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THE
MEDICAL AND SURGICAL REPORTER
A WEEKLY JOURNAL.
li^, ^ABLISHED m 1858 BY S. W. BUTLER, M.D.)
EDITED BY
i
JANUARY— JULY, 1876.
VOL. XXXIV.
PHILADELPHIA: No. 115 SOUTH SEVENTH STREET."
1876.
CONTRIBUTORS.
ALEXANDER, W. W., 322. ALLEN, HA.RRISON, Prof., C7imc, 405. ASH HURST, JOHN, JR., 417. AVERDICK, J. A., 219. BANCROFT, F. J., 438. BARTLESON, S. P., 78. BATES, A., 286.
BEARDSLEY, GEORGE L., 201, 281.
BERRY, J. HO MER, Report, 138.
BINKERD, A. D., 19, 159, 257.
BISSELL, PHILIP A., 197.
BLACK WOO WILLIAM R. D., 196.
BOTKIN. J. WKSLEY,384.
BOTTSFORD, HARRIETTS E., 184.
BOYLAND, GEORGE HALSTED, 21, 125, 164, 424.
BRINTON, JOHN H., Clinic, 45. 150.
BURKE, JOHN, 478.
BURNETT, SWAN M., 178.
CANNIFF, WILLIAM, 299.
CAPSHaW, PRESTON, 403.
CaRR, a. T., 38.
CARRIGAN, A. N., 162.
CHANDLER, W. T., 41, 104, 228, 443.
CHASE, S. B., 37.
CORSON, HIR AM, 221.
CRAIGEN, W. J., 383, 398.
CRANMER, CHARLES C, 161.
CROTH ERS, T. D. , 70, 461.
CUNNINGHAM, A. V., 20.
DA COSTA, Prof., Clinic, 7, 148.
DANTZLER, M. J. D.. 416.
DAVIS, L. N., 245.
DIBRELL, J. A., 284, 444.
DODDS, FORD S., 204.
DORA, J. W., 121, 305.
DRAKE, E. L., 197, 363.
DUHRING, LOUIS A., Clinic, 47, 269.
DULLES, C. W., Report, 349, 381, 405, 421, 441.
EASLEY, E. T., 261.
EBERHART, S. S., 23.
ELEY, M. J., 218.
FARNS WORTH, P. J., 264.
FOLSOM, N. L., 257.
FOWLER, W. B., 119.
FREEMAN, C. A., 159.
FUNDENBERG, GEORGE B.,478,
GAZZO, JOHN B C, 361.
GLEITSMaN, WILLIAM, 1, 141.
GODFREY, J. H., 119.
GOODYEAR, MILES D., 104.
GORDON, N. R., 439.
GROSS, Prof., Clinic, 66, 129.
HADDEN, ALEXANDER, 278.
HaDLOCK, J. W., Report, m.
HALDEMAN, GEORGE W., 266.
HALE, J., 63.
HARVEY, JOSEPH E., 164. HATCHETT, L., 256. HENDERSON, J. D. W., 5. HENGST, D. a., 244. HINTON, RUFUS K., 318. HOOVER, A. M., 378.
HORTON, H. L., 464.
HUTCHINSON. JAMES H., Clinic, 28, 105.
JACKSON, E. H., 349.
JOHNSON, S. P., 6L
JONES, R. K., 337.
BEIFFER, S. B., 85.
KEIPER, C. B., 416.
KIMMEL, J. A., 38.
LAIRD, B. F., 364.
LAWRENCE, GEORGE W., 58.
LEVIS, R. J., 78.
LUSK, WILLIAM T., Clinic, 107.
MAURY, F. F., Clinic, 421, 441.
McGEE, J. P., 321.
McGILL, WARDLAW, 307.
MEARS, J. W., 44.
MECASKEY, G. W., Report, 28, 105.
MILLER, J. K., 123.
MITCHELL, S. WEIR, 101.
MULREANY, JOSEPH, 301.
NORRIS, J. N., 139, 268.
NYE, H., 217.
PERL, M., 338.
PERRY, JOHN E., 267.
PIRNAT, JOHN, 98.
PORTER, G. E., 224.
RAFFERTY, T. N., 241.
READ, WILLIAM, 182.
ROBERTS, JOHN B., Translation, 206, 269.
ROTHROCK. J. T., 181, 425.
SAYRE, LEWIS A., 399.
SCHREIBER, G. F., 125.
SELDNER, S. W., 246.
SENCINDIVER, L. M., 479.
SHELLY, A. F,,344.
SHOEMAKER, J. V.,422.
SIBBET, R. L., 58, 298, 404.
SMITH, T. CURTIS, 81, 147.
SMITH, WILLIAM F, 237.
SUTTON, R. STANSBURY, 341.
SWEARINGEN, R. M., 139.
TACKET, W. B., 43.
TALBOT, R. C, 323.
TAYLOR, J. M., 219.
TAYLOR, WILLIAM L., Report, 26.
TERRY, W. L., 139.
THURBER, GEORGE, 159.
TURNBULL, LAURENCE, 401, 445, 477.
TURNER, P. F., 87.
VAN HARLINGEN, ARTHUR, Report, 47, 289. VON MANSFELDE, ALIUX., 98. WARDER, WILLIAM H., 381. WEIR, F. L., 79.
WESTBROOK, BENJAMIN F, Report, 271, 448. WHELEN, ALFRED, Report, 45, 150. WIGHT, JARVIS S., Clinic, 271, 307, 448. WILKINS, G. L., 216. WILLS, SAMUEL E,, 138. WOLFE, H. S., 145. WOOD. Prof. H. C, Clinic, 26. WOODBURY, FRANK, Report, 7, 66, 129, 148. WOODRUFF, L., 338.
I 3iT ID E X .
Abdomen, section of, for intussusception, 209. Abdominal aorta, aneurism of, 166. Aboriginal method of treating diseases of the ear. 401.
Abortion ; the management of, 13 ; conception forty hours after, 387.
Abscess ; alveolar, the treatment of, 94 ; he- patic. 131.
Absorption by the human diaphragm, 195. Abstinence, an instance of remarkable, 268. Abstracts, Dr. Dobell's on chest diseases, 375. Abuse of various agents for expediting labor, 246.
Acacia, gum, as a food, 158.
Accidental hemorrhage, 119.
Acid; horacic ; in parasitic diseases, 158; its applications, 492 ; carbolic, in malignant pustule, 117; prussic; the detection of, in poison cases, 17 ; atropia as an antidote to, 97 ; salicylic ; as a dressing to wounds, 12 ; for foul breath and offensive expectoration, 148 ; in intermittent fever, 166 ; in dysentery, 177 ; in chronic otorrhoea. 244; preparations of, 256 ; as a febrifuge, 310 ; in acute rheumatism, 332 ; the application of, 391 ; solubility of, 437; sulphuric; in diseased joints, 51 ; the administration of, in enteric fever, 384.
Aconite ; as a febrifuge, 17 ; poisoning, a case of, 125.
Acquired vomiting, 497.
Action; of alcohol. 153, 250; muscular, frac- ture resulting from, 378 ; therapeutical, of the salts of silver, 393 ; mechanical, of pes- saries, 428.
Acts, contagious diseases, success of the, in
England, 316. Acute ; ur£emia, morphia in, 37 ; articular
rheumatism, cyanides in, 97 ; and chronic
syphilitic orchitis, 129 ; rheumatism, salicylic
acid in, 332 ; orchitis treated by puncture,
409 ; gastritis, cupping and ice in, 483. Addison's disease, 407. Adenopathy, bronchial, 177. Adhesions, treatment of, in ovariotomy, 11. Administration ; of sulphurous acid in enteric
fever, 384 ; of arsenic, rules for, 437. Affection, obscure, of the urinary bladder, 66. Affections ; the diagnosis of secondary heart,
52 ; bovrel, 218 ; gonorrhoeal and syphilitic,
of the testicles, 301. Agent ; chloroform as a preservative, 255 ;
veratrum as a remedial, in pneumonia, 322. Agents for expediting labor, the use and abuse
of, 246.
Ahl's splints, some notes on, 85. Albuminuria, treatment of, during pregnancy, 118.
Alcohol ; the form of to be used medicinally,
50 ; the action of, 153, 250 ; as a stimulant, 162 ; native, 297 ; in medicine. 337.
Alienation, mental, management of, 395.
Alveolar abscess, the treatment of, 94.
Amaurosis, through suppression of menstrua- tion, 388.
Amenities, sanitary, 339.
Amenorrhoea from lead poisoning, 410.
American ; association for the cure of ine- briates, summary of some papers read before the, 70 ; medical editors, association of, 479 ; medical association, annual meeting, 1876, 484 ; malt liquors, 502.
Ammonia in rheumatism, 497.
Amputation ; partial, of the hand, 69 ; of cer- vix uteri, by galvano-cautery, 209 ; of index finger, 307 ; combination of the cutaneous and musculo-cutaneous plans of, 321 ; of the thigh, 324 ; of fingers, 405 ; of forearm, 422.
Amyl, nitrate of, in lead poison, 166.
Anaemia ; cerebral, the symptoms and prognosis of, 93 ; headaches of, 101.
Anaesthetic, the ether spray as an, 74.
Ancient relic, 200.
Aneurism ; of the arch of the aorta, 89 ; of ab- dominal aorta, 166.
Angina ludovici, a case of, 453.
Animals ; poisoned, localization of arsenic in the tissues of, 177 ; and vegetables, 435.
Ann Arbor, homoeopathy, at, 339.
Ano, fistula in. 150.
Another miracle, 378.
Ante partum hemorrhage, a case of, 217.
Anterior extension splint, 224.
Antidote to prussic acid, atropia as an, 97.
Anti-pruritic remedy, a new, 158.
Anti-pyretic, ergot of rye as an, 78.
Antiseptic ; method, Prof Lister's, 58, 313 ; surgery, the atmosphere in, 78 ; treatment in incision of hydrocele, 287 ; surgery, briefly reviewed, 298.
Anus, danger of chloroform in fissure of the, 409.
Aorta ; aneurism of the arch of the, 89 ; ab- dominal, aneurism of, 166.
Aphonia, remarkable case of paralysis, with, 79.
Application ; for painful dentition, 77 ; of bro- mide of camphor in therapeutics, 126 ; of salicylic acid, 391 ; of caoutchouc in surgery, 428.
Applications of boracic acid, 492.
Applying iodine to the interior of certain
cysts, a more effectual mode of, 332. Arch of the aorta, aneurism of the, 89. Arm ; fibromata of, 91 ; presentation, cephalic
version in, 256. Army, U. S., the medical corps of the, 156
iv
Index,
medical department of the, in the centennial exhibition, 457.
Arrest of hemorrhage by torsion, 376.
Arsenic ; in malarial diseases, 157 ; localization of, in the tissues of poisoned animals, 177 ; rules in administering, 437.
Arsenical poisoning, 56.
Articular rheumatism, cyanides in acute, 97.
Articulation, sacro-iliac, disease of the, 167.
Artificial ; milk, 17 ; eyes, sensitive, 398.
Ascites, cirrhosis of liver and kidneys, with, 9.
Aspects, the physiological, of religious excite- ment, 76.
Asphyxia, treatment of, 139.
Aspiration of the bladder, vt^ith supra-pubic tapping, 121.
Association ; American, for the cure of inebri- ates ; summary of some papers read before it, 70 ; the British medical defence, 80 ; the climatic, 1 17 ; social science, 479 ; of Amer- ican medical editors, 479 ; American medical, annual meeting, 1876, 484; of superinten- dents of institutions for the feeble-minded, 500.
Athetosis and allied disorders, 472. Atmosphere in antiseptic surgery, 78. Atresia vaginae, a case of complete, 344. Atrophy, progressive muscular, 18. Atropia as an antidote to prussic acid, 97. Aural catarrh, chronic, treated by electricity, 370.
Autographs, medical, 320. Autopsy of a case of intra-cranial haematoma, 7. Avoidance ; of puerperal infection, 172 ; of phosphorus poisoning, 333.
Bacteria discovered in the blood, 208.
Bag of waters, management of the, in natural
labor, 147. Band, elastic, in tenotomy, 211. Bandages, on, 21, 125.
Bark ; coto, in diarrhoea and rheumatism, 97 ; mancona, 217.
Basham's mixture, formula for, 60.
Baths ; cold, in typhoid fever, 230, 427 ; pro- longed, 337.
Belladonna ; in opium poisoning, 37 ; poison- ing in an infant, 464.
Betel nut, effects of the, 97.
Bile ; pigment, a new plan for detecting, in the urine, 312; experiments on, 456.
Bi-polar or bi-manual version, the method of, 32.
Birth ; four at a, 219 ; ringworm in an infant within six hours of, 310.
Births, triplet, the frequency of, 19.
Bladder ; sloughing of uterus and, as a sequel of labor, 10 ; a remarkable case of recovery after mortification of a portion of the bowel and, 38; urinary, obscure affection of the, 66 ; sympathetic irritation of the, 104 ; aspi- ration of the, with supra-pubic tapping, 121 ; catheter removed from the, 167 ; removal of a pessary from a female, 184 ; neuralgia of the, 382 ; irritable, in women, 436.
Bleeding, notes on, 171.
Blindness, color, in sailors and railroad em- ployees, 397.
Blood ; poison in healthy, 118 ; bacteria dis- covered in the, 208 ; letting, topical, 396.
Blue line in lead poisoning, 288.
Board of health ; an imperial, in Germany, 39 ; State, for Pennsylvania, an act to create, 175 ; Wisconsin, 320.
Bodies ; foreign, removal of, from the ear, 292 ; an easy and painless mode of extracting, from the nasal cavity, 338 ; instruments for extracting, from the external meatus, 351.
Bodily temperature, the skin and, 293.
Body ; foreign, in the nostril, 67 ; in the throat, 477.
Bone ; transverse fracture of the patella united by, 197 ; inferior maxillary, fracture of, 448 ; fish, removed from pharynx, 448.
Bones, of the foot, strumous disease of the, 406.
Boracic acid ; in parasitic diseases, 158 ; its ap- plications7492.
Borax product of California, 250.
Botanical history of the so-called damiana, 181.
Botany, medical, of the Spanish-American exhibits, 498.
Bowel ; and bladder, a remarkable case of recovery after mortification of a portion of the, 38 ; affections, 218.
Brain ; tumor vs. chronic meningitis, 8 ; func- tion, the localization of, 119 ; tumors in the, 217 ; disease, characterized by double reti- nitis, loss of intellect and progressive general paralysis, 241 ; concussion of, as a cause of inebriety, 462.
Bran box, treatment of fractures by the, 286.
Brazil, the Emperor's grandchild, 59.
Breast; schirrhus of the, 49, 50; a new method of preventing the secretion of milk in the, 230; female, treatment of phlegmo- nous inflammation of the, 361.
Breath, foul, salicylic acid for, 148.
'* Breathing " cure, the, in diabetes, 52.
Bright's disease ; chronic, autopsy of a case of intra-cranial haematoma occurring in the course of, 7 ; treatment of, 330.
British medical defence association, 80.
Bromide of camphor, application of, in thera- peutics, 126.
Bronchial adenopathy, 177.
Bubo, chancre and, 442.
Buildings, new, as sources of disease, 437.
Burn Brae hospital for mental disease, 99, 160.
Burns, treatment of, 178 ; dressing for, 497.
Calcium, sulphide of, in diabetes, 97. California ; the eucalyptus globulus in, 78 ;
borax product of, 250 ; the medical law of,
357.
Camphor ; application of bromide of, in thera- peutics, 126 ; poisoning by, 154.
Cancer ; a case of, 138 ; of the right supra- renal capsule, 269 ; remedy, the eucalyptus globulus as a, 354.
Cannabis indica in post-partum hemorrhage, 138.
Canned meats, mercurial poisoning from, 476. Caoutchouc, applications of, in surgery, 428. Capillary hemorrhage in phthisis, 165. Carbolic acid in malignant pustule, 117.
inaex.
Carbon, purification of sulphide of, 476. Carbuncle, treatment of. 114, 134. Carcinoma of stomach, 208. Cardial gia, rheumatic, 291. Care of the insane in the United States, 200, 375.
Caries; of the vertebrae, 26; dental, 312; of the spine, 386.
Carious teeth, the prophylaxis of, 93.
Carotid, tying the, for facial neuralgia, 58.
Case ; of intra-cranial haematoma, autopsy of a, 7 ; of intussusception, 23 ; of recovery after mortification of a portion of the bowel and bladder, 38 ; of obscure affection of the urinary bladder, 66 ; of paralysis, with aphonia, 79 ; an undiagnosed, of perityphlitis, phthisis, oedema of lungs, waxy liver, 90 ; of empyema, 91, 131; of condylomota, 110; of syphilis treated by hypodermic injection of corrosive sublimate, 114; of poisoning by eating wall paper, 119 ; of aconite poisoning, 125 ; of cancer, 138 ; of psoriasis diffusa vel chronica, 149 ; severe, of lacerations, frac- tures and contusions, 161 ; of transverse fracture of the patella united by bone, 197 ; of ante partum hemorrhage, 217 ; of brain disease, characterized by double retinitis, loss of intellect, and progressive general paralysis, 241 ; of fracture of the scapula, 271 ; of ununited fracture of the humerus treated by operation, 284 ; of ringworm occurring in an infant within six hours of birth, 310; of ovariotomy, 341 ; of complete atresia vaginae, 344 ; of supra-pubic lithotomy, 349 ; of rup- ture of the perineum extending into the recto- vaginal septum, 404; of Addison's disease, 407 ; of gunshot wound of the head, 439 ; of fracture of the inferior maxillary bone, 448 ; of angina ludovici, 453.
Cases; poison, detection of prussic acid in, 17; criminal, physicians in, 158 ; of leukaemia, 291 ; of puerperal convulsions, 383 ; of exsec- tion of hip joint, 448.
Catacombs vs. cremation, 377.
Catarrh, chronic aural, treated by electricity, 370.
Catarrhal pneumonia, 89.
Catherine Hohmann, the hermaphrodite, 436.
Catheter removed from the bladder, 167.
Catheterization of the Eustachian tube, 429.
Catholicity of science, 235.
Cause ; of the death of vice-president Wilson,
29 ; of varicocele, rheumatism as the, 113 ;
of typhoid fever, 116 ; of typhoid fever, not
sewers and cesspools, 398. Causes ; of the increase of nervous diseases,
475 ;^ of typhoid fever, 478. Cauterization, relief of pain during, 457. Cavity of the tympanum, a new method of
ventilating, 188 ; nasal, an easy and painless
mode of extracting foreign bodies from the,
338.
Centenarians, 36, 259.
Centennial exhibition ; medical staff of the, 239 ; opening of the, 419 ; U. S. medical depart- ment in the, 457^; Professor Politzer's display
in otology, 477; the medical botany of the
Spanish-American exhibits, 498. Cephalic version in arm presentation, 256 ; Cerebral ; rheumatism, treatment of, by chloral,
18 ; anaemia, the symptoms and prognosis of,
93.
Cerebro-spinal meningitis, the management of, 12, 182.
Cerebrum, tumor of the left anterior central
convolution of the, 206. Cervical ; lymphadenoma, 129 ; gland, enlarged,
treated by hypodermic injections of tincture
iodine, 444. Cervix uteri, hypertrophy of, 209. Cesspools and sewers not a cause of typhoid
fever, 398. Chalicosis pulmonum, 408. Chancres ; with phimosis, 67, 151 ; primary,
strange locations for, 430 ; and bubo, 442. Change ; in pension surgeons, 99 ; of life, uter- ine disturbance at the, 230 ; of climate in
consumption, 271. Changes, skull, in rickets, 415. Charitable institutions, 259. Check epistaxis, to, 297. Chemical drugs, new, 137. Chemistry of the urine, 17, 216. Chest diseases. Dr. Dobell's abstracts on, 375. *' Chia," a new dietetic and medicinal product,
249. Chilblains, 297.
Child ; re-positing the, in the vomiting of preg- nancy, 31 ; diffused psoriasis in a, 47. Children, premature, management of, 37. Chinese medicine, 99.
Chloral ; treatment of cerebral rheumatism by, 18 ; in ozaena, 77 ; suppositories, 255 ; hy- drate in the treatment of puerperal metro- peritonitis, 305 ; camphoratus, liquor, 317 ; in pityriasis, 337.
Chloroform ; in hydrocele, 97 ; in flatulent dys- pepsia, 138 ; as a preservative agent, 255; danger of, in fissure of the anus, 409.
Cholera, the spread of, 332.
Chronic ; Bright' s disease, autopsy of a case of intra-cranial haematoma occurring in the course of, 7 ; treatment of, 330 ; meningitis, brain tumor vs., 8 ; ulceration of the endo- cardium, 49 ; and acute syphilitic orchitis, 129 ; dysentery, treatment of, 154 ; suppura- tive synovitis of shoulder joint, excision, 168 ; pleuritis, 228 ; otorrhcea, salicylic acid in, 244 ; aural catarrh treated by electricity, 370 ; diseases of the joints, 399.
Circulation ; of the nervous fluid, 164 ; the, in pregnancy, 411.
Cirrhosis of liver and kidneys, with ascites, 9.
Cities, the use of well water in, 337.
Cleft palate, treatment of, without operation, 454.
Climate, change of, in consumption, 271.
Climatic association, the, 117.
Clinical; lecture on some early forms of syphilis,
441 ; studies of inebriety, 461. Coca, the, 378.
Coccyodinia and ruptured perineum, operation for, 363.
vi
Index.
Cod-liver oil injections, 97.
Cold ; baths, in typhoid fever. 230, 427 ; the ef- fects of, on milk, 297 ; in the head, immediate cure for, 391.
Colds, jaborandi in, 352.
Color ; ph'>to,2;raphs in, 256 ; blindness in sailors and railroad employees, 397.
Colorado as a health resort, 415.
Combination of the cutaneous and musculo- cutaneous plans of amputation, 321.
Commencements, medical college, 237, 259.
Communication of tubercle in food, 51.
Companies, life insurance, and pulmonary phthisis, 1.
Complete atresia vaginae, a case of, 344.
Compound comminuted fracture of the fore- arm, 422.
Conception forty hours after abortion, 38 7. Concussion of the brain, inebriety attributed to, 462.
Condylomata, a case of, 110. Confinement, milk diet in, 260. Congress, the international medical ; meetings
in 1876 and 1877, 39 ; programme for 1876,
279; its aim, 295. Conjugate diameter of the pelvis, narrowed,
version in, 133. Consanguineous marriages, 397. Conservative surgery, a short lesson in, 161. Constipation and diarrhoea, treatment of, 231. Constitutional treatment of joint diseases, 417. Consumption, change of climate in, 271. Contagion, milk as a vehicle of, 278. Contagious diseases acts, the success of the, in
England, 316. Contagium of enteric fever, 311. Continued fever, 28.
Contraction of the colon and ileum, 166.
Contractions ; hour-glass, of the uterus during labor, 61, 104 ; uterine, to diminish, 357.
Contusions, lacerations, fractures, 161.
Convulsions ; puerperal, 383, 408 ; treatment of, in infants, 389.
Cord ; spinal, softening of, 208 ; umbilical, pro- lapse of the, treated by the postural method, 289 ; when to tie the, 412.
Corns, cure for, 398.
Corps, medical, of the U. S. army, 156. Corrosive sublimate ; a case of syphilis treated
by hypodermic injection of, 114 ; poisoning
by, 139. Cosmoline, 298.
Coto bark in diarrhoea and rheumatism, 97.
Cough ; whooping, inhalation in, 288 ; pathology of, 393 ; the " Florida," 419.
Cremation ; in Europe, 297 ; catacombs vs., 377; movement, 460.
Criminal; law and mental pathology, 136 ; cases, physicians in, 158.
Criticisms on evolution, 392.
Croton-chloral, 191.
Croup, treatment of, 17.
Culture, physical, a school of, 157.
Cupping ; value of, in the treatment of pneu- monia, 257 ; and ice, in acute gastritis, 483.
Cure ; the breathing," in diabetes, 52 ; of inebriates, summary of some papers read i
I before the American association for the, 70 ; radical, of salivary fistula, 211 ; immediate, for cold in the head, 391 ; for corns, 398. Curiosity, a physiological, 437. Current of fluid, treatment of gonorrhoea by a
reversed, 117. Cutaneous and musculo cutaneous plans of
amputation, combination of the, 321. Cyanides in acute articular rheumatism, 97. Cyst in kidney, 208.
