered at the Dispensary of the Medical College
of Ohio.
Reported by W. L. Beebe, [Member of the Class].
GENTLEMEN;
This woman comes suffering, as she thinks, with pro-
lapsus uteri. She will assume the recumbent posture on
the left side. We will protect her by a sheet, and make
digital examination. We find the cervix considerably
enlarged, elongated and thrust back into the hollow of
of the sacrum. The OS and intracervical walls, so far as
I can reach the latter, present to the touch a high
state of congestion, if not ulceration. Passing my
finger into the post cervico-vaginal space, pressing up-
ward I detect increased volume and weight indicating
either retroflection, retroversion, or thickening of the
lower segment of the post-uterine wall. From the direc-
tion of the cervical axis, the OS being far back, it cannot
be retroversion. Passing my finger into the anterior
cul-de-sac I find a corresponding forward fulness, there-
fore, I hardly think there exists retroflexion, but most
likely abnormal enlargement of the entire uterus.
This opinion is confirmed by the evidence elicited by
conjoined manipulation with my left hand above the
pubes. The uterine volume is clearly detected through
the abdominal wall. I shall now introduce Simpson's
sound which will settle the points of version, flexion, or
enlargement. I have no hesitancy in introducing the
sound on the ground of possible pregnancy; for this
woman is nursing a child seven months old, and has not
only menstruated four months past, but during the
last period, just closed, the flow has been abundant,
and continued two or three days beyond the usual time.
I find by the sound there is no flexion or version; but
the long diameter of the uterine cavity is nearly four
inches. Each of you, gentlemen, may now make the
digital touch and observe for yourselves the conditions
to which your attention has been called. You will be
as gentle and careful in your manipulations as possible,
that no unnecessary irritation may be inflicted. This
should ever be your rule in practice. And I am certain
you will feel yourselves under special obligation to ob-
serve it with this good woman, who has furnished you
an opportunity for practical instruction, but not with-
out sacrifice to her feelings.
The patient will now be placed upon her back, the
limbs flexed, nates brought to the verge of the couch;
her person completely protected by this sheet which is
perforated by an opening sufficient to admit the specu-
lum. Allow me here, gentlemen, to ask you thus to
prepare the sheet or covering for your patients when-
ever it becomes your duty to employ this instrument,
for it is neater and more thoroughly prevents exposure;
which is no small argument in its favor. I trust that
I address gentlemen who will fully appreciate all that
is here implied, who will throughout their professional
career feel themselves bound by the most sacred obliga-
tions, under all circumstances, with the most tender
Solicitude, to protect the delicate sensibilities of woman,
and equally so whether you find her in the highest or
humblest walks of life. The man who cannot scrupu-
lously do this is utterly unworthy of such trusts as are
committed to the physician. I use Cusco's bivalve
modified by Mr. Autenrieth at my suggestion, being a
little broader at the distal extremity than the ordinary
pattern. For facility of introduction and range of
vision, this style of speculum is in my judgment
superior. You have now, gentlemen, a perfect view of
the OS, cervix, and when I spread the blades wide
asunder you can see considerable distance into the
cervical canal. You have visual confirmation of the
opinion arrived at by touch. The cervical walls are
thickened, highly congested, the cervix elongated, lips
slightly everted, muciparous glands enlarged, pouring
out an abundant secretion, mucous membrane at en-
trance of os in first stages of ulceration, vaginal walls re-
laxed and greatly distended. -
Now, gentlemen, before we announce the diagnosis,
let us consider one or two facts in the history of this
case. This patient is 34 yrs. of age ; seven months ago
she gave birth to a child. At the completion of term,
the uterus, which in the virgin state weighs but one
and a half or two ounces has increased to several pounds;
in dimensions, from one and a half to two inches
longitudinal diameter to more than a foot. After de-
livery as you know the uterus normally returns approx-
MAY 18, 1872.]
T ET H C T.INI c.
237
imately to its virgin dimensions. This process requires
from fifty to eighty days, and is called involution.
This woman informs us that necessity compelled her
to arise from the lying-in bed within seven days after
delivery. From then until now she has discharged all
her household duties, including cooking, washing and
ironing. What is the result 7 The diagnosis of this
case? -
Sub-Involution,
The material constituting the growth which was
essential during pregnancy has not been disposed of;
there is sub-acute cervicitis, endometritis and corporeal
inflammation. The uterine cavity is enlarged, the
vaginal walls relaxed and distended, therefore, losing
their power to grasp the cervix and sustain the uterus,
whose increased weight demands more than ordinary
support, more or less prolapsion must follow. Now
you have an explanation of the pelvic weight, constipa-
tion of the bowels, excessive menstruation, indeed all
the depressing symptoms which torment this poor
woman. She was correct in her opinion that prolapsus
exists, nevertheless it exists to no very great degree,
but in this, as in most cases of so-called prolapsus which
come under our observation, change of structure in the
vagina, uterus, or its appendages or in all of these, change
consequent upon inflammation will be found as the
principal pathological factor; and no treatment which
does not clearly recognise this fact can be either rational
or successful. I beg to remind you gentlemen, that
simple displacement of the uterus, healthy and normal
in size, in any direction including flexions, versions, or
descent to a degree which will be likely to occur is a
matter of no consequence. One moments reflection as
to the weight, location, and normally free movable
character of the organ must convince you of the Sound-
ness of these principles.
I cannot do better than to recommend to those of you
who would be glad to study this subject at length the
admirable work of Jas. Henry Bennett, M. D. on “In-
flammation of the Uterus.” No man in my humble
judgment, either home or foreign, has written upon this
subject with more fairness and candor. And his argu-
ments showing that inflammation usually precedes dis-
placement, sustained by a large number of cases are
unanswerable. It may not be improper for me to add,
that in a large experience embracing several hundred
cases which have been under my charge within the
past twenty years, my observations made in the study
and management of. many of these cases with special
reference to solving correctly these very points of dis-
pute among uterine pathologists fully sustain the doc-
trine above announced. Again, therefore, gentlemen,
let me impress upon you, that in the case before you, as
in nineteen-twentieths of those you will meet in prac-
tice, you should recognise chiefly inflammatory changes,
Secondarily displacement.
Treatment.
I regret that this poor woman's circumstances are
such that she cannot enjoy an almost indispensable ele-
ment of success in curing her, viz., rest. You have al-
ready learned that this woman within seven days after
accouchment while the uterus was yet large and greatly
increased in weight, its ligaments, pelvic fascia, and
other minor means of support weakened, its chief sup-
port, the vaginal walls, rendered almost useless by
recent distension, resulting necessarily in the conditions
we have found. Therefore need I say here, see to it that
lying-in women under your charge remain in bed most of
the time during three or four weeks after delivery; and in
all cases where it is possible their exercise should be
moderate during the first two or three months. If you
will insist upon this course giving authority
to your requests by an intelligent explanation to the
patient and friends of the principles involved, you will
be the means of averting a large per cent. of uterine
disease and a vast deal of suffering. And permit me
here to say, although not relevant to this case
that every woman, married or single, who men-
struates should observe comparative quiet during the
flow. For there is not a pelvic structure which under-
goes congestive changes during parturition, that does
not undergo more or less change at each menstrual
period. I beg you never underrate prophylaxis. The
medical man who intelligently educates his patients to
prevent diseases is a far greater blessing to humanity
than he who is skillful in combating disease when it
exists.
But time will not allow further digressions. This
woman must take all the rest possible. She will have
injections into the rectum of cold water twice daily.
Vaginal injections with warm water every night. Let
the vaginal nozzle of the syringe be inserted so as to
allow the stream to reach the cervix. The effect of this
treatment continued for months, as it must be, will be
quite marked, reducing the changes which have taken
place in the vaginal walls and cervix. Within the cer-
vical canal we shall insert a pledget of lint saturated
with glycerine and tannin. I have derived benefit in
similar cases from Ext. Pinus Canadensis. If relief to
the cervix does not soon follow I shall apply a solution
of nitrate of silver 8 to 15 grs. to 3.j. She is to have a
saline cathartic twice a week. Iodide of potassium 20
grs. three times daily. In the course of a few weeks the
iodide may be substituted by hydrarg bichloridi 1–16th
to 1–10th gr. three times daily, to be continued two
weeks then alternated with the iodide of potassium. If
under this treatment decided improvement is not mani-
fest, leeches should be applied to the cervix. I have
seen the most rapid improvement follow their use, doubt-
less dependent not alone upon the amount of blood ab-
stracted, but largely upon the absorbent activity com-
municated by nervous influence, direct and reflex as a
result of their bite. In cases quite chronic when the
238
[MAY 18, 1872.
TIEE C T , T N T C.
vaginal walls are much relaxed benefit will follow the
use of electricity.
Pessaries.
The practice so prevalent of using these appliances is
not only contraindicated by the pathology of uterine
displacements, but positively condemned by careful
clinical observation.
What good could follow pressing this inflamed uterus
upward through the medium of the neck, also inflamed,
and this by an instrument that must further distend
the vaginal walls? -
The Babcock pessary and others acting upon the same
principle avoid vaginal distention, but they increase
cervical inflammation and retard the cure. Intra-
uterine pessaries are still more objectionable. $
I could only consent to the use of pessaries in Some
rare cases of flexion and version, when all acute inflamma-
tion has subsided, and in such cases the instrument
should be worn temporarily; Hodge's double lever
being best. In complete procidentia also when inflam-
matory symptoms have subsided, the pessary may be
employed as a palliative. -
In conclusion (as we must examine other cases that
are in waiting), allow me to assure you, suc-
cess in the management of uterine inflammations and
displacements either occurring in the virgin or married
women will only crown the efforts of him who studies
each individual case carefully and intelligently, and
conducts his treatment accordingly. Time and perse-
verence will accomplish great results. -
—º-e-º----
DYSMENORREICEA. .
Its Varieties and Nature.
BY
C. D. PALMER, M. D.
There is a tendency in the medical mind to narrow
the pathology of any disease to within the smallest pos-
sible limits, for on such a simple basis the erection of a
plan of treatment becomes correspondingly plain. The
adoption of such opinions has often proved to be most
incorrect on full investigation, and in practice pernicious.
Views although narrow and one-sided, when advanced
by men of marked ability and prominence, almost nec-
essarily meet with a speedy endorsement and adoption
on the part of the profession; it must be confessed, how-
ever, to the decided injury of suffering humanity.
In the study of no disease do we see the proof of the
above remarks better illustrated than of dysmenorrhoea.
In 1848, Simpson whose mind possessed a strong surgi-
cal tendency, and whose mechanical abilities were of
the highest order, recognising with Velpeau, the fre-
uency of, and difficulty in the management of uterine
h;, by the ordinary methods, re-introduced the use
of the intra-uterine stem pessary. With what result
subsequent experience and history have plainly told.
In 1832, Mackentosh of England, conceiving the notion
that all dysmemorrhoea was of mechanical origin, intro-
duced the practice of dilating the uterine canal to over-
come the seat of obstruction. Reporting on the practice
he declared, that out of twenty-seven cases treated,
twenty-four were cured; Of course his practice and
reports largely influenced others. Our eminent country-
man Sims, has for some time entertained similar views,
laying it down “as an axiom that there can be no dys-
menorrhoea, properly speaking, if the canal of the neck
of the womb be straight and large enongh to permit the
free passage of the menstrual blood.” And again, “dys-
menorrhoea is simply a symptom to be found in some
abnormal organic condition.” The originality, genius,
and boldness and success of this distinguished gynae-
cologist, have won to him a large school of ardent ad-
mirers and followers. Not a few physicians to day
coincide in the exclusive mechanical origin of dysmen-
orrhoea.
But, is all dysmenorrhoea mechanical ?, Most of the
recent authorities in gynaecology have divided dysmen-
orrhoea into at least four distinct varieties; the neural-
gic, congestive, inflammatory and mechanical. Is there
propriety in recognising in practice these varieties?
That there is, abundant evidence is afforded by clinical
observation and experience. . . -
Neuralgia it is admitted on all sides, frequently
affects various portions of the human system. There is
no reason why so important organs as the uterus and
ovaries, with such abundant nerve and blood-vessel
organization, should not be similarly affected. And if
so, most likely it would be at the very time of their
greatest functional activity. Painful menstruation is
induced by fatigue, mental and bodily depression, and
various other causes operating upon the nervous system.
Pelvic suffering is by no means uncommon of a severe
kind, during the menstrual interim, from causes acting
locally and capable of inducing neuralgia elsewhere.
The time of occurrence of the pain in dysmenorrhoea in
many cases argues its neuralgic nature. Commencing
before the menstrual flux is established, often increas-
ing in severity after that time, it continues though in a
mitigated form till its close. . The flow does not relieve
it. The state of the general health of the patient gives
evidence of the nature of the menstrual suffering. Is
she anaemic, and subject to neuralgia in other parts of
the body ? If so, the presumption is, that the dysmen-
orrhoea is neuralgic, especially if in a virgin in whom
organic pelvic disease is comparatively uncommon.
Here, there being a degree of immaturity and perhaps
excitability of the sexual apparatus, the painful state is
assumed by virtue of its special impressionability.
The character of the pain is peculiar. Acute, lancin-
ating, and although paroxysmal, still unlike the pain
from the spasmodic contractions and bearing down
efforts belonging to the obstructive form of the disease.
The seat of pain may be either the ovarian or uterine
region, or some distant part of the body. There is no
evidence of organic pelvic disease on account of morbid
symptoms in the menstrual interval, or determined by
a local exploration. The uterine canal is sufficiently
open and the flow is not clotted. -
The seat of pain being the uterus or ovaries, has oc-
casioned the terms uterime and ovarian neuralgic dysmen-
orrhoea. But, as stated, the pain is not necessarily so
limited, for it may attack the head, face, knee or toe.
In the latter circumstance, its special location is not
always uniformly the same.
This is what is meant by systemic or constitutional
dysmenorrhoea, the idea of which Sims has so much
ridiculed. -
Thus, the time, character and seat of menstrual pain,
often become valuable elements in the diagnosis for de-
terming the variety.
Again, corroborative evidence is had in the marked
* Sims' Uterine Surgery. .
MAY 18, 1872.]
TIH. H. C.I.I.INI c.
239
relief which is obtained by the use of anti-neuralgic
treatment. The vast majority of cases occurring in
virgins, through attention to the general health by
proper hygiene, and by the steady administration during
the menstrual interval of such remedies as iron, quinine,
nux-vomica, arsenic and galvanism are effectually con-
trolled. While again, and often, the use of such agents
at the painful periods, as belladonna, bromide of potas-
sium, gelsemium, cannabis indica, apiol and oxide of
silver, remedies addressed to the nervous system, are
attended with the most beneficial results. Certainly,
if there was obstruction of an organic kind to the men-
strual flux, these remedies would not prove curative.
It would seem very reasonable then, to term this
form of dysmenorrhoea neuralgic, and as Anstie correctly
remarks, not on account of the circumstance of the men-
strual discharge, but because it attends the process from
an exaggerated irritability of the organs concerned.*
It is usually thought that those who suffer from
dysmenorrhoea are apt to be sterile. Such is true, when
the disorder springs from a congested, inflamed state of
the organs, or a distorted shape of the uterine canal,
but needs proof when applied to the variety under con-
sideration. On the other hand, the experience of many
good observers would lead us to the opposite opinion.
As to the production of pain in the congestive and
inflammatory forms of the affection, little need be said.
An organ in a healthy condition performs its function
painlessly, quite unconsciously to the patient, but when
inflamed the .* intense suffering may result. As an
exemplification We have the pain of deglutition in
pharyngitis, of digestion in gastritis, of defecation in
rectitis. -
Dysmenorrhoea resulting from the inflammatory affec-
tions of the uterus, throw some light upon the location
of that inflammation. As a rule, little or no pain at-
tends menstruation when the cervix uteri is alone in-
volved, either in its mucous or parenchymatous tissue,
(for this portion of the organ does not take part directly
in the menstrual changes)—provided the canal is
normally well open, so that no stretching of the circu-
lar fibres is provoked. -
Fortunately for the patient, in cervicitis the canal is
rendered patulous. - -
Severe, and long continued dysmenorrhoea coming on
gradually for days prior to menstruation, coupled with
symptoms and signs of uterine inflammation, becomes
strong presumptive evidence of corporeal implication.
Very generally, the degree of suffering is in a direct
ratio with the extension of the disease from the corpo-
real mucous membrance to its parenchymatous sub-
Stance. -
Marked relief from pelvic pain attending uterine in-
flammation sometimes follows a free menstrual dis-
charge; evidently, on account of the local depletion in-
duced. This symptom then, is valuable in diagnosis—
and also as affording a good indication for treatment.
It becomes a very easy matter to understand the
mode of production of pain in ovulation when there is
ovaritis. - -
The uterus is not unfrequently the seat of rheuma-
tism. Its special tissue organization leads us to the
conclusion when we bear in mind the place of selec-
tion of that disease. The many and decided cures which
Dewees obtained by his tincture of guaiacum can be
explained best in this way. Other anti-rheumatic reme-
dies in appropriate cases act equally well.
As to the so-called membranous variety of dysmen-
orrhoea, the weight of opinion is that it has an ovarian
origin. The changes in the uterus at the catamenial
period in extent and kind, are wonderfully influenced
by the condition of the ovaries. Witness the uterine
changes in the decidual formation from the impregna-
tion of an ovum exterior to that organ. So under the
obedience of ovarian irritation, or inflammation, the
uterus is mislead by the morborific influence. This
view is advanced by Oldham, Tilt and others. ; Sir C.
Locock well remarks, “from the supposition that the
membrane is always expelled, and that it consists of
coagulable lymph exuded from the lining of the uterus,
necessarily resulting from inflammatory action, has
arisen a very faulty opinion of the nature of the disease,
and a most mistaken and pernicious mode of treatment
when universally applied.”
The existence of mechanical dysmenorrhoea remains
no longer a doubt. The symptoms arising from the ob-
struction are usually peculiar and enable the carefully
inquiring physician to strongly suspect the return of
the difficulty. Pain does not commence until the flow
is established, increasing in severity in proportion to it,
diminishing as it ceases—in fine, in any individual case
existing in direct relation with the quantity of dis-
charge. -
The character of pain is intermittent or remittent,
like the throes of labor, and is described as such by
women who have gone through parturition. As often
as the cavity of the womb fills with blood, contractions
are provoked to overcome the obstruction and expel the
contents. Until the organ is again refilled no pain is ex-
perienced. The seat of pain is the uterine region.
Here again the time, character, and seat of pain, are
valuable symptoms in differentiation. Of course only a
positive diagnosis is made out by a local examination.
The determination of the presence of obstruction, though
frequently a very easy point, as when arising from an
elongated cervical cervix, cicatricial tissue, versions or
flexions, still is not invariably so. This forces us to
the conclusion, ever to be recognized, that mechanical
dysmemorrhoea may not only be absolute but relative.
Some standard then of normal calibre of the cervical
canal must be established to determine. Dr. Tilt has ven-
tured on this: “Where the cervical canal will not let
an ordinary sound pass through it easily, the cervix
should be dilated or divided.* Ever so patulous a
canal may serve as an obstruction if the discharge is too
freely formed in the corporeal cavity, or become clotted
there from certain blood states, or inflammation of the
mucous lining. Or, a canal considerably smaller than
the average may afford no obstruction if the flow is
scant and prolonged.
To the mind of the author not a few instances of the
so-called obstructive dysmemorrhoea, have their path-
ology in a spasmodic state of the circular fibres of the
cervix and the os-internum. The power of the inner os
to contract is well seen in the difficulties met at times
in attempting the introduction of the sound. In the
healthy organ there is a closure here during the men-
strual interval, a relaxation just prior to the coming
period. The underlying pathological basis producing
this spasm may be either a neuralgia of the uterus or
ovaries, or congestion or inflammation of their organs.
The degree of spasm, amount of obstruction and con-
sequent pain vary at different periods, according to the
amount of local difficulty. This mode of diseased
action is found elsewhere. Vaginitis and vulvitis cause
vaginismus. Neuralgia and inflammation of the rectum
spasm of the sphyncters of that viscus.
Very many cases of dysmemorrhoea have a mixed path-
ology. This may be inferred partly from what has been
stated, and appears more evident upon further consid-
eration. -
Thus the neuralgio, form may by virtue of extreme
* Anstie—Neuralgia and its counterfeits.
* Tilt's Uterine Therapeutics,
240
[MAY 18, 1872,
TIEEE C T.I. NTI c.
suffering in a patient with deterioration and depreciation
of the general health, become complicated with the
inflammatory element. Again the obstruction may
be the primary link in the chain of disease of an indi-
vidual case, which through retention of the menstrual
fluid and consequent distension and excitement of the
uterus to violent contractions, excite inflammation in
the , mucous membrane and hyperaemia of the pa-
renchyma. Still again, mucous inflammation may be
the primary link, which inducing increased weight and
bulk, gives rise to version and flexion, and thus the
Secondary link or mechanical obstruction follow. In
either of the two last instances, the neuralgic element
may enter secondarily. The membranous presents the
symptoms of the mechanical. In a certain sense, nearly
all cases of dysmenorrhoea independent of congenital or
acquired occlusion, strictures, distortions, are mechan-
ical. The neuralgic is so rendered by the condition of
spasm; the inflammatory by the presence of clots of
blood, swollen mucous menbrane, displacements, te.
But it should be borne in mind that the above mentioned
varieties do entirely independently exist, or one of them
at least, is sufficiently prominent to afford the necessary
indications for proper management. .
—º-e—sº-
A C A D E M Y O F M E I DIC [ N E .
vºm-º ºmºmº
JAS. GRAHAM, M. D., PREST., L. WOLF, M. D., SECT.
Transactions May 13, 1872.
Reported by Joseph Ransohoff.
DR. BARTHOLOW read a highly interesting paper
upon the efficacy of paracentesis thoracis in the treat-
ment of pleurisy with effusion, illustrating his re-
marks by a series of cases. .
DR. GRAHAM referred to those cases of this disease
which he had been in the habit of describing as latent
pleurisy. . In these cases the premonitory symptoms are
not at all present, or only so to a slight degree, until
effusion takes place. In the treatment of pleuritic
effusions, he would occasionally succeed in slightly re-
ducing the quantity of the effused liquid by means of
hydragogue cathartics. In other cases this treatment
was found entirely useless. He then related the case of
a boy who had been sick for some time previous to the
first examination. Upon physical exploration one-half
of the cavity of the chest was found full of fluid.
Treated the case with brisk hydragogues without any
apparent absorption of the effused liquid. Paracentesis
will be resorted to, with great probability of a cure.
DR. MILLER presented several pathological specimens
removed from a patient who had died of purpura hemor-
rhagica. The subject was irregular in his habits, but
in robust health until May 4th. Saw him for the first
time on Thursday, and found him suffering greatly from
dyspnoea. Observed a peculiar, offensive, cadaveric
ador emanating from the patient. Upon examination,
the entire trunk was found to possess a peculiar florescent
hue, while red spots were observed in the left iliac
region, and upon the arm. Some of these spots were
also pustular. The patient complained of headache, and
severe pain in the epigastric region. Later, on the same
day, found the entire surface covered with this florescent
hue, with here and there ecchymosed spots. These
ecchymoses had also extended to the hands and feet.
There was no hemorrhage from the mouth nor from the
nose, although some had occurred from the bladder.
The post-mortem examination was made nine hours
after death. The lungs although of a very dark hue,
presented no decidedly diseased condition. Found old
pleuritic adhesions, and the sequelae of a previous attack
of pneumonia. Upon section, the lungs presented a
deep-red appearance, and the exudation of a bloody and
frothy fluid. The right side of the heart was loaded
with adipose tissue, while over its entire surface
ecchymoses were visible. Some effusion was also present
about the coronary arteries. The muscular tissue was
healthy, and the valves were competent. The omentum
was covered by a layer of adipose tissue, half an inch
in thickness. The liver weighed five and a half pounds.
The gall-bladder was entirely filled with gall-stones.
The stomach was spotted upon its external surface, and
ecchymoses were observed in the sub-mucous tissue,
although no free blood was found in the cavity of the
stomach. This condition was present along the whole
extent of the intestinal canal. The pancreas was
hard and indurated, but not hypertrophied. Free
blood was found only in the kidneys and the bladder.
The mucous membrance of the latter organ presented
no mottled appearance.
DR. MUSCROFT called attention to a case of Small-pox
which had came under his charge. The eruption de-
veloped itself in due time, and the case seemed to be a
mild one. It soon, however, became confluent. During
the duration of the disease, the patient was attacked by
severe menorrhagia, which was arrested by means of
aromatic sulphuric acid. Soon after the arrest of the
uterine hemorrhage, indications of purpura became
manifest. -
The Dr. also made mention of two cases of peculiar
hemorrhage in children, which had been sick with
scarlet fever. In both cases, a small, conical tumor
made its appearance upon one side of the neck. From
the apex of this tumor a drop of blood exuded. In
both instances fatal hemorrhage Supervened.
DR. REAMY. remarked that he had seen many cases
of purpura hemorrhagica in an epidemic of diptheria
in 1857. He never knew of a well marked case, that
recovered.
DR. CLEVELAND stated that this case reminded him
of one which he had seen one hour before the death of
the patient. She had all the prodromic symptoms of
small-pox. Ecchymosed patches were visible over the
entire surface, and the conjunctiva was in an ecchy-
mosed condition. There was slight epistaxis, and
profuse hemorrhage from the uterus and vagina. No
papular eruption was noticed. The diagnosis of hem-
orrhagic small-pox seemed to be sustained, since six
individuals who lived in the same locality were sub-
sequently attacked by this disease. - -
DR. C. P. JUDKINs reported one case of small-pox
in which these petechia were visible 48 hours before the
papular eruption appeared. We had seen several of
these cases at the pest house during the present small-
pox epidemic and this condition was not considered as
a very unfavorable symptom as all such cases recovered.
DR. LUDLow referred to a case of purpura hemor-
rhagica in a child one year old which he treated with
iron, turpentine and castor oil. This child made a good
recovery.
DR. MALEY presented a specimen which had been
passed (per rectum) by a patient who had suffered
intense pain in the region of the flexure. Referred to
the section on morbid anatomy. º
DR. LUDLow reports a case of procidentia Vesicº-
The displaced viscus was replaced by the usual method,
and retained in position by means of sponge, tampoºs-
DR. JULER read a very learned and highly, inter-
esting paper upon the treatment of cholera by the use
of morphia hypodermically,
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GooD s AMARITAN HOSPITAT.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of Sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
with commanding views, surround the whole house, and wide
E-
pointments of a First-class Hospital. Porticoes,
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
sISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand or
Bºy" Address, +
SISTEF, ANTHON.Y,
FHospital Of the Good Samaritan,
Corner of Stacth and Lock Sts., Cincinnati, Ohio-




































































Wm. Wilson McGrew,
JW2, 2% WºSA" Mazºzºz Szºzº,
PIKE's OPERA, HOUSE BUILDING,
Importer and Dealer

--~~zee I N weeee-
Diamond and Gold Jewelry,
Watches for Ladies and Gentlemen,
Sterling Silver Tableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
Marble Statuary,
FAN cºr Coons,
G E N E R A L L Y.
|UNHºuſ MP Mºſ
167 EAST 34TH-ST., NEW YORIK,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANUFACTURERS OF PORTABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwanic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
|M|| ||||||—|||ſ|| ||||||}
PEERMANIENT BATTERIEs,
For Hospitals and General Practitioners,
TET IIECTIE,OIDIEGS.
For Eye, Ear, Larynx, Nose, Uterus, Vagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Eleo-
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
IEXTRA (!TS FROM THE OPINIONS OF THE MOST
JEMIN ENT IMEIMIBIERS OF TEII PROFESSION.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “NoTHING CAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. Hammond to announce en-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
MEREDITH CLYMER, M. D., Prof. of Diseases of the Ner-
vous System and of the Mind, &c., &c.—“I consider theºr
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:—‘ In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. GARRATT, M.D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M.D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;
ALLEN MAYNARD, M. D., Cleveland, 0.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, 0.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
CALL OR SEND FOR, CIRCULAR AND PRICE LIST.
\lº"O.S*T*E-IR’s
IE'_A_TIEHINTT
Jimhritial
Are furnished to Officers and Soldiers on Government
account.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTEE,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 172 Jef-
ferson Avenue, Detroit, Mich-
SAML. P. THOMAS
T.A. I. I. O.R.,
DEALER IN
English, French and Scotch
GOODs,
34 West Fourth Street,
("Z.W’("A.W.W.??"A.


William Autenrieth,
ROBERT CLARKE & G0°S,
No. 71 WEST sIXTH sº DEREET,
BETWEEN WAINUT AND WINE,
CINCINNATI, OHIO,
MANUFACTURER OF AND DEALER IN
|||}|| || || |||||||||
Abdominal Supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETC
Keeps constantly on hand a full variety of
Metalic and Rubber Syringes,
Storm.ach Pumps, Etc.
STOCKINGS FOR WARICOSE WEINS,
Special attention given to the fitting of Apparatus for Deformities.
gº Agent for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
—A LSO–
DR. AHL's POROUS FELT SPLINTs,
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ID A Y *S SIPT, IN T S
-AND-
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MHL iBTH in Mºulis Hill,
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5o
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
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BENNETT ON PULMONORY CONSUMPTION. 8vo. $1 50
FIRST HELP IN ACCIDENTS. 12mo. $1 50
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 50
ECHEVERRIA ON EPILEPSY. 8vo. cloth. $5 od
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASES. 8vo. $5 oc
RINDFLEISCH'S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 od Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth. $2 5o
TANNER'S HANDBOOK OF OBSTETRICS. 12mo. $2 oo
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FLINT'S EXAMINATION OF URINE. 12mo. Cloth. $1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 50
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TURNBULL's DISEASES OF THE EAR. 8vo. Cloth. $5 od
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S. W. Elliott’s Saddle=bags
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AND OTHERS,
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Office and Warerooms, 136 and 138 West Second Street,
veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI,

**
2
Sº-
E-
7, Nºvi, S. º
Zºº
bº.
Exc
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-->g
i$º
|sº:º:s
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CINCINN ATI.
IET A C TU T., T Y .
J A M E S G R A H A M, M. D., D E AN,
Frofessor of the The ory and EPractice Of Medicine and Clinical Medicine.
W. W. DAWSON, M.D.,
Professor of Principles and Practice of Surgery and Clinical Surgery
C. D. PALMER, M.D.,
ROBERTS BARTHOLOW, M.D.,
Professor of Materia Medica and Therapeutics.
W. H. GOBRECHT, M.D.,
Professor of Anatomy.
P. S. CONNER, M.D., |
Professor of Surgical Anatomy. $
JAMES T. WHITTAKER, M.D.,
I’rofessor of Physiology.
SAMUEL NICKLES, M.D.,
Professor of Physics and Medical Chemistry
W. W. SEELY,
Professor of Medical and Surgical Diseases of Women.
T. A. REAMY, M.D.,
I’rofessor of Obstetrics and Diseases of Children.
JOHN L. CLEVELAND, M.D.,
Demonstrator of Anatomy.
CHARLES KEARNS, M. D.,
Assistant to the Chair of Surgery
IMC. D.,
I’rofessors of ID is eases O ſº the FCy e a n d HXar, and Secretary of the Faculty
*~
T. LOUIS BRow N, M. D., Posecutor of Anatomy.
*-*…*
E. NOBLE, Janitor, College Building, Sixth St., bet. Vine and Race
Printed and Published by Nor R1s & MURRY, Medical College of Ohio Building, Cincinnati.
•º






THE CLI
g
PUBLISHED EvKRY SATURfAY.
TER M8–$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
Vol. 2. C IN C IN N ATI,
-*
No. 21.
—w-
º
*
£f
M A Y 25, 1872.
JAS. T. VV HIT TAKER, MI, D. Editor.
No. 101 West Ninth Street, Cincinnati.
TREASURER.
W. W. SEELY, M. D.,
No. 118 West Seventh Street, Cincinnati.
Printed and Published by THE CLIN1c. Publishing Company,
*_e.
C LU B R A T E S,
sºmsºmºmº
4 Copies to one address...................................................... $ 7.00
6 & 4 “ ------------------------------------------------------ 10.00
12 & & & & - 18.00
O O N T E N T S.
* — . • Page
ORIGINALL ARTICLES
GoITRE by Th. Sittle, M. D. * -----------....... ‘.241
ADENoMA by G. W. H. Kemper, M.D... 24.]
TRANSLATIONs
On the Employment of Electricity in Labor, by Dr. Tachard (Bull.
Gen. de Therap., Mar. 30, '72.).................................................. 243
Contributions to the Pathology of Gunshot Wounds by Prof. Edwin'
Rlebs (from the Allgem. Militärärztl. Zeit. April 14, '72.)....... 244
ACADEMY or MEDICINE
|| || || || || |||||||},
!
tºº,
Hatiti Hālā; all lºſſ ºf Him,
92 FOURTH STREET,
Opposite Post Office,
CINCITSTINTA-TI, O-,
& The Oldest Established Hat House on the Street. *Sã
|Fine Silk Hats, Standard Quality $6,00.
BoğAN
ºbesiºsº
º, túl Ill º, tº:
Transactions May 20, "72.
Uterine Fibroid—Specimen by Dr. Dandridge, Discussion by Drs.
ICearney, Wright, Dawson, Reamy, Young, Carson—Syphilis,
Cases by Drs. Reamy and Illowy—Cerebro-Spinal Méningitis,
Cases by Drs. Orr and Maley–Stone by Dr. Buckner............. 246
SCIENTIFIC NOTES
Lostorfer's Syphilis Corpuscles, War in Scientific Circles—Move-
ments of the Membrana Tympani—Vivisections 248-249
NIELDHCAL NEWS
The Opportunity of Menstruation—Relief for Baker Brown—Hom-
oepathic Surgery—Fistula for Cystitis—Preventive Medicine.249-250
REVIEWS.
The Treatment of Wenereal Disease by M. H. Henry M. D.—Lith-
otomy and Lithotrity by Gurdon Buck, M. D.—Lectures on
Aural Catarrh by Peter Allen M. D........................ ............250-251
C LINICAL, MIEMMORAN DA
Intussusception, Novel Treatment—Intestinal Invagination—
Galvanic Treatment of Bed-Sores 251-252
The range of electricity in therapy is widening daily.
We publish a translation to-day announcing its utility
in obstetrics.
The germ theory of infection finds new advocates
everywhere. Klebs, as is seen, proclaims the parasitic
nature of pyaemia and Burdon Sanderson has just de-
clared bacterians to be the characteristics by which we
distinguish infective from non-infective inflammations;
their number indicating the degree of infectiveness.
The syphilis question, as it now stands, is still cold in
comfort to that large class of ruminating bovines who
J. TAFT,
* * * * *=m,
W. TAFT.
Editor Dental Fegister
J. & W. TAFT,
TXTEINTTTSTS
*:
17 WEST FOlº
CINCIN IN
• *s
The Dentºs ºgisters
A Monthly Journal,
CONTAINING 48 PAGES,
stolidly oppose every innovation.
Devoted to the Interests of the Dental Profession,















**- *
N
William Autenrieth,
No. 71 WEST sIXTH sº IREET,
BETWEEN WAINUT AND WINK,
CINCINNATI, OHIO,
MANUFACTURER OF AND DEALER IN
|||}|| || || |||||||ſ,
Abdominal Supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
Metalic and Fubber Syringes,
Stomach Pumps, Etc.,
STOCKINGS FOR WARDGOSE WEDNS,
Special attention given to the fitting of Apparatus for Deformities.
Bay Agent for DR. L. A. BABCOCK'S
Af
rine Supporter,
POROUS FELT SPLINTS,
S PT, IN T S
-AND-
T) A Y * S
*.
ROBERT CLARKE & Co's.
LIST OF NEW
MHL intº in Mºllus inſ;
GREEN'S PATHOLOGY AND MORBID ANATOMY, 8vo.
Cloth. $2 50
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN’S DIS-
EASES. 12mo. $1 75
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List of Pharmaceutical Preparations,
MANUEACTURED BY
Jø/ZW WºZºZ & AER07///º,
FEº,4ADrººl: I.A.
——dº
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(Goddardi’s Formula,)
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ELIXIR OF CALISAYA BARK, *~
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
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Extract of Beef, Citrate of Iron and sherry wine,
ELIXIRVALERIANATE OF STRYCHNIA, WINE OF PEPSIN
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N EHOSE’ITAT1.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of Sixth and Lock streets. It is handsomely furnished thr
pointments of a First-class Hospital.
halls and abundant windows secure that full and fr
Service is furnished by the
U
have sacrificed their lives to such purpose know how to afford.
oughout, and is provided with all the necessary ap"
Porticoes, with commanding views, surround the whole house, and wide
ee ventilation which is so essential to health and comfort.
sISTERS OF CHARITY,
*
nder the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over hi
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throu
m in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
quiet asylu
s own especial department. Patients may, however, select from the regular profession
ghout the State as a safe and
some stay is necessary in after treatment.
Rooms vary in price,
general
service.
Bºy" Address,
according to the character of appointments necessary and service required, ranging, in
terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
$.
SISTEER ANTHONY,
FIospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinna” Ohio.














































































































Wm. Wilson McGrew,

ºvo. 27 was r Fovrra Srwºrr,
PIKE'S OPERA, HOUSE BUILDING,

Importer and Dealer
Diamond and Gold Jewelry,
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The Divided Medicine Com’y,
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—c-O-O-
The Company have the honor of bringing to the notice of the Profession, this NEW AND ExcEEDINGLY PRACTICAI,
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
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The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE.
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every Square will consequently contain accurately measured quantities.
But not only SoLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. gº. |
* This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain;
; : *, *, *, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
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Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPoſL BY ANY LENGTH of TIME they may
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Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days. g
For Samples, Price Lists, and Agencies, address
sees,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
MR. Fr.EDERycK KRAUs: CINCINNATI, February 15, 1871.
Dear Sir—The specimens of your “Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz:
SULPH:MORPHII.......................% grain in each square. ARSEN:ACID..........................1-20 grain in each square.
** OH IN INI ....................... I & 6 é & 66 CALOMEL 34 “ 66 $6
“. COPPER ....................... % *. $6
RESPECTFULLY Youns, *
E. S. WAYNE, Analytic Chemist.


