wAs HINGTON, D. C.,
U. s: A. -

4887.
II.
III.
IV.
XIII.
XIV.
XV.
XVI.
XVII.
XVIII.
PRESIDENTS OF SECTIONS.
The Congress is Divided into Eighteen Sections.
SECTIONS. PRESIDENTS.
. GENERAL MEDICINE, . . . . . . . . A. B. ARNOLD, M.D.
GENERAL SURGERY, . . . . . . . . W. T. BRIGGS, M.D.
MILITARY AND NAVAL SURGERY, HENRY H. SMITH, M.D., LL.D.
OBSTETRICS, . . . . . . . . . . . . DE LASKIE MILLER, M.D., PH.D.
. GYNAECOLOGY, . . . . . . . . . . . HENRY O. MARCY, M.D.
. THER A P E U TICS AND MATERIA
MEDICA, . . . . . . . . . . . . . . TRAILL GREEN, M.D., LL.D.
. ANATOMY, . . . . . . . . . . . . . . W. H. PANCOAST, M.D.
. PHYSIOLOGY, . . . . . . . . . . . . J. H. CALLENDER, M.D.
. PATHOLOGY, . . . . . . . . . . . . A. B. PALMER, M.D., LL.D.
. DISEASES OF CHILDREN, . . . . . . J. LEWIS SMITH, M.D.
. OPHTHALMOLOGY, . . . . . . . . . J. J. CHISHOLM, M.D.
. OTOLOGY, . . . . . . . . . . . . . . S. J. JONES, M.D., LL.D.
LARYNGOLOGY, . . . . . . . . . . . W. H. DALY, M.D.
DERMATOLOGY AND SYPHILO-
GRAPHY, . . . . . . . . . . . . . . A. R. ROBINSON, M.D.
Pl] B L IC AND INTERN ATION AL
HYGIENE, . . . . . . . . . . . . . JOSEPH JONES, M. D.
CLIMATOLOGY AND DEMIOGRAPHY, A. L. GIHON, A.M., M.D., U.S.N.
PSYCHOLOGICAL MEDICINE A N ID
DISEASES OF NERVOUS SYSTEMI, J. B. ANDREws, A.M., M.D.
DENTAL AND ORAL SURGERY, . . . JoSATHAN TAFT, M.D., D.D.s.
The Editor takes this occasion to thank his colleagues, Professors Kleinschmidt
and Baker, for assisting him by reading much of the German and French proof and
correcting the foreign titles. Thanks for assistance in translations are also due Mrs.
Meany
and Miss Jones, of the Marine Hospital Bureau, and Mr. Henri Larroque, of
this city.
The small number of Abstracts in the volume is due to the non-receipt of papers
until too late for the preparation of Abstracts.
The Abstracts are alphabetically arranged in each Section.
NINTH
INTERNATIONAL MEDICAL CONGRESS.
ABSTRACTS OF PAPERS.
SECTION I–CENERAL MEDICINE.
OFFICERS.
PRESIDENT: A. B. ARNOLD, M. D., Baltimore, Md.
WICE-PRESIDENTS.
Dr. McCALL ANDERSON, Glasgow, Scotland.
Dr. H. CHARLTON BASTIAN, London, England.
Prof. CHRISTIAN BAUMLER, Freiberg, Germany.
Dr. JoHN S. BRISTOWE, F. R.s., London, England.
Dr. DUDLEY W. Buxton, London, England.
W. W. CLEAVER, M.D., Lebanon, Ky.
Dr. WM. HowSHIP DICKINson, F. R. C. P., London,
England.
Dr. DAVID FERRIER, London, England.
Dr. WALTER B. GIEKE, Toronto, Canada.
Dr. SAMUEL GoRDON, A. M., Dublin, Ireland.
Dr. GEO. Johnson, London, England.
J. A. OCTERLONY, M. D., Louisville, Ky.
Dr. PHILIP H. PYE-SMITH, F. R. C. s., London,
England.
P. G. RobiNSON, M. D., St. Louis, Mo.
PRESTON B. SCOTT, M. D., Louisville, Ky.
Sir EDWARD SIEVEKING, M. D., London, England-
Dr. A. T. H. WATERs, Liverpool, England.
Dr. W. M. WHITMARSH, Hounslow, England.
SECRETARIES.
J. W. CHAMBERS, M.D., Baltimore, Md.
WM. F. WAUGH, M. D., Philadelphia, Pa.
COUNCIL.
L. J. Abbott, M. D., Fremont, Neb.
John R. Bennett, M. D., Cleveland, Ohio.
Peter Bryce, M. D., Tuscaloosa, Ala.
S. S. Clark, M.D., St. Albans, Vt.
E. J. Doering, M. D., Chicago, Ill.
Joseph Draper, M. D., Brattleboro’, Vt.
N. McL. Gamble, M.D., Columbus, Ohio.
Hubert Haywood, M. D., Raleigh, N. C.
G. A. Ketchum, M. D., Mobile, Ala.
D. S. Kinsman, M. D., Columbus, Ohio.
T. B. Lester, M.D., Kansas City, Mo.
Joseph P. Logan, M. D., Atlanta, Ga.
Louis Mackall, M.D., Washington, D. C.
J. B. Marvin, M. D., Louisville, Ky.
Thomas Hay, M.D., Philadelphia, Pa.
A. K. Minich, M. D., Philadelphia, Pa.
W. H. Phillips, M.D., Kenton, Ohio.
A. M. Pollock, M. D., Pittsburgh, Pa.
Dr. W. J. Sheppard, Cleveland, Ohio.
Dr. S. F. Tanner, Shepherdstown, W. Va.
Dr. P. C. Williams, Baltimore, Md.
J. Williamson, M. D., Ottumwa, Iowa.
6 - ABSTRACTS.
THE PRACTICE OF MEDICINE AT THE PRESENT DAY.
LA PRATIQUE MÉDICALE ACTUELLE.
DIE AERZTLICHE PRAXIS DER GEGENWART.
º
BY A. B. ARNOLD, M.D.,
Of Baltimore, Md.
This paper begins with a brief statement of the movements which exerted a dominant
influence on modern practice, and especially in relation to the treatment of fevers.
The limits of our therapeutical resources are next considered, and then the claims of
medicine as an art closes the paper.
ON THE COLD WATER TREATMENT OF TYPHOID FEVER
AND OTHER FEVERS.
DU TRAITEMENT PAR LEAU FROIDE DE LA FIEVRE TYPHOIDE ET DES
AUTRES FIEWRES.
DIE KALTWASSERKUR IN DER BEHANDLUNG DES ABDOMINAL TYPHUS UND ANDERER
IFIEBER,
BY PROF. DR. CHRISTIAN BAUMLER,
Of Freiberg, Germany.
DISEASE OF INEBRIETY AND ITS TREATMENT.
LA MALADIE DE L'IWRESSE ET SON TRAITEMENT.
DIE KRANKHEIT DER TRUNIKSUCHT UNID IHRE BEHANDLUNG.
BY T. D. CROTHERS, M. D.,
Of Hartford, Conn. -
Historical Résumé. Inebriety as a central brain disease always associated with brain
and body degeneration. Largely inherited, directly or indirectly. It follows often from
disease or injury. The symptoms of direct physical causation very common. Often
masked and concealed. Treatment in hospitals a necessity. Inebriety a complex psy-
chosis increasing in this country and requiring very careful study and treatment.
ON THE MORPHOLOGY OF RHEUMATIC BLOOD, WITH
LANTERN IDLUSTRATIONS.
SUR LA MORPHOLOGIE DU SANG DES RHUMATIQUES AVEC ILLUSTRA-
TIONS PAR LA LANTERNE MAGIQUE.
UEBER DIE MORPHOLOGIE DES RHEUMATISCHEN BLUTES.
BY E. CUTTER, M.D.,
Of New York,
1. The form of elements found in the blood of Rheumatic patients.
Varieties.
(a) Oxalate of Lime.
(b) Cystinic.
(c) Phosphatic and
(d) Uric acid. *
2. The Peculiarities of the Red Blood Corpuscles and Serum, including Thrombosis and
Embolism. -
3. Lantern illustrations.
NINTH INTERNATIONAL MEDICAL CONGRESS. 7
ATYPICAL FORMS OF TYPHOID FEVER,
DES VARIAETÉs ATYPIQUES DE LA FIEVRE TYPHOIDE.
ATYPISCHE FORMEN DEs ABDOMINAL TYPHUs.
BY PROF. W. C. DABNEY,
Of University of Virginia.
1. Typhoid fever atypical with respect to temperature.
2. Typhoid fever atypical with respect to eruption.
3. Typhoid fever atypical with respect to the Intestinal symptoms.
4. The causes of atypical forms of Typhoid fever.
(a) Climate.
(b) Season.
(c) Complications.
(d) Individual Peculiarities.
(e) Prevalence of other diseases.
5. The Morbid Anatomy, Cause, Diagnosis, Prognosis. Treatment in the atypical forms
of Typhoid Fever.
PNEUMONIA. AS MET WITH IN VARIOUS PARTS OF THE
DOMINION OF CANADA.
DE LA PNEUMONIE COMME ON LA RENCONTRE DANS LE DOMINION DU
CANADA.
DAS WORKOMMEN DER PNEUMONIE IN VERSCHIEDEN EN THEILEN WON KANADA.
BY PROF. WALTER P. GEIKE, M.D.,
Of Trinity College, Ontario, Canada.
PREVENTIVE POWER OF WACCINATION.
DE LEFFET PREVENTIF DE LA VACCINATION.
DIE SCHÚTZENDE EIGENSCHAFT DER WACCINATION.
BY DR. JOSEPH KOROSI,
Of Buda-Pesth, Hungary.
COCAINE INEBRIETY.
LIVRESSE CAUSIE PAR LA COCAINE.
I)IE COCAIN-TRUNKSUCHT.
BY J. B. MATTISON, M.D.,
Of Brooklyn, N. Y.
Its cause, consequence and cure.
SOME CONSIDERATIONS ON THE PATHOGENESIS OF DIS-
EASES IN WOMEN.
QUELQUES CONSIDERATIONS SUR LE PATHOGENESIS DES MALADIES
- DES FEMMIES.
EINIGE BETRACHTUNGEN UBER DIE PATHOGENESE DER FRAUEN–KRANKHEITEN.
*msºsºsºme
BY WILLIAM B. NEFTEL, M.D.,
Of Chicago.
The paper begins with a description of a series of experiments in animals to investi-
gate the effects of pulmonary compression in favoring the development of tuberculosis.
8 ABSTRACTS.
He found the morbid condition produced by the experiments to consist of arterial ange-"
mia and venous statis. The same condition occurs in women from tight lacing, and
causes a predisposition for the settlement and proliferation of the Bacillus tuberculosis.
He then alludes to certain pathological considerations which support the hypothesis.
The International Medical Congress is requested to appoint a committee to investigate
the whole question of dress for women. - -
THE NATURAL HISTORY OF DISEASE.
DE L'HISTOIRE NATURELLE DES MALADIES.
DER NATUERLICHE VERLAUF DER. KRANKHEITEN.
BY JOHN A. OCTERLONY, M.D.,
Of Louisville, Ky.
A CLINICAL VIEW OF PYREXIAL ANTIPYRETICS.
REVUE CLINIQUE DES ANTIPYRETIQUES PYREXIALES.
KLINISCHES URTHEIL UBERANTIPYREXISCHE HEILMITTEL.
BY PRESTON B. SCOTT, M.D.,
Of Kentucky.
FIBROID DEGENERATION AND ALLIED LESIONS OF THE
HEART, AND THEIR ASSOCIATION WITH DISEASE OF THE
CORONARY ARTERIES. •
DE LADEG£NÉRATION FIBROIDEDUCOEUR ET DES LÉSIONS QUI LUISONT
CONGENERES, ET DE LEUR ASSOCIATION AWEC LES MALADIES DES
ARTERES CORONAIRES,
FIBROIDE DEGENERATION UND AEHNLICHE LAESIONEN DES HERZENS UND DEREN
GEMEINSCHAFT MIT KRANKHAFTEN VERAENDERUNGEN DER CORONAR-ARTERIE.
BY DR. JoFIN LINDSAY STEVEN,
Of Glasgow, Scotland. *;
The paper consists first of a historical and critical review of the literature of Fibroid
Degeneration of the Heart, and of the different opinions that have been, at various
times, held as to the etiology and precise histological nature of this morbid state. The
ordinary teaching as to the coronary circulation of the heart is then commented on, and
the author states his own opinions based on injection and dissection experiments. It is
then shown that these different morbid conditions of the heart wall may result from
obstruction of the coronary circulation, viz.:-
(a) Fibroid Degeneration.
(b) Generalized Fatty Degeneration.
(c) Infarction, often leading to Rupture.
Each of these lesions, the precise circumstances giving rise to them, their naked-eye
and microscopic appearances, and their anatomical and clinical results, are next dis-
cussed in detail. In an appendix the author shortly narrates the cases on which the
foregoing Statements and opinions are based.
VAOCINATION AND PASTEUR'S TREATMENT.
DE LA VACCINATION ET DU TRAITEMENT PASTEUR.
VACCINATION UND PASTEUR's BEHANDLUNG.
BY W. M. WHITMARSH, M.D.,
Of Hounslow, England.
SECTION II—GENERAL SURGERY.
OFFICERS.
PRESIDENT: DR. W.M. T. BRIGGS, Nashville, Tenn.
WICE-PRESIDENTS.
Dr. WM. ANDERSON, F. R. C. S., London, England.
Dr. RICHARD BARWELL, London, England.
T, BRYANT, F. R. C. S., London, England.
Prof. J. W. R. TILANUs, M.D., Amsterdam, Hol-
land.
Dr. ALFRED PEARGE GOULD, London, England.
Dr. Moses GUNN, Chicago, Ill.
Dr. J. W. HAMILTON, Columbus, Ohio.
REGINALD HARRISON, ESQ., F. R. C. S., Liverpool,
England.
CHRISTOPHER HEATH, ESQ., F. R. C. S., London,
England.
Dr. W. N. HINGSTON, Montreal, Canada.
Dr. JAS. M. HollowAY, Louisville, Ky.
f
}
Dr. J. W. HULKE, London, England.
Dr. J. C. HUTCHINson, Brooklyn, N. Y.
Dr. N. S. LINcolN, Washington, D. C.
Dr. WM. MACEwen, Glasgow, Scotland.
Dr. DONALD MACREA, Council Bluffs, Iowa.
Dr. DoNALD McLEAN, Detroit, Mich.
Dr. C. MCNAMARA, London, England.
Dr. THos. G. MoRTON, Philadelphia, Pa.
Dr. EDMUND OWEN, F. R. C. S., London, England.
Dr. WALTER PXE, F. R. C. P., London, England.
Dr. W. DUNNETT SPANToN, Hanley, England.
Dr. M. StoRRs, Hartford, Conn.
Dr. R. MoRRIS Wol FENDEN, London, England.
SECRETARIES.
Dr. DUDLEY P. ALLEN, Cleveland, Ohio.
Dr. KARL MAYDE, Vienna, Austria.
Dr. J. R. WEIST, Richmond, Ind.
Dr. ARTHUR H. WILSON, Boston, Mass.
COUNCIL.
F. Andross, M.D., Mitchell, Dak.
H. W. Austin, M. D., M. H. S.
J. Benjamin, M.D., Camden, N. J.
L. M. Bingham, M. D., Burlington, Vt.
Oscar J. Coskrey, M. D., Baltimore, Md.
F. A. Dunsmoor, M. D., Minneapolis, Minn.
Dr. Edw. Farrer, Halifax, N. S.
Christian Fenger, M.D., Chicago, Ill.
Dr. Geo. E. Fenwick, Montreal, Canada.
R. N. Isham, M. D., Chicago, Ill.
W. S. Janney, M. D., Philadelphia, Pa.
Mr. Frederick B. Jessett, London, England.
S. D. Mercer, M. D., Omaha, Neb.
Truman W. Miller, M. D., Chicago, Ill.
Robt. F. Morris, M. D., New York, N. Y.
H. H. Mudd, M.D., St. Louis, Mo.
Dr. Robt. Newman, New York, N. Y.
Dr. Chas. J. O'Hagan, Greenville, N. C.
Dr. H. L. Orth, Harrisburg, Pa.
Dr. Alfred M. Owen, Evansville, Ind.
Dr. L. R. Pilcher, Brooklyn, N. Y.
Dr. T. F. Prewitt, St. Louis, Mo.
Dr. G. M. Quimby, Jersey City, N. J.
Dr. J. J. Ransom, Burlington, Iowa.
Dr. Thos. P. Russell, Oshkosh, Wis
Dr. Nicholas Senn, Milwaukee, Wis.
Dr. Albert F. Stiefel, Wheeling, W.Va.
Dr. Proctor Thayer, Cleveland, Ohio.
Dr. Theodore R. Varick, Jersey City, N. J.
Dr. W. A. M. Wainright, Hartford, Conn.
Dr. J. P. Wall, Tampa, Fla.
Dr. W. F. Westmoreland, Atlanta, Ga.
DELEGATE: Prof. LÉoN LE FORT, Paris, France.
10 ABSTRACTS.
GREFFE ANIMALE AWEC LA PEAU DE GRENOUILLE
DANS LES PERTES DE SUBSTANCE CUTANEE ET MU-
QUEUSE.
USE OF ANIMAL GRAFTS FROM THE SRIN OF THE FROG FOR THE RES-
TORATION OF LOST CUTANEOUS MUCOUS SURFACES.
GEBRAUCH DER TRANSPLANTATION DER FROSCHHAUT FUER DIE wiBDERGEWIN.
NUNG DER, VERLORENEN SCHLEIMHAUT.
BY DOCTEURS DUBOUSQUET-LABORDERIE AND JEAN BARATOUx,
Of Paris, France.
Les auteurs rapportent des faits concludints en forme de cette greffe et résument les
conditions de succès de cette pratique :
1. Plaie bourgeonnante.
2. Eviter de faire iniquer, la coagulation du sang empêchant le contact immédiat entre
les cellules de la greffe et celles des bourgeons charnus.
3. Eviter la Suppuration qui agit comme la coagulation et entraine ou fait resorber les
minces pellicules de grenouille.
4. Docilité et immobilité du blessé pendant les trois ou quatre premiers jours.
5. Faire lui-même les pansements qui Seront rigoureusement antiseptiques et apporter
le plus grand Soin au pansement de début qui doit étre compressif.
Les auteurs font ressortir dans leur communication divisée en trois parties:
1. Quelles Sont les raisons de leurs recherches et expériences précédées d’une courte
notice historique.
2. Quelles Sont les conditions de succès qui paraissent indispensables.
3. Quels Sont les résultats pratiques, de leurs tentatives et les procédés opératoires
employés par eux.
SECTION III—MILITARY AND NAWAL SURGERY AND
MEDICINE. *
OFFICERS.
PRESIDENT: HENRY HOLLINGSWORTH SMITH, M. D., LL.D., Philadelphia, Pa.
WICE-PRESIDENTS.
JOHN ANDERSON, M.D., M.R.C.P., Lond., M.R.C.S.,
Edin., London, England.
HY. R. BANGA, M. D., Chicago, Ill.
Dr. von ColeR, Berlin, Prussia.
HERR DOCTOR FRIEDERICH VON ESMARCH,
Kiel, Germany.
GEORGE JOSEPH HAMILTON DVATT, M. D.,
L.R.C.S., Ireland, Woolwich, Kent, England.
JOSEPH EwART, M. D., F.R.C.P., Lond., M.R.C.S.,
England, Brighton, England.
CHAs. HENRY YoUNG GoDw1N, M. D., London,
England.
Dr. M. W. C. GoRI, Amsterdam, Holland.
ELISHA H. GREGORY, M. D., LL.D., St. Louis,
MO.
Sir JAMES ARTHUR HANBURY, M. B., K. C. B.,
F. R. C. S., Ireland, London, England.
FRANK HENSMAN, M.R.C.S., England, Regent
Park Barracks, London, England.
FREDERICK HYDE, M. D., Cortland, N. Y.
Prof. THEo. Koch ER, Berne, Switzerland.
WILLIAM HARRIS LLOYD, M.D., L. R. C. S., Ire-
land, Admiralty, London, England.
RICHARD CHAPMAN LOFTHOUSE, M. D., M. R. C. S.,
Edin., London, England.
Sir THOMAS LONGMORE, C. B., F. R. C. S., England,
Netley, England.
JOHN DENNIS MACDONALD, M. D., M. R. C. S.,
England, Surbiton, England.
WILLIAM ALEXANDER MACKINNON, C. B., L.R.C.S.,
Edin., London, England.
JEFFREY A. MARSTON, M.D., M. R. C. S., England,
London, England.
Dr. NEUDöRFER, Vienna, Austria.
GEORGE L. PORTER, M.D., Bridgeport, Conn.
Dr. CHAs. REIJER, St. Petersburg, Russia.
EDMUND H. ROBERTs, M.D., M. R. C. S., England,
Rochester, England.
Joseph R. SMITH, M.D., Surg. U. S. A., N.Y. City.
FRANCIS PATRICK STAPLES, M. K Q. C. P., Ireland,
M. R. C. S., England, London, England.
N. SULLIVAN, M. D., Kingston, Canada.
John SWINBURNE, M.D., Albany, N.Y.
RICHARD FRANCIS TOBIN, M. K. Q. C. P., Ireland,
F. R. C. S., Ireland, Dublin, Ireland.
WILLIAM WARIAN, M. D., Titusville, Penna.
CHAS. HoBART WOORHEES, M. D., New Bruns-
wick, N. J.
A. WATSON, M. D., M. R. C. S., Edin., London, Eng.
B. A. WATSON, M. D., Jersey City, N J.
SECRETARIES.
WILLIAM BROWNING, M.D., Brooklyn, N.Y.
J. McF. GASTON, M.D., Atlanta, Ga.
ELI A. WooD, M.D., Pittsburgh, Pa.
COUNCIL,
Fredk. C. Ainsworth, M. D., Captain and Ass’t
Surg., U. S. A.
S. T. Armstrong, M.D., M. H. S.
John W. Bayne, M. D., Washington, D. C.
R. B. Bontecou, M. D., Troy, N.Y.
Charles W. Brown, M. D., Elmira, N. Y.
Joseph D. Bryant, M.D., New York City.
Charles Wesley Buvinger, M. D., Pittsburgh, Pa.
James Collins, M. D., Philadelphia, Pa.
M. S. Craft, M. D., Jackson, Miss.
J. S. Dorsey Cullen, M.D., Richmond, Va.
S. E. Fuller, M. D., Brooklyn, N.Y.
Charles Ravenscroft Greenleaf, M. D., Major
and Surgeon, U. S. A.
E. Griswold, M.D., Sharon, Pa.
Valery Havard, M.D., Surgeon and Major, U. S. A.
D. S. Hays, M.D., Hollidaysburg, Pa.
Henry James, M.D., Waterbury, Vt.
Daniel Smith Lamb, M.D., Act'g Ass’t Surgeon,
U. S. A., Washington, D. C.
George Thomas Langridge, F. R. C. s., London,
M.R.C.S., England, Surgeon-Major, B. Army,
Royal Arsenal, Woolwich, England.
S. D. Leslie, M.D., Montgomery, Ala.
D. A. Linthicum, M. D., Helena, Ark.
James H. Peabody, M. D., Omaha, Neb.
William F. Peck, M. D., Davenport, Iowa.
H. B. Ransom, M.D., New York.
Robert Reyburn, M.D., Washington, D. C.
J. O. Skinner, M. D., Ass’t Surgeon, U. S. A.
Charles Smart, M. D., Surgeon, U. S. A.
J. L. Stewart, M.D., Erie, Pa.
James D. Strawbridge, M. D., Danville, Pa.
Morse K. Taylor, M. D., Surgeon, U.S. A.
Samuel S. Thorne, M. D., Toledo, Ohio.
William S. Tremaine, M. D., Surgeon and Major,
U. S. A.
11
12 ABSTRACTS.
THE PROPER TREATMENT OF PENETRATING WOUNDS OF
THE ABDOMEN.
DU MEILLEUR TRAITEMENT DES PLAIES ABDOMINALES PáNÉTRANTES.
DIE RICHTIGE BEHANDLUNG PENETRIRENDER BAUCHwuNDEN.
BY S. T. ARMSTRONG, M. D.,
Passed Assistant Surgeon, U. S. Marine Hospital Service.
1. Treatment depends so much on the part injured, and shock is often so profound,
that complete recovery therefrom never occurs; the broad rule of rest and sedatives
is to be applied in all cases.
2. Where the shock is complicated by fair evidence of internal hemorrhage or
intestinal perforation, laparotomy is indicated as a last resort.
3. General explorative laparatomy is not justifiable :-
'(a) Because its statistics of recovery are not sufficiently encouraging.
(b) Because equally good results have been secured where laparotomy has not
been performed.
(c) Because in field work, neither the facilities, time, nor environment are avail-
able, as in municipal hospitals.
WHAT CLASS OF GUNSHOT WOUNDS AND INJURIES JUS-
TIFY RESECTION OR EXCISION IN MODERN WARFARE3
SUR QUELLE CLASSE DE BLESSUREs DOIT ON PRATIQUER LA RESEC.
TION ET L’EXCISION DANS LA GUERRE MODERNE 2
WELCHE KLASSE VON SCHUSSWUNDEN UND VERLETZUNGEN RECHTFERTIGT DIE RE-
SECTION ODER EXSECTION IN DER HEUTIGEN KRIEGSFUEHRUNG 7
BY REED BROCKWAY BONTECOU, M. D.,
Formerly Brevet Colonel U. S. Volunteers, Troy, N. Y.
Definition of terms. Value of the operations as compared with results of expectant
treatment or amputation. Statistics of cranial wounds. Advantages from excision.
Low mortality with antisepsis. Gunshot fractures of clavicle, of scapula. Shoulder
joint. Statistics of Relative mortality to amputations. Advantages of antisepsis.
Gunshot fractures of Humerus not implicating the joint. Statistics and mortality.
Operation on other portions of the Upper Extremity and comparison of results with
the expectant treatment. Gunshot fractures of the Hip joint. Result of resections of
lower limbs as to future usefulness not satisfactory. Excision of shaft of femur in
gunshot fractures. Statistics of antiseptic treatment without operation, favorable.