Cysts ; a more eSectual mode of applying iodine to the interior of certain, 333.
Damiana ; botanical history of the. so-called, 181, 425.
Danger of chloroform in fissure of the anus, 409. Death ; notices, 20, 40, 60, 100, 120, 140, 160, 180, 200, 220, 240, 260, 300, 320, 340, 360, 420, 440, 460, 480, 500, 504; of vice- president Wilson, the cause of, 29 ; from ether, 49 ; sudden, from accidental hemor- rhage, 119 ; -rate in Montreal, 179. Deaths ; in Philadelphia during 1875, 39 ; from
nervous diseases, 249. Decline of life, headaches of, 103. Delirium tremens, the opium treatment of, 290. Delivery, placental, 363. Dental caries, 312.
Department, medical, U. S. army, in the cen- tennial exhibition, 457. Depletion in the good old times, 199. Dermatitis circumscripta herpetiformis, 113. Detecting bile pigment in the urine, a new plan for, 312.
Detection ; of prussic acid in poison ca-ses, 17
of nitro-benzol, 476. Determination of sex, observations on the, 403. Development, self-, of ova, 317. Diabetes; the "breathing cure" in, 52; sul- phide of calcium in, 97. Diagnosis ; of secondary heart affections, 52 ; importance of, 123 ; of hemorrhage and embolism, 188; of empyema, 292; of the sex of the foetus during pregnancy, 357 ; and treatment of variola, 364 ; of dilatation of the stomach, 409. Diameter, conjugate, of the pelvis, version in
narrowed, 133. Diaphragm, on absorption by the human, 195. Diarrhoea ; and rheumatism, coto bark in, 97 ;
treatment of constipation and, 231. Diet, milk, in confinement, 260. Dietetic; " chia," a new, 249 ; value of water- cress, 416.
Difference between measles and small-pox, 368. Diffused psoriasis in a child, 47. Digestibility of milk, 177. Dilatation of the stomach, diagnosis of, 409. Dilating the Eustachian tube, a new method of, 188.
Diphtheria; and its treatment, 41, 170, 191, 204 ; of larynx and trachea, 49 ; in North Carolina, 180 ; a case of, 208 ; ice and ice water in, 221 ; early treatment in, 256 ; his-" tory of an epidemic of, 264 ; inoculation of, 331 ; liquor potassae in, 493. I Diploma peddling, 39.
viii
Index.
the contagium of, 311 ; administration of sul- phurous acid in, 384.
Epidemic ; of diphtheria, history of an, 264.
Epiglottis, hypersemia of, 207.
Epilepsy; picrotoxine in, 236 ; from preputial irritation, 429.
Epistaxis ; ergot internally for, 248 ; to check, 297.
Epithelioma, treatment of, 117.
Epizooty in Memphis, 152.
Epulis of inferior maxilla, 450.
Equivalent, food, of health, 438.
Ergot ; of rye as an antipyretic, 78 ; in intra- utpine polypi, 232, 472 5 internally, for epistaxis, 248 ; a galactifuge, 499.
Ergotinine, 272.
Eriodictyon californicum, 317.
Erysipelas, silicate of potash in, 196.
Ether ; death from, 49 •, spray, as an anaesthetic, 74 ; hypodermic use of, in labor, 451.
Ethics, medical, 180, 260.
Etiology of gravel, 412.
Evolution 5 in man, recent views on, 234 ; criti- cisms on, 392.
Eucalyptus globulus ; in California, 78 ; as a cancer remedy, 354.
Europe, cremation in, 297.
Eustachian tube ; a nevr method of dilating the, 188 ; catheterization of the, 429.
Excessive metrorrhagia, local heat in, 250.
Excision 5 for hypertrophy of the scrotum and prepuce, 44; of a tumor lying under the parotid gland, 130 ; of the knee and amputa- tion of the thigh for disease of the knee-joint, 324.
Excitement, religious, the physiological aspects of, 76.
Exhibition, centennial; medical staff of the, 238 ; opening of, 419 ; the medical features of, 456 ; the United States army medical de- partment, 457 ; Prof. Politzer's display in otology, 477 ; quack medicines at the, 496 ; medical botany of the Spanish-American ex hibits, 498.
Expectoration, offensive, salicylic acid for, 148. Expediting labor, the use and abuse of various
agents for, 246. Experience in hypodermic medication, 5. Experiments on bile, 456, Exsection of hip-joint, 448. Extension splint, the anterior, 224. External meatus, instruments for extracting
foreign bodies from the, 351. Extracting foreign bodies; from the nasal cavity,
an easy and painless mode of, 338 ; from the
external meatus, instruments for, 351. Extraction of teeth, hemorrhage after, 30. Eye, sarcoma of the, 408 ; Eyes, sensitive artificial, 398. Eyelid, tumors of the, 68.
Facial neuralgia, tying the carotid for, 58. Factor of organism, mind as a, 214. Fasting girl, the Lancashire, 288. Fearful death-rate, 179.
F eatures, medical, of the centennial exhibition. 456. *
Febrifuge, salicylic acid as a, 310.
Feeble-minded, association of Superintendents of institutions for the, 500.
Female ; urinary bladder, removal of a pessary from a, 184 ; breast, a new method of pre- venting the secretion of milk in the, 230 ; students, 239, 369 ; medical education, 296 ; breast, treatment of phlegmonous inflamma* tion of the, 361.
Femur ; tubular sequestrum of the, 91 ; frac- ture of, 451 ; subcutaneous osteotomy of the, 493.
Fever ; stools, infusoria in, 310 ; continued, 28; enteric; the turpentine treatment of, 289 ; the contagium of, 311 ; the administra- tion of sulphurous acid in, 384 ; hematuric, malarial, 43 ; intermittent, salicylic acid in, 166 ; puerperal, venesection in, 87 ; scarlet ; ice and ice water in, 221 ; the prevention of, 377; typhoid; probably caused by infected milk, 78 ; the cause of, 116 ; treatment of, 196 ; cold baths in, 230 ; sewers and cess- pools not a cause of, 398 ; treatment of by cold baths at Heidelberg, 427 ; causes of, 478 ; yellow, disinfection for, 212.
Fibro-cellular tumor of the thigh, 49.
Fibroid, intra-uterine, 287.
Fibroma of vagina, 385.
Fibromata of arm, 91.
Finger ; sarcoma of the, 89 ; index, amputation
of the, 307 ; amputation of, 405. Fish bone removed from pharynx, 448. Fissure of the anus, danger of chloroform in,
409.
Fistula ; in ano, 150 ; salivary, radical cure of, 211.
Fistulous ulcers, treatment of, 282. Flatulent dyspepsia, chloroform in, 138. Flesh, the Kentucky shower of, 436. Florida cough, the, 419.
Fluid ; treatment of gonorrhoea by a reversed current of, 117 ; nervous, the circulation of the. 164.
Foetus ; diagnosis of the sex of the, during preg-
ancy, 357 ; the urine of the, 426. Food ; the communication of tubercle in, 51 ;
the value of, 96 ; gum acacia as a, 158 ;
equivalent of health, 438. Foot, strumous disease of the bones of the, 406. Forearm, compound comminuted fracture of,
422.
Foreign ; body in the nostril, 67 ; in the throat, 477 ; bodies, removal of from the ear, 292 ; bodies, an easy and painless mode of extract- ing, from the nasal cavity, 338 ; bodies, in- struments for extracting, from the external meatus, 351.
Fork, the man of the, 456.
Form ; of alcohol to be used medicinally, 60 ; metric, prescriptions in the, 415.
Forms of syphilis, a clinical lecture on early, 441.
Formation, glandular, in the stomach, 50.
Formulae from the pharmacopoeia of the Phila- delphia hospital, 215.
Foul breath and offensive expect jration, sali- cylic acid for, 148.
Index.
Vll
Diplomas, medical, for women, 160. Discharge, ear.y, of the liquor amnii, 337. Discharges, purulent vaginal, systemic infection from, 26 1.
Disease : chronic Bright's, autopsy of a case of intra-cranial haematoraa occurring in the course of, 7; mental, Burn Brae hospital for, 99, 160; of the saeTo-iliac articulation, 167 5 vagabouds', 195 ; brain, 241 ; the para- sitic the iry of, 277 ; of the knee joint, exci- sion of the knee and amputation of the thigh for, 324 ; chronic Bright's, treatment of, 330 ; scarlatinal ear, 330 5 the supervision of, 377 : germs, 388 ; chronic, of the joints, 399 ; stru- mous, of the bones of the foot. 406 ; Addi- son's, 407 ; heart, and pregnancy, 437 ; new buildings as sources of, 437 nervous, causes of the increase of, 475.
Diseased joints, sulphuric acid in, 51.
Diseases; school, 15; malarial, arsenic in, 157; parasitic, bonicic acid in, 158 ; nervous, deaths from, 249 ; sexual, in virgins, 356 ; chest, Dr. Dobell's abstracts on, 375 ; of the ear, aboriginal method of treating, 40 i ; of the middle ear, the use of steam in, 401 ; joint, the constitutional treatment of, 417.
Disguise tannin, how to, 380.
Disinfecting oven, 389.
Disinfection, 411 ; for yellow fever, 212.
Dispersion of tumors, the electrolytic, 33.
Display in otology, in the centennial exhibi- tion, 477.
Distinguishing marks of a nulliparous uterus, _187.
Disturbance, uterine, at the change of life, 230.
Dobell's abstracts on chest diseases, 375.
Doctoring, free, 378.
Dogmatism of nescience, 398.
Doses, of iodide of potassium, large, syphilis
cured by, 139. Double retinitis in a case of brain disease, 241. Dressing ; to wounds, salicylic acid as a, 12 ; for
burns, 487.
Dropping of a molar tooth into the trachea,
dyspnoea from, 48. Dropsy ; scarlatinal, venesection in, 309 ; the
milk-weed in, 416. Drugs, new chemical, 137. Drunkards, mortality of, 137. Dulcamarine, 196. Duties of physii-ians, 100. Dye, hair," 300, 400.
Dysentery ; chronic, treatment of, 154 ; treat- ment of, with salicylic acid, 177.
Dyspepsia, flatulent, chloroform in, 138.
Dyipnoea from the dropping of a molar tooth into the trachea, 48.
Ear ; removal of foreign bodies from the, 292 ; disease, scarlatinal, 330; aboriginal method of treating diseases of the, 401 ; middle, the use of sream in diseases of the, 401.
Early; recognition of scarlatina, 58; treatment in diph heria, 256 ; discharge of the liquor amnii, 337 ; forms of syphilis, a clinical lec- ture on, 441.
Ears, eczema rubrum of the, 47.
Easy and painless mode of extracting foreign bodies from the nasal cavity, 338.
Eating wall paper, a case of poisoning by, 119.
Eclampsia, puerperal, 443.
Eczema ; rubrum of the thigh and ears, 47 ; infantile, lime-water in, 117 ; palmarum et plantarum, 269.
Editors, medical, association of American, 479.
Editorials — 1876, 15.
The " Medical Law " of Pennsylvania, 35. The Mathematical Leanings of Physiology, 55. Arsenical Poisoning, 56. , The Physiological Aspects of Religious Ex- citement, 76. On the Value of Food, 96. The Cause of Typhoid Fever, 116. Criminal Law and Mental Pathology, 136. The Medical Corps of the U. S. Army, 156. The Pennsylvania State Board of Health, 175. Further Remarks on Prostitution, 194. Mind as a Factor of Organism, 214. Recent Views on Evolution in Man, 234. The Training of Nurses, 254. A Universal Language ior Science, 276. The International Medical Congress, 1876, 295. The Liability of Physicians, 315. The Relation of Light to Life, 335. Number 1000, 355.
The Care of the Insane. Dr. Dobell's Ab- stracts on Chest Diseases, 375. Management of Mental Alienation, 395. State-sanctioned Profligacy, 414. Motion as Related to Life, 434. License Laws, 455.
Causes of Increase of Nervous Disease, 475. Quack Medicines at the Exhibition, 496. Exclusive Dogma, 501.
Education ; female medical, 296 ; popular medi- cal, 316.
Effect of cold on milk, 297.
Effectual mode of applying iodine to the interior of certain cysts, a more, 333.
Efficacy of vaccination, how long it may be relied on, 19.
Effusion ; pericardial, treatment of, 32 ; pleu- ritic, treatment of by operation, 290.
Elastic band in tenotomy, 211.
Elasticity of the lungs, 30.x
Electricity ; ozone, and putrefaction, 216 ; chronic aural catarrh treated by, 370.
Electrolytic dispersion of tumors, 33.
Embolism, diagnosis of hemorrhage and, 188.
Eminent physicians, personation of, 500.
Emperor of Brazil's grandchild, 59.
Employees, railroad, color blindness in, 397.
Employment of medicated ice, 210.
Empyema; a case of, 91, 131 ; the diagnosis of, 292.
Endocarditis, 208.
Endocardium, chronic ulceration of the, 49. England, success of the contagious disease acts in, 316,
Enlarged cervical gland treated by hypodermic
injections of tincture iodine, 444. Enteric fever; the turpentine treatment of, 289;
Index.
ix
Four at a birth, 219.
Fracture; of patella, 100, 197 ; of the scapula, 271 ; ununited, of the humerus, treated by operation, 284 ; resulting from muscular action, 378 ; compound, comminuted, of fore- arm, 422 ; of the inferior maxillary bone, 448; of femur, 451.
Fractures, lacerations and contusions, notes of a severe case of, 161 ; treatment of, by the bran box, 286.
Free doctoring, 378.
Frequency of triplet births, 19.
Frogs, pre-Adamitic, 39.
Function^ brain, the localization of, 119.
Fungoid granulations of the mucous membrane of the uterus, 287.
Galactifuge, ergot a, 499.
Galvano- cautery, amputation of cervix uteri by the, 209.
Gangrene, hospital, 308.
Gastric; vertigo, 427 ; ulcer, multiple, 476.
Gastritis, acute, cupping and ice in, 483.
Gelseminum ; in veratrum poisoning, 118; toxic effects of, 419 ; poisoning, 480.
General ; paralysis, the urinology of, 18 ; pro- gressive, in a case of brain disease, 241 ; practice, syphilis as met with in, 81.
Gentian root, no tannin in, 236.
Germs, disease, 388.
Girl, the Lancashire fasting, 288.
Gland ; excision of a tumor lying under the parotid, 130 ; Sigmund's, 280 ; enlarged cer- vical, treated by hypodermic injections of tincture iodine, 444.
Glandular formation in the stomach, 50.
Glass, toughened, 256.
Glioma of retina, 63.
Glycosuria from injury, 452.
Gonorrhoea ; pyaemia following, 105 ; treatment of, by a reversed current of fluid, 117 ; treat- ment of, 190 ; the stages and treatment of, 481.
Gonorrhoeal ; and syphilitic affections of the
testicles, 301 ; rheumatism, treatment of, 370. Good old times, depletion in the, 199. Grafting of skin on stumps, 57. Grandchild of the Emperor of Brazil, 59. Granulations, fungoid, of the mucous membrane
of the uterus, 287. Gravel, the etiology of, 412. Gravid uterus, procidentia of the, 318. Great Britain, practicing in, 220. Grotto of health, 438. " Guessing " at poisons, 140. Gum acacia as a food, 158. Gunshot wound, of the hand, recovery from
pyaemia following, 69 ; in pregnancy, 438 ; of
the head, 439. Gynecological instruments, hard rubber, 398.
Haematoma, intra-cranial, autopsy of a case of, 7. Hair ; tonic, 240 ; dye, 360, 400. Hanging investigations, 200. Hand, recovery from pyemia following gunshot wound of the, 69.
Hard ; on physicians, 59 ; rubber gynecological
instruments, 398. Harvest, the rose, 232.
Head ; cold in the, immediate cure for, 391 ;
gunshot wound of, 439. Headache, notes on, 101. Healing of wounds, 471.
Health; of Eome, 39; an imperial board of, 39 ; resort, western North Carolina as a, 141 ; board of, for Pennsylvania, proposed act to create a, 175 ; of Philadelphia, 198, 417 ; light in its relation to, 236 ; Wisconsin board of, 320 ; resort, Colorado as a, 415 ; a grotto of, 438 ; the food equivalent of, 438.
Healthiness of unseasonable weather, 157.
Healthy; blood, poison in, 118; season, 319.
Heart ; rupture of, 48 ; affections, secondary,, the diagnosis of, 52 ; disease and pregnancy, 437.
Heat ; local, in excessive metrorrhagia, 250 ; stroke, pathology of, 272.
Heidelberg, treatment of typhoid fever by cold baths at, 427.
Hematuric malarial fever, 43.
Hemorrhage ; after tooth extraction, 30 ; uter- ine, infusion of matico in, 57 ; accidental, 119 ; post partum, cannabis indica in, 138 ; capillary, in phthisis, 165 ; and embolism, diagnosis of, 188 ; a case of ante-partum, 217 ; post partum, 363 ; the arrest of, by torsion, 376.
Hemorrhagic pachymeningitis, 209.
Hepatic abscess, 131.
Hereditary web fingers, 460.
Hermaphrodite, Catherine Hohmann, the, 436.
Hernia, labial, 381.
Hiccough ; uterine, 190.
High temperature, 210.
Hint to medical politicians, 457.
Hip-joint ; exsection of, 448.
History ; botanical, of the so-called damiana, 181 ; of an epidemic of diphtheria, 264.
Homoeopathy at Ann Arbor, 339.
Hospital Reports.
Bellevue Hospital Medical College, New York. Clinic of Professor Lusk. Fibrous tumor ; tympanites ; ascites ; peri- tonitis ; diagnosis of pregnancy ; condy- lomata ; carcinoma, 107. Jefferson Medical College.
Clinic of Professor Gross. Case of obscure affection of the urinary bladder ; foreign body in the nostril chancres with phimosis ; two tumors of the eyelid ; recovery from pyemia follow- ing gunshot wound of the head ; subse- quent partial amputation, 66 ; cervical lymphadenoma ; acute and chronic syph- ilitic orchitis ; neuralgia of knee-joint ; excision of a tumor lying under the parotid gland ; case of empyema, 129. Long Island College Hospital.
Clinic of Professor Wight. ♦ Fracture of the scapula, 271 ; amputation of index finger, 307 ; case of fracture of the inferior maxillary bone, 448.
Index,
New York Wbman''s Hospital.
Slouii;hiDg of uterus and bladder as a sequel of labor ; sarcoma of the uterus, removal-, ovariotomy, treatment of the adhesions, 10 ; uterine polypus, 286. Orthopcedic Hospital.
Annual Report, 59. Pennsylvania Hospital.
Clinic of Professor Da Costa. Autopsy of case of intra-cranial haBmatoma, occurring in the course of chronic Bright's disease ; brain tumor vs. chronic menin- gitis ; cirrhosis of liver and kidneys, with ascites. 7 ; salicylic acid for foul breath and offensive expectoration ; a case of psoriasis diffusa vel chronica, 148. Clinic of Dr. Hutchinson. Simple continued fever simulating typhoid, 28 ; pyemia following gonorrhoea, rupia specifica, 1(J5. Philadelphia Hospital.
Clinic of Dr. J. H. Brinton. Venereal ulcers ; urethral stricture, 45 ; fistula in ano ; chancre 5 phimosis ; para- phimosis, 150 ;
Clinic of Professor Harrison Allen. Amputation of fingers ; strumous disease of the bones of the foot ; syphilitic roseola, 405.
State Hospital for Women and Infants.
Summary of the Report, 60. University Hospital,
Clinic of Professor Wood. Caries of the vertebrae.
Clinic of Professor Duhring. Eczema rubrum of the thigh ; diffused psoriasis in a child; eczema rubrum of the ears, 47 ; eczema palmarum et plan- tarum, 269.
Hospital •, for mental diseases, Burn Brae, 99, 160 5 a new, 200; Philadelphia, formulae from the pharmacopoeia of the, 215 ; gan- grene, 308 ; for the insane, Washington, 418 ; Pennsylvania, annual report of, 438 ; patients, recreations for, 498.
Hospitalities to physicians, 300.
Hot water in uterine inflammation, 53.
Hour-glass contractions of the uterus during labor, 61, 104.
Human diaphragm, on absorption by the, 195.
Humerus, ununited fracture of, treated by operation, 284.
Hydrocele; chloroform in, 97; the antiseptic treatment in incision of, 287.
Hydrophobia, the pathology of, 212.
Hyoscyamia, vomiting of pregnancy cure by, 236.
Hyperaemia of epiglottis, larynx and trachea, 207.
Hypertrophy of the scrotum and prepuce, exci- sion, recovery, 44 ; of cervix uteri, 209.
Hypnotic properties of lactate of soda, 11.
Hypodermic ; medication, experience in, 5 ; so- lutions, the questionable value of, 16 ; injec- tion of corrosive sublimate in syphilis, 114; use of morphia, precautions in the, 397 ; in-
■
jections of tincture iodine for enlarged cer- vical gland, 444 ; use of ether in labor, 451.
Ice ; medicated, employment of, 210 ; and ice water in scarlet lever and diphtheria, '221 ; cupping and, in acute gastritis, 483.
Idiopathic tetanus, 13
Incision; subcutaneous, for carbuncle, 114;
of hydrocele, the antiseptic treatm*^nt in, 287. Increase of nervous di^^eases, causes of, 475. Index finger, amputation of, 307. Inebriates ; summary of some pap'^rs read
before the American association loi the cure
of, 70.
Inebriety, clinical studies of, 461.
Infant, ringworm in, within six hours of birth,
310 ; belladonna poisoning in an^ 464. Infantile eczema, lime-water in, 117. Infants ; the State hospital lor women and, 60 ;
convulsions in, treatment of, 389. Infected milk, typhoid fever probably caused
by, 78.
Infection; puerperal, avoidance of, 172; sys- temic, from purulent vaginal discharges, 261.
Inferior maxillary bone, fracture of, 448 ; epulis of, 450.
Inflamed ulcers, treatment of, 282.
Inflammation ; uterine, hot water in, 53 ; phlegmonous, of the female breast, treatment of, 361.
Infusion of matioo in uterine hemorrhage, 57. Infusoria in fever stools, 311. Ingrown nails, 38, 159.
Inhalations; of nitrogen, tuberculosis treated by, 16 ; in whooping cough, 288.
Inheritance a cause of inebriety, 463.
Injections; cod-liver oil, 97 ; hypodermic,^ of corrosive sublimate in syphilis, 114; of tinc- ture iodine for enlarged cervical gland, 444.
Injury, glycosuria from, 452.
Innervation of the tensor tympani, 454.
Inoculation of diphtheria, 331.
Insane ; care of, in the United States, 200,375, 418.
Insanity, religious, 236.
Insect powder, the poison of, 378.
Instance of remarkable abstinence, 268.
Institutions; charitable, 259; for the feeble- minded, association of superintendents of, 500.
Instruments ; for extracting foreign bodies from the external meatus, 351 ; hard rubber gyne- cological, 398.
Insurance; life companies, and pulmonary phthisis, 1.
Intellect, loss of, in a case of brain disease, 241. Interior of certain cysts, a more effectual mode
of applying iodine to the. 333. International ; medical congress, 39, 279 ; its
aim, 295 ; centennial exhibition— the U. S.
medical department in the, 457 ; Professor
Politzer's display in otology, 477 ; medical
botany of the Spanish-American exhibits,
498 ; medical society, 504. Intermittent fever, salicylic acid in, 166. Intra-; cranial hasmatoma, autopsy of a case of,
occurring in the course of chronic Bright's
Index.
XI
disease, 7 ; uterine polypi, ergot in, 232 ;
uterine fibroid, 287. Intussusception a case of, 23 5 section of the
abdomen for, 209. Investigations, hanging, 200. Iodide of potassium in syphilis, 139. Iodine, a more effectual mode of applying, to
the interior of certain cysts, 333 ; tincture,
injections of, for enlarged cervical gland, 444. Iodoform pencils, 317. Iliac fossa, tumor in right, 168. Immediate cure for cold in the head, 391. Imperial board of health, 39. Import of an ulcer, and its treatment, 201. Irritable bladder in women, 436. Irritant, stove polish as an, 476 Irritation ; of the bladder, sympathetic, 104 ;
preputial, epilepsy from, 429. Israelites, the longevity of, 357. Items, 20, 4(7, 60, 80, 100, 120, 200, 260, 340,
360, 379, 400, 419, 440, 480.
Jaborandi, 16^ 165 ; in colds, 352.
Jaw, lower, resection of a portion of the, 266.