T TEI IED CT I I INTI C.
241
Vol. 2.] S A T U R D A Y, M A Y 25, 1872. [No. 21.
O R. I.G IN A L A R T I C L E S.
–-º-º-º-
G O IT R. E.
The Treatment of a Case by the Method
of Lucke (Bonn ).
BY
TH. SITTEL., M. D.
Cincinnati,
Annie M–, Riverside, O., aet. 17, is a daughter in
a family in which any affection of the thyroid gland has
hitherto never been observed. The first signs of hyper-
trophy in the patient, according to the mother's report,
manifested in her earliest childhood. It is only in the
past year, however, that its greatest development in
volume has been observed, and this increase is remarked
to stand in close connection with menstruation which
established itselfin her sixteenth year, and is occasionally
quite profuse.
Four years ago she entered the convent of the Sisters
of the Good Shepherd, where about the middle of last
year she passed into my hands for treatment. I adopted
in this'patient my usual plan in these cases, namely, the
iodide of potassium in medium doses, internally and ex-
ternally the application of the tincture of iodine. The
result, however, was only negative. She was then kept
under the full influence of iodine for a considerable
length of time but with as little benefit.
I then commenced the treatment as recommended by
Lücke (Die Chirurgische Behandlung des Kropfes, A.
Lücke, Volkmann's Sammlung Klinischer Vorträge,
Leipsic, 1870), which consists in the injection into the
tumor of the tincture of iodine.
When this treatment was commenced the tumor
measured twenty-one and one-fourth inches in circum-
ference. The first injectien into its parenchyma was
made Jan. 17. Ten drops of the alcoholic solution of
iodine in the proportion of one to ten were thrown in.
The second injection was made Jan. 27, twelve drops;
the third, Feb. 5, thirteen drops. From this time the
diminution commenced. The enlarged lateral portions,
and more especially the indurated median portion,
which was so increased in size as to be suspended over
the incisura sterni, became completely softened, though
the injections were made only into the sides.
With the disappearance of induration and diminution
of size vanished the difficulty of respiration which had
been the constant and distressing attendant of its
manifestations of reaction were slight.
growth. Directly after the third injection the tumor
measured only 18% inches circumference, [2} in. less].
The fourth injection was made February 12, 15 drops;
the fifth February 23, 20 drops. At this time the
measurement was 18+ inches. Up to this period local
A few days
after the fifth injection there was an unpleasant taste of
iodine; this, however, soon disappeared.
Further injections were made as follows:—sixth,
March 2, 22 drops; seventh, March 11, 25 drops; eighth,
March 26, 25 drops. Measurement now 18 inches. The
flinth injection was made April 10, 25 drops; tenth,
April 17, 25 drops; eleventh, April 24, 25 drops.
Measurement previous to last injection 17 inches.
The tumor has now been reduced by eleven injections
four and one-fifth, inches and its steady and constant
decrease is evidence of the efficacacy of treatment and
is promise of future perfect success.
The digital compression after removal of the syringe
and the closure of the wound of penetration by adhesive
plaster as recommended by Lücke were always relig-
iously observed. The suggestion, too, was adopted of
permitting the needle to remain in the tumor while the
body of the syringe was withdrawn to be refilled that
there might be the least possible danger of injecting the
iodine into a minute vein. The almost entire absence
of local reaction was probably due to the fact that cold
dressings were always applied to the surface after each
injection.
I may add in conclusion that this patient with the
plan of treatment stated was exhibited to the class in
the clinic of Prof. Dawson at the Good Samaritan
Hospital.
—º-e -º-
A D E N O M A .
BY
G. W. H. KEMPER, M. D.
Muncie, Indiana,
Dr. John C. Helm, a prominent physician of our city
consulted me in regard to an unusual symptom presented
in his own case, Dec. 20, 1871. Dr. H. was in his 60th
year. Has practiced medicine in several localities for
a period of about forty years. About twenty years
since he had a severe and prolonged attack of erysipelas
contracted by infection from a cadaver. This attack
led to swelling and suppuration of the axillary glands
of one side, terminating in abscess, followed by tedious
convalescence. No other glands were involved. From
that time he has been prone to traumatic erysipelas.
His general health, however, was good until about two
years ago, when he was prostrated suddenly while at
Indianapolis, probably as a result of malarial poisoning.
His convalescence from this attack was quite tedious,
indeed, he has never recovered his usual health since.
On the 28th of November last, he was called to
242
[MAY 25, 1872.
TIEEE CI.INI c.
attend a boy who had received a severe injury from
machinery; a large mass of flesh having being torn
from his arm. The treatment of this wound required
his presence twice daily. Some sloughing attended the
healing process, but it maintained a healthy course to
the date of recovery. At some time near the first of
December, while removing some of the sloughs, he
pricked his left hand with the scissors, but this led to
no irritation or uneasiness.
At the date mentioned, when I saw him, the most
prominent symptom was enlargement of the lymphatic
glands of the cervical, axillary and inguinal regions.
He informed me that this enlargement began about
December 13, and that the first glands to enlarge were
the inguinal. Some of the glands were as large as
pullett's eggs; others but slightly increased. All had
a semi-solid feel, and were painless unless firmly pressed.
There was never any discoloration of the skin over the
glands. Simultaneously with the glandular trouble
his health began to decline.
The spleen was not enlarged, no anasarca, anorexia,
bowels regular, tongue clean, temperature normal, oc-
casional excessive sweatings, sleeplessness, sense of de-
bility. R. Iodide of ammonium internally and exter-
nally, and general tonic treatment. * -
January 13. The glandsgenerally are smaller. About
one week since, at Dr. Helm's request, I wrote to Dr.
Parvin to meet mein consultation, stating that I regarded
the case as one of adenia. Dr. Parvin came to-day. He
regarded the disease as an anomalous one, and favored
the view which I will state, was held by Dr. Helm him-
self, that his symptoms were due to the absorption of
infectious matter from the wound made by the scissors.
He gave a favorable prognosis and favored a continua-
tion of the treatment.
Jan. 28. The cervical glands nearly reduced to
normal size. One in right axilla is still quite large.
Inguinal glands smaller. Appetite better. Sleeps better,
and feels stronger. .
Feb. 4. The cervical glands are again enlarged.
One in right axilla still large. During the past week
he attended a few patients.
Feb. 16. Since last date has had two attacks of
diarrhoea, which were, however, readily controlled by
remedies. A large number of the glands are still enlarged.
He has been confined to his room for the last few days.
For several days past he has had diurnal paroxysms of
fever, Still subject to the periods of excessive sweating,
mostly confined to face and head. The sweating has
no relation to the fever. He complains of a sense of
oppression about the middle of the sternum, causing
some difficulty of breathing. Physical signs reveal
large mucous rales in the spot indicated, as well as
superior lobe of right lung. Expectoration not profuse,
of a rather tenacious mucus. At the suggestion of my
friend Dr. Carson, of Cincinnati, he has been using cod-
liver oil and arsenic for some time past.
March 11. Dr. Winans became associated with me
| of infection.
in the case on the 8th, and to-day Drs. Todd and Bigelow,
of Indianapolis, arrived and consulted with us in regard
to the case. The latter gentlemen were unwilling to
admit the evidence sufficient to pronounce the disease
true adenia, but rather regarded his case as one of
debility and prostration. They gave a favorable prog-
nosis and concurred in a tonic plan of treatment.
April 7. For a week past he has suffered from
aphonia, merely whispering his communications. An
eczematous eruption of the right nostril appeared three
weeks ago, and has manifested no disposition to heal in
spite of remedies. - * >
At this 9 A. M., we found him much worse. He had
passed a restless night, unable to lie down for one
moment. His countenance presented an anxious ap-
pearance. His hands were livid for the first time. Res-
piration was somewhat difficult.
At his own request we agreed to meet him again at
1:30 P. M. Shortly after our departure his symptoms
assumed a more alarming aspect. At 1:15 P.M., I
found him much worse. Pulse feeble, general lividity,
inability to recognize his friends, and increased dyspnoea.
Stimulants were administered at once. Dr. Winans
soon arrived and concurred in the opinion that the symp-
toms indicated approaching dissolution. Stimulants
partially revived him, but consciousness never returned.
He continued in this condition until the morning of
the 8th day of April, when he died. The duration of
his sickness was about four months.
No post-mortem was made. The emaciation was
strongly marked. From the time I first saw him, until
his death, there were periods of apparent improvement,
but averaging the whole period the descent was gradual
and progressive. -
The symptoms of his disease did not resemble those
of a poisoned wound, for as before stated, while the
prick was received on the left hand, the inguinal glands
were the first to enlarge, being altogether out of the line
Again, the glands were of very large size,
and semi-solid consistence with no tendency to sup-
purate or even become tender, exactly the reverse of
glandular enlargements caused by infectious matter.
Another peculiarity of his glands was the alternation
or succession in their increase and decrease of size.
Such is the history and termination of one of a class
of cases, of which Virchow Iemarks: “In the histories
of all the known cases of leukaemia we only find it once
as yet recorded that the patient, after he had been for
some time the subject of medical treatment, left the
hospital considerably improved in health. In all the
other cases the result was death.”
—sº-º-º-
CHOLERA IN RUSSIA.—Cholera has just (Apr. 13)
broken out in Kamionka with such violence as to carry
off 21 people in this little village of but 150 souls.
This village last year escaped attacks while the disease
raged throughout all the surrounding country.
º
MAY 25, 1872.]
TIH. H. C.I.I.INI c.
243
oN THE EMPLoyMENT of ELECTRICITY To
- FAGILITATE LABort. -
An Abstract from a Thesis entitled “De l'electricité appliqûe a l'art des
accouchments,” by Dr. Tachard, Externe de la Maternité, etc.
Paris, 1871 [From the Bulletin Gen. de. Therap., Mar. 30, 1872].
The applications of electricity in medical and surgical
practice play a daily role in the treatment of the most
diverse affections. Obstetrics, with the other branches
of surgery has been made the field of experimentation.
M. de Saint Germain in his article on the use of elec-
tricity in labor,” after stating existing knowledge on
this subject, gives the results of his experiments on the
effects of electricity on parturition. These results have
been verified by the late investigations of his pupil Dr.
Tachard, who has written upon this subject his in:
augural thesis. . . . . - - -
According to the results of experimentation the in-
terrupted or induced currents are the most appropriate
for the excitation of uterine contraction. If the voltaic
battery be employed the current must be broken. The
induction apparatus of Ruhmkorff or that of Clark pro-
duces the same results as they furnish an interrupted
current. - ... • - -
In his experiments, Saint Germain used by preference
the apparatus of Ruhmkorff employing the electric cur-
rent of the telegraph which connects the hospital Cochin
with the pavillion of the Maternité. This current was
interrupted by a trembleur, and one of the poles was
placed in a vase of water that the intensity of the cur-
rent might be modified according to the susceptibility
of the patient, excitability of the uterus, etc. This
facility of graduating and suppressing the current at
will, makes of electricity an agent superior to all other
oxytoccics, as e. g., the ergot of rye. -
The method of application the least fatiguing to the
patient and the most convenient for the accoucheur
is that which has been adopted by Barnes in England
and Saint Germain in France. • * * -
It consists in bringing the two poles in contact with
the abdominal walls at the level of and on each side of
the umbilicus. The foetus manifests by its very active
movements its sensibility to the current.
At the maternité Cochin, Tachard applied around the
abdomen of the accouchee an elastic girdle provided
on each side with a brass button to which the reophores
were respectively attached. To make the contact more
effective he interposed a sponge saturated with salt water
between each plate and the abdominal wall.
The observations reported by M. Tachard are twenty-
two in number. First he cites three observations of
Frank. In the first, a primipara of forty years of age,
though the efficacy of the current was incontestable,
* Noveau Dictionnaire de médicine et de chirurgie pratiques, Vol.
xii, p. 556 et seq. • .
intensity.
still it became necessary to terminate labor with the
forceps. The second was a case of complete success, the
third a failure. -
Then follow the nineteen observations collected by
the author, cases taken from the inmates of the maternité
hap hazard [au hasard]. Of these cases we publish only
the first in illustration of the action of electricity on the
course of labor. Of the twenty-two trials, thirteen were
cases of complete success, four of failure; in the remain-
ing five cases though the action of electricity was mani-
fest yet it was not sufficient to conduct the labor to a
happy termination.
Victorine Marty, aet. 27, primipara, entered May 20,
1870. Pelvis normal, cervix completely effaced, os per-
mits the introduction of the finger. Cephalic presenta-
tion. Since May 20, feeble pains have been present at
long intervals. On *.* they increased a little in
At 8% P. M. the pains gradually disappearing,
becoming more and more infrequent, the os being about
3 cent. diameter I applied the electric current for twenty
minutes. Uterine contraction was excited immediately;
the pains produced followed each other rapidly. At 10
o'clock the second application was made. From this
time on the pains succeeded each other rapidly and
forcibly. Labor advanced regularly. At half past 11
there was spontaneous rupture of the membranes; at
1 o'clock expulsion of a living child in good condition.
In five minutes more delivery was complete. This
patient was of lymphatic constitution and quite feeble.
These patients in general, the author remarks, bear
electricity well. An intense current is not necessary to
produce good effects. Again, the duration of the
faradaic séances is never long enough to induce irrita-
tion of the skin at the point of contact of the poles; at
least the author has never yet observed a case in which
the least accident of any kind occurred.
The action of electricity in labor is given en resumé
at the end of the thesis in the following conclusions
which we reproduce and which, we may add, are in
accord with those appended to the paper of Saint
Germain. -
1. In no case were uterine contractions induced
where they had not previously manifested spontaneously.
2. In every instance in which labor had commenced
and the pains had progressed regularly and periodically,
whenever we applied the two poles at the lumbar region
we remarked in a very short time the manifestation of
a new activity in the contractions and shorter periods
of interval.
3. We have likewise observed that all the contrac-
tions produced or provoked by electricity were much
longer and much more painful than the contractions of
spontaneous origin. -
4. The dilatation of the os always seemed to increase
with rapidity.
5. In all the cases hitherto observed the expulsion
of the placenta followed immediately upon expulsion
of the child.
6. In no case did the child suffer in any way from
the electric action. The same we may say for the
mother,
244
[MAY 25, 1872.
T EIHL c 1 INTI c.
Tachard adds that during the period of expulsion
electricity always seemed inutile in awakening uterine
action when the inertia occurred just at this period
At the end of the thesis are three short chapters also
very interesting but containing, unfortunately, but few
facts and conclusions, which we here append.
1. Electricity in Puerperal Hemorrhage. The observa-
tions of Randfort,” Dorrington,f and Mackenzief
seem to prove the efficacy of electricity in the
control of uterine hemorrhage. Puerperal hemorrhage,
however, is an accident so rapidly fatal at times that re-
liance may not be placed on this means alone. It is best
in these cases to use simultaneously electricity and
ergot. The author has not had the opportunity to
make any personal observations on puerperal hemor-
rhages as it rarely occurs in the service of Saint Ger-
main because of his practice, the author thinks, of ad-
ministering to every accouchée immediately after labor |infectious condition without any localization. This
2 grm. of ergot. (See the thesis of Dr. Bureau, 1870).
2. Electricity in Induction of Premature Labor.
Dorrington (loc. cit.) reports one successful case; Barnes
two cases of success but he took the precaution of
rupturing the membranes before the electricity was
applied. P. Dubois, Saint Germain and Tachard have
all failed in this procedure.
3. Electricity in Extra-Uterine Pregnancy. M. Buici,
Professor at the University of Pisa reports a case of
extra-uterine pregnancy in which he succeeded, by the
aid of a single application of electro-puncture in arrest-
ing the development of the ovum. All the morbid
symptoms disappeared, the tumor shrivelled, reducing
to the size of a pigeon's egg, menstruation was re-
established and the patient was saved. (Gazetta med.
Italiana, 1857).
En resumé, the author believes that electricity may
be called to the aid of the accoucher:
1. In labor during the period of cervical dilatation
whenever there is uterine inertia.
2. During delivery when the placenta is retained
within the womb.
3. In extra-uterine pregnancy as a means of aborting
foetal growth.
It seems appropriate here to remind our readers again
of the memoire of Dr. S. Iffla presented to the medical
association of Victoria (Australia) and analysed in a
previous issue of our paper [See also THE CLINIC vol.
II, No. 5, p. 60]. In this memoire Iffla reports cases
in which he has obtained good effects in the treatment
of the intractable vomitings of pregnancy by the appli-
cation of the continuous current to the epigastrium.
MEDICAL STUDENYS AT VIENNA.—Fourteen hundred
and seventy-one medical students are registered in the
summer session of the Vienna school. Of these 506 are
Hungarians.
,--
* Lond. Med. Gaz’, 1846.
f do do
! Barnes, The Lancet, 1853, Bull. Gen. de Therap., V. XLVII, p. 48.
contriburroNs to THE PATHological
ANAToMY or GUNSHoT wounds.
From Observations in the Military Hospitals
of Carlsruhe, 1870--71.
By
I’RoR. EDWIN KLEBs, (BERNE).
From the Allgemeine Militärärztlicihe Zeitung, April 14, '72.
Pyaamia is usually distinguished from scepticaemia by
the fact that in the former secondary purulent de-
posits are encountered in the lungs and other parts of
the body while in the latter there is present a febrile,
view is not tenable, however, for there are processes
which are considered as purely septic during life while
on post-mortem, secondary pus formations are encount-
ered in the internal organs.
As to the disturbance which the entrance of pus into
the blood excites it is believed on the one hand that the
pus acts mechanically (embolism) and on the other,
chemically (phlogogenous effects). Under this chemical
action, again, two distinctions are made accord-
ing as the phenomena are attended with transitory or
continued fever. In reference to these differences in
the action of pus it becomes a question whether it is
the pus as such or some substance mingled with or con-
tained in the pus which exercises these deleterious in-
fluences. Microscopic investigation has taught us that
these changes depend upon the presence of the parasites of
decomposition which the author designates microsporon
8epticum.
The author now brings forward the proofs of his view,
and exhibits the extension of the microsporon Septicum,
1st, in the fluids of wounds. These parasites are found
in laudable pus though difficult of detection as well as
in the thinner, unhealthy fluid where they are in rich
abundance. They present in the form of staff-shaped
bodies (bacteriae) motionless, not seldom arranged in
series; further as numerous brilliant microsporons, ex-
tremely minute ($ micromill.) bodies, lying free, when
they exhibit oscillatory motion or accumulated in
groups (like zooglea) or finally arranged in rosicrucial
threads. -
2nd. The author considers their occurrence upon the
surfaces of tissues. - -
In man he has observed these microsporons upon the
following surfaces; on granulating wounds, as well of
old abscesses as of fistulous canals and serous mem-
branes.
The deposition of these spores is clearly dependent
upon the condition of the tissue surface; an excess of
dryness or of moisture being alike unfavorable to their
development. The author has never observed them on
MAY 25, 1872.]
T EH. H. C. T., IIST.I. C.
245
dead bone or cartilage fragments nor upon richly ex-
uberant and excessively moist granulations. He con-
siders the septic parasite to be perfectly distinct from the
parasite of tooth caries as this parasite is colored blue
by iodine while the spores of Septic parasites remain
uncolored. z -
The inplantation upon cartilaginous surfaces occurs
after the solution of their upper surfaces, zoogloea
develop in the depressions and the process advances
further and further, ceasing only when it is mechanically
checked by folds of tissue or apposition of articular sur-
faces. Dead fragments or surfaces of joints do not offer
a suitable soil for the development of parasites.
On granulating surfaces Klebs has been best able to
follow their development in those cases in which a so-
called pyogenic membrane, composed partly of pus cells,
partly of fibrine, was present. There is observed a solu-
tion of the superficial layers of tissue whose reticulae
are opened by the penetrating masses of zoogloea, then
follows the erosion of the bloodvessels. *
On the larger granulating surfaces the regions where
the microscoporon Septicum exuberates to induce the
destruction of tissue are recognized by the existence of
small, round cavities in the superficial layer of fibrin
which easily bleed. The parasites are found more
especially wherever there are narrow cavities whose con-
tents are subjected to light pressure, and are not removed
by the cleansing stream of water. .
It is probable that the microsporon occurs also on
serous surfaces, though the author has had no oppor-
tunity of demonstrating it directly. This much he is
able to state, however, from the observation of one case
that the microspores from the purulent accumulations in
the vicinity of serous cavities penetrate through the tissues
ânto these cavities, and once arrived here they may excite,
even after the subsidence of all local irritation, new inflam-
mations and suppurations.
On the dissemination of the miccosporon septicum in
the internal organs the author expresses himself as
follows: The parasite induces a destruction of tissue on
every surface on which it exuberates and it depends on
the condition of the tissue whether or not penetration
into the blood and lymph vessels is possible. Penetra-
tion into bloodvessels he was able to demonstrate
accurately in one case. The tissue layers of the blood-
vessel are destroyed from without inwards while the
parasite pushes its development inwards. Even before
the intima is entirely desroyed, the parasites penetrate
into the mass of the blood and induce a coagulation which
remains adherent to the vessel walls or fills the entire
calibre of the tube. In advancing destruction, secondary
later tertiary (fatal) hemorrhages occur. In all these
cases the penetration of the parasites is the precursor and
the subsequent ligations are of as little effect as the
subsequent amputations
...In bones, tendons and other resistent tissues the para-
sites do not at all enter the blood or at least only with
Gifficulty; on the other hand, penetration is facilitated
by ingress of the parasites into the marrow.
*
|
Immigration always takes place from the surface of
the wound as the course of numerous hæmatoidin cells
clearly shows. These cells which contain haematoidin
may be followed into the lymph glands. They may also
become carriers of the parasites and excite suppuration
at a distance from the wound. -
In a few cases Klebs was able to demonstrate micro-
spores in thrombi developed behind the valves in veins
and though these microspores did not directly excite
coagulation yet they effected such changes in the vessel
walls as to render them excitants.
Next is considered the metastases of the lungs. The
author exhibits that the necessary connection between
thrombosis, embolism and suppuration is not yet fully
explained. Venous thromboses may occur in the lungs
without suppuration and they may again be absent
when wedge shaped abscesses are present. Pulmonary
metastases, therefore, are not to be explained as thrombi
and emboli. They may originate in this way, may
not. -
Virchow's explanation of this condition, thus, seems
considerably strained while the view of a septic infec-
tion reconciles all contradictions and explains all cases.
In fact, the author was able to demonstrate in a series
of cases, in which pulmonary metastases could not be
derived from thrombi, the importation of parasites into
the vessels of the lungs.
A series of cases of diffuse pneumonia which could not be
derived from emboli and which exhibited in their anatomi-
cal changes important differences from the usual forms of
pneumonia, the author demonstrates to stand in connection
with parasitic exuberations and considers these pneumonias
as produced by this cause. -
As to abscesses of the liver, he says that they, with
few exceptions, do not possess the character of embolisms,
and after expressing the different views as to their
development he states that they, too, originate from para-
sitic processes. The spores of the microscoporon develop in
the capillary system, fill these vessels to distension when de-
struction of the hepatic cells and parenchyma follows. These
spores are then crowded over into the branches of the vena
porta and hepatie veins and pass from one lobe to another.
Concerning the course of the Septic mycosis, Klebs
says that it is perfectly typical and in the more acute
cases, a period of ten days suffices for the development
of parasites in the different regions of the injured part,
in the lungs and the organs of the systemic circulation.
Renewal of these processes may occur later as already
indicated. -
As this mycosis (parasitic infection) occurs gradually,
it will be understood, that under certain circumstances
the healing process may be complete at the seat of injury,
while the parasitic development advances further and
further within the organism. These periods of latescence
and recrudescence excite the question, are not many
other infectious suppurative processes in the interior of
the organism in like manner due to parasitic develop-
ment 2
246 T H. H. C.
T II INTI C. [MAY 25, 1872.
In cerebro-spinal meningitis the author was not able
to demonstrate any parasites, but he was able to do it
readily in a case of multiple osteo-myelitis. From this
fact he draws the conclusion that there are numerous
internal inflammations which belong to the same form
of mycosis as the septic processes after wounds.
The question whether these parasite developments
are not mere accidental and non-essential occurrences
in inflammations and suppurations can now scarcely be
considered; experiment has demonstrated that parasites
induce suppuration and continued fever.
Drs. Zahn and Tiègel report as follows:
By means of a Bunsen's air pump, according to the
method first adopted by Zahn, fluids containing masses of
parasites were filtered through cylinders of clay. The clear,
faintly sweetish smelling filtrate was injected into rabbits.
It excited violent fever which passed over, however, in from
one to three days. Repeated injections of four to six
grammes of this fluid had always, in the same animals, the
same effect. Local suppurations never occurred. On the
other hand the fluid containing the parasites killed the
animals in a few days even if only one or two grammes
were injected beneath the skin. The consequence of this
injection was continuous fever, lasting until death and local,
often extremely widely extended suppurations. •
Influenced with the belief that when the septic
mycosis is once implanted in the body, it is only with
difficulty overcome, the author thinks that gunshot.
wounds should be closed at once; all attempts at removing
foreign bodies, the searchiug of the wound, in general, before
the occurrence of suppuration should be avoided.
Lastly, the author finishes with a historical sketch.
Wahl and Recklinghausen first demonstrated the
mycotic gastric ulcer. Traube showed the origin
of catarrh of the bladder from importation of the parasite
germs by the catheter. Klebs demonstrated that this
affection may be induced also without the catheter and
that this process may pass from the bladder into the
ureters and tubuli uriniferi where pyelo-nephritis may
be excited. Kohl and Waldeyer reported cases of
parasitic, furuncular, intestinal affection in which
bacteria penetrated into the blood and lymph vessels.
Rindfleisch has demonstrated in pyaemia vibriones in
the heart. Recklinghausen and Waldeyer have recog-
mised the capillary emboli of pyaemia, typhus, etc., to
be colonies of bacterians. Finally mention is made of
the workson caries of the teeth by Leber and Rottenstein
and on the parasites of diphtheria by Hueter, Tomasi,
Letzerich and Oertel. *
—-º-º-ºm-
SMALL-Pox IN BERLIN.—Variola still prevails to
considerable extent in Berlin. The city authorities have
alreday expended upon this disease $98,000 since
October 1, and a new sum of $20,000 has just been called
Out.
FEMALE CITY PHYSICIAN.—Miss S. J. Williams has
been chosen city physician of Springfield.
A G A D E M y o F ME D1 or N E.
JAS. GRAHAM, M. D., PREST.; L. WOLF, M.D., SECT.
Transactions May 20, 1872.
Reported by Joseph Ransohoff.
*
amºsºmºsºmsº
Uterine Fibroid. -
DR. N. P. DANDRIDGE presented a specimen with
remarks of which we can only give an abstract. The
specimen was a tumor removed from the abdominal
cavity by Dr. Kearney. Weight 17 ſhs. 9ozs., cicum-
ference 28 inches. The external surface was smooth,
being covered by peritoneum. An opening is observed
on the lower surface of the tumor, leading into what
represents the cavity of the uterus. On the right side,
the broad ligament, ovary and Fallopian tube were
attached to the tumor. On the left side this was true
only of a part of the tube and broad ligament. Upon
section the mass was found to be occupied internally by
a growth of fine and fibrous feel. This mass was of a
white color, and of a fibroid nature, the fibres taking
an irregular wavy course. Surrounding this mass on
every side was the proper uterine tissue, which at the
upper part of the tumor was not more than the one-
eighth of an inch in thickness. The cavity above men-
tioned stretched out about five inches on each side,
showing an exaggerated model of cornua of the uterus.
The vertical depth did not exceed one inch.
Autopsy. This was made eighteen hours after death,
and six days after the operation. The stomach was ad-
herent to the abdominal wall and was opened inadvert-
ently. The adhesions were recent, and readily broken.
The peritoneum showed everywhere the results of a re-
cent inflammatory action, and the intestinal surfaces
especially were covered with recentlymph. The pelvic
cavity contained some purulent fluid. Four ligatures
and a clamp, which had been used for the arrest of
hemorrhage, were found in situ, and the portion of the
uterus external to the clamp wore a gangrenous aspect.
The portion of the uterus which was not removed by the
operation measured three inches in length; about one-
third of the corpus uteri remaining. The ovarian veins
were distended and filled with clots.
DR. KEARNEY, who had performed the operation, very
candidly confessed the error in diagnosis which had been
made in this instance. The operation was determined
upon for the removal of what was supposed to be an
ovarian tumor. Hemorrhage was prevented by the use
of four sutures, and the stump was retained in the lips
of the abdominal wound by a clamp. The history of
this case simulated that of an ovarian tumor, and in
these cases every man is liable to be deceived. The
tumor was first observed about three years ago, and then
in the right ovarian region. The great elasticity of the
MAY 25, 1872.]
TIH. H. C.I.INI c.
247,
tumor was mistaken for fluctuation. The cervix and
os uteri were fixed in their normal position, and the
uterine cavity when examined by the sound, seemed to
be of normal length. In this case the great size of the
tumor precluded the use of those manipulations by
which the mobility of the cervix might otherwise have
been determined. -
DR. M. B. WRIGHT stated that in this individual case
the growth of the tumor resembled that of an ovarian
cyst, and the regular menstruation of the patient, seemed
to sustain the diagnosis that was made. Again pressure
upon the tumor would produce only a very slight de-
scent of the cervix, while the cavity of the neck and
body were of the normal length. He concluded by re-
marking that in his opinion a positive and infallible
diagnosis was an impossibility. -
DR. DAWSON remarked that the rule by which most
surgeons are regulated, is that all solid abdominal
tumors should be excluded from operations, and that
the reason of this rule is that these tumors are generally
uterine and of a fibroid nature. It is very rare to find
an ovary subject to fibroid degeneration, while they are
on the contrary subject to malignant disease. In many
cases of this nature, the depth of the uterine cavity, on
account of the location of the tumor, was liable to mis-
lead the most skillful diagnostician, but he doubted
whether the elasticity of fibroid tumors could be mistaken
for fluctuation. To the rule that ovarian tumors first make
their appearance on one side, there are some exceptions,
and Bright reports a number of these. It is also generally
supposed that when the uterine cavity is greatly
lengthened, the tumor is likely to be connected with the
womb. This supposition is not to be relied upon, since
the uterus and its cavity may be greatly enlarged, and
the tumor be ovarian. In the differential diagnosis
between ovarian and fibroid tumors, Spencer Wells
places great reliance in the complexion of the patient as
a diagnostic symptom. He says that the ovarian patient
has a pale and sallow hue, while the fibroid tumor is
represented by a very florid condition. Dr. Kearney
was precluded from the use of this symptom since his
patient was of African descent. The speaker then re-
ferred to the treatment to be pursued in these cases.
If after an error in diagnosis, one of these fibroid tumors
be encountered, he considered it advisable to abandon
the operation, to close the abdomen and so to give the
patient a better chance for recovery, because the re-
moval of the uterus through the abdominal walls must
necessarily be considered a very unsurgical practice.
The Dr. referred to a case upon which he had operated
several years ago. The tumor a fluctuating, sub-peri-
toneal one, and of a fibro-cystic nature. It was attached
to the uterus by a pedicle one and a half inches in
length. The tumor was always in the median line, and
the uterus was of its proper size and in its normal posi-
tion. The tumor was removed without interfering with
the uterus. The patient however died. The speaker
concluded by remarking that ovarian tumors of very
large size could necessarily be felt in the vagina, while
uterine tumors may or may not be there distinguished.
DR. REAMY stated that the operation for ovarian
tumors was certainly justifiable, since Spencer Wells has
met with great success, seventy per cent. of his patients
recovering. This surgeon places great reliance upon
the mobility of the uterus as a diagnostic symptom. A
positive diagnosis in these cases is always exceedingly
desirable as fibroid tumors always cease growing after
attaining a certain size. He then referred to his only
fatal case, in which the tumor weighed 52 pounds.
This patient died upon the thirty-ninth day after the
operation.
DR. YoUNG had examined Dr. Kearney's patient,
with regard to the mobility of the uterus, and observed
only a slight descent of that viscus, when a great pressure
was made upon the tumor. No lateral motion was
noticed. He did not think that an ovarian tumor must
necessarily be felt when a vaginal examination is made.
DR CARSON called attention to the case of Dr. Thomas
of New York in which the tumor was first observed
in the left ovarian region, and hence was supposed to be
connected with that ovary. The operation disclosed the
fact, that it was connected with the right and not with
the left ovary. •
DR. N. P. DANDRIDGE observed that his faith in the
mobility of the uterus as a diagnostic symptom was
considerably shaken by an ovarian cyst which he found
in the left ovary. The tumor was about the size of a
fist and was firmly adherent to the uterus. It com-
pletely surrounded the side and fundus of this organ
and the latter would necessarily have been moved by
any motion of the tumor.
Syphilis.
DR. REAMY read a report of a case of specific brain
disease which had been very successfully treated by
large doses of the iodide of potassium.
DR. ILLOWY reported a similar case. The patient
has been treated for two years for rheumatism by
various physicians. At the first visit, he was unable to
walk, and there was a complete paralysis of the muscles
of the left arm. The patient had a venereal sore eleven
years ago, but had no symptoms of secondary syphilis
at that time. He complained of very severe pain at
night, and thereupon the diagnosis of tertiary syphilis
was based. He was put upon iodide of potassium and
iodide of iron, and made a very rapid recovery, the
proof of which was his presence at the academy. The
paralysis had entirely disappeared, and locomotion is
perfect.
Cerebro-Spinal Meningitis
DR. G. B. ORR reported a case of cerebro-spinal men-
ingitis. The patient was a little girl aet. 11 years. She
complained of severe headache, and was vomiting pro-
fusely. Upon first visit there was no tenderness along
the spine and the pupils responded readily to light.
The child being constipated, ordered calomel and sub
248
[MAY 25, 1872.
TIH. H. cir, TTSTI c.
nitrate of bismuth. Upon the following day, the symp-
toms were aggravated: marked tenderness along the
spine, and decided opisthotonos. Prescribed bromide of
potassium, and mustard to the feet; also warm applica-
tions to spine. No improvement is manifested under
this treatment, and the results are unknown.
DR. MALEY also reported a case of this disease, the
patient being almost three years old. All the symptoms
of the disease was present. Ordered quinia sulph. and
a supporting treatment, under which the child rapidly
improved. s
DR. GRAHAM stated that the case of pleuritic effusion
which he reported at the last meeting and in which he
had intended to employ paracentesis was not operated
upon. Since the last meeting of the Academy four-fifths
of the effusion had been absorbed, a rssult which does
not warrant an operation. This absorption was going
on while the patient was under the influence of large
doses of potas, bi-tart, - -
Stone.
DR, BUCKNER presented a stone whlch was removed
from the descending colon of a horse by Dr. Bowl.ER,
a veterinary surgeon of the city. The stone weighed
11 ft), 3oz. The horse from which it was removed
was twelve years old and had suffered from
frequent attacks of colic in" one of which he died. A
renal calculus removed from a horse was also presented.
—º-º-º-
SCIENTIFIC NOTES.
Ilostorfer's Syphilitic Blood-cells : Professors
well and stricker; War in Scientific
Circles.
From the Med. Times and Gazette, Apr. 27, ”72.
Dr. Lostorfer's corpuscles seen to have become a
standing article in the Medical Society of this town,
having caused the formation of two parties violently
opposed to each other. At the head of the one Professor
Stricker has been placed, against his own inclination ;
whilst Professor Wedl has voluntarily undertaken the
lead of the other. It will be remembered that in a
recent meeting of the Medical Society Dr. Lostorfer
came forward with the discovery of corpuscles peculiar
to the blood of syphilitic patients, by means of which
the diagnosis of syphilis may be made by the microscope.
This discovery, if true, would have been of the utmost
importance, giving a positive basis to the much-discussed
question of the relation of microscopic growths to con-
tagious and infectious diseases. Everybody was struck
with the novelty of the discovery; and it cannot be said
that those who have worked in the same direction as
Lostorfer did have listened to Lostorfer's lecture without
feelings of jealousy. The first who stepped forward to
oppose the new theory was Professor Wedl, whose work
on pathology has been published by the New Sydenham
Society. We are, however, sorry to say that this
renowned worker came forward too hastily—neither
sufficiently furnished with facts to oppose Lostorfer,
nor even acquainted with Lostorfer's investigation; nay,
he had not even seen the corpusclesin question, but heard
them described by two of his disciples. Standing on
such loose ground, he nevertheless denounced Lostorfer's
corpuscles to be nothing but fat-cells, which are squeezed
out from the skin. When the blood is drawn for micro-
Scopic investigation. He further urged that these cor-
puscles may be seen a few hours after the preparation
is made, and particularly when water is added to the
blood. To this Professor Stricker simply replied very
clearly, that if a man of Professor Wedl’s renown assures
us he has seen fat-cells, there can be no doubt that it
was so; but in the present instance it evidences simply
that Professor Wedl has seen fat-cells, and not Lostorfer's
corpuscles. Dr. Lostorfer has expressly stated—and we
have communicated in this journal—that the corpuscles
only after the fourth day assume such a size as to be-
come visible under the microscope; that they disappear
at once if water is added to the blood—so that an object
is at once rendered useless if by some chance or accident
water had been admixed with it. If, therefore, Profes-
sor Wedl had done all which Lostorfer has strongly ad-
vised to avoid, he had of course no chance whatever to
see the corpuscles in question. At this point the dis-
cussion became hot. Dr. Neumann, the well-known
dermatologist, supported Professor Wedl; and when
Professor Stricker again replied he made use of the ex-
pression that one must be a well “rubbed up” micro-
scopist (ein geriebener Microscopiker) in order to repeat
Dr. Lostorfer's investigations. From this moment the
signal was given for guerre à outrance, and, what is more
peculiar, from this moment Dr. Lostorfer, the original
investigator, was put aside, and Professor Stricker made
responsible for theinvestigation of the former—thus, as I
said, involuntarily placed at the head of one of the oppos-
ing parties. This was the first evening of the great
battles. Skirmishing, however, has been going on con-
tinually in all the Vienna medical journals; and at
every meeting of the Medical Society a paper-war was
kept up, Professor Wedl complaining, by letters sent to
the Society, of Dr. Auspitz, the secretary, having been
biassed by party feelings in framing the report of the
discussion, and also accusing Professor Stricker, the
editor of the Society's journal, of likewise being partial
in performing his duty. To those accusations Professor
Stricker and Dr. Auspitz have responded, eliciting again
written replies from Professor Wedl, each new letter
being more excited, more deviating from the original
question, and becoming more personal, and even offensive.
Under such circumstances it is evident that the
Society's meetings are not always of a very agreeable
character. But the war has already produced some
good—namely, whether Dr. Lostorfer's teachings be
MAY 25, 1872.]
TIEEE TEE C
T I I INTI C. 249
true or not, they have induced the microscopists to
again pay attention to the investigations of blood, which
have been neglected in the last two or three decenniads.
One of the best experienced blood-investigators,
Professsor Stricker is already at work, which he has been
forced to assume. From what we have heard of his
recent investigations, one thing seems certain—namely,
that something has been discovered by Dr. Lostorfer
which has not been known in blood. The corpuscles
according to Professor Stricker, exist decidedly; they
are of a round shape, grow evidently, but form no.
projections (as described by Dr. Lostorfer) giving to the
observer the impression of projections if a smaller cor-
puscle is adjacent to a larger one. Whether or not the
corpuscles are peculiar to syphilitic blood Stricker has
not yet made out. If I am well informed, we may
expect the publication of Professor Stricker's researches
in a short time. Whilst in the one camp preparations
are thus made for a new battle, Professor Wedl’s army
is likewise busy to meet the enemy's movement, or, if
necessary, to open the hostilities. Dr. Neumann, we
hear, has likewise been engaged in the solution of the
important question, and the result of his researches, 1
hear, we shall read in one of the next impressions of the
Wiener Wochenschrift. In conclusion, it may be men-
tioned that whilst the minds of Medical men are heated
by Dr. Lostofer's discovery, Dr. Salisbury is preparing
a paper for Dr. Hallier's Journal of Parasitology, in
order to claim the right of priority of Dr. Lostorfer's
discovery. -
THE MOVEMENTS OF THE MEMBRANA TYMPANI.-
Dr. Emil Berthold gives an account of the very ingen-
ious and beautiful experiments instituted by himself to
illustrate the movements in the membrana tympani by
sounds conveyed to the ear through the bones of the
head. He makes use of a T shaped tube from 4 to 6
inches long, the vertical part.being hermetically fixed
in the external meatus, a gas jet in one arm of the hori-
zontal part, and the movements being cast upon a revolv-
ing mirror at the end of the other horizontal part.
The movements are excited by placing a vibrating
tuning fork on the bones of the head, or on the teeth, or
by the voice.
Of course the movements are very slight, so a revolv-
ing mirror is necessary to bring them out plainly. It is
well known that the eye does not possess the power of
separating very rapid movements, inasmuch as the
retina retains impressions a certain length of time.
Every one is familiar with the ordinary illustration of
twirling a stick with a bright coal on the end, if twirled
fast it makes a continuous circle of fire, the impression
at starting remaining on the retina until the bright
point has completed the circle.
The author's arrangement, a four sided prism, covered
by a plain metallic mirror made to revolve, would cast
the image, like other rotating mirrors, upon different
parts of the retina.
Taking the image of the flame as a horizontal line,
while the membrane was at rest, the different tones
coming through the cranial bones gave waving lines,
differing according to the height or depth of the tone.
The deep tones produced waves whose elevations and
depressions were further separated from each other than
the higher ones; the height of the elevations and the
depth of the depressions were less in the deep tones than
in the higher. -
The difficulty of locating troubles in the middle ear
is well known, and the author hopes to be able to re-
remove some of this by his investigations, the practical
part of which is reserved for a future occasion.—Monats.
f. Ohrenheilkunde, March, '72.
VIVISECTIONS.—M. Claude Bernard, one of the great-
est of living physiologists, in his recent work (Leçons de
Pathologie earperimentale) points out the immense value
of experimental pathological researches, and the neces-
sity for the construction of special physiological labora-
tories (like those of Kühne at Amsterdam, and Ludwig
at Leipzig) wherever physiology is taught, in order that
theory and practice may go hand in hand. Referring
to the absurd scruples of the antivivisectionists, he points
out the necessity that exists for the daily slaughter of a
large number of the lower animals, and gives the follow-
ing anecdote in a note: “In one of his campaigns the
Duke of Burgundy, son of the Grand Dauphin, wrote
to Fénélon to ask whether he might encamp his army
under the walls of a nunnery, as, however objectionable
in point of morality, the position was peculiarly advan-
tageous for the prosecution of the war. Fénélon
promptly replied, “Burn the nunnery, but gain the
battle.' Now, Fénélon was certainly not a man of
lax morals, nor a man of anti-christian spirit, nor a
violent character; but he recognised that war has its
necessities, which must be obeyed if success is to be ob-
obtained. Physiology, too, has its necessities, and these
must be submitted to, or all progress must be renounced.
—Lancet, March 30, 1872.
—-º-º-º-
M IELDHCJAL NEWS.
THE OPPORTUNITY OF MENSTRUATION.—The mental
vagaries, curious conceits and unnatural ideas and de-
sires then developed [during menstruation | are as
diverse as the pains and aches which, at such times, are
so commonly complained of by different patients. It
will frequently happen that the peculiar tendency of
the individual will then be developed, and an opportunity
is thus afforded of learning more of the mental charac-
teristics of a woman by a careful observation of her re-
marks and attention to her conduct during this period
than at any other time.— Vance—Bost. Med. Journ.
May 9, '72.
RELIEF FOR BAKER BROWN.—The Brit. Med. Journ-
mal publishes a weekly list of the donors with
their contributions for the reliefof Mr Isaac Baker Brown,
who is paralysed and in great pecuniary distress.
250
[MAY 25, 1872.
TETH CE,TISTI c.
HOMOEOPATHICSURGERY.—The Alta of the 18th inst.,
announces that “the Homoeopathic system of medicine
is to be hereafter represented in the columns of the
Pacific Journal of Health, to commence with the May
number. The object is to give to the public, popular
instruction in its principles, so that they can be easily
comprehended, and to impart a knowledge of the science,
free from technical terms and dry disquisitions. We
understand that the first number in May will contain a
well illustrated case of the successful removal of nearly
five feet of intestines from a lady in Chicago, by Homoeo-
pathic Surgery.”
It is thought to be a parody on that literary and, so-
called professional monstrosity, Hall's Journal of Health.
—Western Lancet, April, '72.
FISTULA FOR CYSTITIS.—Our readers will remember
the spirited controversy upon this subject in the first
volume of our journal. The following letter therefore
clipped from the American Practitioner May, '72 is of
interest. º
BIRMINGHAM, February 18, 1872.
DEAR SIR—The first case of which I have
cognizance of the operation having been done by Sir
James Simpson occurred, I think, in 1860. I have un-
fortunately no record of it. I feel certain that he had
done the operation before, for he had on several occasions
spoken of the operation, yet forgot the case I refer to till
I reminded him of it. It is more than likely therefore
that it was not his first. Dr. Keith, the celebrated
ovariotomist, has told me that the late Mr. Syme had
practiced the operation on a male successfully. There
can be no doubt that it is a valuable and thoroughly
established proceeding, based on Sound surgical princi-
ple. The criticisms in THE CLINIC are ill-digested
speculations of mere theorists.
Yours truly, LAwSON TAIT.
PREVENTIVE MEDICINE.—The great instruments of
Preventive Medicine will be science, legislative wisdom,
and charity—that blessed and fragrant flower of the
following of Christ. War, that assimilates man to the
brutes, will become more odious as its collateral effects
will be better understood. In the war of liberation in
Spain, we have the authority of Sir Gilbert Blane in
stating that more of our soldiers died of fever than of all
other causes, including the sword.
A time may come when the conqueror of disease will
be more honored than the victor in a hundred fights.
The time may come when no man for his own ends, or
for his profit, will be permitted to damage the health or
the well-being of his neighbor or of his servant, nor the
prisoner have to suffer through the ignorance or the in-
difference of his jailer a greater penalty than was awarded
by the law, while the emigrant with his loved ones will
be protected from disease as he expatriates himself from
the land of his birth. The gifts to man from Heaven—
pure air, pure water, bright light, and wholesome food,
will be more freely shared in, and the moral and physical
evils of overcrowding, and the consequent guilt, and
shame, the pestilence, will disappear. The artisan will
be taught the dangers of his particular calling, and so
far as law and public opinion go, be protected from
them; whether he labor in a hot room, amid the roar
of machinery, or deep in the earth where he has to work
in passages carved by himself of little more than two
feet in hight, inhaling the smoke of gunpowder and
particles of silex till his working life comes to an un-
timely and miserable end.
That false morality which would ignore the existence
of, and therefore would neglect, that unhappy class of
the victims of Society, will be denounced and exposed.
Infant life, concerning the preservation of which
civilized England may well take her lesson from Russia,
will be protected by the State.
The power of science will be brought home to all
men, as to everything that can influence health, food,
drink, labor, residence, occupation; as it touches each
of these considerations, will lead mankind to higher
thoughts and purer lives. -
The principles of the science of public health will be
taught in our Universities, and from them downwards
in our elementary schools; and the influence and the
light of science be brought to bear upon all men.
Think of the millions of our fellow-men—brethren,
subjects of the same crown, at home or on the burning
plains of India, contending miserably with, or yielding
to, the multiplied evils of degradation, and consequent
untimely death, from which the ignorance of their rulers
as well as of themselves keeps the light of knowledge;
and you will admit that it is a noble object for those
who dwell in, and who govern, the homes of science— .
our ancient teaching Universities of these countries, to
prepare and to send out over the world their disciplined
and devoted Soldiers of science and of ethics, with the
highest academical, and therefore social, rank, to con-
tend with and abate those mental and physical evils
the growth of ages the offspring of ignorance, which so
long have afflicted and retarded mankind.—Stokes—
Brit. Med. Journ., Apr. 13, '72.
—-º-o-º-
I REVIEWS.
THE TREATMENT OF VENEREAL DISEASES. A mon-
ograph of the method pursued in the Vienna Hospital,
etc.—By M. H. Henry, M. D. New York, Wm. Wood
& Co., 1872.
In this reprint of an article that appeared in the
Amer. Jour. of Syphil. and Dermat., April, 1872, the
author has presented to the profession 198 prescriptions
used in the treatment of venereal diseases in the Vienna
Hospital, together with eleven pages of general remarks
on the hygiene, dressings, and local treatment of venereal
patients in hospital and private practice, and three
pages upon prophylaxis, dietetics, and health resorts.
We cannot say that we are much in favor of “Books of
MAY 25, 1872.]
T EEIH C T.I. NI c.
251
Prescriptions” under any circumstances, and most cer-
tainly are not at all favorably dispbsed towards those that
fail to make it apparent for what class of individuals
they were prepared, whether for practitioners or the
community at large. From the way in which the pre-
scriptions are written, and the remarks appended to
many of them, we are inclined to believe that the book
under review must have been intended for non-profession-
als, a sort of “Every man his own Doctor, or the treatment
of venereal diseases made easy in one lesson without a
master.” Every educated physician would have pre-
ferred that the pharmaceutical names of remedial agents
should have been employed, and the R, followed by the
genitive, or if the writer must use the common names
that the useofsuch should have been strictly and uniform
ly adhered to. Asit is, we have neither Latin nor English,
neither professional nor ordinary namessystematicallyem
ployed; e.g., at one time we see Aqua, at another Water,
in one formula. Borate of Soda, in another Borax.
Again we find “Liquor sesquichloride of Iron; ” why
not either Solution of the Sesquichloride of iron, or
“Liquor Ferri Sesqui (Per) chloridi.” Following R.
No. 30, (a solution of morphia), it is stated, “to be used
hypodermically. Producing sleep and relieving pain.”
Who that has any business to be using hypodermically
a solution of morphia 20 gr. to the 3., does not know
that it is intended by such use to induce sleep and re-
lieve pain. The amount to be injected is not stated,
and the ignorant man for whose information the effects
of the hypodermic administration of morphia are speci-
fied will be as likely as not to use all of the prescribed
solution that he can get into his hypodermic syringe.
R. No. 25 is as follows:
“Chloral Hydrate, 3ss.
Distilled Water, 3iij.
Take one-half, and if the desired hypnotic effect is not
produced within five minutes, take the remaining portion.
Chloral hydrate must have a different effect either in
the Vienna Hospital or in New York than it has here
if ordinarily the hypnotic effect of 15 grs. is produced
within five minutes. But we forbear to continue these
criticisms. The general remarks are good. The mono-
graph was very well as an article to fill up the pages
of a Medical Journal, but in sending it out in its present
shape, the author pays a poor compliment to the in-
telligence and wants of his fellow-practitioners, and has
added little, if anything, to his own reputation.
LITHOTOMY AND LITHOTRITY.-By Gurdon Buck,
M. D., New York, Wm. Wood & Co., 1872.
In this interesting little monograph we have a report
Somewhat in detail of 50 cases of calculus operated on
by Dr. Buck of N. Y., by lithotomy and lithotrity, to-
gether with some general remarks on lithotrity and the
circumstances under which the cutting or crushing opera-
tion should be preferably selected. The 50 subjects
operated on, in consequence of the relapses that took
place in several instances, furnish a table of 60 cases
treated by lithotrity and 8 by lithotomy, only 3 of the
latter not having been previously subjected to the crush-
ing operation. Of the 55 cases of lithotrity alone, 8
died, i. e., 14.5 per cent, and of the 8 lithotomies only
1, i. e., 12.5 per cent. For several reasons, however,
these figures cannot be taken as exponents of the rela-
tive mortality of the two operations. The general
remarks, especially those with reference to the kind of
cases that should be subjected to the one operation in
preference to the other, are worthy of the careful atten-
tion of all interested in the treatment of stone, for when-
ever Dr. Buck expresses an opinion on a surgical subject it
is always based upon careful observation, reflection and
thorough acquaintance with the literature of the pro-
fession. The typographical execution of the work under
review is excellent. -
LECTURES ON AURAL CATARRH; or the Commonest
Forms of Deafness and their Cure. By Peter Allen,
M. D., Fellow of the Royal College of Surgeons, etc.,
etc.—These lectures are what the author modestly
claims, not an exhaustive treatise, but really cover a
wide range in the space of 271 pages.
They contain the chief facts of certainly the most
common causes of deafness, plainly put and will go far
towards placing the reader au niveau with the current
ideas on this department of aural surgery. -
A book of value, especially to students.
–º- e -º--—
C LINICALL, MI EM [O] RNAIDA. &
Int ception.—Novel Treatment.—Success.
BY
ALFRED W. TALIAFERRO, M. D., (San Rafeal, Cal.)
From the Western (San Francisco) Lancet, April, '72.
The following case of invagination of the gut, occurring
in the State Prison Hospital, is sent because of the
novelty of the treatment adopted and the success attend-
ing it. On June 8, 1871, in making my usual visit to
the prison, I found in hospital, T. S., aet. 24, admitted
fourteen hours previously, apparently suffering from a
severe cramp colic, and from which he had obtained no
relief. Not doubting but that this was a simple case
I ordered the usual remedies without making a very
careful examination. The next day he was still suffering
intensely and vomiting; there had been no action of
the bowels, although the most active medicines had been
given by the mouth and as enemata; the hypodermic
administration of a grain of morphine had given him a
few hours of sleep and ease. A careful examination
revealed a mechanical obstruction in the bowels which
I diagnosed as being at the ilio-caecal valve, the intense
pain being confined to that spot, and an examination
per anum demonstrated that the rectum and sigmoid
flexure of the colon were free. All efforts to remove
252
[MAY 25, 1872,
TIEI IEH C T , T N T C.
this obstruction proved abortive. During the evening
he commenced vomiting large quantities of faecal matter.
On the 11th, he was in a state of collapse, and I returned
to San Rafael with no hopes of finding him alive at my
visit the next morning; therefore I was greatly surprised
on my return to find him not only alive, but in a
comfortable condition, and with free evacuations from
the bowels | This change was due to the treatment
adopted by Wm. Lebur, my steward in the hospital.
Lebur reported that as everything directed by me, had
failed to relieve the patient, and in consequence of his
desperate condition, he had ventured on the evening
before, the experiment of inflating the intestines with
the effervescing draught, in order that the obstruction
might be overcome I This was effected by injecting
into the rectum a strong solution of bicarbonate of soda,
then a strong solution of tartaric acid, and preventing
its egress by making rigorous pressure against the
sphincter ani. The result of this experiment was the
instant removal of the invagination, and free catharsis.
The principle of this treatment becomes obvious when
we reflect a moment, and I wonder that it has not been
in general use. Our chief aim, in this disorder, being
to remove obstruction by inflation of the bowels, what
method is there more potent than the one used in this
instance 7 * * , " -
Lebur is a U. S. prisoner from Oregon, and although
in that State before he became a prisoner, he is by no
means a “regular.” He claims this treatment as origi-
nal; and as far as he is concerned, I believe that it did
originate with him on this occasion. .
On consulting various authorities, I find only in
“Wood's Practice of Medicine,” third edition, any
account of similar treatment. It is a simple mention of
a report made by Dr. Tate, in the Georgia Southern
Medical Journal, of a successful case treated in this
Iſla Il Ile I’. -
INTESTINAL INVAGINATION.—Dr. Herz (Vienna),
spoke(Soc. Phys., Mar. 20, '72,) of the occurrence of invag-
ination in childhood at different ages and exhibited by
statistics in accord with the views of Hansen Smith and
Pilz that the first year and most especially the period
*Historical note by Editor [Lancet]. In 1726, Dean Swift wrote
Gulliver's Voyage to Laputa. The description of Gulliver's visit to the
Grand Academy at Lagado is graphic ; among other things, he says:
“I was complaining of a small fit of the colic, upon which my conduc-
tor led me into a room where a great physician resided, who was famous
for curing that disease by contrary operations from the same instru-
ments. He had a large pair of bellows, with a long slender nozzle of
ivory ; this was conveyed eight inches up the anus, and drawing in the
wind, he affirmed that he cquld make the guts as lank as a dried blad-
der. But when the disease was more stubborn and violent, he let in
the nozzle while the bellows were full of wind which he discharged into
the body of the patient, then withdrew the instrument to replenish it
clapping his thumb strongly against the orifice of the fundament ; and
this being repeated three or four times, the adventitious wind would
rush out, bringing the noxious along with it (like water put into a
pump), and the patient recovered. I saw him try both experiments
upon a dog, but could not discover any effect-from the former. After
the latter, the animal was ready to burst, and made so violent a dis-
charge as was very offensive to me and my companion.
on the 8pot, and we left the doctor endeavoring to recover him by the
same operation.
The dog died
between the 4–6 months furnished the greatest number
of cases. The statements of Rilliet, Hansen Smith and
Pilz as to the great preponderance of cases in the male
sex were also confirmed. From the analysis of 162
cases collected by Pilzit resulted that 56 per cent. were
invaginations of the small intestine into the large.
The speaker in this connection discusses the therapy
of this affection, placing internal medication in the back-
ground, stating that it is limited, indeed, to the exhibi-
tion of opium in moderate doses while mechanical
agencies, the injection of large quantities of water, in-
sufflation of air, the use of the sound played the chief
role. -
The report includes the narration of a case in which
the diagnosis was clearly established, laparotomy was
performed by Weinlechner, the section being made over
the tumor which was found to be three inches long, two
broad, and free from adhesions, though four days had
elapsed. The intussusception which consisted of the
ascending color and coecum together with the vermiform
process, and which measured one foot in length was
easily withdrawn, but convulsions set in with symptoms
of increasing peritonitis and the child died in six hours.
This result, however, should not deter us from future
operations, as cases of success are recorded, that for
| instance of Spencer Wells.-Aerztliches Litteraturblatt,
Mar., '72.
GALVANIC TREATMENT OF BED-sores AND INDol-
ENT ULCERS.–Dr. Wm. A. Hammond recommends for.
indolent ulcers and bed-sores, the galvanic treatment as
first recommended by Crussel, of St. Petersburgh. He
says:—“During the last six years I have employed it
to a great extent in the treatment of bed-sores caused by
diseases of the spinal cord, and with scarcely a failure;
indeed, I may say without any failure, except in two
cases where deep sinuses had formed, which could not
be reached by the apparatus. A thin silver plate—no
thicker than a sheet of paper—is cut to the exact size
and shape of the bed-sore; a zinc plate of about the
same size is connected with the silver plate by fine
silver or copper wire six or eight inches in length. The
silver wire is then placed in immediate contact with
the bed-sore, and the zinc plate on some part of the
skin above, a piece of chamois-skin soaked in vinegar
intervening. This must be kept moist, or there is little
or no action of the battery. Within a few hours the
effect is perceptible, and in a day or two the cure is
complete in a majority of cases. In a few instances a
longer time is required. I have frequently seen bed-
sores three or four inches in diameter, and half an inch
deep, heal over in forty-eight hours. Mr. Spencer Wells
states that he has often witnessed large ulcers covered
with granulations within twenty-four hours, and com-
pletely filled up and cicatrization begun in forty-eight
hours. During his recent visit to this country I informed
him of my experience, and he reiterated his opinion
that it was the best of all methods for treating ulcers of
indolent character and bed-sores.”—Pacific Med. and
Surg, Journ.
O' D C R LEs s A.N ID PA. LATA B L E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. . . . - -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c. . . . . * .
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto, they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin's Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

*.
Carriage Manufacturer,
Nº. 9 amin East sixth Street, ºt. Main & Sycamºre.
I MAKE NOTHING BUT
AW/APS 7" CZ.Z.S. S. WºO /*A*,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of
LIGHT FAMILY CAFFIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to
PHYSECHANS” {{SE,
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen's
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price Q
li tº lication. References S
ists furnished on application. Reference ^ -
> Ø fº
to Dr. W. W. Dawson and ºil the leading wºrs,
V. Physicians in the city and fieighborhood. . .N4–
77







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JEXTRA (!TS FROM THE OPINIONS OF THE MOST
IEIMINTENT IMEIHIB ERS OF THIJ PROFESSION.
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MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
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We are authorized by Prof. Hammond to announce em-
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Portable Electro-Magnetic Machines, published in his recent
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Similar Testimonials have been received from JOHN J.
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ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
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CALL OR SEND FOR CIRCULAR AND PRICE LIST.
Fºš" ("E-R’s
IP_A_TIEHINTT
28, LIMBs \\
Are furnished to Officers and Soldiers on Government
account. - &a
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTEER,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street, Cincinnati, Ohio, or 172 Jef.
ferson Avenue, Detroit, Mich.
wº
As
SAML. P. THOMAS
T.A. I. In O R,
IDEALER IN
English, French and Scotch
GOOIDs,
34 West Fourth Street,
& M.W.’6” Z.W.W.??" Z.



WILSON BRO'S.
S HIRT S
Made to order of N. Y. M. Muslin and 2300
HEAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.00
First three qualities have ALL LINEN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less.
Perfect satisfaction given or money cheerfully
refunded.
Also import and Manufacture Men's Furnish-
ing Goods.
Pike's Opera-House, Fourth Street, Cincinnati; 931
Wabash Avenue, and 88 West Washington
Street, Chicago.
CAM.A. R.G.O
MANUFACTURING COMPANY.,
MANUFACTURERS AND IMPORTERS OF
AND
Window Shades,
jº
67 WºSz' Aſotºzºz Szºz,
CINCINNXT, O,
H. H. BRENEMAN, Proprietor,
wan Trºp—ACIENTs.
School Teachers, Students
AND OTHERS,
Can find light and healthful employment for the Summer, by
engaging in the sale of our valuable and very popular works.
One lady teacher just commencing work for us, reports her
net profits for last week at FoETY DoILARs—many others doing
equally well, Large commissions or liberal salary as preferred.
For particulars, address
NETTLETON & CO.,
161 Elm Street, CINCINNATI, CB10:
P. S.—We will make “SPECIAL TERMs” to medical stu-
dents, who are “working their own way through college.”
BASEM & CARRENTER,
Stationers, Printers
-AND-a-
Blank Book Manufacturers,
136 VINE sº IEEET,
&\\\\\\\\\e
IE. D. ALBIRO & BRO.
IMPORTERS AND MANUFACTUBERS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
frºm:-Mº','!-Biliń'ali ºil,
The only house in the Western country that saws Spanish and Mexi-
can Cedar for Cigar-Box Makers. We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, 136 and 138 West Second Street, §
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI,


JAMES FO
[ESTABLISHED, 1836.] }
Importers and Manufacturers of
Optical and Physical Instruments,
Keep constantly on hand first-class
English and French Microscopes, First-class Objects
and Microscopieal Apparatus of every descrip-
tion, Medical Batteries, Thermometers,
IHydrometers, Urinometers and
Chemical Glass Ware.
*. attention given to adapting the best spectacles to all conditions
OT Slgnt.
We take pleasure in showing the latest novelties from the best Euro-
pean and American manufacturers.
JAMES FOSTER, Jr. & Co.,
S. W. cor. 5th & Race Sts., Cincinnati, O.
No. 758 BROADw AY, NEw York
HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
I
E. S. WAYNE
Suire & Co.,
F. E. SUIRE.
TH". TD.
WHOLESALE DRUGGISTS,
TML A-IN TJ” E" A C T TJ IF, IIST G-
£Hexists AND FHARMAceutists,
CINCINNATI, OHIO.
:
Have constantly on hand a full assortment of
s]ex,)&cºexex, XG)3.U.G.S ANYO WXXX0)(C)(N)es,
cºeryx)(cAx. Axºp ARAºus,
TESTs, MEDICAL, GLASS WARE, &c., &c.,
And solicits the patronage of the trade and profession-
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordance with the U. S. P. and other recognized authori-
ties.
ETINIHE ANID IRAIRIE CHEMICALS,
Of the popular class of preparations known as
IE T, TIXII ER, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
&
An excellent Chalybeate and tonic, Wine of Ison, &c
AGENTS FOR BULLOCK & CRENSHAW'S
Sugar-coated Pills and Granules.
LEWIS A. SAYIRE, M. D.
Surgeon, Bellevue Hospital.
*.
any I have ever examined.
From Prof. Willard Parker to S. D. Townsend. M. D., Surgeon to the
Massachusetts General Hospital.
B EG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hermia. He has instruments superior to any I have ever seen,
and his treatment is unattended with anv of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of houor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
* Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S.N. MARSH & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
OPPOSITE THE HIGH STEEPLE,
& Agents for Clement's Patent Artificial Legs,
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.



º
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CINCINNATI.
—º-
E" A C TU L T Y -
J A M E S G R A H A M, M. D., D E AN,
Professor of the The ory and LPractice of Medicine arid Clinical Medicine.
ROBERTS BARTHOLOW, M. D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and I’ractice of Surgery and Clinical Surgery.
W. H. GQBRECEIT, M.D.,
Professor of Anatomy. T. A. REAMY, M.D.,
P. S. CONNER, M.D., Professor of Obstetrics and Diseases of Children.
P Surgical Anatomy.
º ** JOHN L. CLEVELAND, M.D.,
JAMES T. W HTTAKER, M.D., Demonstrator of Anatomy.
Professor of I’hysiology.
SAMUEL NICKLY'S, M.D., CHARLES KEARNS, M.D.,
Professor of Physics and Medical Chemistry Assistant to the Chair of Surgery.
Wr. W. SEELY, M. D.,
Professor of Diseases of tho Hye and HDar, and Secretary of the Faculty
**-
T. Louis BrowN, M. I.). Proyer tor of A natomy. E. Noble, Jamitor, College Building, Sirth St., bet. Vine and Race.


















IPUBLISHED EVERY SATUR DAY.
T E R MS-$2.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editof:
All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer,
vol. 2. C IN C IN N A TI,
—º
J U N E 1, 1872. No. 22.
JAS. T. VV HITTAKER, M. D.
No. 101 West Ninth Street, Cincinnati,
TREASURER.
W. W. SEELY, M. D., - - - - - -
*- No. 118 West Seventh Street, Cincinnati.
Printed and Published by THE CLINIC Publishing Company,
**
club RATEs.
4 Copies to one address...................................................... $ 7.00
6 6 4. & C 10,00
12 “ “ ------------------..................“............. 18.00
C O N T E N T S. -
- -º-º-º- { Page.
ÖRRGINAL ARTICLES
Reports of CASEs, T1c Doloreux, Tiron AcKNTESIs, by Roberts
, Bartholow, M. D...................................................................253
REMPLANTATION of TEETH, by I. P. Meredith, M. D...............263
TRANSI LATE {DN
The Cause of Death (From Caspar's Gerichtl. Medicin. Berlin, 1871).256
ACADEMY or MHEnricº NE
- Editor.
|
WT iſ ºWTſº,
|
COān & Co.
-Platitál Hall's Ali làleſs iſ fashill,
92 FOURTH STREET,
Opposite Post Office,
CLINTCITNTINTATI, C-,
gºy" The Oldest Established Hat House on the Street. “ºff
Fine Silk Hats, Standard Quality $6,00.
ESIGNERSANPº
Transactions May 27, ”72.
Punctured Fracture of Skull, by Dr. Conner—Gangrene of Gen-
itals, by Dr. Young—Procidentia Vesicae, by Dr. Ludlow—Men-
ingitis, by Drs. Whittaker, Thornton, Carson–The State So-
ciety—Corrections........... - * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * - - - - - - - - - - - - 258-260
Six HENTIFIC NOTES
Lostorfer's Syphilis Corpuscles—Salisbury vs. Lostorfer– The De-
velopment of Intellect by Electricity—Physiological Action of
Tobacco–A Process for Liquefying the Dead—Fallacies of the
Senses—High Science—Artificial Generation................. ------ 260-161
M IELDICAL NEWS'
The N. Y. Record on the Amer. Med. Association—Prof. Bamberg-
er's Introductory—The Cure of the Prince—A Whiskey Formula
—From the Good Old Times—The Assoc. of Med. Editors
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ******
CLINHCAE, NIEMORAN HDA
Eucalyptus Globulus in Intermittent Fever–Skin Grafts—Injection
of Iodine and Alcohol in Bronchocele—A New Means of Com-
batting Muscular Contraction.......................----------.* * * * * * * * * * * * 263-204
Our State Medical Society.
* -a as wºmen ºn “we ºwn as * *
THE CLINIC of to-day continues the exceedingly in-
structive series of articles on medical jurispruden, e.
The syphilis bubble has bursted in due confirmation
of the hopes and vaticinations of all our soothsayers
from birth. In the last number of the Alig. Wien. Med.
Zeit., however, Prof. Stricker intimates that possibly
these corpuscles, whose existence is certainly established,
may prove to be the carriers of the poison.
TJnder Clinical Memoranda we have a most interest-
ing note on the treatment of malarial disease by the new
antiperiodic eucalyptus globulus and a very novel sug-
gestion in the way of combatting the rigidity of muscles
in fractures and dislocations.
:O:
The Reports of the Indiana State Society came to
hand too late for insertion in this number.
RAW
Sºgº.
ºf
* * * *
TAFT.
J. TAFT,
Editor Dental Register
J. & W. TAFT,
TDIEHINTTISTS
117 WEST FOURTH STREET,
CINCIN N ATI,
O.
A Monthly Journal,
CONTAINING 48 PAGES,
Devoted to the Interests of the Dental Profession,
*


William Autenrieth,
ROBERT CLARKE & Co's.
No. 71 WEst sixTER sºrrºris ET,
BETWEEN WAINUT AND WINE,
CINCINNATI, OHIO,
MANUFACTURER OF AND DEALER IN
|||}|| || || ||||||||
Abdominal Supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Koeps constantly on hand a full variety of
Metalic and Rubber syringes,
sº tonnach Pumps, Etc.
stockINGS For VARIcose. VEINs.
pecial attention given to the fitting of Apparatus for Deformities.
Bºy" Agent for DR. L. A. BABC00K'S
Silver Uterine Supporter,
--ALSO-
DR. AHL's POROUS FELT SPLINTs,
—A1,SO-
T) A Y " S S E T, IN T S
\
LIST of New
MHL iBTH in Mºulis iſ:
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 50
DUCHENNE’s LOCALIZED ELECTRIZATION. 8vo. $3 co
DILLENBERGER ON WOMEN AND CHILDREN’S DIS-
EASES. 12mo. $1 75
BENNETT ON PULMonoRY consumpTION. 8vo. $1 $o
FIRST HELP IN ACCIDENTS. 12mo. $1 50
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 5o
ECHEVERRIA ON EPILEPSY. 8vo. Cloth. $5 oc
HOWE ON EMERGENCIES. 8vo. $3 oo
HAMMOND ON NERVOUS DISEASES. 8vo. $; oo
RINDFLEISCH’S PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS’ PRACTICAL THERAPEUTICS, and An. Ed.
8vo. Cloth. $5 oc Leather. $6 oo
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth.
TANNER'S HANDBOOK OF OBSTETRICS. 12 mo.
WAN BUREN ON DISEASES OF THE RECTUM.
Cloth. $1 50
FLINT'S EXAMINATION OF URINE. 12mo. Cloth. $1 oo
VOGEL ON DISEASES OF CHILDREN. 8vo. Cloth. $4 5o
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
ECECTRICITY. 8vo. Cloth. $4 50
ATTFIELD'S MEDICAL CHEMISTRY. 12mo, Cloth. $2.75
Leather. $3 25
BARTHOLOW’S HYPODERMIC MEDICATION.
Cloth. $1 5o -
TURNBULL’S DISEASES OF THE EAR. 8vo. Cloth. $5 OC)
TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 oc
NEUMANN'S HAND-BOOK OF SKIN DISEASES.
Cloth. $4 oo
ANSTIE ON NEURALGIA. 8vo. Cloth. $3 oo.
PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $1 o oo
HOOD ON BONE SETTING. 12mo. $1 5o
RINGER'S HAND-BOOK OF THERAPEUTICS. 8vo. $4 oo
$2 5o
$2 oo .
A 2.1]). O,
| 2, ITIOs
8vo.
Hoºs PARTURITION WITHOUT PA I N. 16mo.
I OO
PROCTER'S LIGHT SCIENCE FOR LEISURE HOURS.
12mo. $1 75
BERNARD's PHYSIOLOGY OF THE HEART, 50 cts.
BARNES’ OBSTETRICAL OPERATIONS. 8vo. $4 5o
NICHOL’S FIRESIDE SCIENCE. 12mo, $1 50.
WOHLER'S MINERAL ANALYSIS. 12mo. Cloth. $3 oo
PLATTNER'S MANUAL OF ANALYSIS WITH THE
BLOWPIPE. 8vo. Cloth. $7 5o
JEFFRIES ON THE EYE. 8vo. Cloth. $1 oo
MANSFIELD, A THEORY OF SALTS. 8vo. Cloth. $4 oo
JEFFRIES ON THE SKIN. 8vo. Cloth. $1 oo
GARDENING FOR PROFIT. 12mo. Cloth. $1 5o
PRACTICAL FLORICULTURE. 12mo. Cloth. $1 5o
FULLER'S SMALL FRUIT CULTURE. 12mo. Cloth. $1
WOODWARD'S COUNTRY HOMES. 12mo, Cloth. $1
DARWIN'S ORIGIN OF SPECIES. 12mo. Cloth. $2.
ARTHUR'S TREATMENT AND PREVENTION OF D
CAY OF THE TEETH. 12mo. $1 5o
TYND ALL ON LIGHT AND ELECTRICITY.
THE AMATEUR, MICROSCOPIST. Small 4to.
BOOKS IN PREPARATION.
BRYANT'S PRACTICE OF SURGERY.
BARNES ON DISEASES OF WOMTEN.
ROBERTS ON RENAL DISEASES.
GUERSANT, SURGICAL DISEASES OF WOMEN AND
CHILDREN.
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by mail or express, free of charge
on receipt of price.
5o
5o
OC)
E-
12mo.81 25
$1 75
S. W. Elliott’s Saddle-bags
65 West 4th Street, Cincinnati, Ohio.
-r
List of Pharmaceutical Preparations,
- MANUFACTURED BY
Jonºv wrazºº anorarn,
FITILADELPHIA.
—º-
-u-
ELIX. PHOS. IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA,
(Goddard’s Formula,) - - -
ELIXIRVALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE FYROPHOSFHATE OF IRON,
FERRATED ELIXIR OF CINCHONA,
- ELIXIR OF CALISAYA BARK, Iron, Peruvian Bark and choice Aromatics,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND syRUP OF HYPOPHOSPHITES, ‘. -
"compound syrup of PHosphaTES, OR CHEMICAL FOOD,
Composed of the Phospinates of Lime, Soda, Potassa and Hron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
. . . . FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH, -
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK, - -
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH, -
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
. . . . BEEF, IRON AND WINE,
Extraet of Beef, Citrate of Iron and sherry wine,
ELIXIRVALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUPSUPERPHOSPHATE OF IRON, J
sº - ELIXIR OF BISMUTH,
COMP. FLUIDEXT. BUCHU AND PAREIRA BRAVA.
- - suſpIPO's ITOERIEs.
Bectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TEN TS.—For the Urethra, of every size and style, made of finest quality of sponge.
---as-
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GooD salm A RITAN HOSPITAL.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner -
of sixth and Lock streets. It is handsomely furnished throughout, and is provided
pointments of a First-class IIospital.
with all the necessary apr
Porticoes, with commanding views, surround the whole house, and wide
haſis and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price,
general terms,
service.
gºy" Address,
SISTEER ANTHONY,
according to the character of appointments necessary and service required, ranging, iº
between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
FIospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio-


























































































Wm. Wilson McGrew,
JW2, 2% WESzº Aºazºzºz Szºzº,
º
PIKE'S OPERA, HOUSE BUILDING,
Importer and Dealer
Diamond and Gold Jewelry,
Watches for Ladies and Gentlemen,
Sterling Silver Tableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
Marble Statuary,


O D C Fe, LL, JED S S A. IN ID IP A. I.L. A. T. A. E L E e
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency.
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated:
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