Resections of knee joint with antisepsis. Encouraging statistics. Other gunshot
fractures of lower extremity as leg, ankle joint, etc. Conclusions.
ON THE ETIOLOGY AND THEATMENT OF CAMP DYSENTERY
AND DIARRHOEA.
SUR L’ÉTIOLOGIE ET LE TRAITEMENT DE LA DYSSENTERIE ET DE LA
DIARRHEE DES CAMPS.
UEBER DIE AETIOLOGIE UND BEHANDLUNG von LAGER-RUHR UND DURCHFALL.
- BY CHARLES W. BUVINGER, M. D.,
Late Assistant Surgeon U. S. Army, and Surgeon of the 80th Ohio Volunteer Infantry, War of the Re-
bellion, 1861-5, Pittsburgh, Pennsylvania,
The writer shows that dysentery and diarrhoea are caused by a radical change in
the manner of living ; by bad water; bad and improperly cooked food ; privations;
malarial, paludal and scorbutic influences, singly or combined. Not due to micro-
NINTH INTERNATIONAL MEDICAL CONGRESS. 13
organisms, bacteria, or a special bacillus. The question as to definite and true causa-
tion, still in doubt and undetermined.
Treatment.—Shows the diverse and discordant opinions in regard to the use of
Ipecacuanha. No one remedy a specific for dysentery or diarrhoea. Having himself
been a great sufferer from both diseases, he gives, briefly, his own personal experience.
Holds that the treatment with Fuming Nitrous Acid, 43°, reinforced by Tinct. Opii,
is the one remedy, par excellence, above all others. Oil of Turpentine also an efficient
remedy, especially in hemorrhagic form, and also for chronic diarrhoea. . For acute
diarrhoea, and summer diarrhoeas of children, a certain combination of calomel, ipecac
and opium, is the best remedy.
THE CONSTRUCTION OF FIELD HOSPITALS, AS ILLUS-
TRATED IN THE DEPOT FIELD HOSPITAL OF THE ARMY
OF THE POTOMAC, AT CITY POINT, V.A., IN 1864–65.
DE LA CONSTRUCTION DES HoPITAux AMBULANTS D'APRES LE PLAN
SUIVI JA L'AMBULANCE GENERALE ATTACHEE A LARMEE DU POTO-
MAC, A CITY POINT, VIRGINIE, EN 1864–65.
TJEBER DEN BAU VON FELDHOSPITAELERN, NACH MUSTER DES DEPOT-FELDHOSPITALS
DER ARMEE DES POTOMAC IN CITY POINT, VIRGINIEN, I.M. JAHRE 1864–65.
BY JAMES COLLINS, M. D.,
Formerly Brevet Lieutenant-Colonel, U. S. Volunteers, Philadelphia, Pa.
1. Field Hospitals in Regiments:
(a) Advantages of tents.
(b) Mode of heating in winter.
(c) Modes of shading.
Experience derived in regimental service.
2. The organization of the Depot Field Hospital at City Point, Va., 1864 and
1865 :—
(a) Plan. Conveniences for water, etc. Modes of heating in winter.
Number of officers. Number of patients. General sanitary conditions and modes
of transportation.
-*-
|UEBER DEN ETSTEN NOTHVERBAND AUF DEM
SCHLACHTFELDE.
ON THE FIRST PROVISIONAL DRESSING ON THE BATTLE FIELD.
LE PREMIER PANSEMENT PROVISOIRE SUR LE CHAMP DE BATAILLE,
-*
BY PROFESSOR: VON ESMARCH,
Riel, Germany.
1. Esist ein, Gebot der Menschenliebe, dass jeder Soldat, derin's Feldzieht, einen
antiseptischen Nothverband bei sich trage, und zwar aus folgenden Gründen:
2. Im Kriege kann jeder Soldat in die Lage kommen, verwundet zu werden, ohne
dass irztliche Hilfe in der Nähe ist (Vorposten, Streifwachen, berittene Abtheilungen,
grosse Schlachten).
3. Der Verlauf einer Wunde hingt in vielen Fällen durchaus davon ab, wie sie
gleich mach der Verletzung behandelt wird. Wird die Wunde sogleich mit unreinen
Fingern oder Instrumenten untersucht, mit unreinen Stoffen verbunden, oder bleibt
sie längere Zeit mit unreinen Kleidungsstücken in Berührung, oder der Luft ausge-
setzt, so ist eine Vergiftung der Wunde durch Făulnisserreger die nothwendige Folge.
14 ABSTRACTS.
4. Schleunige Bedeckung der Wunde mit reinen und fäulnissverhindernden Ver-
bandstoffen kann diese Gefahr in vielen Fällen verhüten.
5. Wenn jeder Soldat einen antiseptischen Nothverband an einer bestimmten Stelle
bei sich trägt, so kann derselbe von dem Verwundeten selbst, oder von einem Kame-
raden auf die Wunde gelegt und befestigt werden.
6. Der antiseptische Nothverband muss deshalb enthalten: –
(a) Antiseptisches Verbandmaterial, gross genug, um zwei Flintenschuss-Oeff-
nungen, und ev. auch eine grössere Wunde genügend zu bedecken.
(b) Eine antiseptische Binde, um diesen Verbandstoff auf der Wunde zu befestigen.
(c) Ein dreieckiges Tuch, gross genug, um ein zerschossenes Glied zu unterstützen,
und um Schienen oder andere Verbände an den verschiedensten Körpertheilen
anzulegen.
7. Wünschenswerth ist es, dass die Soldaten in der Anlegung des Verbandes und
namentlich auch in der Anwendung des dreieckigen Tuches eingeübt werden.
8. Das Verbandpäckchen kann auf verschiedene Weise zusammengestellt werden;
mir scheint die Zusammensetzung des beifolgenden Päckchens die zweckmässigste zu
sein. Dasselbe enthält, in wasserdichten Kautschukstoff eingeschlagen:–
(a) Zwei antiseptische Compressen aus Sublimat-Kochsalz-Mull, 10 cm. breit,
1 M. lang, in Firniss-Papier gehüllt.
(b) Eine antiseptische Sublimat-Kochsalz-Cambric Binde, 10 cm. breit, 2 M. lang,
mit Sicherheitsnadel. k
(c) Ein dreieckiges Tuch mit Sicherheitsnadel.
9. Das Päckchen enthält folgende Gebrauchs-Anweisung aufgedruckt:–
Bei einfachen Schusswunden wird auf jede Schussöffnung eine der Compressen
gelegt, nachdem das Firniss-Papier davon abgenommen ist.
Bei grösseren Wunden entfaltet man die Compressen und sucht die ganze Wund-
fläche mit dem antiseptischen Mull zu bedecken.
Durch Umwicklung mit der Binde wird der Mull auf der Wunde befestigt.
Das dreieckige Tuch dient zur weiteren Bedeckung dieses Verbandes, zur Unter-
stützung des verletzten Gliedes oder zur Befestigung von Nothschienen, wie es auf
dem Tuche abgebildet ist.
Das Päckchen ist 10 cm. lang und breit, 1 cm. dick und wiegt genau 100 gramm.
Der hiesige chirurg. Instrumentenmacher H. BECKMANN liefert das Stück für 60
Pfennige.
--- ==--
ON PRACTICAL CONSIDERATION OF HUMAN NOSOGRAPHY.
E-m-
CONSIDERATIONS PRATIQUES SUR LA NOSOGRAPHIE HUMAINE.
«mºussam-mm-
PRAKTISCHIE BETRACHTUNGEN UEBER MENSCH LICHIE NOSOGRAPHIE.
BY J. W. S. GOULEY, M. D.,
Surgeon to Bellevue Hospital, New York.
1. Causes of the retardation of the progress of Nosography. s
2. To be of practical utility, Nosography should be established upon a stable
basis.
3. The description and definition of diseases.
4. The defects in the past and present nomenclature of diseases. Suggestions for
their remedy.
5. The classifiers of the past and present.
6. Propositions looking toward an improved classification of diseases.
7. Definitions of the terms of classification.
8. Conclusions.
NINTH INTERNATIONAL MEDICAL CONGRESS. 15
AMPUTATION FOR INJURY OF LIVING PARTS NEVER
NECESSA.R.Y.
QUELLE QUE SOIT LA BLESSURE, L’AMPUTATION DES PARTIES VI-
VANTES NEST JAMAIS NECESSAIRE.
-n-sms
DIE AMPUTATION NACH VERLETZUNG LEBENDER THEILE IST NIEMALS NOTHWEN DIG.
BY ELISHA. H. GREGORY, M. D., LL.D.,
Of St. Louis, Mo.
If, by peculiarity of injury, the main channels are cut off, wait for collateral circu-
lation, because the injury is not general.
Improved methods of coaptating deep structures and prevention of wound accidents,
form the foundation of the paper.
ON WHAT CONDITIONS ON THE FIELD JUSTIFY AMPUTA-
TIONS IN GUNSHOT WOUNDS.
QUELLES SONT LES CONDITIONS QUI JUSTIFIENT L’AMPUTATION PAR
SUITE DES COUPS DE FEU SUR LE CHAMP DE BATAILLE.
-*
WELCHE UMSTANDE AUF DEM SCHLACHTFELDE RECHTFERTIGEN DIE AMPUTATION
NACH SCHUSSWUNDEN.
BY E. GRISWOLD, M. D.,
Formerly Brevet Colonel U. S. Volunteers, Sharon, Pa.
I. Amputation on the field in military practice cannot always be done, although
the established rules of Surgery, as well as the opinion of the surgeon, may and do
demand it in many cases in which it is not done. The exigencies of war often separate
the surgeon from his equipments and deprive him of the means of action, or he
may be overworked and unable to do all that lies before him.
II. When cases of shot injuries of the extremities are presented to the surgeon
during the progress of a battle, or soon after its termination, the first consideration is
whether there are any severe body complications, and whether the injuries to the soft
parts of the extremities are such as to require immediate amputation.
III. If there be injury of the bones in their diaphyses to a serious degree, or of the
epiphyses in any degree, the question will be, Whether immediate excision or amputa-
tion is absolutely demanded? and in answering this question, each case should be
subjected to the illuminating power of a full knowledge of the surgery of to-day.
IV. The surgery of to-day and of the future make it necessary for military sur-
geons to be supplied with the means by which asepsis can be practiced in the treat-
ment of Wounds, and this can be done and made practical whenever an adequate
Supply of water is attainable, if a rapid method of filtration and purification is
available.
V. The possibilities of antiseptic surgery are already largely developed, and the
military surgeon of the present and future must know what is to be expected in the
Way of conservatism, and when his patient, having a severe shot wound in one of his
extremities, is found to be clearly beyond the reach of conservatism, he is not only
justified in amputating on the field, but it is his bounden duty to do so.
16 ABSTRACTS.
ON STRETCHERS AND STRETCHER DRILL, WITH ILLUS-
TRATIONS.
DES BRANCARDS ET DE LEXERCICE DE L’AMBULANCE.
*
UEBER TRAGBAHREN UND TRAGBAHR-UEBUNGEN.
*====
BY VALERY HAVARD, M.D., ASSISTANT SURGEON, U. S. ARMY,
Of Staten Island, N. Y. -
Stretcher and Stretcher Drill.
It comprises the following subjects:—
Requisites of the field stretcher in modern warfare.
Forms used during the civil war, and statistics thereof.
Pattern suggested by the experience of the latest wars.
Inter-dependence of stretcher and ambulance wagon; peculiarities of construction
which it involves, $,
Stretcher detachment of bearers; its organization.
Utility of drill with closed stretcher.
Stretcher step.
Marching and manoeuvring with open stretcher.
Position of the stretcher by the wounded.
Loading the stretcher.
Loading and unloading the ambulance wagon.
Transferring patients from stretcher to bed.
ON THE PROPER TREATMENT OF PENETRATING WOUNDS
OF THE JOINTS.
DU MEILLEUR TRAITEMENT DES PLAIES PAEN£TRANTES DES ARTICU-
LATIONS.
|UEBER DIE RICHTIGE BEHANDLUNG PENETRIRENDER GELENEWUNDEN.
BY FREDERICK HYDE, M. D.,
Professor of the Principles and Practice of Surgery in the Medical Department of Syracuse University,
New York.
1. The large number of anatomical structures, comprising the joints, is to be kept
in mind by the surgeon as he studies any form of wound into the joint.
2. The number of textures, and their close proximity to each other, render a penetra-
ting joint wound of proportionate gravity to the rapid progress of the inflammation
and the number of textures involved.
3. First, following inflammation is perversion of function; second, textural changes.
4. The result of the wound, whether incised, lacerated, contused or punctured, will
depend upon the intensity of the inflammation and the destruction of textures.
5. When the lesion is restricted to the synovial tissue, the inflammation may spread
in the same more rapidly and not involve the adjacent tissues until later. -
6. Bearing upon the treatment of joint wounds, the synovial tissue, and its rela-
tions to the bursa should be observed, that the requisite drainage may be obtained.
7. The synovial tissue in the knee, is to be considered in connection with the sup-
puration of joint wounds, illustrating the principle upon which their drainage is
based.
8. That in all cases of suppuration in the joint, a direct opening should be made
for its evacuation; that pus in a joint abscess soon degenerates, and is poisonous, as in
other purulent collections.
NINTH INTERNATIONAL MEDICAL CONGRESS. 17
9. There are parts of the joint, and especially is this true of the knee, where the
pus sacs are shut off from each other; this should be remembered by the surgeon
when thorough drainage is needed. -
10. The rules are given for dressing joint wounds and settling the question of ampu-
tation. -
11. The cases have been frequent enough in which foreign bodies had not been
detected in joint wounds until after amputation, to warrant advising, in persistent sup-
puration, that sufficient exploration should be made to detect any hidden, irritating
foreign material. -
12. In all cases, pus should not be allowed to remain in a diseased joint.
13. We contrast the earlier treatment of joint wounds forbidding the opening of a
suppurating synovial sac with our treatment of to-day, and we are obliged to call the
former the spoliative and the latter the saving treatment.
14. The constitutional treatment consists in sustaining the general health of the
patient.
15. In the more acute stage of the inflammation, due caution should be observed
that the treatment for resolution should have reference to its chances of failure.
16. In patients subject to dyscrasic conditions, the prognosis is unfavorable for reso-
lution, if inflammation, and still more so, when suppuration, has occurred, especially
when it begins in the ossific structures. The treatment should have early reference to
the previous systemic conditions.
ON GUNSHOT FRACTURES OF THE FEMUR.
SUR LES FRACTURES DU FEMUR PAR LES ARMES A FEU.
UEBER SCHUSSFRACTUREN DES FEMUR.
BY HENRY JANES, M.D.,
Formerly Brevet Lieutenant-Colonel and Surgeon, U.S. Volunteers, Waterbury, Vermont.
The paper is based upon the results in 427 cases of gunshot fracture of the femur,
treated from two and a half to five and a half months, in two field hospitals under the
writer's charge, in the years 1862 and 1863.
Of these fractures, 95 were in the upper third of the bone, all but one treated con-
servatively—mortality, 46 per cent., at last reports. 125 were in the middle third,
102 treated conservatively—mortality, 33 per cent. ; 23 were amputated—mortality,
40 per cent.; 207 were in lower third, 67, not including knee wounds, treated conserv-
atively—mortality, 20 per cent. ; 140 amputated—mortality, 35 per cent. Besides
these 427, there were 34 fractures involving the knee-joint treated conservatively, with
a mortality of 85 per cent. Generally the amputation cases terminated earliest, but
about one-eighth of them had tedious bone inflammation. Up to about 40 years of
age, advance in life did not increase the mortality rate.
Antero-posterior wounds did no better than transverse.
Fractures caused by balls moving with great velocity, were more dangerous than
those from balls with less velocity. - -
Prisoners did worse than their captors under the same conditions.
Gunshot fractures sometimes united as readily as simple fractures.
False-joint occurred but once among the 263 cases treated conservatively.
Secondary hemorrhage occurred in 9 cases; several times as an incident in septic
poisoning.
Tetanus occurred once.
2
18 ABSTRACTS.
Hospital gangrene seemed to be induced in the fall of 1863 by bad ventilation and
too much clothing in cold, damp weather.
The shortening generally was more than an inch in cases which recovered.
The shortening was increased by use of the limb in several instances.
Callus was sometimes so irregular and excessive in amount as to impede the action
of the muscles. -
Callus sometimes pressed upon an artery or nerve, and caused secondary hemorrhage
or neuralgia.
Callus was sometimes absorbed in the course of septic inflammations.
Refractures caused by falls, generally re-united readily when the wounds in the soft
parts were healed.
The limbs often became more useful than any artificial substitute. (No statistics.)
Don't saw off ends of fractured bones. Don’t use much force in tearing off frag-
ments of bone attached to the periosteum.
Don’t use too much extension. Moderate simple extension by weight and pulley
is the best in a majority of cases.
Dress wounds dry, with plenty of absorbents, rather than with water dressings.
Strict antisepsis, according to the modern idea, is impossible in large hospitals on
the battle field.
Feed liberally.
NON-FATAL PENETRATING GUNSHOT WOUNDS OF THE
ABDOMEN TREATED WITHOUT LAPAROTOMY.
*ms
SUR LEs, BLESSURES PROVENANT DE COUPS DE FUSIL NON-FATALES
PENETRANTES DE L’ABDOMEN TRAITEES SANS LAPAROTOMIE.
UEBER NICHT TOEDLICHE PENETRIRENDESCHUSSWUNDEN DES UNTERLEIBES; BEHAND-
LUNG OHINE LAPAROTOMIE,
BY HENRY JANES, M. D.,
Formerly Brevet Lieutenant-Colonel and Surgeon, U. S. Volunteers, Waterbury, Vermont,
In 27 cases the abdomen was penetrated, 18 times with, and 9 times without, lesions
of the abdominal viscera, and in 10 cases in which the Rectum or Bladder was injured
the course of the missile was mainly in the pelvic cavity. Pelvic wounds not implicating
the Rectum or Bladder are not reported.
In none of these 27 non-fatal cases, was it certain that the Small Intestines were per-
forated, though in one case it was possible, as for a time the wound discharged a chyle-
like fluid.
In one case, it is possible that the gut was opened by the sloughing process, as the first
discharge of faeces was on the 13th day.
The injured viscerae were probably the Caecum or Ascending Colon 5 times, the Trans-
verse Colon 3 times, the Descending Colon 6 times, the Rectum 7 times, the Liver 3
times, once in connection with a thoracic wound and once with a wound of the Trans-
verse Colon, and the Bladder 3 times, once in connection with a rectal wound. In 2
cases it is uncertain what part of the intestine was involved, and in 9 cases no intestinal
lesion was noted.
In 5 cases the Artificial Anus closed in the 1st month, 4 in the 2d month, 1 in the
3d month, 1 in the 10th month, 1 in the 11th month, and 2 in the 2d year. In 5 cases
the time of closing is not noted. In 2 cases the Artificial Anus reopened after closing
and in 2 cases it was open at the time of the last reports, 4 and 8 years after injury.
In none of these cases were operations performed, except for the purpose of removing
fragments of bone, the missiles, or other foreign bodies.
NINTH INTERNATIONAL MEDICAL CONGRESS. 19
IMPORTANCE OF INTERNATIONAL REGULATIONS FOR
THE MEDICAL TREATMENT OF PRISONERS OF WAR.
DE LIMPORTANCE DE REGLES INTERNATIONALES POUR LE TRAITE-
MENT MEDICAL DES PRISONNIERS DE GUERRE.
UEBER DIE WICHTIGKEIT INTERNATIONALER BESTIMMUNGEN UEBER AERZTLICHE
BEHANDLUNG. KRANKER, KRIEGSGEFANGENEN.
BY DANIEL SMITH LAMB, M. D.,
. Acting Assistant Surgeon, U. S. Army, Washington, D. C.
The ancient custom was to destroy or enslave them. In the modern view, they are
not ipso facto criminals, to be put to death, harshly treated or robbed of their personal
effects, nor are they property, to be bought and sold or enslaved. They are human
beings, and should be treated as such. They should have such food, clothing, shelter
and occupation as will preserve health. If captured while sick, or if they fall sick
after capture, they should receive such treatment as will tend to promote recovery. If
the captors are unable to afford the proper prophylaxis or treatment, the prisoners, sick
or well, should be paroled and returned to their own side, which also should be bound
to receive them. There should be international regulations specifying the minimum
allowances of food, clothing and shelter for prisoners, and providing for sufficient and
suitable occupation to preserve health, and for the proper treatment of the sick.
It is recommended that this Congress give expression to its views and direct its Secre-
taries to notify governments of the same through the legations at Washington.
IS IT DESIRABLE THAT EACH SOLDIER IN TIME OF WAR
SHOULD PERSONALLY CARRY A. FIRST FIELD DRESSING
FOR A. WOUND IF SO, SHOULD IT FORM PART OF THE
AUTHORIZED EQUIPMENT OF EVERY SOLDIER WHEN
HE PROCEEDS ON ACTIVE SERVICE: OF WHAT MATE-
RIALS SHOULD IT CONSIST, AND WHERE SHOULD THE
SOLDIER CARRY IT 2
EST-IL A DÉSIRER QUE CHAQUE SOLDAT EN CAMPAGNE PORTE SUR LUI
UN PANSEMENT PRELIMINAIRE2 S'IL EN EST AINSI, SERAIT-IL BON
QU’UN PANSEMENT PRELIMINAIRE FASSE PARTIE DE L'EQUIPEMENT
DE CHAQUE SOLDAT EN CAMPAGNE2 EN QUOI CONSISTERACE PANSE-
MENT ET DANS QUELLE PARTIE DE L'EQUIPEMENT SERA-T-IL PORTE 2
IST ES ZU wuBNCHEN, DASS EIN JEDER soldAT IM KRIEGE EINEN ERSTEN NOTHVER-
BAND FUER WUNDEN BEI SICH TRAEGT2 UND WENN, IST ES RATHSAM, DASS EIN
WORLAEUFIGER WUNIDVERBAND EINEN THEIL DER AUSFUESTUNG EINES JEDEN
SOLDATEN BEIM AUSFUECKEN IN'S FELD BILDET2 WORIN SOLL ER BESTEHEN UNID
IN WELCHEM AUSRUESTUNGSSTUECKE SOLL ER GETRAGEN WERDEN ?
BY SURGEON-GENERAL SIR THOMAS LoNGMORE, C. B., R. P., F. R. C. S., ENGLAND,
Professor of Military Surgery, Army Medical School, Netley, England.
The custom of issuing a “First Field Dressing ” to soldiers on active service, so
that no soldier, if wounded, should be without the means of a provisional dressing
being applied to his wound, was originally introduced in the British army by general
order during the Crimean war, in the year 1855, and since that date, dressings of a
similar nature have been issued to the troops on all occasions when British forces have
been employed against enemies in the field. First Field Dressings have also been more
or less used in all Continental armies since that date, and they form at the present
time one item of the authorized field equipment of soldiers of the German army.
The question of the materials most suitable for composing the “First Field Dressing,”
or “Soldier's Packet,” as it is frequently called on the Continent, has been extensively
.
20 ABSTRACTS.
§
discussed, and various forms of the Packet and its contents have been devised and
advocated for use on different occasions by eminent Continental surgeons. -
During the last three or four years, doubts have been expressed in several quarters
regarding the advisability of issuing the “First Field Dressing ” to soldiers, and some
eminent surgeons, as Dr. Roth, General Arzt, of Saxony, and Dr. Gori, Lector on
Military Surgery in the University of Amsterdam, have urged objections against the
distribution of Soldiers’ Packets. Staff-Surgeon Dr. Rochs, of the German army, in
an elaborate article in Langenbeck's Archiv für Klin. Chir. (1885, 32d Bund, 4th Part),
records his opinion that the necessity for “First Field Dressings” is open to discus-
sion; and an eminent French military surgeon, 1st Cl. Médecin-Major E. Delorme,
Professeur Agrégé libre at the Val-de-Grâce, Paris, in a special article “On the Anti-
septic Packet of the Soldier and its Utility,” published in the Archives de Médecime
Militaires (January, 1885), has come to the conclusion, that it is not a thing applica-
ble to a field of battle; while at the sitting of the French Surgical Congress, at Paris,
on the 9th of April, 1885, he declared his conviction, that if it were officially intro-
duced into the French army he would regard it as a useless incumbrance to the
soldier, and the cost of its adoption as a dead loss to the State (“pour le soldat une
surcharge inutile, et son adoption, pour l’Etat, une perte seche '’).
As, however, many surgeons of equal eminence, such as Professor Esmarch, of Kiel,
and others, regard the Soldier's First Field Dressing as a very valuable, and indeed,
essential, article of Field Surgical Equipment, it seems to be very desirable that the
following points regarding these dressings should be fully discussed, and, if possible,
settled for future guidance:—
1. Do the needs, the experience of which led to the introduction of Soldiers' Dress-
ing Packets, no longer exist, or do they still exist 2
2. Are the doubts regarding the expediency of First Field Dressings being carried
by soldiers, which exist in the minds of some surgeons, based on solid grounds?
3. If the preponderating advantages of each soldier carrying a First Field Dressing
in time of war can be established, are there any drawbacks which have been met with
in practice that can be remedied; or are there any improvements that can be effected
in the form or contents of the existing patterns of such dressings 2
I propose to consider these points successively, and will attempt to show—
Firstly. That the same needs still exist which existed at the time it was found desir-
able to introduce Soldiers’ First Field Dressings among the articles of field surgical
equipment. Sample shown.
Secondly. That the circumstances which have led certain Surgeons to discountenance
their continued issue are not based on grounds sufficiently firm to warrant the discon-
tinuance of their issue, and
Thirdly. That while the advantages of each soldier having on his person the means
of applying a first dressing to a wound, far outweigh any disadvantages entailed by
having to carry the packet, there are certain steps, which have not hitherto been taken,
that it is desirable to take, in order to enable the First Field Dressing to be turned to
all the useful account it is capable of being turned to, in the interest of wounded
soldiers.
ON STRETCHERS AND STRETCHER SLINGS.
DES BRANCARDs ET DE LEURs ATTACHès.
IJEBER TRAGBAHREN UNID TRAGBAHR-RIEMEN.