Joint; knee, neuralgia of, 130; shoulder, chronic, suppurative synovitis of, 168 ; dis- eases, the constitutional treatment of, 417.
Joints ; diseased, sulphuric acid in, 51 ; chronic diseases of the, 399.
Kentucky shower of flesh, 436.
Kidneys, cirrhosis of liver and, with ascites, 9.
Knee-joint ; neuralgia of, 130 ; excision of the
knee and amputation of the thigh for disease
of the, 324. Kramer, notice of the late Dr. William, 445. Kryolite, 307.
Labial hernia, 381.
Labor ; sloughing of uterus and bladder as a sequel of, 10 ; hour-glass contractions of the uterus during, 61 ; natural, management of the bag of waters in, 147 ; the use and abuse of various agents for expediting, 246 ; hypo- dermic use of ether in, 451.
Lacerations, fractures and contusions, notes of a severe case of, 161.
Lactate of soda, hypnotic properties of, 11.
Lancashire fasting girl, 288.
Language, a universal, for science, 276.
Large doses of iodide of potassium in syphilis, 139.
Laryngitis, phthisical, nitrate of silver in, 457. Larynx and trachea, diphtheria of, 49 ; hyperge- mia of, 207.
Law ; medical, of Pennsylvania, 35 ; criminal, and mental pathology, 136 ; medical, of Wyo- ming Territory, 199 ; medical, of California, 357.
Laws, license, 455.
Lead poison ; nitrate of amyl in, 166 ; the blue line in, 288 * amenorrhoea from, 410.
Leanings, mathematical, of physiology, 55.
Lecture, clinical, on some early forms of syphi- lis, 44L
Left anterior central convolution of the cere- brum, 206.
Lepra, Norwegian, 431.
Lesions, mammary, treatment of, 377.
Lesson, a short, in conservative surgery, 161.
Letter ; from Nebraska, 98 ; from Paris, 178.
Leukaemia, cases of, 291.
Liability of physicians, 315.
License laws, 455.
Lichen, syphilitic, 441.
Life ; insurance companies and pulmonary phthisis, 1 ; headaches of the decline of, 103 ; uterine disturbance at the change of, 230 ; the relation of light to, 335 ; motion as related to, 434.
Ligature, shoe thread as a 479.
Light; in its relation to health, 236 ; the rela- tion of, to life, 335.
Limbs, paralyzed, the temperature of, 353.
Lime-water in infantile eczema, 117.
Limitation of venereal, 311.
Limits of microscopical observation, 273.
Lin. ammon, iodid, 420.
Line, the blue, in lead poisoning, 288.
Liquor; chloral camphoratus, 317; aranii, early discharge of the, 337 ; potassae in diph- theria, 493.
Lister's ; antiseptic method, 58, 313.
Lithotomy, supra-pubic, a case of, 349.
Liver and kidneys ; cirrhosis of, with ascites, 9 ; waxy, an undiagnosed case of, 90 ; oxygen and the, 118.
Local ; treatment of phlyctenular ophthalmia, 231 ; heat, in excessive metrorrhagia, 250.
Localization ; of brain function, 119 ; of arsenic in the tissues of poisoned animals, 177.
Locations, strange, for primary chancres, 430.
London, vital statistics of, 260.
Longevity of Israelites, 357.
Lower jaw, resection of a portion of the, 266.
Lungs ; oedema of, 90, 207 ; elasticity of, 308.
Lupus, nasal, 133.
Lusus naturae, 416.
Lymphadenoma, cervical, 129.
Maladies of mystics, 137.
Malarial ; fever, hematuric, 43 ; diseases,
arsenic in, 157. Malignant ; pustule, carbolic acid in, 117 ;
type of pneumonia, 245. Mammary lesions, treatment of, 377. Mammitis, treatment of, 416. Man ; recent views on evolution in, 236 ; of
the fork, 456. Management; of cerebro-spinal meningitis, 12;
of abortion, 13 ; of premature children, 37 ;
of morphinism, 74 ; of the bag of waters in
natural labor, 147 ; of mental alienation,
395.
Mancona bark, 217. March of the plague, 359.
Marks, distinguishing, of a nulliparous uterus, 187.
Marriage notices, 20, 40, 60, 80, 100, 120, 140, 180, 200, 240, 280, 300, 320, 360, 380, 400, 420, 440, 480.
Marriages, consanguineous, 397.
Mathematical leanings of physiology, 55.
Matico, infusion of, in uterine hemorrhage, 57.
Xll
Inaex.
Maxilla, epulis of inferior, 450.
Maxillary bone, inferior, fracture of the, 448.
Measles and small-pox, difference between, 368.
Meats, canned, mercurial poisoning from, 476.
Meatus, external, instruments for extracting foreign bodies from the, 351.
Mechanical action of pessaries, 428.
Meddlesome urethral surgery, 318.
Medical ; law^ of Pennsylvania, 35 ; of "Wyo- ming Territory, 199 ; proposed, of Ohio, 258 ; of California, 357 ; education, female, 296 •, popular, 316 ; congress, international, 39, 279, 295 ; defence association, British, 80 ; value of vinegar, 153 ; corps of the U. S. army, 156 ; diplomas for women, 160 ; col- lege commencements, 237 ; staff of the centen- nial exhibition, 238 ; autographs, 320 ; stu- dents, female, 369 ; features of the centennial exhibition, 456 ; politicians, a hint to, 457 ; department, U. S. army, centennial exhibi- tion, 457 ; editors, American, association of, 479 ; botany of the Spanish- American ex- hibits, 498 ; botany of the United States, 503.
Medical Societies. Allegany County (Md.) Medical Society. Meeting Jan. 18, 1876, 112; March 21, 1876, 307.
American Medical Association. Annual meet- ing, 1876, 484.
American Association for the Cure of Inebri- ates. Summary of some papers read at its session at Hartford, Connecticut, 70.
Armstrong County (Pa.) Medical Society. Meeting March 28, 1876, 440.
Cass County (Ind.) Medical Society. Meeting April 27, 1876, 406.
College of Physicians and Surgeons, Phila- delphia. Meeting Nov. 3, 1875 — a case of empyema, 91. Meeting Dec. 1, 1875 — a case of hepatic abscess, 131. Meeting March 1, 1876 — excision of the knee and amputation of the thigh for disease of the knee-joint, 324.
Erie County (Pa.) Medical Society. Meeting April 4, 1876, 339.
International Congress of Medical Sciences, Brussels, 1875. Abstract of the Section of Otology. Communication by Mr. Sapolini, on instruments for extracting foreign bodies from the external meatus, 350.
Juniata Valley Medical Association. Meeting Jan. 28, 1876. Officers elected, 159. Pro- ceedings of first meeting, 187.
Juniata (Pa.) Medical Society. Organization, April 25, 1876, 399.
Kings County (N. Y.) Medical Society. Meeting Jan. 18, 1876. Officers elected, 120.
Lawrence County (Pa.) Medical Society. Meeting April 18, 1876, 418.
Medical Alumni Association of the Univer- sity of Michigan. Organization, 220.
Medical and Surgical Society of Baltimore. The use and abuse of various agents for ex- pediting labor, 246,
Medical Society of New Jersey. Annual meeting, May 23, 1876, 458.
Medical Society of the State of Pennsylvania Annual meeting, May 31, 1876, 465.
Minnesota State Medical Society. Meeting Feb. 1, 1876, 168. _
Newport and Covington (Ky.) Medical Society, Meeting February, 1876. Variola ; the statistics as to its prevention through vaccination, its diagnosis and treatment, 364.
New York Medico-legal Society. Meeting Feb. 9, 1876. Milk in its medico-legal rela»- tions, 184.
New York Neurological Society. Meeting Deo. 6, 1875. The cause of the death of Vice President Wilson, 29.
New York Pathological Society. Meeting Dec. 22, 1875. Sarcoma of the finger ; aneurism of the arch of the aorta ; catarrhal pneumonia ; an undiagnosed case of peri- typhlitis, phthisis, oedema of lungs, waxy liver ; fibromata of arm ; tubular seques- trum of femur, 89.
Meeting Nov. 24, 1875. Aneurism of abdominal aorta ; contraction of colon and ileum ; thrombosis ; phlebitis ; catheter removed from the bladder ; disease of sacro- iliac articulation ; tumor in right iliac fossa, operation, peritonitis, death ; chronic suppurative synovitis of shoulder joint, ex- cision ; necrosis of first and second pha- langes of index finger ; urinary calculus, 166.
Meeting Feb. 9, 1876. Hypersemia of epiglottis, larynx and trachea ; oedema of lungs ; pyelitis ; softening of spinal cord ; cyst in kidney ; carcinoma of stomach, presenting no characteristic symptoms during life ; pericarditis, myocarditis, en- docarditis ; diphtheria , pneumonia ; bac- teria discovered in the blood ; hemorrhagic pachymeningitis ; syphilitic pachymenin- gitis ; hypertrophy of cervix uteri ; ampu- tation by galvano-cautery, 207.
Meeting March 22, 1876.^ Fibroma of vagina ; osteo-chondroma of tibia ; sarcoma of thorax ; uterine polypus ; lipoma ; caries of spine, 385.
Meeting April 26, 1876. Eeport of cases of exsection of hip joint; fish bone re- moved from pharynx ; morbus coxae ; epulis of inferior maxilla ; sarcoma of tongue and pharynx ; fracture of femur ; suppurating bursa3, 448.
Northampton County (Pa.) Medical Society. Meeting Jan. 19, 1876, 112,
Ohio Valley Medical Association. Meeting May 5, 1876, 386.
Philadelphia County Medical Society. Annual meeting ; officers elected, 99.
Rhode Island State Medical Society. Meet- ing at Woonsocket, 29.
Southern Illinois Medical Association. Meet- ing Jan. 19, 1876. Officers elected, 160.
Southwestern Texas Medical Association. Organization, 259.
Texas State Medical Association. Eighth annual meeting, 359.
Index,
xiii
West Virginia State Medical Society, Meet- ing June 1, 1876, 500.
Medicated ice, employment of, 210.
Medication, hypodermic, experience in, 5.
Medicinal product, " chia," a new, 249.
Medicine, Chinese, 99 ; alcohol in, 337.
Medicines, quack, at the exhibition, 496.
Medico-legal relations of milk, 184.
Melano-sarcoma of the rectum, 424.
Membrane, mucous, of the uterus, fungoid granulations of the, 287.
Membrana tympani, treatment of perforations of the, 188.
Memphis, epizooty in, 152.
Meningitis; chronic, brain tumor vs., 8; cere- brospinal, the management of, 12, 182.
Menstruation, suppressed, amaurosis through, 388.
Mental ; disease. Burn Brae hospital for, 99, 160 ; pathology, criminal law and, 136 ; alienation, management of, 395.
Mercurial ; and saturine tremor, treatment of, 318 ; poisoning from canned meats, 476.
Method ; of bi-polar or bi-manual version, 32 •, Prof. Lister's antiseptic, 58 ; a new, of dila- ting the Eustachian tube, and ventilating the cavity of the tympanum, 188 ; a new, of pre- venting the secretion of milk in the female breast, 230 5 postural, prolapse of the umbili- cal cord treated by the, 289 ; antiseptic. Lister's treatment of wounds by the, 313 ; aboriginal, of treating diseases of the ear, 401.
Metric form, prescriptions in the, 415.
Metrical system, the, 235, 371.
Metro-peritonitis, puerperal, chloral hydrate in the treatment of, 304.
Metrorrhagia, excessive, local heat in, 250,
Mexican midwifery, 418.
Microscopical observation, limits of, 273.
Middle ear, observations on the use of steam in diseases of the, 401.
Midwifery, native Mexican, 418.
Milk ; artificial, 17 ; the digestibility of, 177 ; in its medico-legal relations, 184; a new method of preventing the secretion of, in the female breast, 230 ; diet, in confinement, 260 ; as a vehicle of contagion, 278 ; the effect of cold on, 297 ; weed, in dropsy, 416.
Mind as a factor of organism, 214.
Miracle, another, 378.
Mixture, Basham's, 60 ; rheumatism, 497.
Mode ; of applying iodine to the interior of certain cysts, a more effectual. 333 ; an easy and painless, of extracting foreign bodies from the nasal cavity, 338.
Morbus COX88, 450.
Morphia ; in neuralgia, 33 ; in acute urasmia, 37 ; precautions in the hypodermic use of, 397.
Morphinism and its management, 74.
Mortality of drunkards, 137.
Mortification of a portion of the bowel and bladder ; recovery, 38.
Motion as related to life, 434.
Mouse, ia singing, 159.
Movement, the cremation, 460.
Mucous membrane of the uterus, fungoid
granulations of the, 287. Multiple gastric ulcer, 476. Muscae volitantes, 473.
Muscular ; atrophy, progressive, 18 ; action, fracture resulting from, 378.
Musculo-cutaneous plan of amputation, combi- nation of the cutaneous and, 321.
Myocarditis, 208.
Mystics, maladies of, 137.
Nsevi, 57.
Nails, ingrown, 38, 159.
Narrowed pelvis, version in, 133.
Nasal : lupus, 133 ; cavity, an easy and painless
mode of extracting foreign bodies from, 338. Native ; alcohol, 297 ; Mexican midwifery, 418. Natural ; pulse, 16 ; labor, management of the
bag of waters in, 147. Nature the use of the word, 299. Nebraska, letter from, 98. Necrosis of first and second phalanges of index
finger, 168. Neglect of ventilation, 460. Nervous; fluid, the circulation of the, 164;
diseases, deaths from, 249 ; disease, causes
of the increase of, 475. Nescience, the dogmatism of, 398. Neuralgia ; morphia in, 33 ; facial, tying the
carotid for, 58 ; of knee-joint, 130 ; obstinate,
pills for, 337 ; points in, 350 ; of the bladder,
382.
New ; York, centenarians in, 36: chemical drugs, 137 ; anti-pruritic remedy, 158 ; pre- paration of santonine, 158 ; remedy, tayuya, 177; method of dilating the Eustachian tube, and ventilating the cavity of the tympanum, 188 ; hospital, 200 ; method of preventing the secretion of milk in the female breast, 230; dietetic and medicinal product, " chia," 249 ; plan for detecting bile pigment in the urine, 312; buildings as sources of disease, 437.
Nipples, ulcerated, 57.
Nitrate ; of amyl in lead poison, 166 ; of silver
in phthisical laryngitis, 457. Nitrates as water-purifiers, 191. Nitro-benzol, detection of, 476. Nitrogen, tuberculosis treated by inhalations of,
16.
" No more " ovariotomy, 309.
North Carolina ; western, as a health resort, 141 ; diphtheria in, 180.
Norwegian lepra, 431.
Nostril, foreign body in the, 67.
Notes ; on current medical literature, 14, 54, 75, 94, 115. 134, 155, 173, 192, 232, 273, 293, 315, 334, 355, 374, 394, 412, 454, 473 ; thera- peutical, 77, 97, 117, 497 ; on headache, 101; of a severe case of lacerations, fractures and contusions, 161 ; on the chemistry of the urine, 216 ; tdxicological, 259 ; obstetric, 363.
Notice of the late Sir William Wilde and Dr. William Kramer, 445.
Nulliparous uterus, distinguishing marks of a, 187.
Number 1000, 355.
xiv
Index,
Nurses, the training of, 254. Nut, the betel, 97.
Obituary Notices.
Dr. Charles Mifflin, 20; Drs. J. H. Nau, Samuel Blair Martin, 40; Dr. Samuel Gridley Howe, 80 ; Mr. James Hinton, 100 ; Dr. George II. Hubbard, 120 ; Dr. T. 0. Edwards, 160 ; Mrs. Louisa A. Gross, 220 ; Dr. Henry F. Askew, 240 ; Dr. Wil- son C. Swann, Dr. John S. Parry, 280, 300, 360; Dr. Vleminckx, 319 ; Dr. R. R. Porter, Dr. W. 0. Woolfolk, 380; SirWm. R. Wilde, 400 ; Dr. T. H. Butterfield, Dr. Joseph Rogers, Dr. Joseph Grain, 420 ; Dr. C. B. Nottingham, 440.
Obscure affection of the urinary bladder, 66.
Observance of Sunday, 498.
Observations ; microscopical, limits of, 273 ; on the use of steam in diseases of the middle ear, 401 ; on the determination of sex, 403.
Obstetric notes, 363.
Obstinate neuralgia, pills for, 337.
QEdema of lungs, an undiagnosed case of, 90, 207.
Offensive expectoration, salicylic acid for foul breath and, 148.
Ohio ; trichinosis in, 180 ; medical bill, 258.
Oil. cod-liver, injections of, 97.
Ointment, resolvent, 398.
Old times, depletion in, 199.
Operation ; ununited fracture of the humerus treated by, 284 ; treatment of pleuritic effu- sion by, 290 ; for coccyodinia and ruptured perineum, 363 ; treatment of cleft palate without, 454.
Operations in pregnant women, 410.
Ophthalmia, phlyctenular, local treatment of, 231.
Opium ; poisoning, belladonna in, 37 ; the use of, 236 ; treatment of delirium tremens, 290.
Orchitis ; acute and chronic syphilitic, 129 ; treated by puncture, 2J2, 409 ; treatment of, 452.
Organism, mind as a factor of, 214. Origin of small-pox, 367.
Originator of the practice of using ice and ice
water in scarlet fever — who was it ? 221. Orthopaedic hospital, 59. Osteo-chondroma of tibia, 386. Osteotomy, subcutaneous, of the femur, 493. Otology, "Professor Politzer's display in, at the
centennial exhibition. 477. Otorrhoea; chronic, salicylic acid in, 244;
salicine in, 349. Ova, self-development of, 317. Ovarian tumors, diagnosis of, 107. Ovariotomy; treatment of the adhesions, 11;
" no more, ' 309 ; a case of, 341. Oven, a disinfecting, 389. Oxygen and the liver, 118. Oxytocic, is quinine an, 145, 196. Ozasna, chloral in, 77.
Ozone; electricity and putrefaction, 216 ; pow- der for producing, 415.
Pachymeningitis, hemorrhagic, syphilitic, 209.
Pain, relief of, during cauterization, 457.
Painful points in neuralgia, 350.
Painless mode of extracting foreign bodies from
the nasal cavity, 338. Palate, clefc, treatment of, without operation,
454.
Paper, wall, poisoning by eating, 119.
Papers read before the American association^ for the cure of inebriates, summary of, 70.
Paralysis ; from a retained pessary, 12 ; gen- eral, the urinology of, 18 ; with aphonia, pro- gressive general, characterizing brain disease, 241.
Paralyzed limbs, the temperature of, 353. Paraphimosis, 152.
Parasitic ; diseases, boracic acid in, 158 ; theory
of disease, 277. Paris ; green, poisoning from, 118 ; letter from,
178.
Parotid gland, excision of a tumor lying under the, 130.
Partial amputation of the hand, 69.
Parturifacient, quinine a, 338.
Patella ; fracture of, 100 ; transverse fracture
of, united by bone, 197. Pathology ; mental, criminal law and, 136 ; of
hydrophobia, 212 ; of heat-stroke, 272 ; of
whooping cough, 393. Patients, hospital, recreations for, 498. Peddling, diploma, 39. Pediculophobia, 267.
Pelves narrowed in the conjugate diameter,
version in, 133. Pencils, iodoform, 317.
Pennsylvania ; the medical law of, 35 ; state board of health, proposed act to create a, 175 ; hospital, annual report of, 438.
Pension surgeons, proposed change in, 99.
Perforation of the membrana tympani, treat- ment of, 188.
Pericardial effusion, treatment of, 32.
Pericarditis, 208.
Perineum, operation for coccyodinia and rup- tured, 363 ; rupture of the, extending into the recto-vaginal septum, 404.
Perityphlitis, an undiagnosed case of, 90.
Personal items, 40, 59, 80, 99, 160, 180, 200, 239, 260, 280, 300, 320, 340, 359, 379, 400, 419, 460, 480 ,500.
Personation of eminent physcians, 500.
Pessary ; retained, paralysis from a, 12 ; re- moval of a, Irom a female urinary bladder, 184.
Pessaries, the mechanical action of, 428.
Pharmacopoeia of the Philadelphia hospital, formulae from the, 215.
Pharynx, fish bone removed from, 448 ; sar- coma of tongue and, 451.
Philadelphia; deaths in, during 1875,39; the health of, 198, 417 ; sanitary situation of, 498.
Phimosis, chancres with, 67, 151.
Phlebitis, 167.
Phlegmonous inflammation of the female breast,
treatment of, 361. Phlyctenular ophthalmia, local treatment of,
231.
Phosphorus poisoning, avoidance of, 333.
Index.
XV
Photographs in color, 256.
Phthisis : pulmonary, life insurance companies and, 1 ; an undiagnosed case of, 90 ; capillary hemorrhage in, 165 ; the varieties of, 353.
Phthisical laryngitis, nitrate of silver in, 457.
Physical culture, a school of, 157.
Physicians; hard on, 59-, duties of, 100; in criminal cases ; 158 ; hospitalities to, 300 ; the liability of, 315; proportion of, to popu- lation, 460 ; eminent, personation of, 500.
Physiological ; aspects of religious excitement, 76 ; action of alcohol, 250 ; curiosity, 437.
Physiology, the mathematical leanings of, 55.
Picrotoxine in epilepsy, 236.
Pills for obstinate neuralgia, 337.
Pityriasis, chloral in. 337.
Placenta prsevia, 237.
Placental delivery, 363.
Plague ; reappearance of the, 138 ; march of
the, 359 ; symptoms of the, 453. Plan, a new, for detecting bile pigment in the
urine, 312.
Plans of amputation, combination of the cuta- neous and musculo-cutaneous, 321. Plants, the sleep of, 438. Plethysmograph, 277.
Pleuritic effusion, the treatment of, by opera- tion, 290. Pleuritis, chronic, 228.
Pneumonia; catarrhal, 89, 208; of malignant type, 245 ; veratrum viride as a remedial agent in, 322 ; sthenic, treatment of, 388.
Pneumonitis, value of cupping in the treatment of, 257.
Points, painful, in neuralgia, 350.
Poison ; cases, the detection of prussic acid in,
17 ; in healthy blood, 118 ; lead, nitrate of
amyl in, 166 ; of insect powder, 378. Poisoned animals, localization of arsenic in the
tissues of, 177. Poisoning ; opium, belladonna in, 37 ; arsenical,
56 ; veratrum, gelseminum in, 118 ; from
Paris green, 118 ; by eating wall paper, 119 ;
aconite, 125 ; by corrosive sublimate, 139 ;
camphor, 154 ; phosphorus, avoidance of, 333;
lead, amenorrhoea from, 410 ; of an infant by
belladonna, 464 ; mercurial, from canned
meats, 476 ; gelseminum, 480. Poisons, " guessing " at, 140. Polish, stove, as an irritant, 476. ' Politicians, medical, a hint to, 457. Polypi, intra-uterine, ergot in, 232, 472. Polypus, uterine, 286, 386. Popular medical education, 31 6. Population, proportion of physicians to, 460. Portion of the lower jaw, resection of a, 266. Position in shoulder presentations, 134, 278. Post-partum hemorrhage, 363 ; cannabis indica
in, 138.
Postural method, prolapse of the umbilical cord
treated by the, 289. Potassae, liquor, in diphtheria, 493. Potash, silicate of, in erysipelas, 196. Potassium, syphilis cured by large doses of, 139.
Powder ; insect, the poison of, 378 ; for pro- ducing ozone, 415.
Practice ; Siberian, 39 ; general, syphilis as met with in, 81 ; of using ice and ice water in scarlet fever — who was its originator? 221.
Practicing in Great Britain, 220. Pre-Adamitic frogs, 39.
Precautions in the hypodermic use of morphia, 397.
Pregnancy; re-positing the child in the vomit- ing of, 31 ; treatment of albuminuria during, 118 ; vomiting of, cured by hyoscyamia, 236; diagnosis of the sex of the foetus during, 357 ; pruritus of, 340, 380, 392 ; the circulation in, 411 ; heart disease and, 437 ; gunshot wound in, 438.
Pregnant women, operations in, 410. Premature children, management of, 37. Preparation of santonine, anew, 158. Preparations of salicylic acid, 256. Prepuce, hypertrophy of the, 45. Preputial irritation, epilepsy from, 429. Prescription for strangury, 240. Prescriptions in the metric form, 415. Presentations ; shoulder, position in, 134, 278 ;
arm, cephalic version in, 256. Preservative agent, chloroform as a, 255. Preventing the secretion of milk in the female
breast, a new method of, 230. Prevention ; of scarlatina, 296 ; of variola
through vaccination, 364 ; of scarlet fever,
377.