T TH THE C T , T TNT I C .
253
Vol. 2.] S A T U R D A Y, J U N E 1, 1872. [No. 22,
O R. I G IN A L A R T I C L E S,
-º-e-º-
REPORTS OF CASES FROM PRIVATE
I PRAGTHCIE
Made to the Academy of Medicinae.
BY
ROBERTS BARTHOLow, M. D.
1. Epileptiform Tic Douloureua, of six years duration
cured by the hypodermic injection of morphia and
by the iodide and bromide of potassium.
Cases of epileptiform tic douloureux are justly regarded
as the most horrible as respects suffering, and the most
intractable as regards cure, of any with which we have
to deal. The terrible operation of excision of the trunk
of the fifth nerve near the Gasserian ganglion, eagerly
borne by patients to be relieved for a time of their
atrocious sufferings, is, as we all know, of temporary
benefit the neuralgia returning aſter some months with
all its original intensity. Hitherto cases of this kind
have not been cured by remedial agents, although the
hypodermic injection of morphia and the galvanic cur-
rent have afforded a temporary assuagement. By the
persistent use of the hypodermic injection of morphia ex-
tending over a period of two years, and the conjoined
use of the iodide and bromide of potassium I have been
enabled, fortunately to cure a case of great severity
which had resisted the efforts of some of our most skil-
ful therapeutists. The particulars of such a case, with
details of the method of treatment pursued cannot fail
to be useful.
JHistory. My patient is a lady 42 years of age, mar-
ried and has four children. Her temperament is nervo-
lymphatic. There is a history of hereditary neuroses in
her family, one ancestor having been insane. She has
all her life suffered greatly with toothache. In 1862,
she experienced such severe and continuous pain in the
superior and inferior maxillary divisions of the fifth,
that she had all of her teeth extracted. This radical
measure was followed by complete relief which con-
tinued four years. In 1866 she had iritis which was
treated by Prof. E. Williams, but which was finally
cured by iodide of potassium administered by Prof.
James Graham our present distinguished President.
During 1867 she experienced a return of pain in the
branches of the fifth nerve. Dr. Graham who diagnos
ticated adventitious products in the brain then essayed
the use of full doses of iodide of potassium, but owing
to an extreme irritability of the stomach and disinclina-
tion of mind of the patient, this treatment could be but
imperfectly carried out, and had at last to be abandoned.
In June, 1866, pains of a very excruciating kind began
in the head, especially on the left side. Nodular swell-
ings appeared soon after, at the sites of the greatest
intensity of pain, and more on the left than on the right
side. The largest node was on the left side of the head
extending backward from the forehead as far as the
parietal protuberance.
The patient during this year drifted into the hands of
various physicians, regular and irregular. In October,
1868, whilst being treated by a homoeopathic physiciah
she had a slight epileptiform convulsion, the loss of con-
sciousness being but momentary. The next month,
[November], she had one night a number of very violent
convulsions, and did not recover consciousness for forty-
eight hours.
During the first eight months of the next year [1869],
she continued in the same state. The pains in the
branches of the fifth pair kept up unceasingly, and the
convulsions recurred at varying intervals. She became
much emaciated, weighing in July of this year, only 82
pounds. The menstrual function had ceased for a year.
My observation of the case began in August of this
year. The particulars already given were obtained from
her daughter, a very intelligent young lady.
Condition in August, 1869, and subsequently. The
patient presented an aspect of great suffering.
She was pallid and emaciated, and had a strange and
startled expression of countenance, the eyes being wide
open and staring. Both pupils were dilated, and were
unequal, the left being the larger. There was no
strabismus. Vision was dim but not otherwise ab-
normal. Hearing was dull, and a continuous roaring
sound was much complained of, and, finally complete
deafness resulted. The sense of taste was impaired but
not abolished. There was no deviation of the tongue.
Her appetite was poor, regurgitation of food frequent,
and she was constipated usually, the constipation term-
inating in severe diarrhoea. Her stomach was exces-
sively irritable, and medicines of all kinds were badly
borne.
Pain was the chief symptom. She described her
sufferings as agonizing. Points sensitive in a high de-
gree were found in various parts of the scalp. Wherever
the pains had existed for any length of time, extreme
tenderness remained. A nodular sweeling exceedingly
painful to pressure, had formed on the upper left side
of the forehead extending backward. Other nodes were
formed at various times and they were always extremely
painful, but were fugitive, appearing and disappearing,
whilst the larger one on the left side of the cranium
continued until near the close of the treatment. The
pains were of two kinds: superficial, corresponding in
distribution to the ramifications of the fifth pair in the
face and scalp, and deep as if located in the very centre
of the brain. This deep pain was heavy, tensive, and
accompanied with a sense of reverberation through the
254
[JUNE 1, 1872.
Tº ti H. C. T., T N T C .
cranial vault. The pains were nearly continuous. The
early hours of the morning were freest from them; they
came on about ten in the morning, gradually increasing
in intensity towards evening; deep pains in the brain,
acute lancinating pains and Soreness of the Scalp. The
act of eating and swallowing, bodily movements, a
eurrent of air, a gentle tap on the bead, the rolling of
carriages and wagons in the street increased them.
It is not surprising that some evidences of impaired
ſmental power were present. She talked slowly with a
drawl, and had great difficulty in giving utterance to
simple ideas. After her convulsive seizures she had
hallucinations and illusions, religious frenzy, and un-
controllable excitement of a melancholic character.
These attacks gradually declined, and her usual mental
state was restored in some days after the convulsive
geizures,
She complained of an extreme degree of vertigo.
When lying in bed she had a strong sense of floating
off, or swimming in the air; when walking, especially
in descending steps, she had difficulty in maintaining
the vertical position, and it was necessary to afford sup-
port to prevent her falling, Various motor disturb-
ances occurred from time to time. The muscles of the
face supplied by the seventh nerve were frequently
agitated by spasm, and she had similar attacks in the
trapezius, In the convulsive paroxysms the head was
drawn to the right.
From this brief description of the symptoms I pass to
the subject of treatment.
As pain was the chief symptom, I advised the hypo-
dermic injection of morphia. In a few days I raised the
amount injected each day to two grains of morphia and
I-96 of atropia. Her daughter was instructed in the
mode of using the hypodermic syringe, and the injections
were continued for two and a half years. The good
affects were these :
She was enabled to take more food.
She could retain the necessary medicine3,
She was relieved of suffering,
She was directed a pint of cream daily in addition to
her other food, and she took gi of the syrup of the
hypophosphites three times a day. As she was much
emaciated and as waste was going on rapidly, it was
considered desirable to supply these important foods to
the organism, Subsequently she was directed a half-
drachin each of the iodide and bromide of potassium
twice a day, and this was kept up steadily for several
months. This medicine was administered after she had
come under the influence of the hypodermic injection,
which enabled her to retain it without difficulty.
I may gum up in a few words the results of the treat-
Inent :
The neuralgia ceased.
The nodes disappeared.
The menstrual function was reestablished in perfect
regularity.
She rose in weight from 82 to 149 pounds.
considered an important advance in therapeutics.
Her mind was restored. The function of hearing was
not improved, and deafness fémains the only sequeſ of
the formidable lesions which must have existed.
The hypodermic injections were continued for two
and a half years. A severe struggle was anticipated in
the effort to discontinue them, but by very gradually
diminishing the amount daily injected, they were, after
six months of careful adjustment of the quantity entirely
stopped without any jar to her nervous system. Three
months have now passed since they were discontinued,
and no difficulty or embarrassment of any kind has
been experienced.
2. Cases of Hydrothoraa treated by Thoracentesis and
by Thoracentesis and Injections of Iodine,
I now report these cases of hydrothorax with the view
to illustrate the success of puncture, and of puncture
and injections combined.
No one has more happily than Niemeyer expressed
the present state of opinion on the value of thoracentesis
in the relief of pleuritic effusions. “Considering our
slender ability to excite or even to hasten reabsorption
of pleuritic effusions by means of internal medication,
and the discovery that their evacuation by Surgical means
is attended by much less danger than was formerly
supposed, the frequent and early practice of such
operations in cases of pleurisy with effusion, must be
It
must be evident that every additional day, during which
the lung is exposed to pressure, and the longer the time
allowed for cells to multiply in the exudation, so much
the more are the chances of complete recovery dimin-
ished, and the danger of a fatal termination increased.”
We are largely indebted to our own countryman Dr.
Bowditch+ for the more general introduction of thor-
Pſe demonstrated the comparative harmless-
ness of the operation itself and the marked relief always
and the permanent cure that frequently result from its
performance. sº
In England Dr. Hughes in a valuable paper, and
Mr. Cock in some observations appended thereto, urged
the operation of thoracentesis, for three definite objects:
To accomplish a cure.
To give relief in cases of severe oppression.
To facilitate the cure by other means.
This paper was the more opportune because Dr.
Henry Bennet published in the Lancet of Dec. 30, 1843,
some very discouraging observations on the result of
this operation. Famous surgeons, have it appears, been
unfortunate in the performance of thoracentesis. Thus
Boyer lost every case. Dupuytren was successful in
only two in fifty cases, and Sir Astley Cooper saw only
one successful case. It is difficult, in view of the usually
acentesis.
*Text Book of Practical Medicine, vol. I, p. 271.
+Am. Journal of the Med. Sciences, April, 1852, and Jan., '99. \
IGuy’s Hospital Reports, 2nd Series, vol. II.
JUNE 1, 1872.]
T ETH, C T.I.N.I. c.
255
good results now obtained, to account for those very
unfavorable statistics of the older surgeons.
In France the operation of thoracentesis is very fre-
quently and very early performed. The practice at
present most in vogue in France, is to evacuate the fluid
as soon as it is ascertained to exist in all cases of pleurisy.
Dr. C. Paul,” Agrégé de la Faculté, in a late paper
gives the statistics of 36 cases of thoracentesis in which
31 were cured without any return of the effusion. In a
more recent paper, he informs us that he has treated 8
cases of acute pleurisy by early puncture of the chest
with remarkable advantage. He mentions a fact, not
generally known, that when the effusion coagulates after
being withdrawn that reaccumulation is not apt to take
place. Trousseaui to whom the revival of this opera-
tion in France is chiefly due, has given an admirable
historical account of it in his lectures.
In Germany, much attention has been paid to thor-
acentesis within a few years. The distinguished
2iemssen of Erlangen, at a recent meeting of the German
medical association at Dresden, section of internal med-
icine, read a paper strongly urging this operation for
hydrothorax. Skoda, of Vienna, has long been an ad-
vocate of the operation, as has also, Traube of Berlin.
In Schmidt's Jahrbücher, vol. 139. p. 175 et seq. there
is an excellent resumé of opinions of eminent authorities
in regard to the indications for and the utility of this
operation. Not to waste further time in these histori-
cal references to recent views on this topic I pass to
marrate my own cases.
Case 1. Mr. Craig, a medical student, came to me in
the Spring of 1868, with an enormous accumulation in
the left pleural cavity. The effusion succeeded an
attack of sub-acute pleuritis for which he was treated
in the ordinary way. The usual remedies had been em-
ployed to secure absorption but without success. The
left side was two inches larger than the right; the inter-
costal spaces were bulging; the heart was displaced en-
tirely into the right side; the respiration was much en-
barrassed; the pulse rapid and weak; the body
emaciated, and a condition of extreme debility existed.
The usual physical signs indicating effusion, collapse of
the lung and compression of the organ at its root, were
present. As the effusion had already existed from the
previous September, it was considered probable that the
lung was bound down by adhesions. Thoracentesis was
performed and a gallon of clear, straw-colored serum
was withdrawn, with remarkable relief to the breathing.
The heart moved over nearly to its normal position;
the superior lobe of the lung expanded somewhat, but
as a large cavity remained, a reaccumulation of fluid
was confidently anticipated. In a few weeks Mr.
Craig presented himself again, the cavity having filled
but his general health had meanwhile much improved.
* Bulletin Général de Thérapeutique, Vol. 77. p. 519.
Mºivraison 2nd.
i Clinique Médicale, etc., Vol. I. p. 619.
f Schmidt’s Jahrbücher der Gesammten Medicin. Vol. 140. p. 133.
Also Vol. 81.
.
He was again tapped and three quarts of fluid were
withdrawn. Not to weary you with prolix details, I
may state that he was tapped fifteen times in the en-
suing three years, the interval between each operation
regularly increasing in duration. I might hesitate to
make these statements, if numerous witnesses had not
been present at these operations and heard Mr. Craig's
story from his own lips. Nearly a year has now elapsed
since the last puncture, and the cure seems to be com-
plete. Considerably more expansion of the lung has
taken place than was at first hoped for, but the lung is
far from its normal size and expansability, and the
cavity has contracted in all diameters, yet Mr. Craig
is in good health and follows a laborious occupation with
comparative comfort. In this case I first used a means
of treatment which has been lately strongly urged by
French physicians. I refer to the injection into the
cavity of a solution of ioduretted iodide of potassium.
The strength of the solution first used was 3ij of the
iodide of potassium, and 3i of the tincture of iodine to
3iv of water.
This iodised solution was gradually increased in
strength each successive tapping until it reached 3i of
iodide of potassium and 3iv of the tincture of iodine to
a pint of water. The solution of this strength produced
a sense of heat in the chest and a decided iodide of
potassium taste in the mouth but no other ill result.
The advantages of this practice seemed to be most clear,
for the accumulation of fluid rapidly diminished, and
since the last strong injection, a cure appears to have re-
sulted.*
Case 2. This case occurred in the practice of Dr. Hitt
of Greensburg, Indiana. The presence of fluid in the
left thoraeic cavity was diagnosticated by my colleague
Prof. Graham and myself. An exploratory puncture
confirmed our diagnosis and the troca evacuated eight
ounces of sero-purulent fluid. Dr. Hitt subsequently
drew off several ounces and at my suggestion injected
the cavity with the compound solution of iodine. The
fluid accumulated "the third time, succussion could be
easily induced showing the presence of air, and hectic
supervened. Spontaneous evacuation of the fluid
through the lung then occurred, and a speedy and re-
markable improvement of health took place. The sub-
sequent history I have not learned.
Case 3. A boy aged 12, Son of a well known citizen
had some pain in the left side about six weeks ago, which
attracted Kittle attention as he had frequently suffered
from muscular pains in the same region. About four
weeks ago it was observed that he got out of breath on
slight exertion, and that he had a slight cough. A
homoeopathic physician saw him and diagnosticated
hepatization and effusion. When I was called the
following was his condition: complete flatness on percus-
* Dr. Cundell Juler after the détaiis of the ease had been read, stated
to the Academy that he knew Mr. Craig, had frequent opportunities
of seeing the progress of the treatment, and bad within a few days
heard that he was yell.
256
[JUNE 1, 1872.
T TH THE C T , T N T C.
sion over the whole of the left chest; absence of respira-
tory and vocal sounds except bronchial voice and respi-
ration over the root of the lung; no increase in size of
the chest ; no bulging of the intercostal spaces; heart
displaced beyond the median line to the right.
I advised tapping without delay for the reasons given so
succinctly by Niemeyer. My colleague Dr. Graham
who subsequently saw the case with me coincided with |
me in the necessity for this measure. Paracentesis was
performed on the next day with an ordinary trocar and
forty ounces of clear, straw-colored serum was removed.
The lung readily expanded; the heart returned to its
normal site; and nothing remained to indicate the lesions
except some dullness over the base of the lung, and
some friction sound due of course to plastic deposits.
Most remarkable improvement in the general condition
of the patient took place on the removal of the fluid.
Several wéeks having now elapsed without the recurrence
of the effusion, the respiration and the general health
having meanwhile improved the most favorable prognosis
is justifiable.
-—-º-º-º-
Re-inxplaintation of Teeth. .
BY
L. P. MEREDITH, M. D., D. D. S.
Cincinnati.
-*-*-
In THE CLINIC of April 25th, is an extract from the
J3rit." Med. Journ., giving a description of an operation
of replanting a tooth, performed for Mr. Steele.
This brought to mind a more complicated case, nearer
home, a report of which I have thought might not be
uninteresting.
The patient was Dr. Jno. L. Cleveland, of the Med-
ical College of Ohio, who has permitted me to report the
successful experiment. The first, upper, left bicuspid
had been afflicted with alveolar abscess for some years.
In August last, I extracted the tooth and cut off the sac
and a necrosed third of the palatine root; a large cavity
on the posterior approximal surface was then filled and
the tooth replaced. The tooth has been doing good
service ever since, without any occurrence of the troubles
that rendered its extraction necessary.
Apropos of this subject, I would mention another
C3SC. - *
Master S. , of this city, aged 15, was kicked in the
face by a horse and had the crown of the right, superior
lateral incisor broken entirely off, the fracture extend-
ing from the maigin of the gum on the labial surface,
to a point considerably below the margin on the opposite
side. A few days after the accident, I extracted the
root, joined the crown to it by means of a gold pivot,
and three hours afterward replaced the tooth in its socket.
Thirteen months have passed and no trouble has
arisen.
Court if the expert declares himself incompetent?
| Such a decision loses sight altogether of the true object
T H E U A U S E { F IP E A T H .
From Caspar's Gerichtl. Medicin. Berlin, 1871.
1. General Remarks.
There are a great many cases in which the loost care-
ful post-mortem examination shows no such material
changes as to warrant us to connect them with the death
of the person. Such cases occur, for instance, after acts
of violence that caused general disease, not terminating
in death until many weeks or months had elapsed, when
all traces of those acts of violence have entirely disap-
peared from the surface of the body. So, too, where a
person is said to have died a violent death, because his
death occurred under unusual circumstances, but where
it is impossible, on examination, to demonstrate the
truth of the rumor. Such cases are apt to puzzle the
unskilled. They find nothing abnormal on the surface
of the body, nothing in the cavity of the skull, nothing
in the thorax, nothing in the abdomen; what was the
cause of death ? Shall the expert say that it is impossi-
ble to determine it with certainty ? Of course, nobody
could successfully attack such a decision, but it is clear
that it would give little satisfaction to the Court, which,
not being versed in such matters, wants to be enlight-
ened by the medical expert. Who shall inform the
But,
of a judicial post-mortem examination. The Court
cares little or nothing about the pathological causes of
death; it does not, for instance, want to know, particu-
larly, whether a person died of paralysis of the brain or
marasmus, which it is certainly impossible, in many
cases, to determine from an inspection of the corpse
alone; ail the Court cares to know is whether the in-
dividual died a natural or a violent death. The decis-
ion of the expert, in the former case, ought, therefore,
to be, that the individual died a natural death, and that
the post-mortem examination had failed to demonstrate
that he died a violent death. In most câses, this satis-
fies the Court. But where it appears that the deceased
had at some time previous to his death been subjected
to acts of violence, the Court would know whether
such acts are not perhaps the remote cause of death. If
these acts are brought to the knowledge of the expert,
he will not find it difficult to give a satisfactory answer.
2. Modes of Violent Death.
For practical purposes the modes of violent death are
divided into six classes.
1. Mechanical Death. It is rapid, generally extremely
sudden, destroying the machinery of the organism, by
mechanical force, either in part or entirely. The causes
are various. Some persons are crushed by the falling of
buildings, walls, beams and masts, or by the wheels of
machinery; others are roasted in fire, or run over by
º
JUNE 1, 1872.]
TIEEE THE C T , T N T C.
25?
a heavy wagon or a railroad train, or killed by an ex-
plosion.* The majority of gunshot wounds, such
namely as destroy the brain, the heart, the lungs or the
spine, belong to this class. - -
2. Neuroparalytic Death. This is the very opposite of
mechanical death and shows itself as such in its effects
on the body. Through the neuroparalitic death (apop-
deavia nervosa, Nervenschlag) the mechanism of the body
is not only innowise altered but there appears no visible
changes either in its solid or liquid component parts.
The post-morten examination shows nothing, and we
assume this mode of death without being able to posi-
tively demonstrate it. The most frequent cause is con-
cussion of the brain. -
3. Death from Inflammation. In this case death is
caused by inflammation in some vital organ, with its
consequences, especially in connection with suppuration
exudation or mortification, after injuries to the brain,
the lungs, the liver, the bowels, the peritoneum, etc.;
after poison by corrosive poisons; sometimes also after
extended burns. .
4. Death from Hyperamia, or death from excessive
obstruction of the bloodin vital centers, a, in the cavity
of the brain (apoplexia sanguinea) where the fatal pres-
sure upon the brain is caused either by hyperamic
fullness of the vessels or by actual extravasation (Haem-
orrhagia cerebri); or b, from obstruction of the blood in
the cavity of the thorax, in the lungs, in large vessels,
and in the heart; that is, death from suffocation (Pul-
monary apoplexy, Lungenschlag, Herzschlag). The for-
mer occurs after various injuries of the head; frequently
from hanging (strangulation), after poisoning with nar-
cotic poisons, after general acts of violence, in cases of |
freezing, and, not often, of drowning. Death from suf-
focation, on the other hand, is the most common in cases
of drowning, and after obstruction of the air passages
by foreign bodies; frequently it occurs also in hanging
and drowning; it kills the majority of those who are
crushed in one way or another, as also those who die in
fire (and smoke) and finally those who come to their
death from inhaling irrespirable gases. The fact that
both kinds of hyperamia are not rarely found together
in one and the same corpse, rests on well known ana-
tomical grounds.
5. Death from Anaemia, or death through such consid-
erable diminution of the volume of blood in the body,
as to cause the economy to perish. To this class
belong the various modes of death from hemorrhage, no
matter what may be its cause, and death from exhaus-
tion and starvation. , a
6. Discºmic Death. It is undoubtedly true that there
exists a mode of dying from corrupted, poisoned blood,
as shown by the microscope and chemical re-agents,
though in an ordinary post mortem examination we can
only occasionally infer this from a peculiar abnormal
quality of the blood, which is, at the same time, very
deceptive. A great many poisons kill in no other way
than by poisoning the blood, especially chronic arsenical
poisoning, prussic acid, alcohol, phosphorus and proba-
bly many other poisons. But under the head of disaemic
death must be classed also those cases in which severe
injuries after prolonged sickness and surgical operations
put an end to life through pyamia. tº
To this group may be added death from parasites. It
is unnecessary to say that this classification cannot claim
to be strictly logical. Such a classification is impossible
from the very fact that several modes of death are fre-
quently found united in one and the same case, as for
instance mechanical rupture and hemorrhage after shot
wounds, mechanical destruction and suffocation in per-
sons buried under walls, beams or earth; inflammation
and disaemia after injuries, etc. Still, the medical jurist
will always feel the need of a certain classification ac-
cording to general category, and the one here presented
has the advantage of being practically useful.
Priority of Mode of Death.
1.
It is frequently necessary to determine which of
several fatal injuries has been the cause of death.*
This occurs in the following two classes of cases:
1. Where several persons have been accused of killing
another by acts of violence. Probably they fell on him
in a great crowd or in the dark; there are no witnesses,
or the witnesses have not been close observers; and
the Court has nothing to rely on except the answer of
the medical expert to the question, which one of the
various injuries received has killed the individual, that
is, in other words, which injury was the prime cause of
his death? So, in a melée, it may be doubtful whether
a man was killed by a cane or the leaf of a table, or by
being thrown on the floor, and in the case of a man
struggling with soldiers, whether he was killed by the
sword of a soldier of the line, or that of a horseman.T
*Dr. Lipman cites the following case: At the explosion of the labo-
ratory of the pyrotechnist D. in Berlin, four persons lost their lives.
D. himself had the entire left half of his head torn away; in every
other respect the body was free from injury. The bones of the head of
one of the workman were completély destroyed, though his scalp was
wninjured; D.’s wife had probably been killed by a beam, and another
workman, who had lain sick in bed in a shed adjoining the laboratory
had been thrown, with his bed, a distance of about a hundred feet.
The corpse could not be recognized, the posterior portion of the head
had been torn off and the limbs were all crushed. Of shed and labora-
tory not a trace could be found.
General Remarks.
* See also Skrzeczka, Ueber concurrirende Todesursachen, Wiertel-
jahrsschr., 1866, p. 316.
+ That it is extremely hazardous for a medical writer to state posi-
tively the description of weapon employed in causing an injury or death
appears from a case reported in the Law Reporter, Vol. VI, p. 52-94,
One surgeon was of opinion that the wound in question had been in-
flicted with a pair of tongs, while two others agreed that it had been
caused by some blunt instrument, a brickbat, or something similar.
After conviction, the criminal confessed that he had inflicted the blow
with an axe.
Dr. Gilman, in his edition of Beck’s Med. Jur., states, that when phys-
ician to the City Prison in New York, he had frequent opportunities
of satisfying himself that a blow upon the head with the club of a po-
liceman, a round, smooth stick, would cause & cut of the scalp so clean
that nothing but the most certain proof would satisfy any one that the
injury was not caused by a sharp instrument. [Note by Transl.
258
[JUNE 1, 1872.
TIEHL E CIT, IISTIC.
2. In other cases it is necessary to answer the fre-
quently difficult question, whether the person died by
his own hand or that of another, or by an accident. We
find, for instance, a dead child under the pillow of its
unmarried mother. An examination shows severe in-
juries of the head, and at the same time, death from suf-
focation. Did the child die as the mother maintains,
by accidentally falling on the fioor, and was it subse-
quently placed under the pillow, or was it put there
living, and did it die from suffocation? It is not always
possible to give a definite answer, and yet an attempt
ought to be made.
2. Biagnosis.
In general it is necessary to consider four points in
order to make a diagnosis, although a single one of the
four is sometimes sufficient. Where a corpse exhibits
various injuries, their condition as regards the signs of
reaction may throw light on their respective priority.
This occurs mostly in the corpse of persons that died
from excessive hemorrhage caused by cuts in the throat
and whose bodies show still other wounds, especially
cuts. In this case we are led to suspect that a murder
has been committed, though suicide is not improbable.
By a very careful examination we may, perhaps, observe,
step by step, the signs of reaction in the various injuries,
so that wound A, for instance, exhibits considerable
lividity around its margin and ecchymoses in the under-
lying cellular tissue; wound B, a great deal less, and
wound C, nothing of the kind. Here we can, without
erring, determine the priority of the injuries in the
order of A, B, and C. This determination of priority |
dissolves, generally, any doubt as to whether the case is
one of murder or suicide. If the first wound, for in-
stance, was one in the left wrist, the second, one in the
upper arm, the third perhaps a superficial one in the
throat, and, finally, the fourth, which proves fatal, a
considerable deep cut in the throat, we cannot, under
ordinary circumstances assume that a murder has been
committed. A murderer does not begin by inflicting
superficial wounds, but a suicide, partly from ignorance,
partly from want of courage, is apt to do that very
thing. In case the criminal should, however, to give
his deed the appearance of suicide, have inflicted other
slight wounds, after the fatal cut, the absence of the
signs of reaction, would give the necessary explanation.
2. In other cases, especially those in which the com-
plicity of several persons is in question and where
different fatal injuries have been found on the corpse,
one of which can only have caused death we must, to
clear up the matter, consider the nature of the injuries
with respect to the instruments used. We find for in-
stance, a deep wound in the liver, another in the lungs;
both had caused hemorrhage and death had followed.
The wound in the liver was triangular in shape; the
one in the lungs has the nature both of a stab and cut.
It is found, also, that one of the assailants had carried a
bayonet, the other one a Sabre. If it is now determined
by a post-mortem examination, that the wound in the
lungs must naturally have caused death sooner than
the wonnd in the liver, the court will, at once, know the
murderer. - -
3. There are still other cases in which we find several
distinct causes in the corpse, any one of which was en-
tirely sufficient to bring about death. Here the criterion
must be to find out the real mode of death, which, in
the order of time, put an end to life before the other
modes. These are the cases where we find, for instance,
hanging and poisoning; hemorrhage and hanging;
drowning and strangling; suffocation and fatal injuries
of the head; shot wounds and cuts in the throat, and
other combinations in the same corpse. Such cases
often present great difficulties in their scientific elucida-.
tion. It might be said that they differ in nowise from
others, because the main object of a post-mortem exam-
ination is to determine the true mode of death, no
matter how many modes may have been possible; but
an expert will not make this objection. He knows that
this very complication of various modes of death obscures
the case and makes it difficult for him to express an
opinion. -
4. The last criterion is the consideration of the ex-
termal circumstances of the case, such, even, as the place
where, and the situation in which, the corpse had been
found. But this subject will be more fully considered
in treating of each single violent mode of death.
Cincinnati, May, 1872.
—sº-º-º-
Henry Haacke.
A C A D E M Y o F MI E D I C H N E .
-*-- -
JAS. GRAHAM, M. D., PREST., L. WOLF, M. D., SECT.
Transactions May 27, 1872.
Reported by Joseph Ransohoff.
Punctured Fracture of the Skull.
DR. P. S. CoMNER presented the post mortem
specimen of a case of punctured fracture of the left
parietal bone. The patient was wounded by a penknife
in the left parietal region on Friday, May 18th. After
the infliction of the injury, he walked a long dis-
tance, but later became stupid. He remained in a
comatose condition until Sunday, when he expired.
The post mortem examination was made 20 hours after
death, and revealed a scalp wound in the left lateral .
region of the cranium, four inches above the zygoma.
There was some infiltration in the neighborhood of the
wound. Upon removing the calvaria, a punctured
fracture was observed in the anterior portion of the left
parietal bone. About one ounce of clotted
blood was under the dura mater, and the
middle meningeal artery was found divided. Upon
section a large cavity was found in the left hemisphere,
JUNE 1, 1872.]
TIEEE THE CIT III INT T. C.
259
which contained a clot of blood in amount of 3oz. The
Dr. then briefly referred to three cases of a similar
nature, which had come under his charge, all of which
were fatal. -
Gangrene of the Genitals.
DR. YOUNG presented a report and appropriate draw-
ings of a case of gangrené of the external genitalia of a
female. She had nine years ago, a soft chancre, which
was not followed by constitutional symptoms. About
four weeks ago she noticed upon the left labium minus
an ulcer which (according to her account) was indurated.
This sore retained its small dimensions until one week
ago, when it gained in size and was as large as a penny.
The destruction now proceeded with rapid strides, and
in three days, the left labia were destroyed, the gangrene
extending into the perineum and involving a portion of
the left thigh. Notwithstanding all this destruction,
the patient walked to the hospital without assistance.
The right labia though infiltratéi were not gangrenous.
After the line of demarcation haë formed, about 4 oz. of
the dead tissue were removed by dissºction. An illus-
tration of the parts after the opt ration was then pre-
sented. This drawing exhibited very clearly the areolar
and muscular tissue of the abdomen and thigh which
had been exposed by the operation. The internal treat-
ment consisted in the administration of tonics and a
stimulating diet. Locally, charcoal poultices and car-
bolic acid were applied, but in place of the latter
Labaraque’s solution will be employed. The speaker
then briefly referred to the use of bromine in these cases,
a custom which was introduced by Goldsmith of the
U. S. A. -
DR. C. P. JUDKINS, in this connection, reported a
case of phagedaena of the prepuce. The individual had
a soft chancre underneath the prepuce, which was fol-
lowed by cedema of that appendage and consequent
phymosis. The physician who had charge of the case
applied three leeches to the prepuce, and the leech-bites
took on a very severe phagedænic inflammation, which
terminated in a very large abscess in the glans penis,
and a destructive inflammation in the skin of the penis.
This was the condition of the patient when first seen by
the speaker, who ordered ferriet potass, tart. internally,
and the application of charcoal poultices locally. The
patient was discharged with a useless organ, erections
being impossible on account of a torsion of the prepuce
to the left.
Procidentia Vesicce,
T)R. LUDLOW called attention to a case of this dis-
placement which he had previously reported. The
organs are retained in position by means of an air pessary
retained in the vagina, and the general condition of his
patient is gradually improving.
Meningitis.
DR. WHITTAKER reported the case of a little girl 18
months old. The child presented three days after the
inception of the illness with marked pallor of the skin,
and a stupid condition, but was very peevish when
aroused. Opisthotonos was present but only affecting
the muscles of the cervical region. The red stripe of
Trousseau was very beautifully demonstratable.
Brain vomiting was also very manifest. All the symp-
toms of basilar meningitis being present, the case was
diagnosticated as one of this disease by the speaker and
two other physicians. A few days after this, the brother
of this child was seized by epileptiform convulsions,
which occurred at the same hour upon alternate days.
Supposing this to be a case of malarial toxicaemia full
doses of quiniae sulph. were ordered, and the boy made
a very good recovery. Being then informed by the
mother that the girl with supposed basilar meningitis
was also subject to these periodic convulsions, quinia
was administered both internally and hypodermically.
Since the adoption of this course of treatment, the
patient is apparently on the way to recovery.
DR. THORNTON recalled two cases of cerebro-spinal
meningitis which he reported several weeks ago. The
younger of these children died after a lingering illness
of three weeks. The Second case was supposed to be
of miasmatic origin (the patient residing in a malarial
district) and hence quinia Sulph., gr. v.j. was daily ad-
ministered. Leeches were also applied to the sides of
the head. The quinia was continued in this case for
four weeks, and the child is making an excellent re-
covery.
DR. CARSON reported a case of this disease, the patient
being a girl aet. 16 years. Vomiting was one of the
earliest symptoms. The highest temperature was 104°.
The average temperature was 1013° in the morning and
103° in the evening. No headache was complained of
and there was no muscular rigidity. Hyperaesthesia of
the entire surface of the body was a most apparent
symptom. The Dr. then referred to the very irregular
character of the symptoms in these cases. He then
alluded to a case (reported at a previous meeting) in
which vomiting was a marked feature, but seemed to
depend upon gastric derangement, the patient having
ingested a large quantity of indigestible food. After
the lapse of twenty-four hours, all the symptoms of
cerebro-spinal meningitis were manifest, and as such the
case was treated. -
The State Society.
DR. DAWSON called attention to the approaching
session of the State Medical Society at Portsmouth, O.,
June 11, with a statement as to the railroad fares, etc.
DR. REAMY remarked in this connection that steam-
boat fare was $300 each way. It would be necessary
to start on Monday evening at 4 o’clock to arrive on
Tuesday at 8 A. M. Even with the reduction of rail-
road fare the steamboat was the cheaper, as the fare
named includes good boarding.
Corrections.
COMMUNICATED:
Please do me the favor to correct your report of my
260
[JUNE 1, 1872.
TIEEE IEH C T , T N T C .
remarks made in the Academy of Medicine during the
discussion of ovarian tumors and operations, as follows:
Respectfully,
Thad A. Reamy.
Dr. Reamy said that Wells gives as a diagnostic point,
that when in doubt as to the nature of the tumor and
when any symptoms indicate a possibility of its being
uterine, that the recession and depression of the cervix
uteri upon lifting the tumor up and pushing it down,
is a better indication of the character of the growth than
the depth of the uterine cavity, and it is also foundathat
Some of these uterine tumors lessen the cavity of that
organ. When in doubt of the nature of the tumor and
an operation is decided upon, the abdominal incision
should be small, and if the tumor is then found solid
the wound may be closed and the operation abandoned,
and the danger incurred is slight. In reference to the
doubts of Dr. Wright that one is justified in attempting
the removal of abdominal tumors, the 70 per cent. of re-
coveries after removal of cystic ovarian growths would
certainly warrant the attempt—the speaker had had
but one fatal case.
IN Dr. Sittel's article on Goitre the phrase concerning
adopting the precaution of filling the syringe without
withdrawing the needle should read, let the piston remain
wntouched in entering and withdrawing the needle that
there may be the least possible danger of injecting iodine
into a possibly ruptured vein, etc.
—-º-o-º-
S4CHIENTIFIC NO’ TES.
Lostorfer’s Syphilis Corpuscles.
A Second Letter from
PROFESSOR BUMSTEAD.
To the N. Y. Med. Record, (May 15, 1872).
º: * * -X. 3:
The method and results of his investigations, which
1 have thus far given, have since been made public by
Prof. Stricker at a meeting of the Wiener Medical
Society, held a week ago, April 18th. But I have now
a more important discovery to report, which was first
announced at the meeting of the same Society held last
evening, April 26, and which Prof. Stricker regards
as the termination of his labors upon this subject.
Your readers have not forgotten the patient men-
tioned in my letter whose blood contained Lostorfer's
bodies in such large numbers and presenting such early
development; also, as I stated, that this man was in an
extremely cachectic condition, that he had several at-
tacks of hemorrhage from the lungs, and that his life
was at one time despaired of.
Prof. Stricker had thus far examined only the blood
of sound persons, of persons affected with syphilis, of a
number with lupus, and of several with acute diseases,
as typhus fever, etc. Among these he had found the
bodies exclusively in the syphilitic cases, with the ex-
ception of two cases of lupus, in which they were un-
questionably present [a second case having been met
with in additton to the one mentioned in my last
letter]. - - . -
But in considering the case I have above referred to,
the question now occurred to Prof. Stricker how far
the abundance and early development of the bodies was
due to the cachectic condition of the patient, and
whether this same condition was not sufficient to pro-
duce them independently of syphilis. To determine
this point, he took blood from a girl, 17 years old, who
had never had syphilis, and who was now in the last
stages of tuberculosis; he examined it under the micro-
scope; Lostorfer's bodies were present 1
He examined another similar case and with the same
result. Further, he examined the blood of three per-
sons dying of carcinoma, and still another exhausted by
Morbus Brightii ; in all he found the “syphilis-
corpuscles,” although the patients had never had
syphilis -
Here then were six persons free from syphilitic taint,
but whose nutrition and vital powers were impaired by
different diseases, and blood from all of them exhibited
the peculiar and (to use the words of Prof. Stricker)
“newly discovered” corpuscles of Dr. Lostorferl
The conclusion was evident, viz., that the presence of
these bodies is due to the impairment of nutrition and
the cachectic condition of the individual, and not to the
existence of syphilis or any other one disease exclusively.
The announcement of this result formed the substance
of the remarks of Prof. Stricker before the Society last
evening. It was followed by him with a statement of
the different possibilities to account for the origin of
these bodies, but as these were hypotheses, I will not
repeat them. No public discussion of Prof. Stricker's
remarks was held by the Society. After the meeting,
I conversed with several members of the opposite party.
and found them jubilant over the result. They had
repeatedly asserted, and had probably led themselves
to believe that Prof. Stricker had committed himself
to the syphilitic nature of the Lostorfer's corpuscles;
his “renunciation” of it they looked upon as a triumph
for themselves. As I said in my first letter, however,
Prof. Stricker has never thus committed himself, either
in his public remarks before the Society, or in what he
has written, or in the private conversations which I
have had with him; and it appears to me that his con-
duct has been deserving of all praise, and worthy of his
high scientific reputation, in going quietly, seriously,
and earnestly to work to investigate this alleged dis-
covery, instead of at the outset rejecting it with a mere
denial and a sneer. -
SALISBURY VS. LOSTORFER.—One significant fact,
which must occur to everyone, and which we would
recommend Dr. Salisbury to consider, is, that, despite
the hundreds of experienced microscopists, whose in-
struments have for months been directed at syphilitic
blood, not a single observer has detected a trace of the
JUNE 1, 1872.]
TTH. H. cI, IISTI c.
261
“Crypta syphilitica” (Salisbury), which our fellow-
countryman finds in every case he examines.— Vienna
Letter to Bost. Med. Journ., May. 23, '72.
THE DEVELOPMENT OF INTELLECT BY ELECTRICITY.
—A European medical journal, the Medizinische Cen-
tral Zeitung, published at Berlin, had some interest-
ing statements of the experiments made by Dr. Cohen
at Breslau. He subjected physically-weak and men-
tally-torpid children to the application of a daily con-
tinuous current, with very satisfactory results. Some
of the dullest children of a class at School were thus
treated, and, the report states, with perceptible improve-
ment of their mental powers.
PHYSIOLOGICAL ACTION OF TOBACCO-SMOKE.—Wohl
and Eulenberg (Arch. Pharm. Chem... cxlvii, p. 130) find
that the amount of nicotine in snuff and tobacco for
chewing is so minute, that nothing like nicotine-poison-
ing can result from their use. The action of tobacco-
smoke and tobacco-juice is not due to nicotine, for it
contains none, but to pyridine, picoline, colledine, and
other bases forming a homologous series, which are pro-
duced during the combustion of the tobacco. The rea-
son why stronger tobacco can be smoked in a cigar than
in a pipe is, that in the pipe a large quantity of pyridine
is formed, which is very volatile and stupefying; while
in a cigar little pyridine and much colledine are formed.
The unpleasant symptoms experienced by persons just
beginning to smoke, or who smoke to excess, as well as
the poisonous effect of tobacco juice, are not due to
nicotine, but to the pyridine and picoline bases; and
they have probably been attributed to nicotine because
these bases, especially those having a high boiling-point,
greatly resemble nicotione both in smell and in physio-
logical action, producing contraction of the pupil, diffi-
cult respiration, convulsions, and death. They do not
act so quickly when injected under the skin as when
taken into the stomach, and their action is less rapid
than that of nicotine. Other plants which are some-
times used for smoking, though they contain no nicotine,
such as dandelion, willow-wood, and stramonium, yield
pyridine bases whose action is very like those from to-
bacco, though rather weaker. Pure picoline from Bog-
head coal had a similar action ; and its vapor was
poisonous, producing irritation of the respiratory passages
slight convulsions, and death. None of these, except
the bases from willow-wood, produced contraction of
the pupil. The authors consider that the effects pro-
duced by opium-smoking are not due to the alkaloids in
the opium, but to the bases formed during its combus-
tion; and that the difference between it and tobacco is
owing to different bases being formed by their combus-
tion.—Brit. Med. Journ., May 11, ’72.
A PROCESS FOR LIQUEFYING DEAD BODIES.—A cer-
tain M. Donac (Lancet April 13) has recently laid before
the French Academy of Sciences a project for liquefying
dead bodies and transforming them into a syrup without
color or smell.
According to his calculations, a moderate |
sized man could be got into six bottles. The size of
each bottle is not stated, but the Paris Journal appears
charmed with the idea, and exclaims, “What an opening
for the exercise of filial piety P’
FALLACIES OF THE SENSEs.—Mr. Spencer Watson
has been lecturing in London on this subject, and by
an ingeniously contrived model of an eye showed how
floating bodies in the vitreous, such as blood-clots,
membranes, and the like, might cast shadows upon the
retina which would be projected outwards, as if images
of external realities, and would thus explain the occur-
rence of certain spectral illusions.
HIGH SCIENCE.-According to Berthelot's statement
in his treatise on Organic Chemistry, no fewer than ten
thousand organic compounds have been discovered, made,
and studied; and the number which may be made is
literally unlimited. As to their nomenclature, we may
take as an example the following title of a short paper
which comes under our notice this week, on “Methyl-
Mercap-Disulphonic Acid, and Methyl-Alcohol-Trisulph-
Acid.”
ARTIFICIAL GENERATION.—Dr. Felix Rouband pre-
sented to the Academy of Medicine [April 8th an in-
strument whose use is explained by the following note.
Since the discovery of ova and spermatozoids the idea
of artificial conjunction of the male and female elements
of generation has occurred to a number of investigators.
Swanmerdam Was the first to attempt it but his attempt
failed. Roëssel did not succeed any better. Spallanzani,
finally, did succeed in artificial fecundation towards the
close of the past century, first with the amphibia, next
with ovipara and finally with vivipara. -
In order to enlarge the field of human artificial gen-
eration as developed by Marion Sims and Prof. Courty of
Montpelier, I have constructed this instrument which I
here present to the Academy. The great advantage of
the instrument is the celerity with which the male
element may be entered without change of temperature
or injection of air.—Lyon Medicale, Apr. 28, '72.
[The instrument as represented is a close imitation of
Dieulafoy's subcutaneous aspirator].
—sº- e-º-
MEDICAL NEws.
THE N. Y. MED. RECORD ON THE AMER. ASSOCIA-
TION.—The Record, we fear, is not duly impressed with
the augustness of our grand national council as the fol-
lowing extracts from a review of the late proceedings
very clearly exhibits:
“But when we leave the social aspect of the conven-
tion, and consider it as a body claiming to represent the
status of a learned profession in this country, we are
alternately humiliated and amused. That a national
society, a quarter of a century old, should have grown
no more mature than to spend the whole of its general
262 TIEEE TE: C
T 1 T. TST I C. [JUNE 1, 1872.
sessions not in listening to scientific addresses, not in
discussing scientific problems, but in petty squabbles
over its Codes of Ethics, and in wild efforts to give its
Transactions an appearance of manly strength and
dignity, when its meetings are devoted to child’s play
—is not consoling to us as a member of the medical pro-
fession of America. But when such a body assumes
to dictate a scheme “to be recognised as the only
system of medical instruction in this country,” and
to demand that college charters be granted and revoked
in accordance with it (Report on Education), the
notion is so supremely absurd that we are put in good
humor again.
It is strange how the men of real culture and power
in such an assembly are dragged down by the dead
weight of its average ignorance and imbecility. Voa,
populi, vow Dei has been a spell to lead even statesmen
to sacrifice their best thought to the supposed wisdom of
majorities. It is the same potent spell which compels
the President of the American Medical Association, in
an address whose every sentence proclaims the elegant
scholar, to ask of German culture, “What has it all
amounted to ?” to doubt whether we have not, after all,
laid rather too much stress on the “accomplishment of
spelling; ” to see no other aim than that of “rugged utili-
ty;” and to counsel us not to get too far in advance
of the people, lest they fail to appreciate us. * * *
It is well that the Association appreciates its own
merits, and we highly approve its proposition to vote
itself a medal, though the distinguished honor of mem-
bership will never be fully understood, except by
those who know the severe ordeal delegates have to
pass at the time of their election. We would suggest
a design: On the obverse, a railway train of Young
American doctors rushing towards the log-built station
of “Rugged Utility,” while a mild-faced German, in
spectacles, is vainly endeavoring to put on the “brakes”
(Report on Education); books, paintings and statutes
being flung madly from doors and windows; inscription
(not over-carefully spelled)—“Away with learned lum-
ber” (President's address). On the reverse, the Editor of
the National Medical Journal, standing on the dome
of the National Academy of Medicine, gazing fixedly
into heaven; inscription—AEsthetics, morals, and the
higher life” (Report on Literature.)”
PROF. BAMBERGER'S INTRODUCTORY..—On last Mon-
day Prof. Bamberger opened his clinical course (Vienna).
The newly erected spacious and most convenient lecture
room was filled as early as 7 A. M., with physi-
cians and students while the numerous guests and
friends of the Professor found places about the beds at
the lower end of the hall. At half past Seven the Pro-
fessor appeared attended by the director of the hospital,
Dr. Hoffman. His appearance was the signal for a right
hearty ovation, a regular storm of applause which lasted
for some minutes. Deeply affected with his reception,
the successor of Oppolzer commenced his address with
allusion to Oppolzer as the beloved father of the students,
the teacher of unattainable merits. The speaker was
glad to be able to return to his native land after his ab-
esnce of 18 years, the trial through which many are com-
pelled to pass. He was convinced that Austria was not
a land condemned to destruction; the well known
phrase “Austria erit in orbe ultima” reads more prop-
erly “Austria erit in orbe prima.” He hopes that
Austria's noble children will recall the motto of the
British navy “The country expects every man to do his
duty in the field” of labor which is no less a field of honor
than the field of battle. He reminds his hearers of the
result of the recent wars as the results of high cultiva-
tion and earnest intent.
Passing over to medicine, the speaker explains, that
he will not attempt now to give any programme or
system of his lectures. All systems everywhere in
schools have been attended with but little result.
This school, the seat of instruction of a Skoda and
Oppolzer, has been from time immemorial a centre of
Hippocratic instruction, alike free from barren scepti-
cism and bald empiricism. The clinical schools, the
brilliant discoveries of Virchow have furnished alike
the most beautiful results. The chief difficulty of
the clinical teacher in fulfilling his duties properly
arises from the great number of students attendant.
When there are hundreds of pupils, it is almost impossi-
ble to educate each individual practically. To attain
fhis education, later clinical instruction becomes a
necessity. He would try to arrange his material that
his students would not be oppressed with its mass.
This is to be the basis of his course.
As the subject of his discourse he selected aneurism of
the aorta, in the discussion of which all his hearers
followed his clear and practical portrayal with that
strained attention which is the best evidence of the
wisdom of the choice of Oppolzer's successor.—Wien.
Med. Presse, Apr. 28, '72.
THE CURE OF THE PRINCE.— * * * Such a
wonder is the daily wonder of medicine; it is repeated
in the annals of hospitals and of private sick-rooms from
day to day. Wonders are not worked especially for
princes; and physicians are proud to learn that they
daily work wonders when they are so often told the
reverse; but they must not be suspected of reserving
special means for the benefit of great persons, or of
treasuring up particular expedients, not known to others,
for great occasions, any more than of practising novel
and surprising experiments on such occasions. It was
wonderful, but “it was prose; ” the every-day work of
medicine, only carried out calmly, judiciously, devotedly
under the fierce light that beats about a throne, instead
of in the dark recesses of the pauper's room or in the
dim religious light of a hospital ward.—Brit. Med. Jour.
A. WHISKEY FORMUL.A.—“Ten gallons of kerosene,
three pounds of potash, one ounce of Strychnine, mixed
with soft water.” It was according to this cheerful, not
to say convivial, formula, that a quantity of “whiskey”
JUNE 1, 1872.]
seized last week in Newton, Mass., was compounded, the
recipe having also been found in the possession of the
unfortunate dealer. If you want “gin,” add quantum
sufficit of oil of juniper | The mystery is that men who
drink this diabolical fluid do not drop down stone dead
at once,—Med. World, Apr. and May, 1872.
FROM THE GOOD OLD TIMES.—An old Roman law is
still preserved in force in Russia. Every individual found
idle on the public streets no matter what his social con-
dition or nativity is arrested and condemned to work
the whole of the next day at street sweeping. The
Gazette Med. de Paris [Apr. 27], from which this note is
clipped, advocates the adoption of this or a similar law
for France.
THE ASSOCIATION OF MEDICAL EDITORS OF THE
TJNITED STATES.—This Association met on Monday
morning, May 6, at Horticultural Hall in Philadelphia.
The following resolution was unanimously adopted :
“Resolved, That an annual prize of $100 be offered by
this Association for the best essay on some subject to be
decided upon at each annual meeting, and the same to
be open for competition to all medical editors belonging
to this Association,”
In accordance with this resolution, Drs. Dawson,
Davis and Stone were appointed a committee to recom-
mend a subject for the prize essays of the coming year,
and to nominatee a committe to examine the Same. The
Association then adjourned until evening, when on re-
assembling, an address on the “Origin of Medical
Science” was delivered by the president, Dr. B. F.
Dawson, of New York. The subject for the prize for
May, '73, is “The Pathology and Treatment of Diseases
of the Ovaries.” -
— — —--—sº- e <> --——
(!_LINICAL MHEMIORNADA.
Eucalyptus Globulus in Intermittent Fever.
From the Brit. Med. Journ., May 11, ’72.
About two years ago, Dr. Lorinser of Vienna laid
before the profession the results of his observations on
the treatment of ague by the Eucalyptus Globulus. A
supply of the tincture was placed, for the purpose of ob-
servation, at the disposal of medical men connected with
the railway stations in localities where ague was frequent.
The quantity, however, was but small ; and a larger
supply was distributed in May of last year. The results
obtained during the summer have been collected and
analysed by . Dr. Joseph Keller, chief physician of the
Austrian railway company. ge -
The number of patients treated with tincture of
eucalyptus was 432. Of these, 310 (71.76 per cent.)
were perfectly cured; and 122 (28.24) required to be
afterwards treated with quinine. Of the 310 patients
who were cured, no paroxysm occurred after the first
TIEEE THE C T , T INT I C .
263
dose in 202; in the remaining 108, there were one or
more subsequent paroxysms, which, however, yielded
to repeated doses of the medicine. Quinine had been
given without result in 118 of the 432 cases; 293 of the
patients had had ague in previous years, and 139 were
attacked for the first time in 1871. Of the 122 cases in
which the eucalyptus failed, 58 recovered under the use
of quinine, 38 were not cured, 10 were sent home, and
16 remained under treatment. Of the 118 cases in which
quinine had been given unsuccessfully, 91 recovered
under the use of eucalyptus, and in 27 no result followed.
The several types of intermittent fever were represent-
ed as follows: quotidian, complicated, 117, simple
73=190; tertian complicated 126, simple 95=221;
quartan, complicated 16, simple 4=20; quintan, com-
plicated, 1. The complications were, enlargement of
the spleen or liver, anaemia or chronic gastric catarrh,
paludal cachexia, etc. The remedy was successful in
161 of the 260 complicated cases, or 61.9 per cent, ; and
in 149 [or 86.6 per cent.] of the 172 simple cases. The
percentages of success in the several types were: in
tertian, 75.57; in quartan, 70, in quotidian, 67.89.
Among the cases in which the first dose of eucalyptus
arrested the disease, were 95 complicated and 107 sim-
ple; 28 of the former and 20 of the latter had previously
been treated unsuccessfully with quinine. In the cases
where the paroxysms recurred, there were 70 compli-
cated and 38 simple; quinine had been given without
success in 27 of the former and in 15 of the latter.
Of the 432 patients, 353 were men, 46 women, and 33
children. There were 155 patients who were immigrants
into the localities; and in these the disease was more
frequently attended with complications, and the treat-
ment was less successful than among the indigenous in-
habitants.
The treatment was generally commenced on the fifth
day after the first paroxysm of ague; its duration
averaged 93 days, that with quinine in previous years
having been 123 days.
The tincture was made by dividing into small pieces
the leaves of eucalyptus obtained through France from
the native country of the plant, and macerating in
alcohol for three months. Ten pounds of the leaves
yielded twenty-five quarts of the tincture. The average
dose was two drachms; and the average quantity used
for each patient was seven drachms—this, however,
varied much, according to the nature of the case and its
complications.
Dr. Keller concludes that eucalyptus must be re-
garded as a very important remedy for ague; but that
the plant as cultivated in Austria is less efficacious than
that imported from its native soil; that the remedy is
of service especially in obstinate cases of ague where
quinine has been given unsuccessfully; and that the
average duration of treatment by eucalyptus is shorter
than that by quinine. He believes that the tincture
is the most eligible preparation of the plant, as the
essential oil is retained. The cost of a quart of the
264
[JUNE 1, 1872.
TIH. H. C.I.I.INI c.
tincture he calculates to be less than two florins ($1). It
has a pleasant aromatic flavor. For women and children
some simple or orange syrup may be added. In the
milder cases, two or three teaspoonsful, taken before
the expected paroxysm, are generally sufficient. Where
cachexia is present, small doses should be taken night
and morning for some time.
SKIN-GRAFTs.—M. Olliver of Lyons considers that
the connective tissue and not the epidermis is the active
agent in the graft, and objects to sowing a number of
small epidermic grafts. He cuts them from six to
eight centimétres in length, and they succeed very well;
but it is inconvenient to procure such large grafts.
He freezes the skin before cutting it away, and finds
that it still answers well, notwithstanding this assault
upon its vitality. This is a veritable autoplasty, and
the healed Snrface has a more persistent vitality than
ordinary cicatrices.
INJECTION OF TINCTURE OF IODINE AND OF ALCO-
Hol. IN BRONCHOCELE.—Dr. Karl Schwalbe ( Virchow's
Archiv, Band 54) speaks of injection of tincture of iodine
and of alcohol in the treatment of thyroid tumors.
Those in which it succeeds best are the soft and cystic
enlargements; in hard fibrous, tumors no result is ob-
tained ; and in vascular swellings there is danger of the
production of embolism, unless the vessels have been
partially contracted and the tumor diminished by the
internal use of iodine and by electrolysis. If blood
escape in a stream on the introduction of a cannula, the
injection must not be made; in any other case, it may
be done with safety. About ten or twenty drops are
injected as nearly as possible in the middle line of the
neck over the tumor, by means of a syringe fitted with
a cannula having a short point. If no blood flow on the
introduction of the cannula, the fluid is forced in ; and
before removing the instrument, the operator waits for
a short time in order that the injection may not again
flow out. The operation is sometimes followed by
transient pain in the course of the nervus auricularis
magnus, cough, gastric oppression, vomiting, and in
weak subjects by fainting. One woman, who was sub-
ject to epilepsy, was seized with symptoms of hemiplegia
soon after the injection, and died in convulsions.
Schwalbe prefers alcohol for the injection, a drachm of
iodide of potassium being at the same time taken daily.
The injection may be repeated at weekly intervals. No
confinement is required during the treatment; the
average duration of which is two or three months.-
Wiener Medizin. Wochenschr., March 16, 1872.
A NEW MEANS OF COMBATTING MUSCULAR CON-
TRACTION.—Every one is familiar with the resistance
offered by muscular contraction in the reduction of dis-
locations or of fractures with displacements of the frag-
ments. In order to avoid this difficulty resort is had to
reduction as soon after the accident as possible to profit
by the condition of stupor existent at that time. After
this period etherisation becomes necessary. M. Broca,
however, has devised a means which is void of the in-
conveniences of anaesthesia; it is compression of the
principal artery of the wounded limb. The muscles de-
prived of the blood necessary for the exercise of their
functions by compression of the brachial or femoral
arteries are unable to contract. By means of this prac-
tice M. Broca has already succeeded on a number of
Occasions without recourse to anaesthesia.-Lyon Méd-
icale, Apr. 28, '72. - -
—-º-º-º-
Our State Medical Society
[The approaching session of the State Society promises
to be one of the largest and most enthusiastic gatherings
in the history of the association. A number of most
interesting papers will be presented, we learn, and but
little time is to be devoted to ethics, and other nonsense.
The following letter from the Secretary explains itself:J
- CINCINNATI, OHIO, May 23, 1872.
The Ohio State Medical Society will hold its Annual
Meeting this year at Portsmouth, Ohio, beginning
Tuesday, June 11th.
Arrangements have been made for reduction of fare,
to members and their families with the following Rail-
roads: -
Marietta & Cincinnati Railroad—Half Fare. Round
Trip Tickets good from June 8th to 15th. Secretary
will furnish return certificates.
Cincinnati, Hamilton & Dayton and Cincinnati, Rich-
mond & Chicago Railroads.-Hamilton to Richmond,
Half-Fare. Return Tickets good until the 15th.
Cincinnati, Sandusky & Cleveland Railroad.—Round
Trip Tickets to Dayton and Return at Half Fare.
Tickets good going, from June 8th to 11th ; returning,
until the 15th.
Columbus & Hocking Valley Railroad.—Round Trip
Tickets at Half Fare. Good on return, June 13th, 14th
and 15th only. - -
Baltimore & Ohio Railroad Company.—If twenty-five
passengers are guaranteed, will place on sale Round Trip
Tickets at principal Stations on Central Ohio and Lake
Erie Division, via Columbus, for four cents per mile,
one way, to Columbus; the rates of other Roads will
then be charged thence to Portsmouth.
The following Roads refuse any reduction in fare :
Pitsburg, Ft. Wayne & Chicago Railway; Cleveland
and Pittsburg and Erie & Pittsburg Railroads; Pittsburg
Cincinnati & St. Louis Railway, and leased lines;
Grand Rapids and Indiana Railroad, and leased lines.
Also, Cleveland, Columbus, Cincinnati & Indianapolis
Railway Company. -
It will be necessary for Members to show their
Circular to Ticket Agents and Conductors.
W. W. DAWSON, M. D., PREST.
J. W. HADLOCK, M. D.
Assistant Secretary Ohio State Medical Society.
—º-º-º- .
CoRRECTION, Semi-Centennial Catalogue: J. Powers
Orr instead of (Powers Orr), Ind., 1865.
DIVIDED MEDICINES,
The Divided Medicine Com'y,
a "
&
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEw AND ExCEEDINGLY PRACTICAL -
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE.
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities.
But not only SoLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. .5%
9 This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; : #, sh, Ibo, and even lobo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. *
* Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH OF TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For Samples, Price Lists, and Agencies, address
The Divided Medicine
§§
TBOX 26ss,
Or FRFDERICK KRAUS, Chemist and Druggist,
walnut Hills, Cincinnati, O.
MR. FREDERYCK KRAUs: - CINCINNAT1, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz:
SULPH:MORPHII....................... % grain in each square. ARSEN: ACID.......................... 1-20 grain in each square.
“ CHIN INI .......................] & 4 6 & ſº tº CALOMEL.............................. % { { • 6 4 &
* COPPER ........................}, 63
RESPECTFULLY YoUBs,
-- . - E. S. WAYNE, Analytic Chemist.



Carriage Manufacturer,
Nº. 9 and Il Fast Sixth Street, ºt. Main & Sycamore.
I MAKE NOTHING BUT
runsz, czzss ºroma',
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of
LIGHT FAMILY CARRIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very €X-
tensive variety of light elegant designs of different cost and finish. In vehicles especially
adapted to - -
PHYSECHANS” （SE.
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
I make for that purpose.
The superiority of my light gentlemen's
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
Physicians in the city and heighborhood.



|||||}|| WMF (MºW
167 EAST 34TH-ST., NEW YORK,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MANUFACTURERs of PortABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwamic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery Fluid.
Mill lllll-llſ. Millſ,
For Hospitals and General Practitioners,
IETIECTIER, CTDES.
For Eye, Ear, Larynx, Nose, Uterus, Wagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Eleo-
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
IEXTRA (!TS FRONT THE O PINIONS OF THE MOST
IEIMINIENT MEMBERS OF THE PROFESS / O N.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “NoTHING cAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. Hammond to announce en-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
MEREDITH CLYMER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider their
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:—‘ In meat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. GARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M.D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, 0.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Dlectrical Instrument for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
IE_A_TIE TSTT
–28, LIMBs \\
Are furnished to Officers and Soldiers on Government
account. - -
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb–why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMEs A. FO's"TEER,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street, Cincinnnnati, Ohio, or 172 Jef-
ferson Avenue, Detroit, Mich.
SAML. P. THOMAS
T.A. I. I. O R,
DEALEF IN
English French and Scotch
GOODs,
34 West Fourth Street,
("Z.W’("A.W.W.??"/.




WILSON BRO's
S HIRTS
Made to order of N. Y. M. Muslin and 2300
HEAVY Linen, per dozen - - - $26 00
Wamsutta Muslin and 2100 HEAVY Lin-
en, per dozen - - - - - - - - 33.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.0)
First three qualities have ALL LINEN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less.
Perfect satisfaction given or money cheerfully
refunded.
Also import and Manufacture Men’s Furnish-
ing Goods.
Pike's Opera-House, Fourth Street, Cincinnati; 931
Wabash Avenue, and 88 West Washington
Street, Chicago.
CAMARGO
MANUFACTURING COMPANY.,
MANUFACTURERS AND IMPORTERS OF
Window Shades,
67 WºSz' Aſotºziz Szºz,
CINCINNXTI, O,
H. H. BRENEMAN, Proprietor,
wanTED–Acriºrs.
School Teachers, Students
AND OTHERS,
Can find light and healthful employment for the Summer, by
engaging in the sale of our valuable and very popular works.
One lady teacher just commencing work for us, reports her
net profits for last week at FoETY DoILARs—many others doing
equally well. Large commissions or liberal salary as preferred.
For particulars, address
- NETTLETON & CO.,
161 Elm Street, CINCINNATI, 0B10.
P. S.—We will make “special, TERMs” to medical stu-
dents, who are “working their own way through college.”
BASCOM & CARPENTER,
-AND-
Blank Book Manufacturers,
136 v1.NE sºrrºrDBT,
&\\\\\\\\e
E. D. ALBRO & BRO.
IMPORTERS AND MANUFACTURESRS OF
FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
frºm:-Maº', 'al-Biliń'anilal-Bitri'Wii,
The only house in the Western country that saws Spanish and Mexi-
can Cedar for Cigar-Box Makers. We import our own wood direct, and
can sell at prices to compete with any and everybody.
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
office and warerooms, 136 and 138 West Second Street,
Veneer Mill, 507, 509, 511, 513 & 515 W. Sixth St., CINCINNATI,

&- É. § §
Simiº
- :
º
JAMEs Fosºrºr,
[ESTABLISHED, 1836.]
Importers and Manufacturers of
Optical and Physical Instruments,
Keep constantly on hand first-class
English and French Microscopes, First-class Objects
and Microscopical Apparatus of every descrip-
tion, Medfeal Baiteries, Thermometers,
Hydrometers, Urinometers and
Chemical Glass Ware.
sº attention given to adapting the best spectacles to all conditions
OI signt.
We take pleasure in showing the latest-novelties from the best Euro-
pean and American manufacturers.
JAMES FosTER, Jr. & Co.,
- S. W. cor. 5th & Race Sts., Cincinnati, 0.
ISR's.N.M.A.R.S.H.’s
No. 758 BROADWAY, NEw York
I HAVE been in the habit of applying and recommending the Truss'
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
.ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, 1 think it far preferable to
any I have ever examined. LEWIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
Parker to S. D. Townsend M. D., Surgeon to the
Massachusetts General Hospital,
BEG leave to state for the benefit of all concerned, that I have known
lor. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
From Prof. Willard
and his treatment is unattended with anv of the risks to the patient
that exist in many of the plans suggested and atteumpted to be carried .
into execution. I have confidence in Dr. Marsh as a gentleman of honol
and integrity, and as such recommend him to the members of the medi- ||
WILLARD PAlt KER, MI. D.
cal profession generally.
* * * - Professor of Surgery, New York City
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder, Braces, . Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Grub Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Qure Truss Offices of S.N. MARSH & CO., No. 2 Vesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
F. E. SUIRE.
F. E.
t
E. S. WAYNE
& Co.,
wholesale DRuggists,
M. A-TN U E A CT Uſ ER, IIST G.
£Hemists AND FHARMAceutists,
CINCINNATI, OHIO,
Have constantly on hand a full assortment of
SYSX. EcºEXO O)3 U G. S ANYO IYYXXJXCXN Es,
cxxxeryxxcAX, APPARAºcus,
TESTS, MEDICAI, GLASS WARE, &c., &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordince with the U. S. P. and other recognized authori-
ties.
*
ETINIHE ANTO EAR HE CHEMICALS.
Of the popular class of preparations known as
IE T, I DK I F, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
º - - * . * * * * * - take.
with his Truss, and the success he has met with in producing a Radical ||
; , . Cure of Hernia. He has instruments superior to any I have ever seen, |
Bitter wine of Iron,
*
An excellent Chalybeate and tonic, Wine of Ison, &c.
AGENTS FOR BULLOCK & CRENSHAW'S
$.
Sugar-coated Pills and Granules.
OPPOSITE THE HIGH STEEPLE,
* Agents for Clement's Patent Artificial Legs. . ]
f
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
zation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.
•




CINCINNATI.
—º-
E" A C U E. T. Y -
J A M E S G R A H A M, M. D., DE AN,
I’rofessor of the Theory and Practice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery.
W. H. GOBRECHT, M.D., e -
Professor of Anatomy. T. A. REAMY, M.D.,
P. S. CONNER, M. D., Professor of Obstetrics and Diseases of Children.
Professor of Surgical Anatomy.
JAMES T. WHITTAKER, M. 5,
Professor of Physiology.
JOHN L. CLEVELAND, M.D.,
Demonstrator of Anatomy.
SAMUEL NICKLYCS, M. D., - CHARLES KEARNS, M.D.,
Professor of Physics and Medical Chemistry Assistant to the Chair of Surgery.
W. VV. S.H.E.I.Y., M. TX.,
I’ro ſers-on' of IDix earses of the Hye and HJar, and Secretary of the Faculty
e--
T. LOU (H Picows, M. I.). Proner for of Anatomy. J. NoPLE, Janitor, College Building, Sirth St., bet. Vine and Race.
&

PUBLISHED EVERY SATURDAY. - -
TERMs—82.00 a Year, Invariably in Advance. All Communications relating to Publications must be addressed to the Editor:
- All Communications relating to Business, Subscriptions, Advertisements, etc., to the Treasurer.
*-------
-*
vol. 2. C IN C IN N A TI, J U N E 8, 1872. - No. 23.
:::::::::::… *}M T. M. T. MTAſſº,
ww.sirty, w. ". . . . . . . tºum. ºn - 2 - -
tº-e== * 00án & Co
Printed * * tº the cut Pºlis * in 11 º
→ºn-faitā Hālā; allºis ºf Him
- ** one-dawn º ~ ...s 7.00 - 92 FOURTH STREET,
6 & 4 “ .: .... 10,00 . opposite Post Office,
12 6 & & © . 7 = - 18.0ſ) - CINTCINTINTA TT, C-,
c o N T E N T S. lar The ºldest Established Hat House on the Street. *Sa
– “Fine Silk Hats, Standard Quality $600.
origiNAL ARTICLEs
DIABETES Msirirus, by S. D. Nickles, M. D. ~~~~ ......265 r −-º-º-º- º-º-º-º-º-º-º-º:
DIGITALIS IN DELIRIUM TREMENs, by J. H. Parker, M. D...............267 @ ogº.Tºrikºſan
TRANs|ArroN - , , , |0) ºf § Nº.
Galvano-Caustic Tracheotomy by Dr. M. Werneuil, (From the Gaz. - wº 2ESIGNERSA) º sº
Med. de Paris, April 27, ”T2)..... 208 - |ENGR AVE R So NWOO Dà
* , - —*— " , , º º- - º'ſ
§§2 MEST FOURTH: Sº
The Influence of the Mind on the Body by Daniel H. Tuke, M. D.
(From the Journ. Mental Science, London, Apr., '72.)...........,266 -
ACADEMY or MEDICINE — * * * * * *m.
Transactions June 3, '72. . . - J T AFT W. TAFT
- e *... * * -- © e .
Cerebro-Spinal Meningitis, by Dr. C. O. Wright—Discussion by Editor Dental Register
Drs. Bartholow, M.B. Wright, Muscroft and Reamy—Aortic
Valvular Disease, Specimen by Dr. Buckner—Discussion by
Drs. Graham and Carson—Intra-Uterine Medication by Dr. - J - & W TAFT
271 - [...] y
Palmer
NTE DHCA. L NEWS
Indiana State Medical Society, 22nd Annual Session—Paris Troub-
les and the Doctors—A New Profession for Ladies—The Stras- - ID E. : S -
bourg Festivities—German Therapy * * 273-276 - IN N I I
CLINICAL MEMORAN DA
Xylol in Small-Pox—Test for Purity of cº-ºwn. & Cº - ºr gº ºn 4 - - - - - 276 * t -
HOME NEWS..., * - ~ . 276 117. WEST FOU RTH STRE ET,
To Dr. G. O. Woolen, of Indianapolis, Ind., we are - + .
indebted for papers containing the very handsome CHIN CININ A TI e O.
abstract of the Indiana State Society proceedings.
Galvano-Caustic Tracheotomy is at least a novelty
if nothing more. - - -
The various instances showing the direct influence of
the mind on the body are official confirmations of many
popular notions. . . . . - -
º note on German . will be likely to
straighten some erroneous professional ideas just now - -
ºr Just A Monthly Journal,
. Our Clinical Memoranda to-day contain two most
instructive notes, one detailing the exact value of xylol, - CONTAINING 48 PAGES
the new remedy for small-pox, the other explaining the y
* why certain cases of adenoma are necessarily
3.08.i. - -
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Physicians in the city and heighborhood. Nº






DIVIDED MEDICINES,
The Divided Medicine Comy,
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEw AND ExCEEDINGLY PRACTICAI,
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE.
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate `
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every square will consequently contain accurately measured quantities. -
But not only SoLUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. x - * .
* This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
# 3. b. sh, Iº, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines. - - .
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE TO SPOIL BY ANY LENGTH OF TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, because they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days.
For Samples, Price Lists, and Agencies, address
2.
- Isox 2ess,
Or FRFDERICK KRAUS, Chemist and Druggist,
Walnut Hills, Cincinnati, O.
Aºy T- w
MB, FREDERick KnAus: - CINCINNATI, February 15, 1871.
Dear Sir—The specimens of your “Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz: . -
sulph:MORPHII....................... % grain in each square. ARSEN:ACID..........................T-20 grain in each square.
“ CHININI ....................... 1 { % § { . $6. CALOMEL -$ 34 “ “ 66
“. COPPER........................ % 6&
RESPECTFULLY Yourts,
& - E. S. WAYNE, Analytic Chemist.