BY JOHN DENIS MACDONALD, M. D., M. R. C. S., ENGLAND,
Inspector General of Hospitals and Fleets.
Three Exhibits, viz. –
1. A new Stretcher leg and roller, so under-hung as to fall automatically into the right
position with Safety, when the stretcher is laid down, and at the same time admit
NINTH INTERNATIONAL MEDICAL CONGRESS. 21
of being folded up beneath the poles when the stretcher is passed into an Ambulance
Wagon.
2. A new stretcher cross-piece, with central hinge, of light construction but of great
proportional strength, and fixing itself automatically when the stretcher poles are
opened out for use.
3. New stretcher Slings, combining the support of the shoulders, loins and hips, and
so more generally distributing the weight; under ordinary circumstances important,
but still more so, when patients have to be carried long distances. These consist of
four essential parts, viz. :—
1. A waist belt.
2. Shoulder straps.
3. Two frogs, with hooks to hold.
4. Two ring-straps attached to the handles of the stretcher.
Several suggestive forms of Frog-hooks and Stretcher ring straps are also ex-
hibited.
ON HOSPITAL AND OTHER HUTS, WITH DESIGNS FOR
TROPICAL AND OTHER SERVICE.
DES ABRIS SANITAIRES, AVEC DESSINS, POUR LE SERVICE AUX TRO-
PIQUES ET AILLEURS.
UEBER HOSPITAL- UND SONSTIGE BARACKEN, NEBST PLAENEN FUER TROPISCHEN UND
SONSTIGEN DIENST.
BY DEPUTY SURGEON-GENERAL JEFFREY A. MARSTON, M.D., M. R.C.S., ENGLAND,
Head of Medical Staff of Sanitary and Statistical Branches, War Office, London.
A few general remarks on Huts and on those commonly used.
The Doecker Felt Hut, which is well known and need not be described.
Improvised Hut Hospitals, shown by Dr. Post at the conference held at Geneva, in
1884.
Description of a form of Hut specially designed for the troops at Suakin, founded on
the results of experience in India and Egypt, and illustrated by plans.
Brief description of the Huts used at Assuan (Egypt). Straw and mud huts. Table
showing the temperature in straw huts, mud huts, and double-fly tents at Abri, in
July, 1885.
Description of Hut designed by Major Marsh, Royal Engineers (with plans), its size,
ventilation, warming, cost, portability, facility of erection and removal, durability.
Some sanitary points to be attended to in Hutting troops.
ON THE TREATMENT OF PENETRATING GUNSHOT WOUNDS
OF THE ABDOMEN.
DU TRAITEMENT DES BLESSUREs PāNÉTRANTES DE LABDOMEN.
|UEBER DIE BEHANDLUNG PENETRIRENDER SCHUSSWUNDEN DES UNTERLEIBES.
BY THOMAS J. MOORE, M. D.,
Of Richmond, Virginia.
When should Laparotomy be performed in gunshot wounds of the Abdomen?
When determined upon, where is the most desirable point for opening the belly 2
When intestine is wounded, or other hollow viscera, what should be the course of
procedure?
The kind of suture most desirable to be used.
How prevent, or lessen surgical shock.
22 ABSTRACTS.
SUPERIORITY OF THE BAVARIAN PLASTER OF PARIS
SPLINTS FOR GUNSHOT AND OTHER FRACTURES OF THE
LIMBS.
SUR LA SUPERIORITÉ DU PANSEMENT A PLATRE BAVAROIs POUR
TOUTES LES, FRACTURES DES MEMBRES, SPECIALEMENT POUR
CELLES CAUSEES PAR LES ARMES A FEU.
s=º.
UEBER DIE VORZüGE DES BAIERISCHEN GYPS-VERBANDES FUER SCHUSS-UND SONSTIGE
FRACTUREN DER EXTREMITAETEN.
BY JAMES H. PEABODY, M. D.,
Formerly Brigade Surgeon, U. S. Volunteers, Omaha, Neb.
1. Experience and Observation of writer during four years' service as Surgeon during
the War of the Rebellion.
2. Instances in which the Spica bandage and other appliances caused gangrene.
3. Brief history of the Splint.
4. Writer's experience in its use.
5. Mode of application.
ON PENETRATING INJURIES OF JOINTS, ESPECIALLY GUN-
SHOT WOUNDS.
IDES PLAIES PćNÉTRANTES DES ARTICULATIONS, SURTOUT DE CELLES
QUI RESULTENT DES ARMES A FEU.
UEBER PENETRIRENDE GELENKVERLETZUNGEN, BESONDERS SCHUSSWUNDEN.
BY GEORGE L. PORTER, M.D.,
Late Brevet Major and Assistant Surgeon, U. S. Army, Bridgeport, Conn.
Paper prepared with special reference to gunshot injuries of large joints. Divided
into—
I. Varieties: 1. Incised,
2. Punctured, | Caused by sword, dirk, bayonet, knife, arrow, frag-
3. Lacerated, ment-shell, large bullet, fragment-bullet, small
4. Contused, | piece of shell, fragment of foreign substance.
5. Comminuted,
II. Frequency: 1. In civil practice, rarely other than accidental.
2. In military practice, (a) difference between modern and ancient fighting,
(b) percentage in the late great wars.
III. Diagnosis: 1. Signs: (a) ocular ; (b) digital ; (c) instrumental.
2. Symptoms: (a) escape of fluid ; (b) impairment of motion; (c) pain ;
(d) inflammation, (1) primary, (2) secondary.
IV. Prognosis: Danger proportionate to this classification, viz.:-
1. Small joints. 2. Intermediate joints. 3. Large joints.
(A) Statistical tables. (B) Sources of danger.
W. Treatment: 1. Adapted to individual injury.
2. Generally, (a) for varieties, (1 and 2) uncomplicated, (1) removal of foreign
substance; (2) asepticism ; (3) rest.
(b) For varieties (3, 4, 5); (1) removal of foreign substances and irritating
fragments; (2) free drainage ; (3) antiphlogistic local treatment.
VI. Illustrative case of gunshot injury to knee joint ; penetration and retention of
ball; laceration of soft and hard tissues; expectant treatment; ice pack;
recovery with perfect use of limb.
NINTH INTERNATIONAL MEDICAL CONGRESS. 23
TYPHUS FEVER IN THE CAMPS, HOSPITALS, AND PRISONS
OF OUR CIVIL WAR.
DUTYPHUS DANS LES CAMPS, LES HOPITAUX ET LES PRISONS PEN-
DANT NOTRE GUERRE CIVILE.
UEBER DEN TYPHUS IN DEN LAEGERN, HOSPITAELERN UND GEFAENGNISSEN UNSERES
BUERGERKRIEGES.
BY CHARLES SMART, M. D.,
Major and Surgeon, U. S. Army, Washington, D.C.
The writer demonstrates the enteric or malarial nature of the cases reported as
typhus from our military camps, and the typhous tendency exhibited by many of
these cases under certain insanitary conditions. He shows that the typhus of our
hospitals was in like manner typhoid or malarial fevers modified by the conditions
which favor the generation of a typhus miasm, and that the rare cases of fully-devel-
oped or true typhus which there occurred, were usually derived from civic, not from
military, contagion. Lastly, he shows typhus fully developed and actively contagious
among prisoners carefully guarded in the interior of a healthful country, which was
itself blockaded on its seaboard and closed in on its landward sides by the lines of
conflicting armies, in which there was no typhus contagion. He claims, therefore, the
generation of typhus under the stated conditions, independent of the contagion of a
previous case.
*====
ON THE BEST RATION FOR THE SOLDIER.
DE LA MEILLEURE RATION MILITAIRE.
UEBER DIE BESTE RATION DES SOLDATEN.
BY JOSEPH R. SMITH, M. D.,
Lieut.-Colonel and Surgeon, U. S. Army.
The paper gives reasons why we are ignorant of the exact or minimum amount of
food necessary to sustain a man in the greatest efficiency.
Gives the amounts of food suggested by various authorities as sufficient, and the
amounts used in various armies.
Discusses the proportions in which different elements should be present in the
food.
Proposes a suitable Ration.
*
ON THE BEST FORM OF REPORT OF SICK AND WOUNDED
OF ARMIES.
DE LA MEILLEURE MANIERE DE DRESSER UN RAPPORT SUR LES
MALADIES ET LES BLESSURES POUR EN FACILITER LA STATISTIQUE.
UEBER DIE BESTE FORM EINES BERICHTES UEBER, KRANKHEITEN UNID VERWUNDUNGEN
WOM STATISTISCHEN STANDPUNKTE BETRACEITET.
BY JOSEPH R. SMITH, M.D.,
Lieut.-Col. and Surgeon, U. S. Army.
Describes the objects of the report in question. Reports of different armies described.
Uniformity desirable. All cases of disease and injury among the troops should be
included. Women and children and non-military not included.
Classification of diseases of different armies given. Preference expressed for the
Prussian Army. A model of a Form presented for adoption in all armies.
24 ABSTRACTS.
Five propositions formulated for adoption by this Section. The 1st stating the ob-
jects of report of S. and M. ; the 2d, frequency and periodicity of same ; the 3d
recommends simplicity and uniformity; the 4th expresses preference for the Prussian
classification of diseases, in the absence of a generally agreed on scientific nosology;
the 5th recommends the model form here presented, and directs the Secretary of the
Section to communicate these opinions to the Medical Bureaux of all nations repre-
sented in the Congress.
*
A SHORT SCHEME FOR WATER ANALYSIS IN THE FIELD,
IN CONNECTION WITH WHICH WILL BE SHOWN A SMALL
PORTABLE CASE FOR RE-AGENTS AND APPARATUS.
D'UN PROCſáDſ, FACILE POUR LANALYSE DE L'EAU EN CAMPAGNE.
EINE KURZE METHODE ZUR UNTERSUCHUNG DES WASSERS IM FELDE.
BY SURGEON-MAJOR FRANCIS PATRICK STAPLES, M.K. Q.C.P., IRELAND,
Medical Staff, Aldershot, England.
1. Water analysis—or examination—in the field is generally regarded as more or
less of an impossibility.
2. Nevertheless there are occasions, such as the selection of camping grounds or
the suspected fouling of the sources of supply of standing camps, when the necessity
for an examination would arise, and when such examination might be demanded by
the Royal Engineer Department or by the general officer in command.
3. The responsible Sanitary medical officer of the army, or division of the army,
would be called upon to give an opinion, and in the absence of any elaborate material
for an exhaustive investigation, the accompanying portable case of re-agents and appa-
ratus has been constructed.
4. The scheme which they are intended to work out, includes a qualitative estima-
tion of organic impurities and of the several compounds into which nitrogenous matter
in water is converted by oxidation ; the quantitative estimation of the alkaline chlo-
rides, and also the quantitative estimation of the “total hardness.”
THE TREATMENT OF PENETRATING WOUNDS OF THE
ABDOMEN, WITH WOUND OF THE INTESTINES.
DU TRAITEMENT DES PLAIES PáNÉTRANTES ABDOMINALES LORSQU”
ELLES SONT COMPLIQUEES DE LESIONS INTESTINALES.
DIE BEHANDLUNG PENETRIRENDER BAUCHWVUNDEN MIT VERLETZUNG DER. EINGEWEIDE,
BY SURGEON-MAJOR FRANCIS PATRICK STAPLES, M.K. Q.C.P., IRELAND,
Medical Staff, Aldershot, England.
The following points will be covered in the paper :-
1. Such wounds are almost invariably fatal—a point which will be illustrated by
available statistics.
2. Fatality due to either acute or sub-acute peritonitis.
3. This pathological condition follows not so much from the wound of intestines
per se as from extravasation of bowel contents and pus into the peritoneum.
4. In the principles upon which the treatment of these wounds is based, this fact
does not seem to the writer to be sufficiently emphasized.
5. The principles of treatment laid down by the British, American and Continental
Writers will then be contrasted, so far as the knowledge of the writer extends.
NINTH INTERNATIONAL MEDICAL CONGRESS. 25
6. The bearing of recent advances in abdominal surgery on the question will be next
alluded to.
7. The conclusion will be put in the form of the following questions, viz.:-
A. Is there a necessity for a new departure in the treatment of these wounds?
B. Presuming that the answer to Question A is a matter of opinion, to be debated,
is it not desirable that a uniform practice for the treatment of these wounds should
be laid down by this great International Congress of medical men ?
*mmemºsºmsºmº
ON THE NECESSITY FOR A MORE CAREFUL EXAMINATION
OF THE WATER SUPPLY OF MILITARY POSTS WHERE
AN UNUSUAL AMOUNT OF SICKNESS PREVAILS, AND
EXAMINATION OF HYGIENIC SURROUNDINGS.
DE LA NáCESSITÉ D'UNE EXAMINATION PLUS PARTICULIERE DE L'EAU,
ET DES CONDITIONS HYGIENIQUES DES POSTES MILITAIRES DONT
L’ÉTAT SANITAIRE EST MAUVAIS.
|UEBER DIE NOTHWENDIGKEIT EINER SORGFAELTIGEREN UNTERSUCHUNG DER WAS-
SER-VERSORGUNG VON TRUPPEN-PLAETZEN, IN WELCHEN EIN UNGEWOEHNLICHER
GRAD VON KRANKHEIT EN HERRSCHT, UND DIE UNTERSUCHUNG DER HYGIENISCHEN
|UMGEBUNGEN.
BY MORSE K. TAYLOR, M. D., MAJOR AND SURGEON, U. S. ARMY,
Of San Antonio, Texas.
The paper shows that very little attention has been given to these subjects, and that,
as a result, a vast amount of sickness has prevailed in the army, which, as it is remedi-
able, is wholly unnecessary ; that malarial and typhoid fevers are largely preventable
diseases, and that where they exist in excess, it is due to inattention or neglect to seek
the cause of them and apply the proper remedies; further, that it has been demon-
strated conclusively, that where efforts have been made to improve the water supply,
the results have been most satisfactory. Statement of many cases in point, and the
ground taken, that where an unusual amount of sickness prevails, it is criminal not to
take efficient measures for its prevention. Some of these measures I shall briefly point
Out.
*me
SOME REMARKS ON THE KIND OF DRESSING MOST AVAIL-
ABLE FOR GUNSHOT FRACTURE OF THE LOWER LIMBS
ON THE FIELD IN CONNECTION WITH TRANSPORTA-
TION.
SUR LE PANSEMENT, QUON DOIT PREFERER POUR LES FRACTURES
DES MEMBRES INFERIEURS PAR LES ARMEs. A FEU, EN EGARD A
LA TRANSPORTATION ULTERIEURE DES BLESSES.
|UEBER DIE ANWENDIBARSTE ART DES VERBANDES FUER SCHUSSWUNDEN DER UNTEREN
EXTREMITAETEN IM WEREIN MIT DEM TRANSPORT.
BY RICHARD FRANCIS TOBIN, M. K. Q. C. P., IRELAND,
Late Assistant Professor Surgery, Army Medical School, Netley, England.
These remarks refer chiefly to fractures of the upper third of the femur and to the
desirability, in treating such cases, of fixing in an immovable position not only the
injured member, but also the opposite limb and the trunk. The appliances that, in
the opinion of the writer, best fulfill these requirements are described.
26 ABSTRACTS,
IS LAPAROTOMY FOR GUNSHOT WOUNDS OF THE INTES-
§i FEASIBLE IN MILITARY PRACTICE AND ITS TECH-
l E 2
LA LAPAROTOMIE POUR BLESSUREs D'ARMES A FEU DANS LES INTEs.
TINS, EST-ELLE A, CONSEILLER DANS LA PRATIQUE MILITAIRE?
MANIERE DE PROCſ. DER.
IST DIE LAPAROTOMIE FUER SCHUSSWUNDEN DER EINGEWEIDE IN DER MILITAIR-
PRAXIS THUNLICH2 IHRE TECHNIK.
BY WM. S. TREMAINE, M. D.,
Major and Surgeon, U. S. Army, Buffalo, N. Y.
1st. The successful results already obtained by Laparotomy and sutures of the in-
testines in perforating gunshot wounds, give hope that the fearful mortality may be
lessened by its adoption in military practice.
2d. It is doubtful if it can be successfully carried out on the battle field.
3d. It probably may be successfully attempted at the Division Hospitals.
4th. The technique should, of course, include antiseptic precautions, which can
only be carried out at the hospitals where the necessary apparatus can be had.
5th. The “let-alone'' or “do-nothing” practice is almost certain to be followed by
death ; therefore, in future wars, Laparotomy should be attempted.
6th. The difficulties of the “technique” in military practice are great, but proba-
bly not insurmountable.
The necessary appliances for the technique are—
1st. A supply of warm water; this involves some form of portable heating stove.
2d. A supply of concentrated and portable antiseptics.
3d. Antiseptic catgut or silk, for suture and ligature.
4th. A large supply of hemostatic forceps. The present operating cases must, in
this respect, be remodeled.
5th. As it is impracticable to properly purify sponges in active military operations,
and as they are a fruitful source of danger unless perfectly aseptic, they should be
abolished in military practice, or, at any rate, never used a second time.
6th. The successful treatment of gunshot wounds, involving the abdomen, will
largely depend upon the absolute exclusion of any possible septic maferial.
PRIMARY DRESSINGS FOR GUNSHOT WOUNDS ON THE
BATTLE FIELD.
LES PREMIERS PANSEMENTS Pour LES BLESSURE DE FUSIL SUR LE
CHAMP DE BATAILLE.
DER, ERSTE NOTHVERBAND FUER SCHUsswundEN AUF DEMſ SCHLACHTFELDE.
*
BY WM. S. TREMAINE, M.D.,
Major and Surgeon, U. S. Army, Buffalo, N. Y.
1st. The life or limb of the soldier will often depend on the character of the “first
dressing.”
2d. This should consist of an antiseptic absorbent pad, with a retaining bandage,
to be carried on the person of the soldier.
3d. The primary dressing should in all cases be dry.
4th. No probing, fingering or attempt to remove bullets should ever be allowed on
the field.
5th. The “field tourniquet” should be abolished, and the elastic bandage substituted.
6th. This (the elastic bandage) should be applied, when necessary to arrest bleeding,
AT and a little above the seat of injury.
7th. The bearers or stretcher parties should carry with them sheets of antiseptic
absorbent materials compressed into portable form, together with light, perforated
metal splints, for the immediate dressing of compound fractures.
NINTH INTERNATIONAL MEDICAL CONGRESS. 27
ON THE ETIOLOGY AND TREATMENT OF HOSPITAL
GANGRENE DURING WAR.
SUR L'ÉTIOLOGIE ET LE TRAITEMENT DE LA POURRITURE D'HOPITAL
DANS LA GUERRE.
UEBER DIE AETIOLOGIE UND BEELANDLUNG DES HOSPITALBRANDES IM KRIEGE.
BY WILLIAM WARIAN, M.D.,
Late Surgeon, U. S. Volunteers, Titusville, Pennsylvania.
I. Symptoms.
II. Etiology.
A. Primarily there must exist a solution of continuity of the cuticle or the soft
tissue generally.
B. Wounds must be in a condition of granulation or suppuration.
C. Direct depressing influences upon the vital forces precede the outset of the
disease.
These may be :—
1. Atmospheric : as
(a) The prevalence of cold, wet weather for one or more days antecedent to the
attack.
(b) Hot, moist weather, with marked electric and barometric disturbances.
2. General : as
Bad food. Imperfect care. Mental depression.
D. Some unknown septic poison communicated through the atmosphere or by
direct conveyance from wound to wound.
III. Nature of the disease.
Hospital Gangrene is a local and not a systemic disease. It develops an auto-genera-
tive contagium, which will spread by atmospheric diffusion or may be conveyed
from patient to patient by the dressers.
IV. Treatment.
Complete destruction of affected tissues is essential to successful treatment.
W. Conclusions.
Aseptic surgery should eliminate Hospital Gangrene from the surgery of the future.
ARE WOUNDS FROM EXPLOSIVE BALLS OF SUCH A CHAR-
ACTER AS TO JUSTIFY INTERNATIONAL LAWS AGAINST
THEIR USE 2
LES BLESSURES DES BALLES EXPLOSIVES, SONT-ELLES TELLES QU’ON
DOIVE EN DEFENDRE D'USAGE PAR DES LOIs INTERNATIONALES.
SIND WUNDEN DURCH PLATZRUGELN DERARTIGER BESCHAFFENHEIT, UM INTERNA-
TIONALE GEZETZE GEGEN DEN GEBRAUCH SOLCHER GESCHOSSE ZU RECHTFERTIGEN.
BY CHARLES W. VOORHEES, M. D.,
Of New Brunswick, N. J.
Explosive balls in warfare are barbarous. Humanity should be observed in warfare.
Result aimed at to place the soldier hors de combat. Can be done in a more humane
manner by less destructive projectiles. With less mutilation of parts and less mor-
tality immediately and consecutively. Explosive balls and explosive substances con-
tained. Explosive ball causes greater shock. Aim in warfare to maim to such a degree
as to unfit the soldier for the present as an active combatant. The discipline of the
infantry arm of the service, is to render the fire effective and maim the antagonist.
Every wounded man takes two effective men to remove him from the field.
This subject appeals to the humanitarians, the Political Economists and the Diplo-
mats of the various civilized nations. The smaller the number killed, the less that
28 ABSTRACTS.
are mutilated, so as to be unable to follow their usual avocations, the less do they become
a burden upon the State. War at times a necessity Financial complications and moral
disasters. Amelioration of its horrors and effects, which are not positive factors ſor its
success. Loss to State of killed or wounded so as to be unable to earn their own sup-
port after retirement from the Service. Effect of dependent classes upon a community
or a nation. Improved ordnance, cannon, torpedoes, shells, etc. The effect of explo-
sive balls and explosive compounds. Success of surgical operations after wounds from
such projectiles. Experiments with explosive balls.
Duty of the Surgeon in this era of the world’s advancement to aid such Govern-
ment agreements as will abolish the use of barbaric projectiles. His duty to endeavor
to bring it prominently before the International Medical Congress.
War not to be courted, but accepted when a necessity. Wars will continue so long
as the world remains. The conical solid ball destructive enough for all ordinary pur-
poses. The use of the explosive ball legitimate upon the common enemy of mankind,
the ferocious denizens of the forest and plain, but not by man upon his fellow-men.
THE PRIMARY TREATMENT OF GUNSHOT WOUNDS.
DU TRAITEMENT DES BLESSUREs D'ARMEs A FEU AUX PREMIERES
PERIODES.
DEBER DIE ERSTE BEHANDLUNG DER SCHUSSW UNDEN.
BY B. A. WATSON, M. D.,
Surgeon to Charity, St. Francis, and Christ Hospitals, Jersey City, N. J.
. The requisite qualifications of a Military Surgeon.
. The selection of the Field Stations.
. The duties required of Military Surgeons at the Field Stations.
. How shall hemorrhage be controlled ? *
. How shall wounds be dressed at the Field Stations in order to preserve complete
asepsis 2
6. How shall fractured bones be kept in apposition ?
7. The various retentive apparatus which may be employed.
:
5
ON THE IMPORTANCE OF THE GOVERNMENT SECURING
AND PRESERVING WITAL STATISTICS IN THE ARMY
AND NAVY, FOR THE BENEFIT OF SUBSEQUENT APPLI-
CANTS FOR PENSIONS.
DE LIMPORTANCE POUR LE GOUVERNEMENT DE COMPILER ET PRÉ-
SERVER LEs STATISTIQUES VITALES DE LARMEE ET DE LA MARINE
POUR SERVIR DES DOCUMENTS RELATIFS AUX DEMANDES SUBSE-
QUENTES DE PENSIONS.
UEBER DIE wrontiGKEIT DER SAMMLUNG UND BEwAHRUNG EINER VITALEN STATISTIK
IN DER LAND- UND SEEMACIIT DURCH DIE REGIERUNG, ZUM BESTEN SPAETERER APPLI-
IRANTEN WON PIENSIONEN.
BY ELI A. WOOD, M. D.,
President Board of Pensions, Pittsburgh, Pa.
The duty of Government toward its soldiers and seamen. Its duty to maintain the
highest efficiency in the service. Its duty toward Science and Art. The cost, trouble
and injustice toward applicants for pensions where no complete and authentic records
are preserved. The Pension Department should be so administered that not only
individual interests are served, but also to protect the Government against wrong.
Also to establish more facts pertaining to the clinical histories of all the disabilities
peculiar to soldiers and seamen ; thus affording greater precision and uniformity in
the Rating of Pensions.
SECTION IV—OBSTETRICS.
OFFICERS.
PRESIDENT: DR. DE LASKIE MILLER, 2011 Prairie Avenue, Chicago, Ill.
g WICE-PRESIDENTS.
Dr. AUVARD, Paris, France. Dr. GEORGE H. KIDD, Dublin, Ireland.
Prof. Dr. GUSTAv BRAUN, Vienna, Austria. Dr. JULEs KIRCH, Rignano, Italy.
Dr. P. BUDIA, Paris, France. Dr. W.M. M. KNAPP, York, Neb.
Dr. LUIGI CASATI, Forli, Italy. Dr. WM. LEISHMAN, Glasgow, Scotland.
Dr. A. CorpEs, Geneva, Switzerland. Dr. DUNCAN C. McCALLUM, Montreal, Canada.
Prof. DomeNICO CHIARA, Florence, Italy. Dr. DOMENICO PERRUzzi, Bologna, Italy.
Dr. J. AMKDE DoDERIs, Paris, France Dr. THOs. R. Powell, Atlanta, Ga.
Prof. ALEX. DUNLAP, M. D., Springfield, Ohio. Dr. DAVID LLOYD Roberts, Manchester, Eng.
Dr. ARTHUR W. EDIs, London, England. Dr. R. L. SIBBETT, Carlisle, Pa.
Dr. EMIL EHRENDORFER, Vienna, Austria. Dr. A. R. SIMPson, Edinburgh, Scotland.
Dr. ALFRED LEWIS GALABIN, London, England. Dr. LAWSON TAIT, F. R. C. S., Birmingham, Eng.
Dr. JNo. GooDMAN, Louisville, Ky. IsAAc E. TAYLOR, New York, N. Y.
Prof. Dr. A. GUSSERow, Berlin, Germany. Dr. J. VEIT, Berlin, Prussia.