Preventive of small-pox, 140.
Primary chancres, strange locations for, 430.
Prize questions, 379.
Procidentia of the gravid uterus, 318.
Product, " chia," a new dietetic and medicinal,
249 ; of borax in California, 250. Producing ozone, powder for, 415. Professor; Lister's antiseptic method, 58;
Politzer's display in otology, in the centennial
exhibition, 477. Profligacy, state-sanctioned, 414. Prognosis of cerebral anaemia, 93. Progressive ; muscular atrophy, 18 ; general
paralysis characterizing brain disease, 241. Prolapse of the umbilical cord treated by the
the postural method, 289. Prolonged baths, 337.
Properties, hypnotic, of lactate of soda, 11. Proportion of physicians to population, 460. Prophylaxis of carious teeth, 93. Prostitution, further remarks on, 194. Pruritus hiemalis, treatment of, 98, 257 ; of
pregnancy, 340, 380, 392 ; vulvse, 437. Prussic acid ; the detection of, in poison cases,
47 ; atropia as an antidote to, 97. Psoriasis ; diffused, in a child, 47 ; diflPusa vel
chronica, 149. Puerperal ; fever, venesection in, 87 ; infection,
the avoidance of, 172 ; metro-peritonitis,
chloral hydrate in the treatment of, 305 ;
thrombosis, 377 ; convulsions, 383 ; 408 ;
eclampsia, 441. Pulmonary phthisis, life insurance companies
and, 1.
Pulvis glycyrrhizae comp., 340. Puncture, orchitis treated by, 212, 408
xvi
Index,
Pulse, the natural, 16. Purification of sulphide of carbon, 476. Purifiers of water, the nitrates as, 191. Purulent va<^inal discharges, systemic infection from, 261.
Pustule, malignant, carbolic acid in, 117. Putrefaction, electricity, ozone and, 216. Pycemia ; recovery from, 69 following gonor- rhoea, 105.
Quack medicines at the exhibition, 496. Questionable value of hypodermic solutions, 16. Questions, prize, 379.
Quinine ; is it an oxytocic, 145, 196 ; a partu- rifacient, 338 ; specific treatment of whoop- ing cough by, 407.
Queries and replies, 20, 60, 80, 100, 140, 160, 180, 220, 240, 260, 280, 300, 320, 340, 360, 380, 400, 419, 440, 480.
Radical cure of salivary fistula, 211. Railroad employees, color blindness in, 397. Reading, writing and, 318. Reappearance of the plague, 138. Recent views on evolution in man, 234. Recognition, early, of scarlatina, 58. Recto-vaginal septum, rupture of the perineum,
extending into the, 404. Rectum, melano-sarcoma of the, 424. Recovery from pyaemia following gunshot wound
of the hand, 69. Recreations for hospital patients, 498. Relation ; of light to health, 236 ; to life, 335 ;
of motion to life, 434. Relations, milk in its medico-legal, 184. Relic, an ancient, 200. Relief of pain during cauterization, 457. Religious ; excitement, the physiological aspects
of, 76 ; insanity, 236. Remarkable ; case of recovery after mortification
of a portion of the bowel and bladder, 38 ;
case of paralysis with aphonia, 79 ; absti- nence, 268. Remarks, on prostitution, 194. Remedial agent in pneumonia, veratrum viride
as a, 322.
Remedy 5 a new anti-pruritic, 158 ; a new, tayuya, 177 ; cancer, the eucalyptus globulus as a, 354.
Removal 5 of a sarcoma of the uterus, 11 •, of a pessary from a female urinary bladder, 184 ; of foreign bodies from the ear, 292 ; of fish bone from pharynx, 448.
Report of cases of exsection of hip joint, 448.
Resection of a portion of the lower jaw, 266.
Resolvent ointment, 298.
Resort, health ; western North Carolina as a, 141 ; Colorado as a, 415.
Re-positing the child, in the vomiting of preg- nancy, 31.
Retained pessary, paralysis from a, 12.
Retina, glioma of, 63.
Retinitis, double, a characteristic of brain dis- ease, 241.
Reversed current of fluid in the treatment of gonorrhaa, 117.
Reviews and Book Notices.
Transactions of the American Otologlcal So- ciety, eighth annual meeting, 14.
Transactions of the Medical Societies of New Jersey and Kansas. George Washington ; or. Life in America One Hundred years ago, Abbott. Notes upon the International Sunday-school Lessons, 1876, Clark. The Popular Health Almanac, 1876, Hofi^man. Lectures on Bright's Disease, Black, 34.
Transactions of the Medical Societies of Michigan and Illinois, 54.
Extra-uterine Pregnancy, Parry. Cyclopeedia of the Practice of Medicine, Yon Ziemssen. A System of Midwifery, Leishman, 94.
Biennial Report of the State Board of Health, of California. A Treatise on the Diseases of Infancy and Childhood, Smith. Trans- actions of the Pathological Society of Phila- delphia, 1874-5. Aids to Anatomy, Brown, 115.
The Body and its Ailments, Napheys, 135.
Atlas of Skin Diseases, Fox. Reports on Diseases of the Chest, Dobell, 155.
Lectures and Essays on Surgery. McDonnell. Medical Thermometry and Human Temper- ature, Seguin, 173.
Medical Jurisprudence of Insanity, Browne. Inhalation in the Treatment of Disease, Cohen, 193.
A Manual of General Pathology, Wagner.
Lectures on Nursing, Smith, 213. Filth Diseases and their Prevention, Simon,
233.
Transactions of the American Ophthalmolog- cal Society, Eleventh Annual Meeting, 251.
The Cause of the Commencement of Parturi- tion, Crombie, 274.
Insanity in its Medico-legal Relations, Cow- perthwaite. Climate in its Sanitary Rela- tions to Medicine, Baldwin. Treatment of the f*'crofulides, Giffard. Territory of Wyoming its History, Soil, Climate, etc., 294.
The Annual Report of the Board of Directors of the Pennsylvania Institution for the Deaf and Dumb, 334.
The Religious Sentiment, its Source and Aim, Brinton, 371.
A Treatise on the Diseases of the Nervous System, Hammond. The Crew of the Dol- phin, Stretton. Free, yet Forging their own Chains, Cornwall, 393.
Nature's Power to Heal, Canniff, 413.
Cyclopaedia of the Practice of Medicine, Von Ziemssen. An Elementary Treatise on Diseases of the Skin, Pifi"ard. An Intro- duction to Pathology and Morbid Anatomy, Green. The Schuylkill, M. K. C, 432.
Botanical Hand-book of Common Local, Eng- lish, Botanical and Pharmacopoeial Names, Hobbs. The Student's Guide to the Prac- tice of Midwifery, Roberts, 474.
A Manual of the Diseases of the Eye, Mac- namara, 494, Rheumatic cardialgia, 291. Rheumatism ; cerebral, treated by chloral, 18 ;
Index,
xvii
coto bark in, 97 ; acute articular, cyanides in, 97; as the cause of varicocele, 113; acute, salicylic acid in, 332 ; gonorrhoeal, treatment of, 370 ; mixture, 497 5 ammomia in, 497.
Rickets, skull changes in, 415.
Right; iliac fossa, tumor in, 168; supra-renal capsule, cancer of, 2G9.
Ringworm in an infant within six hours of birth, 310.
Rome, the health of, 39.
Root, gentian, no tannin in, 236.
Rose harvest, the, 232.
Roseola, syphilitic, 406.
Rubber, gynecological instruments, hard, 398. Rubeola, scarlatina complicating, 323. Rules in administering arsenic, 437. Rupia specifica, 107.
Rupture; of heart, 48; of the urethra, 114; of the perineum, extending into the recto- vaginal septum, 404.
Ruptured perineum, operation for coccyodinia and, 363.
Rye, ergot of, as an antipyretic, 78.
Sacro-iliac articulation, disease of, 167.
Sailors, color blindness in, 397.
Salicine in otorrhoea, 349. #
Salicylic acid ; as a dressing to wounds, 12 ; for foul breath and offensive expectoration, 148 ; in intermittent fever, 166 ; in dysentery, 177 ; in chronic otorrhoea, 244 ; preparations of, 256 ; as a febrifuge, 310 ; in acute rheuma- tism, 332 ; the application of, 391 ; solubility of, 437.
Salivary fistula, radical cure of, 211.
Salts of silver, therapeutical action of the, 393.
Sanitary amenities, 339 ; situation of Philadel- phia, 498.
Santonine, a new preparation of, 158.
Sarcoma ; of the uterus, removal, 11 ; treatment of, 189 ; of the finger, 89 ; of the thorax, 386 ; of the eye, 408 ; of tongue and pharynx, 451 ;
Saturnine tremor, treatment of, 318.
Scapula, fracture of the, 271.
Scarlatina ; the early recognition of, 58 ; the prevention of, 296 ; complicating rubeola, 323.
Scarlatinal ; dropsy, venesection in, 309 ; ear disease, 330.
Scarlet fever ; ice and ice water in, 221 ; pre- vention of, 377.
Scirrhus of the breast, 49, 50.
School; diseases, 15; of physical culture, 157.
Science ; the catholicity of, 235 ; a universal language for, 276.
Screw, swallowing a, 18.
Scrotum, hypertrophy of the, 44.
Season, a healthy, 319.
Secondary heart affections, the diagnosis of, 52 ; Secretion of milk in the female breast, a new
method of preventing the, 230. Section of the abdomen for intussusception, 209. Self-development of ova, 317- Sensitive artificial eyes, 398. Septum, recto vaginal, rupture of the perineum
extending into the, 404, Sequel of labor, sloughing of uterus and bladder
as a, 10,
Severe sprains, the treatment of, 426. Sewers and cesspools not a cause of typhoid fever, 398.
Sex ; of the foetus, diagnosis of the, during pregnancy, 357 ; observations on the deter- mination of, 403.
Sexual diseases in virgins, 356.
Shoulder; presentations, positions in, 135,278 ; joint, chronic suppurative synovitis of, 168.
Shoe thread as a ligature, 479.
Short lesson in conservative surgery, 161.
Shower of flesh, the Kentucky, 436.
Siberian practice, 39.
Sickness, teething, 16.
Sigmund's gland, 280,
Silicate of potash in erysipelas, 196.
Silver ; therapeutical action of the salts of, 393 ; nitrate of, in phthisical laryngitis, 457.
Singing mouse, 159.
Singular vital statistics, 195.
Skin ; grafting on stumps, 57 ; the, and bodily temperature, 293.
Skull changes in rickets, 415.
Social science association, conference of, 479.
Soda, hypnotic properties of lactate of, 11.
Softening of the spinal cord, 208.
Solubility of salicylic acid, 437.
Solutions, hypodermic, the questionable value of, 16.
Sound, when not to, 196.
Sources of disease, new buildings as, 437.
Sleep of plants, 438.
Sloughing of uterus and bladder as a sequel of labor, 10.
Small-pox ; preventive, 140 ; origin of, 367 ;
difference between measles and, 368 ; in
Vienna, 460. Spanish-American exhibits, medical botany of
the, 498.
Specific treatment of whooping cough by qui- nine, 407.
Spine, caries of the, 386.
Spinal cord, softening of the, 208.
Splints, Ahl's surgical, 85, 300 ; anterior exten- sion, 224.
Sprains, severe, the treatment of, 426.
Spray, ether, as an anaesthetic, 74.
Spread of cholera, 332.
Staff, medical, of the centennial exhibition, 238. Stages and treatment of gonorrhoea, 481. Stammering, treatment of, 376. State ; hospital for women and infants, 60 ;
board of health, proposed, for Pennsylvania,
175; sanctioned profligacy; 414. Statistics ; of suicide, 79 ; singular vital, 195 ;
vital, of London, 260 ; as to the prevention of
variola through vaccination, 364. Steam, the use of, in diseases of the middle ear,
401.
Sthenic pneumonia, treatment of, 388. Stimulants, alcoholic, 340.
Stomach ; glandular formation of the, 50 ; car- cinoma of, 208 ; diagnosis of dilatation of the, 409.
Stools, fever, infusoria in, 310.
Stove polish as an irritant, 476.
Strange locations for primary chaneres, 43(>.
xviii
Index.
Strangury, prescription for, 240. Stricture, urethral, 46, 121, 421. Strumous disease of the bones of the foot, 406. Students, female, 239, 369. Studies, clinical, of inebriety, 461. Stumps, skin grafting on, 57. Subcutaneous osteotomy of the femur, 493. Success of the contagious diseases acts in Eng- land, 316. Suicide statistics, 79.
Sulphide ; of calcium, in diabetes, 97 ; of car- bon, purification of, 476.
Sulphuric acid in diseased joints, 51.
Sulphurous acid, the administration of, in en- teric fever, 384.
Summary of some papers read before the American Association for the cure of ine- briates, 70.
Sunday, the observance of, 498.
Superintendents of institutions for the feeble- minded, association of, 500.
Supervision of disease, 377.
Suppositories, chloral, 255.
Suppression of menstruation, amaurosis'through, 388.
Suppurative synovitis of shoulder joint, chronic 168.
Supra- ; pubic tapping, 121 ; renal capsule, cancer of, 269 : pubic lithotomy, a case of, 349.
Surgeons, pension, change in, 99.
Surgery ; antiseptic, the atmosphere in, 78 ; conservative, a short lesson in, 161 ; antisep- tic, briefly reviewed, 298 ; meddlesome ure- thral, 318; applications of caoutchouc in, 428.
Surgical splints, Ahl's, 85.
Sutures, on uniting tendons by, 231.
Swallowing a screw, 18.
Sympathetic irritation of the bladder, 104.
Symptoms ; and prognosis of cerebral anaemia, 93 5 of the plague, 453.
Synovitis, suppurative, of shoulder joint, chronic, 168.
Syphilis ; as met with in general practice, 81 treated by hypodermic injection of corrosive sublimate, 114 ; cured by large doses of iodide of potassium, 139 ; a clinical lecture on some early forms of, 441 : inebriety attributed to 461. _
Syphilitic ; orchitis, acute and chronic, 129 ; pachymeningitis, 209 ; affections of the testi- cles, 301 ; roseola, 406 ; lichen, 441.
System; the metrical, 235, 371.
Systemic infection from purulent vaginal dis- charges, 261.
Tannin ; none in gentian root, 236 ; to disguise,
Tapeworm, treatment of, 37, 219.
Tapping, supra-pubic, 121.
Tayuya, a new remedy, 177.
Teeth, carious, the prophylaxis of, 93.
Teething ; sickness, 16 ; application, 77.
Temperature, high, 210; the skin and bodily,
293 ; of paralyzed limbs, 353 ; and health
of Philadelphia, 417.
Tenotomy, the elastic band in, 211. Tensor tympani, the innervation of, 454. Tendons, on uniting, by sutures, 231. Territory, Wyoming, the medical law of, 199. Testicles, gonorrhoeal and syphilitic affections
of the, 301. Tetanus, idiopathic, 13. Tetter, recipe for, 220.
Theory of tuberculosis, 190 ; the parasitic, of disease, 277.
Therapeutical action of the salts of silver, 393.'
Therapeutical Notes.
Chloral in oz^na ; teething application, 77 ; sulphide of calcium in diabetes ; coto bark in diarrhoea and rheumatism ; chloroform in hydrocele ; cyanides in acute, articular rheumatism cod-liver oil injections, 97 5 lime water in infantile eczema ; carbolic acid in malignant pustule, 117; dressing for burns ; rheumatism mixture ; ammonia in rheumatism, 497.
Therapeutics, application of bromide of camphor in, 126.
Thigh •, eczema rubrum of the, 47 ; fibro- cellular tumor of the, 49 5 amputation of the, and excision of the knee, for disease of the knee-joint,«324.
Thorax, sarcoma of, 386.
Thread, shoe, as a ligature, 479.
Throat, foreign body in the, 477.
Thrombosis, 167 ; puerperal, 377.
Tibia, osteo-chondroma of, 386.
Tie the cord, when to, 412.
Tincture iodine, hypodermic injections of, for enlarged cervical glands, 444.
Tissues of poisoned animals, the localization of arsenic in the, 177.
Tongue and pharynx, sarcoma of, 451.
Tonic, hair, 240.
Toothache, 218.
Tooth extraction, hemorrhage after, 30. Topical blood-letting, 390. ; Torsion, the arrest of hemorrhage by, 376. Toughened glass, 256.
Toxic effects of gelseminum 419. { Toxicological notes, 259.
Trachea ; dyspnoea from the dropping of a molar tooth into the, 48 ; diphtheria of larynx and, 49 ; hypersemia of, 207.
Training of nurses, 254.
Transverse fracture of the patella united by bone, 197.
Treatment ; of the adhesions of ovariotomy, 11 ; of tuberculosis by inhalations of nitrogen, 16 5 of croup, 17 ; of cerebral rheumatism by chlo- ral, 18 ; of pericardial effusion, 32 ; of tape- worm, 37; of diphtheria, 41, 170, 191, 204; of alveolar abscess, 94 ; of pruritus hiemalis, 98; of carbuncle, 114, 134; of syphilis by hypodermic injection of corrosive sublimate, 114 ; of epithelioma, 117 ; of gonorrhoea by a reversed current of fluid, 117 ; of albuminuria during pregnancy, 118; of chronic dysentery, 154 ; of dysentery with salicylic acid, 177 ; of burns, 178 ; of perforations of the membrana tympani, 188 ; of gonorrhoea, 190, 481 ; of ty- phoid fever, 196; of ulcers, 201, 281; of orchitis
Index.
xix
by puncture, 212 ; of tapeworm, 219 ; local, of phlyctenular ophthalmia, 331 ; of constipation and diarrhoea, 231 ; early, in diphtheria, 256 ; of pneumonitis, value of cupping in, 257 ; of pruritus, 257 ; of ununited fracture of the humerus by operation, 284 ; of fractures by the bran box, 286 ; antiseptic, in incision of hydrocele, 287 ; turpentine, of enteric fever, 289 ; of prolapse of the umbilical cord by the postural method, 289 ; opium, of delirium tremens, 290 ; of pleuritic effusion by opera- tion, 290 ; of puerperal metro-peritonitis by chloral hydrate, 305 ; Lister's, of wounds by the antiseptic method, 313 •, of mercurial and saturnine tremor, 318 ; of chronic Bright's disease, 330 ; of phlegmonous inflammation of the female breast, 361 ; of variola, 364 ; of chronic aural catarrh by electricity, 370 ; of gonorrhceal rheumatism, 370; of stammering, 376 ; of mammary lesions, 377 ; of sthenic pneumonia, 388 ; of convulsions in infants, 389 ; aboriginal, of diseases of the ear, 401 ; specific, of whooping cough by quinine, 407 ; of acute orchitis by puncture, 409 ; of mam- mitis, 416 ; constitutional, of joint diseases, 417 ; of severe sprains, 426 ; of typhoid fever by cold baths at Heidelberg, 427 ; of enlarged cervical gland by hypodermic injections of tincture iodine, "444 ; of orchitis, 452 ; of cleft palate without operation, 454.
Tremor, mercurial and saturnine, treatment of, 318.
Trichinosis in Ohio, 180.
Triplet births, the frequency of, 19.
Tube, Eustachian ; a new method of dilating the, 188 ; catheterization of the, 429.
Tubercle, the communication of, in food, 51.
Tuberculosis ; treated by inhalations of nitrogen, 16 ; the theory of, 190.
Tubular sequestrum of femur, 91.
Tuckahoe, 58, 159.
Tumor ; brain, vs. chronic meningitis, 8 ; fibro- cellular, of the thigh, 49 ; ovarian, 107 ; lying under the parotid gland, excision of, 130 ; in right iliac fossa, 168 ; of the left anterior central convolution of the cerebrum, 206.
Tumors ; the electrolytic dispersion of, 33 ; two, of the eyelid, 68 ; in the brain, 217.
Turpentine treatment of enteric fever, 289.
Tying the carotid for facial neuralgia, 58.
Tympanum, a new method of ventilating the cavity of the, 188.
Type, malignant, of pneumonia, 245.
Typhoid fever; probably caused by infected milk, 78; the cause of, 116; treatment of, 196 ; cold baths in, 230, 427 ; sewers and cesspools not a cause of, 398 ; causes of, 478.
Ulcer, multiple gastric, 476. Ulcerated nipples, 57.
Ulceration, chronic, of the endocardium, 49.
Ulcers ; venereal, 45 ; import of, and their treat- ment, 201, 281.
Umbilical cord, prolapse of the, treated by the postural method, 289.
Undiagnosed case of perityphlitis, phthisis,
oedema of lungs, waxy liver, 90. United States ; army, the medical corps of the,
156 ; medical department in the centennial
exhibition, 457 ; care of the insane in the, 200. Uniting tendons by sutures, 231. Universal language for science, 276. Unseasonable weather, the healthiness of, 157. Ununited fracture of the humerus treated by
operation, 284. Uraemia, acute, morphia in, 37. Urethra ; rupture of the, 114: stricture of the,
121, 421.
Urethral ; stricture, 46 ; surgery, meddlesome, 318.
Urinary bladder ; obscure affection of the, 66 ; removal of a pessary from a female, 184.
Urine ; the chemistry of the, 17, 217 ; a new plan for detecting bile pigment in the, 312 ; of the foetus, 426.
Urinology of general paralysis, 18.
Use ; of opium, 236 ; and abuse of various agents for expediting labor, 246 ; of the word " nature," 299 ; of well water in cities, 337 ; hypodermic, of morphia, precautions in the, 397 ; of steam in diseases of the middle ear, 401 ; hypodermic, of ether in labor, 451 ; of ergot in uterine polypi, 472.
Uteri, sarcoma, 180.
Uterine ; inflammation, hot water in, 53 ; hem- orrhage, infusion of matico in, 57 ; hiccough, 190 ; disturbance at the change of life, 230 ; polypus, 286, 387 ; contractions, to diminish, 357 ; polypi, ergot in, 472.
Uterus ; and bladder, sloughing of, as a sequel of labor, 10 ; sarcoma of the, 11 ; hour-glass contractions of the, during labor, 61 ; nul- liparous, distinguishing marks of a, 187 ; fungoid granulations of the mucous mem- brane of the, 287 ; gravid, procidentia of the, 318.
Vaccination, as a preventive of variola, 364.
Vagabond's disease, 195.
Vagina, fibroma of the, 385.
Vaginal discharges, purulent, systemic infec- tion from 261.
Value ; questionable, of hypodermic solutions, 16; of food, 96; medical, of vinegar, 153; of cupping in the treatment of pneumonitis, 257 ; dietetic, of water-cress, 416.
Varicocele, rheumatism as the cause of, 113.
Varieties of phthisis, 353.
Variola, statistics as to its prevention through vaccination, its diagnosis and treatment, 364.
Various agents for expediting labor, the use and abuse of, 246.
Vaseline, what it is, 255.
Vegetables, animals and, 435.
Vehicle of contagion, milk as a, 278.
Venereal ; ulcers, 45 ; limitation of, 311.
Venesection ; in puerperal fever, 87 ; in scar- latinal dropsy, 309.
Ventilating the cavity of the tympanum, a new method of, 188.
Ventilation, neglect of, 460.
XX
Index,
Veratrum ; poisoning, gelseminum in, 118 ;
viride as a remedial agent in pneumonia, 322. Version ; the method of, bi-polar or bi-manual,
82; in pelves narrowed in the conjugate
diameter, 133 : cephalic, in arm presentation,
256.
Vertebrae, caries of the, 26.
Vertigo, gastric, 427.
Vienna, small-pox in, 460.
Views, recent, on evolution in man, 234.
Vinegar, medical value of, 153.
Virgins, sexual diseases in, 356.
Vital statistics ; singular, 195 ; of London, 260.
Vivisection to be legalized, 260.
Vomiting of pregnancy ; re-positing the child
in the, 31 ; cured by hyosoyamia, 236 ;
acquired, 497.
"Washington, the United States hospital for the insane, in, 418.
Water ; purifiers, the nitrates as, 191 ; cress, dietetic value of, 416.
Waters, management of the bag of, in natural labor, 147.
Waxy liver, an undiagnosed case of, 90.
Weakened mental and physical powers, ine- briety from, 463. ^
Weather, unseasonable, the healthiness of, 157.
Web, fingers, hereditary, 460.
Well water, the use of in cities, 337.
Western North Carolina as a health resort, 141.
When to tie the cord, 412.