T. EEL H C T , T N. T. C.
Vol. 2.] S A T U R D A Y, J U N E 8, 1872. [No. 23.
O RIG IN A L A RTI C L E S.
-º-º-º-º-º-
DLARETEs MELLITUs.
The Treatment of a Case with Mills.
BY
S. NICKLEs, M. D.
Until within about a year Mr. E. was always in pos-
session of excellent health, never having been confined
to his bed by sickness, except once, some six years ago,
by a tolerably severe attack of rheumatism. And though
now somewhat worn and debilitated, he is still a hearty
looking old gentleman of sixty years.
For more than a year Mr. E. has occasionally, a few
days or a week at a time, experienced much thirst. At
the same time he noticed that he was passing a greater
quantity of urine than usual. But not being in any
way incommoded thereby, and not experiencing any
disturbance of his general health, he paid no attention
to these symptoms. Until the 1st of January last, he
had not observed any diminution of his weight, which
had averaged 175 ſps.
But after the 1st of January, Mr. E. noticed a remark-
able change in his general health. The thirst, which
had been increased only at intervals, now became very
Severe and continuous. A very considerable augmenta-
tion took place in the amount of urine passed. Soon he
began to feel debilitated. This was to him somewhat
mysterious, since his appetite was not only excellent
but generally voracious. Gradually other symptoms
were developed, such as disturbed sleep, great pain in
the urethra, distress in the chest and shoulders, and a |
peculiar dragging and sinking sensation extending from
the chest through the abdomen and down to the testicles.
Of these the dragging pains extending downward from
the chest, and the burning in the urethra were the most
annoying. - 4. -
When he consulted me on the 9th of April, he was
pale, worn, and much dejected. His tongue was covered
With a white pasty coating. The pulse was somewhat
accelerated, but soft and regular. His skin was still
Soft and moist, his bowels regular, and appetite excellent.
He complained of being constantly tormented with
thirst, and notwithstanding the indulgence of a voracious
appetite, of constantly becoming weaker. He urinated
frequently, each time passing an abundance of pale
urine. No importance had been attached to the exces.
sive excretion of urine, as it was considered a natural
| 24 hours was found to be 83 pints.
| On testing it with Moore's and Trommer's tests distinct
265
result of the excessive drinking. He had called because
he was failing in strength. -
Supposing I had a case of diabetes mellitus before me, I
requested my patient to collect all the urine voided in
| the next 24 hours, and bring a specimen taken from the
The entire quantity passed in the next
Its sp. gr. was 1025.
whole amount.
evidence of sugar was obtained.
Having thus found my patient to be a light case of
diabetes, I determined to try the “skim-milk treatment”
proposed by Donkin of Durham in 1869.
On making a quantitative analysis of the specimen of
urine first brought, it was found to contain 4 per cent.
of sugar, 2.541 grains in the entire quantity. The
patient began the milk treatment at 12 M. April 20. No
solid food of any kind was to be taken. No restrictions
were placed upon his drink, and one or two cups of un-
sweetened coffee daily were allowed. His weight on
the date of beginning the milk treatment was 154 fps.
so that he had lost 21 ſps, since the first of Jan.
On the 22nd, two days later, I again examined his
urine. He had accurately measured the quantity
passed in 24 hours and found it to be only 4 pints. The
specimen I examined contained only 2 per cent. of sugar,
so that about 60 grains of Sugar were eliminated in the
4 pints of urine. Its sp. gr. was 1020. As the patient,
however, forgot to take a specimen from the whole
amount collected, but voided the specimen I examined
just before sending it, the entire quantity of sugar passed
may have been greater. -
The patient having gone to the country on business,
I did not have an opportunity to examine his urine
again until the fifth day of the exclusive milk diet.
April 25. The urine of the last 24 hours amounts to
4 pints, having asp. gr. of 1020, and contains.02 per cent.
of sugar, 59.49 grains. Mr. E. feels very weak. Has
no thirst. Drinks from 2 to 3 quarts of milk daily with
much relish. Burning in the urethra and pains of the
chest considerably diminished. Tongue covered with
creamy coating.
April 26. Quantity of urine 4 pints. Sp. gr. 1016.
Amount of sugar .05 per cent., 14.815 grs. Patient's
weight to-day 153 fos., hence has lost one pound in the
last seven days while under-milk diet.
April 27. Mr. E. passed 3 pints of urine in the last 24
hours. Sp. gr. 1022. Contained .01 per cent. of sugar.
Whole amount of sugar 22.85.
April 29. In the last 24 hours the quantity of urine
passed by E. was 4 pints. Sp. gr. 1014. Contained .04
per cent. of sugar, 11.82 grains. Besides his milk, which
was not always skimmed, because he could not obtain
it, Mr. E. took three cups of coffee.
May 3. Quantity of urine of last 24 hours 33 pints.
Sp. gr. 1012. Contained no trace of sugar. Patient
feels much better. Very little pain in the chest. Rests
well. No thirst. Appetite good. - -
May 4. Quantity of urine 4 pints and 4 ounces. Sp.
266
[JUNE 8, 1872.
T EL EL C.T.I. N. T. C.
gr. 1010. No sugar detectable. Thus far Mr. E. Scru-
pulously abstained from all kinds of solid food. Although
the sugar had entirely disappeared from his urine, he
had lost in weight. This may be attributed to the small
quantity of food taken, usually only from 4 to 6 pints of
milk in 24 hours, and the strong draught made upon |
him by the exercise to which he was compelled to sub-
mit.
The sugar having entirely vanished, I determined to
allow him to take about two ounces of fresh meat and
a small quantity of lettuce, beginning the change at 12 M.
May 5th. His weight on the 4th was only 152 fos., so
that he had lost two pounds in the two weeks he had
been under the milk diet. I hoped to prevent further
loss by adding a small amount of meat and lettuce.
May 6. Amount of urine 4 pints. Sp. gr. 1014. Con-
tained a trace of sugar.
May 9. Mr. E. took a severe cold while in the country
two days ago. Is hoarse and coughs considerably. Feels
quite weak. Complains of urethral irritation, occurring
several times a day, and lasting each time about an
hour.
May 10. Passed 3} pints of urine, of sp. gr. 1016.
Contained a trace of sugar, but too little to estimate.
Catarrh much better. Now weighs only 1513 fps.
May 11. Catarrh nearly gone. Amount of urine 4
pints. Sp. gr. 1016. Contained a small quantity of
sugar. Besides milk, and increased quantity of meat
and lettuce, Mr. E. took two eggs and drank a small
glass of wine.
May 12. Urine 4 pints. Sp. gr. 1012. A trace of
sugar. Urethral irritation has diminished. To take
larger quantities of meat and lettuce.
May 13. Passed 4 pints of urine. Sp. gr. 1014.
Detected a trace of sugar. For the next three days,
while in the country, the patient's diet to consist of
milk, meat, fish, eggs, lettuce and spinage. -
May 17. Quantity of urine as usual 4 pints. Sp. gr.
1014. It contained a trace of sugar but too little to
estimate. Still weighs 1.51% lbs.
May 18. Sp. gr. and amount of urine remain the same.
Mr. E. says he feels much stronger. To continue the
same diet.
May 23. Quantity of urine 43 pints. Sp. gr. 1010.
Discovered no trace of sugar. Still complains of pain
in the urethra, coming on several times a day, continu-
ing about half an hour. No thirst. Rarely drinks
water. Appetite good. Feels stronger. Diet the same
in quality, but the quantity of solid food increased.
Also to take a small quantity of strawberries for supper.
May 24, Urine still 4 ppmts. Sp. gr. 1014. Contains
only a trace of sugar. Patient weighs to-day 158 lbs.,
hence has gained a pound and a half in the last week.
To indulge in a small quantity of peas to-day.
May 25. Amount of urine still 4 pints. Sp. gr. 1014.
Some sugar in the urine, but not enough for quantitive
analysis. Besides the ordinary animal diet, patient will
take about two ounces of white bread, and if the sugar
does not increase in his urine by to-morrow, will con-
tinue this diet for four days, until he returns from the
country.
May 26. Urine a little less than 4 pints. Sp. gr, 1014.
Contains only a trace of sugar. - -
This case, so far as it has been observed, has been
markedly and rapidly benefited by the exclusive milk
treatment. And there can hardly be a doubt that cases
equally mild in character and which have produced no
greater ravages upon the constitution, will be equally
amenable to the treatment. But it must be recollected
that most cases of pronounced diabetes are of a graver.
character, and in the same length of time make a deeper
impression upon the general health. Cases of a year's
standing generally present a much more decidedly
saccharine urine, the sp. gr. of which is rarely below
1080. Many of the cases are marked by great debility
and emaciation, rapid and feeble pulse, a dry, harsh
skin, red, glazed tongue, voracious appetite, excessive
thirst, constipated bowels, sleepless nights, and various
aches and pains. Mr E., though somewhat weakened
and suffering, was able to attend to his business, which
required him to ride in a spring wagon some 25 or 30
miles a day four days of every week. Of the other
symptoms he presented none except those which are
essential to the disease, polydipsia, polyuria, etc.
Again it is well known that the prognosis is most
favorable in elderly persons, who have previously en-
joyed good health. Mr. E., even when reduced consid-
erably by the disease, was above the average weight of
individuals of his height, five feet and five inches. He
had previously enjoyed the very best of health, which
had been sustained by temperate habits and constant
employment in the open country air, having been at his
present business for 30 years.
Mr. E., doubtless ought to be classed with those cases
which are due to excessive formation of sugar. In such
cases the essential pathological condition consists in an
augmentation of the glucogenic function of the liver, so
that most of food taken is rapidly transformed into sugar,
and acting as foreign matter in the blood, is quickly
eilminated by the kidneys. It is well known that such
cases are most amenable to treatment, being rapidly
benefited by a diet restricted to such articles of food as
contain neither sugar or starch. If the skim milk treat-
ment possesses any advantage over such a limited diet,
it must be principally in cases of this description.
Whether it will prove useful in those cases which are
due to defective assimilation of Sugar, which hence ac-
cumulates in the blood and acts as foreign matter,
although not formed in excess by the liver, is very
doubtful. -
In comparing the condition of Mr. E.'s urine before
and after the adoption of the exclusive milk diet, one
cannot but be impressed with the rapidity of the favor-
able change. In the course of 48 hours the amount
fell from 8% to 4 pints, which cannot be considered an
excessive quantity under an exclusive milk diet. On
JUNE 8, 1872.]
the day before treatment E., passed 2541 grains of sugar,
on the day after assumption of treatment only 59.49
grains. Simultaneously with this great diminution in
the quantity of sugar voided; the other symptoms abated.
The incessant thirst was immediately quenched. Sound
sleep returned. Mr. E., though weak and feeble, felt.
better than he had for the previous three months.
The “skim-milk treatment” would therefore seem to
have greatly benefited the patient; and although it was
persevered in only for two weeks, made a very decided
impression upon the disease. Not more than a trace of
sugar reappeared in the urine, although the diet of the
patient during the last three weeks was gradually more
and more extended, and for a few days included articles
containing sugar and starch, as strawberries, peas and
bread. - -
The medicinal treatment consisted throughout in the
use of bicarb. of soda and bicarb of potash, administered
thrice a day in peppermint-water sweetened with glycer-
ine. The doses never exceeded 10 grains, and probably
had no effect upon the disease. -
—-º-o-º-
| DIGITALLIS IN DE LIRIUM I TREM IENS.
By
J. H. PARKER, M. D.
Piqua, Ohio.
Gentlemen of the Piqua. Medical Society; I have
chosen for my subject, “The Use of Digitalis in the
Treatment of Delirium Tremens.” While the employ-
ment of this remedy is by no means new or novel and
while, also, I claim no originality, I have thought that
the report of a few cases in which it has been success-
fully used, might excite your attention and elicit your
interest. My observation, although limited, extends
over a period of seven years, in which time I have per-
sonally treated ten cases; two in conjunction with Dr.
Borsey and six others were reported to me by Drs. Dorsey
and Parker (my father), making a total of eighteen
cases in which this remedy has been employed success-
fully with but a single exception. I may here remark
that in these cases five individuals had two attacks, two
had three and two but a single attack, for unlike variola,
rubeola and kindred disorders, single or multiple attacks,
by no means exhaust the susceptibility of the system,
but rather predispose to the recurrence of the malady,
as it is especially a disease, in which the cause is likely
to continue in operation. -
We are taught by the books and by observation that
digitalis in its effects upon the human economy, is nar-
cotic, Sedative and diuretic, i.e., in moderate and legiti-
mate doses, for in larger and poisonous doses it is capable
of producing frightful symptoms among which may be
mentioned in order of occurrence, great prostration with
the concomitants of nausea, vomiting, copious cold sweat,
convulsions, syncope and even death. In its moderate
TIH. H. cI, IISTI c.
267
*—
use it seems to possess a remarkably sedative power over
the heart and through the heart over the entire circula-
tory system, as evinced in the reduction in the force
and frequency of the pulse. Another peculiarity is its
being cumulative, and hence the necessity of great cau-
tion in its administration even in minute doses for its
explosive effect is no less fraught with danger than the
immediate effect of a poisonous dose.
Delirium tremens is a disease sui generis, the causes of
which are manifest and familiar to all. With the symp-
toms you are alike conversant. The flushed face, in-
jected, ferrety eyes, contracted and irresponsive pupils,
heavily coated and tremulous tongue, the busy delirium,
picking or looking at imaginary objects in the air or
upon the ceiling or walls with the restlessness, loss of
appetite and sleep, irritability of the stomach and the
history of the habits of the patient are sufficient guides
to diagnosis.
A brief synopsis of cases treated after the manner of
each of the chief of these plans will suffice to show their
relative merit. The percentage of death by the conjoint
use of opiates and stimulants was 25 per cent. By the
stimulant plan only 3 per cent. By sedative doses of
tartrate of antimony, in which 80 cases are reported,
there was uniform success. By large doses of digitalis
there was but one death in 67 cases. In 28 cases treated
upon the expectant plan there was but one death, and
that was attributed to the use of opium and stimulants.
A quite common remedy also is capsicum, but with it
I have had no experience and have seen no extensive
statistics. Thus we see that there are three plans which
should claim our earnest attention, the ratio of mortality
being exceeding small, viz., by tart. antim.; 2nd, digitalis;
3rd, but least successful, the expectant plan in which
symptoms alone are treated and exigencies met as they
arise. It cannot be denied but that the reports of the
different courses of treatment being made by their re-
spective favorites or admirers detract in no small degree
from their value but the great superiority of treatment by
digitalis or either of the three plans mentioned over the
old timed and nearly exploded treatment by opium
and stimulants must be patent to every observer.
I am aware that I shall perhaps draw the censure of
some present but my own observation and the experience
of others teach me the incalculable superiority of the
plan of at once cutting off the supply of stimulants
whatever plan (except depletion) be adopted. In the
depletory plan I can conceive of the necessity of stimu-
lants if only to build up what has been torn down.
With these generalisations, the special method of pro-
ceedure in a given case naturally comes in order. My
practice has been uniformly to at once administer tinct.
digitalis in 3ss doses; smaller doses being of little or no
avail besides the loss of valuable time. Apply cold to
the head and sinapisms to the abdomen, where there is
gastric irritation, which is almost invariably present.
As a rule, a like amount is required at the end of four
hours, very rarely a second repetition, but in one
268
[JUNE 8, 1872. .
T E-T THE C T , T N T C.
instance I administered the 4th 3ss, making the
enormous quantity of a drug, whose maximum dose is
10–20 min. three times a day, of 3ij, within 12 hours,
and with total and entire relief. The uniform effect in
the twelve cases I have seen was an almost immediate
amelioration in the condition of the patient, the de-
lirium abating, the fears and tremors vanishing, and
within from four to six hours a comparatively tranquil
sleep with which we all know the disease ends. The effects
of digitalis in the other six cases were equally gratifying.
Usually I have seen what I would call a critical sweat
in these cases before the sleep has been procured, the
patient being literally bathed in it. The pulse becomes
soft, full, and regular; the tongue cleans off, the pupils
become contractile and responsive. The appetite re-
turns, and health and strength are restored, but unhap-
pily, the cause is apt to be continued and the attack to
recur until a fatal issue, as With each attack the recu-
perative power of the system flags and finally fails. So
true is this that it has passed into a proverb that the
third attack is almost surely fatal.
The usual effects of digitalis are not observed in the
manner of its use as indicated. There is no increased
diuresis. The pulse becomes full, soft and regular.
The copious diaphoresis which follows its use here and
its eliminative powers are not its usual characteristics.
Its superior efficacy over opium is proved by the fact of
its having been used successfully in the same cases
where opium had failed, and perhaps by the little more
doubtful fact that patients who have recovered from de-
lirium tremens under digitalis subsequently died under
opium. It is but right that the statistician should also
report his fatal cases in order to give any course of treat-
ment its just position. In the only fatal case I have
witnessed, digitalis had a thorough trial and proved
utterly futile. It was abandoned and another course
adopted [opium] but as already stated with a fatal result.
I had intended to report in detail two or three cases but
having indicated the usual course pursued and stated
its results in my hands I refrain from encroaching
further upon your time.
—sº-º-º-
G A L V A N 0–C A U S T I C T R A C H E O TO MY
BY
DR. M. VERNEUIL, (Paris).
Transactions Paris Academy of Medicine, Session April 23, [IFrom the
Gazette Med. de Paris, April 27, 1872,]
Of all the accidents most dreaded in the operation of
tracheotomy in the adult, hemorrhage is by universal
admission the chief. The operation is never undertaken
until asphyxia has commenced; at this time all the
veins of the body are in the condition of turgescence,
| are blocked as soon as met.
more especially those of the neck and head. It is with
venous more than arterial hemorrhage that the surgeon
has to deal. So soon as the section of the glºin and sub-
cutaneous tissue has been accomplished, the flow of
blood commences and there still remains to be divided
the isthmus of the thyroid body with its attendant
venous plexus.
This period of the operation is truly exciting. The
surgeon has before him an individual half dead with
asphyxia, struggling in his efforts at respiration, and a
wound of section full of black blood which pours in
abundantly as soon as the sponge is raised. Yet he
must be quick, for the danger of asphyxia increases every
moment, and it is thus through the midst of a pool of
blood that the operator must plunge his bistoury in divis-
ion of the deeper parts, the tissues which still pour out
additional blood. -
The trachea is open, there is the gurgle of air and
blood which is spurted to the right and left with the
effort of expiration and inspiration follows only to suck
into the trachea a greater or less quantity of blood.
This is a critical moment for the patient who may now
immediately succumb to the syncope which supervenes
in the midst of his asphyxia ; a moment critical, more-
over, in its more distant results, for if the blood entered
into the bronchia be not entirely ejected, it induces
pulmonary congestions which may become disseminated
and thus precipitate a fatal termination.
Thus, it is seen, that hemorrhage in the adult is the
accident the most to be dreaded. At all periods of
surgery the attempt has been made to perfect this oper-
ation, and it requires only a reference to the classical
treatises on operative medicine to become edified in
this regard. - . . .
The new means which the author proposes is absolutely
free from hemorrhage. Not one single drop of blood
escapes and we may say, paradoxical as it may sound,
that the operation is perfectly dry.
No bistoury, no tenaculum for this procedure. Gal-
vano-cautery takes their place. The terminal platinum
wire; heated to dull redness and kept at this tempera-
ture; divides successively, the various tissues, cutaneous,
subcutaneous, aponeurotic, venous, tracheal. Every-
thing is done gently, without precipitation; the veins
The trachea finally open,
it is only necessary to insert the canula by means of the
simple dilating forceps. *
This proceedure wonderfully simplifies the whole
operation of tracheotomy and assures at the same time
an entirely new degree of success. *
Follows now a case in which these happy results were
obtained:
M. M., aet. 30, a sufferer with laryngitis of several
years duration. Auscultated with the greatest care by
M. Axenfeld, he was considered phthisical.
This laryngitis increased in intensity. The patient
became aphonic, he was subject to attacks of dyspnoea,
threatening suffocation. Laryngoscopic examination
JUNE 8, 1872.]
T H H C T.ITNTIC. —
269
*- * -º
revealed no new element by way of diagnosis. These
attacks of threatened suffocation and oppression assumed
the character as to justify a recourse to tracheotomy.
It was practiced in the manner indicated above. At
the moment of division of the skin the patient experi-
enced a slight pain. But this was all. The cellular
tissue was divided, then the aponeurosis, then the
thyroid body, then finally the trachea with its rings.
A single ring was cut with a bistoury on account of
some resistance. Air entered so soon as the trachea
was divided; the canula was introduced without the
least difficulty and the patient respired at ease.
During the whole course of the operation which lasted
about five minutes, not one drop of blood escaped; it
was not until after the operation when the patient was
raised to the sitting posture that slight sanguineous
exudation, whose whole quantity was not greater than
four or five grammes, took place. .
Since this occasion there has been no accident what-
ever and M. M. finds himself now in full course of re-
covery from his tracheotomy.
—sº-º-º-
The Influence of the Mind upon the Body.
DANIEL H. TUKE, M. D., M. R. C. P.
An Abstract from the Journal of Mental Science (London) April, '72.
Care, it is said, will kill a cat; and its effect, as re-
gards man, is too patent to need illustration. As pointed
out by Fletcher, the convict may grow fat even on
prison fare, simply because his doom is sealed and he
has no anxiety. When considering the influence of the
emotions upon the blood-vessels, we showed that all the
signs of those changes in nutrition which are comprised
under the term “inflammation,” may be so caused. We
proceed now to give illustrations of definite lesions of
nutrition as observed in the changes which frequently
take place in the skin and hair.
As, without actual disease, we see the influence of
moral causes upon the functions of the skin, fear check-
ing perspiration, and other emotions causing congestion,
it is not surprising that definite eruptions should occa-
sionally have a similar origin. The transition to eczema,
impetigo, etc., is not difficult to understand. .
Mr. Hutchinson informs me, in connection with his
experience at the London Skin Hospital, that patients
frequently attribute the affections of the skin under
which they labor to fright and other moral causes; but
I have not been able to obtain any statistics. The re-
lation between some cutaneous diseases and the dis-
tribution of nerves, bears upon this subject. The
instance of shingles has been already referred to in con-
meetion with the nerves engaged in nutrition. When
severe neuralgia is followed by herpes in the course of
the affected nerve, we can see how possible it is for
distress of mind to occasion this cutaneous disorder.
Cazenave, when enumerating the causes of skin dis-
eases, remarks that “strong mental emotions, and grief
in particular, exercise a remarkable influence.” Speak-
ing of impetigo, he says that grief and fear sometimes
produce the disease. Bateman mentions two cases in
which great alarm and agitation of mind caused this
affection. . -
In his lectures, M. Biett used to relate to his pupils
several cases which showed this influence. In particular
he referred to a striking example exhibited in a very
severe form of lichen agrius, occurring within twelve
hours after the receipt of unwelcome intelligence. In
the “Medical Times and Gazette,” July 13, 1867, the
case is reported of an engineer who, treated for syphilis,
from which he remained free for six years, became, a
week after hearing of the fall of a bridge he had built,
the subject of “syphiliticimpetigo of the scalp and beard.”
Gratiolet observes that melancholy dries up the skin
and induces a number of herpetic affections.
Of the influence exerted over warty excrescences on
the skin by hope and confidence directed to the part,
many illustrations might be given, but the space at our
command will not permit us to pursue this subject.
Of the fact there can be no reasonable doubt.
Hair.—The influence of grief or fright in blanching the
hair has been generally recognised.
“For deadly fear can Time outgo
And blanch at once the hair.”—Marmion
1t has been a popular rather than a physiological
belief that this can occur “in a single night.” No one
doubts that the hair may turn grey, gradually, from
moral causes, and this is sufficient proof of the mind's
influence upon the nutrition of the hair. I have known
alternations in the color of the hair (brown and grey)
corresponding to alternations of sanity and insanity.
Some entertain doubts as to sudden blanching of the
hair, but I do not believe them well founded, and can
vouch for the truth of the following interesting case:—
Thomas W., about 20 years of age, the son of a milk-
man, was tall, fleshy, good looking, slightly bronzed,
hair intensely black, stiff, wiry, and rather inclined to
curl. His general appearance was that of a healthy
and well formed man, used to light work, but much
exposure in the open air. In the year 18— one of his
thoughtless companions told him (what was not true)
that a girl in the town was going before the magistrate
on the morrow to swear him father of her child. Poor
W. was dumb-founded. The announcement had given
his whole frame a severe shock; the gall of bitterness
had entered his heart, and the mind was under the bane-
ful influence of its power. He hastened home, and
sought relief in his bed room. Sleep was denied him,
for his brain was on fire. He saw nothing but disgrace
coming from every angle of the room. Such was the
mental agitation produced by a silly trick | Early
morning brought no relief; he looked careworn and
distressed, and his hair was changed from its natural
tint to that of a light “iron grey color.” This to him
was a great mystery. In the course of the following
day the stupid trick was explained, but the ill effects of
it lasted for a long period. Nearly twenty years after,
270
[JUNE 8, 1872.
TEEE CI.TISTI c.
although his health was fair, the mental powers retained
signs of the severe shock they had received; his hair
was perfectly grey, and a medical friend of mine who
met him received the impression that he would carry
the marks of this folly to his grave.
Dr. Laycock, in speaking of pigmentation of the hair,
asks whether greyness and baldness are due to loss of
tone of the hair bulbs solely, or are ultimately associated
with trophic nervous debility of certain unknown nerve
centres. He points out that the regional sympathy
which characterises trophesies is well marked, and that
as regards baldness it extends from two points, the fore- |
head and the vertex, ending at a line which, “carried
round the head, would touch the occipital ridge pos-
teriorly, and the eyebrows anteriorly.” So with the
beard, &c. In connection with a succeeding remark,
that the eyebrows are a clinical region in brown ague,
herpes, and leprosy, the case already referred to, of a
woman who suffered in the night from a severe attack
of tic, and found in the morning that the inner half of
one eyebrow and the corresponding portion of the eye-
lashes were perfectly white, may be mentioned. Lay-
cock points out the fact that the hair over the lower jaw,
is almost always grey earlier than that over the upper
jaw, and that tufts on the chin generally turn white
first.—(Op. cit., May 13.)
Mr. Paget, in his “Lectures on Nutrition,” has recorded
the case of a lady with dark brown hair, subject to ner-
vous headache, who always finds, the morning afterwards
Fº of her hair white, as if powdered with starch.
n a few days it regains its color. Dr. Wilks says he
has on more than one occasion had a lady visit him with
jet black hair, and on the morrow, when seen in bed, it
had changed to grey. Bichat, opposing the scepticism
of Haller, asserted that he had known at least five or six
examples in which the hair lost its color in less than a
week; and that one of his acquaintance became almost
entirely blanched in a single night, on receiving some
distressing news. There is no reason to call in question
the statement that Marie Antoinett's hair rapidly turned
grey in her agony We have it on the authority of
Montesquieu himself that his own hair became grey
during the night, in consequence of receiving news of
his son which greatly distressed him. Dr. Landois, of
Greifvalde, reported not long ago a case in “Virchow's
Archives,” in which the hair rapidly turned white.
But I have not any particulars at hand beyond the fact
that on carefully examining the hair, he found that
there was “an accnmulation of air-globules in the fibrous
substances of the hair.” Erasmus Wilson read a paper
at the Royal Society in 1868 on a case of much interest,
a resumé of which I subjoin in a note.*
rested on it.
The falling off of the hair is too frequent a result of
anxiety, or other depressing emotion, to escape common
observation. A case reported in the “Lancet,” of May
4, 1867, forms an excellent illustration.
A man of nervous temperament began business as a
draper in 1859. At that time he was 27 years of age,
in good health, though not very robust, unmarried, and
.# the usual quantity of (dark) hair, whiskers and
beard. For two years he was in a state of perpetual
worry and anariety of mind, and his diet was very irregular.
Then his hair began to come off. He declares that it
literally fell off, so that when he raised his head from
his pillow in the morning, the hair left on the pillow
formed a kind of cast of that part of his head which
In a month’s time he had not a single visi-
ble hair on any part of his body—no eyebrows, no eye-
lashes; even the short hair of his arms and legs had
gone, but on the scalp there could be seen, in a good
light, patches of very fine short down. This was in
1861. Medical treatment was of no avail, and he was
finally advised to do nothing. So long as his anxiety
continued, the hair refused to grow, but by the latter
part of 1865, his business became established, and,
coincidently, his hair re-appeared, and when Mr.
Churton, of Erith, reported the case, he had a moder-
ately good quantity of hair on the head, very slight
whiskers, rather better eyebrows, and the eyelashes
pretty good.
The influence of painful emotions in causing grey or
white hair and alopecia has been sufficiently illustrated,
and it would have been interesting to adduce a reverse
series showing the opposite effects of joy. But it is a
very different thing to restore to its healthy habit the
function of a tissue whose pigment has been removed by
slow mal-nutrition, or by sudden shock. I may adduce
such a circumstance as the following; however, to show
that hair which has turned grey in the natural course
of life, may, by the stimulus of specially favorable events,
become dark and plentiful again.
An old man (aet. 75), a thorough out-and-out Radical
—even the cancelli of his bones were so impregnated
with a thorough disgust of the Government of George
the Fourth that he threw up a lucrative situation in one
of the Royal Yards, and compelled his youngest son to
follow his example—insisted that his wife, aged (about
70), toothless for years, and her hair as white as the
snow on Mont Blanc, should accompany them to the
land where God’s creatures were permitted to inhale the
pure old invigorating atmosphere of freedom. About
six or seven years after their departure, a friend living
in New York gave an excellent account of their pro-
ceedings. Not only could the old man pull away in
glorious style, and the son do well as a portrait painter,
but old Mrs. had cut a new set of teeth, and her poll
was covered with a full crop of dark-brown hair / -
Teeth.-Many observations might be made in reference
*Every hair of the head was colored alternately brown and white
from end to end. The white segments were about half the length of
the brown, the two together measuring about one-third of a line. Mr.
Wilson suggested the possibility of the brown portion representing the
day growth of the hair, and the white portion the night growth, and
this opinion was corroborated by the remarks of Dr. Sharpey and
others of the Fellows who took part in the discussion. Under the
microscope, the colors of the hair are reversed, the brown became light
and transparent, the white opaque and dark; and it was further obvious
that the opacity of the white portion was due to a vast accumulation
of air-globules, packed closely together in the fibrous structure of the
hair, as well as in the medulla. There was no absence of pigment,
but the accumulation of air-globules veiled the normal color and struc-
ture. Mr. Wilson observed thut as the alteration in structure, which
gave rise to the altered color, evidently arose in a very short period.
probably less than a day, the occurrence of a similar change throughout
the entire length of the shaft would explain those remarkable instances
of which so many are on record, of sudden blanching of the hair; and
ventured to suggest that during the prevalence of a violent nervous
shock the normal fluids of the hair might be drawn inwards towards
the body, in unison with the general contraction and collapsed state of
the surface, and that the vacuities left by this process of exhaustion
might be suddenly filled with atmospheric air.—(“Lancet,”
April 20th, 1867.) -
JUNE 8, 1872.]
THE CLITTI c.
271
to the nutrition of the teeth; but I must content myself
with adding to the favorable results stated in the last
case, a single example of the effect produced by unfavor-
able influences. “Ihave recently known,” says Marshall
Hall, “the teeth to decay in an extraordinary manner
in a few weeks, as the effect of painful emotion, more
allied to fear than any other.” (“Pract. Obs,” p. 40.)
Passing on to the influence of the emotions on secretion,
we commence with the sudoriferous glands.
Sweat.—The ordinary action of mental excitement in
accelerating the cutaneous circulation and secretion is |
familiar enough. This state of the system may be aroused
by painful, no less than by pleasurable emotion. For
example: when Warren Hastings was thrown into a
passion by his recall home, we are told that “the sweat
ran down his face” in an extraordinary manner. Of
interest in connection with an experiment of Bernard,
in 1851, which showed that division of the cervical
branch of the sympathetic in the horse caused increased
perspiration on the corresponding side, is the record by
Gratiolet of a case in which emotional excitement had
the effect of causing the perspiration of the head to be
afterwards limited to one side. The sweats of terror are
cold. The vaso-motor nerves are so influenced as to
cause the capillaries to contract, the temperature is
lowered, and insensible is converted into sensible trans-
piration. If the amount is actually increased, there is
probably an escape of fluid rather than augmented secre-
tion. Checking of secretion is seen in emotional anasarca.
Many medical authorities have referred to the fact of
anasarca following violent emotion of a painful character
(innervation lowered). Bateman witnessed the extra-
ordinary influence of alarm upon a poor woman; a Sud-
den universal anasarca following, in one night, the shock
occasioned by the loss of a small sum of money, which
was all she possessed (“On Cutaneous Diseases,” p. 150).
Copland classes such cases under “primary asthenic ana-
sarca; ” the vital tone of the small vessels being lowered,
the excretory function of the skin is suspended, and
serous effusion from the blood vessels follows. Why, in
some, this serous effusion remains in the cellular tissue, |
and in others is poured forth through the ducts, is diffi-
cult to say. Possibly spasm of the ducts may have
something to do with it. In the following instance, a
very large amount passed away through the ducts; and |
it becomes a question whether fear in this case did not
act simply in exciting the sudoriferous glands to exces-
sive action. The man's fear was of an anxious, fidgetty
kind, which was more likely to arouse than to check the
function of the glands. Such a case is full of interest
and instruction.
John Ford, an officer in the Royal Navy, in George
III.'s time was invalided home from the West Indies
for dropsy. Twelve months afterwards he was discharged
from the Naval Hospital as incurable, from which date
to the time when first seen by a friend of mine, he was
under the paternal medical care of a host of ichneumons,
who fed on the exchequer of his profits secundum artem.
As to the disease, it was a matter of no moment—the
longer he lived to swallow their trash, the better for
boxes, and gallipots.
was flooded with it.
them. “They looked on and grinned, grinned and looked
on again.” Dr.-says he found him propped up in bed
at an angle of 60° with an anxious and cadaverous coun-
tenance. The room was neatly and profusely embellished,
not with pictures, but with empty physic phials, pill
He had been well drugged; This
system was saturated with nearly nine-tenths of the
articles mentioned in the “Materia Medica.” My friend
advised him to throw physic to the dogs for the present
and to submit to the only remedy (in his case) to save
life, a surgical operation, and that as speedily as possible.
This roused him from his lethargy; it was like a power-
ful electric shock. Alarmed, he shook like a poor wretch
under the influence of the cold stage of ague. In a sub-
dued voice, he said (as his excitement partially subsided),
“I never can submit to an operation; I would rather
die!” “If that be your determination,” it was replied,
“your case may be considered hopeless; all the drugs in
the world will not save you. At all events I will visit
you to-morrow morning to know your decision.” Ac-
cordingly Dr. called on him, but the scene was
changed. Soon after his departure, he appeared to be
greatly distressed both in mind and body; groaned aloud,
wept much, and was very restless. The word “Opera-
tion” had worked wonders—in fact, a miracle. A copious
perspiration was produced, and the steam, like that from
boiling water, issued from every pore in his skin. The
nurse said that more than two gallons of fluid had passed
from him during the night. The bedding, consisting of
feather bed, mattress, blankets and sacking, were satu-
rated through and through with serum, and the floor
The patient recovered, and was
appointed to a ship in commission going to Jamaica.
Two years after, he died from the effects produced by
yellow fever, was buried in one of the “Campo sanctos,”
and was no doubt eaten by the land crabs in less than
a week.
[To be Continued.]
—sº-c-º--
A G A D E M Y o F M E D 1 c 1 N E.
gºssºmsºmºs ºsmºs
JAS. GRAHAM, M. D., Pitest., L. WOLF, M. D., SECT.
Transactions June 3, 1872.
Reported by Joseph Ransohoff.
Cerebro-Spinal Meningitis.
DR. C. O. WRIGHT reported the case of a boy ten
years old, whom he found in a semi-conscious condition,
and bathed in a cold, clammy perspiration. Pulse 104.
The antecedent history as given by the mother was very
incomplete. The child had been unwell for one week
previous to the first visit, and had been subject to tem-
porary and slight attacks of torticollis. The patient was
put upon a febrifuge mixture. Six hours after the first
visit, the pulse was reduced to 86, but the cold perspira-
tion still persisted. A marked rigidity of the muscles
of the jaw was also manifest. On the second day of at-
tendance, the pulse was 120; the pupils were dilated,
and there was increased rigidity of the muscles of the
lower jaw. Slight tendency to opisthotonos. The
272
[JUNE 8, 1872.
TIEEE IEL C. T.I.. INT I. C.
bowels having been unmoved for two days, pil. cathart.
comp., were ordered together with injections per rectum.
On the evening of this day the child expired. The
speaker then referred to the congestion of the encephalon
and spinal marrow as the principal pathological lesion
in these cases, and concluded by questioning as to the
modus operandi and efficacy of quinia and opium in
these and analogous cases. -
DR. BARTHOLOW, in answer to this question, remarked
that the value of quinine in these and allied cases, was
due to its peculiar properties as a therapeutic agent.
One of these properties is its power to prevent the
migration of the white blood corpuscle through their
vessel-walls, and another is to prevent their multiplica-
tion after their migration. It is also supposed to be
capable of preventing a multiplication or hyperplasia of
the cellular element of an inflamed tissue. These dis-
coveries we owe to the researches of Prof. Binz, of Bonn.
inorganic muscular fibres of the arterioles, produces an
anaemia of the brain and spinal cord by the diminution
of the blood supply to these parts. The proof of this
anaemia is the marked pallor and the tinnitus aurium
which follow the prolonged use of this agent. The
speaker then referred to the discovery of Burton Sander-
son, which elucidated the power of quinine to prevent
the generation of minute organisms as the bacteria.
He remarked further concerning the discharge from a
wound not virulent, that when injected into the perito-
neal cavity of animals, and allowed to remain there, it be-
comes exceedingly virulent, producing when injected
into other animals a rapidly fatal issue or giving rise to
pyaemia or acute tuberculism. The Dr. concluded with
the remark that he had simply given the general modus
operandi of quinia, and that he intimated nothing as to
the value of the agent in the disease under consideration.
DR. M. B. WRIGHT stated that the remarks of Dr. B.
were the component elements of a very finely-spun
theory, but that they were deficient in practical value
as to the treatment of this disease. He remarked
further that all the cases which had come under his
notice very speedily terminated fatally. Referring to a
recent epidemic of this malady in Peoria, Ills, the
speaker observed that quinia received a fair trial, but
its administration was followed only by negative re-
sults.
DR. MUSCROFT remarked that opium was very highly
lauded in cases of cerebro-spinal meningitis by Dr. Wood,
of Philadelphia, and Dr. Comegys. The latter had
given it with very good success in an epidemic which
prevailed at Oxford several years ago.
DR. REAMY inquired in what stage of the epidemics
opium was given, thinking that the good success ascribed
to the use of opium might have been due to a natural
decline in the malignancy of the epidemic. He then re-
called ten cases which had occurred in a previous
epidemic, and all of which terminated fatally, resisting
all treatment.
internum or even to the fundus uteri.
Aortic Valvular Disease. -
DR. BUCKNER presented a specimen removed from a
female aged 45 years. She was subject to rheumatic
complaints, and had had an attack of acute peritonitis
Some years ago. Some days since the speaker was called
to the patient who was suffering from a very severe
attack of colic. Ordered the inhalation of chloroform
and the administration of an opium and camphor mix-
ture. The severity of the attack was relieved only by
death which occurred suddenly on the day following the
first visit. The colic was owing probably to the irrita-
tion and inflammation produced by some indigestible
food which had been ingested. The autopsy revealed
great distension of the abdomen, and the intestines, with
the exception of 12 inches of the ileum, were greatly
distended by gas. Evidences of recent and chronic
Quinia by acting upon and causing a contraction of the peritonitis were presented in several adhesive bands
b
which were connected with the parietes of the abdom-
inal cavity. The uterus was bound to the rectum by
some of these bands, and a large cyst was found in con-
nection with that organ. The intestines were very
much congested. The most interesting features of the
case were present in the heart. The right side was filled
with clotted blood. The aortic valve was greatly thick-
ened and was hardened by calcareous deposits. Some
of these hardened masses were also found upon the
chordae tendineae of the left side.
DR. GRAHAM observed that it is rare to find a valvular
disease of the heart terminating in the sudden death of
the patient, notwithstanding that this was the belief of
the laity in these cases; there is a far greater tendency to
a gradual decline than to a sudden death.
DR. CARSON remarked that aortic valvular troubles
are. more likely to terminate suddenly than disease of
the mitral valves. He thought that in the case related
by Dr. B, the lesion of the aortic valve was sufficiently
serious to account for the sudden death of the patient.
Intra-Uterime Medication.
DR. PALMER presented to the Academy a compara-
tively new method of intra-uterine medication by means
of linen or cloth tents. The attention of the speaker
was Qalled to this method by the investigations of Dr.
Taliaferro of Columbus. The tents are made from strips
of linen 4-6 inches long, and 1-1% inches wide. Although
very flexible, they are very easily introduced to the os
Before their
introduction, they are Saturated with some medicated .
agents such as the tinct, iodine or carbolic acid. By
means of these tents a triple object could be obtained
namely; 1. dilatation, 2. pressure upon the hypertrophied
tissues, 3. a constant contact of the agent with the dis-
eased surface. -
Hereupon an animated discussion as to the value of
these tents followed, which closed the transactions of
the evening.
JUNE 8, 1872.]
273
MIEDFICALL NEWS.
INDIANA state MEDICAL sociETY.
*
Proceedings of the First Day–Morning Session.
The Indiana State Medical Society commenced its
twenty-second annual session in the lecture room of the
Indiana Medical College in this city at 10 o'clock yes-
terday morning.
Dr. H. P. Ayres, of Fort Wayne, elected President at
the last annual session, assumed the duties of the Chair
with the following address:
GENTLEMEN OF THE INDIANA STATE MEDICAL
SoCIETY-I appreciate the honor you have conferred
upon me: I ask your indulgence and assistance in the
discharge of my duties,
Permit me to congratulate you on this re-union of
1872, after the incidents and changes of another year.
I hope it will be one memorable for its pleasures,
socialities and-harmonies; that old friendships may be
renewed and perpetuated; that new ones may be formed
and cherished; but, after all, that new impulses may
urge us on as medical men to accomplish the great ob-
ject of our mission, viz: the health and happiness of
mankind. And when we return to our homes may we
be invigorated and strengthened for the duties and
labors of another year, continually looking forward with
pleasure to other, and still other reunions, while life con-
tinues. I thank you for the honor.
The Finance Committee submitted the following rec-
ommendation: - -
Your committee would suggest that in their opinion
the dues should be three dollars a member. tº
On motion of Dr. J. H. Woodburn, the recommenda-
tion was adopted. - -
The President announced the Committee on Creden-
tials. After which this Committee recommended a
number of visiting delegates (16) for membership. The
Committee on Membership at Large submitted a rec-
ommendation of some eight new applicants. Both re-
ports were accepted.
Dr. J. R. Wiest announced that the Committee on
Prize Essay had no report to make, no business having
come before it during the year.
Dr. S. C. Munford, of Princon, read a paper on Hyd-
roCele. -
On motion of Dr. L. D. Waterman, the thanks of the
Society were tendered Dr. Munford for his paper, and he is
requested to submit it to the Indiana Medical Journal
for publication. . > . . -
The Society then adjourned till half-past one o'clock
P. M.
Afternoon Session.
The Society was called to order by the President, Dr.
Ayres. .
TIH. H. C.I.I NTT c.
The following papers were read and referred to the
Committee on Publication : By Dr. R. E. Haughton, of
| Richmond—On the Pathology of Malignant and Semi-
Malignant growths. By Dr. L. J. Wollen, of Moorfield
—On an Epidemic of Parotitis (mumps) in Switzerland
county. By the President—His anuual address. By
Dr. T. C. Van Nuys, of Evansville—Researches in
Arsenical Poisoning. By Dr. J, Thompson, of Indian-
apolis—On Anomalies of Refraction and Accommo-
dation. By Dr. Wilson Hobbs, of Carthage—On Ex-
pert Testimony, the conduct of witnesses in court and
the law which governs it.
The last named paper elicited discussion by Drs. Wat-
erman, Boyd and Moffit, after which Dr. Haughton
moved that a committee of three be appointed to take
into consideration the means to be used for the purpose
of securing a definition by the laws of the State of what
constitutes a physician or a medical expert—the com-
mittee to report at this session. The motion prevailed.
The Chair appointed Dr. R. E. Haughton as chairman
of the committee, and upon nomination, Drs. L. D.
Waterman and Wilson Hobbs were appointed as the re-
maining members. -
The Society then adjourned till 8 o’clock P. M.
The Evening Session was occupied in the discussion
of a series of resolutions to adopt measures of uniting
all the various local Societies “to bring the entire profes-
sion of the State into one harmonious body for the pur-
pose of carry out the objects for which the Society was
organized.”
Second Day–Morning Session?.
The Society came to order at 8 o’clock, the President
in the chair. - - -
The President appointed the standing committees.
The Committee on Credentials and Membership made
additional reports. The Committee on Medical Statis-
tics was continued for the ensuing year.
Dr. Thaddeus M. Stevens, of Indianapolis, read a
paper on Legal Medicine. The paper advocated the
formation of a corps of medical experts with a view to
the relief of the profession in general from the embar-
rassment of examination in court. It also advised that
when physicians are called to testify on questions of
sanity they confine their answers to the simple state-
ment that the party is sane or insane, without attempt-
ing to define the particular grade of insanity in any
C2S6.
The paper was referred to the Committee on Publica-
tion. .
Dr. C. E. Wright, of Indianapolis, read a paper on
Diseases of the Eye and Ear. Referred to the Com-
mittee on Publication.
Dr. R. E. Haughton, of Richmond, from a special
committee, submitted the following report:
The Committee to whom was referred the subject of
petitioning the Legislature, beg leave respectfully to re-
port the following resolution;
274
[JUNE 8, 1872.
TIEEE. cI.TISTI c.
JResolved, That a committee of three be appointed to
petition the Legislature of Indiana for the passage of an
anatomical law, embodying such rights and protection,
as well such wise restraints as shall prevent abuse in the
study of anatomy, pathology and surgery as shall not
subject the profession to odium, but which will enable
its members successfully to qualify themselves for the
practice of their profession, and fill the position of med-
ical witnesses and experts in a satisfactory and honora-
ble manner, thus facilitating the administration of jus-
tice and promoting the interests of science. The report
was concurred in and the resolution adopted.
Dr. N. Field, of Jeffersonville, announced, with appro-
priate resolutions, the death of a prominent member of
the profession, Dr. Robt. Curran, of Jeffersonville.
Dr. T. Parvin presented a communication from the
Committee on Medical Education of the National Med-
ical Association.
Dr. T. M. Stevens, from the Standing Committee on
Nominations, submitted the following report, which was
concurred in : for President Joel Pennington of Milton.
For Vice President R. E. Haughton of Richmond. For
Secretary G. W. Woolen of Indianapolis. For Asst.
Secretary W. J. Elstun of Indianapolis. For Treasurer
J. T. Woodburn of Indianapolis. For Librarian A. W.
Davis of Indianapolis. Also the delegates to the
National Association and the various State Societies.
Dr. N. Field, of Jeffersonville, read a paper on Thor-
acentesis, which was discussed by Drs. R. N. Todd, of
Indianapolis, J. I. Rooker, of Castleton, H. W. Passage
of Peru, and R. E. Houghton, of Richmond.
Dr. R. E. Houghton read a paper on Lithotomy,
which was discussed by Drs. Comingor, Boyd, Water-
man and Houghton.
The Society then adjourned till 1% P. M.
Afternoon Session.
The Society was called to order by the President.
Dr. Isaac Casselberry, of Evansville, read a paper on
Electricity as a Cause of Disease, which was referred to
the Committee on Publication.
Dr. G. Sutton, of Aurora, offered, for adoption, the
following resolution, which was adopted.
Resolved, That we recommend to the Board of Trustees
of the Indiana University that they introduce as soon as
practicable, either into the scientific or medical depart-
ment, a course of studies embracing comparative anat-
omy, comparative physiology, and comparative path-
ology—branches of science arising from the progress of
knowledge, becoming daily of great practical importance
in understanding the paleontology of our country, the
zoology of our State, and the diseases which are pro-
ducing such destructive ravages amongst our domestic
animals.
Dr. L. D. Waterman, of Indianapolis, read a paper on
secondary effects of remedies, which, after discussion,
was referred to the Committee on Publication.
Dr. T. Parvin, from a special committee, submitted
the following report:
The committee to whom was referred the communi-
cation from the Special Committee on Medical Educa-
tion of the American Medical Association beg leave to
present the following report:
The communication embraces, as inviting the action
of the Indiana State Medical Society, first, resolutions
relating to the admission of persons to the practice of
medicine, providing for the examination of such, for the
compensation of examiners, and affixing a penalty for
neglecting such examination ; and, second, a resolution
relating to the admission of those desiring to study
medicine to the offices of physicians or medical colleges.
The report was first adopted afterwards reconsidered
and tabled. -
Evening Session.
The Society was called to order by the President.
The Secretary read a report by Dr. J. M. C. Adams,
of Frankfort, on the prevailing diseases, and their treat-
ment, of the Seventh Congressional District.
On motion the paper by fobert Curran, M. D., en-
titled Nosology of the diseases which have prevailed in
Clark county, Indiana, since A. D., 1883, was read by
its title, and referred to the Committee on Publication.
The Secretary read the following list of special com-
mittees to prepare papers for the next annual session:
On Cerebro-Spinal Meningitis by Dr. Wm. F. Cady, of
Lafayette. On the Correlation of Physical and Vital
Forces by R. E. Haughton, of Richmond. Experimental
Researches into the poisonous and chemical properties
of Atropia by Dr. Thomas C. Van Nuys, of Evansville.
On the Toxicological action of and examination for the
Alkaloid, Thad. M. Stevens, M. D., of Indianapolis.
On the Secondary Effects of Gunshot Wounds, by Dr.
J. S. Gregg, of Fort Wayne. On Cerebral Meningitis
as it prevailed in Montgomery county, Indiana, during
the spring of 1872, by Samuel G. Irwin, M. D., of Craw-
fordsville, Indiana. On Malignant Tumors, by Dr. L.
D. Waterman, of Indianapolis. On Surgical Cases which
have fallen under my observation, by J. S. McClelland,
of Crawfordsville. On Chemico Legal Investigations,
by Dr. P. McNab, of West Newton. On Cholera
Infantum, by Dr. G. N. Duzan, of Zionville. On Dis-
eases of the Eye and Ear, by Dr. C. E. Wright, of
Indianapolis. On such subject as he may choose Dr. J.
W. Hervey, of Oakland. -
On motion of Dr. Waterman, the Secretary was au-
thorized to add such further essays to the list as should
be handed to him in time for publication in the printed
proceedings of the session.
The Society then adjourned till the third Tuesday of
May, 1873.
TROUBLES IN PARIS AND THE DOCTORS.–The
ferocity displayed by the opposing troops in the struggles
around Paris during the civil war was all but unparalled
in history. Even in the most savage warfare the persons
of the “Doctors” are, as a rule, held sacred. Not so,
however, in the civil strife of last year. Attention has
JUNE 8, 1872.]
TIEEI IEH C T , T: INTIC . .
275
been drawn by a Paris journal to the fact that several
Surgeons belonging to Val-de-Grâce were summarily
executed by the Versailles troops in endeavoring to pro-
tect a number of wounded insurgents near the Place
St. Sulpice. The Government, it would seem, has at-
tempted to hush up the affair; but the Dolbeau scandal
has aroused some of the intractable students, and a
private inquiry into the matter has commenced. M. M.
Fano and Ferreogobi, two well known Surgeons, who
had disappeared since the depression of the insurrection,
are stated to have been among the victims.-Times and
Gaz., May 11, ’72,
A NEW PROFESSION FOR LADIES.—We learn from
the German papers that a young lady recently presented
herself at the Faculty of Medicine at Munich for exam-
ination for a licence to practice as dentist. Being refused,
she went to Erlangen. The question was here referred
to the Government, who at once authorised the examin-
ation, on the ground that it was absurb to exclude a
person desirous to submit herself to authorised profes-
sional tests of ability by reason of her sex. The young
lady triumphed, and “is likely,” it is added, “to find
immediate imitators.” -
THE STRASBOURG FESTIVITIES.—The opening of the
Strasbourg University took place on May 1, with cere-
monies of great festivity. The President v. Möller de-
livered an address in accord with the events of the day
whereupon the foundation documents from the Emperor
of Germany were exhibited and delivered with becoming
ceremonies to rector Bruch. Telegrams of greeting were
read from the crown prince of the German empire and
from the German parliament. Rector Bruch then de-
livered a most eloquent and brilliant address and he
was followed by Prof. Springer the orator of the day.
Wyss of Zünich expressed, in the name of Switzerland,
the sympathies of his people with their heartiest greet-
ings and good wishes. In the name of the Germans and
on behalf of his university followed next Weitz of Göt-
tingen when Tomaschek addressed the audience in the
name of the Austrian universities calling out peal after
peal of applause by his allusions to the union of the in-
terests and efforts of Germany and Austria. Rector Buch
in the name of the Strasbourg university thanked the
various guests most heartily for their earnest participa-
tion in the foundation ceremonies whereupon the
exercises: closed with the national hymn and a grand
feast.— Wien. Med. Presse, May 5, 72.
—º-e—sº-
German Therapy.
[Periodically, the student of foreign literature
has his sensibilities shocked by a contemptuous
fling at German therapy at the hands of that
gifted class of individuals, more especially to be found
among our own fellow-countrymen who possess what is
known as intuitive (!) capacities in curing disease.
For the direct benefit of these natural bone-setters in
therapy and the indirect protection it may afford to the
educated of professional mankind in the future we
insert the follwing extracts from a review of two Ger-
man works on therapy, by the Huseman brothers of
Göttingen and Nothnagel of Berlin, recently issued
from press. .
The London Practitioner (May, 1872,) from which the
review is abstracted needs no statement from us to its
“practical” character and standing].
“Not very long since we were talking to a medical
man, by no means deficient in intelligence, on the sub-
ject of the progress of therapeutics, when, to our consid-
erable astonishment, our friend observed, in the tone of
a matter of course, that England was the only country
where practical medicine flourished, and that ‘foreigners'
had no intelligent ideas about treatment whatever.
It was impossible to answer that assertion; we were re-
duced to silence; for it happened that only the day
before there had been put into our hands the second of
the works which head this notice; and the conception
of Nothnagel, at any rate, as a writer inferior to our
English authorities in intelligent ideas about treatment,
was rather too ludicrous. We have never yet quite got
over the shock inflicted upon us by the discovery that
an educated English medical man could think in such
a way; and our sensations on this subject have been
revivified by the more recent publication of the mag-
nificent work of the brothers Husemann. It is evident,
in fact, that our medical countrymen are in general
quite ignorant of many of the most important researches
that have been made; and the result of comparing such
a work as the new edition of Pereira (noticed by us last
month) with the Husemanns' book more especially, is
that one feels quite a pang of shame.
“We would by no means be understood, however, as
representing either of the works before us as faultless,
or ideally complete; on the contrary, we have to urge
against them several criticisms. But the fulness of
knowledge, the patience of research, the open-minded
fairness towards the labors of others, which their authors
exhibit, form what should be a very useful lesson to
English authors and students in medicine. * * *
“On the other hand, all these defects are to a large
extent compensated by the exceedingly clear and intelli-
gent way in which the action of individual remedies is
discussed. In each case (after the briefest introduction
relating to the botanical or chemical sources of the
medicine) there is a full account (a) of its physiological
effects on healthy men, (b) ditto on animals, (c) the
theory of its operation, as far as this may be known,
and, finally, an aperçu of all the therapeutic powers to
which it possesses any reputable claim. No English
work on therapeutics has ever presented a view, any-
thing like so complete, of the actions of medicines; and
we feel sure that those of our readers who may take up
the book will be considerably startled at the amount of
information, sure to be almost entirely new to them,
which they will meet with. The article on bark and
276
[JUNE 8, 1872.
TIEH. H. C.I.I.INTI C.
its derivatives, for example, is one to which we have no
parallel at all in English therapeutical literature, for
concise statement, in a few pages, of the result of a very
large number of most important researches.
“We must conclude, as we began, with the remark
that these two excellent works of the Husemanns and
of Nothnagel surpass anything of the kind which we
possess in this country. They are very far from being
perfect; there are many omissions in them (some, by
the way, involving injustice to English observers), and
in neither of them is the plan all that we can approve;
but at least they will serve to convince all that read
them carefully of the desperate need there is for setting
up a standard work, in this neglected subject of thera-
peutics, immensely higher than anything we have as
yet been accustomed to.”
—º-e—º-
C. L.INI ICAL, MIEM [O] RNAIDA,
XYLOL IN SMALL-POX.—Conclusions of an extensive
article with hospital statistics by Dr.A. Buckart (Stutt-
art).
g *in varioloid and the simpler forms of variola
(variola discreta) xylol is at least superfluous as no
medicament is able to hasten the eruption of the pock,
to abbreviate its individual stages or to induce a speedier
recovery.
2. In the confluent, pustular forms with grave con-
stitutional disturbance and high fever, xylol has as
little essential influence on the course of the fever as
the antipyretics proper. In these cases death occurs not
only from the enormous increase of temperature, but
also from the extensive interference with cutaneous
perspiration, as in extensive burns. Any effort from
xylol here would only be possible by a compensation for
the checked insensible perspiration. Xylol has, then,
neither an antifebrile nor a specific action. On the other
hand by its influence on the eruption in the throat and
on the attendant angina it may act as a life-saving agent.
In this regard it is far superior to the chlorate of potash
or lime, and on this account xylol is to be considered as
an important, an indispensable remedy in the treat-
ment of pustular pocks. Here comes in also its deo-
dorizing, disinfecting action.
3. Of the septic forms there are a few very insolated
cases which recover without any treatment at all. In
the grave cases all treatment is useless-Berlin Klin.
Wochenschr., April 29, '72.
TEST FOR THE PURITY OF CREASOTE.-The wood-
creasote of Reichenbach has long been known as a thera-
peutic and antiseptic agent of considerable value. For
it has recently been substituted in commerce, phenic or
carbolic acid, a substance of different properties. To
distinguish those bodies, Mr. Thomas Morson, of the
firm of Morson and son, has discovered a very simple
test. It is only necessary to mix the suspected Sample
with pure glycerine; pure creasote is insoluble in this
medium ; carbolic acid makes a bright Solution, and,
when present in considerable quantity, it make creasote
also soluble in the mixture.—Brit. Med. Journ.
May 18, '72.
ADENOMA.—A most extremely interesting case of
this affection is reported from the Charité, Paris.
Annette L., at. 58, cook, robust health, regular
habits. Neck enormously swollen, almost obliterated
by a large number of glands, indurated, indolent, not
adherent to skin, without fluctuation. This ganglionic
chain passed beneath the clavicle, deflecting the larynx
in the neck away from the median line.
Obesity supervened, with dyspnoea and alteration of
the voice. Iodide of potassium had not the least effect.
On Nov. 21, M. Lannelongue injected into the centre of
the largest tumors a few drops of iodine which he had
already used in two lighter cases with slight but sensible
amelioration. These injections, repeated in this case on
two subsequent occasions were without effect.
The malady made frightful progress. The tumors
rapidly enlarged; dyspnoea increased; sibilant pulmo-
nary rales; increased displacement of the larynx; face
cyanosed; limbs cold and livid. Tracheotomy was con-
sidered but rejected as it was thought that the pressure
on the recurrent nerves would still maintain the dyspnoea.
Resort was had to enucleation. Some twelve of the
larger glands were removed under chloroform. Great
improvement followed; cyanosis and dyspnoea disap-
peared; the limbs became warm; condition confortable.
Dec. 4th and 5th secondary hemorrhage ensued, to be
repeated on several occasions within a few days. The
hemorrhage was abundant and alarming. It was venous
blood. Its source was finally discovered. The internal
jugular was ligated. The patient died exsanguine.
On autopsy it was found that all the glands of the
neck were enlarged down to the base of the cranium.
The coats of the internal jugular were opaque, granular
and ulcerated. The ligatures had not cut through a
single coat. The section was made with great care.
Lymphoid productions were found in the pleura, the
liver, the spleen and the vertebrae.
1. Clinical and microscopic examination demonstrate
that we had to deal with the well known affection which
Trousseau designates adenia, but which we shall term
lymphadenomia.
2. As frequently occurs, this alteration commenced
in the neck. The cervical ganglions first undergo
hypertrophy without appreciable cause. Later this
alteration successively invades the glands of the thorax
and abdomen.
3. The histological tissue of these ganglions is repro-
duced at a distance, in the spleen, liver, pleura, even in
bone.
Wirchow in the third volume of his work on tumors
casts doubt on the lymphoid nature of these productions
in the pleura and the spleen. With this observation we
establish its existence. -
4. Notwithstanding the grave organic lesions, our
patient preserved her embonpoint to the end; a fact
worthy of note. -
5. This disease is formidable from the start. First,
because patients do not recover. Medication at times
can only temporarily arrest its progress. It may ad-
vance, secondly, so rapidly, as to destroy life in a few
months. -
6. We cannot terminate these remarks without
noticing the fact that though the internal jugular vein
remained open for more than half an hour yet no air
penetrated to its interior. The autopsy showed that
there was not the least bubble of air either in the veins
or in the right side of the heart.—Gaz. des Hopitawa; Apr.
9–11, ’72. - -
—sº-o-º-
I HIOMIE NEWS.
DEATHS FROM SMALL-POX still continue at the rate
of 12-15 per week. - -
THE STATE SOCIETY DELEGATIONS depart for Ports-
mouth on Monday afternoon. A profitable and a good
time is anticipated.
o Po R. L.E. s.s A.N D F A LATA H L E.
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. - - -
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated,
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

wo. 7 resr rovara scºrer.
PIKE's OPERA, HOUSE BUILDING,
Importer and Dealer
—“I N--
Diamond and Gold Jewelry, - * --
Watches for Ladies and Gentlemen,
Sterling Silver - Tableware,
Bronzes, Antique and Modern;
Marble and Bronze Clocks,
M ar b le Statu a ry,
FAN cºr Coo: Ds,
GENERALLY.


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GooD s AMARITAN HOSPITAL.
-
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
pointments of a First-class Hospital. Porticoes,
halls and abundant windows secure that full and free ventilati
Service is furnished by the
Under the Superintendence of the We
with commanding views, surround the whole house, and wide
on which is so essential to health and comfort.
stsTLRs or charity,
Il-known SISTERANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford. -
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may,
however, select from the regular profession
of the city any physician of their choice. -
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylu
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appoi
m in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
intments necessary and service required, ranging, iº
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
service.
Bºy" Address,
SISTER ANTHONY,
EIospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio-



























































F. E. SUIRE,
E. S. WAYNE
sºlº-
JAMES FOSTER, Jr. & CO.
[ESTABLISHED, 1836.]
Importers and Manufacturers of
Optical and Physical Instruments,
Keep constantly on hand first-class
English and French Microscopes, First-class Objects
and Microscopical Apparatus of every descrip-
tion, Medical Batteries, Thermometers,
IHydrometers, Urinometers and
Chemical Glass Ware.
Special attention given to adapting the best spectacles to all conditions
of sight.
We take pleasure in showing the latest novelties from the best Euro-
pean and American manufacturers.
JAMES FOSTER, Jr. & Co.,
S. W. cor. 5th & Race Sts., Cincinnati, O.
TXTER, S-INT. TMI_A_TER/SIET’S
àw
gºmº A "ſº
zºº a Cºyº
C޺ & - C޺
No. 758 BROADWAY, New York
HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
From Prof. Willard Parker to S. D. Townsend, M. D., Surgeon to the
Massachusetts General Hospital,
B EG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. sº I am in the constant
habit of sending my patients to him for treatment: I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D.
Professor of Surgery, New York City
f
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder Braces, Supporters, Elastic Stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Cure Truss Offices of S. N. MARSH & CO., No. 2 Vesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
OPPOSITE THE HIGH STEEPLE,
fºr Agonts for Clement's Patent Artificial Legs.
F. E. suire & Co.,
WHOLESALE DBUGGISTS,
IMI A. IN TJ” ET AL C T TJ IF, IT INT G-
- £Hexists AND PHARMAceutists,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
syex,xec 90'xex) ox{UGS ANOO IVX)expxc)(N)es,
cºerºxx.cAx, AeeARAºcus,
TESTS, MEDICAL, GLASS WARE, &c., &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
Made in accordance with the U. S. P. and other recognized authori-
ties. - -
E"INIHE AND EARH, CHEMICALs,
Of the popular class of preparations known as
IH, T, IDXIIIER, S,
Wemanufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Mºon, &c
AGENTS FOR BULLOCK & CRENSHAW's
Sugar-coated Pills and Granules.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.
*


















List of Pharmaceutical Preparations,
MANUFACTURED BY
Jonºv wreznº anorman
PRILADELPHIA.
_*-
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
- fixir of GENTIAN FERRATED,
ELIXIR WALERIANATE OF AMMONIA, *
(Goddard’s Formula,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON, •
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK, t º
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron and Peruvian Bark,
- - FERRATED CORDIAL ELIXIR,
ELIXIR CALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK,
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
- BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry wine,
ELIXIR WALERIANATE OF STRYCHNIA,
WINE OF PEPSIN,
SYRUP SUPERPHOSPHATE OF IRON, {
ELIXIR OF BISMUTH,
CowP. FLUIDEXT, EUCHU AND PAREIRA BRAVA.
STUTEPEPOSITOTER, TIES.
Rectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and Btyle, made of finest quality of sponge.
u
ſ
E - Fº = *— .
§º ºft
%&# Zºś
CINCINNATI.
E" A C Uſ IT, T Y -
J A M E S G R A H A M, M. D., DE AN,
Professor of the Theory and Practice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D., -
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery.
W. H. GOBRECHT, M.D.,
Professor of Anatomy. - T. A. REAMY, M.D.,
P. S. CONNER, M.D., Professor of Obstetrics and Diseases of Children.
Professor of Surgical Anatomy. JOHN L. CLEVELAND, M.D.,
JAMES T. WHITTAKER, M.D., Demonstrator of Anatomy.
Professor of Physiology.
SAMUEL NICKLYS; M. D., CHARLES KEARNS, M.D.,
Professor of Physics and Medical Chemistry . 488istant to the Chair of Surgery.
W. W. SEELY. M. D.,
IP roſessor of Diseases of the Eye and Idar, and Secretary of the Faculty
•- ~
T. LOUIS Brows, M. D., Prosec (or of Anatomy. J. NoHLE, Janitor, College Building, Sixth St., bet. Wine and Race.










PUBLISHED EveRx saturday.
T E. R. Ms—$2.00 a Year, Invariably in Advance. All Communications, relating to Publications must be addressed to the Editoff
. . . . All Communications. relating to Business, Subscriptions, Advertisements, etc., to the Treasurer. . > - -
-ºf
vol.2: . . . . of No INNAT1, J U N E 15, 1872. No. 24.
**. &:
cº-º:
r’
*::::::::::::… *}|| || || || ||M|||||||}|,
.. w, w, smely, M. D., - - - . - - * - •. ,
& - -
º No. 118 West Seventh Street, Cincinnati. . . . . . . . . . . . 0 all - erº, 0
, “ . . . . . . . 3 - - - . . U. º ()
Pinted and Published by THE CLINIC Publishing company, & . . .
—ºriº |Hºltål Hillſ; and lºſſ ºf Him,
**º 92 FOURTH STREET,
1. . . " • . S.----------------- º • opposite Post office,
o o N T E N T S ser The Oldest Established Hat Hºuse on the street.-ès
— *Fine Silk Hats, Standard Quality $6.00.
origiNAL ARTICLEs , , , |--— .
Rºrontos orology, by W.W. Seely, M. D....…. 277
CEPHALAToMIA, by D. Cunningham, M. D. 280 - Boğan. -
10) ºf Sizºº ANDºd
# *:
*ENGRAV, º
TRANSLATION .
stretching of the Cervical Nerves for Relief of Cramp, by Prof. -
Nussbaum, (From Schmidt's Jahrbücher, Aprij, ’72.................. 281] ...
-x. . . . -
The Influence of the Mind on. the Body, by Daniel H; Tuke, M. D.
(From the ºurn; Mental Science, London, Apr., *72.).....:......282
screw TIFIC NOTES: , , ; * - - * -
-- J. TAFT, . . . . - W. TAFT.
Position of the Epiglottis as a Sign of Probable Longevity—Preser- -------------, - sº - - - -
vation of Subjects for Dissection—Tolerance of Tobacco......285-286 - Editor Dental Register
- MIE DICALL NEWS : -
Army Medical School in Japan—Census Statistics of the Three | - J. : & W. TAF T, i
Learned Professions—West Virginia State Medical Society...... 286
CLINICAL MEMORANDA -
Tincture of Iodine in Womiting—Cimicifuga Racemosa as a Preven- ID E. i | N | | - I s | S' | I S
tive of Small-Pox–Parenchymatous Injections into Tumors— s - - -
Amblyopia from Masturbation—Treatment of Spermatorrhoea—
Removal of the Kidney........................... ........ 286-287|
on. “ ” -- || 17 WEST FOURTH STREET,
- - - - - - - - - -
Our readers will miss the usual report of the proceed-
ings of the Academy of Medicine. The absence of
members attending the State Medical Society was such
that it was deemed best to postpone business till next.
monday evening. . - -
We give this week a novelty in the way of surgical *
practice by Prof. Nussbaum of Munich, in which the
cord was exposed and stretched for the relief of anaes- -
thesia and cramps. A Monthly Journal,
The interesting article showing the influence of the º
mind on the body is continued from last week.
Our space would not permit us to give the minutes
of the West Virginia State Medical Society in full. Devoted to the Interests of the Dental Profession,
CINCIN NATI, O.
CONTAINING 48 PAGES,

















WILSON BRO's.
S HIRTS
Made to order of N. Y. M. Muslin and 2300 ||
HEAVY Linen, per dozen - - - $36 00
Wamsutta Muslin and 2100 HEAVY Lin- "
en, per dozen - - - - - - - - 38.00
Wamsutta Muslin and 1900 Linen, per doz. 30.00
Lonsdale Muslin and 1700 Linen, per doz. 27.00
First three. qualities have ALL LINEN Cuffs
and Neckbands. At above prices Cuffs are
attached. Same quality of our own manufac-
ture, ready-made, $3 per dozen less. -
Perfect satisfaction given or money cheerfully
refunded. . . . .
Also import and Manufacture Men's Furnish-
ing Goods. -
Pike's Opera-House, Fourth Street, Cincinnati; 92.1
Wabash Avenue, and SS West Washingtons
& Street, Chicago.
CAMARGO
MANUFACTURING COMPANY,
MANUFACTURERS AND IMPORTERS OF
AND
Window Shades,
& Wasr Fovarw Szºzº,
was rap—admists.
School Teachers, Students
AND OTHERS,
Can find light and healthful employment for the Summer, by
engaging in the sale of our valuable and very popular works.
One lady teacher just commencing work for us, reports
net profits for last week at ForTY DoILARs—many others doing
equally well. Large commissions or liberal salary as preferred.
For particulars, address
NETTLETON & CO.,
. . . 161 Elm Street, CINCINNATI, OHIO:
P. S.—We will make “spºCIAL TERMs” to medical stu-
dents, who are “working their own way through college.”
BASCOM & CARTENTER,
|Stationers, Printers
Blank Book Manufacturers,
136 VINE sº CEREET, -
s\ssWA\\\,
CINCINNXT, O,
H. H. BRENEMAN, Proprietor.
E. D. ALBRO & BRO.
IMPORTERS AND MANUFACTURERS OF
|FOREIGN and DOMESTIC WOODS
In Veneers, Boards and Plank,
frtaint-Maºri', 'al-Builibri'ami Hi-Hinº
The only house in the Western country that saws Spanish and Mexi;
can Cedar for Cigar-Box Makers. We import our own wood direct, and
can sell at prices to compete with any and everybody. -
Also saw and keep on hand a large stock of Poplar, White Walnut and
Sycamore, for Cigar-Box Makers.
Office and Warerooms, #36 and 138 West Second Street, *
Veneer Mill, 501, 503, 5ii, 513 & 515 W. Sixth St., CINCINNAT1,

- Sº r
FOSTER, Jr.
[ESTABLISHED, 1835.]
Importers and Manufacturers of
Optical and Physical Instruments,
English and French Microscopes, First-class Objects
and Microscopical Apparatus of every descript.
tion, Medical, Batteries, Thermometers,
Hydrometers, Urinometers and
Chemical Glass Ware.
given to adapting the best spectacles to all conditions
JAMES dº. CO.
Special attention
of sight. .
We take pleasure in showing the latest novelties from the best Euro-
pean and American manufacturers. - ... • *
JANIES FostER, Jr. & Co.,
S. W. cor. 5th & Race Sts., Cincinnati, O.
D.R. 5.N.M.A.Rs.H.’s
* ~ * . . Aºtº
- - , No. 758 BRoapw AY, New York
I HAVE been in the habit of applying and recommending the Truss
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. WIS A. SAY RE, M. D.
Surgeon, Bellevue Hospital.
£º
º
}
º
From Prof. Willard Parker to S. D. Townsend, M.D., Surgeon to the
Massachusetts General Hospital. .
BEG leave to state for the benefit of all concerned, that I have known
Dr. S. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the success he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with any of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence, in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the members of the medi-
cal profession generally. WILLARD PARKER, M. D. .
Professor of Surgery, New York City
Dr.S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trusses, Shoulder. Braces, Supporters, Elastic stockings,. Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Qure Truss Offices of S. N. MARSH & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 3 West Fourth St.,
between Main and Walnut, Cincinnati.
OPPOSITE THE HIGH STEEPLE,
* Agents for Clement's Patent Artificial Legs.
*——
F. E. SUIRE, E. S. WAYNE
IF. E. Suire & Co.,
WHOLESALE DRUGGISTS,
IM. A. INT UT EP A CT U ER, I NT G-
£Hemists AND FHAR MACEUTISTS,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
skex, Ecºexex, Yokkö GS ANYO IVXXExpxc)(N)es,
ck{xeryx)(CAX, APPA)3A%Us,
TESTs, MEDICAL, GLASS WARH, &c, &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
alſº in accordance with the U. S. P. and other recognized authori-
ºiGS.
FINHE AND EARE CHEMICALs,
Of the popular class of preparations known as
E. T., IL&T I IR, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
the nauseous taste of medicines are disguised, and they made pleasant to
take. -
Bitter wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c
AGENTS FOR BULLOCK & CRENSHAW'S
Sugar-coated Pills and Granules.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and welf and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally.