Dr. HERMAN M. Jon ES, London, England. Prof. ELIVAN DE WARKER, M.D., Syracuse, N.Y.
SECRETARIES.
Dr. W. W. JAGGARD, Chicago, Ill. | Dr. Jos. KUCHER, New York, N. Y.
Dr. J. WILLIAMS, London, England.
DELEGATE: Prof. Dr. A. CHARPENTIER, Paris, France.
COUNCIL.
Dr. Jno. Bartlett, Chicago, Ill. Dr. A. C. Miller, Cleveland, Ohio.
Dr. L. Ch. Boislinière, St. Louis, Mo. Dr. G. A. Moses, St. Louis, Mo.
Dr. Horatio B. Buck, Springfield, Ill. Dr. Ira E. Oatman, Sacramento, Cal.
Dr. W. S. Caldwell, Freeport, Ill. Dr. Thos. D. Opie, Baltimore, Md.
Dr. S. T. Cleaver, Keokuk, Iowa. Dr. W. W. Potter, Buffalo, N. Y.
Dr. G. B. Dunmire, Philadelphia, Pa. Prof. Park Ritchie, M.D., St. Paul, Minn.
Dr. Wm. Fox, Milwaukee, Wis. Dr. Luke Robinson, San Francisco, Cal.
Dr. Lorenzo S. Fox, Lowell, Mass. Dr. E. P. Sale, Aberdeen, Miss.
Dr. R. Glison, Portland, Oregon. Dr. Wm. Shaw Stewart, Philadelphia, Pa.
Dr. B. E. Hadra, Austin, Texas. Dr. J. Algernon Temple, Toronto, Canada.
Dr. T. B. Harvey, Indianapolis, Ind. Dr. Wm. Varian, Titusville, Pa.
Dr. Homer O. Hitchcock, Kalamazoo, Mich. Dr. Emerson Warner, Worcester, Mass.
Dr. H. D. Holton, Brattleboro’, Vt. Dr. W. H. Wathen, Louisville, Ky.
Dr. H. P. Lowry, Lincoln, Neb. Dr. L. D. Wilson, Wheeling, W. Va.
Dr. Wm. T. Lusk, New York, N. Y. Dr. A. T. Woodward, Brandon, Vt.
Dr. Thos. Menees, Nashville, Tenn.
A STUDY OF DEVENTER'S METHOD OF DELIVERING THE
AFTER-COMING HEAD.
UNE ETUDE DE LA METHODE DE DEVENTER POUR DELIVRER LA TETE
APRES-VENUE.
EINE STUDIE DER DEVENTER'SCHEN METHope DER ENTBINDUNG DES NACHIKOMMEN-
DEN KOPFES.
BY JOHN BARTLETT, M.D.,
Of Chicago, Ill.
The following is a summary of this paper :-
Evidences in the writings of Deventer that he practiced a method of delivering the
after-coming head, which he regarded as easier, and safer for mother and child than
other methods.
29
30 ABSTRACTS.
Inquiry from Deventer's writings as to the nature of his method ; his description
thereof unsatisfactory and defective.
Deventer's method, as described and practiced by Dr. Smellie, showing it to consist
of a reversal of the so-called Prague method, in that the body of the child is carried
backward toward the perineum, with a view of turning the occiput out from under the
pubes; the anterior surface of the neck resting on the perineum.
Mechanism of Deventer's method ; containing a reference to the peculiar decomposi-
tion of the wedge, formed by the head and arms, by the withdrawal of the larger
transverse diameters of the head from between the arms as descent of the head, accom-
panied by extension, occurs.
Advantages of Deventer's method.
Review of the opinions of obstetrical writers regarding Deventer’s practice.
RELATION OF THE MEMBRANES TO THE PROCESS OF PAR-
TURITION.
LA RELATION DES MEMBRANES AVEC LE PROCEDſ, DE LENFANTE-
MENT.
DAS VERHAELTNISS DER MEMBRAN ZUM ENTBINDUNGSPROZEss.
BY HENRY T. BYFORD, M. D.,
Of Chicago, Illinois.
I. Statement of conclusions arrived at in the author's former papers on this subject.
II. Relation of the rupture of the membranes to the commencement of abortion and
labor.
III. Relation of the time of rupture to the character of the labor.
IV. Unreasonableness of placing the normal time of rupture at the end of the first stage
of labor.
V. Origin of the notion that the membranes must rupture at the end of the first
Stage.
VI. Natural advantages of persistence of the membranes in an intact state beyond the
first stage.
A STUDY OF CERTAIN QUESTIONS IN CONNECTION WITH
PUERPERAL FEVER, WITH PARTICULAR REFERENCE TO
THE USE OF INTRA-UTERINE DOUCHE AND THE CU-
RETTE.
ETUDE DE CERTAINES QUESTIONS RELATIVES A LA FIEVRE PUER-
PERALE.
EIN STUDIUM GEWISSER FRAGEN IN VERBINDUNG MIT DEM PUERPERAL FIEBER.
BY PROF. CHARLES WARRINGTON EARLE, M. D.,
Of Chicago, Ill.
First. The great majority of practitioners are not fully in accord with the present ad-
vanced ideas in regard to puerperal fever.
Second. A short résumé of the most important theories respecting puerperal fever.
Third. In a larger number of cases than we suspect, débris, pieces of placenta, decidua,
etc., are left in the uterine cavity, which are, in our present methods of practice,
infected either by the patient, nurse or doctor.
Fourth. The only rational treatment is to remove all decomposing material and prevent
a local poison from invading the entire system and producing general sepsis.
Fifth. Indications and contra-indications.
Sixth. Instruments and operations.
NINTH INTERNATIONAL MEDICAL CONGRESS. 31
CONSERVATIVE OBSTETRICS; WITH SPECIAL REFERENCE
TO THE REMOVAL OF THE SECUNDINES AFTER ABOR-
TION, AND TO THE TREATMENT OF THE THIRD STAGE OF
LABOR.
LEs oRSTÉTRIQUES CONSERVATIFS, AVEC RAPPORT SPECIAL DU DÉ-
PLACEMENT DES SECONDINES APRES L’ABORTION, ETAU TRAITEMENT
DU TROISIłME Pſ. RIODE DES DOULEURS DE L'ENFANTEMENT.
CONSERVATIVE GEBURTSHUELFE, MIT BESONDERER BEZIEHUNG AUF DIE ENTFERNUNG
DER PLACENTA, ETC., NACH DEM ABORTUS, UND ZU DER BEHANDLUNG DES DRITTEN
STADIUM'S DER GEBURT.
BY PROFESSOR RODNEY GLISAN, M. D.,
Of Portland, Oregon.
Dr. Glisan is of opinion that although extreme methods of obstetric practice by
experienced specialists may generally be successful, yet the golden mean in practice
yields on an average the best results.
He thinks that the expectant method of treating retained secundines after abortion,
and of the placenta in labor is unsafe in private practice, especially when the doctor
resides at a distance from his patient ; yet it may succeed fairly well in hospitals under
the constant vigilance of experienced practitioners.
He believes that the heroic method of always removing the Secundines in abortion
immediately after the expulsion of the embryo, and of the placenta immediately after
the birth of the child, is in private practice safer than the do-nothing mode because
there is less danger of hemorrhage and septicemia, yet he prefers a conservative method
to either of the others. For instance, he approves of the immediate removal of the
Secundines after abortion in all cases where the obstetrician finds the cervix uteri some-
what dilated or dilatable, as is generally the case for an hour or so after the expulsion
of the embryo ; and in all cases of septicæmia, or dangerous hemorrhage, no matter
when they occur. When neither of these accidents is present, and the medical adviser
is not summoned in time to avail himself of the dilatation or dilatability of the cervix
uteri he would not advise, as some heroic practitioners do, the immediate and forcible
removal of the secundines. When the cervix assumes a more favorable condition for
the insertion of the finger they should be removed. In the meantime moderate hem-
orrhage may be controlled by the tampon, ergot, etc.
In an active practice of thirty-nine years he has never found any instrument for the
removal of the secundines after abortion so safe, useful and trustworthy, as the finger.
He adopts the bi-manual method of abdominal depression of the uterus with one
hand to within easy reach of the index finger of the other ; and then of inserting the
latter finger far enough into the womb to seize the secundines and remove them.
In cases of excessive sensibility, or great abdominal rigidity, or of undilatability of
the cervix, he administers an anaesthetic—either chloroform, or a combination of it and
ether; except when the patient is anaemic from hemorrhage, when ether alone is used.
In the removal of the placenta during labor the doctor adopts a modified or conserva-
tive Credé method. That is, he advises pressure to be made on the fundus of the womb
in somewhat the manner recommended by Credé, and with his precaution of using
force only during the acme of uterine contractions, but he would use less pressure than
is advised by Credé, and aid it by moderate traction on the cord, to which Credé is
strongly opposed.
Dr. Glisan does not believe that moderate traction on the cord, when the womb is in
a state of good contraction, and is properly grasped by one hand externally, is attended
by the least risk of inversion of the uterus, or of increasing the hemorrhage by a suction-
like process of the placenta on the cavity of the womb.
He is inclined to the opinion that the late experiments by expectant practitioners at
32 ABSTRACTS.
Giessen and Strassburg tend to disprove Spiegelberg and Matthew Duncan's assertion
that the placenta when undisturbed by the manipulations of art always presents by its
edge at the vulva, and that it is inverted so as to present its foetal surface first at the
vulva only when interfered with by traction on the cord. The expectant experiments
seem to prove that when labor is left to nature the foetal surface of the placenta, instead
of its edge, almost always arrives first at the vulva.
The doctor insists, however, that it makes but little difference which party is correct
concerning the manner of the natural expulsion of the placenta, so far as it relates to
moderate traction of the cord when properly executed during the acme of a uterine Con-
traction, and while circular and downward pressure of the superior portion of the uterus
is being made ; because such traction can do no harm, but may render great assistance
in the delivery of the after-birth. He thinks that traction upon the umbilical cord as an
aid to the delivery of the placenta ought not to be abandoned.
LITHIASIS IN PREGNANCY.
LITHIASE DANs LA GROSSESSE.
LITHIASE IN DER SCHWANGERSCHAFT.
• BY J. E. KELLEY, M. D., F. R. C. S., M. R. I. A.,
Of New York.
Being struck by the frequency, during gestation, of many of the arthritic, gastric and
other phenomena which ordinarily are present in lithiasis, Dr. Kelley reviews in detail
the relations existing between the two conditions, and arrives at the conclusion that the
association is due to the correspondence of the condition of the blood in lithiasis and
pregnancy. He first considers the general pathology of lithiasis and subsequently that
of the various systems, mentioning those manifestations which are most frequently ob-
served in each. He then investigates the phenomena of pregnancy, and indicates the
influences which produce in the maternal blood a condition almost identical with that
which is present in lithiasis, and draws a parallel between the diseased conditions most
frequently observed in pregnancy and the symptoms of lithiasis. He dwells upon the
organic lesions which are detected in the circulatory system during pregnancy, or sub-
sequently, and indicates the close relation to those which are developed in lithiasis.
The normal phenomena of gestation predisposes the organs to these lesions by the Con-
servative hypertrophy and the consequent increase of the cardiac action which subjects
the areas of valvular impact and the sites of tension of the chordae tendineae to local in-
flammation which, with the morbid condition of the blood, may induce insufficiency,
stenosis, or the development of vegetations. He suggests the possibility that this con-
dition of blood, and particularly the excessive quantity of fibrin or plasmine which is
present, may afford a clue to the etiology of many of those obscure cases of intra-uterine
disease and deformities as well as of adherent placenta which appear to be dependent
upon inflammatory and plastic changes and Subsequent contraction. He notices an in-
teresting and practical point with regard to the maternal cardiac action which, while
increasing little, if at all, in its maximum rapidity during gestation, does not present the
normal diminution when the sitting or the recumbent posture is assumed, and con-
sequently the total number of pulsations in the twenty-four hours is much greater in
the pregnant than in the non-pregnant female. The relation of pregnancy to the res-
piratory and digestive functions is reviewed, and special attention is directed to the
remarkable association between yellow atrophy of the liver, gestation and lithiasis.
That the jaundice which is seen in pregnancy is not due to pressure upon the liver ducts
is obvious when we consider their protected position; but it may be ascribed with greater
probability to the traction exerted upon them by the displacement of the liver during
the later months. The physiological relations of the urinary organs to pregnancy are
very evident when the exigencies of the foetus and its metabolic activity are remembered.
NINTH INTERNATIONAL MEDICAL CONGRESS. 33
This increased action, associated with the essential hyperaemia of the kidneys, affords
peculiarly suitable conditions for the renal changes which are characteristic of lithiasis,
and it is probable that those “explosive” manifestations such as eclampsia result from
the imposition of the additional burthen entailed by parturition being placed upon
organs which are already inadequate. The conjectural mechanical effects of the gravid
uterus upon the ureters in the abdominal cavity have been refuted by other writers; but
Dr. Kelley reminds us of the close, and possibly the injurious, relations which exist be-
tween them and the cervix in the pelvic cavity where they are in contact, and where,
necessarily, any expansion of the latter would produce tension and consequent obstruc-
tion. It is possible that such an influence may be potent in the later stages, and per-
haps may throw some light upon the interesting exception to the general rule that
increased action is associated with an elevation of temperature, a speculation which is
based upon the diminution of temperature consequent upon the ligation of the ureter
in experiments upon the lower animals. In the nervous system, also, the parallelism is
sustained by the frequency of insomnia, the occurrence of mental exaltation and depres-
sion, as well as by the various sensory and trophic disturbances which are present in
pregnancy and lithiasis. In the skeletal structures mollities ossium is cited as an inter-
esting evidence of the exacting demands of the foetus, while the frequency of arthritic
complications and sequælae, as well as of muscular rheumatism, afford evidence of the
adoption by the system of an arthritic diathesis after the exercise of a seemingly tran-
sitory and foreign influence. The foregoing would suggest the careful supervision of the
condition of the pregnant female, especially with regard to the digestive, circulatory and
urinary systems and, in suitable cases, the intelligent application of prophylaxis.
THE PROGNOSIS OF CAESAREAN SECTION.
LE PRONOSTIQUE DE L'OPERATION CAESARIENNE.
DIE PROGNOSE DEs KAISERSCHNITT's.
BY PROF. WILLIAM T. LUSK, M. D.,
Of New York City.
Earlier statistics. Nature's method of closing the uterine wound. The suture.
Good results obtained from its use, obtained in former times in this country. Sånger's
operation. An examination of fatal cases in which the improved method has been
performed shows that the deaths have been due to preventable causes. Poor results in
this country in recent years. Causes and suggestions.
ON THE PREVENTION AND TFEATMENT OF PUERPERAL
SEPTICAEMIA.
SUR LA PREVENTION ET LE TRAITEMENT DE LA SEPTICAEMIE
PUERPERALE.
UEBER DIE VERHUETUNG UND BEHANDLUNG DER PUERPERALISCHEN SEPTICAEMIA,
BY THOS. MORE MADDEN, M.D., F. R. C. S. ED., ETC.,
Of Dublin, Ireland.
Under this heading the writer includes all forms of septic fever, consequent on parturi-
tion and occurring within the puerpetal period. These, whatever different phases they
may assume, or however named, are in reality manifestations of a specific puerperal
fever, the character of which is modified in each instance by the general condition of the
patient, the intensity of the septic intoxication, and by the prevailing epidemic consti-
tution of the atmosphere. Puerperal septicaemia may originate in three ways, viz.:
from inoculation with the micrococci of clinically allied diseases, such as erysipelas or
3
34 ABSTRACTS.
scarlet fever. Secondly, and more frequently, by infection from the pathognomonic chain-
like micro-organisms evolved by other puerperal fever patients, and thirdly, the disease
may arise from auto-infection with self-generated septic matter. If these views be
admitted, then the utter impossibility of ever permanently and completely stamping ou?
puerperal septicaemia by any of the measures yet suggested for this purpose must be
apparent. More especially Utopian would the realization of this idea appear in the
crowded maternity wards of hospitals, general or special, constantly occupied by lying-
in women, in which septicæmia is liable to develop with a rapidity and virulence that
apparently defies either prevention or treatment.
Although absolute immunity from puerperal fever must, unfortunately, in our present
state of knowledge, be considered as hopeless, unquestionably its prevalence may be
much diminished and its virulence may be minimized by the rigid observance of judi-
cious precautionary antiseptic and hygienic measures, such as many of those formulated
by Dr. Fordyce Barker, of New York, and acted on with marked advantage in the
present practice of the Dublin Lying-in Hospital. The writer of this paper dwells at
some length on the prophylaxis of puerperal septicaemia, and details the plan of treat-
ment which, from long clinical experience of its value in the prevention of septicæmia,
he adopts, and for this purpose strongly recommends the administration of the chlorates
of iron, potash and quinine during the latter months of pregnancy. In this connectiouſ
the all importance of a strict supervision of the functions of the nurse in reference to the
patient’s general and local hygiene and aseptic condition are insisted on and above all.
Dr. More Madden urges the advisability in all cases of the obstetrician himself washing
out the uterine cavity daily with a weak carbolic injection (which he much prefers to
the corrosive sublimate solution) throughout the whole puerperal period, and during
which from the first he invariably gives liquor ergot in large doses, twice or thrice a day,
until the uterus has permanently regained its normal size and condition.
The treatment of puerperal fever must be governed by the special form of the disease
and the condition of the patient in each case. The prevailing type of puerperal fever
has changed repeatedly in the various epidemics of the disease that have come under or
within the writer's clinical experience in hospital and consultation practice during the
past twenty years. At the present time we most frequently meet with a distinctly
remittent form of septemic fever after parturition. And in these cases Dr. More
Madden relies primarily on the maintenance of the patient's strength by suitable nour-
ishment and stimulants. Secondly, on the daily washing out of the uterine cavity
with hot water, plain or medicated. Thirdly, in the way of medicine, on full doses of
quinine and turpentine. The latter he regards as the most valuable of all drugs in
every form of puerperal fever, and believes that it acts not only as a most potent stim-
ulant, and as a depurating agent by its action on the excretory organs, but also pro-
bably directly arrests the development of the micro-organisms which are so intimately
connected with the phenomena of puerperal septicaemia. In all such cases he believes
that turpentine should be given by the mouth or rectum in as large doses and as long
as its use can be persevered with.
gºssºmsº
THE HISTOLOGY AND PATHOLOGY OF REPRODUCTION.
HISTOLOGIE ET PATHOLOGIE DE LA REPRODUCTION.
DIE HISTOLOGIE UND PATHOLOGIE DER REPRODUKTION.
*ms
BY HENRY O. MARCY, A.M., M.D.,
Of Boston, Mass.
The Studies offered in this paper are based upon the conviction that the Profession
owes to the late Professor Ercoloni of Bologna, Italy, the establishment of new and
simple truths, which are fundamental and of the first importance.
NINTH INTERNATIONAL MEDICAL CONGRESS. 35
Comparative Studies of the Placenta teach that there is a Unity of Type in Placental
development.
The author will endeavor to show that immediately after conception a destructive
process affects the inner surface of the Uterus; in Some animals and in women this pro-
cess is limited to the epithelium, while in other animals, as in the rodents, the destruc-
tion extends to the entire submucous connective tissue layer.
This destruction is essential, since it facilitates the setting up of neo-formative changes,
from which will result the maternal portion of the Placenta. This process consists in
the formation of new vessels, which are distinguished from the vessels of the unimpreg-
nated uterus in that both the artery and vein consists of only a simple endothelial wall,
and that from the external surface of this is elaborated a layer of special cells not sepa-
rable from the wall of the vessel. These are the so-called decidual or placental cells.
That the foetal portion of the placenta is neo-formative, no one questions.
The relation established between those two factors of new formation is what is known as
placental development. The manner in which this relation is established gives rise to
the different forms of the mammalian placenta.
The elementary form of these two parts is anatomically a simple villus, maternal as well
as foetal, the one secretory, the other absorbent. The manner in which this relation is
established varies greatly, but the fundamental condition is never lost, the contact be-
tween the vessel of the absorbent villus and the epithelium of the secretory villus remain-
ing Constant.
Only two very simple changes occur in the fundamental parts of the placenta when
single, and they are the factors of the manifold differences met with; first, the loss of the
epithelium of the absorbent villus which is not important, since there is established
direct contact of the vessel of the villus with the secretory epithelium of the maternal
villus, and this fact is constant ; second, the dilatation or ectosia of the vessel in the
maternal villus, and this is remarkable only in the placentae of the quadrumania and in
woman. The belief that these ectosic villi were lacunae so called, really large cavities
as they had the microscopic appearance of being, and not the maternal vessels greatly
dilated, has long been held, as is still taught in most text-books, as indisputable, and it
has been through this belief that two other deceptive appearances were received as actual
truths, namely: that the villi floated in the maternal blood and that the villi covering
them appertains to the foetus instead of the mother.
The nutritive material which is to serve for the growth of the foetus, in all the verte:
brates, is furnished by the mother. In mammals it is supplied by the maternal portion
of the placenta, gradually as foetal growth requires. In the oviparous vertebrates the
material in the quantity necessary to the development, is emitted in a mass from the
mother, in the form of yolk with the egg. In the mammiferous, as in the oviparous,
animals, the absorbent or foetal part of the placenta does not change, and it is by means
of an absorbent villus, more or less complicated, that the material elaborated by the
mother is conveyed to the foetus. There is, therefore, but one law, a physiological
modality, that governs the nutrition of the foetus in all the vertebrates.
Based upon this simple law of anatomical and physiological modality of placental
structure and development, the pathology of the placenta becomes for the first time
comparatively simple and scientific. It will result in the departures from the ana-
tomical normal structure and development as traced in the changes which occur in both
factors of placental formation, the chorial and decidual villi. A brief outline of these
changes as observed in woman will be given, explaining so-called “mole” pregnancy
and hydatids as illustrations of changes which not seldom occur in the foetal villi.
Also changes which occur in the maternal villi, a hyperplastic development of abnormal
cells, and a connective tissue transformation of the villi as may be not seldom observed
as a cause of abortion.
36 ABSTRACTS,
THE NECESSITY OF ACCURATE DIAGNOSIS IN THE WARIOUS
MALFORMATIONS FOUND IN THE PELVIS.
LA NáCESSITÉ DU DIAGNOSTIC EXACT DANS LES DIVERSES IRRAEG-
TJLARITES TROUVES DANS LE PELVIS.
DIE NOTHWENDIGKEIT EINER GENAUEN DIAGNOSE DER WERSCHIEDENEN UNREGEL-
MAESSIGKEITEN, DIE IM PELVIS GEFUNDEN WERDEN
BY WILLIAM S. STEWART, A.M., M.D.,
Of Philadelphia, Pa.
First.—Some thoughts on the causes and necessity of the numerous cases of abdominal
Surgery.
Second.—The importance of careful diagnosis, as exhibited in the history of a rare case
of pregnancy in a retroflexed uterus, going to full term with safe delivery to
mother and child.
TREATMENT OF POSTERIOR OCCIPITAL POSITIONS.
LE TRAITEMENT DES POSITIONS POSTÉRIEURES DE L’OCCIPUT.
BEHANDLUNG DER HINTEREN STELLUNGEN DES OCCIPUT. .
mºmºmº
BY J. ALGERNON TEMPLE, M. D., M. R. C. S., ENGLAND,
Of Toronto, Canada.
The object intended to be brought out in my paper on the above subject is the
manual rectification of such positions, if seen early enough, before engagement of the
head in the brim of the Pelvis has occurred, in preference to allowing it to progress in
the hopes that anterior rotation will take place, and while admitting that this does take
place in a vast majority of cases, yet some few do not rotate, and it is especially with
regard to the benefit of these few that I propose to revive a treatment which in my
hands has proved easy of application and free from risks.
I lay claim to no originality whatever in such treatment.
INTERNAL UTERINE HEMORRHAGE, THE RESULT OF
OVER-DISTENTION OF THE UTERUS FROM HYDRAM-
NIOS.
L'HôMORRHAGIE UTÉRINE INTÉRNE, RESULTAT DUNE DISTENSION
EXCESSIVE DE L’UTERUS PAR, L’HYDRAMNIOS.
INNERE UTERINE BLUTUNG ALS RESULTAT DER UEBERMAESSIGEN AUSDEHNUNG DES
e TUTERUS DURCH HYDRAMNIOS.
*
ºmºsº
BY EDWARD HY. TRENHOLME, M.A., M.D.,
Of Montreal, Canada.
The author points out the serious effects of such distention, resulting in hemorrhage
between the decidua and uterine wall (case cited) in some cases, and the danger to life
from possible rupture of the Fallopian tube, and subsequent embolism. Treatment.
SECTION W-GYNAECOLOGY:
OFFICERS.
PRESIDENT: HENRY O. MARCY, A. M., M. D., LL.D., Boston, Mass.
WICE-PRESIDENTS.
Dr. GEORGE GRANVILLE BANTOCK, F. R. C. S.,
London, England.
Dr. ROBERT BARNES, F. R. C. P., London, Eng-
land.
Dr. NATHAN Bozem AN, Surgeon, Woman's Hos-
pital, etc., New York City, N. Y.
Prof. A. BREISKY, Vienna, Austria.
Dr. A. CordEs, Geneva, Switzerland.
Dr. J. MATTHEWS DUNCAN, LL.D., F. R. S. E.,
London, England.
Prof. HAUBEN, Braxelles, Belgium.
Prof. A. HEGAR, M.D., Freiberg, Switzerland.
Dr. R. HESSE, Dresden, Germany.
Dr. GRAILY HEWITT, F. R. C. P., London, Eng-
land.
Dr. THOMAS KEITH, LL.D., F. R. S. E., Edinburgh,
Scotland.
Dr. GILMAN KIMBALL, Lowell, Mass.
Dr. LEOPOLD LANDAU, Berlin, Germany. .
Prof. G. LEoPold, Dresden, Germany.
Dr. AUGUST MARTIN, Berlin, Germany.
Prof. P. MENIERE, Paris, France.
Prof. PETER MUELLER, Berne, Switzerland.
Prof. SAMUEL PozzI, Paris, France.
Dr. T. A. REAMY, Cincinnati, Ohio.
Dr. H. REIMANN, Kiev, Russia.
Prof. KARL ROKITANSKI, Vienna, Austria.