Whistles, the, 257.
Whooping cough ; inhalation in, 288 ; the pathology of, 393 ; specific treatment of, by quinine, 407.
Wilde, Sir William, notice of, 445.
Wisconsin board of health, 320.
Women ; and infants, the State hospital for, 60 ; medical diplomas for, 160 ; pregnant, opera- tions in, 410 ; irritable bladder in, 436.
Word " nature," the use of the, 299.
Wound ; gunshot, of the hand, recovery from pyaemia following, 69 ; in pregnancy, 438 ; of the head, 439.
Wounds ; salicylic acid as a dressing to, 12 ; Lister's treatment of, by the antiseptic method, 313 ; the healing of, 471.
Writing and reading, 318.
Wyoming territory, the medical law of, 199.
Yellow fever, disinfection for, 212.
WHOLE No. 988.J
JANUARY f, 1816.
[VOL. XX
a? HIE
MEDICAL AND 8URGICAL
A WEEKLY JOURI^AL
EDITED BY D. G. BRINTON, M. D.
Xerius oJ Sub»»c'ri|itioii, Fill: DOLLAKS per Auuiini, in nd vance.— Siui^le Co|>ies« Ten i eiitA.
C O IN T K rV T S
ORIGINAL. DEPARTMENT. COMMUNICATIONS.
JLEITSMANN, William.— Life Insurance Com- panies and Pulmonary Phthisis 1
Iendekson, J, D. W.— Experience in Hypoder- mic Medication 5
HOSPITAL REPORTS.
Pennsylvania Hospital.— Autopsy of a Case of Intra-cranial Heematoma, Occurring in the Course of Chronic Bright's Disease; Brain Tumor vs. Chronic Meningitis; Cirrliosis of Liver and Kidneys, with Ascites (.Da Costa) 7
^ew Yorlv Woman's Hospital.— Sloughing of Uterus and Bladder as a Sequel of Labor; Sarcoma of the Uterus— Removal ; Ovariotomy —Treatment of the Adhesions 10
EDITORIAL DEPARTMENT.
PERISCOPE.
lypnolic Properties of Lactate of Soda 11
'aralysis from a Retained Pessary 12
lalicylic Acid as a Dre-sing to Wounds 12
'he Management of Cerebro-spinal Meningitis. . J2
)n Idiopathic Tetanus 18
'he :Management of Abortion 13
REVIEWS AND BOOK NOTICES, ffoles on Current Mtdical Literature 14
BOOK NOTICES.
'ransactions of the American Otologlcal Society 14
EDITORIAL.
1876
NOTES AND COMMENTS.
School Disease.?
On Jaborandi
The Questionable Value of Hypodermic Solu- tions
Tuberculosis Treated by Inhalations of Nitrogen
The Natural Pulse
On " Teething Sickness
On the Chemistry of. the Urine
Treatment of Croup
Artificial Milk
Aconite , ,
On the Detection of Prussic Acid in Poison Cases ;
Treatment of Cerebral Rheumatism by Chloral.
Progressive 3Iu.scular Atrophy
The Urinology of General Paralysi.s
Swallowing a Screw
C O R R ES P( ) N D E y C K . How Long May the Efficacy of Vaccination be
Relied on ? (Dr Binkerd)
The Frequency ofTi iplet Births (Cunningham^.
NEWS AND MISCKLLANY.
Items ,
Queries and Replies
OBITUARY.
Dr. Charles Mifflin
Marriages and Deaths
Established in 1868, by S. W. BUTLEB, M. D,
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THE
MEDICAL AND SURGICAL REPORTER
No. 983.] PHILADELPHIA, JAN. 1, 1876. [Vol. XXXIV.— No. 1.
Original Department.
Communications.
life insurance companies and
PULMONARY PHTHISIS.
BY WILLIAM GLEITSMANN, M. D.,
Physician in charge of the Mountain Sanitarium for Pulmonary Diseases, Asheville, N. C.
The object under consideration is of such vast importance to a large body of corpora- tions, as well as to the single individual, whose whole confidence and hope for the support of his family after his death are based on the hon- est and careful management of these companies, that it may be of value to dwell on this ques- tion more closely. The great mortality from pulmonary phthisis in life insurance companies has been eliciting many comments and efforts to explain the large share which falls to this disease amongst the class of so-called selected lives. Many different explanations have been sought for, according to the basis which a writer occupies, but so far we see but little practical value for the companies arising from these discussions. I do not pretend to explain and remedy this evil, but simply desire to ex- press some thoughts which occurred to me in reading a paper and discussion following, etc., which took place at the Ohio State Medical Society.^ Although the number of people dying from the disease in question is decidedly beyond our expectation, and certainly not in proportion to the care bestowed upon the ex- amination of the applicants, I, however, think
* The Medicdl and Surgical Reporter. July 31st and August 2«th, 1875.
1
that the writer of the above-named article is somewhat exaggerating the death-rate. He says, on page 85, " that the mortality from con- sumption among the selected lives of insurance companies in England is from 25 to 30 per cent.5" which assertion I am not able to discuss, as I have no reports of English life insurance companies at hand. But the statement on the same page, that " in our own country the mor- tality tables of insurance companies indicate that consumption is responsible for one death in every four, and often for one in every three of the total mortality," and furthermore, that consumption claims a larger percentage of victims from selected lives than from the popu- lation at large, even after excluding those under 16 years of age," may be an excuse for the fol- lowing remark.
Table viii of my statistics,* based on data re- ceived from twenty-five of the largest companies in the United States, and enumerating the deaths from all causes and from phthisis, in their relation to each other and to living members of the com- panies in 1873, embraces 4890 deaths from all causes and 837 from phthisis, and shows a much more favorable proportion for our American companies, as only 17*11 per cent or about \ of all deaths were, according to tMs table, caused by phthisis. The same table also contains the statement that the German life insurance com- panies have not only a larger death-rate from all causes, but also from phthisis, as they lost 20'5 per cent of their members in 1871 by the latter disease. But also in these companies the
* statistics of the mortality from pulmonary phthisis in the United States and in Europe. Balti- more, Turnbull Bro., 1875.
2
Communi cat tons.
[Vol xxxiv,
death-rate from phthisis does not reach the high figure of 25 or o3 per cent.
The relation between deaths from phthisis of popuhitions at large and selected lives, is shown by the following calculation : life insu- rance companies have hardly ever losses by deaths occurring among members under 20 years of age. Of 772 persons dying from phthisis, "whose age is given, only one died under 20 years. We can, therefore, compare the death-rate of insurance companies with the same of entire communities, by subtracting in the latter case all deaths, and the deaths from phthisis, under 20 years. Although the United States census of 1870 does not give the actual number of deaths, and therefore, not the rela- tion of deaths to living populations, the distribu- tion among the different seasons, sexes, ages, oc- cupations, etc., can fairly be assumed to repre- sent a correct co relation. The United States census shows 492,263 deaths from all causes, and 699,896 from phthisis. Under 20 years of age 265,783 died from all causes, and 12,280 from phthisis, leaving 226,480, respective 57,616 for all ages above 20 years. Under 100 deaths, therefore, 25.48 were caused by phthisis, which is a considerably higher ratio than the insur ance companies represent.
Although these figures show a more favor- able condition of the companies, still their death-rate is quite out of proportion, consider- ing the circumstances under which their mem- bers are accepted. Besides the two points mentioned, there is a third, which is even more surprising and of greater importance for the companies than a death-rate of 17 or 20 per cent. Twenty-two companies gave the length of time that those who died from phthisis were insured, and from their reports the remarkable fact is evident, that they had 54 deaths among people who were insured* only one year or less. Seventeen of these com- panies gave the duration of insurance only for the period of entire years, but five, giving the time in years and months, show that 2 deaths occurred after 3, 1 after 4, 3 after 0, 1 after 7, 2 after 9, and 1 after 10 months from the time the application was granted. Considering the extremely short time of insurance in these eases, and the large number dying within the first year of their membership, we are justified to assume that a number of persons are ac- cepted who are already tainted by disease. ♦1. c, Table x, p. 52.
Against this fact all the eflForts of the com- panies are directed and concentrated, and in this connection a few suggestions may be allowed.
We can scarcely expect that the actions of an agent, or of an applicant, can ever be perfectly controlled by the companies. Both are interested parties to effect the insurance, whilst the companies are anxious only to take " good risks," and the physician, as a neutral party, stands between them and the two former. In order to avoid any possible cooperation of the physician and canvasser* and to make the former perfectly independent, the companies ought to have stringent and binding rules, not to accept any application, except when tilled by the physician, who is especially selected and authorized by the home office. But even in this case there will always be a certain dissimi- l\irity between the examinations of the physi- cians for different companies, some passing the applicants more readily, whilst others make thorough and rigid examinations. It will happen, that persons are rejected by one physi- cian and company, and accepted by the next o ie to which they apply. This state of affairs can easily be changed, if all the companies doing business in one city will agree to appoint one phy- sician only, who shall make all examinations for all the companies. He would draw a very good income from his position, perhaps a better one than his practice would yield him, and could devote all his time to the Jife insurance busi- ness. He would never be compelled to hurry through an examination for the sake of his own business, and would assume a position which would make him perfectly independent of all agents and canvassers. The profit arising from this arrangement would be a double one, for the companies and their members. The companies would pass less " bad risks," and the insured would profit from the greater soundness of the members, by larger dividends.
The medical examination itself, as the most important point of all, presents another feature worthy of discussion. Above all, the compa- nies should pay the physician well for the labor he bestows in their interest, and five dollars ought to be the lowest medical fee for an ex- amination, which, in order to be thorough and answering to the interest of the company, would require adequate time and skill. If a physi-
♦Unfortunately this happened on a quite extensive scale, not long a^o, in a well known company of high standing.
Jan. I, 1876.]
Communications.
3
cian,so often pressed by urgent business, has not the full equivalent for his work, he mif^ht be- come induced not to devote so much attention to a single case as the interest of the com- pany would require. There may always be medical examiners who do not do their full duty in every respect, or lack the necessary ex- perience and skill, but it would be wrong not to limit these faults to single cases, and to make the physician responsible for the high mor- tality from phthisis, as the author in the Philadelphia Reporter expresses, on page 85.
This spring some few companies thought it to their interest to issue formula of applications, comprising most rigid questions, to be filled out at the examination. The question of law, which arose from the reservation pretended by these companies in the formula, has been well and strikingly ventilated by the well-known Baltimore lawyer, Reverdy Johnson. The guarantee and safety of medical examination will scarcely be increased by a lengthy and rigorous series of questions. The physician in the service of an insurance company will al- always direct his attention to the whole present sanitary condition of the man before him, and will probably arrive at the proper result in less time and with less inconvenience for himself and the applicant than when he is compelled to answer the questions of several pages. The protection of the companies lies always in a careful examination, that cannot be regulated by an answer to a number of stipulated ques- tions, but the extension of which in certain directions must be left to the discretion and judgment of the physician, to meet the require- ments of the special case. It is, therefore, the examination itself, and the auxiliaries employed in it, that have to be considered, if not capable of an amelioration. The transfer from the agent to the physician, to ask all the questions pertaining to the history of the applicant, is very appropriately stated in the article of the Reporter. Besides the unpleasantness arising to the applicant in some cases, to state details of his former life to the agent as a layman and a stranger, it is often very important to know exactly what kind of disease the party has had in former years.
In cases where pulmonary deposits have already been formed, or a phthisical catarrh of the alveola3 and finest bronchioles, with the usual consequent symptoms, has made its ap- pearance, the diagnosis by percussion and aus-
cultation is an easy matter for the examiner. Such cases, however, are seldom presented, as the manifestation of the disease is mostly within the knowledge of the individual. But in prac- tice we frequently meet with persons who have a more or less delicate complexion without be- ing unwell. They may be liable, once in a while, to a slight catarrh of the air passages, which passes off" again without leaving any traceable sequelae. We can observe no loss of strength, weight or appetite ; the party ipaay have a good family record. The examiner hesitates to de- cline the applicant absolutely, when he presents himself at the time of his catarrhal afi'ection, proposes a second examination, and finding him well after a week or two, recommends him for insurance. We have no positive means, neither by physical examination nor by symptoms, to decide if the above quoted instance is of a merely transient character in a sound person, or due to the incipient stage of phthisis, when there will be a repetition of its occurrence, with the following order of well-known symptoms. In the very earliest stages of the commencement of phthisis, one single observation and examination renders it sometimes very difficult to form a judgment upon the nature of the otherwise harmless affec- tion. If in such cases we use the spirometer, and apply it properly, we avail ourselves of an auxiliary help to diagnosis which is not to be under-estimated. But it is not the simple appli- cation of the spirometer, without any further consideration, as I have already advocated in a former paper.* We have to calculate first the physiological capacity of the lungs of the per- son presented for examination, as no average standard exists, and the physiological figure has to be calculated for each single individual. The first use of the spirometer with this object in view was made by John Hutchinson, who was also the inventor of the first instrument of this kind answering scientific demands. Pre- viously, only unsuccessful efforts had been made, proving perfectly unreliable, owing to inac- curacy of the instruments. So Kentischf made patients expire into a graduated bell ; Aberne- thy,J into an overturned glass, which was filled with water. Hutchinson published his exten-
* Value and Utility of the Spirometer for Life In- surance Companies. Baltimore Underwriter, A.\i^\i^t 20th, 1874, reprinted, New York Medieal Record, Oc- tober I5th. 1874.
t Kentisch : an account of baths, with a drawing and a description of a pulmometer. London, IMl.
X R. Laennec, Traite de 1' Auscultation mediate, 3 ed. Paris, 1831, vol. i.
4
Com7nuni cat ions.
[Vol. xxxiv.
sive investi<i;\tioD3 in 184G,* and drew very soon the attention of the profession to his researches. He declared the vital capacity mainly dependent upon height, weight, and age, and was followed by Simon, t who confirmed his statement, espe- cially regarding height, and brought two more factors into consideration, viz., the circumfer- ence and expansion of the chest. Later investi- gators, such as Wintrich, % who examined over 3500 individuals, Schneevogt. | and others, eliminated the weight as one of the main fac tors of calculation, on account of its variability, and Wintrich stated the influence of the age on the spirometrical capacity more precisely. "We will arrive at a very good and reliable figure, when we make the height, age, sex, circumfer- ence, and expansion of the chest the basis of our calculation. Age comes less into considera- tion with life insurance companies, as the highest capacity with the least deviation per tains to the age between 20 and 40 years, the age when the majority of the people present themselves for insurance. The other four fac- tors are easily determined at the examination, and the insurance companies can very well furnish tables to each examining physician, which enable him to calculate the normal physio- logical capacity belonging to the respective individual. If the circumference or expansion exceeds or remains under the normal, figure, the correction can be made without difficulty. Already Hutchinson, who examined a great many persons sufi'ering from lung diseases, and still more Wintrich and Schneevogt, pointed out the value of the spirometer for examination of soldiers to be enlisted in the army, and mainly for life insurance companies. Hutchinson re- lates the interesting case of a gentleman, who, examined by him for the first time, was in per- iect healtn, and had, with a height of 209 centi- metres, || and a circumference of the chest of 117.5 centimetres, a capacity of 7118 cubic centi- metres^ Two years later, the patient was ex- amined by two experienced physicians, who could not detect any disease of the lungs, and the spirometer indicated only 5040 centimetres.
* John IlntchinKon on the Capacity of the Lun^s etc. Medu-'t-Chirurf/ IVaruiUct . , lc4i). vol. xxix. " '
t GicH'. Simon. (Jher die Menge dor juisi^wat iimeten Luft bel vo schiederiH?) Menisirlieii. Ciiessen, liUH.
XM. A. WuitrLck. Krankheiteu dnr He.spiratlons organe. Ilandbur-h d^r specielleti Palholoiiin and Th-rapie, Hd. V, Abtheiluni; 1. Erlangeu, ls.>l.
iVoorht'Lin {^Jineevof/l. Ueher den pracLischen werih des SpiroineterB, in dor Zeitscrlinft lu'er ra- tioneile Medizln Nene Folge, Band v.
!■ 12 inches Euyliah measure c-qual to oO.-lS centime- tres.
^ 1 cubic inch equal to 1C.4 cubic centimetres.
Not quite a year later, he died from phthisis. Almost all the writers on this subject agree, that if the spirometer is used in the manner above described, it often indicates the incipiency of phthisis, where percussion and auscultation cannot reveal the disease yet. With these re- marks, it is not desired to say that the physical examination is less necessary or loses any of its value ; on the contrary, percussion and aus- cultation always remain the main help to diag- nosis ; but in cases where they fail to give proof of disease, the deficiency from the physiological capacity, indicated by the spirometer, ought to rouse our suspicion and attention, and induce a renewed, perhaps more careful examination, before deciding about the case. According to the unanimous consent of all investigators, the deviation from the normal figure, under ten- or fifteen per cent, of the physiological capacity, allows us to assume the probability of an exist- ing, although latent disease, whilst a decrease of twenty per cent, gives almost certainty. Over ten per cent, deviation from the normal mean should always raise our attention. Hutchinson says that the loss in the first stage of phthisis amounts from 10 to 50, in the second from 50 to 85 per cent, of the physiological figure. To conclude with an example from my own practice, a patient staying little over four months at my Sanita- rium, showed, when he came, 2050 centimetres. He had suffered from hsemoptic night sweats, troublesome cough, fever to a slight extent, and was very weak and not able to walk any dis- tance. Although not entirely recovered, yet he has now not only gained considerable in weight and strength, and is able to walk almost as well as any sound person, but also, his appearance and complexion are natural, and his cough has almost disappeared, especially when he is at rest. Percussion and ausculta- tion do not detect any abnormal status, his family record is good, and if he would be anxious to obtain a life insurance, and* would conceal his former disease, ho might be accept- ed. If we take the spirometer in hand, we find that he has 3200 centimetres (a gain of 1150 centimetres), but according to his height, of 178 centimetres, and the circumference of his chest, of 89 centimetres (expansion in ac- cordance with the standard figure of 178 centi- metres height), he onght to have 4050 centi- metres He has, therefore, 850 centimetres less than his physiological figure. That similar
Jan. I, 1876.]
Communications.
5
cases frequently present themselves to life insurance companies, can scarcely be doubted, from the high number of deaths, as well as from the short time of the insurance, in some cases. To my knowledge, the spirometer has once before been used by the companies, but was given up, as not yielding satisfactory re- results. If the companies are willing to apply the spirometer in the manner set forth above, it will not fail to be a reliable and useful means of confirming or detecting the disease in ques- tion, and so save the companies losses which otherwise may fall to their share.
EXPERIENCE IN HYPODERMIC MEDI- CATION.
BY J. D. W. HENDERSON^, M. D.,
Glen Loch, Chester Co., Pa.
"Within the last two or three years, in a fre- quent interchange of opinion with professional brethren, I have noted the fact that quite a large proportion have little or no experience with the hypodermic method of administering medicines; many of them having never given it a single trial, and a few manifesting a decided antago- nism to its adoption.
My experience with the hypodermic method of administerfng remedies has been fully up to the prompt performance of my requirements. In a series of years these demands have been by no means few. That it is entirely free from danger, I deny 5 while, at the same time, I aver that its dangers are no greater, where the pro- per precautions are used, than those experienced in the administration of remedies by the mouth or rectum. My experience leads me to conclude that a resort to the hypodermic method is justi- fiable, and urgently demanded when, from irri- tability of stomach, or some other cause, our remedies cannot be taken in the usual way ; when, from delirium, suicidal intent, or obsti- nacy, our patients refuse to attempt to swallow ; in cases in which we want a prompt effect ; when medicines given in the ordinary way fail to do their work, and where we wish an instan- taneous, or almost an instantaneous, effect of a drug.
■ I have never resorted to the hypodermic use of nutritious substances. My operations have been principally confined to the relief of pain, insom- nia, and violent nervous symptoms. The hypo- dermic syringe is familiar to most physicians, and needs no description here. The graduation
of the cylinder I do not regard as of the first importance, but I find it of great convenience in practice. While some authorities tell us there is little pain produced by the insertion of the tube, my experience justifies the belief that con- siderable nerve is required to endure the ordeal. I have, on different occasions, where the instru- ment had to be used several times during the same day or night, inserted the tube into the point first punctured. But I do not regard this as good practice.
My custom has been to have my medicinal agent dissolved in as small an amount of water as possible, so as to have the greatest attainable result, with the least probability of inflamma- tion or abscess from a deposition of a foreign substance in the cellular tissue. My point of selection has been, as a rule, the insertion of the deltoid-, occasionally I have chosen the thigh.
Sulphate of atropia and sulphate of morphia I mention, in their relative importance, as the remedies which have given the best results in my hands. The latter has always seemed to me less prompt than the former. I have no doubt as to the result in c-ase the atropia itself were used, but the ready solubility of its sulphate in water is an advantage which should not be overlooked. One grain of sulphate of atropia, dissolved in sixty drops of water, and kept in a securely stoppered bottle, makes a supply suffi- cient for a great many injections; and, in cool or cold weather, undergoes no appreciable change from the growth of fungi, decomposi- tion, or flocculent deposit. I usually placed thirty or forty drops of this solution in my syringe, introduced the tube, after I was sure every particle of air was excluded from the instrument, then, by a motion of the syringe, from the right to the left, and from the left to the right again, I caused the point of the tube to lacerate the cellular tissue so as to form a small cavity to receive the injected fluid. This last procedure was designed to prevent the escape of the solution around the tube, at the point of entrance. Of course, inserting an instrument filled with such a powerful fluid into the patient's' arm is a procedure demanding very careful manoeuvring on the part of the physician ; for a sudden movement might throw into the fibro-areolar tissue such a quantity of the atropia as to destroy the patient, or at least give occasion for serious apprehen- sion. This accident has always been guarded
6
Communications,
[Vol. xxxiv,
against, on my part, by pushing down the piston rod by a very slow rotary motion, watching the cylinder carefully all the time, so that the required number of drops, and no more, should be given. This is why I regard the graduation of the glass cylinder of so much importance.
Where I have reason to believe that one in- jection will not suffice, I do not withdraw the instrument, but allow it to remain in position ; by sitting near, the patient can be prevented from serious accident, and can receive a second, or even a third dose, and be spared the pain of a reinsertion of the sharp tube, which I regard as of some importance, especially with a nervous patient. My commencing dose of sulphate of morphia has usually been one-fourth of a grain for an adult ; but I believe one-eighth of a grain would be safer and better. Two drops of my solution, representing the one-thirtieth of a grain of sulphate of atropia, constitute the dose with which I have, ordinarily, heretofore, begun the treatment of any case. I have no experience with hypodermic medication in the treatment of the diseases of children ; my subcutaneous in- jections have all been limited to adults. On more than one occasion have I given, hypoder- mically, the large dose just mentioned, and re- peated every half-hour until a second and a third dose had been inserted ; yet this large amount, in all the one-tenth of a grain, pro- duced no alarming symptoms, but yielded the happiest therapeutic results. The patient who endured these heroic doses was one in whom, from frequent repetition of the agent, there seemed to be established an unusual tolerance of this alkaloid. In all cases, and under all circumstances, I watch the pupil carefully, and inquire frequently whether there is any dryness or stiffness of the mouth and throat ; and when there is the least dilatation of the pupil, or com- plaint of constriction of the throat, I deem it prudent to withdraw the instrument.
The case to which I have just referred was a very interesting one, and I will give some of its details. My patient had been, for a long time, quite an invalid ; and had been treated, at different times, for pleuritis, pneumonitis, hysterical vomiting, and insomnia. On one occasion she was suffering great pain, and could retain nothing when administered by the mouth ; a resort to the sulphate of atropia seemed my only resource, and it was given in the usual way, with an interval of half an hour between each dose. Very soon after the
third dose had been given, I was alarmed by the sudden supervention of aggravated symp- toms of poisoning from belladonna. There was a convulsive movement of the whole body, the jaws and mouth became tremulous, the face, which a moment before was pale enough^ assumed a red, then a livid hue. accompanied with tumidity ; the pulse became very rapid and seemed finally lost at the wrist ; in fact, there seemed to be a total prostration and paralyza- tion of all of what the ancient physiologists termed the vital functions. The case seemed hopeless enough.
Fortunately, I had with me a quantity of sulphate of morphia, and having faith in its antidotal powers, I speedily dissolved something over one-fourth of a grain in a little water, and threw it into the arm. I soon had the joy to discover the pulse assuming its wonted work at the wrist, and my patient returning to con- sciousness. This was the only bad result I have ever witnessed ; but it taught me a lesson.