Hiſtºl Muſº ºwl
nFoster's
167 EAST 34TH-ST., NEW Yo 1; K,
By Special Appointment Electrical Instrument Makers to
the New York State Hospital for Nervous Diseases,
MAN UF ACTURERS OF PORTABLE
ELECTRO-MAGNETIC MACHINES,
Portable Galwanic Batteries,
Continuous Current, Stöhrer's Improved, patented June 1st,
1870, and May 30th, 1871.
These Instruments are the most Elegant, Powerful, Effica-
cious, Reliable and Cheapest ever manufactured. Can be
instantly set to work or stopped. Will remain in operation
for a considerable period without changing the Battery
Fluid. Can be carried around Charged and Ready for Use
without danger of Spilling the Battery I'luid.
|M|| |||||—|| || |||||||}
PER MAN ENT BATTERIEs,
For Hospitals and General Practitioners,
IET IIECTIE, OTDIEBS.
For Eye, Ear, Larynx, Nose, Uterus, Wagina, Bladder, Rec-
tum, Feet, Phrenic and Sympathetic Nerves, Elec.
trolysis, Galvano-Caustic, and all Elec-
trical Instruments for Medical Use.
º
—->O-3-O->-
EXTRA (17'S FRONT TH F O PIN TON'S OF THE MOST
IEIMIN ENT ME M BERS OF TEM Jº PROFESS / ON.
WM. A. HAMMOND, Prof. of Diseases of the Mind and
Nervous System, Bellevue Hospital, says: “Nothing cAN
EXCEED THE EFFICIENCY AND CONVENIENCE OF THIS INSTRU-
MENT. It possesses the great advantages of supplying both
the inducing and induced currents, and enabling the physi-
cian to regulate the interruptions, so as to give the shocks
very slowly, a matter of great importance in the treatment
of Paralytic Disorders.”
We are authorized by Prof. Hammond to announce etn-
phatically that the above extract, and the description of our
Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
Al EREDITH CLY MER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider theºr
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:—‘ In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. G ARRATT, M. D., Boston :-" In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, M. D.;.
ALLEN MAYNARE), M. D., Cleveland, O.; Dr. C. WANNIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, 0.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWELL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
himlitial
Are furnished to Officers and Soldiers’ on Government
account.
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
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\ RESPECTypII.Y. YoURs,
E. S. WAYNE, Analytic Chemist.


TIEEE IEH C T , ITNT I C .
277
Vol. 2.] S A T U R D A Y, J U N E 15, 1872. [No. 24.
O R. I.G IN A. L. A R T I C L E S.
-º-º-º-
R E P O R T O N 0 T O L O G Y -
BY
PROF. W. W. SEELY.
Read before the Ohio State Medical Society, June, 1872.
GENTLEMEN:
I propose only to occupy so much of your time
as will enable me to call your attention to some points and
make some suggestions in otology that I have deemed
worthy of consideration, presuming on a knowledge
more or less extensive of the subject.
I trust I shall be able to add some little to your in-
terest in this department that lays so much claim to
consideration, and whose practical out-comings are so
important and are so earnestly demanded. A constantly
increasing experience convinces me that in no depart-
ment of medicine are more brilliant therapeutical re-
sults to be looked for. The accessions to the ranks of
earnest workers are greatly on the increase, the great
lacuna occupied by empirics has been filled, and to-day
the science and art of otology stands on a foundation
worthy of all honor.
It would be a difficult problem to estimate the value
of our hearing power. Its true worth is only to be
sought in the longings of those who have lost it.
I am especially desirous of fixing your attention on
ear troubles in children; for it is in early age that the
seeds of so much future trouble are sown.
As yet the popular and professional fallacy with re-
gard to ear-ache and deafness in children, is by no means
done away with.
The subject reveals itself in all its magnitude when
we reflect that the majority of children suffer from ear-
ache, and its importance is shown when we know that
almost the sole cause is an inflammation, and that at this
age the drum cavity is exceedingly small, so that the
most serious results may follow. A large per cent. of
patients will tell you that they suffered from ear-ache
in childhood.
Ear-aches and otorrheas may be “out grown;” curing
them saves time and does away with the risks. In
many of the diseases of childhood we may have compli-
cations on the part of the ears, frequently so serious as
not alone to cause symptoms of brain trouble, but actual
meningitis. Valuable statistics could soon be collected
if physicians would record in their note books the con-
dition of the ears, along with the symptoms and time at
which the complications arose. The results in my prac-
tice show a very great increase in the percentage of cures,
and an enormous increase in the improvements, in the
cases that present. As regards the means for per-
fecting the diagnosis, I would call your attention to the
significance of the sound-conducting power of the cranial
bones. It will be readily understood that this conduct-
ing power alters with increasing age, hence in old persons
little use can be made of it.
We no longer regard an examination complete with-
out the use of the tuning-fork and the galvanic current.
Value of the Tuningfork.
In THE CLINIC of May 25, I gave a short abstract
of the striking experiments of Tºr. Emil Berthold to
render the conducting power of the cranial bones visible
by showing the movements excited in the membrana
tympani. Most of you are aware that if a watch or
tuning-fork is placed upon the head or the teeth,
stopping the ears causes it to be heard better; stopping
the two ears alternately, increases the sound in the closed
€2.I.
The great difficulty that has been experienced, is in
locating the affection. It was easy formerly to solve the
question by calling it “nervous,” but such a diagnosis
in the majority of cases now would be not a little
hazardous for any one who valued his reputation. The
idea that, because the watch is not heard when in con-
tact with the cranial bones, or between the teeth, the
nerve, or its expansion, is diseased, has been shown to
be fallacious, because the bones do not alone conduct
the sound. We must take into consideration the
resonance of the other parts.
If we assume, as Mach claims, [see p. 249 Roosa's
Translation of Tröltsch], that “The tones are increased
in strength, because the Sonorous waves are prevented
from being softened or dissipated by passing out of the
ear,” then anything that prevents the passage out of the
ear, cerumen, closing of the external meatus by inflam-
mation, thickening of the membrana tympani, collections.
in the middle ear, etc., provided the nerve is normal,
will cause the sounds through the cranial bones to be
heard louder in the affected ear. If, however, the fork
is not heard better or as well in the bad ear, then we are
more or less justified in assuming that the nervous ap-
paratus is affected, and it then remains for us to decide
whether it is a primary or secondary affection of the
labarynth, as we have every reason for believing that
the auditory nerve may lose more or less of its sensibility
by continued deprivation of its normal stimulus sound.
To make my meaning a little clearer, if the patient does
not hear the watch or fork when placed close to the ear,
but distinctly when placed on the bones, we are justified
in concluding that there is some interference to the pass-
age of the Sound through the external canal, the
membrani tympani, or the cavity of the drum, If, on
278
[JUNE 15, 1872.
T H E C T I INTI C.
the contrary, the fork is heard very indistinctly or not
at all on the vertex, we can infer either extraordinary
pressure on the two fenestrae, or some diminution of the
sensibility of the nerve.
One great difficulty in the way of all such tests, is
that patients fail to give correct expression of their ex-
perience, and it is then advisable to have additional means
for verification, which, to a great extent, obviates the
defects. The double otoscope enables us to judge for
ourselves. In this apparatus a tube is placed in either
ear of the patient and the third arm in our own, when
the sounds will be heard loudest by the examiner (closing
alternately the tubes in the patient's ears) from the
patient’s better ear.
The Constant Current.
I presume there is little doubt remaining in the minds
of the majority of aurists that the acoustic nerve will
respond to the constant current.
My experience has left no room for doubt in my own
mind. -
It is probably well known that the galvanic current
is the only one that can exercise a direct influence upon
the nerves of special sense, and the great nervous centres.
It is likewise known, as Pflüger has shown, that the
nerve is excited only by the appearance of the
catalectrotonic state, and by the disappearance of the
analectrotonic, and that it is the galvanic current that
produces the molecular change in the nerve, as declared
by Du Bois-Raymond, electrotonus.
Brenner gave certain formulae which he claimed
could always be produced by the current upon the
auditory nerve. I have been in the habit of trying the
current upon the cases of ear trouble that have presented
at my private rooms, that I regarded as at all suitable.
I will state the formulae as given by Brenner, for con-
venience of comparison while giving my results. With
the cathode upon the ear and the anode in the hand,
on closing the current, there is an acoustic sensation.
During the continuance of the closing, the sound
diminishes and finally disappears.
At the cathodic opening of the circuit no acoustic
sensation is heard. At the anodic closing of the circuit
when the ear is under the influence of the anode, no
acoustie sensation is felt.
During the anodic duration no acoustic sensation, at
the anodic opening the same sound being heard as at the
cathodic closing. In order to use the current to the
best advantage the instrument must be as perfect as
possible. I make use of 30 elements of Siemens &
E[alske, And the accessory apparatus as devised by
Brenner, and made by Krüger & Hirschmann of Berlin.
It is well known that tinnitus aurium is one of the
most annoying circumstances in connection with some
ear troubles and patients will frequently say, if they
could only be relieved of the noises they would not
mind the deafness.
I propose to narrate a few cases not only because I
feel that they are important as illustrations of the reac-
tions which the current is capable of producing, but be-
cause they also serve to show that galvanism may be
made of service in a diagnostic and therapeutic point of
view, that some percentage of patients can at least be
relieved from the worrying noises by the current.
CASE 1. An intelligent patient of 34, who has been
growing hard of hearing for fifteen or twenty years, has
been under my care off and on for several months for
chronic otitis media. -
The membranes were thickened, opake and somewhat
concave. Light spots nil. '
No deposits in the membranes. There was at first
almost complete atresia of the Eustachian tubes, only a
suspicion of air passing into the middle ear by inflation
through the catheter. - -
I, on several occasions, mechanically dilated the tubes
by means of the cat-gut (Size E fiddle string).
Six weeks ago the patient had, as the result of a cold,
a sub-acute attack of inflammation of the middle ears.
Under inflations once or twice a week he improved
somewhat, and his hearing is considerably better than
when I first saw him. I found a very great difference
between the hearing of the fork when placed upon the
vertex and when placed in the ear. -
Also a very great difference between the length of
time the patient could hear the vibrations through the
bones and that through my own, fully half a minute's
difference. The patient could hear the fork for # minute,
when the handle was placed in the meatus, while I could
continue to hear it for 14 or 1% minutes.
I found that as the hearing improved, which it did
rapidly after his sub-acute attack, I eould see a cor-
responding change in the length of time the fork was
heard in the meatus. I found also that as the hearing
improved the fork was not heard quite so long upon the
vertex (The time on the patient's vertex and in his ear,
on my vertex and in my ear, was about reversed). The
constant current confirmed my diagnosis of the great
hyperaesthesia of the acoustics, for by the most careful
and almost indefinitely repeated trials I found that three
elements would produce, on cathodic closing, a distinct
singing sound which was immediately quieted by chang-
ing the current in the metallic part.
I interpolated the rheostat though no resistances were
necessary. - -
The patient only had very slight indefinite sounds in
the ears when the use of the current began, and only
has them occasionally, now when the hearing is not
quite so good. . -
CASE 2. Mr. L., aet. 28, affected with sclerosis of the
tympanic lining, forming one of those hopeless cases
on which, so far as our present knowledge extends rem-
edies have but doubtful effect. -
Slight noises in one ear. 10 elements with cathodic
closing produced a singing. . At the cathodic opening a
similar singing sprang up in the opposite ear, which
continued during the anodic , closing and gradually
disappeared on the anodic opening,
JUNE 15, 1872.]
T ET E c T, TTSTI c.
279
Here it will be seen we had 3, CàSe of tinnitus with the
so-called paradox formula in the opposite ear.
Dividing the electrode, so that its two branches could
be placed in either ear and slightly increasing the
strength of the currents had the effect of stopping the
noises without the exciting of one in the opposite ear
Case 3. This was a case of chronic otitis media in which
I found reversal of the formula. Instead of the noises
being quieted by anodic treatment, they required the
cathodic,
I presume I will be asked about further therapeutic
results. I have only stated what I have seen and am
positive of: - -
As yet I have had but a limited opportunity to test
the treatment by the current alone. I have eliminated
a few cases on which I am confining myself to the use
of the battery. The large majority of cases of deafness
in grown persons comes from catarrh of the tympanic
cavity, and as we already by our present therapeutic
means have such striking results, one is unwilling to
resign a case till a thorough trial. Thus it will readily
be seen that an extensive experience at all intelligent, is
not to be gained in a few months. -
Acute Otitis Media.
Arresting acute otitis media or acute inflammation of
the middle ear and quieting the pain, have always been
points of extreme moment. The pain is extraordinarily
severe in many cases, and the disease if not properly
treated may extend to the mastoid cells, thus causing
not only a wearying abscess in the mastoid process, but
even inflammation of the brain and death.
Catheterization of the Eustachian tube, repeatedly fill-
ing the ear with hot water, leeches, have been the reli-
ance, and while I would especially call your attention
to their wonderful effects, yet the recommendation of
Prof. Weber, of Berlin for such cases, I can endorse so
far as my trials have gone, fully, viz., the internal ad-
ministration of the oil of turpentine. I think that a
few cases of acute otitis externa not purely such, but
with more or less extension to the middle ear, where I
have had striking results, justify me in recommending
its trial in those painful inflammations with the forma-
tion of abscesses. The dose is a half teaspoonful morn-
ing and noon, and a teaspoonful at night.
By the measures recommended, I believe that a large
number of mastoid complications will be averted.
Treatment of Otorrhea.
As regards the treatment of otorrhea both in children
and grown persons, the chief disideratum is the thorough
cleansing of the ear.
Syringing is by no means always sufficient, in fact
many times seems to be absolutely injurious. The Se-
Cretion can be blown out by inflation either by the
catheter or by Politzer's method, or washed through the
Eustachian tube into the throat, by filling the ear with
Water and making pressure on the tragus, or washed the
other way by passing the water through the meatus
inflating at the same time that the patient swallows
while the head is inclined at the same time far to the
diseased side. The use of the probe and cotton will
be found of great service also, especially when the parts
need to be dry for the application of remedies, as in
polypus and polyposed conditions of the membrana
tympani.
While all the astringents are used for otorrhea, I
would especially recommend zinc, both the sulphate
and acetate, and nitrate of silver. My advice is always
to begin with a weak solution (} to 3 grs. ad. 3i. twice
or three times daily,) not only because it is often suffi-
cient, but because a stronger solution may cause pain
and thus terrify the patient, and prevent further appli-
cations, and also actually do harm instead of good, if not
preceeded by a weak solution to accustom the parts to
the contact. I need not say that frequently it will be
necessary to change from one astringent to another.
Everybody knows that in treating iritis the effort is to
prevent synechiae posterior, and if already formed, to
tear them loose, otherwise the ear cannot be regarded
in a healthy condition.
We have in otorrhea, a larger or smaller perforation of
the membrana tympani, the purulent fluid coming from
the middle ear. Certainly neither parent, nor doctor,
in his right mind, would allow such a stinking discharge
to run on from any other part of the body, and in a
purely sanitary point of view, its neglect is beyond com-
prehension. --
Again, how can it be expected that the ear will become
sound until the perforation or perforations (as they may
be multiple) have healed, and of course the longer the
discharge continues, the more difficult is it for this to
occur. Every one should then put before him as the goal
to be reached in the treatment of otorrheas in children,
the healing of the perforation.
So great importance is attached to the soundness of
the drum-head, that both many patients and not a few
physicians, are unwilling to admit that there is a per-
foration.
Again in cases of very great deafness with discharge,
the reigning idea seems to be that the membrana
tympani is totally destroyed. -
While the membrana tympani is of very great value
in an acoustic point of view, it also plays an all important
rôle in protecting parts of still more value, the
soundness of the two fenestral membranes being of still
greater importance. Bear these points in mind and all
the mystery of hearing with a perforated membrane, of
very bad hearing with a very extensive loss of the
membrane, capable of being made very good, will be
solved. -
If a perforation remains unhealed, the ear is left in an
wnhealthy condition and you can never tell when the
disease may reappear. Then remember the membrana
tympani in its tutaminal function, its protecting rôle and
endeavor to make it perfect. w
280
TIH. H. cI.TISTI c.
[JUNE 15, 1872.
Polypi. -
The rule for the treatment of polypi is avulsion with
the snare, undoubtedly the plan when it is possible to
do it, and the rule will hold in about one-half of the
I wish particularly to call your attention to the
treatment of the other, the more important half, at the
same time to explain why simple avulsion does not
always succeed. - - .
When the mass of the polypus is torn away, the pedi-
cle may or may not be destroyed, if the latter is the
case you may expect a return without energetic treat-
Iment of the remaining base. Many substances have
been used for touching this base, such as nitrate of silver,
chloride of zinc or iron, etc., and undoubtedly success
is obtained by their effects. However, I much prefer
the chromic acid.
I can see but one drawback to my unhesitatingly rec-
ommending it in all cases of polypus of the ear, for it is
in my opinion the most efficacious, that is, the great
care necessary in its application. Those who have seen
its employment hundreds of times at the Dispensary of
the Medical College of Ohio, will testify to its freedom
from danger when carefully used. With this remedy,
polypi in children no longer offer any embarassment,
since a few applications of the acid suffice to remove
very large ones completely. -
While polypi are the result of purulent otitis, they as
results may in time become continuing causes of the dis-
charge and with their removal the otorrhea is cured. .
After thoroughly drying the ear, cleansed of all discharge,
I apply on the point of a small probe, a minute crystal
of the acid, seldom larger than an ordinary pin's head.
If the polypus is large and I find the medicine has only
made a small impression, I apply it again the next day,
and then wait three or four days, when usually a white
mass of chared tissue will drop off. After two applica-
tions I wait for this exfoliation.
I use more care in the application of the remedy.
Every one knows that a discharge from the ear is only
a symptom. Where polypi are not present, we may
have a very granulated condition of the mucous mem-
brane to deal with. In such cases I have found strong
solutions of the chromic acid to answer a good purpose,
but no brilliancy is to be looked for by any plan of treat-
Iment.
Before closing my report I must say a few words
about the use or rather abuse of the Eustachian catheter.
I find, now that the use of this instrument has become
more general, a good many patients to whom the process
has not only been painful, but 'where the results to say
the least, have been doubtful. Some of these patients
have presented normal meatus, and whose deafness has
been most amenable to treatment. .
Certainly the fault was in the operator, and everyone
should be fully aware that an operation so free from
danger and the results of which are so brilliant, may,
if bunglingly performed, do harm.
As the mass diminishes
cer is a 1. At on 1 A.
D. Cussingham, M. D.
- wastenberg, Pa.
*
April 2nd, 1872, I was called to see Mrs. P., act. 33,
in her fifth labor which progressed favorably, so that in
about two hours she was delivered of a stout healthy
male child weighing eleven pounds. On the following
day about noon (eighteen hours after birth) I was called
to see the child. The nurse informed me that she had
noticed an enlargement of the right side of the head:
Upon examination I found a tumor, kidney-shaped,
situated on the right parietal and occipital bones extend-
Af
ing backward from a little in front and above the right
ear, and encroaching something more than three-fourths
of an inch on the anterior border of the occipital bone.
The tumor was three and a half to four inches in length
by one-half to two inches wide and three-fourths to one
inch in height. The color of the scalp covering it was
unaltered. The tumor presented a well defined margin,
giving to the finger the sensation of a bony edge. The
body of the tumor had a doughy elastic or fluctuating
feel. It did not pit on pressure ; no pulsation could be
detected, nor did crying, sneezing nor heavy breathing
cause any motion in it. Pressure did not diminish the
size of it. There was slight ecchymosis of the upper
eyelids. In addition there was hemorrhage from the
umbilical vessels. From this array of symptoms I diag-
nosed a case of cephalatomia. The variations of this
from recorded cases consists, first, in the fact that writers
confine the locality of these tumors to only one bone,
never encroaching upon a suture, whereas in the pres-
ent case it not only laid over sutures but was partly
situated upon both the parietal and occipital bone, and,
second, that in cases reported I have not seen anywhere
coincident hemorrhage from the funis. The cause is
invariably declared to be the result of a circumscribed
effusion of blood beneath the perieranium upon the sur-
face of the skull from rupture of the blood vessels. The
|primary cause by which the rupture of these blood
vessels is produced is a strong restrictive force applied
to the particular part of the head on which the tumor
may be developed (as it may occur on other bones, but
most frequently on the right parietal and in male chil-
dren) by the bones of the pelvis during labor. Others
declare that the circular pressure of the neck of the
uterus during labor may produce it. I am of the opin-
ion that the essential cause in my case was a peculiar
constitutional hemorrhagic tendency existing at birth,
and in support of my belief I may allege the almost
simultaneous appearance of the tumor and the hemor-
rhage from the umbilical vessels. Sorbefacient appli-
cations aided by compression were applied to the tumor
as were later ligatures, compresses and all available
remedies to arrest the hemorrhage from the navel, but
JUNE 15, 1872.]
with only temporary effect. The child lived three days
and died exsanguine and comatose from which latter
condition I was led to believe that effusion had also
taken place within the cranium. -
A post-mortem examination was denied,
Exposure of THE cord AND ExtENsion
BY STRETCERING or TEE Fourt Low ER
S orrvicAL NERVEs.
An Operation for the Relief of Anaesthesia and Cramps.
PROF. v. NUSSBAUM, [Munich].
From the Bayer, àrztl. Int. Bl. 9, 1872|Schmidt's Jahrbücher, Apr. *72.
This operation which is without analogue in surgical
literature was performed by Prof. Nussbaum on a
soldier aged 23, who had received in the battle of
Brazeilles a stroke upon the elbow and back of the neck |
from the butt of a musket. An abscess developed on
the nape of the neck but healed in 14 days. In conse-
quence of these two injuries a spasmodic contraction of
the left pectoralis major and minor, and all the flexors
of the left arm, fore-arm and hand developed. The con-
traction of the muscles was so powerful and constant
that it was impossible with the greatest force to straighten
the fingers and the elbow at the same time. Sensibility
was very much reduced but still not entirely absent.
Needle punctures were not felt on the dorsal surface of
the fore-arm, but deeper incisions gave rise to a light
degree of pain. When the patient was brought under
profound chloroform narcosis, which was tried on several
occasions, all the spasmodically contracted muscles could |
be straightened, as is always the case in spasm, and |
fastened straight to a board. But long before the patient
was recovered, while still perfectly devoid of feeling and
consciousness the spasm returned with such violence
that the board would have caused deep wounds in the
skin unless at once removed. A few hours after chloro-
form narcosis the patient became unconscious in light|
upon, this wound in its turn was cleansed and closed as
before.
degree upon which spasmodic muscular contractions of
the whole body supervened to last, however, for but a
few minutes, * * - -
As cause of these phenomena mentioned, the author
considers, based upon an examination by Prof. Voit, an
irritation of the motor branches of the four lower cervical
nerves with slight affection of the sensitive roots but
central origin in the cord itself. Since now the various
agents (narcotics, strychnine) which act upon the spinal
cord seemed to injure rather than benefit, the author
concluded to make an attempt at relieving this agonizing
condition by exposing the affected nerves and subjecting
TIH. H. C.I.INI c.
trunks from their various adhesions.
28i
them to physical tension. He was led to this operation
in consequence of the fortunate result attained in a case
of resection of the elbow wherein the extension of the
| ulnar nerve which occurred during the operation re-
lieved for ever afterwards a previous spasmodic contrac-
tion of the ring and little fingers.
The patient who had already been subjected to the
most diversified treatment without effect, having even
been considered as a malingerer, and having been treated
by the author himself by subcutaneous section of several
| stongly contracted tendons with only very temporary
benefit, declared himself ready for any kind of an
operation.
Having been brought then, Feb. 15, under the most
profound narcosis consistent with safety, the author
made a long incision (3 in.) over the elbow just above
the ulnar nerve which was soon exposed. This nerve
was then lifted out of its bony furrow, gently stretched
and again reposited, whereupon the wound was cleansed
and united. Next the author made a section in the
axillary cavity just over the axillary artery, likewise
three inches long; here he isolated the whole nervous
plexus about the artery, dissecting away the thicknerve
ſº In effecting this
he separated both cutaneous and muscular nerves, an
operation of great difficutly, yet the median, radial and
ulnar were recognised by the strong muscular contrac.
tion which followed upon their extension. This wound
in turn was cleansed and closed by suture. Finally the
author made a transverse section, three inches long,
over the convexity of the left clavicle seperated the
platysma and dissected out with two pairs of forceps the
inferior cervical spinal nerves. These he raised out
with his fingers, extending them in the act of elevation
and followed out each one with the point of his finger
up to the vertebral column (an operation more easily
effected than was anticipated). Having reached the
spinal column he pushed them up and down, to the
right and left, exercising a light degree of force in each
direction as if he would draw the nerves from out of
the spinal cord. During these manipulations violent
contractions of the left-arm and pectoral muscles again
occurred. The stretching finished, the nerve cords
which were now looser, but else apparently normal,
were replaced as nearly as possible in their old positions.
Two small cutaneous vessels required ligation, where-
The patient awoke slowly from his narcosis. Fore-
arm and fingers could now be stretched and bent with
ease. The cutaneous surfaces which before could be
penetrated with needles without sensation possessed now
a sensibility so delicate that the patient could percieve
the touch of the fingers. With the most profound
amazement the patient stated that he could now play
with his fingers for the first time since the stroke of the
musket. -
His condition after the operation was not very good
282
[JUNE 15, 1872.
T H. H. C. T.I.N. T. C.
as the chloroform made him very sick and pains soon
supervened in the different wounds. These were not
marked in the elbow and axilla, but were severe in the
neck where the operator had followed out the spinal
nerves and stretched them with his finger. His coun-
tenance presented extreme anxiety which had hitherto
never been observed or experienced, but the result sur-
prised and rejoiced him to such degree that he was in
continual fear that his old pitiful condition would again
return. From hour to hour, however, be became better
and better. The muscles before contracted to strong
hardness softened day by day, and his spirits brightened
accordingly. •.
Sensibility became more and more delicate. For some
little time after the narcosis light convulsions and slight
loss of consciousness still manifest.
On the second day after the operation it became
necessary to reopen the cervical wound to give vent to
an accumulation of a sero-purulent secretion. The
wound was diligently cleansed with a very week solution
of carbolic acid, drainage was established and cold ap-
plied. As the hospital was full of patients suffering
with pyaemia and hospital gangrene the patient was sup-
plied with a respirator provided with a piece of woºl
saturated in a weak solution of carbolic acid, to be kept
over the mouth and nose. He soon objected to this
procedure, however, pretending after 4 or 5 hours to be
suffering from pains in the chest. -
In further course there was nothing special to men-
tion.
comfortable and it is hoped that baths, good mourish-
ment galvanisation and gymnastics will fully restore
him to health.
Finally the author remarks that from this experience,
exposure and stretching of the facial nerve in obstinate
facial spasm deserves a trial as well also might the ap-
plication of this method to the respective nerves be of
service in cases of hyperaesthesia.
—-º-o-º-
The Influence of the Mind upom the Body.
BY
DANIEL H. TUKE, M. D., M. R. C. P.
An Abstract from the Journal of Mental Science (London) April, '72.
Continued from No. 23.
Some emotions affect the cutaneous secretions, not
only in regard to amount but odor. In this and the
vitiated intestinal secretions which occur when fear
acts powerfully upon the system, it is reasonable to con-
nect what in man appears to be useless, and indeed
highly inconvenient, result with the analogous occur-
rence in animals in which flight from the pursuit of the
enemy is often secured.
The patients condition remained in every sense
Urine.—The curious influence upon the renal secre-
tion of a sound which grates upon the mental ear of the
listener, referred to by Shakspeare in a well-known
passage, is no doubt exceptional. . . . .
“And others, when the bag-pipe sings i’the nose,
Cannot contain their urine.” . .
The action of mental anxiety in causing a copious dis-
charge of pale fluid is familiar enough to all, especially
to the medical student about to present himself for ex-
amination, the amount being in a pretty direct-ratio
to his fear of being plucked. The action of the skin is
usually checked, the extremities are cold, and the kid-
neys have to pump off the extra amount of fluid retained
in the circulation. Müller calls it an example of “sup-
pression of the urine,” and though this seems paradoxical
there is in fact a non-elimination of the substances
usually separated from the blood, compared, at least,
with the aqueous character of the whole excretion. Of
complete emotional suppressions of urine I do not know
an instance. The odor may be affected by the emotions,
in man as in animals. - .
The alleged changes in the chamical composition of
this secretion, the result of mental disturbance, are of
much interest, but the forces of fallacy in their investi-
gation are great and may lead to very erroneous conclu-
sions. Dr. Prout states that the depressing passions,
particularly anxiety or fear, will in many predisposed
individuals cause a deposition of the triple phosphates
in the urine. (“Stomach and Renal Diseases,” p. 281.)
In adducing proof that the functional activity of the
nervous tissue causes its disintegration by the agency
of oxygen (in the blood) Dr. Carpenter refers to the in-
crease of alkaline phosphates in the urine after much
wear of mind, whether emotional or intellectual, and
alludes to “more than one case of this kind occurring
among young men, whose anxiety for distinction had
induced them to go through an excessive amount of
intellectual labor during their student life, and who
found themselves forced to pay the penalty of that
excess in a subsequent prolonged abstinence from all
mental occupation involving the slightest degree of
effort.” (“Human Phy.” p. 352.) With regard to the
observations on the state of the urine in the insane,
which have, from time to time, been made, they are
somewhat contradictory. Those of Drs. Sutherland and
Rigby would accord with what one might expect from
the foregoing statements, while those more recently
made by Dr Adam Addison, and conducted with great
care, lead to a different result, although confirming the
conclusion that during a maniacal paroxysm the urine
is very acid, scanty, and of higher specific gravity.
The possible sources of error, however, and the difficulty
of determining the priority of the mental and physical
phenomena, are so great that we shall not enter further
now into this subject.
The influence of certain mental states, if prolonged,
in causing diabetes appears to be clearly proved. Wat-
son specifies “distress and anxiety,” and Copland
JUNE 15, 1872.]
TIEEI IEH C T III INTI C.
283
“great mental exertion, and the depressing passions.”
Bernard's experiments on the vaso-motor nerves and
the centres which control them, in explaining the
pathological symptoms which arise from the changes
induced in the nervous system by definite surgical
lesions, show, also, how the emotions may produce the
same results.” -
Dr. Dickson's post-mortem examination of cases of
diabetes have confirmed these observations. He found,
first, dilatation of the arteries, followed by degeneration
of the nervous substance external to them, and vacuities,
which were most marked and constant in the vicinity
of the median plane of the medulla, the grey matter of
the floor of the fourth ventricle, and in particular, a
spot just internal to the origin of the facial nerve.
Lockhart Clarke has observed degeneration of the floor
of the fourth ventricle, and erosion of the calamus
scriptorius, with destruction of the nuclei nerves. Dr.
Dickson concludes that the nervous changes are antece-
dent, to and productive of the glucosuria, and that
diabetes is primarily and essentially a nervous disease.
(“Medical Times and Gazette,” March 19, 1872.)
Saliva.-Deferring the consideration of the influence
of simple ideas upon the secretion of saliva to the section
“Intellect,” we may refer here to the alleged influence
of anger on the quality of this secretion.
Bichat entertained no doubt that anger and love do
inoculate the saliva with something “qui rend
dangereuse la morsure des animaus agites parces pas-
sions, lesquelles distillent wraiment dans les finides un
funeste poison, comme l'indique l'expression commune.”
(“La Tie et la Mort,” p. 43.) The saliva of an enraged
animal, and the venom of a viper are, according to
Eberle, essentially the same.
In the “Lancet” for July 14, 1860, is the report of a
case of a boy, aet. 9}, who was bitten by a boy in anger.
There was no evidence of rabies, but the boy died. He
was seized with hydrophobia 48 days after the bite, and
died in 24 hours. Trousseau quotes from Van Swieten
the case of a young man who died of rabies after having
bitten his own finger in a fit of anger. Also of an old
woman who died with all the symptoms of rabies, after
she had received a wound from a cock in passion. He
observes that Van Swieten could not admit that a virus,
which was not present in an animal, could by it be com-
municated, and, therefore, conjectured that the cock had
been bitten by a mad fox. This seems rather far-fetched;
but it is difficult to understand why anger does not more
frequently effect the saliva, and poison those who are
bitten by angry persons or animals. Of these cases,
however, and of one cited by the same author from
Ú
*A wound was inflicted on a portion of the anterior surface of th;
fourth ventricle; the abdominal circulation is suddenly accelerated
and the vessels in this region become turgid, just as if the sympathetic
had been divided. Acceleration of the corresponding secretions is the
result, and the flow of urine is much increased. Albuminuria, some-
times accompanies this flow, and sometimes diabetes mellitus. “This
is the case when the circulation of the liver has been also accelerated.”
The presence of grape sugar in the urine is thus referred to the accel-
eration of the hepatic circulation, more of the amylaceous and substance
produced by the liver and afterwards converted into sugar, being
formed than the system can dispose of in a given time, and this surplus
being excreted by the kidney. (Bernard; “Medical Times Gazette,”
Apr. 27, 1861,
Malpighi, who asserts that his own mother died of hy-
drophobia a few days after being bitten by an angry
epileptic, the true interpretation may be, not only that
the character of the secretion was altered, but that those
who were bitten were in a peculiar condition of health
at the time. --
Gaubius records several cases. A soldier quarreled
with a woman, who thereupon bit his hand. He was
seized with rigors and died. An enraged Italian youth,
unable to revenge himself, bit his own hand and was
seized with a deadly fear of water, as if bitten by a rabid
Gaubius confesses himself unable to explain how “such
pestilent corruptions of the fluids are so suddenly ex-
cited.” In reference to this observation, Prochaska
admits that it is quite possible that the nerves, irritated
by anger, may by virtue of their influence over the
Secretions, render them impure, although we cannot
determine in what this impurity consists. (“Laycock's
Translation.” p. 421.) While anger increases and poi-
Sons this secretion, fear checks or suspends it, as is indi-
cated by the parched mouth.
Gastric Juice.—Pleasurable emotions increase the
amount of gastric juice secreted; the opposite effects
being produced by depressing passions. In dyspepsia,
which constitutes so forcible an illustration of the influ-
ence of abnormal mental conditions, a change in the
character or amount of this secretion may or may not
be the principle cause, but that morbid feelings acting
directly on the stomach through the organic nerves, do
form one important element in the psychical genesis of
the dismal symptoms comprised under this term, cannot
admit of doubt.
Fletcher in his “Sketches” mentions a barrister, who
enjoyed perfect health except when anxious during the
assizes. Then the tongue became brown, the appetite
vanished, and if food was taken, severe pain in the
stomach succeeded. His anxiety once removed, his
tongue cleaned, and “his appetite, a distinguished one,
returned with such uncontrollable force, that his limb
of the Law stops at a half-way house in his return home,
When the limb of an animal less dangerous than himself,
Satisfies in some measure the capricious humor of his
otherwise most respectable, and certainly very capacious
stomach.” (p. 19.)
Brierre de Boismont records the case of a convict, who
was greatly surprised and distressed with the verdict he
received. Gastric and hepatic symptoms followed, and
it was thought he would die. He was removed from
the prison. He scarcely took any nourishment, and
suffered from continual nausea, and frequent vomiting,
the matter thrown up being chiefly mucus. Organic
lesion of the stomach and hepatic tumor, were diagnosed.
In a week, however, he improved; he was able to take
a few spoonsful of Soup, and he eventually recovered,
He said (and his doctors agreed with him)—“Si j'etais
resté huit jours de plus dans la prison, j'etais un homme
mort.” (“Annales Medico-Psychologiques,” 1853.
Bile.—Popular opinion connects bile and bad temper
or melancholly together, perhaps more thoroughly than
any other psychical and physical facts, the supposed
order of events being sometimes psycho-physical, and at
others physico-psychal. Gaubius, in asserting that the
natural properties of the juices may be so altered that,
284 j
[JUNE 15, 1872.
T IEEE IEH C T III INTI C.
with astonishing rapidity, the bland becomes acrid, and
the salubrious hurtful—nay, virulent—asks, “Do you
doubt it? I give you the example of a hysterical woman
who, in a passion, vomits vitiated bile of every color
and acridity.” Dr. Carpenter remarks that it is “per-
haps not an ill-founded opinion that melancholly and
jealousy have a tendency to increase the quantity, and
to vitiate the quality of the biliary fluid,” and that “it
is certain the indulgence of these feelings produces a
decidedly morbific effect by disordering the digestive
processes, and thus reacts upon the nervous system by
impairing its healthy nutrition.” (“Human Phys,” p.
982.) The influence of sudden fright in checking the
secretion of bile, and so occasioning jaundice, is adduced
by Bichat, as a striking proof of the connection between
mental states and the secreting organs. Emotional
jaundice, as also emotional cholera, may, as already
stated (antea, July, 1871, p. 178), be also caused by ab-
normal action of the muscular coat of the gall duct and
the intestines, and it would be hard to decide in a given
case to which division to refer the symptoms. Dr.
Budd observes that jaundice, following mental shock,
long continued anxiety, or grief, is often unattended by
any alarming symptom, “but now and then, after it has
existed for some time without any symptoms indicative
of especial danger, disorder of the brain, which proves
rapidly fatal, comes on. After death in such cases,
portions of the liver are sometimes found completely
disorganised. It would seem that some virulent poison is
generated in the liver, which deranges and then paralyses
the brain, and after death comes softening and dirorgan-
isation of the liver itself.” (“Disease of the Liver,” p.
478.) Dr. Wilson Plilip asserts that depression of mind,
if protracted, alters the structure of the liver.
Dr. Badely records the case of a certain great military
officer who left England at an advanced age, to take
possession of his government without his lady, and
without bidding her farewell. As soon as she heard
of his departure, she almost immediately become yellow,
took to her bed, refused all food and medicine, and died
in a very few weeks.
Intestinal Secretions.—Apart from muscular action,
defecation may become urgent, or occur involuntary from
various causes, one being the increased secretion from
the intestinal canal, as from fear, and in Some cases from
the altered character of the Secretion itself. Certain
cases of choleraic diarrhoea (although of course compli-
cated with other pathological states) may be referred to
here.
The story of the Russian convicts under sentence of
death, some of whom were placed in beds falsely said to
have been occupied by cholera patients, will occur to
the reader. Mr. G. Smith reported in the Lancet, of
Aug, 4, 1866, the case of a fine hale blacksmith under
surgical treatment in King's College Hospital, who
carried down the bed on which a cholera patient had
died. He sat up until late, brooding over what he had
done and its probable consequences. He died next
morning of cholera. Those, however, who believe that
cholera is contagious would not admit that, in this case,
fear was more than the exciting cause of the attack.
When, some years ago, the cholera was prevalent at
Newlyn, a fishing village near Penzane, intercourse was
forbidden between the two places. One day a man en-
tered the shop of a barber in Penzance, and was shaved.
On leaving, some one, who had recognized him, asked
the barber if he knew whom he had been shaving.
He replied, he did not. “Why, he's a man from
Newlyn !” It was enough. The terrified barber was
. with cholera, and died within twenty-four
OUII’S.
Mr. —, of Falmouth, some years ago, had the
cholera. When well, he went to the Lizard for change.
The woman who opened the door of the house to which
he went, having heard that he had had the cholera, was
exceedingly alarmed, and had an attack herself.
Catamenia.-It would be tedious to enumerate even a
small proportion of the cases which are on record, show-
ing the influence of moral causes on the suppression of
this secretion. Disappointed affections, everyone knows,
are a fruitful cause, and in such instances there can be
no confusion between cause and effect. The sequence
of the phenomena is also clear when rage operates, as in
a case recorded by Brierre de Boismont, of a lady who
was thrown into a furious passion by some circumstance,
in consequence of which suppression took place. Reme-
dies failed to relieve her, and she became insane. Re-
garded as possessed, she was exorcised, but without
effect. Subsequently, medical treatment restored the
uterine functions, and concurrently, her mental health.
(“Annales.,” 1851, p. 293).
Milk.-The influence of emotional excitement on the
secretion of the mammary gland is generally recognized,
and there is no difficulty in meeting with cases which
forcibly illustrate it. We have only space, however,
for the following:—
Descuret states that during a period of four years, a
young woman suddenly lost her two children and a
foster-child from giving them the breast immediately
after being in a violent passion (“La Médecine de
Passions,” 1841, p. 56). He also cites from Parmentier
and Deyeux, that after powerful emotional excitement,
the mammary gland Secretes an insipid yellowish serous
fluid instead of one possessing its normal white saccharine
character. Copland cites from Graeffe the very striking
case of a woman who received a fright a week after de-
livery. This caused complete suppression of the milk,
followed by ascites and anasarca. Paracentesis was per-
formed, “a bucket of fluid resembling whey, and exhaling
an acidulous odor was drawn off. Upon being boiled
with dilute sulphuric acid, it furnished a substance re-
sembling casein. When tapped six weeks afterwards,
the fluid was of a greenish-yellow, and without the trace
of casein.” (Dict, vol. 1, p. 189).
Tears.-The secretion of the lachrymal glands is,”
we know, excited by joy (and tender emotions) as well as
by grief, its natural excitant.
“Back, foolish tears, back to your native springs—
Your tributary drops belong to woe,
Which you mistaking offer up to joy.”
We must confess with Brodie that we are unable to
answer so simple a question as why or how does a cer-
tain state of mind augment the Secretion of the gland 7
Gratiolet inferred, partly from his own sensations, that
tears result from reflex irradiations which traverse the
JUNE 15, 1872.]
fifth pair of nerves; that is to say, the emotion of joy or
Sorrow acts first upon the heart or other viscera through
motor channels, and is then reflected upon the sensory
nerve supplying the gland. But this track does not
seem anatomically or physiologically justifiable. Much
more likely it is that the influence is transmitted directly
either to the capillaries of the gland by actively dilating
motor nerves, or through nerves to the lachrymal cells
themselves, directly exciting their functional activity.
We might apply to the lachrymal gland, Sinitzin's con-
clusions in regard to the trophic influence of the cervical
sympathetic and the fifth pair on the eyeball, but some
difficulties present themselves, into which, however, we
cannot now enter. -
The quality of the secretion seems to be altered by
powerful emotions, the saline ingredients being increased,
causing “a strong brine.”
Lastly, the secretion may be checked. The intensity
of the feeling or the suddenness of the sorrow is the
most frequently witnessed cause. Taily observation
shows that the first result of distressing intelligence is
the negative one—inability to cry. See, too, what the
want of a handkerchief may do. “I went,” says Hunter,
“to see Mrs. Siddons acting; I had a full conviction
that I should be very much affected, but unfortunately
I had not put a handkerchief in my pocket, and the dis-
tress I was in for the want of that requisite when one is
crying, and a kind of fear I should cry, stopped up
every tear, and I was even ashamed I did not, nor could
not, cry.” (Posthumous Papers, Vol. i., p. 257).
Eachalation and Absorption.—All dropsies, as Copland
observes, may be referred to increased exhalation or
diminished absorption, and so under this head we would
briefly refer to two cases illustrative of the influence of
emotional excitement in checking and exciting these
functions. The influence of the sympathetic nerves
upon absorption has been demonstrated by Bernard,
their division accelerating and galvanism suspending the
process. -
Dr. Py, physician to the hospital at Narbonne, re-
ported in the Gazette de Santé, the case of a boy, aet. 11,
in whom ascites occurred, under the following circum-
stances:—Pierre Peyrel, having lost his father, imagined
in a dream that he returned and embraced him, which
gave him a great fright. He was a pupil at the “Hotel
e la Charité,” and the officers of the establishment were
surprised next morning to find the abdomen distended
(enflé du ventre comme un ballon), as the lad had played,
and taken his food as usual the preceeding day. He
was found by the doctor to be feverish, the pulse small
and hard, and the abdomen painful and tender.
icines having failed to remove the effusion, the surgeon
to the hospital drew off 10 pints (Paris measure) of clear
fluid, the cure being completed by local frictions and
diuretics. -
In the following case of ascites, for which I can vouch,
the fluid was rapidly absorbed, and the action of the
kidneys increased:— - -
A woman, aged about 45, was attended by Dr. B–,
in a small town in Devonshire. He found medicines
perfectly useless, and was, therefore, determined to try
TIHE CLINI c.
Med-
285
his hand (his first essay) at paracentesis. He intimated
to the patient what he intended to do on the following
morning, , which alarmed her much; in fact, nearly
frightened her out of her wits. He invited two of his
medical friends to assist him in the operation. The trio
were duly ushered into the sick room—but no operation I
The fluid had vanished, dicharged chiefly by the bladder.
They found the poor creature exhausted, blanched, and
“as thin as Sam Slick's teetotal lawyer, who had been
drawn º a gimlet hole.” The abdomen was
bandaged, and the worthy doctors walked back to the
surgery to consult, and unriddle the mystery.
In conclusion, a passing reference may be made to
the influence on pulmonary exhalation of emotional
states, the breath being rendered notably offensive by
distress of mind, and to the acid eructations and
flatulence, “partly exhaled from the digestive mucous
surfaces” (Copland), which arise from the same cause.
Of heartburn, an expression which receives an illustra-
tion from Shakspeare, indicates the popular belief.
“How tartly that gentleman looks I never can see
him but I am heart-burned an hour after.” Though
mental heartburn only be implied, the metaphor is itself
a recognition of the relationship between the two states
—bodily and mental.
– sº-o-º-
SCIENTIFIC NOTEs.
POSITION OF THE EPIGLOTTIS AS A SIGN OF PROBA-
BLE LONGEVITY.-Mr. Duncan Gibb has volunteered
the singular observation that the epiglottis occupies a
vertical position in persons who have attained the age
of 70 years, and that depression of this carilage can be
taken as a sign that the person will not attain advanced
age. He claims to have examined five thousand per-
sons in apparent good health, and in all those who were
between 70 and 95 years the epiglottis was vertical.—
N. Y. Med. Rec., June 1, ’72.
PRESERVATION OF SUBJECTS FOR DISSECTION.—In
the Progreso Medico, April 1, we see it stated that a
certain Professor Gaillery has submitted to the approba-
tion of the Royal Academy of Medicine of Belgium a
very simple method of preserving subjects. He placed a
dead body on a table and covered it completely with a
sheet wet with a solution of phenic acid in the propor-
tion of two per cent. ; afterwards, every four or five
days he pours over the body a certain quantity of the
same solution. The first result was the absence of
mephitic emanations, and in examining the body from
time to time it was found to preserve almost the same
appearance as it had at death. The walls of the abdo-
men gradually sunk. The experiment has lasted for
six months, and the body remains in the same condition.
This is a most important discovery.—Medical Press and
Circular.
TOLERANCE OF TOBACCo.—A remarkable instance of
tolerance by the human system of the excessive use of
tobacco is given in The Lancet for May 11. A gentle-
286
[JUNE 15, 1872.
T THE EIH C T , T INT I C.
man of Rotterdam, named Klaés, who was known as
“the King of Smokers,” has just died in his eightieth
year, and is said to have consumed during his long life
more than fourtons of tobacco. The ruling passion was
apparent in the will of the deceased, and in his eccentric
request that his oak coffin might be lined with the cedar
of his old cigar-boxes, and that a box of French caporal
and a packet of old Dutch tobacco might be placed at
its foot, and by the side of his body his favorite pipe,
together with matches, flint and steel, and tinder.—Phil.
Times, June 1, ’72. .
—-º-o-º-
MIELDIGAIL NEWS.
ARMY MEDICAL SCHOOL IN JAPAN.—Three medical
officers have left Prussia for Japan, to establish an army
medical school on European principles, in that country.
The Japanese Government have promised to spare no
expense in founding the establishment and providing
it with all necessary equipments; the object being that
the Japanese surgeons may be rendered equal in knowl-
edge and practical attainments to the surgeons of the
Prussian army.
CENSUS STATISTICS OF THE THREE LEARNED PRO-
FESSIONS.—For the year 1850 there were returned 28,842
clergymen; 40,564 physicians; 23,939 lawyers. For
the year 1860 there were returned 37,529 clergymen;
54,543 physicians; and 33,193 lawyers.
It is perhaps fair to presume that each retains about
the same proportion to each other in the census of 1870.
The following is the number of deaths reported among
clergymen, physicians and lawyers in each State and
Territory of the United States for 1870:—
C. P. L. C. P. II.
Alabama, 19 30 14||Nebraska, 2 I 2
Arkansas, 2 11 9||Nevada, - I 2
California, 17 28 29||New Hampshire, 10 20 10
Colorado, 4 3||New Jersey, 15 20 13
Connecticut, 10 14 9||New Mexico, I
Delaware, 4 1|New York, 74 136 114
I)ist. Columbia, I G|North Carolina, 16 15 10
Florida, 7 4 5|Ohio, 46 66 31
Georgia, 15 30 12|Oregon, 3 5
Illinois, 33 45 31|Pennsylvania, 57 94 50
Indiana, 27 35 17| Rhode Island, 2 5 1.
Iowa, 19 29 8|South Carolina, 13 10 7
Kansas, 9 10 6|Tennessee, 13 23 17
Kentucky, 10 32 20|Texas, 8 33 9
Louisiana, 8 2 13| Utah, 1
Maine, 12 13 12| Vermont, 9 9 4
Maryland, 13 23 16|Virginia, 23 25 15
Massachusetts, 41 42 30|Washington, 1. 15
Michigan, 17 23 23|West Virginia, 7 4. 3.
Minnesota, 10 2 2|Wisconsin, 18 22 12
Mississippi, 7 20 14|Wyoming, 1 -
Missouri, 30 40 13 -** --s --
Montana, l I €29 947 595
CAUSES OF DEATH ASSIGNED.
C. P. L.
Unknown, 10 15 7
General diseases, 242 344 234
DiBeases of the nervous system, 77 143 93
4 & “ circulatory system, 54 73 45
{ { “ respiratory system, 84 130 58
{ { “ digestive system, 7G 105 61
§ { “ urinary and generative organs, 32 37 19
4 & “ organs of locomotion, 3 4 -
& 4 “ integumentary 8 ystem, - I 1. 3
Condition not necessarily associated with general
or local diseases, 39 31 19
Poison, 2 18 13
Accidents and injuries, 9 46 43
— Toner—Brit. Med. Journ., May 30, '72.
west Virginia. state Medical Society.
We are indebted to Dr. S. S. Jepson of Wheeling for
the daily papers containing minutes of the West
Virginia State Med. Society, which met in Wheeling
June 5th, continuing its session for three days. This
is the 5th annual spssion of the Society. It is in a very
prosperous condition and has succeeded beyond the
most sanguine expectations of its friends. Dr. Bates in
his address of welcome stating that its membership had
increased 100 per cent. since 1867. º
The proceedings appear to have been highly satisfac-
tory; papers and remarks were read on subjects,
medical, surgical and scientific. - -
The utmost harmony and good feeling prevailed, but
this it seems was not entire as there appeared to have been
some difficulty between Dr. Hupp and Dr. Reeves, in
which the latter was censured.
Dr. R. H. Cummins of Wheeling was elected president
for the ensuing year. A communication was received
and accepted asking the society to hold its next annual
session at Parkersburg mineral wells free of charge. Dr.
Lazzell, of Fairmouth, the retiring president, delivered
a valedictory; after which the society adjourned to meet
at Parkersburg mineral wells on the first Wednesday in
June, 1873. - -
—-º-o-º-
CHAINICAL VIEM [OIRNADA.
w
TINCTURE OF IODINE IN WOMITING.—Schneider of
Offenburg (The Doctor, April 1, 1872) administered
tincture of iodine in doses of ten drops on sugar thrice
daily to a patient who was troubled with salivation and
vomiting after intermiittent fever. Although the
vomiting had proved rebellious to all other treatment,
it yielded to tincture of iodine.
CIMICIFUGA RACEMOSA AS A PREVENTIVE OF SMALL-
Pox,−Dr. G. D. Norris, at a recent meeting of the
Alabama State Medical Association, “stated that during
the prevalence of small-pox in Huntsville, certain
families, at the instance of some one unknown, had re-
sorted to the free use of the tea of the cincifuga racemosa,
or black snakeroot of the United States Pharmacopoeia
[cohosh], as a preventive of Small-poa. In the families
using the cimicifuga, there occurred no case of the small-
pox, though some were exposed to the disease. In the
same families, Dr. Norris vaccinated the members, but
without effect so long as they continued the use of the
cohosh ; after ceasing to use the tea as a prophylactic,
he again vaccinated them, when the specific effects of
the vaccine virus were procuced. He submitted the
results in these cases as new, and not without interest
to the profession.”—Atlanta Med. and Surg. Journal,
Apr., 1872.
PARENCHYMATOUS INJECTIONS INTO TUMORS.—Dr.
Danzel (Hamburg) reported his experience at the Marien
JUNE 15, 1872.]
TIEET THE C T , I INT I C .
287
Krankenhaus at Hamburg, which brought nothing
particularly new; and Prof. Heine (Imusbruck) read an
interesting paper on “Parenchymatous Injections as a
Means of destroying Tumors.” He had made injections
with pepsine, hydrochloric acid, nitrate of silver and
salt water, iodine, &c., injecting 6-8 subcutaneous in-
jection-syringes full every third or fourth day into the
periphery and centre of the tumor; in general he had
obtained only negative results, in one case, however,
which is still under treatment, the injection of dilute
hydrochloric acid during eight months produced a con-
siderable waste and schrivelling of both cancerous mam-
mae, the duration of which good result is still uncertain.
He also injected a solution of iodide of potassium and
iodine through the rectum into a hypertrophied prostate,
which prevented the free discharge of urine, and thereby
caused an abscess and consequent waste of the glands
and of course the cure of the patient.
Prof. Billroth rose to warn against the indiscriminate
use of such injections into tumors; his results, chloride
of gold, argentum nitricum, pepsine, and alcohol having
been employed, had been entirely negative, except in
one case where the injection of pure alcohol into a large
lymphonia of the neck had caused putrefaction of the
tumor, acute Septicæmia and death on the fifth day.
- A previous incision into the lymphonia had given exit
to a quantity of foetid brown fluid with a peculiar odor
of acetic acid (from the decomposition of the alcohol)
and containing numerous bacteria. The body, although
in winter, became decomposed very rapidly.—Congress
German Surgeons—W. Y. Med. Record, June 1, ’72.
AMBLYOPIA FROM MASTURBATION.—The patient
was a boy of fifteen, affected with congenital phimosis.
He was small, pale, of sad expression. He had com-
plained of his sight growing bad from day to day, and
for some time he had been unable to read.
The test revealed V-1-5; peripheric vision of normal
range ; neither convex glasses nor concave improved
the sight. -
The ophthalmoscope revealed nothing abnormal either
in the media or fundus oculi. Careful questioning re-
vealed the fact that the boy urinated with difficulty,
and also that he stained his pants with urine. An ex-
amination of the genital organs showed a very close con-
genital phimosis. The mother and boy now both re-
vealed the fact that he had masturbated daily for a long
time. Knowing the injurious effects of phimosis in
children, the author proposed circumcission, which was
assented to. A tonic regimen was prescribed, cold
baths, exercise, etc., and the mother was told to exercise
the greatest care over the boy. In a month, both the
general health and the sight had greatly improved.
After several months, the patient urinated easily, and
his sight was quite perfect.—Journal D’Ophthalmologie
April 1872. p p 9té,
TREATMENT OF SPERMATORRHOEA.—Mr. G. G. Gas-
Coyne recommends, in the treatment of this oft times
troublesome complaint, the occasional introduction of a
catheter as large as the urethra will take. It should be
passed into the bladder and allowed to remain for five
or ten minutes, according to the tolerance of the patient.
Its mechanical pressure helps to unload the congested
capillaries and small vessels of the urethra; its contact
deadens and destroys the extreme sensibility of the
urethral nerves and renders them less susceptible to the
influence of slight excitants; whilst by stimulating the
muscles, it provokes their contraction, and so renders
material assistance in emptying the larger veins. A
silver catheter is the best instrument for the purpose,
as it exerts a firmer pressure than an elastic bougie;
and as the urine can be drawn off through it, the patient
will not require to micturate for several hours, which is
a point of some importance, as the urethra is often very
tender after the passage of an instrument for the first
few times. The frequency with which it should be em-
ployed depends upon the amount of discomfort its
presence occasions; and if the pain be great it should
not be left in more than a few seconds, lest rigors,
swelled testicles, etc., be occasioned. Sometimes the
urethra is extremely sensitive, and much pain attends
the use of the catheter; but this is an additional reason
for persisting with it, though a smaller one may be em-
ployed at first, so as to cause less pain. Sometimes
smearing the catheter with calomel or blue ointment, or
with half a grain to a grain of nitrate of silver rubbed
down in an ounce of lard, in obstinate cases is of service.
Care should be taken that these applications do not
reach much beyond the curve of the instrument, and it
should be thoroughly well oiled before using it.—Brit.
Med. Journal.
REMOVAL OF THE KIDNEY.—On Tuesday, Mr.
Durham removed the right kidney of a woman at Guy’s
Hospital, and, we are glad to be able to state that, up to
Thursday morning, she was progressing favorably.
The patient, who is 43 years of age, is the same in whom,
more than two years ago, Mr. Durham exposed the
kidney which was removed on Tuesday, with the expec-
tation of finding a calculus in or about its pelvis, No
calculus being found on that occasion, and the kidney
appearing healthy, the wound was closed. The patient
recovered from the effects of the operation well, and the
wound healed, but she was not relieved from the severe
pain, haematuria, and other symptoms, from which she
had suffered. The patient, early on Thursday morning,
was apparently progressing satisfactorily in every way,
there being no sign of any bad symptom ; the tempera-
ture was normal; the pulse was beating ninety permin-
ute and, although weak, not more so than frequently had
been the case before the operation; and the patient had
less pain than she had constantly suffered for a long
time previously.—Brit. Med. Journ., May 18, '72.
MR. DURHAM's operation of extirpation of the kidney
has ended fatally,–Ibid, May, 25,
288
[JUNE 15, 1872.
TIEEE CI.I.INI c.
O H I O S T A T E MI E D I C A L S O C I ET Y.
ANNUAL SESSION OF 1872.
PoRTSMOUTH, OHIO, JUNE 11, 1872.
Special Correspondence of THE CLINIC,
The Cincinnati delegation* reached Portsmouth at
7 A. M. to-day and were right royally received at the
new and commodious Biggs House on the river bank.
At ten A. M., the Society was called to order by the
President Dr. Dawson in the chair. The Opera House
in which the assembly convened is a very neat and con-
venient hall close to the hotel about as large as, but
more comfortable than Hopkins Hall. Not more than
50 delegates were present at the opening of the exercises
but all day long they have been pouring in so that full
Dr. Jones the
chairman of the executive committee has made excellent
one hundred and fifty are here to-night.
arrangements in every particular for the comfort and
entertainment of the numerous guests so that a really
enjoyable time is to be realized.
The morning was occupied with the organization of
the various committees and sundry miscellaneous
business, in which we are pleased to note there is no
report from the committee on ethics. A propositoon
from the finance committee to raise dues to $300 to
meet the necessary expenditures was thrown over-
board by reducing the salary of the Treasurer from $150
to $50, whereupon the treasurer, Dr. Thompson, re-
signed his position and Dr. Gray was elected in his
place. It was really sad, the manner in which the old
treasurer of 27 years, all of them of faithful labor,
presented his papers; but then $150 was really out of
all proportion to his services, considering that the
onerous duties of the secretaryship are not to be re-
warded at all, -
Two papers were read this afternoon, one by Dr
Scovill on the transmission of nervous influence, really
on nerye force and dynamics; an exhaustive and learned
compilation of all the more recent views on the subject
including the latest agony on the polarisation of
molecules of matter; and one by Dr. Bartholow on the
therapeutics of electricity. This last paper was a hand-
*Drs. Dawson, Bartholow, Conner, Steyens, Seely, Iſeyt, Hadlock,
Whittaker. ... "
Some resumé of the novelties in electro-therpy, illustrated
principally by cases from private practice. The paper
was received with a good deal of applause, and elicited
quite an interesting discussion.
To-night comes Dr. Keyt on “The Semeiotic Value of
Yellow Elastic Tissue in Sputum.” Other papers
announced as ready are as follows: Dr. Seely, “Report
| on Otology; ” Dr. Conner on Hernia Cerebri, Dr.
Whittaker on The Year's Contributions of Physiology
to Practical Medicine, Dr. Dawson the Annual Address:
a volunteer paper by Dr. Bartholow on Aneurism of the
Basilar Artery, and others not yet reported. -
It is impossible at this writing to predict the results
of nominations. Probably Dr. Jones of this city will be
elected president, and Dr. Hadlock of Cincinnati, Sec-
retary. -
To-morrow evening we are to have a grand supper by
the citizens of this city. To-morrow the Holly water
works exhibition, and Thursday a visit to Gaylord &
Co’s iron foundry and steel works. *
—-º-o-º-
HERO HUNTING.—Sympathy seems sometimes to be
a cover for inquisitiveness, just as philanthropy is some-
times only an allotropic form of fussiness. If European
forms of sympathy are as obtrusive as the Transatlantic,
the mutilated heroes of the Franco-German war must
have a hard time. A one-legged survivor of the
American strife declares that his physical sufferings are
much enhanced by being incessantly subjected to
interrogatories, which he publicly catalogues, with a
request that they may be brought to an end.
“I can never,” says he, “obtain a moment's rest in any
public place. I no sooner take a seat in a car, restau-
rant, or lecture-room, than Some one near me, whom I
have never seen before, introduces himself with the
stereotyped remark, ‘I see you’ve met with a misfortune,’
and, on my assenting, proceeds to ask the following
questions, ‘Did you lose your limb in battle? What
battle? Did a cannon-ball take it off? A rifle ball, eh?
Did it knock it clear off? Did it sever an artery 7
Did it hit the bone? Did it break it? Did you after-
wards find the ball? Was it crushed out of shape
Did you falk when hit 7 Did you walk off the field 2
Who carried you off? Did you feel much pain? How
long after you were wounded was it amputated? Who
performed the operation? Did you take chloroform?
Did it put you to sleep? And didn’t you feel the opera-
tion? Not even the sawing of the bone? Could not
your limb have been saved ? Was it taken off right
where the wound was? Can you wear an artificial leg;
Would the Government furnish it if you could? Do
you draw a pension? How much? How old are you?
What is your name? What did you do before the war?
Don't you often wish you hadn’t lost your leg? How
does a person feel with a leg off? Does it ache when
the weather changes? Would you rather lose a leg
than an arm 2 I have heard persons say that an ampu-
tated limb still feels as if it were on ; is that so? How
do you account for that?’”
,, . . . . . . . . e.
tº t º, -º-;
----.”
Xº III,
Z23)
Carriage Manufacturer,
resumasa sº wºn asſamº.
I MAKE NOTHING BUT
Jø//*S 7" CºA, 27 S S W 0/PA’,
Of every variety and style, embracing all the improvements in Carriages of any value, many of
my own invention and used only by me. My experience in the construction of large Carriages,
such as Landaus, Clarences, Landauletts, Broughams, Coupes, Callaches, Coupaletts is unsur-
passed. Of - -
LIGHT FAMILY CAFFIAGES
Rockaways, Bretts, Victorias, Phaetons, Barouches, Eugenias, Nilssons &c., I make a very ex-
tensive variety of light elegant designs of different cost and finish. In vehicles especially,
adapted to - . . - d . . .
Physicians' Use.
The annexed engravings Nos. 80, 82, 83 and 77 are popular selections from a number of styles
Imake for that purpose. - -
• . - - - The superiority of my light gentlemen's
buggies, road and trotting wagons, and
racing work of every description, has long
been acknowleged. Catalogues and price
lists furnished on application. References
to Dr. W. W. Dawson and all the leading
NZ_L\Z Physicians in the city and heighborhood. Y
83 77









O' D C R L E ss A NIP PAL.A.T A. H. L. E.
, - “. .
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency. ; : «s ºf sº- - - - - - . . . .
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded. -
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachitic Affections, in
Chronic Rheumatism, &c. ... . . . - - . . . . . . . . . . . . .
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated. .: *
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN wVETH & BROTHER, 1412 Walnut Street, Philadelphia.