Dr. M. SANGER, Leipsic, Germany.
Prof. SCHAUTA, Innsbruck.
Dr. HoRATIo R. STORER, Newport, R. I.
LAwson TAIT, ESQ., F. R. C. S., Birmingham,
England.
Dr. A. N. TALLEY, Columbia, S. C.
Dr. T. GAILLARD THoMAs, New York City, N.Y.
J. KNowsley THORNTON, ESQ., F. R. C. S., Lon-
don, England.
Dr. J. WEIT, Berlin, Germany.
SECRETARIES.
Dr. GEORGES APOSTOL1, Paris, France.
Dr. HoRATIO R. BIGELow, Washington, D. C.
Dr. ERNEST W. CUSHING, A. B., Boston, Mass.
Dr. CARL PAWLECK, Vienna, Austria.
COUNCIL.
Nathan Allen, A. M., M.D., LL.D., Lowell, Mass.
Dr. R. Beverly Cole, San Francisco, Cal.
Prof. Emilius C. Dudley, M.D., Chicago, Ill.
Dr. Alexander Dunlap, Springfield, Ohio.
Dr. A. F. Erich, Baltimore, Md.
Dr. George Jackson Fisher, Sing Sing, N. Y.
Dr. Simon Fitch, A. M., Halifax, N. S.
Prof. George F. French, A. M., Minneapolis,
Minn.
Dr. Wm. Gardner, Montreal, Canada.
Prof. Hiram L. Getz, M.D., Marshalltown, Iowa.
Dr. H. C. Ghent, Belton, Texas.
Prof. Seth C. Gordon, Portland, Maine.
Dr. Jas. Graham, Charlotte, N. C.
Dr. J. B. Hunter, New York, N. Y.
Prof. J. Reeves Jackson, A. M., M. D., Chicago, Ill.
Prof. Edward W. Jenks, M. D., Detroit, Mich.
Dr. J. W. Jones, Tarborough, N. C.
Prof. Willis P. King, M.D., Sedalia, Mo.
Dr. L. L. McMurty, Danville, Ky.
Prof. Middleton Michel, M. D., Charleston, S. C.
Prof. Edward E. Montgomery, M. D., Philadel-
phia, Pa.
Thomas More-Madden, M. D., F. R. C. S., Dublin,
Ireland.
Prof. Daniel T. Nelson, A. M., M. D., Chicago, Ill.
Dr. Michael O’Hara, Philadelphia, Pa.
Dr. William W. Potter, Buffalo, N. Y.
Dr. David Prince, Jacksonville, Ill.
Dr. Thomas Savage, Birmingham, England.
Dr. William W. Seymour, Troy, N. Y.
Prof. H. Marion Sims, M. D., New York City, N.Y.
Prof. Alexander J. Stone, M. D., St. Paul, Minn.
Prof. E. H. Trenholme, M. D., Montreal, Canada.
Dr. L. F. Warner, Boston, Mass.
Prof. Stephen H. Weeks, M. D., Portland, Maine.
Dr. William G. Wheeler, Chelsea, Mass.
Dr. F. H. Whittemore, New Haven, Conn.
37
38 - ABSTRACTS.
ON THE RESULT OF SIX YEARS' EXPERIENCE OF THE
OPERATION OF SHORTENING THE ROUND LIGAMENTS OF
THE UTERUS.
EXPERIENCE DE SIX ANS DANS EXERCICE DE L’OPÍRATION DU RAC-
COURSCISSEMENT DES LIGAMENTS CIRCULAIRES POUR LES DEPLACE-
MENTS UTERINS.
DIE ERFAHRUNGEN IN SECHS JAHREN DER AUSUEBUNG DER OPERATION FUER, VERKUER"
ZUNG DER RUNDEN MUTTERBAENDER BEI LAGEWERAENDERUNGEN DES UTERUS.
p
BY DR. W. ALEXANDER,
Of Liverpool, England.
This paper gives in a tabular form and under the “headings” of initials of name,
age, symptoms, date of operation, operative disturbance, anatomical results, therapeu-
tic results; a résumé of all cases upon which the author has performed the above
operation up to the end of April, 1887.
A summary of the tabulated results then follows.
The paper next proceeds to describe what the writer believes to be the best method
of performing the operation, the cases eligible and ineligible for treatment by it, the
causes of failure or of disaster, the effects of the operation upon the ovary and bladder,
and finally its relation to future pregnancies.
CONSERVATIVE GYNAECOLOGY.
GYNſ COLOGIE CONSERVATIVE.
CONSERVATIVE GYNAEKOLOGIE.
BY DR. HORATIO R. BIGELow,
Of Washington, D.C.
. Plan and purpose of this communication.
. The conservation of energy in its relation to conservative medicine.
. What is meant by conservative gynaecology?
. General medicine and its relation to specialism.
. The tendency to operative measures a dangerous one. Experience gained at the
cost of great loss of life. Operations often performed unnecessarily.
6. Conservatism as applied to the treatment of uterine tumors. Recent results from
the use of ergot, and from the electric current. Exceptionally only do myoma
call for laparotomies. The constitutional treatment.
7. Conservatism applied to tubal diseases, and inflammations of the ovary. The
psychic element. The subjective and objective symptoms. Rest treatment,
electricity, massage, Swedish movement, and bathing.
8. The relation of gynaecology to the general environment of the patient. Minor
disorders magnified into undue prominence by social factors in the every-day life of
the woman. The treatment of such cases.
9. A consideration of oophorectomy for hysteria. Nervousness and kindred disorders.
Seldom warranted.
10. The restriction of abdominal surgery to men competent to practice it.
11. Closing remarks.
:
NINTEI INTERNATIONAL MEDICAL CONGRESS. 39
WHEN SHALL WE OPERATE IN TUBAL PREGNANCY }
QUAND DEVONS-NOUS OPáRER DANS LA GROSSESSE TUBALE2
WANN SOLLEN WIR IN TUBEN-SCHWANGERSCHAFTEN OPERIREN ?
BY J. E. BURTEN, M. D., LL.D.,
Of Liverpool, England.
These operations are dangerous to life, perhaps more so than ovariotomies, while the
diseases for which they are recommended and performed are, as a rule, not so ; they are,
therefore, on a different footing from ovariotomy in a vital particular.
The operation is not by any means a striking success therapeutically; many of the
cases operated on are no better for the operation, Some are even worse, while in good
cases it takes at least twelve months for the patient to recover completely from the effects
of it; we hear of “brilliant” cases that have taken two or three years before the “brilliant”
results became manifest. It may fairly be assumed that a large percentage of those
operated on would have got well without operation within such a lengthened time.
When the results are the best that can be claimed, the patient is mutilated for life.
Mutilation without adequate and even ample cause is an offence against conservative
surgery, the glory of which is that it cures without destroying, as well as against the
first canon of medicine—non mocere.
The mutilation entailed by the operation is particularly offensive to sentiments
cherished by all civilized nations, and reduces a woman to the condition of a female
eunuch. Her loss (and her degradation (?)) will certainly be remembered when the
memory of her sufferings will have faded.
The objections to the operation being so grave, it ought to be performed only in
justifiable cases—after (1) prolonged treatment by less heroic (?) and radical measures;
(2) consultation with colleagues; (3) full explanation of the nature of the proposed
operation and its results to the patient herself and her nearest friend (husband, mother
or father).
As regards the operation itself, it is justifiable in—
1. Rapidly-growing or bleeding myomata after other treatment, patiently carried out,
has failed.
2. Pyosalpinx, if life is threatened by repeated attacks of peritomitis.
3. Chronic ovaritis (especially inflammation of the albuginea, when Graafian vesicles
cannot burst through), when the pain is fixed and constant, and months have been spent
in unavailing treatment.
4. Perimetritis, which, although it may not be dangerous to life at the time, may
render the patient a permanent invalid.
5. Cystic degeneration of ovaries, under the same conditions as to pain as in No. 4.
6. Neuroses distinctly of ovarian origin that have withstood years of treatment.
The operation is not justifiable in—
1. Myomata, except as noted.
2. Pyosalpinx, if the disease has become quiescent, if pain and fever have subsided
and the pus has become inspissated.
3. Hydrosalpinx at any time, unless an associated perimetritis demand removal of
the parts. A less radical operation will usually suffice.
4. Perimetritis, unless the disease promises to render the patient a permanent invalid.
5. Ovaritis, except under conditions noted.
6. Cystic degeneration of ovaries, except under conditions noted.
7. Haematocele and haematosalpinx under any conditions. Laparotomy and drain-
age may be called for, but removal of organs never. The same applies to ectopic
gestation.
40 ABSTRACTS.
VASCULAR GROWTHS OF FEMALE MEATUS URINARIUS.
EXCROISSANCE, WASCULAIRES DU CANAL URINAIRE F£MININ.
ERECTILE GEWAECHSE DER WEIBLICHEN HARNROEHRE.
BY AUGUSTUS P. CLARKE, M. D.,
Of Cambridge, Mass.
Vascular growths near the meatus wrimarius are admitted to be the most common
neoplasms of the female wrethra.
They cause much suffering, and both palliative and radical treatment are often
unsatisfactory.
Some authors call them Caruncles; while Gosselin and others employ the name,
polype cillule vasculaire du méat wrimaire, Gosselin differentiates them from common
polypus; the structure being less limited, containing fibrous and muscular tissue; also
from the classic polypus, in the peculiarity of the pedicle.
The growth is irregular, usually, highly injected, and caused by nervelets which
acquire most exalted sensibility. The exquisiteness of this sensibility has led some
authors to suspect a change in the sympathetic fibres, in their relation to the vessels.
Urethral hyperaemia and hypertrophied papillae may be induced by pressure of the
uterus, gravid or displaced, upon a venous plexus or the capillaries of the part.
Basement epithelium covers the growth, and long-continued congestion, no doubt,
causes undue and altered development of the nervous tissue. Some writers assert free
distribution of nerve elements, others have found none whatever; some denying the
fact, attributing the extreme sensitiveness to the nerve supply of the basement mucous
membrane. This view is untenable, for they are often sensitive to the slightest touch,
not affecting the basement membrane. Skene mentions an old lady, a virgin (though
married), so exquisitely sensitive from this cause, that coition was impossible. Even
contact with the clothes caused anal and vaginal spasms. Hart and Barbour (quoted by
Pepper) define these growths as “dilated capillaries in connective tissue,” the whole
being covered with squamous epithelium.
Skene cites one case in which this form was replaced by the columnar sort.
The presence of nerve tissue has long been recognized. Braxton Hicks says that the
suffering depends upon the hypertrophy of the sensitive papillae (Pacinian bodies). In
some growths the vascular element preponderates; in most, the nerve tissue ; in others,
epithelium ; in the most sensitive, the Pacinian bodies are distinct. When removed by
snare or noose, the injection is well shown. The anatomical structure of the Pacinian
corpuscles wherever situated, especially in the perinaeum, glans penis, and bulb and
meatus of the urethra, explains their acute sensibility when hypertrophied and patho-
logically changed ; and accounts for repullulation, after extensible excision. without
thorough cauterization.
Jonathan Huttohinson assigns these growths as a common cause of constitutional dis-
turbance ; in one case, of urethral or urinary paraplegia.
Erichsen attributes them to gonorrhoeal origin in occasional instances. He describes
them as composed of a sort of Spongy erectile tissue, and often accompanied by great
sympathetic irritation. The erectile tissue is said to increase at the menstrual epoch
greatly.
These considerations chiefly affect prognosis. Gosselin cautions us to inquire whether
they are benign ; and whether referable to septic and infectious origin, especially when
prone to suppuration. Sir James Y. Simpson first brought them into prominent notice;
although Sir Charles Clarke seems to have alluded to them fourscore years since. The
tumors described by the latter were reddish in color, raised above the mucous surface,
prone to bleed, and the cause of much dyscrasia.
Their mention by earlier writers is mostly vague and indefinite. Their benignity is
now generally conceded. Repullulation, when occurring, takes place in parts nearest
NINTH INTERNATIONAL MEDICAL CONGRESS. 41
the growth. The disposition to bleed (owing to viability and vascularity), causing
the patient alarm, lest the growth be malignant. The suffering they entail is excrucia-
ting; temporary insanity has been known to result : owing to the coexistence of other
diseases, the real cause of trouble has been occasionally overlooked until the patient
becomes exhausted and wretched. In some reported cases treatment has been directed
to uterus and appendages, vulva, etc., without avail, until after the removal of the
little tumor, when relief was immediate. According to Goodell it is a disease of after-
life and more common in married than single women. They may be single or multiple;
pediculated or sessile. The color varies from raspberry to strawberry. Their size varies
also, some being no larger than a mustard seed, others as big as a cherry. The usual
site is the angle of the meatus, but they often extend into the urethra and so escape
notice. Goodell has seen the rim of the meatus studded with them. According to
Tait, they are attached to the mucous membrane, and, usually, by pedicle. He states,
too, that in women of middle age they are often coincident with vascular degeneration of
that membrane ; having, perhaps, a common origin ; that, histologically, they are
chiefly characterized by abundant loops of capillaries, irregularly dilated, with very
thin walls, and a singular deficiency of cell elements, and fibrous stroma. He has seen
nerve fibres in them. These facts explain many phenomena; and perhaps the growths
progress like vascular degeneration and atrophy of the nymphae ; for their recurrence is
not that of malignancy, but rather an invasion of neighboring districts. This agrees
nearly with Gosselin. Their recurrence is persistent, for Tait mentions a case in which
they were removed at intervals of four or five years for forty years. In support of his
view that they are mere capillary dilatations, due to atrophy of surrounding tissues,
he claims that they are never large. In reference to the nymphae, and their atrophie and
degenerative changes, when associated with vascular growths, he has made elaborate
study, by careful and most exact methods, of a fragment of mucous membrane, and
discovered the pathology of the disease. At the seat of trouble, all textures had been
removed save a few fibres, walls of capillaries thinned and dilated and the epithelial cells,
barely covering them.
Thus he thinks the three chief clinical facts are explained, viz., great pain, abnormal
vascularity and tendency to bleed on touch, and ultimate contraction of surface; in
short, a progressive atrophy of the mucous membrane, the blood vessels and nerves being
the last texture to yield. At the close, nothing remains (pain and redness having dis-
appeared) but a greatly narrowed vestibulum vagina. In two cases he has studied the
disease almost from inception to completion, in perfect recovery, and noted all the
Stages mentioned. The degeneration process often works its own cure.
Treatment varies with circumstances. Ligatures are sometimes effective ; in other
cases excision followed by cauterization. In case of sessile growths caustics, or actual
Cautery, are required. (The galvano-cautery has given way to Paquelin's instrument.)
Carbolic acid solid, in insaturated solution, is useful, but sometimes requires an alkali
to limit its effect. Nitrate of silver is too weak; and nitrate of mercury and potassa
fusa too painful. A red-hot needle, followed by nitric acid, is sometimes an effective
application.
The following cases, of his own, illustrate the treatment:-
I. Mrs. H.; at. 42; physique and constitution good, married ten years, childless ;
first seen August 10th, 1870. Much dysuria, and pelvic and lumbar pain; has suffered
five years; occasional escape of blood at close of micturition ; also discharge from vag-
ina; inconvenience in walking. On examination, an irregular excrescence, the size of
a pea, found at meatus urinarius; highly sensitive ; bleeding freely on slightest touch ;
flat and Sessile; attached to mucous membrane at lower verge of meatus.
Sprayed parts with solution of chlorinated soda, diluted, and removed growth with
portion of mucous membrane on each side; applied fuming nitric acid; subsequently
tannin and glycerine frequently, till October 10th. At that time bad symptoms all gone;
meatus or urethra narrowed ; no subsequent trouble.
42 ABSTRACTS,
II. Mrs. K. ; aet. 60 ; six children; labors normal, except one attack of phlegmasia
dolens; smarting and pain in micturition noticed five years ago; dragging and other
uncomfortable sensations, referred to hip and loins; later, slight discharge of blood
after urinating, which gradually increased. Patient became dejected and impressed
with the idea of cancer. Examination revealed slight retroversion of uterus, with nar-
rowing of vestibulum vaginae from degeneration and atrophic changes in mucous mem-
brane ; vulvar capillaries dilated ; several small patches of mucous membrane injected,
redness disappearing only partially on pressure ; immediately in front of meatus was a
mass of veins and capillaries, flat and firmly held together by strong connective tissue ;
painless and of bluish color. Just within meatus was a sessile growth, acutely sensi-
tive, friable and bleeding on slightest touch.
Patient having a weak heart, contraindicating ether, I first applied fuming nitric acid
to painful growth, sponging adjacent parts with tepid water. The acid was applied
every two to six weeks for eighteen months, since which nearly all bad symptoms have
disappeared. No bleeding now, and excrescence gone. The matted mass of veins and
capillaries, in point of growth, is not very sensibly diminished, but neither.gives nor
threatens appreciable inconvenience.
III. Mrs. G.; aet. 50 ; five children; suffering dates from May, 1880; first, dysuria.
Disturbed frequently at night; “bearing-down pain in bladder”; heat and burning of
vulva; slight leucorrhoeal discharge; urine tinged slightly with blood. She gradually
became more restless and nervous; and, when first called, in July, I found her suffering
exquisite pain, with other constitutional symptoms. Vaginal examination showed
uterus and appendages in fair condition, but just within meatus urinarius a vascular
growth, cherry size, red, extremely sensitive, and raised above mucous surface. This
was partially pediculated and could be raised from the membrane. It was friable, and
bled profusely when touched with forceps. Next day, under ether and antiseptics, the
growth was removed with Scissors, the mucous membrane on either side being included
in the excision. The wound was seared by galvano-cautery.
Cicatrization speedy and complete, the patient considering herself both relieved and
cured. But, after five months, great sensitiveness returned to the adjacent parts. Sev-
eral enlarged papillae appeared ; these were removed and their bases touched with strong
nitric acid. This gave only slight relief, and enormous doses of morphia and other seda-
tives were required to overcome the nervous disturbance. The severe irritation now
seemed to be centred in the nerve fibres and Pacinian bodies in and about the meatus.
Suffering was, at length, so great that I was often sent for to remove other growths
which the patient supposed herself to have discovered. The sensitive papillae were
removed with scissors curved in the flat, and their bases touched with carbolic or nitric
acid. Finally, the mind became unbalanced and could not be restored for several months.
Indeed, before complete recovery, the patient died of an intercurrent disease. The
mucous membrane of vestibule and nymphae had undergone gradual degeneration and
atrophy. I have seen another case presenting similar mental conditions, in which another
surgeon had operated for urethral caruncle. In this, too, a long period of constitutional
disturbance preceded recovery.
Iv. Miss B. ; aet. 36; unmarried; of nervous temperament; health delicate for
several years; catamenia established at thirteen years; quite regular afterward. During
summer of 1881 experienced pain in micturition and uncomfortable feelings in pelvic
area. Consulted a female physician, who attributed sufferings to uterine displacement,
and treated her accordingly. Gradually grew worse and suffered impairment of the
power of locomotion. The latter symptom, too, was referred to perverted uterine con-
ditions. Pain and other symptoms became aggravated, and total helplessness resulted.
Naturally amiable, she grew excitable and showed symptoms of insanity. When first
seen, June, 1883, helpless and emaciated; having been, for most part, confined to room
and bed for several months; had had some cough, and that morning profuse ha-mop-
tysis. Some râles, but no marked dullness, nor. history of phthisical heredity. She
NINTH INTERNATIONAL MEDICAL CONGRESS. 43
Tallied at length, and examination revealed some uterine anteverism, but not enough
to account for condition. Complained of dysuria and extreme urethral hyperaesthesia.
The whole vulva was hyperaesthetic, and pressure of clothes produced severe pain.
Microscopic examination of urine showed blood and epithelium, undoubtedly urethral.
Exploration of urethra by means of speculum and Ellenger's dilator, under anaesthetics,
revealed a urethral neoplasm, flat at the anterior aspect of canal, but less sessile
beyond. When lifted from the mucous membrane it seemed about the size of a straw-
berry, red and friable. Both growth and mucous membrane, on either side, were dis-
Sected away, and parts thoroughly cauterized with Paquelin's instrument. Much hem-
orrhage ensued, but was controlled by tampon in vagina. Cicatrization followed, dys-
kinesia disappeared, and recovery was complete. No relapse has occurred and the ante-
version gives no trouble.
Recently I have used muriate of cocaine in these cases (4%), with happy temporary
effect. This has enabled removal by scissors without other anaesthetic, and hemorrhage
Was easily controlled—no pain being complained of during or subsequent to operation.
Of course, a general anaesthetic cannot be dispensed with in any but exceptional cases.
TRAITEMENT MEDICAL DU CANCER UTÉRIN.
THE MEDICAL TREATMENT OF UTERINE CANCER.
DIE MEDIZINISCHE BEHANDLUNG DES GEBAERMUTTERKREBSEs.
*sº
PAR LE DR. A. CORDES,
De Geneva, Switz.
Considération Générale : Traitement chirurgical et médical. Hippocrate, Celse. Ob-
Scurité des symptomes du début. Impossibilité de l’hystérectomie dans certaines cas:
adherence, extesion aux autres orga. Statistiques. Topiques. Traitement de la pe-
riode avancée du cancer partérébéne, propriétés de ce produit, son application, sa pré-
paration, par M. Bétrix, assistant à la Clinique, Conclusion.
A BRIEF SKETCH OF THE EARLY HISTORY OF GYNAE-
* COLOGY.
UN RESUMſ. DE L'HISTOIRE PRIMITIVE DE GYNáCOLOGIE.
EIN KURZER ABRISS DER FRUEHZEITIGEN GESCHICHTE DER GYNAEKOLOGIE.
BY GEORGE JACKSON FISHER, M. D.,
Of Sing Sing, N. Y.
In this paper is given the earliest traces of special study and treatment of diseases
peculiar to women, with an account of the old gynaecologists; their methods and their
works are briefly reviewed down to the commencement of the past half century.
IMPROVED MODES OF INTRA-UTERINE EXAMINATIONS
AND THEATMENT.
MODES PERFECTIONN£S D'ExAMENS ET DE TRAITEMENT INTRA-
UTERIN.
VERBESSERTE METHODEN FUER INTRA-UTERINE UNTERSUCHUNG UND BEHANDLUNG.
BY SIMON FITCH, A. M., M.D., EDIN.,
Of Halifax, Nova Scotia.
1. The position of the patient.
2. The gynaecological table.
3. The uterine sound.
44 ABSTRACTS.
4. Intra-uterine forceps.
5. A gauge for intra-uterine instruments, visible in the speculum and easily felt in
digital manipulations, indicating the exact distance to which any instrument is
introduced.
DEFECTIVE SEXUAL POWER AND SEXUAL ABNORMALL-
TIES AS SOURCES OF UTERINE DISEASE.
IMPOTENCE SEXUELLE ET ANORMALITÉs COMME SOURCES DE LA
MALADIE UTERINE.
MANGELHAFTER GESCHLECHTSTRIEB UND SEXUELLE ABNORMITAETEN ALS QUELLEN
VON GEBAERMUTTERLEIDEN.
BY GEORGE F. FRENCH, A.M., M.D.,
Of Minneapolis, Minn.
Is the sexual relation exclusively a procreative function?
A priori and a posteriori conclusions.
The effect on the circulation of interrupted sexual orgasm, congestion, inflamma-
tion, hyperaesthesia, recovery.
Cases.
Conclusions.
TUMORS OF THE BREAST TREATED BY ELECTROLYSIS.
TRAITEMENT ELECTROLYTIQUE DES TUMEURS DE LA MAMMAIR.E.
gººd
GESCHWUELSTE DER BRUST DURCH ELEKTROLYSE BEHANDELT.
BY ALFRED C. GARRATT, M. D.,
Of Boston, Mass.
Many or most of the tumors that so frequently occur in the human breast we find can
be completely cured, if treated while young, or new, that is, while in their first stage of
existence, by certain mild applications of electricity.
In the first place, then, in order to obtain uniform success by this method of treat-
ment, we must plan to find these tumors soon after they first form in the breast—while
they are in the curable stage, in a large majority of cases. To this end we must bring
about an entirely new impression among women generally, so as to break up their habit
of hiding the breast tumor. They should know that all tumors of the breast are not at
first necessarily malignant or fatal. They must know and feel the exceeding great
danger there is in putting off from their family physician the knowledge of the very first
appearance or existence of any sort of lump in the female breast, even for one month,
a week, or a day. Also they should learn that they may expect, in the majority of
cases, to be completely cured, not by surgery, nor yet in experiment, but by the
regular physician or surgeon, without ether, pain or blood, with gentle and safe means,
which has never been known to drive the disease to any other part of the system ; that
here, surgery is to be reserved for only the few malignant, older or otherwise incurable
tumors of the breast.
However, we already know we cannot assume that every morbid lump that grows or
appears in the human breast begins from the first a purely simple or non-malignant
tumor, though the most of them seem to do so, judging from the very uniformly suc-
cessful results of these treatments by electricity when applied to the selected new or
Tecent twmor.
NINTH INTERNATIONAL MEDICAL CONGRESS. 45
It is determined that here we must choose the form of electricity and the method of
its application as carefully as we seek to find the curable cases; for we are not to resort
to the usual electro-puncture needles, knife or wire, nor to any active destructive elec-
trolysis, nor other means that produce solution of continuity. . We are to employ simply
Surface applications of certain graduated galvanic steady currents, through peculiar,
large, soft and moist electrodes, so adjusted close to each side of the tumor as to cause
this gentle chemical current to completely permeate and wash through and through the
whole mass from side to side in its deeper parts, mainly in directing toward the axilla
for about a half hour at each séance. It is not enough to simply apply these two elec-
trodes to the surface of the breast anywhere or in any manner. Moreover, we need to
use a milliampère metre to measure the current that actually passes through the tumor and
gland; also a key-board that can enable the operator to pick up and increase the current,
Cell by cell, to the tolerant and efficient strength, which will be from ten to fifty milli-
ampères. The current required for each individual case cannot be stated in precise
terms, as it is found in practice that there is a wide difference in the resistance, tolerance
and effect in different persons; yet this point is of very great importance (and is to be
explained).