I am confirmed in the belief that small doses are better than large ones. It is far easier to repeat a small dose than to combat the mis- chief done by one too large. One drop of my solution, representing one-sixtieth of a grain of sulphate of atropia, is the dose I now prescribe in a robust adult patient ; in half an hour I would repeat, if there was no palliation of pain or other unpleasant symptoms, and in one hour from the second injection would throw in a third one, if necessary. I would diminish this quantity if I thought the indications demanded it. But the frequency of the dose must be regu- lated by the urgency of the peculiar symptoms in every case. A little preliminary treatment is sometimes required. An emetic to evacu- ate the stomach just after a full and hearty meal, or an enema to unload a distended rectum^ might, very properly, in many cases, precede the subcutaneous use of the anodyne ; but I imagine the cases are few indeed in which the medical attendant is compelled to waste precious time in this way.
Emetics, tonics, oxytocics, nutritive sub- stances, all these, and doubtless many other remedial agents, may be given subcutaneously ; but I have never met with any cases which I* thought demanded their use in this manner.
I remember once being asked, by a very able physician, what advantage the hypodermic method possessed over the old methods of ad- ministering medicines. Need I point to hys-
j
[ Jan. I, 1876.] Hospital
terical vomiting and aggravated cholera morbus ; to the agonies of neuralgia in its manifold forms, to threatened miscarriage, with its frequent ac- companiment of irritable stomach and throbbing brain, to cholera itself, and many other affec- tions, and note the promptness with which they so often yield to hypodermic medication, to answer this question ?
Quite recently I was called to see a young woman in about the fifth month of her first pregnancy, who was threatened with miscarriage. She had quite a violent fever, a severe headache, an irritable stomach, and constipated bowels, with frequent recurring uterine pains. Opium and its preparations, bromide of potassium, creasote, subnitrate of bismuth, the rectal syringe, all failed. Two or three, at furthest, of the drop doses of my solution of the sulphate of atropia, gave her complete relief. She passed a comparatively comfortable night, had an alvine evacuation next morning, and in a few days was well enough to visit me at my office.
At another time, I was called to see a patient suffering from an attack of neuralgia of the cardiac orifice of the stomach. The attack was unusually severe and refused to yield, as on former occasions, to the ordinary remedies ; the sulphate of atropia did not disappoint my ex- pectations in this case.
But it is needless to multiply cases. I have given only a few out of the many instances in which I have resorted to the hypodermic method, and almost, if not quite, with invariable success. I would feel lost without my hypodermic syringe, and is it any wonder that I should be warm in my eulogy of hypodermic medication ?
Hospital Reports.
PENNSYLVANIA HOSPITAL.
CLINIC OF PROFESSOR DA COSTA. DEC. 4th, 1875. REPORTED BY FRANK WOODBURY, M.D.
Autopsy of a Case of Intra-cranial HEematoms, Occurring in tlie Course of Chronic Bright's Disease.
Gentlemen : — I will first call your attention to the post-mortem results of a man who was admitted to the hospital in a dying condition, and who, indeed, never really came under my care, as he expired before I saw him in the morning. His name was ascertained from papers found in his possession, from which it was also learned that he was a laborer, of Scotch extraction, and was probably about forty-eight
Reports. 7
years of age. The only history that could be obtained was that he had been found at night on the street, insensible, and was brought to the hospital in that condition. He was unable to give any account of himself; his breathing was stertorous, and, in fact, he was in a comatose state. His left pupil was dilated, and did not respond to the light ; the right appeared of about the normal diameter, but contracted feebly. The pulse, when he was admitted, was 80, but soon afterward it was noticed that it had fallen to 68. The respiration was labored, the inspira- tions being twenty-four to the minute. His axillary temperature was 95° F. There was no external evidence of injury, and the face was not much congested. Stimulants, warm appli- cations, turpentine enemata, and all the other efforts to promote reaction failed ; even the hypodermic injection of four minims of tincture of digitalis, resorted to by Dr. Hopkins, the resident physician, as a cardiac tonic, Avas also ineffectual, and the patient died about 7|- o'clock yesterday morning. It should be men- tioned that his bladder had been emptied by a catheter when he was first brought in, and the urine was found to be albuminous.
The specimens are before you. You will ob- serve that both kidneys are contracted and that they contain cysts ; they well represent the con- dition known as " the contracted kidney.^' Now, when you examine such a kidney closely, you will notice first that the organ is smaller in size than in health, and, secondly, that the capsule is contracted and adherent. On section tha. secreting portion of the gland is seen to be diminished, and masses of exudation may be discerned, which encroach upon and surround some of the pyramids, causing atrophy of their structure. The organs are not fatty, and on apply- ing a drop of tincture of iodine we do not observe the peculiar reddish brown discoloration which denotes and constitutes the test for the presence of amyloid or albuminoid degeneration. The disease is, therefore, the simple contracted or granular kidney of chronic Bright's affection, and occurring in this case of brain trouble is of special interest, because it is preeminently the form of Bright's disease which is apt to be asso- ciated with apoplectic effusion. The same general principle underlies both conditions ; there is a similar disease of the fine blood vessels of the brain, and of the renal vascular system, connected and coincident.
On looking at the brain we find that a large clot, weighing four ounces, existed on the left side, on the surface, compressing the left hemisphere anteriorly, extending somewhat toward the base of the brain, and coming appar- ently from the meningeal vessels. The vessels of the membranes were swollen and distended with dark blood. The brain substance was not congested, nor was it softer than normal ; but the left side had been so much compressed that the walls of its lateral ventricle were in contact with each other. There was also some reddish fluid in the ventricular cavities.
Now, I have already told you that this form
8
Hospital Reports.
[Vol. xxxiv.
of contracted kidney is the form that gives apoplectic seizures ; but it is also the form that is especially liable to be complicated with uraemia. TJ^is was, in the case before you, a very nice point of diagnosis — to determine, when he was brought insensible into the hos- pital, with stertorous respiration, albuminuric, and comatose, whether this was due to apo- plexy or urjBmic convult?ions. In this connec- tion, the temperature report is significant. You will remember that his axillary tempera- ture on admission was only 95°, therefore several degrees below the normal temperature, which may be considered as 98.6°. This condi- tion of the bodily heat, occurring in a case of what may be called a stroke, if you please, favors the view that it is apoplectic. When cerebral apoplexy occurs, the temperature of the body becomes greatly depressed, and remains so for some time. If the patient live, as he improves the thermometer rises steadily, until it gets a degree or two above normal, where it will remain for a considerable period ; should a fresh effusion occur, it will fall as before, to repeat the same course if life continue. This is a point that can be turned to good account in doubtful cases. It is important, because, upon the diagnosis depends the treatment, and on your prompt recognition of the cause of the convulsion may rest the life of your patient. What would be eminently proper for a man with a clot in the brain, might prov^ fatal to a per- son suffering from urasmic poisoning of the blood. The course of treatment in each case is radically different, but I will not dwell upon it, as the patient did not come under my care ; I merely brought the post-mortem results before you to illustrate certain points of pathological interest connected with it.
Brain Tumor vs. Chronic Meningitis.
The next case brought before you is full of knotty points, and is one the discussion of which will bring before you some of the ob- scure points in the diagnosis of brain disease. The man's statements are confusing and con- fused, but this is part of his disease,' he cannot help it ; at the same time it makes deductions from his statement unreliable. His memory is somewhat impaired and he recalls incidents with difficulty, but the chief points in his hist(n'y are as follows : His name is Joseph S., a sailor, of American birth ; he is thirty-nine years of age. ]Ie is, apparently, a robust, plethoric man, whose health has been generally good. He has always been a drinking man ; on only one occasion, however, had he any symptoms of mania-a-potu ; this was about ten years ago, and was merely a light attack of delirium- tremens after a debauch, which lasted only one day. lie persistently denies venereal dis- ease, but states that, about five years ago, he had a non-specific discharge from the urethra for a few days, following a contusion of the perineum. Eleven months ago he was in good health, apparently, and was standing on the deck of his ship, when he suddenly found him-
self unable to speak ; this condition continued about ten minutes, and then passed off entirely ; while it continued he was neither unconscious nor paralyzed, although some papers that were in his hand a,t the time fell to the deck. He continued at his work, aUhough the attacks recurred several times during the succeeding six mcmths, but at no time had they been accompanied by pain in the head, or other bad symptoms ; he was in his usual health. But in May last he had a severe pain in his head, lasting two weeks, for which he entered this hospital for treatment, where it was then regarded as a supra-orbital neuralgia. He was discharged, well, about the first of June, but the pain returned a month later, and he has had more or less of it ever since, although not as severe as the first attack. About one month before his readmission, he had a tonic spasm of the muscles of the right forearm and hand, which lasted only a few minutes, but since then he has noticed a feeling of numb- ness of the right hand, as if it were asleep, and some weakness in the right leg. His second admission was on the 7th of Novem- ber, when he complained of frontal headache, not limited to one side ; constant hissing," or tinnitus in the left ear, with some pain, which was found on examination not to be due to any ordinary local cause, as the tympanum appeared to be normal, and there was no impaction of cerum. He had curious sensations, suggesting impaired innervation, the skin of the face felt as if it were drawn tense, the jaws seemed, at times, stiff, as if he had locked-jaw, and his tongue felt as if it were too large for his mouth, but he never bit his tongue or his lips when chewing his food. There were no symp- toms of facial paralysis. He answered readily at first, but seemed to hesitate for words if the questioning was prolonged. Occasional flashes of light appeared in the right eye, with tempo- rary dimness or loss of vision ; he had lost the power of sight in the left eye since 1862, with- out any history of previous injury or inflamma- tion of the organ. Examined with the ophthal- moscope, the left eye was found to be catarac- tuus ; in the right, the optic disc was very much swollen and prominent, with minute hemor- rhagic spots on its surface ; the arteries were notably lessened in size, the summit of disc seen with a No. 10 glass ; the macula was emme- tropic. In short, a choked disc existed in the only eye whose fundus was accessible, indicat- ing disturbed cerebral circulation. To this may be added a statement made by him of hav- ing about six years ago received a blow on the left side of his head by a block falling from aloft, which knocked him insensible to the deck, and produced a wound that kept him in bed for three weeks. A depression can be felt at the spot indicated, situated in the vicinity of the coronal suture and about two inches from the border of the squamous portion of the temporal bone. About an inch in front of this may be seen the scar left by a stab from a knife, made five years ago.
Jan. I, 1876.] Hospital
Reports,
9
He also states that he had two epileptic convul- sions eicrhteen years ago. but has had none since. He -never has vertigo, does not stagger when walking, and can walk or stand with his eyes closed. His urine examined was found to be normal.
This is a conflicting history ; there is an ac- count of two isolated attacks simulating epilepsy, eighteen years ago, alfecting principally the right side ; but since that time he has been struck on the head, with possible fracture of the skull. Let us add to this that the grasp of the right hand is defective, and the right leg does not seem to have much power. Tested with the battery, the electro muscular contractility and sensibility are not so marked on the right side as on the left, but the muscles do respond alike in the arm and leg. Now, what is the matter with the man ? His statements could not be fully relied upon ; we, therefore, called in the aid of the ophthalmoscope, which revealed a choked disc, and demonstrated the existence of intra-cranial pressure, for this is the most that we can assume it to mean. The papilla was bulged out, and its vessels were almost obliter- ated, showing obstruction to the circulation, and it is an interesting point for consideration whether or not the cataract in the left eye may not be connected with the same cause, and pro- duced by impaired nutrition.
Examining into the probable nature of the lesion, we find embolism excluded by the fact that the heart is normal ; there is no disease of the kidneys ; and everything that could act on the brain is negative. The diagnosis thus nar- rows down to one of two conditions, between which it is difficult to choose, on account of the history. There may be present either chronic meningitis, affecting principally the left side of the cerebrum, or brain tumor. It is hard to decide between these two conditions ; I incline to the meningitis, but am by no means set in my opinion. Reviewing the symptoms, we find that this man has had some confusion of ideas, anomalous attacks of temporarily impaired faculties, of severe and afterward constant pain in his brow, of actual one-sided loss of muscular power, as tested by the grasp and the battery, of interfered speech, and choked disc — all signs of pressure upon the brain 5 but they may happen in either meningitis or in the course of a tumor, so they do not help us much. But what I do consider of importance is this point.
With a tumor large enough to give this group af symptoms, there should be frequent epilepti- form convulsions and severe steady headache. It is not so here. He has had no convulsions lately, nothing but evidences of disturbed circulation and loss of power. The absence of marked headache, epileptic seizures, and vertigo, are important points against the hypothesis of a new growth. Again, one-sided loss of power adds additional weight to this view, for hemi- plegia is generally considered as conclusive evidence against the existence of a tumor. Besides, there is no cause to lead us to suspect Buch a condition. There has been no syphilis ;
this has been carefully inquired into, for this is the usual cause of brain tumor in young people ; and he is not old enough to be subject to the forms of cerebral disease that occuf late in life. The idea of meningitis seems then to be more tenable. It isi a remarkable fact that a tumor is unattended by mental aberration ; as a rule, the mind remains clear till the closing scene (always excepting, of course, those cases of cerebral cancer attended by great destruction of brain substance). Mental phenomena do not characterize an intra-cranial growth, but gene- rally do attend the course of inflammation of the meninges.
You ask me, why not speak of the blow on the head ? Because I am obliged to say that we cannot accept the history as conclusive ; we can take the general facts, but must not depend too much on special statements. I have dis- cu*!sed, at some length, the evidence of increased intra-cranial pressure, the loss of power on the right side, and the peculiar mental state of the patient, as being the leading features in the case.
In regard to the treatment, he has been taking ten grains of iodide of potassium, morn- ing, noon, and night, since his admission into the hospital ; this dose shall be now increased to twenty grains, and blisters shall be applied to the back of the head and behind the ear. The bowels shall be kept open by Rochelle salt, and he shall have a nourishing diet, with- out any stimulant whatever; in other words, a strong alterative regimen. This will fall in with the diagnosis. If it is a case of meningitis, it will be improved ; if one of tumor, the treat- ment will do it no harm.
In dismissing the patient, I will mention that this case well illustrates the importance of the ophthalmoscope in obscure cases of cerebral disease ; without its aid the diagnosis would have been far less certain than it is.
Cirrhosis of Liver and Kidneys, with Ascites.
This case, although not as interesting as the preceding, is one of a kind that is more fre- quently met with in practice. His name is Edward F., a sailor, fifty-two years of age. I call your attention to the peculiar tint of his skin, which is very much the color of Addison's disease, but the bronzing is confined to his face ; it does not appear elsewhere on his body, and is probably due to exposure to the w^eather. He has always been intemperate in his habits, but has been healthy, with the exception of occasional attacks of malaria some seven years ago. He nev*er had hematuria or symptoms of acute nephritis, but, about four months ago, his feet began to swell, and he remembers that he was obliged to pass water often. About this time he had an attack of tertian ague, which stopped in a few days under treatment, but which was followed by increased frequency of micturition. One month before admission, his abdomen began to enlarge, his feet were very cedematous, and he passed less water than be- fore. In this condition he was received into
lO
Hospital
Reports.
[Vol. xxxiv.
the hospital. His eyes show a slight arcus senilis, more marked in the left than in the right ; there is also a corneal speck in the left eye. His tongue is coated in the ce«tre ; appe- tite fair. His pulse is 96, and very compres- sible. Auscultation of the heart discovers no murmur : the first sound is short and badly de- fined, the second is sharp and clear. The abdomen is distended with fluid, the superficial veins are swollen. There is very decided fluctuation, showing marked abdominal dropsy. The liver dullness stops abruptly at the edge of the ribs. The splenic area is increased, but it does not extend below the costal border. The feet are moderately swollen and pit on pressure.
You have heard the history of the case ; it will be completed by an examination of the urine, which, after standing some time, precipi- tates a heavy deposit. It contains a moderate proportion of albumen, with many hyaline and a few granular casts ; it is of specific gravity 1020, and acid in its reaction. Practicing the test commonly used here, by pouring half a drachm of nitric acid into a test-tube, and dropping the urine upon it along the inside of the glass, you notice a white ring of coagu- lated albumen at the juncture of the two liquids ; this is a very delicate and striking test, of easy application.
Now, what is the matter with the patient ? There is some malaria in the case ; he says he has had gonorrhoea several times, but never had a venereal sore, so we may exclude syphilis. There is undoubtedly some forms of Bright' s disease here, any of which may be complicated "with dropsy ; but what form, and is this the whole malady ? We find here evidence of beginning cirrhosis of the liver, and of a simi- lar condition in the kidney, which, indeed, are frequently associated, and which, in this case, have not, as yet, reached a very high degree of development. He has never had any disease or fracture of a bone, and never had syphilis ; we have not, then, to deal with the albuminoid de- generation, and the chances are in favor of its being the contracted kidney of chronic Bright' s disease.
The altered hepatic percussion-dullness, the dropsy, which is not general, but is confined to the abdomen, gives a clear and connected state- ment that the effusion here is not entirely due to the renal affection, but is connected with the liver trouble of a man that admits he has been drinking freely for a number of years. The decreased hepatic dullness, without jaundice, indicates commencing cirrhosis, which is often accompanied by ascites due to obstructed portal circulation. As a rule, when this condition of the liver is present, a corresponding change oc- curs in the renal structure, forming the cirrhotic, granular or contracted kidney.
This patient has very much improved under the use of the tincture of the chloride of iron, •with the solution of the acetate of ammonia, in the combination generally known as Basham's mixture. Of this he has been taking half an ounce three times a day, and it shall be con-
tinued. But this is hardly enough ; while it improves the general condition and relieves the kidney, it does not strike at the cause ; it does not modify the progress of the disease in the liver and kidneys sufficiently. In addition, then, flying blisters shall be applied over the hepatic region, and he shall have alteratives to correct the morbid condition. My first choice would be corrosive sublimate, given in small and steadily-increasing doses ; but the man ia too weak to bear mercury, as is denoted by the first sound of the heart. Therefore, although I would under other circumstances prefer the other, I will order him ten grains of iodide of potassium thrice daily, with a plain, nourishing diet, consisting largely of milk, eggs and animal broths. He is to have no stimulants, and will be directed to take gentle exercise in the open air when the weather is favorable.
NEW YORK WOMAN'S HOSPITAL.
REPORT OF INTERESTING CASES.
SlougMng of Uterus and Bladder as a Sequel of Labor.
A patient entered the service of Dr. Emmet with the following history : — At the age of twenty-two she was taken in labor with her first child, and about forty-eight hours after the waters ruptured, and a child weighing fourteen pounds was delivered by means of the forceps. The condition of the patient was favorable for two weeks, when she noticed that her urine dribbled away by the vagina. Two weeks afterward, or one month after labor, she passed some large sloughs. These sloughs were pre- served by her physician, and, on examination, proved to consist of two masses — one of them consisting of the placenta, and the other th« base of the bladder and cervix of the uterus.
At this point the main interest of the case rests, and, unfortunately, it is involved in obscurity. The point referred to is this : Under what circumstances did the accoucheur, after delivering a child of fourteen pounds, neglect to see that the placenta was delivered? The only explanation possible, without gravely impeaching the competency of the attendant, is to suppose that the cord, with a portion of the placenta, came away, and, from causes not explained, the deficiency was overlooked. Another question to be considered is, did the remaining placenta, directly or indirectly, cause the extensive sloughing of the pelvic viscera? This is another question difficult of solution, though, from the time intervening between the labor and the passage of the sloughs — one month — it is fair to assume that the retained placenta did have an influence. When the patient entered the hospital, nearly five months had elapsed, and her condition then was as follows : On placing the patient on her back and separating the labia, a prolapsed fundus of the bladder was discovered. When this was replaced by a sponge probang, no sign of uterus could be discovered. When she was examined
Jan. I, 1876.]
Periscope,
by the rectum, a small nodule was discoverable in the place that should be occupied by the uterus. After a careful examination of the case it was decided that no operation for the closure of the base of the bladder could be suc- cessful, from the fact that there was not a sufficiency of tissue. It was then decided, with the consent of the patient, to perform an opera- tion for the closing of the vagina. This was done, and after it was performed the patient enjoyed comparative comfort.
Sarcoma of the Uterus— Removal.
An interesting case entered Dr. T. G. Thomas' service, the recital of which may prove of benefit to some who have similar cases under observa- tion. The history of the case revealed nothing special beyond metrorrhagia. When she was placed on the examining table and the finger carried into the cervix, a mass was discoverable which conveyed the sensation of a wet sponge. This was not cancer of the uterus, for the reason that the uterine probe could be carried around the mass, showing it to be a tumor.
Dr. Thomas diagnosticated it as sarcoma, and said that last winter a similar case came under his observation, which he supposed to be slough- ing polypus. He removed it by means of the ecrascur, and found that in doing so he took off
one of the horns of the uterus, which had become inverted by the weight of the mass. The patient recovered, notwithstanding. The pres- ent case was treated by removal. The growth was fixed by means of a tenaculum, and then dug out by means of the uterine depressor. AVhen it was removed it formed a mass about the size of a pear.
Ovariotomy — Treatment of the Adhesions.
The patient gave the ordinary history of ovarian tumor. The interest of the case rested mainly on the method of avoiding the separa- tion of the adhesions. When the abdomen was opened the cyst was found to be extensively bound down, and the treatment pursued was that which Dr. Thomas had seen practiced in Europe in similar cases. It was as follows : — • An incision was made into the cyst after its contents had been removed by a trocar, and the sac turned inside out. It was then cut off and the clamp applied to the pedicle. By this plan the adhesions were removed with the sac and all hemorrhage avoided. It is important to bear in mind to be careful and see that no portion of the intestines adhere to the surface of the cyst, for if so, when the sac is cut away, a por- tion of the intestines will be amputated. Beyond this there are no other dangers.
Editorial Department,
Periscope.
Hypnotic Properties of Lactate of Soda.
W. Preyer, of Jena, in a communication to the Centralhlatt fur die Medicinischen Wissen- schaften, for August 7th, states that numerous experiments and observations have shown him that a feeling of weariness and sleepiness, and even a condition very closely resembling or identical with natural sleep, is produced when a concentrated watery solution of lactate of soda is injected subcutaneously, or introduced in large quantity into the empty stomach, provided that strong irritation of the senses be avoided. In many cases, also, sleep was pro- duced when the lactate of soda was not given as such, but the materials were afforded for its abundant formation in the digestive canal, as after drinking highly concentrated solutions of sugar, and after the abundant use of fresh, and especially of sour, milk, and of sour or sweet whey. There were great differences in regard to the time, duration, and intensity of the sleep. It appeared to occur more readily in young than in old animals ; in animals having high than in those having low reflex excita- bility ; more readily in mice, cats, pigeons, and frogs than in rabbits and guinea-pigs ; more
readily in small than in large animals, and in a low temperature than in a high one. In man, also, considerable individual differences were observed. While one would be seized with almost invincible drowsiness soon after the use of a quart of coagulated milk or a glass of highly concentrated solution of sugar, or after taking into the empty stomach a solution of twelve grammes (three drachms) of lactate of soda in 120 grammes of water, this effect was not produced in another. In order to obtain data for an investigation of the causes of this varying action, Preyer invites practi- tioners, in cases where it has hitherto been the practice to procure sleep by means of opium or chloral, to inject, subcutaneously, concentrated solutions of lactate of soda, or to give as drink large quantities of solution of sugar, or milk- serum, or condensed milk, and to communicate the result, either in published papers or by letter. He remarks, also, that the lactate of soda deserves investigation as an antipyretic, and also as a calmative in mania and in certain forms of convulsive disease, on account of its property of speedily inducing weariness during muscular action. In all cases where sleep was produced by lactate of soda, Preyer found the respiration deepened and reduced in frequency, the reflex irritability diminished, and, in warm-
12
Periscope,
[Vol. xxxiv.
blooded animals, the temperature " lowered, especially when large doses were given. Larger doses of the lactate than were necessary to produce sleep were borne without the least injury. The sleep produced cannot be distin- guished from natural sleep. When the animals awake, they do so in the natural way, become lively in a few moments, readily take food and drink, and, if left to themselves, readily fall asleep again, to awake quite lively. Lactates of potash, mngiiesia, and lime cannot be recom- mended as substitutes for lactate of soda.
Paralysis from a Retained Pessary.