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Good sa MARITAN Hospita L.
The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of Sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
with commanding views, surround the whole house, and wide
pointments of a First-class Hospital. Porticoes,
entilation which is so essential to health and comfort.
halls and abundant windows secure that full and free V
Service is furnished by the
sts.TLRs or CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford.
endance of the house is supplied by the Faculty of the Medical College of Ohio, each
The regular Medical Att
ent. Patients may, however, select from the regular profession
Professor presiding over his own especial departm
of the city any physician of their choice.
The GOOD SAMARITAN HOSPITAL presents extra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment.
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
service. . . ' -
gas-Address, - .
SISTEER ANTHONY,
Hospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio.




























































William Autenrieth,
ROBERT
CLARKE & CO's.
No. 71 WEST sIXTH stEEET,
BETWEEN WALNUT AND WINE,
CINCINNATI, OHIO,
MANUFACTURER OF AND DEALER IN
{I}|| || || ||||||||ſ.
Abdominal Supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Koeps constantly on hand a full variety of
Metalic and Rubber Syringes,
Stomach Pumps, Etc.
STOCKINGS FOB WARUCOSE WEDNS,
Special attention given to the fitting of Apparatus for Deformities.
Bay Agent for DR. L. A. BABCOCK'S
$ilver Uterine Supporter,
-AI,SO—
DR. AHL's POROUS FELT SPLINTS,
|
*
S TH> T, IN T S
-AND-
—A LSO–
T) A. Y. * S
HAMMOND ON NERVOUS DISEASES.
|WOGEL ON DISEASES OF CHILDREN. 8vo.
BARTHOLOW'S HYPODERMIC MEDICATION.
LIST OF NEW
MHL iBTH in Mällis Hill;
GREEN'S PATHOLOGY AND MORBID ANATO MY, 8vo.
Cloth. $2 5o -
DUCHENNE'S LOCALIZED ELECTRIZATION. 8vo. $3 oo
DILLENBERGER ON WOMEN AND CHILDREN'S DIS-
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BENNETT ON PULMonoRY CONSUMPTION. 8vo. $1 5o
FIRST HELP IN ACCIDENTS. 12mo. $1 50
BEASLEY'S DRUGGIST RECEIPT BOOK. 8vo. $3 go
ECHEVERRIA ON EPILEPSY. 8vo. Cloth. $5 od
HOWE ON EMERGENCIES. 8vo. $3 oo
8vo. $5 od
RINDFLEISCH's PATHOLOGICAL HISTOLOGY. $6 oo
WARINGS' PRACTICAL THERAPEUTICS, 2nd Am. Ed.
8vo. Cloth. $5 od Leather. $6 oo -
SCUDDER'S SPECIFIC MEDICATION. 12mo. Cloth.
TANNER'S HANDBOOK OF OBSTETRICS. 12mo.
WAN BUREN ON DISEASES OF THE RECTUM.
. Cloth. $1 5o - -
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- - Cloth. $4 5o
BEARD AND ROCKWELL’S MEDICAL AND SURGICAL
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Leather. $3 25 *
$2 50
$2 oo
I 2 Iſl O.
I 2 II] O.
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TILT'S CHANGE OF LIFE. 8vo. Cloth. $5 oc
NEUMANN'S HAND-BOOK OF SKIN DISEASES.
Cloth. $4 oo *
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PANCOAST'S OPERATIVE SURGERY. 4to., with many
plates. $10 oo -
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12mo. $1 75 -
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CHILDREN. -
Medical, Scientific, and other Catologues sent on application.
Any book in the above list sent by mail or express, free of charge
on receipt of price.
12mo. $1 25
$1 75
: “…
S. W. Elliott’s Saddle=bags
65 West 4th Street, Cincinnati, Ohio.
st of Pharmaceutical Preparations,
Jonºv wrera e anorarn,
PHILADELPHIA.
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIRVALERIANATE OF AMMONIA, •
(Goddard’s Formula,)
ELIXIRVALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE FYROPHOSFEATE OF IRON, - -
FERRATED ELIXIR OF CINCHONA,
ELIXIR OF CALISAYA BARK, ". oice Aromatics,
ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES, -
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Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OFIRON,...
- FERRATED CORDIAL ELIXIR,
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WINE OF WILD CHERRY BARK,
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- - TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
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Extract of Beef, Citrate of Iron and sherry wine,
ELIXIRVALERIANATE OF STRYCHNIA, WINE OF PEPSIN
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eare, and of every variety of combination. Lists sent on application. -
SPOINGE TENTS.—For the Urethra, of every size and 8tyle, made of finest quality of sponge.

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CINCINNATI.
- FA C U L T Y.
J A M E S G R A H A M, M. D., D EA N,
JProfessor of the The Ory and Practice Of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., . . W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics.
W. H. GOBRECHT, M.D., jºs -
I’rofessor of Anatomy. . T. A. REAMY, M.D.,
P. S. CONNER, M.D., Professor of Obstetries and Diseases of Children.
Professor of Surgical Anatomy. '*'.
JAMES T. WHITTAKER, M.D.,
I’rofessor of Physiology.
Professor of Principles and Practice of Surgery and Clinical Surgery.
JOHN L. CLEVELAND, M.D.,
Demonstrator of Anatomy.
SAMUEL NICKLY'S, M.D., - CHARLES KEARNS, M.D.,
Professor of Physics and Medical Chemistry Assistant to the Chair of Surgery.
WV. V. S.E.E.T.Y., M. D.,
Professor oſ IDiseases of the HSye and FCar, and Secretary of the Faculty
*--~
T. LOUIS BROWN, M. D., Prosec (or of Anatomy. - E. NoBLE, Janitor, College Building, Sixth St., bet. Vine and Race


























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C IN C IN N ATI,
*
J U N E 22, 1872. No. 25.
Vol. 2.
was. T. whirTAKER, M. D. : - - - - Editor,
No. 101 West Ninth Street, Cincinnati.
W. W. SEELY, M. D., sº tº º ºs. º ºs TREASURER.
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printed and Published by THE CLINIC Publishing
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on Io state MEDICAL society NUM IEER.
THE PRESIDENT's ADDREss, delivered at Portsmouth, O., June 13,
'72, by W. W. Dawson, M. D ...289
Transactions
Finst Day—The Call to Order–Report of Executive Committee—
The Reception Speech—Treasurer's Report—Twenty Minutes
Papers—Announcement of Volunteers—A Bony (?) Heart.
Afternoon Session.—New Members—Country Societies—Essays;
Nervous Transmission, S. S. Scovill—Therapeutics of Electric-
ity, Roberts Bartholow.
Evening Session.—Essays; Elastic Tissue in Sputum, A. T. Keyt—
Hernia Cerebri, P. S. Conner....... 294-296
is is e º ſº tº ºn
SEGGND DAY. —The Status of Auxiliaries—Finance Report—Elec-
tion of Officers—Essays; Medical Chemistry, J. B. Hough—
Otology, W. W. Seely—Fracture Apparatus, Dr. Gay.
Afternoon Session.—Refracture of Femur, W. W. Dawson—Multiple
Tumors, A. Andrus—The Water Works, Manufactories and
Banquet.........................................------------------------------------ 296–298
THIRD DAY. —New Instrument, T. A. Reamy—ESSAYS ; Amputa-
tions, T. H. Kearney—Physiology in Practice, J. T. Whittaker
Obituaries—The Presidents's Address—Standing Committees
Fºº —Special Committees—Appointment of Delegates--The Round
* T of Thanks in a Rising vote--The Fall of the Gavel *r-sº
Medical College of Ohio.
THEWhole Report of the Transactions, from beginning
to end, is an earnest of the zeal and industry of the
newly and meritedly elected Secretary, Dr. J. W. Had.
lock, of this city. ...sºsºsºsºmº
is The Proceedings of the Academy of Medicine are
crowded over to the next number.
Corrections.—In the last number of THE CLINIC Sec-
ond original article, the word Cephalatomia appears
in both title and text for Cephalaematoma, Wastemburg,
as place of author's residence for Wurtemberg, and in
.255-300
The Dental
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tº 2
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tº T H E c T, INTI c.
289
Vol. 2.] s A T U R D A Y, J U N E 22, 1872. [No. 25.
O HIO STATE MEDICAL SOCIETY
N U M B E R .
T H E PR E S I HD E N T 2 S A D D R E S S .
BY
W. W. D.Awson, M. D.
Gº-mºssºms; mºsº
Delivered before the Ohio State Medical Society June 13, 1872,
**mº
I propose to occupy this hour of your time with a few
reflections upon the American Profession of to-day in com-
parison to what it was twenty years ago, especially do I
wish to contrast the teaching of the present with that of the
past. Annual addresses, both state and national, are
very much the same, so alike are they that the anti-
quarian in looking over them will imagine them written
by the same hand—dictated by the same brain. They
all eulogize the honor, the dignity, the divinity-kinship
of the Profession, but deplore at the same time the want
of a high esprit du corps among its members, the fearful
ignorance of medical students, and the great defects of
medical education. To hear these railers you would
think we are in a most deplorable condition.
As this has been so general I think I will be excused
from departing from a custom, so long and so faithfully
if not profitably observed. It may profit us to look at
physicians as they are, at medical students as we see
them scattered over the land teaching country schools,
as we find them grouped in medical colleges, and at the
manner and success of medical teaching.
Physicians form a large body of men, everywhere
needed, everywhere present, in village, town and city.
In character standing and influence they are in advance
of any other class. Here and there an unworthy one is
found but the great mass of them are men of temperance,
integrity and high moral worth. They lead in works
of benevolence, they respond to the call of humanity,
they leap to the front when their country is in danger,
they are identified with all efforts for the development of
man's physical, moral and mental nature. Amongst
themselves an esprit du corps characterizes their inter-
course to which all other avocations and professions are
Strangers, an esprit du corps, which, in its high tone, in
its utility for protection and defense, in its ability to
generate and maintain the kindliest relations between
its members, is a marvel and a wonder to the non-pro-
fessional.
Who are the medical students found yearly in our
Medical Colleges 2 They are young men gathered in
large proportion from country school houses; many of
them have graduated at Literary Colleges, most of them
have fair educations, and in a very large number of
cases, the education is the result of individual effort.
It is from this class of self-developed young men that
have come the physicians of to-day and from these
physicians have arisen the men who give distinction
to all departments of medicine. I say distinction for in
many respects the Physicians of America are the peers
of their fellows in any land.
It will not be inferred that I underrate in the student
the advantages of a thorough classical education. What
I mean to say, is, that the profession is in better condi-
tion than could be inferred from our annual orations on
the defects of medical education, and what I hope to
prove, is, that the real defects are gradually being reme-
died, and that in time, and in a very short time too,
medicine here will be as well taught and students will
be of as high character as in any place on this globe.
The marvel is that as much has been accomplished as
has when we look at the history of the country
and the early surroundings of most medical men. Sur-
mounting all difficulties, overcoming all obstacles, by
hard study making up for the deficiencies of thorough
early training, the American Physician to-day stands
abreast with the most distinguished, he brings his achieve-
ments, his successes, his improvements, and his discov-
eries and places them by the side of those gathered by
the sons of more favored lands; these achievements,
these discoveries, though probably not so numerous are
equally positive, equally meritorious, are in fact great
contributions to medical science.
The reforms insisted upon by those who dwell upon
the defects of our system of medical education consist
of three recommendations, First, a higher standard for
the Doctorate. Second, Longer sessions. Third, Graded
studies. These are important suggestions, and fortu-
nately for all parties the faculties of medical colleges
have generally been alive to them, and as I have already
said I hope to show that the radical defects of medical
education are gradually but steadily being remedied,
that sessions are gradually being lengthened, that lec-
tures with this increase of session necessarily become
graded and that the Doctorate yearly advances in worth,
honor and dignity. This advance is as steady and faith-
ful as it is desirable. *
In proofof what I have said let us look at our Colleges,
the time and manner of teaching, the qualifications of
the young men who come to be taught and who in the
end receive the degree. In most of our Colleges, in all
I may say, the length of the session amounts to six
months, formerly it was but four, then it was increased
to five—now however, with a preliminary course in
September which a large portion of the class attends,
the session is in reality six months long. In less than
half a decade the introductory in all colleges to the
regular course will be delivered on the first Monday o
290
[JUNE 22, 1872.
T THE TEE C T , IITNT I C.
September and the valedictory on the corresponding
day in March. The times demand the advances—the
Colleges will undoubtedly make them. Already grad-
ation in sludies has been adopted by one leading college
and its example will be followed by others. The graded
teaching as established at Harvard can be markedly
improved upon, in many respects it is better than the
old system of repetition, in some it is not so good, still
it is a step in the advance and as far forward as the
circumstances would justify.
If you compare the manner of teaching now with what
it was forty years ago or even twenty, the improvement
will be as marked as they are hopefully inspiring.
Take Anatomy, the basis of the whole structure—
twenty years ago the Bones and Muscles occupied
almost the whole course—these with a few and a very
few lectures on the Viscera, Arteries and Nerves were all
that were vouchsafed to the student. Now most schools
have two professorships devoted to Anatomy, one to
Anatomy proper the other to Surgical Anatomy, Wilsom
inaugurated a new era in the teaching of this important
branch, he brought form out of chaos, he showed how
to teach Anatomy by teaching the relations of various
parts to each other and faithfully and profitably have
the Anatomists of the whole world followed his example.
Now when a student leaves his College he knows more
than than the origin and insertion of a muscle, more
than that an artery is a branch of the aorta, more
than that the stomach is in the abdomen. He is taught
the situation and topography of the organs, the relation-
ship of the various parts. He knows where to cut to
divide a muscle, he knows where to seek for an artery.
I do not overstate the fact when I say that the present
intelligent and efficient manner of teaching anatomy in
comparison to the past is as light to darkness.
Think for a moment how Chemistry was taught
twenty years ago and how it is taught to-day. Then
the whole ante-holiday part of the session was devoted
t) the fearful imponderables. In the last half of the
term somewhat of Oxygen, Carbon, Nitrogen, Hydrogen,
Alkalies, Acids, and Salts was discussed. Medical Chem-
istry was not reached, the analysis of the secretions and
excretions did not enter into the list of what was re-
garded as essential in a medical man’s education. Now
however, the graduate if he has been diligent, is master
of these subjects, at least he has been so instructed that
he has all the elements of success. He is drilled in
urinalysis, he knows how to examine sputum, he can de-
tect poisons and furnish the antidote for them in fact he is
or has had the opportunity to be thoroughly competent to
do all those things in Medical Chemistry required in the
intelligent practice of his profession.
In Materia Medica one of my Professors read from
dingy, smoky manuscript that had seen service for
twenty years. Once in a while, and a long while, a
fresh scrap of white new paper could be seen interleaved
with the yellow veterans. Now and then a specimen of
plant or of earth, or of mineral was presented. The
dryness, the dullness, the want of interest in that course
is not easily forgotten. I do not select this course of
lectures because it was an exception—it was a type.
In Therapy the student was regaled with learned dis-
quisitions on the fluids and solids, and the action of
medicine upon them. If a man twenty years old in his
profession will enter the room of the Professor of Materia
Medica and Therapeutles of to-day he will be struck
with the change. By throwing out the hundreds of
useless agents and confining himself to the essentially
valuable, by an intelligent discussion of their qualities,
uses and indications, by a philosophical estimate of their
actions, by an accurate knowledge of the parts of the
body upon which they exert their influence, the Pro-
fessor makes this department one of the most interesting
and captivating to the student.
Pharmacy is the legitimate offspring of an advancing,
demanding spirit in the profession. Compare the
elegant preparations of our Pharmaceutist with the
villianous compounds which were prescribed a few years
ago. Our patients, if not ourselves, have great cause
for felicitation.
Perhaps in no department has twenty years made
such striking changes as in the teaching of Physiology.
At that time in most of our schools Physiology Was
appended to the chair of Anatomy and positively received
no attention at all. In some schools a seventh chair was
added called the Institutes of Medicine, this embraced
or should have embraced Physiology and Pathology.
One of the schools which I attended had a Professor of
the Institutes, he was called a Giant in Physiology. This
Giant spent a large portion of his time in teaching us
Phrenology and Mesmerism; occasionally he relieved
the tedium of these twin sciences by a lecture on vital
forces. Another Professor in this department lectured
from manuscript from which he seldom raised his eyes.
These Giants had both been educated abroad and taught
Physiology as they had learned it. Now the student is
taken into the laboratory and taught the functions of
the body by experiment—by vivisections. The gastric
fistula by which digestion can be watched and estimated
is now not an uncommon spectacle in our medical
colleges. The functions of the nervous, lymphatic and
glandular systems, the part which the great organs take
in the animal economy are demonstrated with remarka-
ble exactness. -
When we reflect on the manner and successs of teaching
the elementary branches, Anatomy, Chemistry, Physiol-
ogy and Materia Medica of the present in comparison to
what it was a quarter of a century ago we cannot but
be struck with the hopeful contrast and we must admit
that with all the defects of our system of medical teach-
ing, that it is, all things considered, equal to any other
department of science or letters in our new and develop-
ing country.
This brings us to a review of the present manner of
teaching the practical branches, the application of the
elements. And first I may say that almost everywhere
JUNE 22, 1872.]
in our country, Didactic and Clinical instruction go hand
in hand. The importance, the absolute necessity of the
union seems to be recognised by all. To Cincinnati
belongs the honor of first uniting in this country a Col-
lege and Hospital, Dr. Drake was the author of this
system and from this initiative have grown results of
the most lasting benefit. Colleges and Hospitals are now
most intimately associated, not usually made one and
the same institution as was projected by Dr. Drake, but
so associated as to make the Clinics of the Hospital com-
plementary to the Didactics of the College. But few
schools are to be found without a College Dispensary at
which students are trained in diagnosis and treatment.
The chair of Gynaecology has been added in most of
our colleges, thus rendering the instructions upon the
diseases of women much more thorough and practical
than was possible under the old regime. The diseases
of the uterus, its degenerations, malignant and non-
malignant, its changes of position and shape, its intimate
relations with and modifications of its neighborhood
furnish subjects for a full course of lectures, the vital
importance of which need not here be discussed.
In the Practice of Medicine the student is no longer
sent away with theories and prescriptions, educated in
the pathology of disease daily drilled in its diagnosis, he
goes easily to the best remedies for its treatment.
Physical Diagnosis is not old, but the last ten years has
added very greatly to its exactness, to its reliability.
The use and value of the Stethoscope is rendered familiar
to the student because at the bed side he is taught the
interpretation of the sounds transmitted through it. He
knows when he leaves his Alma Mater what this means
at the base and what that means at the apex. Ther-
mometry now so important an adjuvant in revealing
the vital condition is taught in the same practical
manner. The Sphygmograph, a refinement in diagnosis
is presented if not estimated. I think it would be diffi-
cult to find a medical student of two years of age who
could not tell you when and how to use the Induced
Current and in what cases the Continuous Current is
applicable. In the application, if not in the literature
of this great remedy, we are certainly not behind the
most advanced. -
We have now the two special departments of Oph-
thalmology and Otology, the importance of which is
being so thoroughly realized, not alone for their practical
results but as well for the opportunity afforded of pre-
senting through them so many general points, and the
student now has this additional advantage over the
student of even ten years ago.
When we come to review the present with the past of
Surgery we may say that in America Surgery has always
been well taught, and the world knows how successfully
it has been practiced. The achievements of American
Surgeons furnish among the highest adornments of our
history. With what pride we constantly refer to the
triumphs of such men as McDowell, Dudley, Mott,
T EHI E3 CT, ITN. T. C.
291
Physic, Mussey and Blackman. Europe as well as
America is filled with the renown of many of our lead-
ing living surgeons. The "Europeans read their books,
discuss their papers, use the instruments of their in-
vention, admire and adopt many of their original oper-
ations. The foreign surgeon when criticising American
surgery is generally just—sometimes unjust—occa-
sionally ungenerous. The following paragraph from
the recent valuable work on the Science and Practice
of Surgery by Frederick James Gant belongs to the
latter class; in discussing the the history of Ovariotomy
he says: “Extirpation of ovarian tumors, cystic or solid,
is an operation of comparatively recent date, suggested
by Dr. Wm. Hunter, advocated by John Bell and first
practiced by Dr. McDowell in 1809, the latter an Amer-
ican pupil of John Bell. Ovariotomy is, therefore, un-
questionably, an operation of British origin, and it is to
the labors of British surgeons that its subsequent progress
is chiefly due.” Mr. Gant is somewhat more accurate
than his neighbor Mr. Butcher, of Dublin, who in a late
article attributes to Mr. Lizars, of Scotland, the credit
of having first performed the operation. Mr. Lizars cut
into an obese woman in 1823 but found no ovarian dis-
ease, while Ephraigm McDowell, of Danville, Ky., per-
formed Ovariotomy successfully in 1809. His patient
lived for years after. How absurd and unjust in Mr.
Gant to claim the honor of this great operation for
British surgery when we remember that Great Britain
never had a completed case until 1840, nor a successful
one until 1842, and especially as up to that time the
operation had been performed in America more than
forty times.
This pioneer operation of Ephraigm McDowell may
justly be regarded as the most daring feat in the history
of surgery. Imagine his surroundings, in the “back
woods” of Kentucky, in 1809, it was indeed a back woods
full yet of Indians and wild animals, there, in that almost
unbroken wilderness, with no counsel, no support, he not
only conceived, but successfully performed that wonder-
ful operation. Realize if you can the intrepid heart and
force of brain of that early American Surgeon as he made
the first incision in that case—as he progressed in that
operation—an operation hardly thought of, occasionally
suggested, but never really advised. Picture if it be
possible the surroundings of that man and then you may
have some idea of his great knowledge, his wonderful
nerve and his unequaled self-reliance.
Benjamin Dudly was as successful in Lithotomy as is
Sir Henry Thompson to-day with his selected cases of
Lithority. -
American surgeons have taught the world that Vesico-
vaginal Fistula is almost always remediable, they did
not originate the operation, but they have shown how
it can be successfully performed, and that too under the
most unpromising complications. You will realize the
truth of what Isay when I tell you that a colleague of mine
during a recent visit to Europe witnessed the treatment
of a case of Vesico-vaginal Fistula in a London hospital
292
[JUNE 22, 1872.
TIEEI IEH C T , I INTI C.
by the daily application of Nitrate of Silver. The tide
of surgical students might with profit be reversed.
Such Hospital Surgeons could learn something, could
indeed learn much, by visiting this country. The relief
of one case of Vesico-vaginal Fistula is worth a whole
lifetime of labor, it is a diadem in the crown of a surgeon
and I am proud to say that most American Surgeons
have a number of these jewels.
Pulleys and Adjusters have given away to manipulation
in the reduction of dislocations, the key to this was
furnished a few years ago by a New York surgeon.
What a revolution in the treatment of fractures we
have made by elastic extension and sand bags. The
surgeons of all countries read Dr. Hamilton's book on
“Fractures and Dislocations,” they read it because it is
the best book in any language. For the general practi-
tioner what book can be compared to Gross' System of
Surgery.
A new era has dawned in the treatment of joint dis-
eases, especially disease of the hip, and it is most doubt-
less true that the most valuable contributions are due
to the learning and skill of New York surgeons. Where
except in this country do you find Morbus Coxarius so
treated as to secure complete use of the limb and joint?
I might extend this list of American contributions to
surgery very greatly and with instances equally striking
as those already presented, for it cannot be denied that
in surgery we have given as much as we have received.
And here I may make the pertinent inquiry; if our
system of medical education be so defective why this
great excellence in the men who have been educated
by it? It is unusual to see such fruit from a tree that
is all unsound.
The annual examination for the degree of Doctor of
Medicine in most of our colleges is now made by written
questions and written answers, thus a better knowledge
of the student’s ability is obtained than by a thesis
written in his own room with books and his room mate
or some medical friend to draught upon. The plan is
essentially the same as that adopted in Great Britain in
the examination for Degrees, License, for Hospital Interne
and entrance into the Army, Navy or India service.
And now let us look for a moment at the questions pre-
sented in this country and in Europe. For comparison
I take those given by the staff of the Cincinnati Hospital
at the last examination for Internes, and those adopted
by the faculty of one of our colleges at a recent exami-
nation for the Degree. I use the questions of these two
institutions because I happen to be in possession of them
—I have no doubt however but that they are fair types
of those used in most of our Colleges and hospitals.
Questions Submitted to the Candidates for the Position of Interne in Cincin-
nati Hospital, 1872.
O}}STETRICS.
1. Name the positive signs of pregnancy. . . .
2. What presentations are unnatural requiring interference 2 .
3. Where the face presents what relation must its long diameter
sustain to the inferior strait for safe delivery 7
4. How is assistance to be rendered when the presentation is dis-
tending the perimeum ? -
5. Where and how soon should the funis be tied after the expulsion
of the foetus 2
6. What are the signs of placenta previa?
7. Name the displacements of the uterus.
8. Name the symptoms of prolapsus uteri.
9. How would you treat dysmemorrhoea 7
10. How would you treat amenorrhoea 7
OPHTHALMOLOGY.
1. How would you treat foreign bodies lodged in the cornea 7
2. Give a differential diagnosis of simple conjunctivitis and iritis.
3. What is accommodation and how is it effected ?
4. What is the difference between presbyopia and hypermetropia 2
5. What nerves supply the muscles of the eyelids and eyeball?
6. Give the diagnosis, course and treatment of ulceration of the
CO1 nea.
7. Give the diagnosis and sym É. of cataract.
8. Describe the treatment of diphtheritic conjunctivitis in its three
StageS.
9. Give the diagnosis and treatment of acute granulations.
10. Ilescribe the different methods of operating for entropion of the
lids.
SURGERY.
1. In strangulated hernia what difference in the dissection of the
division of the strictures is necessary to avoid the internal
epigastric artery in cases where that stricture is at the internal
ring and in others where the stricture is at the external ring 2
What is the condition of the skin in eczema, the pathological
products of that disease, and its chief symptoms ?
Name the common forms of gangrene.
What effects may be obtained from poultices and mention some
of the conditions indicating their use ?
wººion of the alimentary canal is apt to occur in cases of
urn ? .
At what point is the clavicle most frequently fractured, state the
symptoms indicating such injury and what are the chief indi-
Cations in the treatment 2
At what portion of the urethra is stricture most frequent 2
State the chief characteristics of the initial lesion or sore of
syphilis and those of the soft sore or chancroid respectively.
What is Hunter's method of ligature of arteries for aneurism
and the principle on which it is based ?
Mention different means for the arrest of hemorrhage.
&
:
:
PRACTICE OF MEDICINE.
What is your method of taking the clinical history of a patient 2
How do you distinguish between pleuritic effusion and consolid-
ation of the lung from pneumonia 2
Give the diagnosis and treatment of pericarditis-
What pathological conditions may produce dropsy % º
How would you proceed to investigate a specimen of urine 2'
On what different pathological conditions may Bright's disease
depend ?
What conditions may produce hemiphlegia 2
What is the difference between dysentery and diarrhoea 7
What causes may produce obstimate constipation ?
Give the symptoms and treatment of delirium tremens.
1
PATHOLOGY.
Origin of pus corpuscles.
Pathology of thrombosis.
Pathology of embolism.
Minute anatomy of healing by granulations.
Pathology of miliary tubercle.
Pathological characters of a malignant as distinguished from a
benignant tumor. - -
Morbid anatomy and pathology of cerebral hemorrhage.
Pathology of cardiac hypertrophy.
Pathology of aneurism.
Morbid products in pleurisy and the manner in which, they are
disposed of. -
I
The following Questions, ten in each Department, were submitted to the
; Graduating Class of 1872 in the Medical College of Ohio.
wº-
ANATOMY.
Give a general description of the skeleton.
Describe the os femoris.
What are the essential components of an entirely movable
Joint 7
Describe the elbow joint.
Describe the heart.
Give its position.
Describe the larynx.
Describe the trachea, bronchi and bronchia. - -
What are the enveloping membranes of the cerebro-spinal axis 2
*A
JUNE 22, 1872.]
T IEEE EIH C T , T TNT I. C.
}
293
10. What are the great divisions of the encephalic mass and their
relation ?
suPGICAL ANATOMY.
1. What is the best place for ligating the common carotid artery,
and what are its relations at that part 2
2. Popliteral artery, where found and relations 7
3. What are the anatomical objections to ligating the first and sec-
ond portions of the subclavian artery 7
4. Scarpa's triangle, boundaries and important parts contained ?
5. By what muscles is the inner border of the foot elevated ?
Fº l, upper third of radius, in what position best treated,
and why
What are the parts divided in the lateral operation of lithotomy 7
8. Surgical anatomy of the shoulder joint.
9 Surgical anatomy of the elbow joint.
0. Surgical anatomy of the hip joint.
PHYSIOLOGY.
The digestive juice with the widest range of action, and its
chief ingredients 2 *
Trace fat through the system.
The cause or causes of circulation in the veins ?
Capillary circulation, continuous or intermittant, in either case
why?
Chief use of the red blood corpuscles 2
Uses of Sweat 2 i
Th: Hºnºliate and subsequent effects of wounding the cere-
€ll lirrh
The diurnal range of temperature and the variations compatible
with health ? -
The necessary quantity of air in cubic feet for 24 hours ?
Describe a spermatozoid.
I
CHEMISTRY.
Enumerate the general properties of acids and bases.
Give the composition, formula, and mode of preparation of hy-
drochloric acid.
Describe the tests for arsenic.
What is the antidote to arsenic and how prepared 7
Describe normal urine. -
How is urea obtained from urine 7
How are chlorine, sulphuric acid, potassium and sodium detec-
ted in urine 2
Describe the tests for sugar in urine.
How would you determine whether a deposit consists of urates,
phosphates, oxalate of lime or uric acid 7
How would you discover blood in urine?
:
i
8. Mention the forms of dysmemorrhoea and differential diagnosis.
9. What are the conditions capable of producing amenorrhoea 7
What are the disease which may produce pelvic abscess 2
OBSTETRics.
Give positive signs and duration of pregnancy.
Give diameter of pelvis at brim and outlet.
Give diameters of foetal head. -
Describe the anterior and posterior lateral inclined plains, and
their relations to the mechanism of labor.
Give the four cranial presentations, with the diagnosis of the first.
Management of natural labor.
Under what circumstance would you turn, and how 2
Cause, symptoms and treatment of unavoidable hemorrhage.
Cause and treatment of post-partum hemorrhage 2
Symptoms and treatment of puerperal convulsions f
.
I
OPHTHALMOLOGY.
Name the bones that form the orbit.
Name the muscles found in the orbits giving the nerves that
innervate them.
Giving a case of internal squint, how could you tell whether it
was paralytic or not?
Give the condition of the lids in ptosis and facial paralysis, with
the muscles and nerves involved.
Give the structure of the eye from before backwards.
Give the points of differential diagnosis in the various con-
junctival inflammations.
Differential diagnosis of iridal and corneal inflammation with the
general plan of treatment in the latter and the particular of the
former ? -
Of what does the lachrymal apparatus consist and what may
interfere with the carrying off of the tears?
9. What is a cataract, and what is its treatment 7
Wºre the two methods of examining the eye with artificial
19.
.
8.
MATERIA MEDICA:
1. Why is cod liver oil the best form in which to administer a fat
2. Describe the effects of arsenic on the primary assimilation.
3. Name the preparations of arsenic and the dose of each.
4. Give the composition of opium.
What is the treatment of opium narcosis 7
What practical test for the purity of chloroform may be made at
the bedside 2 •.
In danger of chloroform harcosis what methods of resuscitation
are proper ?
What is the distinction between galvanism and Faradism 2
To what class of cases are these two forms of electricity especially
applicable 7 & *
Write a prescription for a purgative pill ?
ººe gº
10.
*
Questions at the Examination of Candidates for the English Indian Medical
Service.
I
0.
SURGERY.
What are the various processes by which fractured bones unite 7
What are the means you would use for strangulated hernia be-
fore resorting to an operation, and, failing in these, what are the
operations recommended, and the advantages of each 3
. In what injuries of the ankle joint is deformity inevitable 7
. What are the stages of hip-joint disease, and the treatment of
tº each stage 2 &
#.
3
4
5. How wouiſ you treat wounds of the stomach 7
6. What are the indications for amputation ?
7. Describe the various methods of Acupressure.
8. Differentiate between intra and extra-capsular fracture of the
neck of the femur.
9. Differentiate between abcess, encephaloid, aneurism, hermia and
adenoma 2
Name the principal disease which affect bones.
PRACTICE.
1. sº the prominent facts in the clinical history of malarial
OVerş.
2. What is the cause, course and termination of hepatic abcess 7
3. What are the symptoms and dangers of desquamative nephritis?
4. Diagnosis between real and feigned epilepsy 7
5. How treat habitual constipation ?
6. What are the physical signs of pericarditis 2
7. Diagnosis between peritonitis and enteritis.
8. How distinguish fixed neuralgia from inflammatory palm ?
9. Give the dry and moist rules; what do they indicate 7
10. How would you treat cardiac hypertrophy Ž
GYNAECOLOGY.
1- Describe the uterus, location, size, weight, division, structures.
2. In what particular does the neek of the wound differ from the
body of the wound 7
3. Describe ovulation and menstruation. *
4. . What §. would enable you (if possible) to determine
the difference between specific and non-specific vagunitis
5. Mention the most common diseases of the uterus in the order of
their frequency.
0. Nºme the various substances that may be expelled from the
female pelvic organs.
7. Give the probable and positive evidences of the existence of
uterine cancer.
ANATOMY AND PHYSIOLOGY:
1. Give a genearl description of the spinal column, arid of the course
of its ossification.
2. Describe the mode of development of a vertebra in general,
iudicating the exceptionable cases (exclusive of the sacrum
and coccyx) 2
3. Enumerate the various muscles and describe their respective
actions, by which the deformity witnessed in the following fractures is
robably caused : 1st, Fracture of the neck of the femur ; 2nd,
ractuae of the lower end of the femur immediately above the
condyles; 3rd, Fracture of the lower end of the radius (Collis's
fracture.)
4. Describe the arch of the aorta, the relations of its various posi-
tions and the dissection necessary to examine it, mention also
the principle variations in the positions of its branches.
5. Describe the parts contained in the space bounded in front by the
osterior border of the sterno mastoid, behind by the anterior
i. of the trapezius, ahd below by the claviclé.
6. Gaye a general account of the lymphatic and lacteal system,
ºng the minute structure of the lymphatic vessels and
&ll C. S.
7. Dº the physiological effects of the division of the vagi
Ile I'VeS.
8. Mention the parts in other vertebrate animals which are homolo-
gous with the human händ, or parts of it.
SURGERY.
1. Describe the states tiamed respectively “shock” and “reaction,”
as seen in such agaše as that of a crushed limb
2 Enumerate the chief varieties of inflammation of the testicle, and
state the distinctive characters of each:
Give an account of secondary hemorrhages such as may occur
after amputations, and of the best modes of treating them,
3:
294
[JUNE 22, 1872.
TIH. H. C.T.I.N.I.C.
4. Whnt ill consequences may follow dissecting wounds, and what
are the best means of treatinent, preventive and curative 7
5. What are the chief means by which in the treatment of hernia,
the taxis may be assisted, and in what conditions is each of
them most useſul ? º
6. Describe the process of repair of a tendon after subcutaneous
Section. 4- -
Lescribe the several diseases of the eye that are connected with
syphilis and gonorrhoea.
8. A man 53 years old while under treatment for slight stricture of
the uretha, was exposed to cold damp weather, the next day
had a severe rigor followed by heat and sweating, and Com-
pletely lost the power of passing urine. On each of the next
two days he had similar rigors, and on the third day he was
not only still unable to pass urine, but had constant straining
and extreme pain in his endeavors to do so. During three days
more these symptoms continued with rigors, and these were
gradually added to them, pain in the perineum and about the
arms, tenderness on deep pressure in front of the anus and
º, forcing pain referred to the lower part of the rectum.
The bladder was regularly emptied with a catheter and was
not painful on pressure, the urine was generally healthy.
Diagnose this case and give treatment.
Questions submitted to Candidates at the Primary Examination jor the
Diploma of Membership of the Royal College of Surgeons, London.
*
Describe the boundaries of the posterior mediastinum and its
contents in their relative position.
Describe the structure of veins and the forces by which the
venous circulation is carried on.
Describe the ligaments of the hip joint, and mention the mus-
cles in contact with its capsule. -
Give an account of any ºriº with which you are ac-
quainted, illustrating the influence of the pneumogastric
nerve upon the action of the heart.
Lescribe the ligaments connecting with the clavicle, and men-
tion the parts that pass beneath it in their relative positions.
6. Describe the ciliaris muscle and its action.
:
5
º
SURGERY AND PRACTICE OF MEDICINE.
How would you distinguish, surgically, chronic induration of
the breast from scirrhus. What are the microscopic ap-
pearances by which each is characterised ?
2. Describe the operation of excision of the elbow joint, and state
under what circumstances it may be required.
3. What treatment would be required in a case of incised wound of
the cornea, with protrusion of the iris. Mention the conse-
quences which may ensue, and the proper mode of dealing
with them.
What are the causes which may impede the union of a fracture
of a long bone; describe the mode of treatment which might
be resorted to in order to promote the union of an united
fracture ?
5. Describe the deligation of the right carotid artery in the first
part of its course, giving the exact relations of the parts con-
cerned in the operation.
6. Mention the different forms of naevus and appropriate modes of
treatment.
7. Describe a case of Fº of the facial nerve, and mention the
causes upon which it may depend, and the treatment you would
adopt for its relief.
8. What are the circumstances which would induce you to have a
recourse to thoracentesis in a case of effusion in the pleural
sac, state how you would perform the operation and the
changes that would follow it.
9. Write perscriptions in Latin in full, and directions in English, for
a diuretic mixture and a purgative powder and give composition and
doses of the following preparations; Pulvis Julapae Composita; mix-
tura ferri composita; tinctura Camphora Composita. Liquor Morphia
Hydrochlor.
In the exhibition of these questions I hope I have not
been tedious, I have ventured upon them for herein lies
the argument, for we see by them that our Schools and
Hospitals take as wide a range and ask as difficult
questions as is done by examining bodies elsewhere.
These questions show the extent of teaching and it will
not be contended that a young man who answers seventy
percent of them is not well educated. The lesson of
this whole matter is that the Professon in this country
is not in as bad condition as would be inferred from
these annual howlers.
In Medical Literature America certainly stands well,
our books are read in all countries. In Surgery, Med-
icine, Therapeutics, Physiology, Chemistry, Obstetrics,
Gynecology our authors have won well merited fame.
Our Medical Journals are yearly by their merits chal-
lenging recognition. It is said that they contain much
trash, this is true but it is equally true of foreign period-
icals. It is not all wheat within the lids of any medical
work, unadulterated wisdom is not found in medical
journals, I do say however that brains predominate in
our medical literature. -
Thus by the steady advance in the manner and
efficacy of teaching, by the yearly improvement in the
preliminary education of students, by the increase in
the length of the lecture term and what is still better
than all an enthusiastic love of the profession, our
Medical Colleges will annually send out a class of young
men from whom may be expected the best of things,
many of them will take high rank and distinguish
themselves in fields where distinction is the result of
true Worth.
..—sº-º-º-
on 1 o sºr a re n e orca 1 so c 1 Etx.
Twenty-seveNTH ANNUAL MEETING.
PoRTSMOUTH, JUNE 11th, 12th, AND 13th, 1872.
FIRST DAY.
Morning Session.
The Society met in Wilhelm's Opera House at 10
o'clock and was called to order by the President, Dr. W.
W. Dawson, of Cincinnati. -
Rev. Dr. Burr of the Episcopal Church opened the ,
meeting with prayer.
Vice-Presidents Drs. C. P. Landon, E. Sinnett
and J. W. Russell took seats on the stand.
Secretary Dr. J. W. Hadlock was present.
Ex-President Dr. Hempstead was escorted to the
stand and introduced as one of the earliest Presidents of
the Society. Also Ex-Presidents Drs. E. B. Stevens,
Kincaid, and Dunlap, took seats on the stand.
Dr. Jones, of Portsmouth, moved that the reading of
the minutes of last year's meeting be dispensed with.
Carried.
REPORTS OF COMMITTEES.
Dr. Pixly made the report of the Executive Com-
mittee as follows:
Your Executive Committee wish to report that they
have secured the use of Wilhelm's Opera House for the
Society.
JUNE 22, 1872.]
The Committee suggest that the meetings be held
at 9 o'clock A. M., and at 2 o’clock P. M. On Wednes-
day at 9 o'clock A. M., Election of Officers; at 2 o’clock
P. M., President's address; at 4 o’clock P. M., Display
of Water Works; at 9 o'clock P. M., The Society is in-
vited to a Banquet given by the citizens, at the Opera
House. Thursday at 11 o'clock, invitation to visit
Gaylord & Co.'s Rolling Mills, and Burgess's Steel and
Iron Works. - -
Arrangements for the reduction of fare to members
and their families have been made with the following
railroads, viz., Marietta and Cincinnati; Cincinnati,
Hamilton and Dayton; Cincinnati, Sandusky and
Cleveland; Columbus and Hocking Valley and the
Baltimore and Ohio. - - - -
A. B. Jones, M. D., Chairman.
C. M. Finch, M. D.
M. S. Pixley, M. D.
- L. Schwab, M. D.
Dr. A. B. Jones of Porttmouth welcomed the Society
in the following neat address:—
M.R. PRIESIDENT: - - . . .
Gentlemen of the Ohio State Medical Society and
others: The Profession of Portsmouth has made it my
pleasing duty, to formally extend to you, their kindliest
greetings. This I do with mingled emotions of pride
and pleasure—of pride when I reflect that this society
has numbered among its members, physicians, Surgeons
and specialists, peers, to any the world has ever produced;
and upon whose worthy shoulders now rest the mantels
of the great departed. Of pleasure in giving my right
hand with the hearty God bless you to our home—to
our quiet little city. :
We all, both in and out of the profession, fully appre-
ciate the very distinguished honor you have conferred
upon us by bringing here the ripe sheaves as the fruit
of your past year's sowing, working and reaping to be
garnered amongst us. Then let us rejoice and make
merry together; and when the day's work is done,
remember the last load of corn for the year has been
brought home: and, when you retire to rest to-night
have no nervous or fitful dreams, for fear the loud rat-
tling of the door bell may summons you in the still
watches of the night, to again go over and over your
weary rounds with your still more weary limbs.
We hail your advent in our city, as the dawning of a
new era in our profession here. So many great and
good men whose lives and energies have been devoted
to the relief and comfort of others, cannot come and go
without leaving an impress behind them of good. I
trust our meeting together on this occasion will
not only be a pleasurable, but also a profitable one; and
that each one of you may return to your respective fields
of labor and usefulness, refreshed in body, strengthened
in mind and cheered with hope—hope of the hopeful,
whose reward consists in the self-gratulatory feelings
of having done ones duty, by lightening the burden of
life which man inherited when he fell, and brought
TIEEI IEH C T , T INT I C -
| has been reaping.
295
“death into the world and with it all our woes
Yours can never be the reward of gold. Schiller tells
us that at the sharing of the earth, the husbandman,
the merchant, the lawyer, the monarch, all got their
share; and, even the parson came in for his wine: while
the poet who had been holding up nature's mirror to
each fond professor got nothing: so in utter dismay he
appealed to the gods. Jove asked him where he had
been when the earth was divided. I was, said the poet,
with thee and so enraptured was I with thy world as to
love every portion of it. “Alas, alas, said the god,
earth is given I Field, forest, and market, and all!
What say you to quarters in heaven? We'll admit you
whenever you call.” Now gentlemen I have no doubt
but the gods have reserved a place for the doctors up
there with them; and if so I know you will be thankful.
Another year since last we met has closed its book
and stamped its record forever; time too, with his sickle
He spared not even the healer, and
among them, has he taken into the dark beyond, the
immortal Blackman, whose name is now never spoken
either by friend or foe, without profound admiration.
Many others of us have gone over into the unknown
world to shed their lustre there; and me thinks, that as
one by one of our social few goes over, it will lessen the
darkness of the gloom; and soon, very soon, our Society
will number more there than here. Then let us forget
not, while we are trying to cool the fevered brow, or
relieve the burning thirst, to drink deep, ourselves, of
the pure waters of Siloam.
Report of executive committee was adopted.
Dr. E. Sinnet with appropriate remarks presented to
the Society a beautiful silver mounted gavel.
The President returned thanks for himself and all
future Presidents of the society, for this timely, useful
and handsome present. -
REPORTS OF COMMITTEES.
Reports of committees being called for a number
were announced ready to report.
REPORT OF TREASURER.
The report of the Treasurershowed a balance of $12,81
cents in the treasure. Report received and referred to
committee on finance.
Dr. W. J. Conklin, of Dayton, was, at this juncture,
appointed Secretary pro tem.
MISCELLANEOUs BUSINESS.
Dr. Bartholow moved that all papers be read by
abstract not to exceed twenty minutes in reading. After
some discussion the motion prevailed—when Dr. J. B.
Thompson moved a reconsideration of the matter for the
purpose of so modifying Dr. Bartholow's motion that
the rule shall not apply to the reading of papers this
year. A reconsideration was had and Dr. Thompson's
modification prevailed.
VOLUNTEER PAPERS,
Volunteer papers being called for Dr. Bartholow
296
[JUNE 22, 1872.
T IEEE THE cIIINI c.
announced a paper on “Aneurisms of the Basilar Artery.”
Dr. E. Sinnet announced a volunteer report of “Two
cases of Monstrosity.”
Dr. Gay presented a pathological specimen with
history of case, of heart incased in bony formation.
Remarks were made on the case by Drs. W. W. Seely
and J. T. Whittaker. In answer to Dr. Bartholow Dr.
Gay stated that a specimen of the bony case had been
subjected to microscopical examination and found to
be true bone,
The following named gentlemen were favorably re-
ported on for membership and unanimously elected.
Drs. Robert Wesley, Athens, Ohio; D. T. Daris, Day.
ton, Ohio; W. V. Peck, New Richmond, Ohio; Thomas
G. Vaughters, Portsmouth, Ohio; David Coleman,
West Union, Adams Co., Ohio; J. L. Wylie, Ripley,
Ohio.
The President announced the name of members of
committee on finance as follows: Drs. Jones, (of West
Liberty,) E. B. Stevens, D. D. Bramble, Finch, and
Jenney.
Drs. S. S. Scovill and Bartholow were announced to
read papers during the afternoon session.
The Society then took a recess until 2 o’clock P. M.
Afternoon Session
The Society met at 2 P. M., as per adjournment, and
was promptly called to order by the President.
Dr. Pixly, from Executive Committee, reported that
soda water would be served the members of the Society,
free of charge, at the various drug stores of the city,
The following names were presented for membership
and unanimously elected: Drs. A. Andrus, D. W.
Coffee, both of Westerville, Ohio; B. F. Kitchen, Clay
P. O., Jackson Co., O.
A question here arose as to the status of members of
this Society who came as delegates from auxiliary
societies. Referred to Committee on Medical Societies.
Dr. L. A. Grimes, of Concord, Ky., and Dr. C.
Honacker, of Vanceburg, Ky., were here introduced and
invited to take seats with the Society.
The Finance Committee here made a partial report,
Report received.
Dr. Gray moved that the salary of the Treasurer here-
after be $50 instead of $150. Carried.
Dr. Kincaid moved that the annual dues be fixed at
$2 instead of $3, as recommended by the Committee.
Carried. Report was then adopted.
Dr. J. B. Thompson here offered his resignation as
Treasurer. Resignation accepted and Dr. Gray elected
Treasurer of the Society.
The President announced the Committee on Medical
Societies as follows: Drs. A. C. Miller, Miles, Wylie,
Hough and Hyatt.
The Committee on Admissions reported the following
named gentlemen for membership, who were
unanimously elected: Drs. James L. Taylor, Wheelers-
burg, O., J. A. Warren, Wheelersburg, O., W. A.
Frizzell, Buena Vista, O.
Dr. J. B. Thompson resigned his place as Librarian,
and Dr. Gray, treasurer elect, resigned his place on the
committee on admissions. -
Dr. E. Sinnett moved that a vote of thanks be tendered
Dr. Thompson for his long and useful services as
Treasurer of the Society. Motion heartily responded
to.
REPORTS OF SPECIAL COMMITTEES.
Dr. S. S. Scovill, of Lebanon, having previously been
announced, read a report on “Nervous Transmission.”
The report was elaborate, read with energy and listened to
with marked attention by the members of the Society.
Remarks on the report by Drs. Whittaker, Hough and
Scovill; after which the report was received and re-
ferred to Committee on Publication. *.
Dr. R. Bartholow, read a report entitled
“Some Points in the Therapeutics of Elec-
tricity, illustrated by cases.” The report was well
received and listened to attentively by the members.
Remarks on the report by Dr. Reed who reported cases
confirming the position taken by the author of the re-
port on the value of electricity as a therapeutical agent.
Drs. Hough, Whittaker, Miller and Scovill also made
remarks touching the report. Report received and re-
ferred to Publication Committee.
Dr. Landon moved that the Society take a recess
until half-past Seven o’clock in the evening. Carried.
Evening Session.
Society called to order by Vice-President Dr. C. P.
Landon.
REPORTS OF SPECIAL COMMITTEES CONTINUED.
Dr. A. T. Keyt read a report on the
“Semiological Value of Yellow Elastic Tissue in
Sputum.” The report, although lengthy, and occupied
the major part of the evening in its reading, was listened
to throughout with marked and critical attention by all
present. Report received and discussed by Drs. Barth-
olow, Whittaker : whereupon it was referred to Com-
mittee on Publication,
Dr. P. S. Conner read a report on “Hermia Cerebrº.”
Referred to committee on publication.
The society then adjourned to meet Wednesday
morning at 9 o'clock
S E C O N D D A Y.
Morning Session.
The Society met at 9 o'clock, and was called to order
by the President, Dr. Dawson. Prayer was offered by
the Rev. Mr. Manly, of the Biglow M. E. Church.
Minutes of yesterday's proceedings were read by the
Secretary and approved.
JUNE 22, 1872.]
T H H C T.I.N.I. c.
297
REPORTS OF COMMITTEES.
The Committee on Medical Societies made their re-
port as follows:
Mr. President : º
Your Committee on Medical Societies having had
under consideration the matter which to them was re-
ferred beg leave to report the following as the result of
their deliberation, viz:
1st. That in accordance with article 7th, of the by-laws
of the Ohio State Medical Society it is the opinion of
your committee that societies represented by the
delegates are subjects for consideration in committee
and not the delegate.
2nd. That in accordance with the foregoing your com-
mittee have examined the credentials of S. S. Scovill,
M. D., and J. B. Hough, M. D., regularly appointed
delegates from Lebanon Medical Society, and of C. R.
Reed, M. D., representing the Meigs County Medical
Society, and of H. C. Watterman, M. D., of Middleport,
representing the Meigs and Mason Academy of Medicine;
Drs. A. Blymer and A. Andrus, Delaware County
Medical Society; Dr. J. W. Coble, Central Ohio Medical
Society; Drs. N. S. Hill, W. V. Peck, W. L. Anderson,
A. W. Ashburn, R. B. Davy, Eugene Moore, R. C.
Moore, Clermont County Medical Society; Drs. D. B.
Cotton, W. J. McDowell, Scioto County Medical Society;
and find that said societies are in good and regular
standing as Auxilaries of this society, and that said
delegates by virtue of their appointment are entitled to
a part in the deliberations of this Society.
3rd. That your committee have examined the con-
stitution and by-laws of the “Delaware Medical Insti-
tute,” and find that they strictly conform to the require-
ments and usages of this Society, and recommend it be
made auxiliary to the Ohio State Medical Society.
4th. Whereas, there does not appear to be any estab-
lished usage in the transactions of this Society, regu-
lating and governing delegates from Societies made
auxiliary to the Ohio State Medical Society, and,
Whereas, to avoid controversies hereafter, and for the
more uniform government of said delegates, be it there-
fore
Resolved, That delegates representing Auxiliary Socie-
ties in good standing, shall, upon satisfactory evidence,
be entitled to take part in the deliberations of said State
Society during the session for which they were elected,
but shall not be entitled to membership or other con-
siderations unless they become a regular member of this
Society, and pay the usual initiation fee.
Respectfully submitted; A. C. Miller, J. L. Wylie,
A. J. Miles, E. H. Hyatt, J. B. Hough, Committee.
The Committee on Finance after having examined
the books and accounts of the Treasurer made their
Supplemental report as follows:
Mr. President;
Your Committee on Finance have examined the
book accounts and vouchers of the Treasurer, and find
them all correct.
We recommend the payment to the estate of Dr.
Hall (late deceased) the balance of his salary for 1871,
of $25; also account rendered by Dr. Hall (for postage)
$270. {}
Dr. Hadlock, as Secretary, presented a bill of
items $25.20, which was recommended to be paid.
A bill for salary of Dr. Hadlock, as Secretary,
for $50, we do not feel authorized to allow ; but we
recommend the payment to Dr. Hadlock, of whatever
expenses he may have incurred additional to the above,
in performing the duties of Dr. Hall during his dis-
abilities. Respectfully submitted; L. M. Jones, C. M.
Finch, E. Jennings, Edward B. Stevens, D. D. Bramble.
Committee. 4.
During the morning Session the executive committee
presented the following communication.
PortSMOUTH, O., June 12, 1872.
Drs. Pixley, McDowell and Bing, Executive Com-
mittee.
Gentlemen :—The undersigned committee of the
Board of Trade of our city, in behalf of the body we
herein represent and of the citizens generally, hereby
extend to the members of the Ohio State Medical Asso-
ciation, now here assembled in convention, a cordial
invitation to accept an entertainment to be given them
by said Board and the citizens at Wilhelm's Opera
House this evening, the 12th inst., at 9 o'clock.
Very Respectfully, Thos. Dugan, R. Bell, Jas. Rum-
sey, George Davy, P. Tainey. Committee. *
On motion the above invitation was accepted.
The following named gentlemen were presented for
membership and unanimously elected ; Drs. E. D. S.
Morgan, Berlin, Ohio; D. C. Wilson, Ironton, Ohio;
Emil Arnold, Ironton, Ohio; C. M. Wilson, Miami
Springs, Ohio; H. K. Steel, Denver, Colarado, Honorary
member; P. Beeman, Iola, Allen Co., Kansas, Honorary
member.
Dr. J. B. Thompson made a statement that Dr. R. J.
McClain owes the Society near $15.00 and the Doctor
having been absent for Some years, int he army, he now
proposes to pay the Society two-thirds the amount and
be reinstated to good standing in the society. Referred
to committee on finance.
ELECTION OF OFFICERs.
The election of officers for the ensuing year resulted
as follows:—President Dr. A. B. Jones, of Portsmouth,
Ohio; Vice Presidents Drs. A. Blymer, Delaware,
Ohio; J. D. Cotton, Marietta, Ohio; W. J. Anderson,
Newtonville, Ohio; J. B. Hough, Ridgeville, Ohio.
Treasurer and Librarian, S. S. Gray, M. D. Piqua,
Miami Co., O.
Secretaries, J. W. Hadlock, M. D. Cincinnati, Ohio;
W. J. Conklin, M. D. Dayton, Ohio.
Committee on Admission, Dr. M. Cassat, Dr. N. S.
Hill, Dr. S. S. Scoville, Dr. T. W. Gordon, Dr.
E. H. Hyatt, -
598
[JUNE 22, 1872,
TIEI IE C T , I INT I. C.
REPORTS OF SPECIAL COMMITTEES CONTINUED.
Dr J. B. Hough from Special Committe read a report
on Medical Chemistry. Report received and discussed
by Drs. Conner, Kincaid, Scoville, Miles, Bing, Hyatt,
Gordon, Reed and Frizzell. At the close of the discus-
sion Dr. Hyatt introduced the following resolution
which was unanimously adopted:
Resolved, That the sense of this Society is that a better
knowledge of Medical Chemistry, on the part of students
preparatory to entering the profession is demanded,
and that the profession of Ohio is pledged to the work
of bringing about a reform in this department of medi-
cal education. -
Dr. W. W. Seely read a report from special committee
on “Otology.” Report received and referred to Com-
mittee on Publication.
Dr. Gay of Columbus, presented to the Society speci-
mens of wire gauze apparatus for treatment of fractures.
Society then took a recess until 2 o’clock P. M.
Afternoon Session.
The society met at 2 o'clock and was called to order
by President Dr. Dawson.
Vice President Dr. Landon took the chair while Dr.
Dawson reported a case of Re-fracture of the Femur. The
Doctor exhibited drawings showing the condition of his
patient prior to the re-fracture and also showing the
happy result of the operation. Remarks on the case by
Dr. Conner.
Dr. Stevens moved that the thanks of the Society be
tendered Dr. Dawson and that he be requested to write
out his remarks on the subject for publication in the
Transactions. Carried.
During the afternoon session the following new mem-
bers were elected. *
Dr. J. P. Primrose, Nelsonville, Athens Co., Ohio;
Dr. James Moor, Ironton, Ohio; Dr. C. B. Hall, Millers-
port, Laurence Co., Ohio; Dr. Camillus Hall,
Burlington, Ohio;
VoIUNTEER PAPERS–REPORTS OF CASES.
The President annouced that owing to the amount of
business before the society Dr. Bartholow withdraws
his paper on “Aneurism of the Basilar Artery.”
Dr. A. Andrus read the report of a case showing
the front surface of a body studded with tumors
varying in size from a pea to a walnut.
Report received, and discussed by Drs. Dunlap—who
reported a similar case—Hyatt, Miller, Bartholow, Sin-
nett and C. P. Landon.
Dr. Miller, with remarks, reported a case which much
resembled the case of Dr. Andrus, Dr. C. P. Landon,
having seen the case of Dr. Andrus in consultation, gave
it as his opinion that the tumors were due to scrofulous
or tuberculous deposits. Dr. Bartholow spoke of the
cases as possibly multiple adenoma which was known to
be a very dangerous form of disease.
To this suggestion Drs. Andrus and Miller replied
that in neither of their cases were there any symptoms
of implication of the glandular system; on the contrary,
the family history of the patient proved a cancerous
diathesis.
Dr. E. Sinnet reported a case which bore some resem-
blance to the cases of Drs. Andrus and Miller.
The paper was then received and referred to Com-
mittee on Publication.
Dr. Gay moved that when the Society closes its meet-
ing at this place it adjourns to meet in Columbus
on the second Tuesday in June, 1873. Carried.
The Society then adjourned until Thursday morning
at 9 o'clock. -
After adjournment the Society was entertained by a
visit to the Holly Water Works, and the extensive shoe
factory of Resenberrick, Drew & Co.
At 9 o'clock in the evening the Society was entertained
by the Board of Trade and the citizens of Portsmouth
with a sumptuous banquet given in the Hall of Wil-
helm's Opera House. The evening passed pleasantly ;
good-eating, good music, good dancing, good “Big Med-
icine Man” who administered to the thirsty in a way to
be remembered by all who came under his treatment.
T H I R D ID A. Y.
Morning Session.
The society was called to order by the President Dr.
Dawson at 9 o'clock. -
Prayer by the Rev. Mr. Stanly, of the Sixth Street
Methodist Church. *
On motion of Dr. Miller the reading of the minutes
of yesterday's proceedings was dispensed with.
Dr. Thad. A. Reamy exhibited an instrument of his
own invention, for intra-uterine medication.
He thanked Prof. P. S. Conner for valuable sugges-
tions, during the time he was preparing his
instrument. At the close of his remarks Dr.
Reamy said he hoped the society would accept this
report in lieu of the report which he was posted to have
made on the “Surgical Diseases of Women.” Report
received and referred to publication committee with
orders to print.
Dr. Thomas H. Kearney read, his report from special
committee on Amputations. Report received and after
remarks by P. S. Conner was referred to committee on
publication.
Dr. Bing moved that Dr. A. G. Sellards, of Vanceburg,
Kentucky, be admitted to the courtesies of the Society.
Carried.
Dr. G. S. B. Hempstead, was at this juncture elected
an honorary member of the Society. Dr Hempstead,
retired from practice fourteen years ago, after having
practiced forty-three years. He was one of the Original
Members of this society, was its President in 1855; and
is now its oldest living member, being seventy-eight
years of age. -
JUNE 22, 1872.]
TEEE CI ITTI c.
299
The Finance Committe reports in the case of Dr.
McClain in favor of his reinstatement upon his
pnying into he treasury two-thirds of the amount
he owes the society. Report received and adopted.
Dr. J. T. Whittaker read a report. from Special
Committee on “The Year's Contributions of Physiology
to Practical Medicine.” Report received and referred
to committee on publication.
Dr. L. M. Jones, of West Liberty, read a report from
standing committee on Obituaries, in place of the Chair-
man, Dr. B. B. Leonard, who was not present. Report
received, and, after some remarks by members to the
effect that the report was not complete, since it did not
embrace a notice of all who have died of our number
the past year, was adopted.
Dr. E. B. Stevens moved that a committee be appointed
to report on the death of our late secretary Dr. W. C.
Hall. Carried. The President appoined Dr. Stevens
as the committee. -
Dr. Miller was appointed a committee to report on
the death of Dr. Cary, of Salem, Ohio.
Dr. Alex. Dunlap was appointed a committee to re-
port on the death of Dr. Kyle, of Xenia, Ohio.
Dr. A. B. Jones requests that his report from special
committee on “Relation of the Mental to Man's Physical
Forces,” be read by title and referred to publication
committee. - -
On motion of Dr. Bing it was so read and referred.
A communication was here received and read by the
secretary, from Dr. Geo. Mendenhall, embodying the
following resolutions:
Resolved, That a committee of five, of which Dr. Clem-
denin be Chairman, be appointed to prepare a memorial
to the Legislature of this state, on the subject of Public
Health, in accordance with the resolution of the Ameri-
can Medical Association presented by Wm. Logan, of
California. -
Resolved, That this committee co-operate with Dr. A.
E. Jenner in reference to the bill presented by him in
the Senate of Ohio.
Resolved, That this committee shall prepare a suitable
memorial and have five hundred copies printed and dis-
tributed to the members of this society for signature;
and draw upon the treasurer for the amount expended
for same. -
Trusting that the members will consider this subject,
favorably, -
On motion of Dr. Conner the resolutions of Dr. Men-
denhall were so amended as to instruct the committee
to report upon the subject of a State Board of Health
at the next meeting of this society. *
Dr. Clendenin not being a member of this society,
the President appointed Drs. Geo. Mendenhall, J. R.
Black, P, S, Conner, G, B, Orr, Geo, E, Walton, com
mittee on State Board of Health,
Dr. Miller stated that Dr. Joel Pomerine had a report
ready from special committee on Puerperal Convulsions
but was unable to be present to read his report and
therefore requested to be continued on the same com-
mittee until next year. By vote of the Society Dr.
Pomerine was continued as he requested.
President Dr. Dawson gave a synopsis of his valedict-
ory address, which was well received. The subject was
that of medical education. The annual wail and lamen-
tation on that topic was not indulged in by the speaker;
a more cheerful view was taken of the question. The
speaker showed how rapidly we had advanced in that
respect within the past twenty years, how our works on
medicine were translated into foreign languages and
read abroad. He also referred to the general diffusion
of education by our system of public schools, and how
they were auxiliary to medical education by preparing
the youth of our land with a thorough primary education.
On motion of Dr. E. B. Stevens the President’s address
was referred to the Publication Committe with
instructions to print.
The President announced the following
z- STANDING COMMITTEES:
Evecutive. N. Gay, J. B. Thompson, J. W. Hamilton,
C. P. Landon, R. M. Denig.
Publication. J. W. Hadlock, W. J. Conkling, E. B.
Stevens, S. S. Gray, C. M. Finch.
Medical Societies. J. P. Bing, M. S. Pixley, Louis
Schwab, A. C. Miller, J. H. Green.
Finance. L. M. Jones, E. Jennings, E. B. Stevens,
C. M. Finch, D. D. Bramble,
Admissions. M. Cassat, N. S. Hill, S. S. Scovill,
T. W. Gordon, E. H. Hyatt.
Obituaries, T. W. Gordon, David Cotton, E.
H. Hyatt, E. Sinnett, Alex. Dunlap,
SPECIAL COMMITTEES.
Castration for Epilepsy—M. S. Pixley, Portsmouth.
Quinine—S. S. Gray, Piqua. Progress of Surgery during
the year—P. S. Conner, Cincinnati, J. L. Wylie, Easec-
tion of the Hip Joint—D. D. Bramble, Cincinnati. In-
sanity—D. A. Morse, Midway. Therapeutics of Alcohol.
—E. H. Hyatt, Delaware, Consumption in Ohio Pen-
etentiary—N. Gay, Columbus, Stricture—A. C. Miller,
Cincinnati. Ophthalmology—J. H. Buckner, Cincin-
nati, Syphilitic Affections of the Nervous System—W. J.
Conklin, Dayton, Nervous Diseases—R, Bartholow,
Cincinnati, Pathology and treatment of Diphtheria and
Scarlet Fever—J. W. Hoff Small-Pow—E. Jennings,
Dayton. The distinction between Caseous Pneumonia and
True Tubercle—A. T. Keyt, Walnut Hills, Cincinnati, O.
Urinalysis—J. W. Russell, Mount Vernon. Functions
of the Spleen—S. S. Scoville, Lebanon, Cerebro-Spinal
Meningitis—A, B, Monohan, Lebanon. Skin Grafting—T.
D. Davis, Lebanon Gastric Irrigation—E. Sinnett, Gran-
300
[JUNE 22, 1872,
T TEI IET: C T , T TNT I C.
ville. Nervous Diseases—N. S. Hill, Newville. Incura-
ble Diseases—J. P. Bing, Portsmouth. New Remedies—C.
R. Reed, Middleport. Trêtment of Ulcers and other Cuta-
neous Diseases of the Lower Ertremities—C. M. Finch,
Portsmouth. Efficacy of Vaccination—David B. Cotton,
Portsmouth. Small-Poac—A. G. Stevenson, New Rich-
mond. Small-Poa:—M. Cassat, Cincinnati. Shoulder Pre-
sentations—W. V. Peck, New Richmond; Epilepsy—N.S.
Hill, Newville. Cataract—W. W. Seely, Cin-
cinnati.
SPECIAL COMMITTEES CONTINUED FROM LAST YEAR.
Therapeutics—H. J. Herrick, Cleveland.
Ovariotomy—A. Dunlap, Springfield. Vaccination—
W. B. Davis, Cincinnati. Pverperal Convulsions— J.
Pomerine, Millersburg. Therapeutics of Mineral Springs
—G. E. Walton, Cincinnati. Gynaecology—C. D.
Palmer, Cincinnati. Chronic Diseases of the Lungs—
W. Carson, Cincinnati. Obstetric Record—J. Helmick,
Cleveland. Electrolysis—W. H. Mussey, Cincinnati.
Belladonna—J. A. Little, Delaware. Diseases of the
Laryna-R. Wirth, Columbus, Uterine Diseases—E.
B. Stevens, Cincinnati. Diseases of the Skin—C. O.
Wright, Cincinnati, Prevailing Diseases throughout the
State—J. R. Blacky, Newark. Inflammations of the
Chest—J. A. Murphy, Cincinnati. Physiology—J. T
Whittaker, Cincinnati.
Uterime
DELEGATES TO THE AMERICAN MED, ASSOCIATION,
E, S. Hyatt, Delaware; L., M. Jones, West Liberty;
E, Sinnet, Granville; M. Cassat, Cincinnati; L.
Schwab, Portsmouth; J, D, Cotton, Marietta; E, Jen-
nings, Dayton; C, R, Reed, Middleport; J, B. Hough,
Ridgeview; John W, Russell, Mt. Vernon; S. S.
Scovill, Lebanon; C. P. Landon, Westerville; A, J,
Miles, Cincinnati; T, H, Kearney, Cincinnati; R., W.
Erwin, Athens; J. W. Hadlock, Cincinnati; A. C.,
Brainard, Olmstead Falls; S, S. Gray, Piqua; A. Dun-
lap, Springfield; J. B. Thompson, Columbus; N, Gay,
Columbus; Thos, W. Gordan, Georgetown; G' W.
Pullin, Logan; A, C, Miller, Orville; W, F, Paige;
Johnstown; Joel Pomerine, Millersburgh; J, R., Black,
Newark; Dudley Allen, Oberlin; W. T. Ridman, Toledo,
J. C. Brown, Urbana ; John Bennett, Cleveland; H.
Culbertson, Zanesville; H, S, Conklin, Sidney; L, S,
Ebright, Middleburg; W, P, Kincaid, New Richmond;
B, Gundry, Dayton; W. L., Peck, Columbus; G,
Mitchell, Mansfield; J, C. Hubbard, Ashtabula; David
Noble, Hillsboro; T, G, McEbright, Akron; W, D,
Scarf, Bellefontaine; O. G., Seldon, Shaneville,
DELEGATES TO STATE MEDICAL SOCIETIES,
Indiana—W. H. Mussey, J. W. Hamilton, C. M.
Finch, A, H. Agard, W. J. Conklin.
Rentucky—T. W. Gordon, J, T, Whittaker, H, C,
Brainard, G, W. Brook, S. Loring.
New York—J. A. Murphy, T. A Reamy, S. S. Gray,
H. J. Herrick, B. F. Miller,
Illinois—P. S. Conner, J. A.Little, J. P. Wylie,
Roberts Bartholow, C. B. Reed.
Ransas—E. Sinnet, S. S. Scovill, W. W. Seely, J. H.
Buckner, J. N. Burr.
Western Virginia—E, B, Stevens, A, T, Keyt, T, H,
Kearney, J. P. Bing, J, W, Russell, Jr,
Dr. E. B. Stevens introduced the following resolutions,
1st. That the thanks of the society are due to the
officers of this session for their ability and impartiality.
2nd. Resolved, That we return thanks to the several
Railroad Companies who have extended their courtesies
to the members in attendance.
3rd. Resolved, That we are especially indebted to the
Profession, the Board of Trade and to the Citizens gen-
erally of Portsmouth, for the magnificent hospitality
and thoughtful attention which we have received ; in
the words of Rip Van Winkle, “May they live long and
prosper.”
[A rising vote was given in the affirmative to all the
above resolutions, when twelve minutes to 12 o'clock M.
the gavel fell and the twenty-seventh annual meeting
of the Ohio State Medical Society was declared adjourned
to meet in Columbus on the second Tuesday in June, 1873,
Portsmouth situated in a broad valley and surrounded
by beautiful hills with her genial hospitable citizens
will long be remembered by all those in attendance
upon the meeting just closed. From the time we
stepped upon her wharf until the steamer—which was to
bear us home—left her shores, nothing but cordial hos-
pitality greeted us on every hand; not a jar, not a dis-
cordant sound, not an unpleasant thing to mar our
remembrance of her and her citizens occurred during
our stay of three days within her limits. J. W. H.]
W. W. Dawson, President.
J. W. Hadlock,
W. J. Conkling,
-º-º-º-
| Secretaries,
MEDICAL GOLI, EGE OF OHIO.
THE FIFTY-SECOND annual session commences its
preliminary course, as usual, Sept. 1, ’72. The regular
term begins Oct. 1. Fees, etc. unchanged. The Col-
lege, it is useless to state, preserves all its peculiar
advantages for instruction in every particular. Prelim-
inary Announcements exhibiting some new features in
the way of increased facilities now in press.
Circulars with detailed information sent to any address
by the Secretary.
Prof. W. W. Seely, Secty.
Prof. J. Graham, Dean.
Portsmouth—State Medical Society.
To the Editor of the Commercial: , , , , /r??.
It was my privilege to attend the twenty-
seventh annual meeting of the Ohio State Medi-
cal Society in the beautiful and hospitable city
of Portsmouth. Portsmouth is indeed a beauti-
ful little city—beautiful in itself, beautiful in its
surroundings. It will be long before I forget
the lovely frontispiece given to this place by the
green, fresh Kentucky hill on the opposite
Shore. Long may its Verdure remain to bless
and delight the generous people who dwell at
the junction of the Ohio and Scioto. Of these
citizens—the noble men, the lovely women—we
can hardly find Words to express our high ap-
preciation. To doctors worn and weary with
Work, and more... used to the rough than the
th Đhase of life, the deligate civilities mani-
fested on all sides were peculiarly refreshing,
D.R. G. S. B. HEMPSTED,
. On the stand Was this Venerable man. Tyr.
Heppsted has been practicing medicine fifty-
eight years, and is still hale, hearty, and able to
work. A doctor for fifty-eight years—thunk of it!
THE DRs. COTTON.
We met here three brothers, §. physi-
eians, Dr. John Cotton, of West Virginia, ix. J.
D. Cotton, of Mariettà, and Dr. D. B. Cotton, of
Portsmouth. They are the sons of , one of the
earliest and most distinguished physicians of
Ohio. Dr. Cotton, besides having these three
sons, who now represent him in the profession,
had two daughters, both of whom married
hysicians. The high character of Dr. Cotton
as been transmitted to his sons. It has seldom
been my fortune to meet three more dignified
and refined gentlemen.
MR. DUGAN, COLONEL MOORE, COLONEL COATES
- AND JUDGE THOMPSON
Took charge of the doctors during the afternoon
of Thursday, and in elegant carriages and be-
hind spirited horses, showed those sons of Escu-
lapius the surroundings of the city... So genial,
so pleasant, so entertaining were these gentle-
meñº" he whistle of the steamer was truly
an unwelcome sound. Mr. Dugan exhibited his
“talking dogs.” . Colonel Mooºshowed us how
“premises might be correct, but conclusions
wrong.” Colonel Coates dispensed the hospitali-
ties and judge Thompson proved by his anec-
dotes that he had seem dogtofs,
• THE PORTSMOUTH DOCTORS,
Doctors Finch, Jones, Bings Pixley, Schwab
and Cotton were untiring in their efforts to ren-
der the stay of the Visiting brethren pleasant.
THE MEETING.
The meeting was pronounced by all present as
i.
f * * , *,
} , . . ; tº “. & }
\. # Uk * * /* , -
L, MONDAY, JUNE 17,
not only the most pleasant, but o
y Ile Of
ſºle held in the State for years. #.§§
l Tº learned and most of the discussions were
Olear and to the subject.
REV, DR. BURR.
Por more than a third of a cent
º Ulry thi •
ãº
r • € t
§.e. on Tuesday morning, and .*.*...;
S º # calm,. benignant face, and heard his
, tender voice, now Sºal Cely tremulous at (
I
the age of sixty-eight, we felt th
* y at cy” *-
tinuange in one fiéià of labor was § º:
£ºſe: , May his sheaves at th *
embrace all the people of #;" *Yºst
