The result is, that out of 186 tumors treated since 1864, a record of them having been
kept and looked after, 157 disappeared and have remained well. Several others, how-
ever, did not quite obliterate, but left a small nodule, size of a chestnut, but which in
every case disappeared, or have remained benign. Two of these have been removed by
the Scalpel, because these two ladies were worried by their presence. The larger nodule
was removed by Dr. H. O. Marcy, of this city, the other by Dr. Charles Homans. No
recurrence of any of these ever appeared, so far as could be ascertained.
HINTS ON THE CAUSES, PREVENTION AND TREATMENT OF
CHRONIC METRITIS.
CAUSES, PREVENTION, ET TRAITEMENT DE LA METRITE CHRONIQUE.
WINKE UEBER DIE URSACHEN, VERHINDERUNG UND BEHANDLUNG DER CHRONISCHEN
METRITIS.
BY H. LANDIS GETZ, M. D.,
Of Des Moines, Iowa.
Causes: child-bearing, injuries during child-birth, getting up after delivery, expo-
Sure of body, displacements, interference with circulation.
Prevention: early marriage to be avoided, longer intervals in child-bearing, various
precautions to be observed by the obstetrician during labor, when to get up, the early
correction of uterine displacements, etc., etc.
Treatment: leeching, douching, puncturing, treatment of erosions or ulcerations,
reducing displacements, rest, exercise, etc., etc.
RELATIONS BETWEEN CHANGES IN THE TISSUES AND
CHANGES IN THE SHAPE OF THE UTERUS.
RAPPORTS ENTRE LES CHANGEMENTS DEs TISSUS ET LES MODIFICA-
TIONS DE FORME DE L’UTERUS.
DAS VERHAELTNISS ZWISCHEN VERAENDERUNGEN IN DEN GEWEBEN UND VERAENDE-
RUNGEN IN DER GESTALT DES UTERUS.
BY PROF. GRAILY HEWITT,
Of London, Eng.
In order to determine more precisely the true relation subsisting between changes in
the tissues of the uterus and changes in its form and shape, concerning which wide dif-
46 ABSTRACTS.
ferences of opinion prevail, it is evident that the initial stage of these changes offer the
most advantageous field for inquiry.
In describing tissue changes in the uterus the term “chronic metritis” is generally
employed. The author wishes particularly to direct attention to a tissue change some-
times observed on or soon after arrival of puberty, particularly in young women who
have been inadequately nourished, and consisting in undue softness of the uterine
tissues, sometimes in very marked degree, and associated in them with commencement
of uterine suffering. This undue softness is not “inflammatory '' in nature. It is
associated with great flexibility of the uterus and generally with marked flexion. The
author first described it ten years ago, and has repeatedly observed it since. It has
been noticed by other observers, and recently by Dr. Charles D. Scudder, under the
term “mollities uteri.”
The recognition of the liability to occurrences of this initial change in the uterime
tissues is to be regarded as very important in the explanation of the origin and increase
in degree of flexions of the uterus. For the uterus being in such cases abnormally
flexible, the flexion may be easily and gradually intensified by ordinary exertion, but
will be likely to be much exaggerated and perpetuated by any severe and suddenly
acting mechanical disturbance. The process by which the uterus becomes permanently
flexed may thus be slow or rapid. The influence of particular occupation or traumatic
disturbances in producing or accentuating uterine flexions and displacements is thus
more readily appreciated.
Hardening of the uterus occurs sooner or later. After hardening the flexion is per-
sistent.
In some few cases, with or without undue softness being present, flexion may be per-
sistence of a congenital condition, or be due to absence of developmental growth at the
time of puberty.
The foregoing remarks apply to multiparae. But in multiparae a somewhat analo-
gous condition is present, in what is known as “defective uterine involution,” the
uterime tissues being soft and wanting in resistance. As is generally admitted, slow
flexions not unfrequently originate at such times and under such circumstances.
Two typical cases of soft uterus are described.
The foregoing observations refer to a condition of the tissues which cannot be properly
described as chronic metritis, but which may, and probably does, frequently precede
chronic metritis.
Jacobi's valuable investigations on “endometritis” are next referred to, particularly
the relation supposed by Jacobi to exist between congestion of the uterus and chronic
metritis. The author considers Jacobi's description of chronic uterine congestion as a
result of defective “menstrual involution,” and the analogy between this and “puer-
peral sub-involution” as very truthful. So also the idea entertained by Jacobi that a
general feebleness and wanting of force in the blood current is greatly responsible for
the occurrence of this menstrual sub-involution. While recognizing, as Jacobi
expressly does, the disturbing effects of dislocations and deformities of the uterus in
relation to its primitive morbid processes, this author does not appear, however, to
appreciate the influence of changes in tissues as leading to change of shape, nor the
influence of traumatic disturbances in causing the latter.
The author contends that the interference with the circulation present in uterine con-
gestion is, in most cases, and chiefly, due to association of a weak blood current and
mechanical compression of uterine tissue due to flexions present in such cases. The
uterus being unduly soft, and being thus unduly plastic and mouldable, takes a flexed
shape, which in many cases becomes perpetuated by the hardening process result of
the chronic metritis described fully and microscopically by Jacobi. One consequence
of the latter is the presence of sclerosis of the uterine parenchyma, which, it is note-
worthy to mention, is described by Jacobi, in an interesting case, related as being
present in the tissues at the flexed part of the uterus. It is to be remarked that the
NINTH INTERNATIONAL MEDICAL CONGRESS. 47
incidents of some of the cases related by Jacobi favor the view that the flexion and dis-
placement were operative in producing the menstrual sub-involution rather than the
cervical catarrh, which Jacobi assigns as the principal cause.
As regards endometritis, the author considers the condition so described as more gen-
erally due to congestive hypertrophy of the uterine lining, and to retained irritating
secretion, and that, excluding gonorrhoeal and syphilitic cases, the endometritis is sec-
ondary rather than primary.
As regards congestion, the author states that he has observed acute congestion of the
uterus, and marked fungous endometrical hypertrophy, clearly associated with acute
ante-flexion, in certain cases, the congestion of the walls and of the interior of the uterus
rapidly disappearing on reduction of the displacement. He also points out the fre-
quency with which congestive hypertrophy of the os uteri is met with in long-standing
acute flexions.
The atrophy of the uterine walls, sometimes observed at the seat of the flexion, is
mostly the result of long-standing compression of the unduly softened tissues, as the
situation in question. The atrophy so produced perpetuates the flexion.
ON IMPORTANT POINT CONNECTED WITH ABDOMINAL
SURGERY.
UN POINT IMPORTANT RELATIF A LA CHIRURGIE ABDOMINALE.
EIN WICHTIGER PUNKT IN DER ABDOMINAL-CHIRURGIE.
BY ADDINELL HEWSON, A. M., M.D.,
Of Philadelphia, Pa.
The condition of the cicatrix following sooner or later laparotomy.
Refers particularly to the remarkable stretching following the operation.
Professes to dispense with stitching, and depends on the prolonged use of support
by gauze instead of Sticking plaster.
IMPORTANCE OF THE NEURAL_MECHANISM IN ITS RELA-
TION TO THE STUDY OF PELVIC DISEASE.
SUR LIMPORTANCE DU SYSTEMENERVEUX DANs SA RELATION A
L’ÉTUDE DE LA MALADIE PELVIENNE.
TJEBER DIE WICHTIGKEIT DES NERVENsystems IN SEINER BEZIEHUNG ZU DEM STU-
DIUM DER, KRANKHEITEN IM BECKEN.
BY C. H. HUGHES, M. D.,
Of St. Louis, Mo.
1. The neural mechanism is so generally distributed over the organism, that it can
seldom be ignored in the study of any disease.
2. The ganglionic system is intimately associated with the functions of the pelvic vis-
cera, and so closely related to the ganglionic chain that connects with the organs of the
other great visceral cavities, that the study of pelvic disease must, of necessity, involve
a survey of much more than the pelvic organ, or organs, appārently specially involved
in disease.
3. The relationship of the ganglionic system to the cerebro-Spinal axis and to the vas-
cular supply of the pelvis makes the neural factor often a most significant one to the
proper comprehension of pelvic disease ; and, finally,
4. The relation of vascular supply to pain, and of neural hyperaesthesia to vascular
conditions, ovarian, cerebral, and spinal, and to disturbed function, without grave distinc-
tive organic disease, (as in ovarialgia, spinalgia, cephalalgia, cardialgia, etc.), and the
recognized metastatic character of the ganglionic hyperalgesias, contribute to the neural
elements in gynaecic disease as interesting and important a factor in the sphere of the
gynaecological practitioner as they are in that of the neurologist. sº
48 ABSTRACTS.
MODERN TREATMENT OF UTERINE CANCER
TRAITEMENT MODERNE DU CANCER UTÉRIN.
DIE HEUTIGE BEHANDLUNG DES GEBAERMUTTERKREBSEs.
*
BY A. REEVES JACKSON, A. M., M.D.,
Of Chicago, Illinois.
Correct views of pathology and accurate diagnosis form the only rational grounds
for proper treatment of disease. The modern treatment of cancer is based upon
the theory of its local origin, and implies the possibility of complete removal. If
this theory be true, failure to cure must depend upon the essential inadequacy
of the means used or their untimely or inefficient employment. All remedial
means are inadequate which have not the power to remove the diseased structures.
The object of treatment may be palliative or radical, the determination depend-
ing upon the location and extent of the disease, and the general condition of the
patient. Palliative treatment is always available in greater or lesser degree, while
radical measures are not always safely applicable. Medical agents taken inter-
mally may be beneficial as palliatives, but are useless, so far as we know, in re-
moving or modifying the progress of the disease. For the latter purposes we can rely
only upon topical treatment. Topical means comprise various astringent, detergent
and anodyne agents as palliatives; and for the partial or complete removal of the
disease, caustics, the cautery (thermo-galvanic), Scraping, gouging and cutting instru-
ments. Results which have been obtained by the use of these agents, singly and
variously combined. Reasons why operative measures so frequently fail. The ques-
tion of hysterectomy. Statistics of the operation and their fallacies. Has it been
beneficial 2
Conclusions :—
1. Any operation for cancer which does not completely remove the disease will be
followed by recurrence.
2. During life, the limit of cancerous disease originating in any part of the uterus can-
not be known ; hence, no operative procedure can afford a guarantee of complete removal.
3. In view of this fact, no operation is justifiable which greatly endangers life, pro-
vided other and safer methods of treatment are available.
4. Vaginal hysterectomy is more dangerous, in a certain sense, than the disease
against which it has been used; that is, a given number of patients afflicted with
uterine cancer will live longer without the operation than with it.
5. Other methods of treatment attended by not more than one-sixth to one-fourth the
mortality of vaginal hysterectomy, are equally efficient in ameliorating the symptoms
and.retarding the progress of the disease; and they have been followed, apparently, by
as good results as regards recurrence. Hence, they should be preferred.
6. Vaginal hysterectomy does not avert or lessen suffering; it destroys, and does not
save, life. It is, therefore, not a useful but an injurious operation, and being such, it
is unjustifiable.
UTERINE DISPLACEMENTS CORRECTED BY MODIFICATIONS
OF THE ALEXANDER OPERATION, WITH THE REPORT
OF TWENTY CASES.
DÉPLACEMENTS UTÉRINS CORRIGES PAR LES MODIFICATIONS DE
L’OPERATION-ALEXANDRINE AWEC LE RAPPORT DE WINGT CAS.
BERICHT UEBER ZWANZIG FAELLE WON KAISERSCHNITT NEBST BEOBACHTUNGEN UND
|BESULTATEN.
BY J. H. KELLOGG, M. D.,
Of Battle Creek, Mich.
1. A brief report of 20 cases of Alexander's Operation, including Procidentia, Retro-
.version and Anteversion.
NINTH INTERNATIONAL MEDICAL CONGRESS. 49
2. Observations of a number of interesting anatomical peculiarities.
3. Proof of the adaptability of the operation to the relief of Anteversion.
4. A new view respecting the Etiology of Retroversion.
5. An Improvement in the mode of operating.
My paper will briefly discuss each of the above points, and will not occupy more
than ten minutes in reading.
ON THE CAUSES AND THEATMENT OF BARRENNESS.
CAUSEs ET TRAITEMENT DE LA STÉRILITÉ.
UEBER URSACHEN UND BEMANDLUNG DER STERILITAET.
BY THOS. MORE-MADDEN, M. D., F. R. C. S., E.D., ETC.
MR. PRESIDENT :-In response to the courteous invitation of your Honorary Secre-
tary, I venture to submit to the judgment of the International Medical Congress, at its
meeting in Washington, the capital of the land in which modern gynaecology may be
said to have originated, and in which it certainly has attained its highest development,
some observations on the etiology and treatment of infecundity. I may premise that
these remarks are based on a clinical experience extending over a period of Some twenty
years in hospital and private gynaecological practice. And I would add, that they are
now brought forward mainly because it seems to me the duty of every physician who
has enjoyed any extensive opportunities of acquiring experience to thus contribute his
mite, of however little value this may be, toward the advancement of whatever branch
he may have specially pursued of the great Science of medicine.
Few gynaecological questions come so constantly before us, and none probably are of
greater practical importance than those connected with sterility, involving, as these do,
not merely the physical health of our patients, but also, in many instances, intimately
affecting the happiness and welfare of married life. For, at least in the country wherein
my practice lies, child-bearing is, still generally, and as I believe rightly, held to be one
of the chief functions of a woman’s conjugal life ; while to be sterile is commonly
regarded as the Protean source of marital troubles.
In this paper will be found, in tabular form, a statement of the causes of sterility in
five hundred and twenty-eight of the cases of infecundity occurring in married women,
within the child-bearing period of life, that have come under observation in the gynaeco-
logical department of my hospital. The cases may be roughly divided into two classes,
viz.: 1stly. Those in which barrenness was occasioned by sexual impotency or some
physical impediment in the passages from the vulval orifice to the ovaria. 2dly. Cases of
true sterility, or conceptive incapacity from deficiency congenital or acquired, structu-
ral disease, arrested developments, supra-involution, etc., of the uterus or from
analogous morbid conditions of its appendages. 3dly. Cases of barrenness from con-
stitutional causes. And 4thly. Cases in which the causes of infecundity were appa-
rently moral rather than physical, such as sexual incongruity, etc.
According to the table referred to, the most frequent of these causes of sterility is
stenosis of the cervical canal. And, as I believe that the operative treatment of such
cases, simple as it is deemed by some, requires more consideration than it generally re-
ceives, and frequently proves worse than useless from the disregard of certain details
and precautions which I consider essential, I now venture to recommend the adoption
of a method of procedure and the use of instruments which I have found advantageous
in the curative treatment of stenosis in three hundred and eighty cases of obstructive dys-
menorrhoea and sterility traceable to this cause. During the present session seventy cases
have been treated in my hospital, and in most of these I have had the able assistance of
my friend, Dr. Duke, Obstetric Physician to Stevens Hospital, Dublin.
The essential features of the method of treatment now referred to are the separation by
cutting and simultaneous forcible expansion of the affected parts, followed by dilatation
4
50 º ABSTRACTS.
during the period of cicatrization, so as to prevent their subsequent contraction, and
thus to secure the permanent patency of the erst occluded passage. To obtain this
result I employ three instruments, namely: a special form of uterine director, which can,
generally speaking, be introduced into any cervical canal, however narrow, and along
which a serrated, triangular-guarded knife is made to travel up through the os internum ;
and, thirdly, a uterine dilator of great power, by which any required degree of cervical
expansion may be effectually Secured and accurately gauged. These instruments are fully
described and depicted in my paper.
The influence of uterine flexions in the prevention of pregnancy and the treatment I
adopt in cases of sterility dependent thereon are next described. So also is the man-
agement of aphoria when it results, as is frequently the case, from chronic endo-metri-
tis. In like manner, the methods we have found most serviceable in cases of infecundity
due to other commonly met with causes, vaginal, uterine and ovarian, are briefly
reviewed. More fully dwelt on is the subject of conceptive incapacity from morbid con-
ditions of the Fallopian tubes, as I regard stenosis, as well as occlusion of these ducts
by vaginitis and its results, such as hydro- and pyo-salpinx, as far more common causes
of sterility than is generally recognized. Moreover, I also hold that such tubal diseases
may, in many instances, be efficiently dealt with without resort to the serious operative
procedures, i.e., the removal of the uterine appendages, which, by some surgeons, are
considered invariably necessary, and are by them so freely employed in such cases.
Therefore, I have referred at some length to those less heroic alternative measures, such
as aspiration and catheterization of the Fallopian tubes, the feasibility and the success-
ful results of which, in appropriate cases of this kind, I have demonstrated clinically.
Finally, the question of sterility, arising, as I believe it not unfrequently does, from
constitutional disorders, and as in some instances even apparently irrespectively of any
physical cause, and the method of dealing with such cases, is also discussed in the paper
of which this is an abstract.
SOME POINTS IN THE PATHOLOGY AND TREATMENT OF
LACERATIONS OF THE CERVIX UTERI. ©
TRAITEMENT DES LACERATIONS DU COL DE L'UTÉRUS.
DIE PATHOLOGIE UND BEHANDLUNG DER CERVICALRISSE.
BY THOS. MORE MADDEN, M.D., F. R. C. S., ED.,
Of Dublin, Ireland.
Elsewhere, and more especially in America, the pathology and treatment of lacera:
tions of the neck of the uterus have received an amount of consideration which, were
it to be measured by the comparatively scanty attention as yet accorded to this subject
by British gynaecologists, would appear exaggerated. Thus, when a few sessions ago I
read a paper on Dr. Emmet's operation at the closing meeting of the Dublin Obstetrical
Society, the very name of that operation, or the circumstances callingr fo trachelorraphy,
had never been previously alluded to in the transactions of the premier association of
British obstetricians and gynaecologists, nor to the present day has this topic obtained
anything like sufficient notice in these countries.
In neither American nor English medical literature have I found any adequate recog-
nition of the frequent occurrence of pure and immediate complications arising from
cervical lacerations in obstetric practice, namely, the causation of one of the most
troublesome forms of post-partum hemorrhage ; and, secondly, the occasional occurrence
of puerperal septicaemia as the direct result of lacerations of the cervix uteri. More-
over, as far as I am aware, the advantages of amputation of the mutilated and hypertro-
phied cervix, in many instances of extensive stellate and bilateral lacerations, over
trachelorraphy are not generally recognized. It is obvious that the obstetric conse-
quences of cervical lacerations are not such as should be materially affected by the
NINTH INTERNATIONAL MEDICAL CONGRESS. 51
different racial and climatic conditions existent on the opposite shores of the Atlantic,
and that any method of treatment found useful in such cases in Dublin or London
should, caeteris paribus, have a like effect in similar instances in Boston or New York.
I therefore may venture in the communication, of which this is an abstract, to submit
my clinical experience on these points to the judgment of the Ninth International
Medical Congress, and more especially to my American medical brethren therein, as to
them it is that we who practice in the narrower limits, and perhaps more conservative
atmosphere, of the old country, are mainly indebted for our present acquaintance with
this and most other departments of modern gynaecology.
We may here refer, firstly, to the increasing frequency of cervical lacerations ob-
servable in recent traction, and to the causes assignable for this. Secondly, I must allude
in some detail to those special obstetric or parturient and puerperal troubles which I
have frequently found in my own pratice to be consequent on these lesions. And,
thirdly, while fully admitting the advantages of Dr. Emmet's operation in all appro-
priate cases, I still venture to point out that in certain cases where the cervix has
been extensively lacerated, and has subsequently been the seat of long-standing,
chronic, congestive hypertrophy, any attempt at trachelorraphy will generally be found
useless. In such cases I have never thought it advisable to repeat Emmet's oper-
ations, being convinced, by my own clinical experience, which is now tolerably large,
that it is far better and more rational practice under those circumstances, if any oper-
ative treatment be really required, to resort to the amputation of the entire extent of
the mutilated and diseased cervix by either écraseur or galvano—cautery. It need
hardly be said that I don’t advise this operation indiscriminately; indeed, I think that
the majority of cases of cervical laceration require no special operative treatment
whatever, and certainly an operation such as the removal of the cervix is not to be
undertaken without due caution and, above all, real necessity. When thus justified,
however, the amputation of the cervix, despite the protestations of some eminent
gynaecologists, by whom it is reprobated, is unquestionably as legitimate as any oper-
ation in gynaecological surgery. By this procedure, when successful, not only may the
surgeon rapidly and effectually remove every trace of a morbid condition which, if
uncured, would probably entail a life of continual uterine discomfort, but he may also,
and with certainty, prevent the otherwise not unlikely possibility of the lacerated and
hypertrophied parts becoming the seat of malignant disease at a future period.
HISTOLOGY AND SURGICAL TREATMENT OF UTERINE
MYOMA. ILLUSTRATED BY PHOTO-MICROGRAPHS PRO-
JECTED UPON THE SCREEN.
-*
HISTOLOGIE ET TRAITEMENT CHIRURGIQUE DES UNGOME UTERIN.
-**
HISTOLOGIE UND CHIRURGISCHE BEHANDLUNG DER. UTERUSMYOME.
BY HENRY O. MARCY, M. D.,
Of Boston, Mass.
It has been the attempt of the author to demonstrate more clearly the origin and
development of myoma, especially in their relation to the surrounding uterine tissue
and the changes which are produced therein. It is believed this demonstration holds
a practical bearing on the subject of surgical treatment.
Hysterectomy is carefully considered; especially recommended is the author's method
of the use of “rubber down" with constriction at the base of the tumor by the elastic
ligature. This effectually shuts off the peritoneal cavity, and allows the operation to
be effected under irrigation. The stump is sewed through with tendon suture by a
double sewing-machine or shoemaker's stitch, by the use of a strong needle, fixed in a
52 ABSTRACTS.
handle, with the eye near the point. The divided peritoneum is carefully adjusted by
a continuous animal suture, and the pedicle is returned to the pelvis. The abdominal
wound is closed, and where drainage is deemed advisable it is effected through the
Vagina. e
The advantages claimed are:—
1st. An aseptic operation and wound.
2d. Very little loss of blood and security from subsequent hemorrhage.
3d. A pedicle safe from infection.
4th. The subsequent condition of the pelvic organs far better than by fixation of
stump to abdominal wall.
mº-ºsmºs
A METHOD OF TREATMENT OF FIBROID TUMC).RS OF THE
UTERUS BY STRONG CURRENTS OF ELECTRICITY
BASED UPON EXACT DOSES.
UNE MÉTHODE DE TRAITEMENT DESTUMEURS FIBROIDſ. DE L'UTÉRUs
PAR DES COURRANTS FORTS D’ELECTRICITE EN DOSES EXACTES.
EINE METHODE ZUR BEHANDLUNG DER. UTERUS-FIBROIDE DURCH STARKE ELEK-
TRISCHE STROEME IN GENAUEN GABEN.
BY DR. FRANKLIN H. MARTIN,
Of Chicago, Ill.
Conclusions reached as to the effects of electricity,in the treatment of uterine fibroids.
1. Local effects of the Poles, their explanation. Reason why density rather than
amount of current is required, with results of experiments.
2. Atrophic effect of the Currents, explained on the theory of destruction of trophic
IlêTVeS.
3. Electrolytic Action, explanation and effects of
4. Antineuralgic Effect.
Explanation of the treatment by peculiar electrodes and exact dosage. Description
of the electrode and mode of Application. Variations of Operation. Positive and
negative intra-uterine galvanism. Modus Operandi and effects of each. Ad-
vantages of the Method.
*
*-
ELECTRO-THERAPEUTIQUE DES TUMEURS FIBREUSES DE
L’UTÉRUS.
ELECTRO–THERAPEUTICS OF FIBROMA OF THE UTERUS.
DIE ELECTRO-THERAPIE DES UTERUS-FIBROME.
mº-
PAR LE DR. P. MENIERE,
De Paris, France.
De tous les traitements médicaux préconisés jusqu'à ce jour pour les tumeurs
fibreuses de l’utérus l’Electricité sous ses différentes formes a Seule donné des résultats
appréciables. ſ
Mais, chaque électro-thérapeute a vanté sa méthode et l’a mise en pratique à l’exclu-
sion des autres. Pour l'un c'est le courant faradique, pour l'autre le courant continu,
plus récemment ce sont les courants galvaniques discontinus, puis la galvano-caustique
intra-utérine et enfin l'acupuncture galvanique abdominale qui ont été successivement
conseillés.
J’ai tour à tour mis en pratique toutes 'ces méthodes et j'estime actuellement que
chacune d’elles a ses indications spéciales et ce Sont ces indications que j'ai étudiées et
que je me propose de développer dans cette communication.
NINTEI INTERNATIONAL MEDICAL CONGRESS. 53
J'utilise tel moyen, de préférence à tel autre suivant le diagnostic anatomique et to-
pographique du corps fibreux à traiter, et cela d'après la classification suivante:
1. Fibrômes interstitiels sous-séreux.
(A) Les fibrômes dans lesquels prédomine le tissu conjonctif se reconnaissent à leur
consistance, ils sont très durs, se développent lentement et occupent de préférence le
voisinage du fond de l'utérus et particulièrement la partie moyenne des parois anté-
rieure ou postérieure. Peu volumineux ils devront être réduits par la galvano-caustique
intra-utérine négative 3 séances par semaine de 10 à 15 minutes chaque; courants de 40
à 100 milliampères.
Très volumineux, multilobes et occupant la plus grande partie de la cavité abdomi-
nale, acupuncture électrolytique à l'aide d'aiguilles en or implantés à travers la paroi-
abdominale les 2 pôles dans la tumeur ce qui permet de donner au courant une inten-
sité de 100 à 200 milliampères sans anesthésie.
(B) Les fibrômes dans lesquels prédomine l'élément musculaire (fibro-myomes) sont
plus mous que les précédents, ils se développent plus rapidement et occupent les faces
antérieure ou postérieure de l'utérus. On les traitera par les courants galvaniques
discontinus à la seconde, 3 séances par semaine de 15 minutes chaque, intensité 10 à 15
milliampères seulement. Tous les trois mois interrompre le traitement pendant
quinze jours.
Excessivement volumineux acupuncture électrolytique abdominale comme ci-dessus :
(C) Les fibrômes dans lesquels prédomine l'élément vasculaire et probablement nerveux
(fibrômes, élangiectasiques) sont rénitents, très douloureux, se développent très rapide-
ment et ont pour siège les parois latérales et les cornes de l'utérus.