At a late meeting of the Obstetric Society of London, Dr. Gervis exhibited a pessary which had been removed from a patient tifty-six years of age. Filteen years previously, it had been introduced in the vagina to relieve prolapsus of the womb. Four years ago she began to feel a weakne^'S in the lower back. Two years ago her legs became weak, and she was unable to walk without assistance. For six months she has been bedridden. For the last six months she has had discharge from the vagina, occa- sionally tinged with blood, and highly offensive. She can neither stand nor walk, and is able to move her legs in bed with difficulty, being at- tacked two or three times during the night with cramp in them. On examination, a large round metallic pessary was found imbedded in the vaginal walls, and was removed by the aid of bone forceps, a considerable quantity of brownish purulent discharge, horribly offen- sive, escaping. All the paralytic symptoms were relieved after its removal. Dr. Cleveland remarked that, apart from the interest attach- ing to the long impaction of a foreign body in the vagina, there was the notable fact that a quantity of highly offensive putrid matter must have been locked up for a considerable time, without the supervention of septiccemia. The case tended to show, in connection with the recent debate before the Society, the necessity for the co-existence of some peculiar condition of the general system befo<re absorption of morbid matter, followed by blood-poisoning, could be effected.
Salicylic Acid as a Dressing to Wounds.
At a society meeting in London, lately, Mr. Callender brought forward a series of cases illustrating the use of this agent as an applica- tion to wounds. The acid was used in various ways, and the three following preparations were the ones chiefly employed : — a. Phos- phate of soda, three parts ; salicylic acid, one part-, water, fifty parts, b. Salicylic acid, one part 5 olive oil, forty-nine parts, c. Salicylic acid, one part ; bicarbonate of soda, half a part 5 water, 100 parts. In addition to these, however, it was occasionally used com- bined with borax, or in the form of an ointment with prepared lard ; and a preparation of the acid with mastic and spirits of wine was trjied,
but had to be abandoned by reason of the irrita- tion caused, as it was thought, by the ingredients combined with the acid. Seven cases in which the acid had been employed were narrated. In three of the cases a vesicular eruption was caused by the acid, and necessitated its withdrawal. In one case it was followed by considerable local irritation, which was re- lieved by the withdrawal of the acid. In a case of excision of the elbow-joint for strumous disease, the wound was washed out with salicy- lic acid, and was dressed with solution " a" on Japanese paper. There was considerable dis- charge from the wound, and the granulations were pale and tlabby ; the dressing was after a time changed to carbolic acid, when the granula- tions became florid, and the discharge was re- duced to a minimum. In the remaining two cases the wound healed rapidly under the application of salicylic acid. From these cases, and from other observations, Mr. Callender arrived at the following conclusions : — Putting together its good points, he found that salicylic acid was free from odor, and so far was accept- able to the patients ; that wounds healed under its influence, and, during the progress of the repair, were free from bad smells ; that, unless strong with spirit, or but little diluted, it did not cause local pain. Its bad points seemed to be these : That, above the strength of two per cent., it caused local irritation, with some con- stitutional disturbance ; and if the patient had a delicate skin, even the weak preparation was a source of trouble ; that there was more dis- charge from a wound dressed with salicylic than there was where carbolic acid was used 5 that its influence upon a recent wound, as after an operation, was not efficacious against the occur- rence of decomposition as was that of carbolic acid, chloride of zinc, or of boracic acid 5 that the repair of a wound was less active, and the granulations, if any, more flabby than when other simple or antiseptic dressings were em- ployed. On the whole, while admitting its usb as a local application to be fairly commendable, Mr. Callender thought it inferior in its antisep- tic properties to other agents, and did not con- sider it to be a remedy meriting the strong recommendations which hnd been given it by some of those who had made trial of it.
The Management of Cerebro-spinal Meningitis.
In the Peninsular Journal of Medicine^ Dr. J. J. Mulheron remarks: —
During the epidemic prevalence of cerebro-spi- nal meningitis I noticed that when the cerebral trouble began to abate there was a simultane- ous improvement in the abdominal symptoms, and, taking the hint from this, I have, for the past two years, adopted a line of treatment which I have had no reason since to modify. I will not here discuss the occurrence of cerebral complications as a sequel to the abdominal dis- orders of children, and the modus in quo of this occurrence. Suffice it to say that a neglected
Jan. I, 1876.]
Periscope.
13
or improperly treated diarrhoea is most prone to result in grave cerebral complications, and in the cases we are called to see these compli- cations have, in the great majority of instances, supervened. What then is to be done under such circumstances? At once apply suitable counter-irritation — either mustard or canthari- des — to the nape of the neck, and administer a combination of ergot, bromide of potassium and belladonna. If the head symptoms are very persistent, do not hesitate to apply a bladder tilled with pounded ice. This may sound some- what heroic : but, gentlemen, what is done must be done decisively 5 be sure you are right in your diagnosis, and go ahead.
On Idiopathic Tetanus.
At a meeting of the Clinical Society of London, Dr. Southey related a case of this disease : —
The patient, a railway ticket collector, well nourished, aged twenty-one, came into St. Bartholomew's Hospital. Fourteen days pre- viously, he had remained for some hours in wet clothes, two days after which tetanic symptoms had supervened, and had been treated, without apparent improvement*, by moderate doses of chloral. On being seen at St. Bartholomew's, he was sensible, able to move his arms, unable to move his legs, and had trismus. His skin perspired freely. Temperature 100°, pulse 120, respiration 40. The muscles of certain regions felt hard, and were tender. Attacks of opistho- tonos, lasting from two to five minutes, came on about every hour. The bowels were confined ; the urine was scanty and high colored. Fluid food only had been given. The treatment after admission consisted of one pill of calomel and opium, followed by a mixture of bromi de of potassium (one drachm) and conium juice (two drachms), to be taken every three hours. Stimu- lants were discontinued, and the diet consisted only of iced milk alternately with beef-tea. Great quietness was enjoined. The skin of the body was hyperassthetic, and exposure to draughts of air excited the tetanic spasms. For the first three days the bowels did not act, and the spasms increased in violence and frequency. He was then ordered thirty grains of compound jalap powder, to be repeated every three hours until the bowels acted, and he was to be put into a bath, temperature 98°. Three doses of the powder had to be given. After the bowels were opened, the trismic spasm was lessened. On the fifth day, the bowels acted four times copiously ; temperature 98°, pulse 120, respira- tion 30. On the sixth day three attacks of tetanic spasms occurred, after which the patient steadily improved, and no further spasms were observed. No wound or splinter could be found upon the patient's body after most diligent search. The invasion of the disease, as well as its declension, was gradual. The improvement coincided with the evacuation of the bowels. Purgatives have been highly commended in tetanus, the normal peristaltic action of the in-
testines being invariably arrested so long as the spasms are severe and continuous, and returning coincidently with the cessation of the spasms. But Dr. Southey did not think this indicated the administration of purgatives, which he con- sidered might produce damage precisely as ex- citation of the cutaneous nerves was harmful. He had given the compound jalap power, almost against his own will, when, perhaps, the bowels would have been naturally opened without its aid. The tepid bath was employed daily, some- times for nearly an hour, and had a marked tranquillizing effect. Bromide of potassium was commenced only on the thirteenth day of the illness — which date, if cases of tetanus sur- vived, they often recovered ; but the drug seemed to be specially indicated physiologically for the disease. Dr. Wood had recorded the re- sults of treatment by its means in sixteen cases — nine of traumatic tetanus — all of which recor- ered ; and seven of idiopathic tetanus, with five recoveries.
The Management of Abortion.
Dr. 'W. D. Hazzard says, in the Virginia 3fedical Monthly: — ..n being called to a cas-e threatened with abortion, my invariable rule of practice is first to ascertain as nearly as possi- ble the stage of the pregnancy, frequency and the extent of the pains, the amount of hemor- rhage, the cause, if known, that has induced the symptoms present — whether they be habitual, or accidental, inimediately predisposing or exciting. Having elicited all the information I can from the patient or her friends, I then institute an examination per vaginam. If I find the os uteri dilated and flaccid, with expul- sive pain at the menstrual periods, whether attended with hemorrhage or not — if the os be dilated to any considerable size, I regard the case as of doubtful character and make my prognosis accordingly. But if I find the os uteri firm and undilated, even if I find hemor- rhage attended with severe pain, T regard the case more favorably ; and if the other symptoms warrant the belief that the foetus be living, I make the efibrt to save the conception. I en- deavor to bring my patient as speedily under the influence of opium as possible. Having done this, I endeavor to keep her under the in- fluence of the drug as long as any symptoms remain of pain or hemorrhage — experience hav- ing taught me that many cases may be carried to a favorable termination that under a more temporizing treatment would result in miscar- riage. I am thoroughly convinced that many cases of abortion are caused by nervous irrita- bility of the uterus, resulting iu j^n intolerance to the presence of the foetus in the womb ; hence nature endeavors to rid the organ of its con- tents by expulsive efforts. If this irritability be overcome by the free and full administration of the sedatives and narcotics, the pregnancy may oftentimes be saved.
I do not think authorities have laid stress
Reviews and
Book Notices.
[Vol. xxxiv.
enough on the importance of thorough investi- gations in such cases as I have spoken of, to enable the practitioner to make a clear diag- nosis. Neither do I think they attach sufficient importance to the veonderful powers of opium, administered with the view of procuring its full effect. In my hands, it has seldom disappointed my expectations.
Reviews AND Book Notices.
NOTES ON CURRENT MEDICAL LITERATURE.
The Leavenworth Medical Herald will
be discontinued after January 1st.
The Scientific American, now in its
thirty-first year, enjoys the widest circulation of any weekly newspaper of the kind in the world. A new volume commences January 1st, 1876. The contents of the Scientific American embrace the latest and most interesting informa- tion pertaining to the industrial, mechanical, and scientific progress of the world ; descrip- tions, with beautiful engravings, of new inven- tions, new implements, new processes, and im- proved industries of all kinds ; useful notes, recipes, suggestions, and advice, by practical writers, for workingmen and employers, in all the various arts. Every number contains sixteen large quarto pages. The year's issue contains 832 large pages, at a cost, including postage, of only $3.20 a year to the subscriber.
BOOK NOTICES.
Transactions of the Amerioan Otological Society.
Eighth annual meeting. Vol. 2. Part 1.
pp. 96. James Campbell, Boston. 1875.
This report on the progress of otology is presented, as was that of the preceding year, in two divisions, viz. : Part i, including Anatomy and Physiology, by Dr. C. J. Blake, is most valuable, bemuse no less than fourteen of the articles contained therein are translations from the original sources. Part ii, including Path- ology and Therapeutics, by Dr. A. Mathewson, is just half the size of the first division, and con- tains some interesting matter, notwithstanding
much of the material has already been made available to the profession through the various American journals.
It is as Dr. Blake says, " This report is in- tended simply as a report on the Progress of Otology, and not, as Prof. Jacoby has, in his (hypercritical) reviews in the Archiv. fur Ohrenheilkilnde, taken the liberty of considering that it should be, a critical review."
We were disappointed by the great scarcity of original contributions, there being but nine, with one exception very brief and unsatisfac- tory articles, and for these but six members were responsible.
The most elaborate paper was that by Dr. Albert H. Buck, of New York, on Eustachian Bougies," where he cites fifteen cases, with varying results, which do not go to prove that either the solid stick or strong solutions of nitrate of silver are ever advisable when applied directly within the Eustachian tube. Another contribution is termed " Intra- tympanic Pressure during Phonation," by Clarence J. Blake, m.u., with experiments and illustrations after those of Dr. Henry J. Bigelow, who has given rules for practice in phonation 5 these enable the patient, by varying the pressure in the buccal cavity in cleft palate, to increase the clearness of articulation. Another is a case of ^'Angioma of the Lobule of the Ear," by Dr. C. J. Kipp, of Newark, N. J. "Aural Contributions," by Dr. George Strawbridge, of this city, and we are only sorry the doctor was so economical with his usually interesting material. " Multi- ple Abscesses of the Auricle," and an interest- ing case of " Otitis Media Hemorrhagica," by Dr. 0. D. Pomeroy, of New York city. " Re* marks upon the Early Treatment of Ear Affec- tions ;" a hint that aurists, above all others, should not require. An interesting case of "Purulent Infection (Pleuro-pneumonia) from. Suppuration of the Middle Ear," and " Experi- ments on the Effects of Quinine upon the Ear," by Dr. D. B. St. John Roosa, of New York city, with whom we cannot agree, and certainly we cannot deduce, from his experiments, " that tinnitus aurium and impairments of hearing, following the use of quinine, depend upon con- gestion of the ultimate fibres of the auditory nerve in the cochlea, and that the redness of the drum-heads is merely an index of the fornfer condition." Better say large doses of quinia may tend to a temporary aggravation of pre- viously existing tinnitus aurium.
Jan. I, 1876.]
Notes and Comments,
15
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With this number we commence one of those years in our country's history which will long stand out as landmarks on its records. The daring experiment our forefathers inaugurated has been tried, and has proven successful. Not America alone, but the whole world, has par- taken of the fruits of their labors ; not only the interests of political life and social relations, but those remoter ones of applied science and ab- stract thought.
To one branch of this narrower field, namely, to the reaction of individual liberty on the study of science, we would more especially call atten- tion. Freedom of life has led to freedom of thought, to untrammeled research, to unbiased deduction, to a sound and true philosophy.
Hand in hand with the ancillary sciences, that of medicine has progressed from the brief details and unfruitful empiricism of a hundred
years ago to that wealth of resources and wide- reaching connections which mark its study now.
This astonishing change, wrought in a space of time spanned by a single life, is what should fix our attention for a while in this year. To this end the profession of the United States ask their fellow-workers from abroad to assemble by delegates in this city, here to reflect on the in- spiring lesson of the past, and to lay broad the foundation for a second century of yet more productive activity, yet nobler usefulness.
The details of this plan are known to our readers, and it is needless to rehearse them. Let us rather say a word of the genuine value of halting from time to time on the journey of life to exercise that human prerogative of " looking before and after." How healthful it is to the individual to give an occasional solitary hour to a review of his past efi'orts, to a com- parison of his present with his former self, to a re-estimate of his capacities, his possessions, and his chances for the future ! So it is with a na- tion. It is not the season for a false adulation, but for taking a correct "account of stock." Much we may justly boast of ; not a little we may properly regret ; and yet more there is to provide against.
In medical science many a method now in vogue will be forgoten in a decade ; many a name now foremost will be supplanted ; many a remedy now applauded will be discarded. In appraising such values, let us seek the his- torical perspective, not be guided by the pas- sions of the hour. Thus doing, we may hope that this coming year will sow as good seed and on as fertile a soil as did that one now immortal in the world's annals, 1776 !
Notes and Comments.
School Diseases.
The Rhode Island Medical Society, at its late meeting, gave considerable attention to the causes of disease among children in the public schools, and the members were generally agreed that it is due not so much to hard study as to
1 6 Notes and
bad ventilation and other causes, one of which 13 hereditary or acquired predisposition for dis- ease ; that normal activity of the brain is help- ful to the best health of individuals, and that judicious study in school is by itself a healthy functional exercise. They declared, however, against long hours of study, and finally adopted a resolution declaring " that among the most prominent causes of ill health among pupils while attending school we must recognize the following : — Attending balls and parties, sitting up late at night, eating improper food, drinking t^a and coffee, and especially reading works of fiction."
On Jaborandi.
Dr. Felippo Cesari, of Eome, in the Gazeta Medica, of that city, has an article entitled *• Physiological Experiments and Clinical Notes on the Polycarpus Pinnatus, or so-called Jabo- randi," in which he comes to the following eonclusions : — 1. That the jaborandi of Con- tinho has an elective action on the salivary glands. 2. That it has a secondary action, but less constant and copious, upon the sudoripa- rous glands. 3. That it has well-marked diuretic action. 4. That it produces no effect whatever on the circulation, nor on the genera- tion of heat, nor (except in an unimportant degree) on the respiration. 5. That its action is most efficacious when it is injected into the veins. 6. That its after-effects are distinct debility, with an imperious thirst, directly pro- portioned to the action of the emunctories. These effects, however, are transitory, and soon disappear under restorative diet.
The Questionable Value of Hypodermic Solutions.
Dr. Lafitte, of Paris, attacks hypodermic medication, so far as the alkaloids are concerned. He says, not the alkaloid, but simply the water, distilled or not, has the merit of allaying pain. Startling cases are mentioned (i' Union M4d., Nos. 113 and 114, 1875), and from these we find that severe lumbago, obstinate neuralgia, etc., are instantly relieved by the injection of about thirty drops of water. Failures are but few, and the author consoles himself respecting these by the consciousness of not having done any harm, if he did no good.
M. Lafitte now asks himself how the simple water acts, and he throws out the theory that the. ultimate nerve filaments are compressed by
Comments, [Vol. xxxiv.
the water, and, being thus paralyzed, can no longer convey the sensation of pain. M. Lafitte goes the length of maintaining that all the hypodermic injections hitherto performed acted through the agency of the water, and he is very particular in stating that his operations were never followed by abscesses or any un- pleasant symptoms.
Tuberculosis Treated by Inhalations of Nitrogen.
The Doctor states that Dr. Steinbriick declares in the first stages the disease is cured with positive certainty by systematic inhalations of nitrogen, if used long enough. He does not know whether relapses occur. In the second stage improvement and cures are attained to an extent hitherto impossible. The younger the patient the better is the withdrawal of oxygen borne, and the more certain is the result. In the third stage the inhalations are dangerous. All beneficial treatment of tuberculosis must depend upon quieting of the nervous system. The inhalations are practiced in an air-tight cabinet, under the supervision of the physician, and the effects looked for are easier and deeper breathing, with coughing up at first of muco- purulent matter. Subsequently, the cough should stop, the pulse and temperature fall, and the nervous system be calmed.
The Natural Pulse.
Dr. Broadbent, in a late lecture, describes the normal pulse as, of course, of average fre- quency, regular as to time, and equable as to strength, compressible by moderate force, not shooting under the fingers nor lingering long on the touch. The artery ought not to be easily distinguishable in the intervals of pulsation 5 it should present no irregularities when the skin is rubbed along its course ; and especially it should not roll under the fingers like a solid cord, or be traceable far up the forearm. The pulsations ought not to be visible, or, at any rate, not conspicuous.
On "Teething Sickness." Dr. Dawson remarks, in the Jounial of Ob- stetrics : —
It is the popular idea that when an infant begins to teeth it is time to begin giving him more substantial food, and this is certainly correct in principle ; yet this very period of infant life is also popularly considered the
Jan. I, 1876.]
Notes and Comments,
most critical, for the reason that the process of cuttinor teeth renders the child liable to fevers, convulsions, diarrhoea, etc., and vt^hen these disorders occur at this period of infant life the cause is at once said to lie in the fact that " the baby is teething," and that consequently it is an unavoidable misfortune that it is sick. If there ever was an absurd fallacy fastened upon the popular mind, it is, in my opinion, this bugbear of " teething sickness." I have never seen such a case myself, and it is beyond my comprehension why the Creator should afflict only the young of man with a normal physio- logical process dangerous to health and life.
On the Chemistry of the Urine.
Galipe [Pharm. Zeitschrift f. Eussland, xiii, 683) uses the following method for the deter- mination of albumen, which is applicable in the presence of the phosphates or the urates. A test-tube is one-third filled with a deep yellow solution of picric acid, and one or more drops of the to-be-tested urine added. If albumen is present, there immediately appears a sharply marked white cloud ; upon heating the liquid, the albumen collects in a lump and floats. The reaction leaves nothing to be desired for deli- cacy.
E. Reichardt, in the same journal, xir, 45, demonstrates the presence of a body similar to dextrine in albuminous urine.
David writes {Bull, de la Soc. de Chem. de Paris, XXIII, 235) of a peculiar urine which decolorizes Fehling's solution, but did notafi'ect the beam of polarized light. A substance possessing the same properties was separated from the urine. The death of the patient so limited the supply of the material that further investigations were prevented. z. e. b.
Treatment of Croup.
Dr. Lesdorf, says the Doctor, contributes the following treatment of croup : At the outset an emetic is to be given, sulphate of copper in small doses every quarter of an hour (until vomiting is produced) being the best; after vomiting, the copper is to be given every two hours, in doses of one-eighth to half grain. The dyspnoea generally ceases after vomiting has once occurred. The administration of copper is to be continued for a day or two until the dry whistling cough has changed its character. A cold compress is to be applied round the neck immediately after vomiting. If the
dyspnoea seems not to yield, a vapor bath is to be given, as follows : a wooden vessel, contain- ing eight to ten quarts of hot water, half to three-quarters of a pint of vinegar, and a hand- ful of meal, is to be placed at the foot of the child's bed ; a quilt is then to be suspended over the bed, so that one end is to cover the vessel, and the other so arranged that the vapor, in escaping, must pass over the child's head. A red-hot iron is then to be placed in the vessel, and left there so long as it develops the hot acid vapor. This bath is to be repeated every two hours, night and day, while there is any danger. The very best results may be antici- pated from this method of treatment, and opera- tive interference, even in acute cases, may often be prevented by energetically carrying it out.
Artificial Milk.
The American Journal of Pharmacy says the best substitute for mother's milk, according to Beno Martiny, is the yolk of chicken egg, which weighs, on an average, fifteen grammes, and when diluted with 57.1 grammes of water of about 100° and five grammes of milk-sugar has nearly the same composition as the milk in the first period of lactation. Subsequently, the fat and protein decrease, and to one yolk may be added one hundred grammes of water and six grammes of ijailk-sugar.
Aconite.
From an elaborate series of observations in St. Thomas^ Hospital Reports, New Series, vol. V, Dr. John Harley reports conclusions which indicate that, if it be conceded that aconite ameliorates the febrile condition, it does not much control it •, and that it cannot in any degree anticipate or cut short the pyrexial stage in a disease (relapsing fever) against which, if it did possess the febrifuge properties ascribed to it, its influence ought to be most marked.
On the Detection of Prussic Acid in Poison Cases.
"W. Sokoloff [Ber. d. deutsch. Chem. Ges. z. Berlin, viii, 437) poisoned a young dog with 0.028 grammes of prussic acid. The presence of the poison was detected six, ten, fourteen, and up to twenty-two days after death. Soko- loff further calls attention that in the first distillation of the contents of the stomach with water and sulphuric acid no hydrocyanic acid could be detected, while it showed itself in the
i
i8
Notes and
Comments, . Vol. xxxiv.
second distillate. This circumstance goes to show that hydrocyanic acid exists after poison- ing, not in the form of a simple cyanide, but in that of a double salt, which is decomposed with diflficulty by dilute mineral acids. z. e. b.
Treatment of Cerebral Rheumatism by Chloral.
M. Bouchut, in a memoir, says that cerebral rheumatism is only a form of meningitis. Ex- amination of the membranes of the brain reveal a considerable venous stasis, with an opaline in- filtration of the pia mater, caused by numerous leucocytes. The ophthalmoscope discloses a serous infiltration of the papilla and of the retina adjoining, with dilatation of the retinal veins, which represent corresponding changes in the pia mater and in the brain. Rheumatism of the brain is ushered in by delirium more or less violent, terminating by coma or by asphyxia, sometimes very rapid, which may cause death in a few hours. In three cases of this kind, a cure was obtained by means of hydrate of chloral, given by the mouth, in doses of from forty-five grains to one and a half drachms, once or twice at short intervals, so as to obtain an immediate abatement of the agitation the patients presented.
Progressive Muscular Atrophy.
At a meeting of a medical society in Man- chester, lately. Dr. Bramwell showed two cases of this strange disease. The first was a pitman, aged twenty-two. Eighteen months ago he first noticed a weakness in his left hand. A pail of water which he was in the habit of carrying slipped every now and again out of his hand. "Cold made the fingers curl up." The right hand became affected a year ago. The patient's general health was very good. The muscles of the body generally were well developed ; the biceps remarkably so. The muscles of the left thumb and hand were com- pletely atrophied. The muscles of the right hand were affected, though to a less degree. The muscles of the left forearm were beginning to be atrophied. The second patient was also a pitman. lie was twenty-eight years of age. lie was admitted to the Newcastle Infirmary some weeks ago, under Dr. Embleton, by whose kind permission Dr. Bramwell was enabled to exhibit the patient. In this case the disease was in a very advanced stage. The man was unable to rise from his seat. lie could not
raise his hand to his head. The muscles of the arms and thighs were most affected. The dis- ease had commenced only seven months ago, in the ball of the left thumb. It had rapidly spread to other muscles. The atrophied muscles still responded to galvanism. This patient stated that when sitting he felt perfectly well. Vision was somewhat dim. On ophthalmo- scopic examination, commencing gray atrophy was seen to be present. This fact favored the nervous origin of the disease.