ºr. º their
l be educated without impairing their
r and made known on day of sale.
Ct and sale positive.
ſuses Will leave the office of Hemmel-
[48 Main street, Cincinnati, at 1 o’clock,
3 of H. DeGruyter & Co., Sheriff's office,
Cy., at 1% o'clock, and Newport Court-
2 at 1% o’clock, to take persons to and
free of Charge.
jë15-3t-HemózCod. DeG&Co
by Robert J. Cresap,
Broker and General Auctioneer, Nos.
272 Central av., above Seventh, Cin.
Sale—Six Building Lots, on Spring
venue, Addison and Cook Streets, at
(Monday) AFTERNOON, June 17,
., will be sold at public auction, on the
ose six Building Lots on Spring Grove
son, and Cook streets; also, a good lot
nd Addison Streets. Terms—Ofeathird
ance in One and two }. These lotS
ed, about two squares from the Brighton
the same distance from the new Stock
3 indisputable and sale positive.
any person, desiring to purchase good
s, in a good location, convenient to street
}roperty is increasing in value evºy §y,
x-CI:
are opportunity.
epohl, Bender & Enneking,
gents and Auctioneers, Office No. 32
West Court Street.
d Saloon, Corner of Fourth and
ill Streets, at Auction.
UESDAY MORNING, June 17,
the undersigned will sell at auction, on
a splendid stock of Groceries, all lately
sons désiring to purchase will find this a
pportunity to secure §§ bargãins on
Bsh goods. Will be sold by the whole or
OSitive. TêImS Cash.
je16-3t-H,B&E
Hoeffer & Bueming,
gents and Auctioneers, 652 Race St.,
pposite Findlay Market,
Story Brick Building, with Lot,
e Street, No. 167, at Auction.
n MONDAY, June 17, 1872,
the premises, on the South side of
167, between Linn and Baymiller sts,
2-story brick dwelling, containing 6
, cellar, hydrant, Cistern and a splen-
lanted With viness The lot has 25 feet
'eet, more, or léss, in depth. This
i chance to all désiring to procure
dence in the western part of the city
is raising in value, on a nice stree
lent neighborhood, or to those wishing
rable investment, Title good.
fourth Cash, balance in 1, 2 and 3 years,
secured by mortgage on the premises.
jelá-3t-14,16,17-Hé.E.
.
are, of course, that immenºś
jºi to conduct a Presidentiº
jºispeakers are to be paid:
ic; special trains are to be paid for;
f dollars are to be
urnals. Other items could be
which are inseparable from expº
cal campaigns.
iation will be
ind in Pennsylvania.”
}
ECRET
at the O
137 Sycam
|
Manhood
tute in the
3. -
the only knº
confidential
ture. Send
Separate en
See perfect
cured, and t
tute and Se
tlent S,
is a D
A. REGU
(as diploma
his Special a
eases. ReCé
are treated
and Impoter
or excesses,
fects: as em
dizzineSS, Iae
Stipation, CO
of memory a
for business
Sanity or CO
nently CUTed
fines himself
Class of dise
specialty tha
matter Who
cured. The
om 12 A. M.
Street, betwe
66 &
OUNG IV
yourselvé
nervous, wea.
IneSS, marriag
pliance for se
cure. Price $
Middle-aged
vance of thei
reg. you
€TSOIAS SUlf
especially tho
no time in ma
Female dise
mali $5. Con,
bet. Central av
of money
-Caſmpaign.
thousands of
anners to be raised in all parts of the Repu
* ertising im Imany
paid for adver ºã
in all polit-
Money collected by this 98.39.
ăiº, in the Western States
Then followed the names of officers
box 953, Cinc
Rºº-ºº:
thousands
ent office and received similar
= E−i–Š 4-2-º- s º
rºa -tº-
ion. ur years ago I Was in a
º: Four y g COIſl{d.
of Said a S-
Govern-
At


DIVIDED MEDICINES,
C’REPAIRED BY
The Divided Medicine Com’y,
CINCINNATI, OHIO.
The Company have the honor of bringing to the notice of the Profession, this NEw AND ExcEEDINGLY PRAUTICAL
METHOD of dividing into doses Medicinal and especially Narcotic Agencies, and recommending the same likewise to
the consideration of Managers of Hospitals, Boards of Health, and the Public in general.
The Divided Medicines are prepared by FREDERICK KRAUs, Chemist of the Company, with the most scrupulous
accuracy, according to the rules-of Pharmacy, in conformity with the latest improvements and discoveries in Chemistry, and
in such a manner that the several SQUARES must of necessity contain just the exact quantity of the PREPARATE in question,
as indicated on the envelope, and No MORE.
The Divided Medicines, being prepared by the fluid process and afterwards effused into mathematically accurate
square forms, it must be obvious, every drop of the solution necessarily containing an equal quantity of the medicament,
that in the solidified mass every Square will consequently contain accurately measured quantities.
But not only SoDUBLE, but also INSOLUBLE MEDICAMENTS, we are able by this process to reduce in most accurate
division into the form of DIVIDED MEDICINES. &
• This PATENTED METHOD of preparing Divided Medicines enables us to produce squares, each containing 1 grain,
; , , , ºo, and even idoo part of a grain, and, if so ordered, even less quantities, which accurate division could not be
effected by the dry process of preparing medicines.
Besides the peculiarity of THESE MEDICINES, that they are NOT LIABLE To SPOIL BY ANY LENGTH of TIME they may
be preserved, they recommend themselves to Physicians: first, because they may be administered instanter when ordered;
and, second, use they are perfectly reliable in their efficacy on account of their accurate preparation. At the same time,
the Divided Medicines claim this superiority over otherwise prepared medicines, that they may be administered to the
tender babe as well as to the decrepid old man, in an easy and agreeable manner, it being simply necessary to put into a
tablespoonful of water and swallow down, without experiencing any disagreeable taste.
Gentlemen of the profession, practicing in the country, will welcome these medicines gratefully, as being easily
transportable, enabling the Physician to furnish the sick directly at their professional calls with good accurately dosed
medicines; and that these medicines have the Superiority of being cheaper than any others, as seen by the schedule of prices.
Should any gentleman of the Profession wish to get these Divided Medicines, according to his own prescriptions,
stating accurately weight and doses to one of our agents, or send the same, as below, he will receive the medicines in any
number desired, (though not below one hundred squares,) within four days. '
For Samples, Price Lists, and Agencies, address
Divided Medicine Coe
I-3CIX 2688,
Or FRFDERICK KRAUS, Chemist and Druggist,
t Walnut Hills, Cincinnati, O.
MR. FREDERYCK KRAUs: CINCINNAT1, February 15, 1871.
Dear Sir—The specimens of your “ Divided Medicines,” handed to me for analysis, I have carefully
examined, and would report, that I find all the specimens to contain the substance they are said to contain, in the quantity
specified in each, viz:
SULPH:MORPH II....................... % grain in each square. ARSEN: ACID.......................... 1-20 grain in each square.
** CHINTNI .......................] ‘‘ ‘‘ {{. CALOMEL % “ • & { {
* COPPER........ * > * tº gº º ei º •......}% $3
RESPECTFp LLY Youps,
E. S. WAYNE, Analytic Chemist

O D O E& L E S S A. IN ID PA I L. A. T. A. E. L. E =
In calling the attention of Physicians and Druggists to the Cod Liver Oil manufactured by .
Messrs. MARVIN BROTHERs & BARTLETT, of Portsmouth, N. H., (of which we are the sole wholesale
agents in the United States, we can confidently assert that this article has merits which should
gain it the preference over any other Oil in the market.
Our notice was first attracted to this Oil by several leading physicians of the city, who had
found that it was not only well borne by invalids who had been unable to take that supplied
from other sources, but that its use was attended with such advantage as to prove its activity
and efficiency.
Careful testing with chemical reagents, and examination of the sensible properties of taste
and smell, convinced us that the claims of this Oil were well founded.
In order to secure the best medicinal effects, Cod Liver Oil should be derived from the per-
fectly fresh livers, and at such a temperature that certain principles contained in it should not be
volatilized. Thus prepared, the article is not a mere fuel or fattening agent, but also an alterative
of much value, as is attested by its beneficial influence in Scrofula, in Rachilic Affections, in
Chronic Rheumatism, &c.
The inferior Oils which abound in the market are some of them prepared from livers partially
decomposed, or by means of a degree of heat which drives off the iodine, bromine, &c., which the
oil naturally contains; others are made up in greater or less proportion of the oil from the livers
of lower priced fish. In either case the article is rendered not only less tolerable in the stomach,
but less valuable as a remedial agent.
We believe the leading druggists have always endeavored to furnish their customers with as
good an oil as possible, but hitherto they have been unable to secure a uniform quality, so that
from time to time complaints have been made to all apothecaries, either of disagreeable taste or
smell, or that the medicinal effects obtained have disappointed the expectations of the prescribers.
We are now, however, confident that we can offer Marvin’s Oil as a reliable preparation for
use in every case where an article of this kind is needed; and that the more extensively its merits
are tested by the medical profession the more highly will they be appreciated.
The Messrs. MARVIN, in order to devote their personal attention exclusively to the manufac-
ture of the Oil, have retired altogether from its sale, which is in our hands only.
JOHN WYETH & BROTHER, 1412 Walnut Street, Philadelphia.

JAMEs Fosºrºr, Jr. & co.
[ESTABLISHED, 1836.j
Importers and Manufacturers of
Optical and Physical Instruments,
eep constantly on hand first-class
English and French Microscopes, First-class objects
and Mieroscopical Apparatus ºf every descrip-
tion, Mestical Batteries, Thermometers,
t Hydrometers, Urinometers an
Chemicai Glass Ware.
*. attention given to adapting the best spectacles to all conditions
of signt.
We take pleasure in showing the latest novelties from the best Euro-
pean and American manufacturers.
JAMES FosTert, Jr. & Co.,
**. S. W. cor. 5th & Race Sts., Cincinnati, 0.
IXER, 5.IN.INMARSH's
º º
s Nsº
ºrE:º Q
No. 758 Bao ADw Ay, New York
HAVE been in the habit of applying and recommending the Truss,
manufactured by Dr. S. N. Marsh, for the last eight years, to the ex-
clusion of all others, and have found it to give general satisfaction, effect-
ing a radical cure, in the majority of cases, in a very few months.
As a Truss for the radical cure of Hernia, I think it far preferable to
any I have ever examined. LEWIS A, SAYRE, M. D.
Surgeon, Bellevue Hospital.
**
*
From Prof. Willard Parker to S. D. Tówásends M. D., Surgeon to the
Massachusetts General Hospital.
#EG leave to state for the benefit of all concerned, that I have known
Dr.'s. N. Marsh the last fifteen years. * * * I am in the constant
habit of sending my patients to him for treatment. I have been delighted
with his Truss, and the sūccess he has met with in producing a Radical
Cure of Hernia. He has instruments superior to any I have ever seen,
and his treatment is unattended with anv of the risks to the patient
that exist in many of the plans suggested and attempted to be carried
into execution. I have confidence in Dr. Marsh as a gentleman of honor
and integrity, and as such recommend him to the nearbèrs bf the medi-
cal profession generally. WILLARD PARKER, M. D.
Professor of Surgery, New York City
Af
Dr. S. N. Marsh's Patent Radical Cure Truss and all other kinds of
Trussés, shoulder Braces, Supporters, Elastic stockings, Suspensory
Bandages, Apparatus for Spinal Curvature, Club Feet, Bow Legs, and all
other Physical Deformities, made and accurately fitted at the Radical
Oure Truss Offices of S. N. MARSH & CO., No. 2 Wesey St. (Astor House),
New York, and S. N. MARSH, CORLISS & CO., No. 8 West Fourth St.,
between Main and Walnut, Cincinnati.
d
OPPOSITE THE HIGH STEEPLE,
sº Agonts for Clement's Patént Artifióial Legs.
F. E. SUIRE. E. S. WAYNE
F. E. suire & Co.,
wholesale DRUGGists,
IMC A. IN TJ E" A C T TJ IE, I INT G-
£HEMists AND PHARMAceutists,
CINCINNATI, OHIO.
Have constantly on hand a full assortment of
sex,xec ºxex) ox3. UGs ANOO myxxe)oxc)(N)es,
ckxxeryxxcAx. AxºpAx{A^eus,
TESTs, MEDICAL, GLASS WARE, &c, &c.,
And solicits the patronage of the trade and profession.
We would call attention to our select preparations, such as
Solid and Fluid Extracts,
Resinoids and Proximate Principles of Plants,
iſºde in accordance with the U. S. P. and other recognized authori-
ties.
ITINIFD AND R A RHC CHEMICALs,
Of the popular class of preparations known as
IE T, ILK! I ER, S,
We manufacture a full line. Those of our make may be relied apon as
being what they are represented, containing the active agents in them
in the quantity named. They will be found useful compounds, in which
# the nauseous taste of medicines are disguised, and they made pleasant to
take.
Bitter Wine of Iron,
An excellent Chalybeate and tonic, Wine of Iron, &c.
AGENTS FOR BULLOCK & CRENSHAW'S
Sugar-coated Pills and Granules.
Price Lists of preparations and of Sugar-coated Pills sent by Mail
upon application. The long standing and well and widely known repu-
tation of our house we offer as a guarantee for the reliability of our
preparation, and the quality of the goods sold by us generally,





Tw illiam Autenrieth,
ROBERT GLARKE & G0.’S
No. 71 WEST sIXTH sº REET,
BETWEEW WAINUT AND WINE,
CINCINNATI, OHIO,
MANUFACTURER OF AND DEALER IN
|| || || |||||||||
Abdominal Supporters, Trusses,
CLUB-F00T SHOES,
SPINAL APPARATUS, ETſ
Keeps constantly on hand a full variety of
Metalic and ERubber Syringes,
Stomach Pumps, Etc.
STOCKINGS FOR WABDCOSE WEDNS,
Special attention given to the fitting of Apparatus for Deformities.
gº Agent for DR. L. A. BABCOCK'S
Silver Uterine Supporter,
-ALSO–
DR. AHL's POROUS FELT SPLINTS,
-ALSO-
T) A. Y. * S S EP T, IN T S
-AND-
8. W. Elliott’s Saddle-bags
LIST OF NEW
MHL iBTH in Mºulis Hill;
HEWSON, A. Earth as a Topical Application in Surgery. $2.5o
BROWN, J. H. B. Medical Jurisprudence of Ihsanity. $4.5o
HARLEY, GEO. The Urine and its Derangements. $2.75
ALLINGHAM, WM. On the Rectum. $2 5o
SCHELLEN, Dr. H. Spectrum Analysis. Colored plates. $6 oo
LUBBock, Sir JNo. Prehistoric Times. Illustrated. $5 oc
HUXLEY, THOS. H. Manual of the Anatomy of Vertebrated
Animals. $2 5o
HINTON, JAS. Man and his Dwelling Place. $1 75
FONTAINE, E. How the World was Peopled. $2.5o
MITCHELL, S. W. Injuries of Nerves, and their Consequences.
$3 oo
DRAKE, F. S. Dictionary of American Biography, including Men
of the Time. 8vo. Cloth, $6 oo; Sheep, $7 oo; Half
Morocco, $8 5o.
FOTHERGILL, J. M. Digitalis; its Action and Use. $1 25
WUNDERLICH, C. A. Medical Thermometry and Human Tem-
perature, $2 oo
ALLEN, P. Aural Catarrh.. $2 oo
GANT, F. J. The Irritable Bladder. $250
HOLLAND, Sir HENRY. Recollections of Past Life. $2 oo
TAINE, H. English Literature. 2 vols. $10 oo
TAINE, H. Notes on England. $2.5o
CLARKE, E. H., and AMORY, R. Bromide of Potassium and
Ammonium. $1 5o 3:
MARKOE, T. M. Diseases of the Bones. $4.5o
SIMPSON, Sir J. Y. Diseases of Women. $3 oo
BUCK, G. Lithotomy and Lithotrity. $1 oo
TANNER, T. H. Memoranda of Poisons. 75 ctº
HENRY, M. H. Treatment of Venereal Diseases, as treated in the
Vienna Hospital. $1 oo *
COBBOLD, T. S. On Worms. $2 oo
APPLETON'S Hand Atlas of Modern Geography. $2.5o
BEETON'S Dictionary of Geography. $3 75
TOWNSEND, G. H. The Every Day Book of Modern Literature.
$375
How, J. Freemason's Manual. $4 25
DANA, JAS. Corals and Coral Islands. $6 oo
LYELL, (Sir CHAS.) Principles of Geology. 2 vols. $12 60
CURTIS, G. T. Life of Daniel Webster. 2 vols. $6 oo
HERSCHEL, Sir JNO. Outlines of Astronomy. $4 oo
LECKEY, W. E. H. Leaders of Public Opinion in Ireland. $175
CURTIUS, Prof. E. History of Greece, 3 vols. $7 50
MACAULAY, Lord. Complete Works. 4 vols. New ed. $9 oo
RECLUS, ELISEE. The Earth. $5 od
MALTHUS, T. R. Principle of Population. $4 oo
THOMAS, T. G. Diseases of Women. Cloth, $5 oc; Sheep,
$6 oo
ASHURST, JNO. Principles and Practice of Surgery. Cloth,
$6 5o; Sheep, $7 5o **
SMITH, J. L. Diseases of Children. Cloth, $5 od; Sheep, $6 oo
Medical, Scientific, and other Catalogues sent on application.
Any book in the above list sent by mail or express, free of charge,
1 on receipt of price.
65 West Fourth Street, Cincinnati, Ohio.
List of Pharmaceutical Preparations,
MIANUFACTURED BY
Jonºv wrºzºr & amozwan,
PHILADELPHIA.
—º-
ELIX. PHOS, IRON, QUININE AND STRYCHNIA,
ELIXIR OF GENTIAN FERRATED,
ELIXIR, WALERIANATE OF AMMONIA,
(Goddard’s Formula,)
ELIXIR VALERIANATEAMMONIA AND QUININE,
ELIXIR OF THE PYROPHOSPHATE OF IRON,
Iron, with Phosphorous and Calisaya,
FERRATED ELIXIR OF CINCHONA,
Iron, Peruvian Bark and Choice Aromatics,
ELIXIR OF CALISAYA BARK,
* ELIXIR PEPSIN, BISMUTH AND STRYCHNIA,
COMPOUND SYRUP OF HYPOPHOSPHITES,
COMPOUND SYRUP OF PHOSPHATES, OR CHEMICAL FOOD,
Composed of the Phosphates of Lime, Soda, Potassa and Iron,
BITTER WINE OF IRON,
Citrate of Iron amud Peruvian Bark,
FERRATED CORDIAL ELIXIR,
ELIXIECALISAYA BARK, WINE AND BISMUTH,
ELIXIR CALISAYA BARK, IRON AND STRYCHNIA,
WINE OF WILD CHERRY BARK, º
FERRATED WINE OF WILD CHERRY BARK,
ELIXIR OF PEPSIN AND BISMUTH,
TASTELESS COD LIVER OIL,
TASTELESS COD LIVER OIL. FERRATED,
BEEF, IRON AND WINE,
Extract of Beef, Citrate of Iron and sherry Wine,
ELIXIR WALERIANATE OF STRYCHNIA, WINE OF PEPSIN
SYRUP SUPERPHOSPHATE OF IRON. D
ELIXIR OF BISMUTH,
COMP. FLUIDEXT. BUCHU AND PAREIRA BRAVA.
slº.J EPIE OSITOTER, MIES.
Rectum, Waginal, and Male Urethral Suppositories and Soluble Pessaries of Pure Butter Cacao, made with great
eare, and of every variety of combination. Lists sent on application.
SPONGE TENTS.—For the Urethra, of every size and style, made of finest quality of sponge.
P
ºNº-
V.
-
º
:
..|
ºW.
||
§
*
*...* - *-* * * Słº-zz-sº
2 * ~ ; º ...Nº Nºv ºv sº. -
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NºżS.
*-
CINCINN ATI.
E" A C U L T Y.
J A M E S G R A H A M , M. D., D E AN,
Professor of the Theory and Practice of Medicine and Clinical Medicine.
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery.
W. H. GOBRECHT, M.D.,
T. A. REAMY, M.D.,
Professor of Obstetrics and Diseases of Children.
Professor of Anatomy.
JOHN L. CLEVELAND, M.D.,
P. S. CONNER, M.D.,
Professor of Surgical Anatomy.
Demonstrator of Anatomy.
JAMES T. WIIITTAKER, M.D.,
Professor of Physiology.
CHARLES KEARNS, M.D.,
Assistant to the Chair of Surgery.
SAMUEL NICKLY'S, M.D.,
Professor of Physics and Medical Chemistry
VV. V.V. SEFCLY, IN.I. D.,
I’rofessor of Diseases of the IEye and Far, and Secretary of the Faculty
E. NoBLE, Janitor, College Building, Sixth St., bet. Vine and Race
.*** **-
T. LOUIS BROWN. M. I.). Prosec to of Anatomy.

















*a*aeaeºſºl-CºA-aa– ~~~&l-tº-aa-ºeſºté
Nº. 225S-7 S-ZT*S*TS-7 St’CŞSºNEL:) º º e-ºr-ee-va-E-p
l →º –
Published ºx ery saturday.
- •º gº * *
- ºr-º-
tºs - * ... ºf a
CINCINNA Pi, JUNE, 1872.
#
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I Nſ O. E. × -
lºst Numbers, stian sil, smid ſº.
A.
Abscess, Cerebral, Trephined. . . . . . . . . . . . . . . . . ... 311
Abscesses, Multiple. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Abscesses, Spleen . . . . . . . . . . . . . . . - . . . . . . . . . . . 196
Academy of Medicine . . . . . . . . 156–199–207–240–246–258–271
Accident in Laboratory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Actonian Prize . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Adenoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241–271
Aethylidenchloride . . . . . . . . . . . . . . . . . . . . . 152
Agenesis Oculorum . . . . . . * * * * * * * * * * * * * 309
Agglutination Method * * * * * * * * * * * * * * * * 190
Agoraphobia . . . . . . . . . . . . . . . . . . . . . . . . . 61
Air Exhausting Apparatus . . . . . . . . . . . . . . . . . . . . 62–145
Alaska, Diseases of . . . . . . . . . * * * * * * * * * * * * * * * * * * * 24
Alcohol, Action of . . . . . . . . . . . . . . . . . . 140
Alcohol and Amblyopia . . . . . . . . . . . . . . 148
Alcohol at different Periods Life . . . . . . . . . . . . . . . 155
Alcohol, Coffee, Tea, etc. . . . . . . . . . . . . . . . . . . . 204
Allen's Aural Catarrh . . . . . . . . . . . . . . . . . . . * * * * * * * * * * 251
Amaurosis, Tobacco . . . . . . . . . . . . . . . . . . . . . .222
Amblyopia, Masturbation . . . . . . . . . . . . . . . . . . . . 288
American Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . 58
American Medical Association . . . . 149–177–188–228–229–261
American Infecundity . . . . * * * * * * * • * * * * * * * g 67
A mour de la Patrie . . . . . . . . . . . . . . . . . . . . . . . 203
Amputation Cervix Uteri. . . . . . . . . . . . . . . . . . . . . . . . 145
Anaesthesia, Inventor of . . . . . . . . . . . .
Anderson Lamp Bracket . . . . . . . . . . . . . . . . . . . . . . . 13
Aneurism, Foreign Bodies in . . . . . . . . . . . . . . . . . . . , 311
Animal Hospital . . . . . . . . . . . . . * * * * * * * * * s a s 125
Animal Laboratory, Physiology . . . . . . . . . . . . . . . . . . . 9
Anstie's Neuralgia . . . . . . . . . . . . . . . . . . . . . . . . 82
Anthracosis Pulmonum . . . . . . . . . . . . . . . . . . .91–102–114
Antidote to Carbolic Acid . . . . . . . . . . * * * * * * * * * * * * 84
Arsemiate Quinia in Tetanus . . . . . . . . . . . . . . . . . . . . . . 144
Ashurst's Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Atrophy Progressive Muscular. . . . . . . . . . . . . . . . . . . . . 218
Atropia, Antidote to Opium . . . . . . . . . . . . . . . . . . . . . . . . . 54
Autoplasty, Hand . . . . . . . . . . . . . . . . . . . . . . . 228
B
Baby Farms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Baker Brown, Relief for . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Bamberger's Introductory. . . . . . . . . . . . . . . . . . . . . . . . . . 262
Bartholow, Review Brown-Séquard. . . . . . . . . . . . . . . . . . 169
Battery, Good Samaritan Hospital . . . . . . . . . . . . . . . . . . . . S5
Bed-Sores, Galvanism in . . . . . . . . . . . . . . . . . . . . . . . 252
Belladonna against Mammary Secretion. . . . . . . . . . . . . 4
Bellevue Medical College . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Bennet's Consumption . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Benzine in Whooping Cough . . . . . . . . . . . . . . . . . . . . . . . . 204
Berlin Battle . . . . . . . * * * * * * * * * * * * * * * * * * * * * * * * * * 8
Bladder, Puncture of . . . . . . . . . . . º 10
Bladder, Rupture of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Blepharospasm . . . . . . . . . . . . . . 153
Boast Not . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .307
Bogus Medical Colleges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Books and Pamphlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81–118
Bordeaux in lieu of Strasbourg. . . . . . . . . . . . . . . . . . . . . . . 305
Bound in Human Skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Bromide Potash, Epilepsy . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Bronchocele, Injection in . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
Brown Scquard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225–307
Brown Sequard Lectures . . . . . . . . . . . . . 121–133–157
Bullet Explorers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
C
Calculi Preputial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Camphor in Phag. Chancres. . . . . . . . . . . . . . . . . . . . . . . . . . 310
Cancroid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75–90–126–136
Captured Students. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136–306
Carrier Pigeon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Catalepsy, Galvanism in . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304
Cataract . . . . . * * * * * * * * * * * * * * * * * * s = e º ºs e s e º a e s tº a 83
Catarrh, Middle Ear. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Catheterism in Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Census Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Cephalaeinatoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Cerebro-Spinal Meningitis. . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Cerebro-Spin. Mening. Conclusions . . . . . . . . . . . . . . . 213
Twenty-five Bound Copies of Volume II for Sale at $2.00 each.
Cerebro-Spin. History . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Cerebro-Spin. in New York . . . . . . . . . . . . . s & & 4 & 8 & º a 214
Cerebro-Spin, Morphia in . . . . . . . . ' ' ' ' - a . . . . 216
Cerebro-Spin. Pathology . . . . . . . . . . . . . . . . . . 211
Cerebro-Spin. Physostigma in . . . . . . . . . . . . . . . . . . . . . . 216
Cerebro-Spin, Quinia and Opium in . . . . . . . . . . . . . . 216
Cerebro-Spin. Recom. Am. Med. Assoc. . . . . . . . . 216
Cerebro-Spin. Review General . . . . . . . . . . . . . . . . . . . 209
Ceremonial Purification . . . . . . . . . . . . . . . . . . . . . . . . . 60
Charcoal in Gastric Dis . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Chemistry of Hail . . . . . . . . . . . . . . * * * * * * * * * * * * * * 78
Chemistry, Progress in . . . . . . . . . . . . . . . . . . . . 104
Chloral, Clinical Researches . . . . . . . . . . . . . . . . . . . . . . 113
Chloral in Gout . . . . . * * * * * * * * * * * * * * * * * * * * * * *
Chloral in Venereal Ulcers . . . . . . . . . . . . . . . . . . . . . 227
Chloral, Windication of . . . . . . . . . . . . . . . * * * * * * * * * * * * 99
Chlorate Potash in Dysentery . . . . . . . . . . . . . . . . . . . . 27
Chloride Ammon in Liver Dis. . . . . . . . . . . . . . . * * * * * * * 60
Chloroform in Robbery . . . . . . . . . . . . . . . . . . . . . . . . . 80
Cholera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21–141
Cholera in Russia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , 242
Cholera in Turkey . . . . . . . . . . . . . . . . . . . . . . . . . . . & E. & 4 8
Cimicifuga in Small Pox . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Circumcision of Corpses . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Cirrhosis of Liver . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Clinic, Readers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
Closure Paris School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Coal Dust in Lungs . . . . . . . . . . . . . . . . . . . . . . . . . . 91–102–114
College Dispensary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6)
College for Siberia. . . . . . . . . . . . . . . . . . . . . . . . . . * * * * * * * 20
Compressed Air in Whooping Cough. . . . . . . . . . . . . . . 24
Qongress, German Physicians’. . . . . . . . . . . . . . . . . . . . . . 31
Conjunctivitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Conquest of Alsace . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Constipation, Galvanism in . . . . . . . . . . . . . . . . . . . . . . . . 304
Cord, Dis. Gray Matter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
Cormack, Honors to . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Corpulence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09
Correspondence . . . . . . . . . . . . . . . . . . . . . . 32–45–95–105–142—214
Creosote, Test for . . . . . . . . . . . . . . . . . . . . . * * * * * * * * * * * * 276
Criminal Jurisprudence. ... . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Cross for Virchow. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Crotonchloralhydrate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Croup, Treatment of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Curious Suggestion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Customs of Physicians B. C. . . . . . . . . . . . . . . . . . . . . . . . . 179
Cysts, Treatment of... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
D
Dead on the Table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Death, Cause of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
B.º.º.º. Progress of . . . . . . . . . . . . . . . . . . . . . . 160–172
Delpech, Bust of . . . . . . • * * * * * * * * * * * * * * * a tº e º ºs e s s a s : w w e 303
Diabetes and Fourth Ventricle . . . . . . . . . . . . . . . . . . . . . 44
Diabetes, Galvanism in . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310
Diabetes Mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
Diagnosis, Significance of . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Dickson, Dr., Death of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Digitalis on Anaphrodisiac . . . . . . . . . . . . . . . . . . . . . . . . . 132
Digitalis Action on Circulation and Temp. . . . . . . . . . . 146
Digitalis in Delirium Tremens. . . . . . . . . . . . . . . . . . . 267
Doctor, Title of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Doctors Murdered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274
Dodge, Dr. I. S., Death of. . . . . . . . . . . . ** - - - - - - . . . . . . 120–155
Dogberry-cal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . * > * * * * * * * * * 130
Dubois, Death of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Duchek, Liver Cirrhosis. . . . . . . . . . . . . . . . . * * * * * * * . . . , 27
Dupuytren, Anecdote of... . . . . . . . . . . . . . . . . . . . . . . . . . 141
Dysentery, Chlor. Potash in . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Dysentery, Ipecac Enema in . . . . . . . . . . . . . . . . . . . . . . . . 74
Dysmenorrhoea. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
Dysmenorrhoea, Treatment of. . . . . . . . . . . . . . . . . . . . . . . . 23
E
Ears, Laycock on . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Eclipse, Dangers of . . . . . . . . . . . * * * * * * * * * * * * * * * * * * * * 9
Eds. Med. Assoc. U. S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
Educational Feature, New . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
Electrophysiologica. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Electrotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304
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Vol. 2.
C IN C IN N ATI,
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J U N E 29, 1872. No. 26.
JAS. T. VVHITTAKER, M. D.
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C O N T E N T S.
- Page
ORIGINAL ARTICLES
HERNIA CEREBRI, by P. S. Conner, M. D......................................301
CFREBRO-SPINAL MENINGITIS, by J. R. Black, M.D......................... 303
TRANSLATEoN
Electrotherapy, Collected from Various Sources (From Schmidt's
Jahrbücher, April 18, '72.)................................................. ..304
ACADEMY OF MED}{CHNIE
Transactions June 17, ”72.
Meningitis by Drs. Whittaker and Ludlow—Stone by Dr. Mussey
Uterine Fibroid, Specimen by Dr. Wood, Discussion by Drs.
Reamy, Young, Wood, Dawson, Mussey—Intra-Uterine Medi-
cation, Instrument by Dr. Reamy.............................................
MIEDICAI, NEWS
Havana Med. Students—Prof. Wm. W. Greene—Prof. Benj. How-
ard–Honors to Prof. Sayre—The Munich Jubileo—A Millienial
Celebration—Students at Strasbourg—Changes in Paris Facul-
ties—Dr, Brown Séquard—Joe Jefferson’s Eyes—The Night
Watches of Berlin—Female Med. Students—Dead on the Table
—Boast Not 306–308
e e g º te sº a º ºs w a tº a tº * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * is º is º a º ºs e s is a vºw a e s º ºs s ∈ a wº
Iº. EVIEWS
A Treatise on the Diseases of Infancy and Childhood by J. L.
Smith, M. D., New York—The Urine and its Derangements by
Geo. Harley, M. D. London—Minutes Amer. Med. Association..308
cLINICAL MEMORANDA
Extraction Fish-Hook from Oesophagus—Agenesis Oculorum—In-
oculation of Small-Pox by Skin Grafting—Vesicants in Ear
Diseases—Camphor in Phagedaenic Chancres—Galvanism in
Diabetes—Treatment of Tremor of the Hand—Tapping and
Strapping of Hydrocele—The Properties of the Principles of
Opium—Treatment of Ulcerous Paronychia—Foreign Bodies in
Aneurisms—Removal of Hair-Pin from the Bladder—Trephin-
ing a Cerebral Abscess—Sea-Sickness—Double Uterus--A Two
Pound Penis 309-312
To The Readiers of The Clinic.
s = e = e s a s a s e º a se e s ∈ tº e a se e s s e < * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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Dear Sir—The specimens of your “Divided Medicines,” handed to me for analysis, I have carefully
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E. S. WAYNE, Analytic Chemist.