Je les ai toujours guéris très vite à l'aide de la galvanisation labile, méthode dont je
préciserai la formule. Séances de 10 minutes, quotidiennes et faibles 5 à 12 milliam-
pères. Excitateur vaginal et roulé ou promené sur le ventre.
2. Fibrômes interstitiels sous-muqeux.
Proéminents dans la cavité utérine ils se distinguent facilement des précédents par
les écoulements muqueux et muco-sanguinolents abondants auxquels ils donnent
naissance.
Je les traite par la Galvano-caustique intra-utérine double employant simultanément
les deux pôles représentés par deux électrodes de platine introduits simultanément
dans la cavité utérine. Courants de haute intensité 2 fois par semaine, séances aussi
longues que les malades peuvent les supporter.
3. Fibrômes interstitiels non proéminents ou Utärus fibreux.
Cette variété mal connue qui sert de trait d'union entre le corps fibreux et la métrite
hypertrophique à laquelle il ressemble d'ailleurs histologiquement (Virchow) exige la
galvano-caustique positive intra-utérine alternée avec les courants continus excessive-
ment faibles ; alterner les deux méthodes, tous les 2 mois.
J'ai laissé de côté dans ce travail les tumeurs fibreuses du col de l'utérus et la thé-
Tapeutique chirurgicale. Je ne veux pas non plus passer en revue tous les médica-
ments vantés en pareil cas et dont aucun ne donne des succès reéls.
J'ai eu trop de succès avec l'électricité pour recommander aujourd'hui d'autres mé-
thodes, cependant il peut y avoir lieu de conseiller une thérapeutique accessoire contre
les douleurs, les pertes muqueuses, les meno ou métrorrhagies.
Règle générale : le traitement ne sera pas interrompu plus de 6 jours à l'époque
des règles, et dans le cas d'hemorrhagie persistante ou recommencer le traitement par
de fortes faradisations, des courants galvaniques discontinus, ou cautérisations positives
intra-utérines, moyens qui agissent particulièrement comme hémostatiques.
L'expérience de ces méthodes et des indications électro-thérapiques ci-dessus re-
pose sur près de 300 observations recueillies tant à ma clinique que dans ma clientèle
particuliere.
54 ABSTRACTS.
CONTRIBUTIONS TO THE PATHOLOGY OF INFLAMMATION
OF THE LINING MEMBRANE OF THE UTERUS (ENDO-
METRITIS CORPORIS CHR).
ENDo-MáTRITE CHRONIQUE, PATHOLOGIE DE LA MUQUEUSE UTÉRINE.
ENDOMETRITIS CHRONICA. DIE PATHoLOGIE DER. MUCOSA UTERI.
BY LEOPOLD MEYER, M.D.,
Of Copenhagen, Denmark.
1. (a) In cases of chronic endometritis we, as a rule, find two varieties of cells, or
rather of nuclei (as the limits of each single cell frequently are not distinct), in the
inter-glandular tissue. The one variety has smaller nuclei; these are in average as
large or a little larger than red blood corpuscles, are stained brightly by Haematoxylin,
Carmine, Bismarck-Brown, and only rarely the substance of the nucleus presents a
granular condition.
The second variety has the greatest resemblance to the so-called decidua cell.
The nucleus is large, of an oval shape, and is proportionally feebly stained by the
named methods, as only the few granules which are regularly found in the nucleus are
stained brightly, the other part of the substance of the nucleus not staining much
more than the protoplasm of the cell itself.
(b) This second variety of cells is not only to be found in cases where the woman has
been pregnant. They can be found even in the most developed form, scarcely to be
distinguished from a regular decidua cell in women whose virginity is unquestionable.
(c) This second variety of cells seems, as well as the first variety, to be derived from
the cells normally found in the inter-glandular tissue of the lining membrane of the
uterus, the decidua-like variety owing their peculiar character to the irritative pro-
cesses going on in the tissue being the seat of chronic inflammation. The probability
of this derivation is so much greater, as we find a successive transformation from the
first variety into the second, and as we can find cells of the second variety in the
normal lining membrane during menstruation.
(d) Besides these two varieties of cells, we may find regular connective-tissue cells
and white blood corpuscles in the inter-glandular tissue.
2. In cases of chronic endometritis the epithelium covering the lining membrane of
the uterus can preserve its character of a low columnar epithelium ; but frequently it
changes character altogether. Besides the change into a plaster epithelium, described by
Zeller (psoriasis uterina), but which the author of this paper has never observed, may
be mentioned the change into an epithelium with very high and very thin cells, and as
the most remarkable change, the one by which the epithelium takes an altogether villous
character, this feature being made still more prominent by the circumstance that the
sub-epithelial layer of the lining membrane changes its even surface into an uneven,
nearly papillomatous one.
*=====
STUDIES OF THE ENDOMETRIUM.
D£VELOPPEMENT GLANDULAIRE INTRA-UTÉRIN.
STUDIEN UEBER DAs ENDOMETRIUM.
BY SAMUEL N. NELSON, A. M., M. D.,
Of Boston, Mass.
The object of this contribution is to present to the Congress the results of the studies
of a long series of specimens of the endometrium which have been removed at different
intervals after the cessation of the menses. The scrapings as removed by the curette
were saved, hardened, and prepared for section cutting. These sections have been
studied by the microscope, and the results are now presented. The micro-photographs
and stereopticon views exhibited show the actual appearances as no drawing can do,
however accurate an interpretation it may be.
NINTH INTERNATIONAL MEDICAL CONGRESS. 55
TJTERO-OVARIAN INSANITY.
FOLIE UTÉRO-OVAIRE.
DER UTERO-OVARIAL DES waRNSINN.
BY J. W. NEWLIN, M. D.,
Of Nashville, Tenn.
States that many women are now languishing in public and private asylums who
might be readily cured by removing the original cause.
Insists that an expert Gynaecologist should be attached to all public institutions of
this character. &
sºmºrºssºmsºmºmºs
THE USE OF THE WAGINAL TAMPON IN PELVIC INFLAM-
MATION.
USAGE DU TAMPON VAGINAL DANs L'INFLAMMATION DU BASSIN.
DER GEBRAUCH DEs VAGINALTAMPONs BET ENTZUENDUNGEN IM BOCKEN.
BY w. W. Potter, M. D.,
Of Buffalo, N. Y.
A married woman, 22 years old, came under the author's care about a year ago with a pre-
vious history of abortion, which happened eight months before, from which time her in-
validism dated. Upon his first examination, early in June, he found great tenderness of
the intra-pelvic organs and tissues, with partial fixation of the womb. The left tube
was enlarged, and presented a banana-shaped mass to the touch, while the surrounding
cellular tissue was more or less hard and tense. This finally grew soft, and late in
August pus was discharged through the uterus, after which the tube diminished in size.
There was relief from pain, and the general health improved. This improvement was
continuous until October, when the tube again grew tender and swollen ; but another
discharge of pus, also per vias naturales, soon brought relief again. From this time
onward the gain was regular without interruption, and she was dismissed cured April
1st, 1887.
The treatment consisted in the systematic and regular tamponnement of the vagina
twice a week, copious vaginal lavements of hot water, frequently administered and con-
stitutional measures consisting principally of iron and arsenic. The vagina was insuf-
flated just prior to each packing with iodoform, bismuth, mineral earth, or other powder,
and then small pledgets of cotton, wool, or jute were introduced in sufficient numbers
to make gentle, firm, and even pressure, as well as afford comfortable support. Though
there was much of detail not necessary to elaborate, these, he said, were the essentials
of the management, and their continuous employment for a period of nine months
brought recovery.
Reference is made to the advancement made of late in the differentiation of
pelvic diseases of women, whereby the domain of gynaecological therapeutics had been
So enlarged that it was no longer possible to group all the ailments of woman under the
inexact and misleading heads, “Ulceration,” “Prolapsus” and “Inflammation.” One
of the important consequences, he said, of the more accurate differentiation and classifi-
cation of pelvic disease, had been to invite surgical aid and interference in regions
which had been previously considered unsafe for the knife, and for maladies which had
before been regarded as incurable. The road to fame was so direct through the open
gateway of a brilliant abdominal section, that it was just possible some ambitious men
had removed an innocent ovary or an unoffending tube now and then in their zeal to
obtain a “record ” as spayers of women. He would not disparage the work of Battey,
Tait, Hegar, Goodell and others in this field, for he believed it had been of great and
inestimable worth, nor would he deny that excision was often necessary ; but, on the
other hand, he thought the appendages might often be saved by timely and judicious
56 ABSTRACTS.
management. The case reported, one of a number which he had seen of a similar
nature, was sufficiently typical to illustrate his purpose, and from which the following
deductions might fairly be drawn —
1. That many cases of disease of the uterine appendages might be arrested in their
progress and diverted to successful issue without operation by appropriate treat-
ment resorted to in their earliest stages.
2. That the early employment of regular, prolonged, and systematic vaginal tam-
ponnement afforded one of the safest, surest, and simplest ways of preventing the
ravages, in whole or in part, of the maladies in question, and of averting than
mutilation of the sexuality of women consequent upon excision.
VAGINAL TAMIPONNEMENT.
This occasion presents to him the opportunity of offering some remarks upon the
employment of vaginal tamponnement in the treatment of pelvic disease in general,
a subject which was again creeping into medical literature through society discussions
and papers. Some years ago he had published a paper, read before the Medical
Society of the State of New York, in which he discussed the use of the tampon with
reference to displacement of the pelvic viscera. Now, however, with the added experi-
ence of years and cases, he desired to not only reaffirm his former statements,
but in these remarks to extend the principles then advocated, to the treatment of
inflammatory conditions of the pelvic viscera and tissues whenever they can be made
applicable thereto.
In order to obtain the full benefits of this treatment in pelvic inflammations, or for
any other conditions in which it might be employed, it was, he affirmed, of the first
importance that the packing should be well done; that it should be so placed as to
afford ample support, give secure rest to the parts, make firm pressure, and not become
dislodged during its wearing ; while, at the same time, it must not produce discomfort,
interfere with the functions of the pelvic organs, nor cause irritation in the least degree.
In giving instructions as to its use, he states the tampon must be multiple, and not be
made up of a single wad or mass, as was too often done. He then gives some hints in
regard to the construction of the tampon, which he thought important, since much of
failure or discredit to the method came from faulty construction or ineffectual placing.
He next spoke of the “dry treatment ’’ of Dr. Engelmann, which he commended,
and thought it was a valuable addition to our resources. He had been particularly
pleased with bismuth, and considered it one of the best of the powders for insufflation
of the vagina previous to the tamponnement.
The posture of the patient during tamponnement he considers a very important
question. Taking it all in all, he thought the knee-chest posture came nearer the ideal
for this work than any other. The semi-prone or Sims' position became some cases,
but the dorsal decubitus was almost worse than useless, because in it the tampon could
not be crowded up behind the uterus, or any other tender organ, with sufficient firm-
ness to make it either useful or retentive.
For the past ten years he has made systematic use of the knee-chest posture in the
reduction of pelvic visceral displacements, and of the multiple tampon in connection
therewith, while latterly he had also employed them in the treatment of pelvic inflam-
mations, the whole comprising many hundred cases. As a result of this experience he
had reached the following conclusions :—
1. In retro-deviations of the uterus the reposition of the organ should be made in
the genu-pectoral posture without the aid of any other repositor than the finger; it
should then be shored up and held in place by the multiple tampon. This treatment
should always precede the employment of the pessary (when one was needed) for
a longer or shorter period, according to the peculiarities of each particular case.
2. The foregoing applies with equally cogent force to inflammations and prolapses of
the ovaries whenever these principles can be suitably adjusted to such cases.
NINTH INTERNATIONAL MEDICAL CONGRESS. 57
3. In abrasions, erosions, and ulcerations of the os; in the hyperplastic womb ; in
subinvolution, in cystocele, in rectocele, and in all conditions of disturbed or
impaired nutrition of the pelvic organs, it affords a most efficient form of prepara-
tory or curative treatment, tending to give the organs rest, restore their tone,
deplete engorgement, remove blood stasis, improve locomotive power, and arrest
retrograde tendencies in general.
4. In pelvic inflammations, whether of cellular, peritoneal, tubal, or other origin or
involvement, it will often change their current or arrest their progress, prevent
suppuration or abridge its ravages, and thus frequently guide to a successful issue
without the necessity of a final appeal to a formidable, and perhaps dangerous,
operation.
ASEPTIC ATMOSPHERIC CONDITIONS AS APPLIED TO
ABDOMINAL SURGERY.
CONDITIONS ATMOSPHÉRIQUES ASEPTIQUES COMME APPLIQUEES A LA
CHIRURGIE ABDOMINALE.
EIN ASEPTISCHER ATMOSPHAERISCHER ZUSTAND AUF DIE ABDOMINAL-CHIRURGIE
ANGEWANDT.
BY DAVID PRINCE, M.D., Q
Of Jacksonville, Ill.
The sterilization of air by straining it through cotton, warming it by gas jets, and
moistening it by steam.
The plan is illustrated by a diagram.
Observations as to what passes through the cotton besides air.
Similar observations, for comparison, upon outdoor air and upon the air of an unheated
TOOIſle
This is to be a short paper, containing only original matter.
THE INTRA-UTERINE STEM (PESSARY) AS AN EMMENA-
GOGUE.
LE PESSAIRE INTRA-UTÉRIN COMME UN EMMENAGOGUE.
DAS INTRAUTERIN-PESSARIUM ALS EMMENAGOGUM.
BY C. R. REED, M.D.,
Of Middleport, Ohio.
The position taken in the paper is, that cases frequently occur of amenorrhoea and
Scanty menstruation, in young women especially, from torpor of the uterus and ovaries,
where the general health seems good, and in which general treatment has failed to
restore the function. In these cases the stem may be of great advantage, and if per-
sisted in will rarely fail to restore the lost or suspended function. That its judicious
use is perfectly safe, and more free from the objections urged to other forms of local
treatment.
58 ABSTRACTS.
ON THE OPERATION OF SHORTENING THE ROUND LIGA-
MENTS. |
RÉSULTATs £LOIGN£s DE LOPERATION_DU RACCOURCISSEMENT DES
LIGAMENTS CIRCULAIRES POUR LES DEPLACEMENTS DE L’UTERUS.
DIE FERNEN FOLGEN DER OPERATION ZUR, WERKUERZUNG DER, RUNDEN MUTTER-
BAENDER BEI LAGEVERAENDERUNGEN DES UTERUS,
BY WILLIAM L. REID, M.D.,
Of Liverpool, England.
A comparatively new operation, and one chiefly intended for the relief or cure of
cases otherwise incurable.
In one class of cases reckoned suitable for the operation, namely, aggregated prolapse,
the relief is immediate, but the question of permanency remains. In the other class,
namely, retroversions and retroflexions, the immediate relief is not usually marked, but
the remote results may be good and well worth the risk and trouble incident to the
operation.
The chief difficulty in arriving at a conclusion in the latter class of cases, is the
fact that the displacement is but one of a number of coexisting diseased conditions.
The word “remote ” in the title means a year old at least. The remote results of
cases operated on by the author, and by those who have favored him with details.
Opinions of certain individuals who have observed results, but who have not given
details. 0
Author's survey of the general results and opinions, in view of continuing, modify-
ing, or condemning the operation.
Eºmº
ON SOME POINTS IN CONNECTION WITH CYSTITIS IN
WOMEN.
CYSTITE CHEZ LES FEMIMES.
KYSTITIS BE FRAUEN.
BY M. D. SPANTON, M. D.,
Of Hanley, England. *.
The author describes some local conditions which lead to cystitis in women, among
which are enumerated diseased states of the uterine appendages, bands of adhesions
dragging upon the bladder, and some of the affections causing obstruction to the pas-
sage of the urethra, which are often obscure or trivial in themselves, and not unfre-
quently overlooked. *
THE EXTIRPATION OF THE UTERUS FOR BLEEDING
MYOMA.
ExTIRPATION DE L'UTÉRUs POUR MYOME SAIGNANT,
gºssº
DIE EXSTIRPATION DES UTERUS FUER BLUTENDE MYOME.
BY E. H. TRENHOLME, M.D.,
Montreal, Canada.
The author contends that the operation is indicated in all cases not amenable to other
treatment. He discusses the methods of dealing with the stump, and that the forma-
tion of a pedicle for clamping, or pocketing, is always possible. He also mentions
some points connected with abdominal section, and the toilet of the peritoneum.
NINTH INTERNATIONAL MEDICAL CONGRESS. 59
DISPLACEMENTS OF THE UTERUS.
DÉPLACEMENT DE L'UTÉRUS.
LAGEVERAENDERUNGEN DES UTERUS.
BY W. C. WADE, M.D.,
Holly, Mich.
Displacements of the uterus are more common than generally supposed, because phy-
sical exploration for diagnostic purposes is infrequent.
The affection is very prevalent among young women who have been given insuffi-
cient attention by the profession. Whether per 8e or by influencing adjacent struc-
tures, the displacements of the uterus are capable of rendering, and almost invariably
do render, the patient very uncomfortable, and frequently a confirmed invalid. The
treatment by mechanical means, that is almost universally in vogue, if any treatment
is recommended, is uniformly unsuccessful. The propositions of this paper are based
upon an experience in the construction, by the writer, of over two thousand uterine
supporters by measurement for his own cases. This clinical work is believed to be
unique. The method must be regarded as theoretically correct. The writer desires to
confirm the theory by the results of his practice.
PREGNANCY COMPLICATED WITH UTERINE FIBROIDS.
GROSSESSE COMPLIQUEE DE FIBROIDEs UTÉRINEs.
SCHWANGERSCHAFT I)URCH UTERUSFIBROIDE COMPLICIRT.
BY STEPHEN H. WEEKs, M.D.
The paper which I shall present to the Gynaecological Section, will include seven ques-
tions for discussion. The one that will receive special consideration is the following:—
When pregnancy is complicated with a large interstitial uterine fibroid, occupying
and wellnigh filling the pelvic cavity, is it better to induce abortion or premature
labor, or to allow gestation to go on to full term, and then deliver by abdominal section?
Guided by the light of abdominal surgery, I shall claim that in the vast majority of
cases, as stated in the above question, it is better to allow pregnancy to go to term, and
then, if it is found that delivery is impossible, via naturalis, to resort to abdominal
section, without waiting until the patient's strength is exhausted by protracted labor.
The operation best suited to such cases is Caesarean section, Sänger's method, and then
...the removal of the ovaries, and, if possible, the Fallopian tubes.
SECTION WI–THERAPEUTICS AND MATERIA MEDICA.
OFFICERS.
PRESIDENT: DR. TRAILL GREEN, Easton, Pa.
WICE-PRESIDENTS.
Dr. JUSTUS ANDEER, Munich, Germany. Dr. GEO. GRAY, Castlewellan, Ireland.
Dr. DUJARDIN BEAUMETZ, Paris, France. Dr. ROBT. GRAY, Armagh, Ireland.
Dr. DUDLEY W. BUxTon, London, England. Dr. THOMAS GREENISH, London, England.
Dr. J. M. G. CARTER, Waukegan, Ill. Dr. KERSCHFELD, Paris, France.
Dr. TIIoMAS EDMONSTON CHARLEs, Limehurst, Dr. SIDNEY H. C. MARTIN, London, England.
England. Dr. RICHARD W. MOTT.
Dr. HIRAM CoRSON, Pennsylvania. Dr. W.M. MURRELL, London, England.
Dr. J. G. S. CoGHILL, Isle of Wight, England. Dr. CHAs. D. F. PHILLIPs, London, England.
Dr. HY. M. FIELD, Dartmouth, N. H. Dr. RALPH STOCKMAN, Edinburgh, Scotland.
Dr. THOS. A. FRASER, F. R. C. P., Edinburgh, Dr. FREDERICK TAYLOR, London, England.
Scotland. Dr. CHAs. WEBBER, Rome, Italy.
Dr. A. FRICKE, Philadelphia, Pa.
SECRETARIES.
Dr. F. DRONKE, Berlin, Germany. Dr. L. LEWIN, Berlin, Germany.
Dr. ALFRED S. GUBB, London, England. Dr. FRANK WooDBURY, Philadelphia, Pa.
COUNCIL. *
Dr. A. E. Adams, Danbury, Conn. Dr. Charles Rice, New York (Bellevue Hospital).
Dr. W. E. Casselberry, Chicago, Ill. Dr. F. E. Stewart, Philadelphia, Pa.
Dr. J. H. Etheridge, Chicago, Ill. Dr. A. B. Tadlock, Knoxville, Tenn.
Dr. E. P. Fraser, Portland, Ore. Dr. J. B. Vanvelsor, Yankton, Dak.
Dr. Wm. B. Hazard, St. Louis, Mo. Dr. D. W. C. Wade, Holly, Mich.
Dr. W. F. Kinsman, Lancaster, Ohio. Dr. Robt. D. Webb, Livingston, Ala.
Dr. J. W. H. Lovejoy, Washington, D. C. Dr. Theo. A. Weed, Cleveland, Ohio.
Dr. J. F. B. Payne, Galveston, Texas.
THE CHEMISTRY AND PHARMACOLOGY OF THE NITRITES
AND OF NITRO-GLYCERINE.
LA, CHIMIE ET L.A. PHARMACOLOGIE DES NITRITES ET DU L’NITRO-
GLYCERINE.
DIE CHEMIE UND DIE PHARMACOLOGIE DER NITRITE UND DES NITRO-GLYCERINS.
BY GEORGE ARMSTRONG ATKINSON, M. B. C. M.,
University, Edinburgh.
In this paper the author will briefly discuss the chief chemical points of medical
interest of these bodies, and then will pass to the consideration of their general and
special action upon various animals, especially frogs and rabbits, and will also in
some detail enter upon their diuretic action with special reference to the elimination
of urea and uric acid.
60
NINTH INTERNATIONAL MEDICAL CONGRESS. 61
INTRODUCTION TO MEDICAL BOTANY OF UNITED STATES.
smºsºms
INTRODUCTION A LA BOTANIQUE MÉDICALE DES £TATS-UNIS.
EINLEITUNG ZU EINER MEDICINISCHEN BOTANIK DER WEREINIGTEN STAATEN.
BY J. M. CARTER, M.D., SC.D., PH.D.,
Of Waukegan, Ill.
The study of Medical Botany in the United States has been brought to its present
condition chiefly during the past few years, and by the mild efforts of botanists and
physicians.
The writer has prepared a synopsis, including 140 orders, 620 genera and more than
1300 species and varieties, collected from standard medical works and there searches of
our leading botanists.
Of these orders, the most important in regard to number of plants used in medicine
are: Ranunculaceae, 17 genera, 40 species; Cruciferae, 16 genera, 30 species; Legu-
minosae, 27 genera, 45 species; Rosaceae, 15 genera, 57 species; Umbelliferae, 26 gen-
era, 46 species; Compositae, 67 genera, 180 species, etc.
The vegetable materia medica list of our country is extensive, but by properly classify-
ing the plants their study may be greatly simplified. It is believed, and perhaps justly,
that all the plants of a genus have similar properties, differing only in degree. Prof.
Vogel has shown that this difference may be due often to difference in places of growth,
and cites quinine, among other plants, as one in which the chemical constituents are
changed by a change in the habitat.
The physiological relations and therapeutic action of plants must likewise change, and
in one region this may be illustrated by reference to the genus Grindelia, which varies
in its action in different localities.
Dioscorides, who described some 500 plants used medicinally, mentions many genera
and species found in America to-day. Some of the most familiar are Achillea, Anthemis,
Datura, Galium, etc.
Many of the plants not belonging to the orders mentioned above are very useful as
remedial agents, and to which special attention might be called.
The American Mistletoe, Phoradendron Flavescens, is one of the most important of
these. Others are Convallaria majoralis, Viburnum prunifolium, etc. nº
Besides these native plants there are many introduced and naturalized species, which
are very valuable, as Conium maculatum, Aconitum Napillus, etc.
sºmºsºssmº
CHLORATE OF POTASH.
LE CHLORATE DE POTASSE.
DIE CHLOR-POTTASCHE.
BY J. G. SINCLAIR COGHILL, M. D., F. R. C. P.,
Of Victoria, Isle of Wight.
This paper is an endeavor to ascertain the true value of Chlorate of Potash in the
materia medica. The author is of opinion that it has been unjustly and too hastily
relegated an inferior therapeutic position. The peculiarities of its chemical compo-
sition ; its great diffusion-power ; the large proportion of oxygen, and the readiness
with which it parts with that constituent ; and the potential energy of many of its
chemical combinations all indicated, and at first led to, great expectations of its
efficacy as a remedy.
62 ABSTRACTS.
STEHBERGER, O'SHAUGHNESSY.
The earlier chemical analysis of Wöhler and others, declaring that, practically, all
the Salt is eliminated from the body unchanged—mainly through the kidneys—struck
a serious blow to its reputation as a remedial agent, which was, unfortunately, founded
on a chemical theory of its action, and which undoubted clinical proofs of its efficacy,
in a variety of morbid conditions, was unable to withstand. This unfortunate state
of matters was further brought about by the fatal consequences resulting from too
large doses of the salt, either accidentally or imprudently administered for the sake
of experiment. The ocular demonstration, however, afforded by its specific action
in a rapidly-curing foul and unhealthy condition of the mucous membrane of the
buccal cavity by local application was too much in evidence to be passed over, and
Consequently to this humble therapeutic rôle, mainly, is the Chlorate of Potash rele-
gated in the Orthodox works on materia medica.
These original researches of Wöhler and others seemed so unsatisfactory, in view of
the undoubted therapeutic activity of the salt, that as far back as 1878 Dr. Coghill
arranged a series of observations, the chemical part of which was conducted by Mr.
Otto Helmer, F. C. S., with characteristic energy. He verified many of the experi-
ments in his own person, and applied more than one novel process for attaining
correctly the quantitative reduction of the Chlorate as eliminated.