The Urinology of General Paralysis.
In the West Riding Lunatic Asylum Reports, Dr. Merson has a paper ou " The Urinology of General Paralysis," at the end of which he thus sums up the results of his observations : —
1. The quantity of urea varies above and below the average of health, being in the ma- jority of cases considerably increased. Probably also the uric acid is increased.
2. The quantities of chlorides and phosphoric acid are notably diminished ; that of sulphuric acid remains about normal.
3. The specific gravity varies within wider limits than in health, but the mean does not differ materially.
4. The absolute quantity of urine passed is slightly below the average of the healthy cases examined, but, estimated according to weight of body, the amount excreted by seventeen general paralytics was slightly in excess of that excreted by six healthy men.
5. Under the influence of Calabar bean, there is a considerable diminution in the quantity of all the solid constituents, especially the urea.
The results obtained in the three cases treated with alcohol are in favor of the view that both the quantity of urine and the amount of solid constituents are diminished under the in- fluence of that substance.
Swallowing a Screw. ' Dr. W. F. Hilrabeck, of Windsor, Illinois, gives us the following curious incident : —
A boy two years old swallowed a common wood screw one inch in length ; the head of the screw was \ of an inch in width. It was forty- four hours in passing through the alimentary canal. The child seems to suffer no inconve- nience from its dose of hardware. It is enjoying as good health now as before it swallowed the screw.
Jan. I, 1876.]
Correspondence,
19
* Correspondence.
How Long May the Efficacy of Vaccination "be Relied On?
Ed. Med. and Surg. REroRXER : —
The above question is so often asked, and so Yariously answered, and often answered so little in accordance with the actual facts, that we are not much surprised at the growing distrust in the efficacy of vaccination as a safeguard against small-pox.
Jenner taught that protection by vaccination was life-long. It did not require the observa- tions of half a century to disprove this statement of the great discoverer.
The question, " How long ?" cannot with cer- tainty be answered. It is generally agreed by all observing members of the profession that protection by thorough vaccination is for a few years certainly reliable. It is highly probable that one person may be protected by vaccina- tion for a longer time than another person of equally distinct cicatrix.
The range of susceptibility to any contagion is very wide in the human family. One indi- vidual will contract disease, while another equally exposed will escape with impunity. It is certainly safe to vaccinate indiscriminately every five years, or oftener if the disease prevail. At least make the eflFort. " Best safety lies in fear." But, since specific disease enters so largely into the catalogue of human ills, we un- hesitatingly commend the employment of animal vaccine virus.
We have repeatedly vaccinated individuals well advanced in years, and obtained a typical vesicle, though numerous efibrts had failed in the same person in years gone by, subsequent to vaccination in early life. The writer was vaccinated in his first decade, and well remem- bers some of the constitutional symptoms. A distinct cicatrix is still visible, and bears testi- mony to the completeness of the work. He also believes that that vaccination afibrded im- munity against small-pox for more than a third of a century. The following are hi's reasons for the hope within him : —
During the late war, being on duty in the valley of the Mivssissippi, the writer was desig- nated to muster for pay, and to sign the rolls for all the patients and attendants in and about the small-pox hospital, situated a few miles outside of Memphis. Military orders are peremptory, and this one was promptly complied with. On reporting at the hospital, he was forthwith con- ducted into every occupied apartment of the building, thus coming in contact with the disease in all its stages, except the stage of in- cubation, which is the very least dangerous, and perhaps never seen in a small-pox hospital, ex- cept in an attendant, as that stage is generally over before being sent to hospital.
The muster completed and the rolls signed, he returned to the Post Hospital, of which he had charge, and vaccinated himself and all un-
vaccinated attendants most thoroughly. tJpoiji himself no symptoms of a vesicle appeared.
Within the next three months numerous cases of sniall-pox occurred in the fort, in the prison, and in the Post Hospital, bringing him daily in contact with its emanations, and yet he escaped the disease.
In 1872-73, at Parker's Landing, Pa., there occurred an epidemic of small-pox of very fatal type. Here, again, the writer came in contact with the disease in its worst form, ministering to the sufiFerers' wants night and day, and yet sufi'ered no inconvenience in health from the contact.
After making a call on a case of small-pox, he would sponge off his clothing, hands, face and feet with gasoline. (Gasoline, by the way, turned out to be one of the very best antiseptics, and one which we freely used before knowing its full value.) Here, again, he vaccinated him- self freely, but to no effect.
During the present winter the writer was detained at Cumberland City, Md., for a few hours. Here small-pox is epidemic with unusual fatality. The writer procured from the Penn- sylvania Vaccine Agency a quill of animal virus, with which he again vaccinated himself, and at this writing there is a typical vesicle in full bloom on his arm. The constitutional symptoms are also well marked.
A. D. BiNKERD, M.D.
The Frequency of Triplet Births. Ed. Med. and Surg. Reporter : —
On December 10th, 1875, Mrs. Martha B. Barr, of New Castle, Lawrence county, Pa., gave birth to triplets, two boys and a girl, weighing respectively six, six and a half, and seven and a half pounds, including slips. Being in town on the 14th inst., I called to see the little strangers, and found mother and babes all doing well. Mrs. Barr had walked a consider- able distance the day previous to her confine- ment, and carried a child two years old. Dr. Isaac Winans, of New Brighton, was the at- tending physician. Mrs. Barr is aged twenty- five, and the mother of three other children, one of whom is dead.
There is also a lady in Buffalo township,' this county, viz., Butler, Mrs. McCaffeily, who gave birth to triplets, March 27th, 1873. There are two boys and a girl in this little trio also. They are all living and well. They were on exhibi- tion at a harvest home recently held in Penn township, this county. They look very much alike. There is also another lady in Worth township, Butler county, and one in Beaver, Beaver county, who recently gave birth to triplets.
My father. Dr. Robert Cunningham, of North Sewickley, some years ago delivered a Mrs. Wm. Smiley and Mrs. John C. Johnson, neigh- bor women, of triplets, also a Mrs, Ralston. These three were the only ones which fell to his lot during a practice of twenty-five years,
20
News and
Miscellany,
[Vol. xxxiv*
and two of these, Mrs. Smiley and Mrs. Johnson, happened in the same year. My father is dead, but I remember the circumstances well, and the dates are in his book, which can be given at any time.
I give you these facts to show that triplets are of more frequent occurrence than is gener- ally conceded. In Churchill's system of Mid- wifery, Philadelphia, ed. 1846, p. 411, there are statistical statements on the subject of twin and triplet pregnancies. Dr. Churchill states that out of 448,998 cases of pregnancies there were 5776 cases of twins, or one in 77f , and 77 cases of triplets, or one in 5831 cases. Now, if triplet births occur as frequently in other places as in our immediate vicinity, I think the num- ber would exceed the above statement. I know if all cases were reported it certainly would do so. A. V. Cunningham, m. d.
Zelienople, Dec. \bth^ 1875.
News and Miscellany.
Items.
— Deaths from trichinosis are reported from Indianapolis, and in Hamilton county, Indiana.
— The total number of lunatics and idiots in the asylums and prisons of the Canadian pro- vince of Ontario is officially reported at 1179, an increase of 104 during the year.
— A medical commission, appointed by the Board of Health in Boston, to investigate the sanitary condition of that city, reports that nearly two-thirds of its total population are foreigners and their offspring, and of this pro- portion two-thirds arc Irish.
— The immigration to the United States during the last fiscal year numbered. 227,498. This is a falling off of 85,841, compared with the previous year, and of 232.305, compared with 1872-3. The decline in two years, it will thus be seen, is slightly over one-half.
— Mr. Henry Bergh, of New York, in his last protest against vivisection, says : — " The most learned physiologists of the present and past centuries have declared vivisection to be a sci- entific failure, and some of the leading surgeons in this city and country pronounce living ex- periments— except in one single example, the nervous system — to be needless barbarity when not performed by the aid of anaesthetics."
QUERIES AND REPLIES.
Dr. B. A. M., of Mo.— There is nothing in the Code of ethics forbidding a physician placing on his sign
Physician and Surgeon." It may not be good taste, however.
Dr. W. H. II. S., of Ga.— What you complain of is pruritus hyemalis. We know of no efficient treat- ment for it.
OBITUARY.
DR. CHARLES MIFFLIN. Dr. Charles Mifflin died in Boston, December 9th, aged seventy years. He was born in this city, July 19th, 1805, graduated at the University of Pennsyl- vania, and studied medicine under the charge of Dr. Thomas T. Hewson. He practiced medicine in this city from 1826 to 1838, and was one of the sur- geons attending the cholera hospital in 1832. In 1835 he married a daughter of the Hon. Benjamin Crowninshield, of Boston, and in 1838 removed to that city. Subse quently he lived at Nahant, where he practiced for many years.
MARRIAGES.
Bacon— Read.— At Columbia, Mo., Wednesday, 15th ult., Charles A Bacon, m. d., of this city, and Mary Brice Read, daughter of Dr. Daniel Rtad, President of the State Universitv of Missouri.
Brown— RuDM AN.— December 15th, at the resi- dence of the bride's mother, by Eev. A. A. Riektt, Alexander Brown, M. D.. and Bertha J. C. Rudmau, youngest daughter of the late Wm. C. Rudman.
Butler— HoiiTON.— In Dummerston, Vt., Nov. 24th, by the Rev. L. G. Chase, Fred M. Butler, of Jamaica, and Lillian H. Holton, of Dummerston.
Carter— Hazen.— December 4th, by Rev. Moses Kidder, T. C. Carter, of Boston, and Percy, only daughter of Dr. Edwin Hazen, of Woodstock, Vt.
Darling— WiiiSON.— In Georgetown, Mass., Dec. 1st, by Rev. Mr. Marsh, Dr. J.H. Darling, of Thomp- sonville, Ct.. formerly of Keene, N. H., and Carrie E. Wilson, of Georgetown.
Evans— Taylor.— In Newport, Ky., on Thursday evening, December 2d, by Rev. H. W. Taylor, Fir- man R. Evans, M. D., of Franklin, Ohio, and Miss Sallie Kemper Taylor, daughter of the officiating clergyman.
LANGnoN— Edwards.— At the residence of Wm. Edwards, Esq., December Ist, 1875, l)y Rev. Daniel J. Jones, Dr. H. A. Langdon and Miss Sidney Edwards.
McCandless— Beck — By the Rev. J. A. Crawford, D. D., of Chambersburg, Dr. W. A. McCandless and Mary M. Beck, all of this city.
Peale— WiswELL.— At Green Hill Presbyterian Church, Philadelphia, Thursday, December 28d, If-TS, by the Rev. Dr. Beadle, Emily ^. Wiswell, daughter of Rev. G. F. Wiswell, and Dr. Albert C Peale, of the U. S. Geological Survey.
Perkins— Cook.— In Moodus, Conn., Nov. 25th, Myron W. Perkins, formerly of Windsor, Vt., and. Mattie S., daughter of Dr. H. C. Cook.
DEATHS.
Anderson.— On October 19th, at Lahore. India, Dr. Henry James Anderson, of this city, in the 77th year ot his age.
Bradley— William J. Bradley, son of Dr. I. B. Bradley, of Fryebnrg, Maine, died in Philadelphia, the 5th ult., aged 27 years and 7 months.
Doughty.— In New York, on the 21st ult., Augus- tus Durfeee, only child of Dr. F. C. and Hannah M. Doughty, aiffcd 8 months and 19 days.
Dunham —On Thursday, December 9th, Dr. Chas. Dunham, in the -leth year of his age.
Green.— In Trenton, N. J., on the 2d inst., Mary A., wile of Dr. Wm. Green.
Jacbson.— Dr. John Davis Jackson, a prominent physician of Kentucky, died at Danville last week, aged 42 years.
Lewis.— On the evening of the 21st ult., in Phila- delphia, Mrs. M. Faris Fassitt, wife of Dr. E. J. Lewis.
Parker.— On Saturday, 18th inst.. Dr. Joseph E. Parker.
DEFRESNE'S PANCREATINE,
PANCREATINE Is the active principle of the Pancreatine Fluid, which is generally acknowledged by physiologists to be the most important of tlie secretions necessary for the proper Digestion and As- similation of Pood, since IT ALONE possesses the property of digesting and preparing for assimila- tion all the various kinds of food, whether of an albuminoid, fibrinous, starchy or fatty natnre*
Mr. DEFRESNE, having made this subject a matter of special study, in a work' published in 1872, Bucceeded in obtaining Pancreatine, in a concentrated form, and possessing all the properties of the natural secretion.
PAXCREATIJTE, therefore, becomes a very important remedy in a great many cases of Indlg^estion, Atony of the I>igrestiTe Org^ans, and various forms of Dyspepsia, where Pepsine and other remedies have failed.
As a Help for the I>igrestion of Fats, physicians will find PANCREATINE invaluable to patients who are unable to support Cod Liver Oil or fatty substances, and are, therefore, deprived of their nourishing and restorative properties.
The Dose of DEFRESNE'S PANCREATINE is 5 to 15 grains, according to the nature of the case, taken before or during meals. It is sold in bottles containing Half, or One ounce.
The following PREPARATIONS of PANCREATINE are also offered :—
PANCKEATINE PILLS, containing 4 grains each.
PANCREATINE WINE and ELIXIR, given in doses of one or two tablespoonfuls. PANCREATIC EMULSION OP COD LIVER Olio, representing Cod Liver Oil in a state of perfect emulsion, and readily borne by the stomach.
PANCREATIC EMULSION OP COD LIVER OIL, with Iodide of Iron.
PANCREATIC EMULSION OF SOLID PAT, fresh and sweet, representing fat perfectly emul- sified and ready for immediate absorption.
Mr. Defresne haTlng: made Pancreatine preparations a subject of special study for several years, has succeeded in obtaining: them in ^reat perfection, and hence they are recommended as superior to similar preparations heretofore offered.
DUSART'S LACTO-PHOSPHATE OF LIME.
[SYRUP AND WINE].
LACTO-PHOSPHATE OP LIMB is a new therapeutical agent, based upon the physiological researches of Mr. L. Dusabt, and first proposed by him. .
The publication of his work on the "Physiological Action of Phosphate of Lime" had led to the adoption of advanced views in regard to the importance of this substance in the animal economy. It is now considered necessary, not only for the Perfection of tte BonySystem, butalso, and above all, for the Formation and Alimentation of the Muscular Tissues, and of Cerebral matter itself. Under its influence the nitrogenized matter of food is transformed into muscular flesh, and upon the quantity of this substance present in the system depends the vital activity and temperature of the individual. Hence, an insufficient supply of the phosphate causes a rapid decline of the general health.
DUSART'S PREPARATIONS OP LACTO-PHOSPHATE OP LIME present to the physician 'he phosphate of lime in the combination in which it exists in the stomach, after it has been acted ipon by the gastric fluid. It is, therefore, presented ready for assimilation, and hence, the Lacto-Phos- phate should be preferred to the ordinary bone phosphate, which frequently is insoluble, or nearly so.
DUSART'S PREPARATIONS have been used in the hospitals of Paris with great success, and in I wide range of diseases, as :— Rachitic and Scrofulous Affections in children ; the Languor caused by 00 rapid a growth and development in youth; the Debility attendant upon old age; Weakness in ielicate Females, caused by the nursing of children; Slow Convalescence ; certain forms of Dyspepsia, saused by the low vitality of the system. In cases of Practures, their use has been found to caus'e a more ■apid formation of the Callus, and in cases of wounds, the cicatrization has been more prompt, irhile its administration to children facilitates the general develop^nent, and especially the process of Jssification and Dentition. ^
When the use of iron is indicated, Dusart's Syrup of Lacto- Phosphate of. Lime and Iron is iffered.
Dusart's Work on the " Physiological axd Therapeittical Action of Phosphate of Lime" ".be sent, free, on application to Agents.
mmmi I m., iiw 1011^ %iti fm s.
CINCHO-QUININE
CiNCHO-QuiNiNE, which was placed in the hands of physicians in 1869, has been tested in all parts of the country, and the testimony in its favor is decided and unequivocal.
It contains the important constituents of Peruvian Bark, Quinia, Quinidia, Ciuchonia and Cinchonidia, in their alkaloidal condition, and no external agents.
University of Pennsylvania, Jan. 22, 1^75. " I have tested Cincho-Quinine, and have found it to contain quinine, quinidine, cinchonine, and cinchonidine." p. a. GENTH, Prof, of Chemistry and Mineralogy.
Laboratory of the University of Chicago, February i, 1875. 1 hereby certify that I have made a chemical examinHtiou of ihe contents of a bottle of Cincho- Quinine, and by direction I made a qualitative examination for qiiinine, quinidine, and cincho- nine, and hereby certify that I found these alkaloids in Cincho-C^uinine."
C. GILBERT WHEELER, Professor of Chemistiy.
" I have made a careful analysis of the contents of a bottle of your Cincho-Quinine, and find it to contain quinine, quinidine, cinchonine, and cinchonidine.''
S. P. SHARPLES, State Assay er of Mass.
In no other form are combined the important alkaloidal principles of Bark, so as to be accessible to medical gentlemen.
In it is found Quinidia, which is be- lieved to be a better anti-periodic than Quinia; and the alkaloids actinff in association, unquestionably produce favorable remedial inflttences which can be obtained from no one alone.
In addition to its superior efficacy as a tonic and anti-periodic, it has the following advantages which greatly increase its value to physicians : —
1st. It exerts the full therapeutic influence of Suljjhate of Quinine, in the same doses, without oppressing the stomach, creating nausea, or produc- ing cerebral distress, as the Sulpiiate of Quinine frequently does, and it pro- duces much less constitutional disturb- ance.
2d. It has the great advantage of be- ing nearly tasteless. Thp bitter is very slight, and not unpleasant to the most sensitive, delicate woman or child.
3d. It is le»s costly ; the price will fluctuate with the rise and fall of barks, but will always be much less than the Sulphate of Quinine.
4th. It meets indications not met by that S.tlt.
Middleburg, Pa..
April 13, 1875. Gentlemen: I cannot refrain from giving you my testimony regarding
Cl.VCllO-QutNINE.
In a practice of twenty years, eight of which were in connection with a drug store, I have used Quinin such cases as are generally recom- mended by the Profession. In the last four or five >ears I have used cer;/ fre- quently your Ci.NCHO-QuiNiNE m place of Quinine, and hdvenei-er been disappointed in my expectations.
J.\0. Y. .^Jlll.VDKL, M.D.
Gehts: It may be of some satis" f. ctioii to you to know that 1 have used the alkaloid for two yeais, or nearly, in my practice, and 1 have found it re- liable, and a/Z I think that you claim for it. For children and those of irri- table stomachs, as well as those too easily qmninized h\ the Sulphate, the Cincho acts like a charm, and we can hardly eee how we did without it so long. 1 hope the supply will continue. Yours, with due regard,
J. R. T.WLOR, M.D., Kosse, Texas I have used your CixcHO-Quis imk exclusively for four years in this malarial region.
It is as active an anti-periodic as the Sulphate, and more agreeable to ad- minister. It gives great satisfaction.
D. H. Chas,r, ai.D., Louisville, Ky. I have used the Cincho-Quinine ever since its introduction, ai d am so well satisfied with its results tliat 1 use it in all cases in which I formerly used the Sulphate; and in intermittents it can be given during the paroxysm of tever with perfect safety, ana thus lose ■lO time.
W. E. SCHENCK, M.li., Pekin, 111.
I am using Cincho-Qi'ini.ne, and find it to act as reliably and efficiently as the Sulphate.
In the case of children, I employ it almost exclusively, and deem its ac- tion upon them more beneficial than that of the time-honored Sulphate. W. C. SCHULTZE, M.D.,
Marengo, Iowa. Cincho-Qlinine in my practice has given the best of results, being in my estimation far superior to Sulphate of Quinine, ar.d has many advantages over the Sulphate. G. InoallS, M.D., Northampton, Mass. YourCiNCHO-Qi'iNiBE Ihaveused with marked success. I prefer it in every way to the Sulphate.
D. Mackay, M.D., Dallas, Texas.
We will send a sample package for trial, containing fifty grains of CiNCHO-QuiNiNE, on receipt of twenty-five cents, or one ounce upon the receipt of one dollar and sixty cents, post paid. Special prices given for orders amounting to one hundred ounces and upwa'"'
WE manufacture chemically pure salts of
Arsenic, Ammonium, Antimony, Barium, Bromine, Bismutli, Cerium, Calcium, Copper, Gold. lodir''.
Iron, Lead, Manganese, Mercury, Nickel, Phosphorus, Potassium, Silver, Sodium, Tin, Zin- , etc.
1^°* Price List and Descriptive Catalogue furnished upon npplication.
BILLIJsGS, CLAPP & CO.,* Manufacturing Chemists,
( SUCCESSORS TO JAS. R. NICHOLS & CO. )
BOSTON, MASS.
WHOLE No. 984.J
JANUARY 8, 1876.
[VOL. XXXIV, No. 2.
2^
EDICAL AND 8URGICAL
A. WEEKLY JOTJR^^r^JL,,
EDITED BY D. G. BRINTON, M. D.
Terms of Subscription, FIVE DOLliARS per auiiniu, in advance.— Siufflf- Copies Ten Cents.
CONTJEIVTS:
ORIGINAL DEPARTxMENT.
COMMUNICATIONS.
BoYLAND, George Hal,sted.— On Bandages 21
Eberhakt, S. fcs.— Case of Intussusception 28
HOSPITAL REPORTS.
University Hospital.— Caries of the Vertebrse
(Wood) 26
Pennsylvania Hospital.— (Hutchinson) 28
MEDICAL SOCIETIES.
New York Neurological Society.— The Cause of
the Death of Vice-President Wilson 29
Rhode Island State Medical Society 29
EDITORIAL DEPARTMENT.
PERISCOPE.
Hemorrhage after Tooth Extraction 30
Re-positing the Child in the Vomiting of Preg- nancy 31
Treatment of Pericardial Effusion •32
The Method ot Bi-polar or Bi-manual Version. . . 32
On the Electrolytic Dispersion of Tumors 33
Morphia in Neuralgia 33
REVIEWS AND BOOK NOTICES.
BOOK NOTICES.
Medical Society of New Jersey, Transactions of
187:
34
George Washington ; or, Life in America One
Hundred Years Ago (Abbott) 34
Notes, Explanatory and Practical, upon the In- ternational Sunday-school Lessons for the Year
1876 (Clark) 34
The Popular Health Almanac for 1876 (Hoffman). 34
Transactions of the Kansas State Medical Society,
1875 34
Lectures on Bright's Disease (Black) 34
EDITORIAL.
TnE"MEDicAii Law" of Pennsyi^vania . NOTES AND COMMENTS.
35
Centenarians in New York.. 36
Morphia in Acute Ursemia 37
Treatment of Tapeworm ; 37
Management of Premature Children 37
CORRESPONDENCE.
Belladonna in Opium Poisoning (Dr. Chase) 37
A Remarkable Case of Recovery after Mortifica- tion of a Portion of the Bowel and Bladder (Dr.
Carr) 38
Ingrown Nails (Dr. Kimmel) 38
NEWS AND MISCELLANY.
Deaths in Philadelphia During 1875 39
The International Medical Congress 39
Diploma-Peddling 39
The Health of Rome , 39
An Imperial Board of Health 39
Pre-Adamitic Frogs 39
Siberian Practice 39
Items , 40
Personal 40
OBITUARY.
Dr. J. H. Nau
Dr. Samuel Blair Martin..
Marriages and Deaths.
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Alabama.— Dr. S. P. Smith.* Arkansas.— Dr. W. F. Waller.* Connecticut.— Bts. E. K. Leonard;* T. G. Wright,* T. M. Hills,* Geo. L. Porter.* Delaware.— Brs. J. P. Chandler,* W. S. Dunlap.* District of Columbia.—Surgeon General U. S.- A.* Georgia.— Dr. W. B. Tackett.*
Illinois— Brs. J. J. Fyke,* J. M. James,* A. P. Nelson,* W. A. Townsend,* W. T. Sherwood,* A. Felkete,* C. A. Wilbur,* F. C. Brooke,* F. P. Van Valkeuburg,* I. W. Runcie,* A. Y. MeCof mick,* C.
G. Smith.*
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Iowa.— Drs. M. I. Powers,* E. Burd,* A. Drake,*
H. G. Ristine *
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Minnesota.— Drs. O. H.