T H H C T , T NT I. C.
301
Vol. 2.] S A T U R D A Y, J U N E 20, 1872. [No. 26,
Q R. I.G IN A L A R T I C L E S.
MHI E R N H A C E R E E R iſ e
BY
P. S. CoNNER, M. D.
prof. Surgical Anatomy in the Medical College of Ohio.
Read before the Ohio State Medical Society, June 12, 1872.
Nearly half a century ago Baron Larrey declared that
“a large hernia cerebri is one of the most serious acci-
dents accompanying wounds of the head, and it is sel-
dom that individuals so affected recover.” Why thisis so is
a question that has much engaged professional attention,
its consideration of course involving that of the associated
question of the nature of the protrusion. When and
under what circumstances is it developed ? There must
be a preliminary loss of substance of the cranium. In
the vast majority of cases this loss of substance is the
result of fracture or the application of the trephine, but
that it is not necessarily so is proved by such cases as
Caesar Hawkins' and Pearson's, in which there was loss
by progressive thinning in the one and extensive necrosis
in the other, both patients being syphilitic. The loss of
any extensive portion of the cranial vault, even to 7x5
inches as in the case reported by Kinkaid, of Ireland,
(Dub, Quart. Journ., Feb., 1869,) is by no means
necessarily followed by hermial protrusion; indeed such a
hernia need not be so much expected under these cir-
cumstances as when the opening is Smaller. Reported
cases have proved that Guthrie was not so far away
from the truth as has been by Some supposed, in saying
that “these protrusions rarely take place when a
considerable portion of the skull has been lost or re-
moved.” Generally the separation of these large pieces
of the bony covering of the brain is a slow process and
the result of necrosis, under which circumstances hernia
cerebri is not likely to occur, be the opening large or
small. Again, not only must the bony wall be defec-
g tive, but generally the dura mater has been lacerated
at the time of the injury or operation; yet the integrity
of this membrane under such circumstances does not
necessarily forbid the development of the protrusion,
for in consequence of pressure from below the membrane
may be pushed outwards and became gangrenous, or as in
the famous case reported in the Edinburg Medical Es-
says, torn by the violent impulse of the cerebral mass
against it, strengthened though it was by cicatricial
tissue of seven months standing.
Age seem to have some influence in the production of
the hernia ; certainly a decidedly greater number of
cases occur in patients under the age of puberty than is
proportionate to the relative frequency of lesions of the
head before and after that period, Facts, however, do
not warrant so sweeping an assertion as that of John
Bell, who declared that “whenever it is necessary to
make large openings in the cranium of boys, protrusion
of the brain and death ensue.” It is very doubtful if
sex has any influence upon the lesion in question. It
is true that the great majority of cases are in males, but
the same is true also of the relative frequency of the
injuries and operations which are likely to be followed
by the hernia. At what time in the progress of the
case does the protrusion occur ! It has been said that
in some cases the hernia manifested itself immediately
after the receipt of the injury. Using the term hernia in
its usual sense, to wit, the abnormal protrusion of a viscus
or part thereof from the cavity in which it is normally
contained, a hernia of the brain may certainly occur at
such a time, but this differs widely from what is techni-
cally known as hernia or fungus cerebri. This last may
appear as early as the third day or as late as in the
fourth month, but in the majority of cases it shows itself
in the latter part of the first or during the second week.
Its appearance and development may or may not be
attended with symptoms of cerebral disturbance. Very
generally the characteristic phenomena of inflammation
of the brain substance or the meninges, or both, appear
sooner or later, and death is preceeded by coma of longer
or shorter duration. In one of the fatal cases under
my care, it was not until the 21st day that headache
became a prominent symptom, and not until the 23rd
day, 16 hours before death, that convulsions occurred,
followed by coma,
What is the nature of this protrusion, slowly or rapidly
rising up through any abnormal cranial opening ;
pulsating synchronously with the heart ; in some cases
spontaneously subsiding ; in others falling back after
sloughing or removal or removals of protruding por-
tions; in yet others growing mushroom-like all the faster
the more it is meddled with ; always, even when very
small, a source of much anxiety, and throwing grave
doubts over the prognosis; in a large majority of cases
the complication of fractures of the skull that leads the
surgeon to say to himself, if not to others, “this case will
certainly prove fatal.”
In the various writings on the subject there have been
described as cases of hernia cerebri, luxuriant granula-
tions from the unbroken dura mater, blood clots, gran-
ulations arising from the injured brain substance, and
protrusions of cerebral matter more or less altered from
the state of health. We may leave out of consideration
exuberant granulations arising from the edges of the
wound and the dura mater at its base; for these, though
not uncommon, are of no special severity nor danger,
and should not be regarded nor described, as herniae
cerebri. Blood-clot tumors, again, need not detain us.
302
[JUNE 29, 1872.
T EHI E CIT, IISTIC.
We may find such very early, when they are the results of
primary hamorrhage, or later, when the blood is poured
out from small vessels opened by the inflammatory pro-
cesses going on in the part. It is very questionable if
such clots can become organized, and any enlargment
of these clot-tumors must if real be in consequence of
renewed bleeding, or be apparent only, the increase of
protrusion being due to pressure from below.
The two remaining forms of the protrusion may be
considered together, By some it has been contended
that there is not in any case a true pushing-out of the
brain-substance, but few as are the records of careful
microscopic examinations of portions of removed herniae
yet there are among these, reports of the finding of
unmistakable evidences of the cerebral nature of the
tumors, Again, if no brain substance is present, how
are we to understand such cases as that related by
Spring, where after successive growths and removals,
running through a period of eleven years, autopsy
showed complete absence of the left hemisphere, For
a long time the opinion was held that the tumor was
the result of the increased blood supply or the part, the
overfilled portion of the brain pushing out where it met
with least resistance, and by such pushing out, in many
cases, relieving the individual affected from the evils
that would otherwise have arisen from abnormal pres-
Sū Pe.
Again it has been held, as by Sedillot, that the pro-
trusion is due to pressure from within from intraven-
tricular dropsy ; thus associating the disease under
consideration with congenital encephalocele. In some
cases at least this pressure is undoubtedly the cause,
for post-mortem examinations have shown a distended
ventricle with softened walls, and before death for many
days sometimes there is a continual flow from the hernia
of a thin fluid in considerable amount, as I have
myself observed in one case.* As to how this
ventricular dropsy takes place we are of the opinion
that they are correct who maintain its dependence
upon, most generally, inflammation of the pia mater,
Any traumatic inflammation of this membrane spreads
rapidly from the place of injury over the whole side of
the head, and through the connection of the basilar pia
mater with the choroid plexus there is little difficulty
in understanding how secondary intraventricular inflam-
mation and effusion may occur. In Some cases doubtless
an inflammation of the lining membrane of the lateral
ventricle and of the choroid plexus is developed by con
tiguity from the local inflammation of the injured por-
tion of the brain, and this inflammation thus excited
will be followed by intraventricular effusion. The true
nature of the hernia is, I believe, expressed by Wilks
who says, “after fracture of the skull and injury or
sloughing of the dura mater an inflammatory exudation
takes place and this mixed with the softened oerebral
* Lowe attempted to explain these watery discharges by declaring
that the fluid was the natural Secretion of brain granulations as pus is
of granulations in other parts.
substance protrudes from the surface; if cut off it is
found to be composed of brain and inflammatory
products.” That such inflammation should be developed
is most natural. The cerebral substance has been more
or less contused and lacerated at the time of the injury,
perhaps of the operation; the parts either directly or
covered by the meninges are exposed to the air and thus
excited to inflame; and in not a few cases spiculae of
bone are driven deep down into the brain, and escape
detection and removal. Are not these, one or all,
sufficient to develope acute encephalitis and meningitis,
which latter, if not primary, “almost constantly coincides
with superficial inflammation of the convolutions?”
What are the pathological changes that take place in
the course of inflammation of the cerebral substance?
Says M. Laugier, the author of the article on Encepha-
litis, in the 13th vol. of the Nouveau Dictionnaire;
“thanks to Hayem's researches it is well known that the
inflammatory process presents in nervous tissue the same
characters as in other tissues, AS in all vascular parts,
proliferation of cellular elements, hypergemia and the
formation of an exudate constitute the essential
elements. It may terminate in hyperplasia or suppura-
tion, probably also in resolution, perhaps in gangrene.
“There is,” says the same author, “oedema and con-
gestion in parts around the inflammation-centre, and
serous effusion into the ventricles.” Jaccoud says;
“Vascular exosmosis follows the initial fluxion, and a
serous or sero-fibrinous exudation is poured out into
the tissue, which separates its elements and produces the
rapid early softening which characterizes encephalitis,
Most ordinarily the exudation presents itself in the form
of an albuminous mass, finely granular, diffused between
the nerve elements and mingled with Small flakes of
coagulated fibrine.”
Numerous post-mortem examinations in cases of
hernia cerebri have revealed just such a condition of
the protrusion and parts around as would be produced
by an inflammation presenting the characteristics above
given, I have myself found the posterior lobe of the
right hemisphere very extensively softened, even
diffluent, so much so that the posterior cornu of the
lateral ventricle could not be traced; the cortical sub-
stance of the middle lobe of dark color, shading off
through an olive-green to the normal color seen in the
anterior lobe. All the ventricles had been much dis-
tended, and their walls were softened. But slight
evidences were present of meningeal inflammation.
In a number of cases, a number too great to admit
of the theory of accidental association, cerebral abscesses
have been found to exist below the hernial protrusions.
Microscopic examinations of specimens from cases of
acute encephalitis, according to Jaccoud, show “with
the exudate the following elements; red corpuscles,
leucocytes granular or not, debris of fibres’ or nerve-
cells, masses of granulations, free nuclei, finally, fatty
granules coming either from the nerve-elements them-
selves, or the cells of the neuroglia which very probably
, JUNE 29, 1872.]
T IEEI IE C T , T INT I C .
303
are first attacked by inflammatory hypernutrition.”
Similar examinations of removed portions of hermial
tumors have shown with portions of tubules and cells,
broken down nerve-fibres and cells, free nuclei, blood
corpuscles and granular matter.
The argument in favor of the inflammatory origin of
hernia cerebri is further strengthened by the fact already
stated that the protrusions are most common in early
life, the period in which acute inflammations of the
brain and its coverings are most frequent and run highest
and yet further, by the fact of their comparatively sel-
dom occurrence in cases of necrosis of the cranial bones;
cases in which chronic inflammation has been long pres-
ent and in which acute encephalitis or meningitis is
very rarely developed,
If then cerebral and meningeal inflammation is the
cause of hernia cerebri, and if it is not the protrusion
and loss of brain-substance that kills, but this causative
inflammation, the indications of treatment are plain ;
viz., to remove all irritating causes as far as possible,
and moderate the inflammation by appropriate general
treatment. All cauterizing, excising, ligating, violently
compressing the protrusion must do harm, Maintaining,
cleanliness and slight pressure upon the tumor, and so
far as practicable excluding the air, are all the local
measures of treatment that it seems to me should be
adopted, I have myself applied nitrate of silver and
acetic acid, have made firm compression by adhesive
straps and lead plates, have used the knife, scissors and
the ligature, but shall hereafter hesitate a long while
before I repeat such treatment. If the inflammation
does not run so high as to bring about a fatal result, it
will after a time subside, and with its decrease will come
a spontaneous gradual reduction of the hernia,
-—º-o-º-
C E R E E R O S P IN A I. -N.I E N IN G IT I S.
BY
J. R. BLACK, M. D.
Columbus, Ohio,
As cerebro-spinal meningitis appears to be prevailing
more or less over the country, the following case may
prove instructive:
W. H. B., twenty-five years old, by occupation a
machinist, was seized April 25, with what appeared to
be a remittent form of fever. On the 26th, however,
the symptoms of concentrated disease in the head, assum-
ed a prominence which I hoped was mainly due to
sympathy with a deranged stomach. A thorough action
of a cathartic on the ensuing night did not give the
relief to the cephalic symptoms that I had hoped. The
pain persisted in the head, often of a severe lancinating
character. The face was flushed, the eyes slightly in-
jected, the skin moist, temperature nearly normal, the
pulse 82, but fuller and rather harder than natural.
The thirst was considerably increased, the tongue moist
and lightly furred. The mind was clear, though evi-
dently oppressed, and every now and then he said he
was chilly.
As he had not slept for 48 hours and the indications
all pointed to inflammation of the cerebral membranes,
I ordered bromide of potassium 15 grs., every hour, to
be continued until case and sleep were procured,
April 27. The morning report was, that the medicine
seemed to make him worse and more restless; he had
no sleep, but moaned and tossed with pain in the head
the night through. The pain shot from the forehead to
the back of the head every few minutes; and I noticed
that the head was decidedly retracted. By my invita-
tion, Dr. Spencer saw the case with me, and concurred
in the diagnosis of cerebro-spinal meningitis. As the
bromide seemed to be indicated on the physiological
property claimed for it, of diminishing the quantity of
the circulation in the brain, I determined to continue
it, and at the same time administer small doses of
morphine ; hoping that any exciting effect of the latter
would be guarded by the former. The effect not being
all I desired, or but partially quieting, I determined in
the evening as the patient was of a full habit to bleed;
which I did from the arm to the amount of a quart.
This to be followed with morphine one-fourth of a grain
and calomel half a grain every two hours until pain is
relieved and sleep procured.
April 29. Slept well, feels very much better, not so
much retraction of the head, in short all the symp-
toms, Save that shown by the tongue which was very
dry, were better. This treatment by morphine was
continued for a week with occasional cathartics, until
the disease was entirely subdued. His recovery was
slow but complete.
Though this was by no means a rapid and malignant
case; such as it was my fortune to see in 1864; yet the
character of the disease was unmistakable. In some
respects it is more instructive than the fulminant form
to which I have referred; for here the course of the
disease is so rapidly fatal that it is diffcult to discern
what treatment is beneficial and what is not. The good
effects of depletion and opium were very decided;
although the former was practiced at a period in the
case somewhat late, yet, as the result proved, not too
late. Of course venesection to be beneficial in the
fulminant form should be resorted to at a much earlier
period of the disease.
—-º-º-º---—
A BUST of DELPECH.-The city of Toulouse renders
homage to one of its most illustrious sons, by the in-
auguration, May 1, of a bust to the distinguished
surgeon, Delpech, which was placed in the capital
among the celebrities of France. The inauguration
oration was delivered by Prof. Bonisson, one of his
former pupils.
304
[JUNE 29, 1872.
TIEEE THE C T , T N T C .
E L E C T R O T H E R A P Y.
CoIIected from Various Sour|rces.
From Schmidt’s Jahrbücher, April 18, 1872.
Electrolysis and Galvano-cautery (Hedinger, Würtemburg),
For electrolysis the batteries to be recommended are
those of Daniell, Stöhrer and Pineus in the entire
strength of their construction. A chief consideration
is this, that the needle from the negative pole only be
introduced into the tumor, the positive to be placed
upon the skin in its vicinity. To avoid pain, which is
only experienced at the beginning of electrolysis, the
current is to be gradually strengthened. The duration
of sessions must not be less than } of an hour, may ex-
tend to $ an hour. The stronger the current, the more
marked is its effect in shrinkening the tumor; to a
speedy effect contribute also the softness and blood-
vessel richness of the tissue. -
The author himself has had but limited experience in
this way. His cases were 8truma, eaco8tosis, lipoma,
adenoma, myxoma, and several cases of complete opacity
of the membrana tympani. The tumors were partly re-
solved, partly, at least, essentially reduced. The cases
of opacity so far improved that the handle and drum
contents became visible.
For galvano-cautery the author recommends the bat-
tery of Groves; for cauterisations of short duration the
new battery of Bunsen with bichromate of potash and
dilute sulphuric acid is also appropriate.
Individual experience in this field the author has only
had in otology. He used the instrument of Jacoby for
ablation of the polyp. This ablation can only be prac-
tised in cases where the polyp, whose pedicle is not
broad, springs from Some base other than the promontory.
Else, the linear or punctated cauterisation must be
adopted and repeated, according to necessity, until final
resolution. The chief advantage of this treatment in
these cases consists in the fact that the remains of the
tumor becomes covered with a thick Secreting membrane,
hence the consequences of suppuration are avoided.
On several occasions, the author had the opportunity
of observing the development of a new membrana tym-
pani from the remains of the tumor, of cicatricial tissue.
Galvano-caustic perforation of the membrane has no
advantage over the usual method.
Tinnitus aurium was treated on the plan of Brenner
and when it was uncomplicated, as by catarrh of the
middle ear, the influence was favorable. Improvement
occurred in a case of one-sided paralysis of the acoustics
in consequence of atmospheric pressure. Congenital
deafness was not affected. Several cases of neuralgia
trigem. and occip. were cured as were also several of
joint stiffness and muscle paralysis after gun-shot
wounds. ---
Dr. Ludwig Seeter (Vienna) reports three-cases of
resolved tumors which are not without interest.
The first case was that of a young woman attacked in
the puerperaſ bed with left sided abdominal pains pro-
duced by a hard tumor which gradually extended to oc-
cupy almost the whole left lower half of the abdomen up
to the umbilicus. This tumor induced cramp in the
hip and knee joints which, with subsequent oedema of
the lower extremities and abdomen and albuminuria,
reduced the patient to the last degree. All treatment
both internal and external had been futile. After a
duration of six months, the electrical treatment began.
The positive pole was placed in the lumbar region, the
negative over the hypogastrium and the current was
gradually increased from 8-12 elements. Improvement
both local and general commenced after a few sessions,
and in 33 months cure was perfect.
The second case was that of a considerable swelling of
the glands of the right groin and vicinity as sequelae of
Scarlatina, in a young person. After two months this
Swelling presented as a dense, flat, exceedingly painful
tumor, which gradually increasing in size occupied the
whole space between the quadriceps cruris and adduc-
tors extending down to the middle of the thigh, render-
ing passive as well as active motion of the hip impossi-
ble. The application of the constant current was made
exactly as before. Improvement rapidly manifested,
and in 29 session (6 weeks) a perfectly normal condition
of the parts was established.
The third case was an inflammatory affection
of the right iliac fossa incident to puerperium
with great pain and tenderness and contraction of
the hip-joint, but without demonstrable tumor in
the abdomen. After two months duration the
electrical treatment was commenced as above described
and after 23 sessions (one month) the patient was cured.
Encouraging results were obtained also by the same
method of treatment in cases of exudation in the lungs
and pleurae but no detailed statements are given,
* Bysteria—Catalepsy.
Dr. v. Holst (Riega) reports atypical case of catalepsy
in a hysterical girl aged 17, with flexibilitas cerea of
the whole body including the muscles of mastication,
perfect anaesthesia of the skin and muscles, total loss of
consciousness except necessity of drink and urination,
superficial respiration of 20, pulse 80–100, temperature
30–30.5° R, and markedly diminished muscular reaction
to Faradisation. As all other means of treatment had
been without result, the author commenced galvaniza-
tion of the spine on the fifth day of the disease.
A descending current of 18–24 elements, Stöhrer's
plate battery, was without effect; a current from 30
elements both ascending and descending, however,
secured, during the whole time of application, an imme-
diate relaxation of the body including, at first, the
muscles of mastication, so that the patient, during
galvanization could be easily fed. At the same time
there was an increase in respiratory frequency to 40 and
suffusion of the hitherto pale face.
Under the continued application of this agent the
patient gained ground steadily through relapses and re-
newed attacks at longer intervals were not infrequent.
At the end of four months, after daily sessions, sensibility
and motion had become normal when suddenly a fourth
JUNE 29, 1872.]
TIEEE IEH C T , I INT I C .
*
305
attack of catalepsy ensued and lasted 24 hours. After
this the patient recovered entirely, Cutaneous Faradisa-
tion was still being maintained at time of report.
Tremor Mercurialis et Potatorum.
Dr. Camille Chapot Duvert (Paris) has observed most-
favorable effects in these affections by the use of the in-
duction current in the form of electric baths. He uses
the Bunsen's elements, medium size, primary current.
The positive pole, connected with a large carbon end is
put into the lower (foot) end of the bath, the negative,
a zinc plate into the upper (head). The baths are to be
taken daily, duration 20 minutes.
The patients treated for mercurial tremor were mostly
young persons: all recovered after 16-40 baths though
the tremors had existed from 8 weeks to 12 months.
The recovery was perfect and permanent. Only once
was there any recurrence, and this yielded to 14 baths.
With tremor, potatorum the author has treated but one
case. This was marked, however, affecting all the ex-
tremities. Seven electric baths cured it perfectly.
Constipation.
Cases of obstinate constipation cured by electricity
are reported by Dr. A. Cade (Paris), and Dr. Löwy
(Vienna).
Cady reports a case of 40 days constipation, a sequel
of former dysentery. The patient, a female of 80 years,
was very near death when the treatment began. The
author employed the increasing induction current, neg-
ative pole in the anus, positive over the umbilicus. In
ten minutes after the first session an operation ensued
though this effect had not been gained by all other kinds,
of therapy.
In Löwy's case the constipation was clearly induced by
the ingestion of an excess of grapes with the seeds.
After the adoption of various means, when the patient
was in collapse, having had stercoraceous vomiting, the
induction current was applied, one pole in the anus, the
other in the neighborhood of the pylorus. It was
allowed to run in full intensity for 15 minutes. There-
upon ensued a chill, stercoraceous vomiting and an
alvine discharge, all to be repeated with a repetition of
the Faradisation after several hours. On the next
morning two applications were made, followed directly
by fecal vomiting, and in two hours by the discharge of a
hen’s-egg sized mass of grape seed. Another Faradisa-
tion on the following day produced another discharge
of seed; whereupon a tedious convalescence to perfect
health. -
—º-o-º-
BordEAUx IN LIEU of STRASBOURG.—The Medical
Times and Gazette states that M. Jules Simon, the
Minister of Public Instruction in France, has accepted
in principle the creation of a Faculty of Medicine at
Bordeaux to replace that of Strasbourg, and that a com-
mission has been appointed to report upon the project
in question. It is also in contemplation to establish a
School of Medicine and a School of Pharmacy at Lyons.
A C A D E M Y O F MIE E M C H N E .
*
JAS, GRAHAM, M. D., PREST., L. WOLF, M. D., SECT,
Transactions June 17, 1872.
Reported by Joseph Ransohoff.
Meningitis,
DR, WHITTAKER called attention to a case
which he had reported at a previous meeting. The
patient, a girl 18 months old, presented all
the symptoms of basilar meningitis, which
had been diagnosticated, together with epilepti-
form siezures which occurred at the same hour upon
alternate days. Other members of the family suffering
at this time from malarial fever, the convulsions were
supposed to be of that origin, The child having been
placed upon quinia, made apparently rapid strides
towards convalescence, Within the last week, however,
all the symptoms of basilar meningitis have again
become manifest, and there is now no possibility of a
recovery.* The Dr, then alluded to the fact that though
meningitis often simulates intermittent fever in its
fluctuations yet in this case he believed in the super-
vention of the latter upon the former disease, or the co-
existence of both. In this belief he is supported by the
temporary effects of the quinia administered.
DR. LUDLow remarked that he had been called to a
patient nine years old, whom he found delirious and
in convulsions, There was one peculiarity with regard
to this case, that is, the child was semi-conscious while
in a convulsion, this condition being manifested by the
manner in which it followed a light held before its eyes.
The case was treated as one of meningitis, by calomel
and quinine internally, and by the application of leeches
to the temples, and cold to the head and neck,
Bronchial irritation supervening, the patient was placed
upon a cough mixture, and is at present apparently re-
covering from both diseases. . A
DR. W. H. MUSSEY exhibited the cast of a stone
which was sent to him by Dr. Jackson, of Boston, The
cast measured 6 inches in its longest and 4} inches in
its widest diameter. The patient from whom this was
removed suffered from stricture of the urethra, and was
in the habit of promoting a flow of urine by the intro-
duction of a bottle into his rectum. This method being
resorted to without relief, the sufferer introduced this
stone into his rectum, which upon an attempt at its ex-
pulsion probably caused a rupture of the intestine.
The stone was afterwards removed from the peritoneal
cavity by an incision made to the left of the umbilicus,
and after its removal the patient made an excellent re-
covery.
× Died June 21, Post-mortem denied.
306 Tº EI IEEE C
T I IN T C. [JUNE 29, 1872.
The Dr. also presented a pathological specimen taken
from a hen. It measured 5 inches in longest by 4 inches
in its widest diameter. The tumor was, in all prob-
ability, of ovarian origin.
Uterine Fibroid.
DR. T. WooD presented a specimen of this nature
which he removed from a patient aged 35. She was in
very good condition, and enjoyed excellent health, with
the exception of the distressing inconvenience caused
by the tumor, which had been growing for four years.
It was a multiple uterine fibroid, one portion of the tumor
extending to the umbilicus, while two other tumors
were depressed in the pelvic excavation, thus pressing
upwards the uterus and the bladder. This condition
gave rise to very frequent and painful micturition,
which suffering was, at the patient's express desire, the
immediate cause of the operation. During the opera-
tion the Dr. met with a peculiarity which he had never
before observed. After making an incision through the
abdominal wall, he came upon a membrane which
greatly resembled the omentum, and which was covered
by a very thick layer of adipose tissue. Supposing it to
be omentum, an unsuccessful attempt was made to
place it aside in order to make room for the removal of
the tumor. An incision was then made through this
membrane, which revealed the omentum in its proper
position beneath. This layer was then nothing but one
of cellulo-adipose tissue which had been formed between
the peritoneum and the abdominal walls. After an in-
cision through this tissue the tumor was removed to-
gether with the greater portion of uterus, a portion of
the cervix being left in the pelvic cavity. The ovaries
and broad ligaments were also allowed to remain. The
patient at the time of meeting was still alive.
DR. REAMY who had witnessed the operation stated
that it was a perfectly justifiable one since the patient
would have succumbed under the exhaustion caused by
so large a growth. He thought that the tumor was
twice as large at the time of removal, its size having
been reduced to this extent by its loss of blood. He
remarked further that the pain in micturating was as
constant as this act was frequent. He thought that
this together with the rapid development of the tumor
were causes sufficient in justification of the operation.
DR. YoUNG remarked that there was one point of
great interest connected with these cases of fibroid and
cystic tumors. This point was the subject of a rule
with Spencer Wells, who affirms that ovarian cysts
descend into the pelvic excavation, while fibroid tumors
rise into the abdominal cavity. This was a deviation
from that rule. -
DR. WooD stated that he placed very little reliance
on this rule, since he has seen very many exceptions |
to it.
DR. DAWSON observed that this specimen differed
from uterine tumors generally in its attachment, since
a part of it was bound down by the broad ligaments,
and since a portion of the tumor was depressed in the
pelvic cavity. Although the chances are decidedly
against the patient, the operation was perfectly justi-
fiable.
DR. MUSSEY remarked that he was treating a case of
uterine fibroid with electricity. In this instance the
tumor ean be felt in the pelvic excavation. It presses
the uterus upwards, and it can readily be distinguished
above the symphysis pubis. Before she came into the
Dr.'s charge, she was suffering from very debilitating
attacks of hemorrhage. Since the adoption of the treat-
ment with electricity the patient has observed no recur-
rence of the hemorrhage, and she has gained decidedly
in health. In this case from 12–20 cups were used, the
positive electrode being applied to the hypogastrium,
and the negative pole (a button attached to an insulated
wire) to the uterus itself. As to the tumor, it had been
diminishing in size during the first few months, but for
the last six months has been in statu quo. This partial
removal of the fibroid tumor has been in accordance
with the speaker’s observations which demonstrated that
for a certain time there will be a reduction in the size
under the use of electricity, but soon the latter seems
to lose its effect upon the tumor. To this rule, but one
exceptional case was found, namely, that of a large
tumor in the right side, which came on after delivery.
It extended from the lower border of the ribs to the
crest of the ileum. In this case the electricity (from
15–20 cups) was employed by means of broad electrodes
which were applied to the abdominal wall in the region
of the growth. Under this treatment the tumor lost at
least one-third of its original dimensions, and probably
a farther diminution would have been obtained if the
patient had not been several months pregnant. Under
these conditions it was considered best to abstain from
the use of electricity.
Intra-uterine Medication.
DR. REAMY presented to the Academy an instrument
of his own invention for intra-uterine medication. With
this he states that medicines of any character or strength
in solution can be applied to any part of the uterine
cavity with perfect facility, at the same time obviating
all the objections to uterine injections. *
As a full description of the instrument and its mode
of application will be furnished our readers by the
author, we refrain from any attempted description at
present. * *
On Motion the Academy stands adjourned over the
holiday8. -
—-sº-º-º-
MEDro,AL NEws.
º
THE HAVANA MEDICAL STUDENTS who were im-
prisoned and threatened with death for alleged desecra-
tion of a cemetery, have been released by government
orders. -
JUNE 29, 1872.]
TETH. cI.TISTI c.
307
PROF. W.M. WARREN GREENE, of the Bowdoin Med-
ical College, Maine, has accepted the Chair of Principles
and Practice of Surgery and Clinical Surgery in the
Long Island College Hospital, Brooklyn, N. Y.
DR. BENJAMIN HowARD, of New York, has accepted
the appointment as Professor of Principles of Surgery,
with Clinical Surgery and Diseases of the Genito-urinary
Organs in the Medical Department of the University of
Vermont,
AN AMERICAN SURGEON DECORATED.—His Majesty
the King of Sweden and Norway has bestowed, through
the legation at Washington, upon Dr. Lewis A. Sayre,
of New York, the knighthood of the Royal Order of the
Wasa, “in acknowledgment of the services rendered by
you to the study of medical science in Sweden.”
This is accompanied by the letters patent and a most
beautiful jeweled decoration, with Greek cross and
crown, together with letters, couched in terms of friend-
ship and admiration, from the King and the Royal
Physician.-Phil. Times, June 15, '72.
THE MUNICH JUBILEE.—On the first of August of
this year the University of Munich celebrates its four
hundredth anniversity. Representatives from all the
universities of Germany and Austria are invited to be
present. - 4.
A MILLENIAL CELEBRATION.—The University of
Oxford celebrates its one thousandth anniversary this
SUIIA). O16Iſ, -
STUDENTS AT STRASBOURG.—Up to May 27, 227
students had been registered at the new university of
Strasbourg.
THE PARIS FACULTY.—M. Béclard has been appointed
Professor of Physiology, vice M. Longet, deceased; and
M. Verneuil, Professor of Surgical Pathology, has been
transferred to the Professorship of Clinical Surgery made
vacant by the death of M. Laugier.
DR. BROWN-SíquARD.—The recent announcement
in our columns that Dr. Brown-Séquard would deliver a
course of lectures before the Harvard Medical School the
coming winter was premature. We learn that no
arrangement has as yet been made for the course alluded
to.—Bost. Med. Journ., June 20, 1872.
JoB. JEFFERSON's EYES.—The operation for the re-
lief of glaucoma which threatened a total blindness of
this distinguished actor has resulted successfully in the
hands of Dr. Reuling, of Baltimore.
THE NIGHT WATCHES OF BERLIN.-During last
month two sanitary night watches were opened in
Berlin. Their location is marked by a red cross of gas
lights for easy recognition. Each watch includes six
physicians and three experienced nurses. Of these each
alternate two physicians and one nurse stand guard
every night, in the summer months from 10 P.M., to 5%
A. M., in winter from 10 P.M., to 64 A. M. The interior
of these places is so arranged that reception and assist-
ance can be at once afforded in all cases of accident, and
the patients are retained under medical supervision
until they can be forwarded to their homes or to the
hospitals, The paraphernalia of instruments and
medicaments is of course complete.
FEMALE MEDICAI, STUDENTS.–In St. Petersburg in
consideration of the admission of females to the univer-
sity of Helsingfors the following laws have been estab-
lished: 1st, Females are admitted gratis to the lectures
of the medical faculty, and in consideration of a sum to
be hereafter established to the occupations of the labora-
tory and the anatomical theatre. 2nd, Lectures shall
be delivered in the Swedish language. 3rd, Females
are required to bring certificates as to their former edu-
cation and avocation. 4th, They are not allowed to
omit any examination.
At Zurich there are among the 200 medical students
some 20 women. This session, 15 new applicants are
registered; only five of these have as yet been accepted,
as the rest have only been able to exhibit pass-ports in
evidence of character. It is intended to be still more
rigid, in this regard in future, as it is designed to limit
this class of students.-Wien. Med. Presse, May 19,
1872.
DEAD ON THE TABLE.—On May 27, a patient with
osteo-myelitis was placed on the operating table at
Vienna for enucleation at the hip-joint. Chloroform
had been given, the femoral artery happily ligated, the
Langenbeck incision made, when as Prof. Billroth, the
operator, was busied with scraping off the periosteum
while in the act of Seizing the galvano-caustic noose to
divide the soft parts, there was heard a gurgle and his
patient was a corpse, Billroth performed tracheotomy
at once but in vain, as were all the other means of re-
suscitation undertaken. The operator had already
stated that the case was one of extreme danger as the
patient had been reduced to the last degree. He men-
tioned further that this was the third operation of this
kind during the day, and two of these had died under
the knife.—Allgem. Wien. Med. Zeit., June 4, '72.
BoAST NOT.-The late Mr. Lynn, an English surgeon
cut twenty-five patients for stone without losing one.
He them boasted that he had, at last, discovered the
secret of performing lithotomy with success. Afterwards
he declared that the Almighty punished him for his
presumption, for he lost the next four patients that he
cut.— Paciftic Med. and Surg. Journal. -
It was rather a small business for the great God of
the universe to kill four innocent afflicted men to dampen
the feathers of a self-conceited egotistical surgical ass.
This combination of egotism and blasphemy is a bow-
shot beyond anything we have ever seen in print, or out
of it. His last boast was greater than his first, Pun-
ished him by killing four other men l l l—Sr. Ed. Nash-
ville Jour. Medicine and Surgery, June, ’72.
308
[JUNE 29, 1872.
T IEEE TEH C T , T: INTI C.
REVIEWS.
A TREATISE ON THE DISEASEs. OF INFANCY AND
CHILDHooD. By J. Lewis Smith, M. D., New York.
Published by H. C. Lea, Philadelphia. For sale by
Robert Clarke & Co., Cincinnati, Ohio. Price $6.00,
Cloth $5.00.
It gives us pleasure to notice the publication of
the second edition of this valuable work. It comes to
us revised and enlarged, a handsome octavo containing
740 pages.
To the making of books there is no end, but good
books are limited. The ease and rapidity with which
books are ordinarily written, to the uninitiated is some-
thing wonderful. It has been said, and with a great deal
of truth, that all that is necessary for the production of
a book is that the ambitious and learned writer should
surround himself with the literature of his subject and
then proceed to compile. If he does his work well we
have a useful book. We are far from despising such
productions and extend our hearty thanks to workers of
this class. But our libraries are overrun with such
books, and it is difficult to read much in medicine with-
out being impressed with the idea that what is said has
been said.
But the book before us is not a compilation. While
the writer has made free use of other authors in bringing
his book up to the present status of his department of
medicine, he advances his own ideas with the freedom
of a man that has had clinical experience. We think
the author has done well what he endeavored to do.
We quote from his preface “he has endeavored to incor-
porate in the treatise all recently ascertained facts re-
lating to this branch of practice, and especially to rec-
ommend such modes of treatment as comport with and
are suggested by our present knowledge of the pathology
of early life, the efficacy of hygienic measures in the
treatment of the young and the recuperative powers of
the system. * * As a result of independent investi-
gation, opinions are now and then expressed different
from those commonly accepted. Novel views, however,
have not been presented, unless the author was fully
satisfied that they were substantiated by a sufficient
number of observations.” We know of no book on this
subject that we can more cordially recommend to the
medical student and the practitioner.
THE URINE AND ITS DERANGEMENTs with the Ap-
plication of Physiological Chemistry to the Diagnosis
and Treatment of Constitutional as well as Local Dis-
eases; being a course of original lectures delivered at
University College, London, by George Harley, M. D.,
F. R. S., F. R. C. P., Corr. Member various medical,
etc., societies, former Prof. Univ. Coll., and Physician
to Univ. Coll. Hospital, with illustrations. Philadelphia,
Lindsay and Blackiston, 1872. For sale by Robert
Clarke & Co. Price, $2.75.
These lectures were originally delivered as stated, and
afterwards published at intervals in the Medical Times
and Gazette. Two of them ouly Diabetes and Albumi-
nuria were subsequently reproduced separately.
Notwithstanding its confessed importance it is a
question whether there is a department in medicine that
becomes more distasteful to the general practitioner
than that of urinalysis. The young practitioner com-
mences by eagerly testing every specimen upon which
he can lay his hands. But the novelty soon wears off;
he soon tires of toying with his tubes and the time comes
when it is absolutely irksome to examine a case when
there is even more than a suspicion of kidney disease.
The older practitioner can hardly be hired to touch it,
he turns the specimen over to the chemist, if at all
conscientious, or, if not—and such, too, there are—he
turns over the specimen which he has so solicitously
obtained to the spontaneous processes of decomposition
and “goes in on general principles.” .*
Why is this the case? We do not stop to discuss
the reasons which actuate the last category. This con-
stitutes the great class of ‘regular' quacks who can write
75 prescriptions before breakfast without making a single
diagnosis, who sleep with the snore of the unctiously
pious and who die and are canonized in the good course
of time after having blocked the path of honor and
usefulness throughout the whole course of their indolent
lives,
Urinalysis is distasteful to many conscientious physi-
cians for two reasons. One is because this field is
usurped to such extent by the most unscrupulous
pretenders that the honest physician almost fears to
enter it. The other, and the main reason is the time
and the labor prerequisite to obtaining the necessary
knowledge and skill. The first is really no objection at
all or at least is only common to every means of diagnosis
and treatment in our possession. We may quote,
indeed, in this regard from the work upon the table.
“It is true that uroscopic charlatanism has, more or
less, in all ages, laid human credulity under contribution
and thereby brought discredit upon, and retarded the
advance of legitimate science; but this must not deter
the honest practitioner from reaping the advantages
which a knowledge of this secretion affords.”
The second objection may easily be obviated by the
study—it is so pleasantly written it may be studied by
simple perusal—of just the very book under review.
It is really wonderful how interest kindles into pleasure
—that pleasure which surpasses all other, the pleasure
of the acquisition of knowledge—as its pages are rapidly
turned.
We cannot give in the short notice which our space
affords even a synopsis of its contents. We may state
only that the work is systematically arranged in its full
and thorough description of the various ingredients of
the physiological and pathological Secretion and that
the chapters on diabetes and albuminuria (including
puerperal) occupy full one-third of the volume.
Two golden sentiments we encounter as we hastily
JUNE 29, 1872.]
TIEEE THE CIT, TINT I. C.
309
review its pages and we reproduce them here in evidence
of the spirit of its author, best of evidence, too, of the
value of his work.
“In fact until within the last year or two men have
been constantly attempting to place, as it were, the
pyramid of medical science on its apex instead of on its
base, and the result has naturally been that they reaped
little benefit from their labors. It seems, indeed, as if
they were only now becoming alive to the all-important
fact that Physiology is the only true basis of Rational
Medicine and that in direct proportion as they adopt
its principles will be the success of their labors in ad-
vancing the healing art. Such being the views now
held by the pioneers of Clinical Medicine in all coun-
tries, you will readily understand why, before entering
in the pathology of urine, I first try to give you a
succumct account of its physiology.”
And here is the other.
“When I hear men saying that the medicines they
are employing are little better than useless, *t often
occurs to me that they are, perhaps, not far from wrong,
although the want of success may not be, as they “vainly'
imagine, due to the impotence of remedies, but to
the want of knowledge and judgment brought to bear
on the employment of them. A man needs only to pay
a little attention to the teachings of physiology to learn
what powerful weapons nature has put into his hands.
Like all weapons, however, they may be turned to good
or to evil account, according to the knowledge or the in-
clination of their employer. I would even venture to
suggest to our skeptical brethren that it would, perhaps,
be wiser if, before passing judgment on any particular
remedy, they first made themselves familiar with the
how, when and why to employ it.”
It is really a matter of regret that we may not give a
synopsis of the author's views on the treatment of albu-
minuria and Bright's disease, but space compels us to
leave the richer treat to the reader of enjoying it in ex-
tenso in the author's better words. It is sufficient for
us to say that in our humble opinion, the book covers
its title.
In typography, etc., need it be stated, the book is
faultless.
MINUTES OF THE 23RD ANNUAL MEETING OF THE
AMER. MED. Association, Philadelphia, 1872,
Price, 50 cents.
The minutes include a full report of the transactions
with lists of delegates, announcements of committees,
etc. Two faults we have to find with these minutes;
1st, that they are not published in time to put one in
the hands of each delegate before he leaves the place of
meeting. See what lessons the politicians teach us in
this regard. 2nd, that they do not contain full reports,
at least abstracts, of the work of the special committees.
But we are not blinded by these two defects to the gen-
eral excellence of the minutes so far as concerns secre-
taryship or typography,
CLINICAL MEMORNADA.
EXTRACTION OF FISH-Hook FROM OESOPHAGUS.–
Dr. D. Cunningham of Wurtemburg, sends us the de-
tails of a case of accidental lodgement in the throat of a
fish-hook which he succeeded in removing by a very
ingenious device. -
“Every attempt on the part of the boy to detach the
hook by drawing on the line which protruded from the
mouth only imbedded it more deeply. As I could not
reach it nor see it, I took a pistol ball, hammered it out
flat and bored a hole through its centre. I then inserted
the line through the orifice of perforation and pushed
the ball down over the hook with a gum elastic catheter
The point of the hook became imbedded in the lead
when it was easily withdrawn.”
AGENESIS OCULORUM.—Dr. Parsons of Carbondale,
Illinois, sends a report of a case of congenital absence of
both eyeballs.
The palpebral openings are extremely small, the free
edges of the lids being furnished with cilia. No trace
of globes, only a smooth cavity lined with the conjunctiva
which was affected with inflammation, against which
the Doctor used injections of tannic acid, bromide of
ammonium and rose water. The child in other respects
is perfectly formed and is growing well.
It was born early in May, '72; the fourth child of a
woman of 25.
An absence of these important organs is not so unusual.
Dr. Strowbridge, of Philadelphia, (see the Ophthalmo-
logical Trans, of 1871,) reports three cases. In one of
these cases, there was absence of one eyeball, with a
large colaboma of the iris and choroid in the other.
INOCULATION OF SMALL-POX BY SKIN-GRAFTING.—
In a recent discussion on skin-grafting in the Berlin
Medical Society, Herren Hahn and Zülzer referred to
an instance recorded in the Deutsche Militair-arztlich.
Zeitschrift, in which portions of skin for grafting were
taken from the amputated limb of a woman in whom,
the day after the operation, the eruption of small-pox
appeared, and proved fatal. One of the four patients
on whom the skin was grafted had small-pox, but in a
mild form. He was, however, a man of intemperate
habits, and died, according to Herr Zülzer, of pneu-
monia.
VESICANTS IN EAR DISEASE,-According to Dr.
Gruber, of Vienna, vesicants are useful, 1st, to cure sub-
acute and chronic inflammatory processes in the ex-
ternal auditory meatus. 2nd, to abate pains that do
not yield to narcosis,
Vesicants are suitable only when the inflammation
originates in the bony canal, as they are either injurious or
unnecessary when the inflammation is in the cartilaginous
portion. The author advises that they be placed not
on the mastoid process, but under it.—Allg. Wien. Zig-
Arch. f. 0.
310
[JUNE 29, 1872.
T EEL HD CT, ITNTI C.
CAMPHOR IN PHAGEDAENIC CHANCRES.—By Dr.
Henri Gafé.-These remarks, based on thirteen clinical
observations, close with the following conclusions:
In all cases where camphor has been employed the re-
sult has been favorable, as is proven by the facts brought
forward by MM. Cochard, Bandoin, Viguard. A modi-
fication of the ulcer has been brought about promptly,
within eight days. The longest period which we have
observed was eight, the shortest two days. M. Bandoin
observes in an average of five days a very satisfactory
change. -
As is well known the duration of a chancre of what-
ever nature varies from five to eight weeks. We have
observed a mean of one month ; some of them, it is true,
are perfectly cured in 15-18 days. Surfaces of bad
nature, like buboes of long duration, are perhaps less
modified than chancres proper, but even they progress
under this medication infinitely more favorably and
quickly.
The employment of camphor is exempt from pain.
The powder is to a certain degree hemostatic, for we ob-
served a cessation of hemorrhage a number of times
after its application. It is likewise a potent disinfectant.
In a case of excessively fetid cancerous ulcer the appli-
cation of powdered camphor for three days sufficed to
modify it considerably in both odor and aspect.
But what is the best method of its application. As
for ourselves, we have always employed the method of
Netter, which consists in applying layer upon layer as
fast as the lower layers liquefy, None is to be removed
until treatment is ceased.
This medication should be employed so long as the
phagedaenic surface is covered by the pale pellicle
characteristic of it. So soon as the surface becomes rosy
and vivified, the pultaceous matter destroyed, camphor
is useless. The best treatment then is a mild applica-
tion. If the camphor be continued too long, it will
necessitate the application of the nitrate of silver,
when as much would be lost on the one hand as had
been gained on the other.—Journ. de Méd. d. l'Ouest—
Lyon Medicale, June 9, '72.
GALVANISM IN DIABETES-An interesting applica- |
tion of the constant galvanic current has been
recently made by M. Lefort (Gazette Médicale
de Paris, April 13) in a case of diabetes, He applied
the positive pole to the back of the neck, and
the negative pole to the hepatic region. The patient
was in the habit of passing five or six quarts of highly-
saccharine urine; but under the influence of the daily
application of the constant current the quantity
diminished to two quarts in twenty-four hours, and the
proportion of sugar was about one-fourth of what it had
been. The treatment, unfortunately, was interrupted
at the end of a month, and nothing further is known of
the history of the patient. Notwithstanding this, the
amelioration of the symptoms produced by galvanism
in this case affords ground for hope that it may have the
power of curing diabetes.—Phil. Times, June 15, '72.
TREATMENT OF TREMOR OF THE HAND.—-Dr. Cazenave
(Bordeaux) has devised a most ingenious instrument
[plate represented] to act as a support for the hand in
those distressing cases of manual tremulousness. The
support leaves the hand free in its movements so that
the mechanism of writing can be performed with ease.
In one of the number of cases narrated, a surgeon so far
regained steadiness as to be able to operate with skill.
In all the cases recovery was complete.—Gaz. Med. Paris.
TAPPING AND STRAPPING OF HYDROCELE.—In
regard, however, to hydrocele, it appears to me that we
have in this plan of tapping and strapping one which
satisfactorily fulfils the idea of curing safely, quickly,
and pleasantly, and which, though perhaps not about
to prove infallible, is one which should be certainly tried
in all cases (especially, I would add, those treated away
from the patient's home), before the injection of iodine
or other stimulant is resorted to. If cases, occur in
which neither the mode I here advocate nor the iodine
treatment is successful, I am of opinion that a combina-
tion of the two would be likely to prove so.-Bradley—
Brit. Med. Journ., June 1, ’72.
THE PROPERTIES OF THE PRINCIPLES OF OPIUM.–
Note by M. Rabuteau, presented to the Paris Academy
by Ch. Robin.
My experiments, some 150, have been made on man
in health and disease, on dogs, rabbits and frogs. I have
studied the action not only of the six principal alcaloids
of opium, but also of mecomic acid and meconine. These
different substances have been at times ingested per
stoma, at times injected hypodermically.
The alcaloids of opium may be classed as follows ac-
cording to their effects on man:
Order Soporific: Morphine, narceine, codeine; the
others do not induce sleep.
Order Toxic : Morphine, codeine thebaine, papaverine,
narceine, narcotine.
Order Analgesic :
papaverine, codeine.
alleviate pain.
Order Anexosmotic: Morphine, narceine.
do not arrest diarrhea.
Action when combined with chloroform or bromoform.
It is known that the combined action of morphine and
chloroform induces analgesia without of necessity pro-
ducing sleep. A dog which had received 5 per cent.
chlorohydrate of narceine under the skin, and was after
wards anaesthetised by chloroform did not feel anything
on awakening. He could be pinched, stuck, marched
on his feet without evincing the least pain; yet he was
able to walk, run even around the the laboratory. This
extraordinary condition in which sensation was totally
abolished, persisted for several hours. I have discovered
that the same results, in different degrees, may be ob-
tained with bromoform or chloral and any other alkaloid
of opium except narcotine.—Gaz, Med. de Paris, May
4, 1872,
Narceine, morphine, thebaine,
Narcotine does not seem to
The others
JUNE 29, 1872.]
T E-ITEI C T , T TNT T C .
311
THE TREATMENT OF ULCEROUS PARONYCHIA,-The
occlusive method,according to the precepts of Chassaignac
(covering the extremity with silk dressings), affords the
greatest Service. It quiets pain, modifies the surface,
favors cicatrisation. It is the treatment par excellence.
M. Tourneur. has had excellent results with another
method, as yet, but little known, viz., the application
of the powder of iodoform. -
In three most rebellious cases Diday obtained a cure
by applying with care and perseverance a solution of
nitrate of silver 1 grim, 20. It was applied on charpie
which, thus saturated, was forced down in between the
ulcerations to the bottom. In these three cases, ameli-
oration commenced with the first applications and pro-
gressed uninterruptedly, Cure was not complete, how-
ever, until after 4–6 weeks,—Annales de Dermat. et de
Syphil., No. 2, 3. '72.—Lyon Medicale, June 9, '72,
ON SOME FURTHER ATTEMPTs To CURE LARGE IN-
TERNAL ANEURISMS. By William Murray, M. D.—
This was an account of some attempts to cure internal
aneurisms by the insertion of foreign bodies with a view
to the formation of clots in the interior of the sac. Some
of these bodies were introduced and again withdrawn
(needles), and their introduction was repeated at inter-
vals with manifest thickening of the aneurismal walls
on each occasion; others were of a material the presence
of which would be as harmeless as possible (carbolized
catgut), and they were used because of the hope that
their absorption might take place after the work of co-
agulation was completed. Lastly, wire was tried, as in
Mr. Moore's case, and with more favorable results as
regarded the preservation of the patient's life, he having
laid more than three weeks with twenty-four feet of
wire in him. Although none of these efforts were actu-
ally successful in curing the patient, they marked out
a line of practice which might some day be perfectly
safe and successful.—Brit. Med. Journ., June 1, ’72.
REMOVAL OF A HAIR-PIN FROM THE BLADDER OF A
WOMAN.—Elizabeth Woods, aged 25, unmarried, a
sewing-machine girl, admitted into the Melbourne
Hospital, January 17th, 1872. Two days before her
admission she had applied as an out-patient, stating that
she had a hair-pin in her bladder. The vagina and the
bladder were carefully examined, but no trace of any
foreign body could be found. On the 17th she again
applied, apparently in great pain. Another examina-
tion was made, and the pin was then detected in the
bladder. Her account is, that she had great difficulty
in making water, and believing that there was some
obstruction in her urethra, she attempted to clear it by
passing one of her hair-pins up. By some means it
slipped from her fingers and went into her bladder. She
says she has often passed a hair-pin up her urethra. She
was put under chloroform, and the urethra dilated by
Weiss's dilator. On putting the fingers into the bladder,
the hair-pin was found lying immediately behind the
symphysis pubis. The two points were thrust through
the mucous membrane of the bladder, the round end
pointing downwards and backwards, being quite free.
A pair of forceps was passed along the fingers, the round
end was caught hold of, and the pin removed. On the
following morning the patient stated that she was quite
free from pain. She had perfect command of her blad-
der, and there was not the slightest incontinence of
urine from beginning to end. She was discharged well
on the 25th.-Australian Medical Journal. -
—-º-e-ºn-
Trephinaing a Cerebral Abscess
Surgeon J. T. Weeds, U. S. A., reports a case incident
to gun-shot wound. The diagnosis was established and
death was imminent. The operation is thus graphically
described :
“Made a crucial incision through the integument and
sub-ligamental tissues to the bone, over the left frontal
eminence, cut the supra-orbital branch of the left oph-
thalmic and left anterior temporal arteries; closed them
by torsion; bleeding stopped; applied the centerpin of
Dr. Galt's conical screw trephine, at a point seven-
eighths of an inch to the left of the mesial line, and an
inch above the superciliary ridge. I selected this local-
ity to avoid the falx cerebri and longitudinal sinus, to
have uninjured bone to operate on, and it being the
point over what I believed to be the position of the
abscess. • -
“A button of bone was removed without the least
difficulty, but much to my mortification there lay, in
contact with the calvarium, the dura-mater, in appar-
ently a healthy condition, the coma as deep, and the
respiration as embarrassed, as before the operation.
What was to be done? Abandon the patient to certain
and speedy death, and console myself with the belief
that, having used the trephine, my duty was all per-
formed? No, I felt satisfied my patient was dying
from cerebral pressure, and I was equally well satisfied
that pressure was produced by a cerebral abscess, and
that abscess, I had already determined, lay beneath the
left frontal eminence—the point I had selected for the
operation. -
“I proceeded to examine the wound and its surround-
ings closely. Just to the left of the fenestra was a
shallow groove, three-quarters of an inch long, made by
the bullet; the bone seemed healthy; immediately on
the side of the opening in the skull next to the mesial
line, and beneath the groove, was a small delicate scale
of bone flaked off the inner surface of the internal table,
The dura-mater at this point, was slightly lacerated,
but not inflamed, and seemed to be closely adherent to
the skull. I thought it presented a bluish tinge I had
never before observed, and it seemed to bulge up further
into the fenestra than usual. I also imagined I could
distinguish obscure fluctuation—I might be mistaken,
it was so obscure—it might be only a fancy; yet I was
convinced an abscess existed in close proximity to where
312
[JUNE 29, 1872.
T TH. H. C. LI INTI C.
the operation had been performed, and probably directly
beneath the fenestra, I remembered how Roux, in a
similar case, after trephining his patient, and even incis.
ing the dura-mater, hesitated to extend the incision into
the cerebral substance. Hispatient died, and an autopsy
demonstrated that an incision, half an inch deep, through
the external vesicular layer, would have reached and
evacuated a large abscess. The celebrated cases of Du-
puytren, Petit, Detmold, and Hawkins, flashed across
my mind, and without further hesitation, my resolution
was taken, I incised the dura-mater, and plunged my
knife into the cerebral substance, My diagnosis Was
correct—half an ounce of dark green and somewhat fetid
pus flowed from the wound. Yet the coma and stertor
continued, apparently not the least improved by the
operation.
“I cleansed and dressed the wound in the usual man-
ner, put my patient to bed with head and shoulders ele-
wated, applied a refrigerant mixture to the head, and
waited anxiously for the result. The stertor gradually
subsided; at 10 o'clock P. M. he moved easily; at mid-
night he turned, and asked his attendant for water.
“The subsequent treatment was simply expectant.
Not a single unfavorable symptom supervened. The
wound healed rapidly, and in two weeks my patient
was walking about convalescent.”—Nashville Journal.
SEA-SICKNESS,-As regards treatment, since sea-sick-
ness arises from certain impressions on the senses, the
obvious indication is to render these sensations as feeble
as possible. Application of the mind to an engrossing
book will keep it off for a short period; and Dr. Cham-
bers relates that his having to bind up a broken finger
of one of the seamen relieved his own distress for the
time. But the mind will speedily become alive to the
sensations which force themselves on its attention. In
order to lessen them as much as possible, the patient
should preserve the recumbent posture, as near the
center of the ship as possible; he should lie on a thickly
padded couch, so as to diminish the vibration. Fresh
air should be admitted in order to remove bad smells.
The eyes should be shaded, and as much noise as possi-
ble shut out. As regards drugs, the most rational Sug-
gestion is that of Dr. Döring, of Vienna, that a full dose
of hydrate of chloral should be taken shortly before the
vessel starts; and even in long voyages the repeated use
of this medicine will ensure comfortable nights without
the disagreeable after-effects of opium and chloroform.—
Pollard–Brit. Med. Journ., June 8, '72.
Double UTERUS.—Dr. Lloyd Roberts (Manchester
Med. Soc., Apr. 3, '72.) showed an interesting specimen
of double uterus and vagina, of the highest degree of
division, taken from a young woman who died of
epilepsy. She was also found to have only one kidney.
AMPUTATION OF THE PENIS.—Mr. Westmorland
(Manchester Med. Soc., Apr. 3, '72.) exhibited a penis
weighing one pound and ten ounces, which he had
amputated on account of venereal warts,
To THE READERs or “THE CLINHC). *
The close of the first half of the year ends the second
volume of THE CLINIC, In the retrospect which we
may now enjoy we experience in every sense that kind
of satisfaction which is the legitimate reward of honest
effort. It will scarcely be credited by those who are
Somewhat familiar with the great expense of medical
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Among the many self-evident good effects which such
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The time is but short when the columns of these
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Portable Electro-Magnetic Machines, published in his recent
work on Nervous Diseases, has reference only to the im-
proved and re-modified Instruments made by our Company.
MEREDITH CLYMER, M. D., Prof. of Diseases of the Neº-
vous System and of the Mind, &c., &c.—“I consider theºr
Galvanic and Induction Instruments as decidedly the very
best for the therapeutic application of Electricity.”
LEWIS BAUER, Prof. of Surgery, St. Louis:—‘ In neat-
ness, compactness and efficacy, they can not be excelled.”
ALFRED C. GARRATT, M. D., Boston :-"In cases of
local palsy of muscles, it is the best, decidedly, of any and
all I have seen.”
Similar Testimonials have been received from JOHN J.
CRANE, M. D., Vice-Pres. Med. Board, Bellevue Hospital;
ALEX. B. MOTT, Prof. of Surgery; A. MURRAY, M. D.;
CHAS. E. BLUMENTHAL, M. D.; E. C. SEGUIN, MI. D.;
ALLEN MAYNARD, M. D., Cleveland, O.; Dr. C. WAN NIE,
Waynesburg, Pa.; Dr. JOHN KING, Cincinnati; Dr. JAMES
KELLY, Florence, O.; Dr. JOHN BECKER, Brighton, Iowa;
Dr. G. R. SKINNER, Polo, Ill.; Dr. E. R. MAYER, Wilkes-
barre, Pa.; JOHN J. CALDWILL, M. D., Brooklyn, and
many other prominent Physicians who are using our Appa-
ratus in their daily practice, who thoroughly understand,
both theoretically and practically, what is required in an
Electrical Instrument for medical purposes.
CALL OR SEND FOR CIRCULAR AND PRICE LIST.
Thritia
Are furnished to Officers and Soldiers on Government
account. ^-
I claim to have combined such improvements in ARTI-
FICIAL LIMBS as to make them superior to any others now
in use. For the truth of this assertion, I would respectfully
refer to my descriptive pamphlet which is sent free to the
Medical profession, or to those wishing information con-
cerning Artificial Limbs. It gives illustrations and a
full description of the Limbs and tells why my attention
was called to artificial limbs—my choice in a limb–why I
commenced to manufacture them—suggestions to those suf-
fering from loss of limbs—is it best to have an artificial
limb—why is it that some get artificial limbs and do not
wear them—what class of men ought to manufacture ar-
tificial limbs—testimonials from the press and from those
wearing the limbs—how to order a limb, etc., etc.
All communications should be addressed to
JAMES A. FOSTER,
911 Chestnut Street, Philadelphia, Pa. No. 60 West
Fourth street. Cincinnati, Ohio, or 17.2 Jef.
ferson Avenue, Detroit, Mich.
SAML. P. THOMAS
O R. y
DE ALER IN
English, French and Scotch
GOODs,
34 West Fourth Street,
C.A.W.C.A.W.W.? Z"A.



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The GOOD SAMARITAN HOSPITAL is pleasantly situated on an eminence overlooking the city, at the corner
of sixth and Lock streets. It is handsomely furnished throughout, and is provided with all the necessary ap-
pointments of a First-class Hospital. Porticoes, with commanding views, surround the whole house, and wide
halls and abundant windows secure that full and free ventilation which is so essential to health and comfort.
Service is furnished by the
SISTERS OF CHARITY,
Under the Superintendence of the well-known SISTER ANTHONY, with that care and attention which only they who
have sacrificed their lives to such purpose know how to afford. -
The regular Medical Attendance of the house is supplied by the Faculty of the Medical College of Ohio, each
Professor presiding over his own especial department. Patients may, however, select from the regular profession
of the city any physician of their choice. - -
The GOOD SAMARITAN HOSPITAL presents oxtra inducements to Invalids throughout the State as a safe and
quiet asylum in any case of protracted illness, or in cases, more particularly, requiring Surgical Operation, where
some stay is necessary in after treatment. *
Rooms vary in price, according to the character of appointments necessary and service required, ranging, in
general terms, between $3.00 and $15.00 per week. This includes, of course, the diet list, and every demand of
service.
tº Address,
SISTER ANTHON.Y,
Hospital of the Good Samaritan,
Corner of Siacth and Lock Sts., Cincinnati. Ohio.





















































































































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CINCINN ATI.
—--"
IET A C U L T Y .
J A M E S G FR A H A M , M. D., D E AN,
Professor of the Theory and I?ractice Of Medicine and Clinical IMedicine.
2"
ROBERTS BARTHOLOW, M.D., W. W. DAWSON, M.D.,
Professor of Materia Medica and Therapeutics. Professor of Principles and Practice of Surgery and Clinical Surgery.
W. H. GOBRECHT, M.D.,
Professor of Anatomy. * T. A. REAMY, M.D.,
P. S. CONNER, M.D.,
Professor of Surgical Anatomy. JOHN L. CLEVELAND, M.D.,
JAMES T. WHITTAKER, M.D., Demonstrator of Anatomy.
IProfessor of Physiology.
SAMUEL NICKLES, M.D.,
Professor of Physics and Medical Chemistry
Professor of Obstetrics and Diseases of Children.
CHARLES KEARNS, M.D.,
Assistant to the Chair of Surgery.
W. W. SEELY, MI. D.,
Professor of L) is eases of the IEye and Hjar, and Secretary of the Faculty
,-
T. Louis Brows, M. I.). Prosec tor of Anatomy. E. NoBLE, Janitor, College Building, Sixth St., bet. Vine and Race





















Electric Chamber Samaritan Hosp. . . . . . . . . . . ... • - • * * 86
Electricity in Labor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Electricity in Trachoma. . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Electricity in Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Electricity in Vomiting Pregnancy . . . . . . . . . . . . . . . . 60
Electricity Med. and Apparatus. . . . . . . . . 25
Electricity, Prize in . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Embalming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Emperor of Brazil . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
Encyclopedia Ophthalmology. . . . . . . . . . . . . . . . . . . . . . . . 70
Enuresis, Treatment of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168-
Epiglottis, Position in Age. . . . . . . . . . . . . . . . . . . . . . . . . 285
Epilepsy, Artificial Induction . . . . . . . . . . . . . . . . . 200
Epilepsy, Management of . . . . . . . . . . . . . . . . . . . . . . . . . 180
Epileptiform Tić . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Ergot in Dysentery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Ergot in Varices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Ergot in Hemoptysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Error of the Empire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Eucalyptus in Intermittents . . . . . . . . . . . . . . . . . . . . . . . . 263
Examination Questions . . . . . . • & s = e s s = * * * * * * = . . . 107
Exegetic Document . . . . . . . . . . . . . . . . . . . . . . . . . . . 68s
Expectoration in Asthma. . . . . . . . . . . . . . . . . . . . . . . 31
Experiments in Epilepsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Extra-Uterine Pregnancy . . . . . . . . . . . . . . . 105
Extract of Meat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
F -
Facial Nerve, Spasm of . . . . . . . . . . . . . . . . . . . . . . . . . . 154
False Melanosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Fecundity of Germs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Female Students . . . . . .# - - - - - - - - - - - - - - - * * * * * * * * * * * * 307
Female City Physician. . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
First Medical Journal . . . . . . . . . . . . . . . . . . . . . . . . 203
Fish Hook in Oesophagus. . . . . . . . . . . . . . . . . . . . . . . . 309
Fisk’s Brain, Weight of . . . . . . . . . . . . . . . . . . . . . . . . 48
Fissure of Lids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _T
Fistula for Cystitis . . . . . . . . . . . . . . . . . . . . . 40–84–250
Fistula in Ano. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .218
Foetation Extra-Uterine . . . . . . . 19
Foster, Dr. H. C., Death of . . . . . . . . . . . . . . . . . . . . . 150
French Patriotism . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
G
Gastric Juice in Cancer, etc . . . . . . . . . . . . . . . . . . . . . . . 62
Generous Testatrice . . . . . 141
Generation Artificial. . . . . . . . . . . . . . . . . . . . . . . . . 261
German Professors' Salary . . . . . . . . . . . . . . . . . . . . . . . . . 203
German Provisions for Science . . . . . . . . . . . . . . . . . 79
German Therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Germs, Healthy Blood. . . . . . . . . . . . . . . . . . . . . . . 147
Goitre, Iodine Injections in . . . . . . . . . . . . . . . . . . . . . . . . . 241
Gomorrhea, Water Treatment. . . . . . . . . . . . 34
Good Samaritan Hospital. . . . . . . . . . . . . . . . . . . . . . . . 36
Graduates of 1872. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179-119
Greene, Prof. W. G. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Guarana in Sick Headache . . . . . . . . . . . . . . . . . . . . . . 220
Gun Shot Wounds, Pathology. . . . . . . . . . . . . . . . . . . . . . 244
H
Płair Changes . . . . . . . . . . . . . . . . . . . . * * * * * * * * * * * * * * 148
Hair Pin in Bladder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.11
Harley's Urine and Derangements . . . . . . . . . . . . . . . . . 308
Heavily Backed Journal . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Heels vs. Brains. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Hemorrhoids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
Henry’s Venereal Dis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
Hernia Cerebri . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Hernia, Digital Dilatation. . . . . . 168
Hernia, Irreducible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Hernia, Puncture of... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Hero Hunting . . . . . . . . . . . . . . . . . . . . . . . . . . . . • * * * * * * * 2
Home News . . . . . . 35–72—84–96–108-119–132–144–180–204–228
Homoeopathic Surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Honors Declined. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Honors Reciprocated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Honors to Dr. Gill. . . . . . . . . . . . . . . . . . . . . . . . . . . * * * m = 2 * 130
Honors to Physicians, Prince. . . . . . . . . . . . . . . . . . . . . . . 59
Hop Pillow. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Hoppe Seyler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Hospital Capacity, Vienna . . . . . . . . . . . . . . . . . . . . . . . . . . 54
#º Beni... d Strapping . . . . . . . . . . . . . . . . . . ;
rocele, Tapping and Strapping . . . . . . . . . . . . . . . . . . . 3
#. Treatment of. . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Hydrophobia, Pathology of . . . . . . . . . . . . . . . . . . . . . . . . . 29
Hydrophobia, Spontaneous . . . . . . . . . . . . . . . . . . . . . . . . . 127
Bydrothorax, Thoracentesis . . . . . . . . . . . . . . . . . . . . . . . . . 254
Hyperperexia, Cold in . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Hysteria, Diagnosis of... . . . . . . . . . . . . . . . . . . . . . . . . . . . 218
Ice in Intestinl. Obstruct. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Icterus Epidemic, Paris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Impetigo Rodens, etc. . . . . . . . . . . . . . . . . . . . . . . . . 74–90–126
Impotency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
Ind. State Med. Soc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Infection, Cause of . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Inoculat. Small Pox by Skin Grafts . . . . . . . . . . . . . . . . 309
Intellect Developed by Electricity. . . . . . . . . . . . . . . . . . . 261
Intermittent Blepharospasm. . . . . . . . . . . . . . . . . . . . 153
Intermittent Fever, Eucalyptus in . 263
Intestinal Invagination . . . . . . . . . . . . . . . . . . . . . . . 37–252
Intra-Urine Intermit. Polyp . . . . . . . . . . . . 191
lntussusception, Novel Treatment . . . . . . . . . . . . . . . . . . . . 251
Insanity, Law and Med. Relat . . . . . . . . . . . . . . . . . . . . . 139
Iodine in Goitre . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Iodine in Vomiting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Ipecac Enema in Dysentery. . . . . . . . . . . . . . . . . . . . . . . . . . 74
Iron, Coloring Matter Nature . . . . . . . . . . . . . . . . . . . . . . . . 19
J
Jackson, Dr., Death of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Jackson's Cough Syrup . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Jager, Death of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Japan Med. School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Jewish Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Journal Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Jugulated Med. Colleges . . . . . . . . . . . . . . . . . . . . . . . . . . 226
P&
Kentucky Med. Society . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Kidney, Removal of . . . . . . . . . . . . . . . . . . . . . . . . . . tº 287
Knighthood for Cormack . . . . . . . . . . . . . . . . . . . . . . 167
L
Lacto-Phosphate Lime in Fevers . . . . . . . . . . . . . . . . . . . 128
Ladies, New Profession for . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Lamp Bracket, Anderson. . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Largest Practice in the World. . . . . . . . . . . . . . . . . . . . . . 141
Larynx, Section Cartilages . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Laughing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Laycock on Ears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Lessons from Sandringham . . . . . . . . . . . . . . . . . . . . . 129
Liberal Party in Prussia. . . . . . . . . . . . . . . . . . . * * * * * * * * * * 166
Life Insurance Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Life, Painless Destruction of. . . . . . . . . . . . . . . . . . . . 104
Liquefaction of Corpses . . . . . . . . . . . . . . . . . . . . . . . . . . 26 |
Lithotomy and Lithotrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Liver, Cirrhosis of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Logan's Consumption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Lostorfer's Corpuscles. . . . . . . . . . . . . . . . . . . . . . 189–248–260
Loyalty to Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Lyell’s Displacement Radius. . . . . . . . . . . . . . . . . 183
M
Marriage and Crime. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Medical College of Ohio. . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Medical Councillors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Medical Electricity and Apparat. . . . . . . . . . . . . . . . . . . . . 25–86
Medical Fees in Italy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Medical Jurisprudence . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Medical International Congress . . . . . . . . . . . . . . . . . . . 148
Medical Science in Quito. . . . . . . . . . . . . . . . . . . . . . . . 179
Medical Senators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
Medical Soc. State Committees . . . . . . . . . . . . . . . . . . . . . . 12
Medical Students at Vienna . . . . . . . . . . . . . . . . . . . . . . . . . 244
Medicine, Preventive . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Medlicott Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Membrana Tympani Movements. . . . . . . . . . . . . . . . . . . . . . 241
Menstruation, Mammary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Menstruation, Opportunity of . . . . . . . . . . . . . . . . . . . . . . . . 249
Milah and Mohel . . . . . . . . . . . . . . . . . . . 165
Millenial Celebration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Mind Infl. on Body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169–282
Minutes Amer. Med. Assoc. . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Morphia and Chloroform . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Morphia Hypodermically . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Munich Jubilee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Munificent Donation . . . . . . * * * * * * * * * * * * * * * * * * * * * * * * * * * 179
Muscular Contraction, Pressure . . . . . . . . . . . . . . . . . . . . . 264
Narceine Hypodermically . . . . . . . . . . . . . . . . . . . . . . . . . 168
Navy, Med. Service in the . . . . . . . . . . . . . . . . . . . . . . . . 44
Nerves, Stretching of . . . . . . . . . . . . . . . . . . . . . . . . . . 2S1
Nervous Diseases, Origin and Treatment. . . . . . . . . . . . . . 157
Neuralgia, Facial Convulsive . . . . . . . . . . . . . . . . . . . 138
Night Watches of Berlin . . . . . . . . . . . . . . . . . . . . 307
Noli Me Tangere . . . . . . . . . . . . . . . . . . . . . . . . 74–90–126–136


<x * ~ * Z. -- … . . '- -- s: -
--& & ... s. c. "...? . < *. :*: —º * ~x.3
• *-*. * - * * > - s : . . . ~~ - - . . . . .” ... " -- ºr 4 - - , , , - - *
- * , - • , . F -
... •. ! * • * , - - . ...;
* { . . . - s= y- - * - -*.
*. - • { - - " - - r = * 3. - ń.
; * ... * * - - - - - - - , X- -
Ö . Spleen; Tumors of . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 . . .
•. : & * ~ - ,
** *~. > *. r *
©esophagoscope. ... : . . . . . . . . . . . . . . . . . . . . . . . . . . . -- - - - 31
Qhio State Med. Society. , ...,
Qldest Medical College in the
Oldest Medical Work... . . . . . *
Old Times . . . . ‘.….. . . . . . . . . . . . . . ... tº . - ... . . . .
Opacities Tattooed. . . . .‘. . . . . . . . . . . . .
Qpthalmia Neonatorum . . . . . . . . . . . . . . . . . . . . . . .
Opthalmia Sympathetic. . . . . . . . . . . . . . . . . . . .
Opthalmology in Art. . . . . . . . .....:
Opium, Import. of . . . . . .
Opium, Principles of... 3-, cº-ºe.'. * * *.
Qppolzer's Successor. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .21
w is 4 & 5 tº º a
West . . . . . * . .
. . . . . .227
• * * * * * * * * * * * * *
Opportunity, an: . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... 226.
• * Y= - - - , , , , , a • * * * *
Otólogy, Report on...….... . . .
P
Palm to the True Victors...' .
• * * * * * * * * * * * * * * * * * * *
*
Paris Faculty. . . . . . . . . . . . . . . . . . . . . . .
Paronychia, tr. of. . . . . . . . . . . . * . . . . . ". . . . . . . . . . . . . . . . . . .
Pathology and Therapy of Still-birth. . . . . . . . . . . . . .”
Patriotic . . . . . . . . . . . . . . . . . . . . - -
Paying a Fine . . . . . . . .
Penis, Amputat, of . . . . . . . . . . . . . . . ." -
Penis, Constriction of... . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Persia, the Pest in . -
Phag. Penis, Opium in... . . . . . . . . . .
Phil. Hospital, lockley. . . . . . . . . . .
Phrenic Neuralgia. . . . . . . . . . . . . . . .
Physiology of Virus and Infect. Dis. . . . . . . .
Plague in Bombay. . . . . . . . . . . . . . . . . . . . . . . . . . ‘. . . .
Pleuritis, Treatment of.... . . . . . . . . . . . . . . . . .
Poisoning by Atropia. . . . . . . . . . . . . . . . . . .
Polyp. of the Uterus, Fibrous: . . . . .
Polypus. Uterine Intermittent
Polyp Uterine, Removal of . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Pregnancy, Extra Uterine
Preputial Calculi . . . . . . .
Prince, Cure of
Professional Prerequisites
Professions, the Liberal . . . . . . . . .
Professors in Germany
Promotion of Mediocrity . . . . . . . . . . . . . . . . . . . . . .
Paralysis Traumatic. º.º. . . . . . . . . . . . . . . . . . . . . . . . . ... 203.
* * * * * * * * * * * * * * * *
s & e º f * * * * * * * * * * * * * * * * * * * * *
&
s & a s e s s - s s ºr e º s = * * * * s = < * * * * *
• * * * * * * * * * * * * * * * * *
• * * * * * * * * * * * * * * * * * * * * * * * *
a 9 s m º e < * = < * * * * * * * * *
* * * * * * * * * * * *
* = < * * * * * * * * *
& e º nº e º º sº a
# * * * g º a
• * * * * * * *
a 3 s a a e < * * * * * s & s = < * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * * *
• . * * * * * * * * * * * * * * * * * * * * * * *
. . . , s a s = < * * * * * * * * * * * * * * * * * * * * * * * * * * * *
• * * * * * * * * * * * * * * * * * * * * * *
• * * * * * * * * * * * * * * * * * * *
* * * * * * * * * * *
s & s 4 e s s a 4 & a s = * * * * * *
Pruritus Vulvae, Treatment of..... . . . . . . . . . . . . . . . . . . 83
Puncture for Abdominal Tympanites. . . . . . . . . . . . . . . 5
Puncture of Hernia. . . . . . .
Quacks and Penn. Hosp. . . . . . . . . . . . .
Questions Examinat. . . . .
~Quinine Collyrium .
Quinine, Effects on
Quinine in Trachoma
Quinine Salts, Relat.
Quito, Med. Science in
* * * * * * * * * * * * * * * * *
• e º a s º ºs e º e º sº a w = * * * * * * * * * * * *
• * * * * * * * * * * * s s
* * * * c e s ſº e s = e s a r * * * * * * * * * * *
* * * * * * * * * *
Radius, Lyell’s Displace’t. . . . . . . . . . . . . . . . . . .
Reimplantation Teeth ... . . . . . . . . .
Report C. m. Pensions
Review Brown Sequard . . . .
Rheumatism, Acid Treat & a tº
Rheumatism Infl. on Character. . . . . . . . . . . . . . . . . . .
Rites Foundation Sacrifice * * *
* * * * * * * * * * * * * * * * * * * *
• 2 g º a s a s a e s tº s = * * * * * * * *
a. * * * * * * * * * * * * * * * * * * * * * * *
& 8 & 9 & 3 m ^ 4 tº º ºr
26()
94
A a 4 tº s & # * * * * * * * * * 30'ſ
174
261
Salisbury vs. Lostorfer
Sarcina in Blood . . . . .
Sayre, Dr. Decorated
Science of Man . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Science, High - - - -
Soury Epidemic . . . . . . . . . . . . . . . . . . . . . . . . . . . 70-91–196
Sea Sickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163–175-312
Senses. Fallacies of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sick Headache
Sick Headache, Treatment of. . . . . . . . . . .
Signs of Death . . . . . . . . * * * * * * is is ~ *
Signs of the Times. . . . . .
Skin (}rafts * * *
Skin Human, Binding. . . . . . . . . . . . . . ‘. . . . . . . . . . . . . .
Skin Puncture in Anasarca * -
Skoda
Slee
§. Pox in Berlin
Small Pox in Germany . . . .
Sinall Pox, New Remedy for . . . . . . . . . . . . . . . . . .
Smith's Dis. Children
Solid Food in Typhoid Fever
Spasm of Levator Anu. . . . . . . .
* * * * * * * * * * * * * * * * * * * * * * * * * * * *
s s a s , , , s = * * * * * * * * * * * * *
• * * * * * * * * * * * * * *
ºr e º a s.
s • * * * * * * * * * * * * * * * * * * *
* * * * * *
* * * * * *
s s = < * * * * * * * * * * *
tº e < * * * * * * * *
s s = e s a s = * * * * * * * * * * * * * * *
* * * * * * * * g e º
* * * * * * * * *
g a g º si º e º e < * * * * * * * * * * * * *
. . . . . . , s , , , , , , , s e < * * * * * * * * * * * * * * * * * * * * * *
• * * * * * * * * * * * * * *
& s , is a s & © 2 & 6 s is a s a sº e º a s g º º s º
* . . . . . * * * * * * * * *
... . s = a + r * * * * * * * * * * * * *
& º f * * * *
, , ; a s a s a s , a g º is a s ºr a s a e º e = * * * * * *
º, º a g º is s tº e º sº & & # e º e º sº tº
& F * * * * * * * * *
* > . . * * * * * * * * * * 203–224–288-289–300
- . . . . 179 -
* ^- • ** ** . .
• . . . . ----- ". . . . . . . . * * *, 6'ſ ...i
- • ** { -:
‘. . . . . 363
* 52. º
... 165
|* Stricture, Prostatic . . . . . . . . . . . . . . . . . . . . . . . .
S, - -
º: Çord, Ghāfigésºfº. 3:. . . . . . . . . . . . . . . . 225
$germatorrhea, tr. di . . . . . . . . . . . . . . . . . . . . . . . 28: - .
Spring Course . . . . . . . . . * . * ~ * &
t.
Stantön, Wra. Letter. . . .
º Abscess of . . . . . . . . . ... . . . . . . . . . . . . . . 156*. H.
Şăinal Cord. Disease of... . . . . . . . . . . . .
* * * * * * * * * * .
* * * * * * * * *
Statistics of the Race . . . . . . . . .
Štěřility, tr. of -
Still-births . . . . . . ....... . . . . . . . .
St. P Sul and St. Luke . . . . . . . . .
Stomach, Rapture and Wounds of .
Strasbourg . . . . . . . . . .... ". . . . . . . . .
Strasbourg School. . . . . . . . . . . . . . . .
• * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * - a .
. . . . . . . . ... 143
- Strasbourg Festivities . . . 275
Stricture; "Urethra . . . . . . 2.
Study of Science. … . . . . . . . . . . . . . . . . . . . . .7
Subcutaneous Aspiration . . . . . . . . . . . . . . . . . . . . . . . 15
Šubjects, Preservation of . . . . . . . . . . . . . . . . . . . . . . . . . . 28
ºf $uccessor to Zouave. . . . . . . . . . . . . . . . . . . . . . . , . . . 130
Suicide by Morphia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Sugar, Infl. of fººt * * * * * . . . . . . . . . , * * * * * * * . . . . . . . . . 44
Suit for Forgery. . . . . . ‘. . . . . . . . . . . . . . . º. . . . . . . f6()
Sulph, Acid in Contusions . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Surgery of War . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .54
Syphilis Cummittee . "… . . . . . . . . . . . 150
Syphilis Corpuscles 4 º'
Syphilis, Microscope in . . . . . . . . .
Teaching and Practising..... . . . . . . . . . . . . . .
Teeth, Reimplantation of... . . . . . . . . . . . . . . . . . . . ;
Teratological. . . . . . . . . . . . . . . ... -
Testicles Undescended. . . . . . . . . . . . . . . . . .
Testimony to Italian, Physician. . . . . . . . . . . .
Tetanus, Arsen. Quinia in . . . . . . . . . . . . .
Tetanus Treatment by Chinese . . . . . . . . . . . . . . .
Tobacco Smoke, Action of . . . . . . . . • *.
Tobacco, Tolerance of . . . . . .
Tonsils, Excision of
'Torticollis. . . . # = s. * * * *
Tracheotomy-Galvano-Caustic . . . . . . . . . . . . . . . . . . . . 268
Trachoma, Electricity in
Transfusion of Blood . . . .
Tremor of Hand
Trepanning the Sternum . . . . . . . . . . . . . . . . . . . . . . . . . .
Trophic Neuroses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '76
Tumor, Electric Treatment . . . . . . . . . . . . . . . . . . .
Tumor, Injections into . . . . . * * *
Turkish Med. Journal . . .
Turpentine in Ear Disease. . . . . . . . .
Tympanites, Puncture in . . . . . . . . .
• * * * s • • * * * * : * * * , , , - - , , , º, . . .
* * * * * * *
* * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * > . . . .
• * * * * * * * * * * - - - - - - - - , , . . . . . . . .
* * * * * * * * s = e º a s s s is a • , s , s , s , e.
* * * * * * * * * * *
* * * * * * * * * * * * * * * s 5 & 8 º' &
* * * * * * * * *
* * * * * *
* * * * * * * * * * * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * *
* e s 3 & E ºr
* * * * * * * * * r s s a e = * *
* * * * * * * * * * * * * * * * * * * * * * * * * * * s e s = <
s # 8 & = s : * * * * * * *
• * * * * * * * * * * * * .
Urea formed in Liver . . . . . . . . . . . . . . .
Uterus, Carcinoma . . . . . . . . . . . . . . . . . . . . . .
Uterus Contraction Force
Uterus Double * * *
Uterus, Fibrous Polypus of. . . . . . . .
Uterus, Fibrous Tumor of - *
Uterus Polypus, Point in Diagnosis . .
Uterus Subinvolution . . . . . .”.
Uterus Versions and Flexions . . .
* * * * * * * , , v 4 tº s s a º y a s e tº e º s
* * * * * * * * * * * * * * * * g . g º 'º w w tº e º s
* * * 4 * r * * * * * * * *
* - - - - - - - - - - - - - -
* * * * * * * *
* * * * * * * * * * *
• * * * * * * * * * * * *
* * * * * * * * * * *
Vaccination Papers . . . . . . . . . . . . . . . .
Vaccination Cheaper-than Shaving . . . . . .
Vaccination Martyr. … . . . . . . . . . . . .
Waledictory Address'. . . . ."
Varices treated by Ergot -
Venerable-Surgeons.” . . . . . . . . . . . . . . . . . . .
Ventral Body Heat. . . . . . . . . . . . . . . . .
Vesicants in Ear. Disease...
Wirehow Peripatetic. . . . . . . . . . .
' Wivisections - 't
Vomiting in Hernia. . . . . . . . . .
Womiting, Iodine in . . . .
* * * * * * * * * * * is tº * *
s • * * * * * * * * * * * * * * * * * * * * * * * * * * *
• * > . * *
• * * * * * : * * * * * * * * * * * * * . . . ; * * *
• * * * * * * * * * * * * * *
* : * * * * * B is s ºf
s. * * * * * * * * * * * * * * * * * * *
• * * * * * * * * * * * * * * * * * * * * * * * * * * s =
Watson Shryock,
West Virginia State Medical Society
Whisky, Formula for . . . . . . * * * * * * '... : : . .
Whiting, L. M., M. D., Note from . . . .
Wrist, Backward Dislocation. . . . . t
Wurzburg Clinic. . . . . . . . . t
Xylol in Small Pox . . . . . . . . . .
º 80
. . . . . . . . . . . 168–276
• * * * * * * * * * * * * * * * * * * * * * * *
er ; : : -
& # * * * * * . . . . . . . . . . . . . . . . . . . . . 128.
... 184

ſv-3
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