The results were such as only to confirm the views already stated by previous
observers. Several interesting points developed themselves in the course of these
experiments :—
The appetite became in every instance greatly improved, in some voracious; the
Salivary Secretion became, when the salt was pushed beyond grs. 45 per diem,
intensely acid, the teeth even showing evidence of corrosion. The specimens of
urine also voided when the Chlorate was being taken remained for an indefinite
time without odor or other evidence of decomposition. If we are to accept these
results as conclusive, we are driven to the view that Chlorate of Potash acts by its
mere presence in the blood as a catalytic simply—in this respect resembling Iodide
of Potash and some other salts, according to competent observers. The accuracy of
these analyses, however, has been challenged, in 1881, by Ludwig, and subsequently
by J. Von Nering, in 1884. They declare, as the result of independent investigations,
that the Salt undergoes decomposition within the system in the presence of some acid
—not certainly carbonic acid, as alleged by Won Nering—losing part of its oxygen, and
being resolved into chloric acid and chloride of potassium. It is difficult, if not,
indeed, impossible, to reconcile such diametrically opposite statements by such com-
petent observers, without concluding that the conditions under observation were not
identical. It is probable that the explanation may be found in the circumstance
that both Ludwig and Von Nering's researches were made in cases where excessive
Or even toxic doses of the Chlorate had been administered.
It is not, however, necessary, much less essential, to believe in the efficacy of a
remedy that we should be able to follow the chemical processes within the body, by
or through which its curative influence is attained. That undoubtedly desirable
consummation in every case will come in due course.
It may be stated, generally, that the therapeutic properties of Chlorate of Potash
are those suggested by its chemical constitution and properties. In all states of the
system where the blood is impoverished either in amount or quality, where its nutri-
tive efficiency, especially as regards oxygen, is impaired, the Chlorate of Potash is
indicated, either alone or in such combinations as the complexity of the conditions
present demand. In appropriate cases, its action, when judiciously administered in
proper doses, will be found most potent. It is also a cardiac stimulant in Small doses,
and seems to exert an important influence on the nutrition of these tissues generally.
Its action as an antiseptic, particularly in arresting chemical decompositions within
the body, is to be considered as one of its most valuable properties.
NINTH INTERNATIONAL MEDICAL CONGRESS, 63
COLD AS A REMEDY IN INFLAMMATORY AFFECTIONS.
LE FROID COMME UNE REMEDE POUR LES INFLAMMATIONS.
DIE KAELTE ALS EINE EIUELFSMITTEL IN DEN INFLAMMATORISCHEN ECRANKHEITEN.
BY HIRAM CORSON, M. D.,
Of Conshohocken, Pa.
My experience of more than fifty years in the use of cold—ice and cold water—as
an agent to reduce fever, and to allay inflammation wherever it is so situated that the
remedy can be applied, is detailed briefly in the paper prepared on that subject for the
Section of Materia Medica of the Medical Congress to meet in Washington in Sep-
tember. Brief as is the paper, it is yet, perhaps, too long to be read there, and I
therefore send a summary, or abstract, of the conclusions to which I have been led.
First.—That the application of cold to a heated and inflamed part speedily cools it,
by its effect on the capillaries.
Second.—That, in Measles, the free use of cold water, even ice water, when craved,
joined to sponging of the surface with cool water when the temperature of the body
is great, is the most safe and pleasant treatment ever adopted. In an extensive prac-
tice during fifty-nine years, I have never known a case thus treated to prove fatal.
Third.—When properly used in Scarlet Fever and Diphtheria, internally and exter-
nally, cold water and ice are the most comfortable and efficient remedies that can be
used for their relief. Under their early use, cases which would have been of the most
malignant character have often been rendered mild, and other cases which had been
allowed to reach the most dangerous condition, have been arrested and relieved ; the
patient saved from premature death.
Fourth.--Smallpow, as it occurs in country places, is greatly modified by the cool
treatment—the disease is thus rendered mild—when contrasted with the condition
procured by stimulants and hot drinks and warm rooms.
Fifth.—In Rheumatism, cold applications to the inflamed and swelled joints are com-
fortable, curative of the inflammation, and do not tend to produce metastatis to other
organs or parts of the body; on the contrary, by reducing the inflammation, they
avert it.
Siath.—In inflammations Qf the brain and its membranes, the affusion of cold water on
the head is a curative measure of the very first importance.
Seventh.—In cases of Narcotic Poisoning, it is one of the most prompt, powerful and
efficient means of cure.
Eighth.—The same may be said of its use in Apoplery and Coup de Soleil—the Ther-
onal Fever of Professor H. C. Wood.
Ninth.—In all peritoneal inflammations, it is easily applied, and its proximity to the
diseased part so close, that it is exceedingly efficient, beside being pleasant to the
patient.
Tenth.—The same may be said of its use in Pleurisy and in Pneumonia—safe,
pleasant and far more efficient than the popular but suffocating poultice.
Eleventh.-In Gastritis, the use of ice water as drink, and, still better, of lumps of
ice to be swallowed, joined to the application of a bladder of ice to the epigastrium,
is, of all known means, the most efficient.
Twelfth.-In Glossitis the effect of the ice and ice water is so prompt and efficient as
to render useless leeches and incisions. But my experience with it in this is limited to
a single case—but a dangerous one, badly treated previously.
Thirteenth.-In Typhlitis and Cellulitis it is invaluable.
Fourteenth.-In Mastitis it is a specific—a remedy safe, pleasant and successful, even
to the puerperal woman.
64 ABSTRACTS,
Fifteenth.—Safe and efficient in Laryngeal and Tracheal inflammations (including
croup).
Sia:teenth.-In all febrile diseases indispensable as a drink, and greatly useful as
baths and when used as a lavement.
Seventeenth.—Cold applications, when used in acute Orchitis and Parotitis, do not
cause metastatis of the inflow—to other parts—as so generally believed and so much
feared.
Eighteenth.—In Convulsions of Children, I but voice the popular opinion when I say
affusion of cold water is a remedy of value.
Such are the conclusions drawn from an experience of more than fifty years of
careful, patient, daily observation at the bedsides of those afflicted with the diseases
here named.
*=mºs
THE NECESSITY OF AN INTERNATIONAL PHARMACOPOEIA.
LA NáCESSITE DUNE PHARMACOPEE INTERNATIONALE
DIE NOTHWENDIGKEIT EINER INTERNATIONALEN PHARMACOPOEIE.
BY DR. F. DRONKłº,
Of Berlin, Germany.
Of the many difficulties with which Pharmakotherapy has to wrestle, dosing of the
medicines is none of the least. We may safely assert that every usual dosing of a med-
icine is unreliable and a mere attempt. The reasons for such an assertion are plain
enough. Of the chief reasons I will only mention —
I. The difference
a. of men among each other ;
b. of each individual at different times;
c. in the intensity of sickness of men of the same malady ;
d, in the intensity of the maladies among themselves for which the same medicine
is used.
II. The fluctuations (uncertainty) of the effectiveness of a large part of our medi-
cines.
One is at all times convinced of the essential influence of these and other factors,
yet in specific cases they cannot be referred to at all, or only a little, because the greater
part of them will remain forever a secret to man's knowledge. Therefore, dosing of
medicines working not heroically, or only in very large quantities, was effected down to
our times by considering as normal certain average-doses, found by experience, and by
considering also in the use of them, as far as possible, the individuality. Only in few
pharmacopoeias, i.e., the British and the Spanish, these, in a certain sense traditional, doses
have been marked down, of course only for the information of physicians and without
being binding. But besides these average-doses the pharmacopoeias of most countries con-
tain legal fixings of single or daily doses, or as the Swedish or Norwegian pharma-
copoeias, only for the single doses of such substances which produce an effect by a rela-
tively small quantity, or which engender easily poisoning by raising the doses. The
necessity of such maximal dosing (without being absolutely binding), which, of course,
does not exclude a discreet going beyond, becomes evident, from the consideration that
the injudicious, unsuitable giving of such substances may greatly damage health.
Such a maximal dosing is to the prescribing physician not an absolute law but a caution.
It would be desirable that countries which thus far have no such officially fixed maxi-
mal dosings, should introduce them. In that case, e. g., there could not happen, should
the medicine work badly—prosecution—to which the physician is most easily exposed,
where no such legally fixed maximal dosings exist.
Two groups of substances enter into these maximal doses —
1. Plants, raw plants, products, and pharmacist's eductions from them.
NINTH INTERNATIONAL MEDICAL CONGRESS. 65
2. Chemically simple, well-defined substances, as metalloids, metallic salts, and carbon
combinations.
The first-named substances are in themselves, in their effect, almost all inconstants,
and as far as galenic preparations come here in question, they show differences in their
effect, because an international agreement in their eduction has thus far been impos-
sible. Medicines of the second group, on the other hand, may be prepared everywhere
in equal quantities, and have, consequently, all things being equal, the same effect.
Maximal doses of such substances, which ought never to be gone beyond without solid
reasons, are obtained by experiments with well and sick persons, through poisonings of
men and by experimenting on animals. Now, although the basis for such a result is a
sufficiently broad one, yet the corresponding notations in the different pharmacopoeias are
with many substances very different. This difference is comprehensible in regard to the
first group, but incomprehensible in regard to the second. This point offers the occa-
sion for the present article, and the proposals connected with it. If it were possible to
produce in the same way internationally all strongly working galenic preparations, then
there would be a possibility of a universal like maximal dosing of all substances belong-
ing here. But I consider this beyond our reach until farther. However, the second
group of the substances to be provided with a maximal dose may be very easily equal-
ized (i. e., noted with the same figures). The importance of such a system is plain.
(The international communication in our times so active.) The, in our time, so active
intercourse of the different nations, the fact that the prescriptions of our country are
frequently prepared in another, and that great inconveniences might result from it,
require much that we strive at least for that which might be obtained in this respect.
The until now existing inequality of the dosing, and the assortment of said sub-
stances, is at times exceedingly great. Thus, the maximal number for codein in the
pharmar hungarica (1871) is 0.03 grim., but in the phar. succica (ed. VII), 0.025. The
pharm. neerlandica gives a maximal number to diluted mineral acid. Gutti gives none.
Moreover, basing on my toxicological investigations, I may safely assert that many of
these official notations have no scientific basis, and need already, on that account, a
revision; others might be arranged more conveniently by the physician, without impair-
ing essentially the effect of the doses.
Therefore, basing on my own investigations, and on most of the pharmacopoeias, which
give maximal doses, I made a synopsis of substances belonging to the group which I
named second, and marked them with the maximal number, which I consider recom-
mendable. To each pharmacopoeia—to such, too, which contain nomaximal doses—should
for the general interest such tables be added to enable a physician to prescribe in
proper quantity even strong working preparations, which are in his country not official.
The International Congress should make a motion to regulate, internationally and soon,
this matter in the sense here insisted upon or suggested.
THERAPEUTIC VALUE OF NATURAL MINERAL WATERS.
LA VALEUR THERAPEUTIQUE DE L'EAU MINERALE NATURELLE.
DER THERAPEUTISCHE WERTH DER NATUERLICHEN MINERAL-WAESSER.
BY A. ENFIELD M.D.,
Of Bedford, Pa.
. Mineral Waters in General.
. Physiological Action of Mineral Waters.
. General Chemical Constituents of Mineral Waters.
. Therapeutical Action of Mineral Waters in the Cure of Acute and Chronic Dis-
€aSeS.
5. Choice of Resorts and General Suggestions.
:
5
66 ABSTRACTS.
THE POISON OF THE COBRA. (NAIA TRIPUDIENS.)
LE POISON DU COBRA (NAJA TRIPUDIENS)
DAs GIFT DER COBRA (NAJA TRIPUDIENS)
BY T. GNEZDA, M.D.,
Of Berlin, Germany.
The above named poison was obtained in the following manner: A snail-shell, covered
with sheep-skin, was exposed to the bite of the snake, so that the poison entered the
shell. This was brought in a dry state by R. Koch, from India. It was a yellowish,
brittle matter, which showed reactions by giving precipitates with : HCl, NaCl, HNO3,
CrHA, I found that the poison lost its poisonous properties when heated. I ob-
served the symptoms of death in guinea-pigs, rabbits, sparrows, pigeons, pikes, frogs,
etc. I found that the hedge-hog dies from this snake poison. I made experiments
concerning the influence of vagisection and artificial breath in poisoned animals; also
experiments on the influence of the poison concerning the irritability of nerves and
muscles.
THE CHEMICAL PHILOSOPHY OF REMEDY.
LA PHILOSOPHIE CHIMIQUE DU REMāDE.
DIE CHEMISCHE PHILOSOPHIE DER HEILMITTEL.
BY HUGH HAMILTON, M. D.,
Of Harrisburg, Pa.
1. Disease Chemically Considered.
2. What is Remedy?
3. The part Chemistry plays in the use of Means for Cure.
A paper occupying fifteen minutes, illustrated by charts.
THE THERAPEUTICS OF ALCOHOL IN DISEASE.
LA THERAPEUTIQUES DALCOOL DANS LA MALADIE.
DIE THERAPEUTIK DES ALCOHOLS IN KRANKHEITEN.
BY E. N. LIELL, M. D.,
Of New York.
A résumé of the preceding may be given as follows:–
1. In alcohol we have one of the most powerful and substantial agents in the treat-
ment of disease, combining antithermic, paratriptic, alimentary and tonic properties.
2. The mechanism of its favorable action upon the animal organism and its utility in
disease, more especially acute febrile, may be explained in several ways:—
(A) Its dynamic action in increasing and sustaining the vital powers, through its
action upon the circulation and nerve centres.
(B) Its antithermic or apyretic property, in causing a reduction of temperature
proportionate to the amount of alcohol ingested, and
(C) Its alimentary and paratriptic property due to its own combustion and oxida-
tion, thus retarding disintegration and oxidation of the tissues.
3. No routine practice can be made in the use of alcohol in disease; each case should
be treated upon its merits and the indications presented ; because of the advantages
accruing in most, its unqualified recommendation in all diseases is not to be thought of:
in this way, it should be prescribed similar to any other drug or therapeutical measure.
- 4. Finally, measures adopted with the view of modifying or protecting any changes
that take place in the tissues in disease, are certainly legitimate and rational in
procedure.
NINTH INTERNATIONAL MEDICAL CONGRESS. 67
ON ELECTRICAL STIMULATION OF THE MAMMALIAN
HEART.
SUR LA STIMULATION £LECTRIQUE DU CCEUR DES MAMMIFſ: RES.
DIE ELEKTRISCHE REIZUNG DES SAUGETHIERHERZENS.
BY J. A. McWILLIAM, M. D.,
Of Aberdeen, Scotland.
The question of the effects of electrical stimuli upon the mammalian heart is one
of obvious importance, both in its purely physiological and its clinical aspects, bear-
ing as it does on the possibility of restoring the cardiac beat after it has been arrested
by causes of a temporary nature. In the clinical aspect it specially concerns the car-
diac failure, which is so grave a possibility among the results of the action of anaes-
thetic agents. It may indeed be alleged that in such instances the cardiac failure is
due frequently to a general loss of vascular tone, or to a gradual enfeeblement and
paralysis of the nervous or muscular arrangements of the heart, in consequence of
the prolonged action of the poison upon the cardiac tissue. But, on the other hand,
it would appear, as Lauder Brunton and others have urged, that in very many in-
stances—probably in a large majority of the cases of heart failure during the admin-
istration of anaesthetics—the cardinal standstill is due to inhibitory influences trans-
mitted along the vagi nerves, impulses that do not necessarily cause any permanent
damage to the cardiac tissues, but simply depress or suspend the spontaneous discharge
of beats by the organ. The possibility of exciting the action of the heart will, in such
cases, at least, appear to be an eminently feasible one. Among the means that have been
tried to excite the cardiac action, electrical stimulus has been frequently employed,
and usually without success. The mode of excitation commonly employed has been
the application of a faradic current to the chest wall over the heart, at times electro-
puncture has been used. But Ludwig and Hoffa showed that the application of strong
constant currents, or of faradic currents, to the ventricles of the dog's heart immedi-
ately abolishes the normal beat, and throws the ventricles into a state of arhythmic
quivering movement (Fibrillar contraction, Herz delirium, Delirium cordis), which is
entirely insufficient to propel the blood from the ventricular cavities. The heart becomes
gorged with blood ; the blood pressure falls rapidly ; and the animal dies as rapidly as
though the root of the aorta had been ligatured. The essential features of this condition
appear to occur under faradization, not only in the heart of the dog, but in all mamma-
lian hearts. I have myself observed it in the dog, cat, rabbit, rat, mouse and hedge-
hog. I have found it to occur both when the thorax has been opened and the heart
laid bare, and when the current has been passed through the walls of the intact heart.
Hence, it is obvious that the employment of faradic currents as a means of cardiac exci-
tation is one fraught with the gravest danger. It has, indeed, been argued that the
Currents used to stimulate the heart in man are not so strong as those employed by Lud-
wig and others, and would probably be insufficient to produce such a disastrous result.
But this argument is one on which there is no reliance whatever to be placed, notwith-
standing the fact that Von Ziemssen and others have described the application of fara-
dic currents to the human heart without unfavorable results. For one of the facts with
which I have been most strongly impressed during my experimental investigation of
the subject has been the variability of the behavior of the heart in this respect, the
extreme readiness with which in certain circumstances the ventricles pass into the arhyth-
mic quivering condition described. This state of increased sensitiveness to electrical
currents appears to occur most frequently in abnormal conditions—when the respiration
has been interrupted or when there have been symptoms of incipient cardiac failure from
various causes (excess of chloroform, etc.). In such cases I have seen again and again an
exceeding weak faradic current—such as could hardly be felt upon the tongue—cause
an immediate arrest of the ventricular beat, and an immediate Supervention of the
68 ABSTRACTS.
arhythmic fibrillar contraction. Von Ziemssen, indeed, tried the effects of faradic cur-
rents upon the human heart (in a case of “Ectopia Cordis’’), without obtaining any
marked results. So also have Herbst and Dixon Mann in experimenting upon the normal
chest. But the conditions obtaining in these experiments are entirely different from
those present in the cases where stimulating currents are required clinically. In the
former the heart was beating normally ; in the latter the cardiac action had been mark-
edly impaired or entirely suspended. And it has been seen that in such conditions the
heart frequently manifests an extraordinary sensitiveness to the influence of faradic cur-
rents; a sensitiveness that differs most markedly from the state of comparative insus-
ceptibility obtaining in the normal heart. Further, a faradic current too weak to pro-
voke fibrillar contraction in the ventricles appears to have no stimulating influence upon
the heart.
It is certain that some form of stimulation must be sought other than faradic or
strong constant currents. Such a means of stimulation is available in the form of single
induction shocks. A single induction shock acts as a powerful excitant of cardiac Con-
traction. During cardiac standstill, brought about through the vagus nerves, a single
induction shock readily excites a single contraction of both auricles and ventricles. A
slow series (say one per second) of induction shocks of moderate strength causes a
series of complete heart beats at the same rate; and never in my experience have single
induction shocks produced the fibrillar condition. Single induction shocks are thus
readily available for the purpose of exciting cardiac beats. The order of the heart (i.e.,
the succession of auricles and ventricles) varies, however, according to the part of the
heart most strongly excited by the shock. When a shock is applied to the auricles the
contraction follows the normal order. But when the shock is applied to the ventricles,
the ventricular contraction occurs first, and then the auricular contraction; in other
words, the heart beat occurs in reversed order. And this raised the question as to
whether such a reversed form of beat would be effective in discharging the blood from
the heart, especially, as, in employing induction shocks upon the heart in the intact
thorax, it would necessarily be uncertain what part of the heart would be specially acted
on by the stimulating shocks. And during my work on the hearts of cold-blooded
animals, I found, in the case of the eel, that a series of induction shocks applied to the
ventricle gave a series of reversed heart beats which were not effective in keeping up the
circulation of the blood. The auricle became gorged and the circulation became pal-
pably obstructed. I have tested this question on the mammalian heart, the thorax
being opened and artificial respiration kept up, by comparing the effects of induction
shocks applied to the auricles and ventricles respectively during cardial arrest brought
about through the vagus nerves. I have found that the state of matters is very different
from what obtains in the eel. Contraction of the mammalian heart, whether resulting
from stimulation of the auricles or of the ventricles, whether excited in the normal order
or in the reversed fashion, is, though the beat differs in various respects, effective in
causing a discharge of blood from the ventricles into the great vessels, and a marked im-
provement in the condition of the heart and of the circulation generally. It would
appear, then, that during an arrest of the heart's action, brought about through the vagus
nerves, there is available an effective means of excitation, by which the activity of the
organ may by aroused, provided the standstill has not been of so long duration as to cause
the death of the cardiac tissue.
The mode of excitation by induction shocks appears to be the method plainly indicated
by our physiological knowledge of the subject, based upon facts that appear to be appli-
cable not merely to one animal but to the whole mammalian class.
Induction shocks should be employed in preference to the make and break of a pri-
mary current, on account of the greater power which the induced current possesses of over-
coming resistance. The shocks ought to be sent through the heart, one electrode being
applied over the apex of the heart and the other over the sixth or seventh dorsal vertebra,
the electrodes to be of large extent. The shocks ought to be about the normal rate of
the heart's beat.
NINTH INTERNATIONAL MEDICAL CONGRESS. 69
VICARIOUS RESPIRATION SUPERINDUCED IN CERTAIN DIS-
EASES BY ADMINISTRATION OF OXYGEN-YIELDING COM-
POUNDS THROUGH THE ALIMENTARY TRACT.
RESPIRATION SUBSTITUTIVE APPORTÉE DANS CERTAINES MALADIES
EN ADMINISTRANT PAR LE CANAL AILIMENTAIRE DES SUBSTANCES
PRODUISANT L’OXYGENE.
STELLVERTRETENDE ATHMUNG IN GEWISSEN KRANKHEITEN DURCH DIE EINFUEHRUNG
VON OXYGEN ABWERFENDEN MISCHUNGEN IN DEN DARMKANAL.
BY WILLIAM WARD, M. D.,
Of Washington, D. C.
Vicarious respiration, superinduced in certain diseases by administration of oxygen-
yielding compounds through the alimentary tract.
Has the alimentary tract the power to act vicariously for the lungs, by absorption of
oxygen-yielding substances, and admission into the circulation for the purpose of effect-
ing those tissue changes incident to the inspiratory act 2
From clinical observation, I think the stomach has the power to act vicariously for
the lungs in some cases of disease, in the inspiratory act ; even as the skin, in other
cases, acts vicariously for the lungs in the expiratory act. Letourneau, however, in his
work on “Biology” says: “So far, at least, it has not been shown that the chemical
reactions of (animal) nutrition set at liberty oxygen gas.” His views are from a physi-
ological standpoint ; mine from a clinical and pathological.
Physiologists universally hold that oxygen is admitted into the system through the
lungs only, and physicians generally entertain the same opinion. Probably in health,
respiration and nutrition are so perfect that all the oxygen necessary is carried into the
system through the lungs, but in certain diseases (cholera, cholera-infantum, post-
partum and secondary post-partum hemorrhages, etc.), when the lungs and blood fail
in function, the system doubtless has the power, through the chemical processes of
digestion and nutrition, of liberating oxygen gas and utilizing it in tissue changes, if
that gas, in a suitable chemical and digestible combination, be given by the stomach.
According to the felicitous idea of Claud Bernard, all organisms, in fact, live an
aquatic life ; the histological elements are aquatic ; the blood of animals and the sap of
plants alike bathe them in a fluid medium. The oxygen we breathe is condensed and
liquefied in the blood, is fixed in the blood corpuscles; our food is liquefied during
digestion, and is carried to the tissues by the circulation in a fluid form.
The essential acts of respiration, and nutrition also, take place in the tissues, and
“the lungs are but ports of entry’’ for the oxygen of the air carried thither. Life is
therefore maintained in a sea of histologicals and aqueous elements. In that histologi-
cal warfare called disease, in certain cases where the ports of entry are blockaded, a
Surreptitious commerce springs up, and new ports of entry are formed. One of these
ports is in the alimentary canal ; entry to this place is, however, by water, not by air.
Here the oxygen yielding substance, in solution, is absorbed by the vascular network
of the stomach, the chemical compound broken down, and oxygen carried hither and
thither by the blood corpuscles, and possibly by the liquor sanguinis, to meet the com-
mercial and nutritive demands of the tissues.
Fothergill says, “The now generally acknowledged starting-point of the pathological
processes in cholera is spasm of the pulmonary arterioles (Parkes and G. Johnson).”
This may be so, or it may be that there is such destruction of the red corpuscles that
too few remain to carry a sufficiency of oxygen to keep up motion in the blood, animal
heat and nutrition. It would be better to say, however, that the “spasm of the
pulmonary arterioles” is the most threatening lesion in the general collapse which
endangers life in cholera. There is such an outpouring of the fluids of the body
(tissues), and such destruction of the red corpucles of the blood, together with reflex
70 ABSTRACTS.
“spasm of the pulmonary arterioles,” that those corpuscles which escape destruction,
and the young corpuscles which await commissions as carriers of oxygen, find themselves
in both an oxygen and a water famine. This condition is clinically denominated a
collapse, or a threatened collapse. If twenty or thirty drops of “acid sulph. aromat.”
be now given in ten or twelve ounces of water (or in the earliest stages) a most remark-
able change will be noticed, confirmatory of the views herein expressed. The same
may be said of post-partum hemorrhage. In these acute diseases the reasons for
believing that this treatment acts as a nutritive oxidant, supporting vicarious respiration,
cannot be so well explained. In those diseases, however, which are subacute or more
chronic in character, the reasons are very evident.
In one case (No. 1) of Secondary post-partum hemorrhage occurring eleven days after
labor, in a case from a midwife, which lasted three days and required turning, every-
thing went on well until the hemorrhage set in ; then the symptoms became grave, and
grew more serious on the third day, although the hemorrhage was stopped. On this
day the extremities became cold, the pulse was absent at the wrist, there was vomiting,
great apathy and a sense of impending death—a complete collapse. Thirty drops of
“acid sulph. aromat.” in twelve ounces of water arrested the vomiting, gave sound and
refreshing sleep, warmed the whole body in seventy minutes, restored the pulse, and in
twelve hours induced a flow of the lochia—that yellow or greenish-yellow flow—the
ashes of oxidation after parturition. This occurred in summer (July, 1881). No
other medicine was given after commencing the oxidant treatment ; and only three (3)
doses of that medicine, viz.: thirty, twenty and ten drops respectively in ten or twelve
ounces of water every four hours. After that time beef tea every two hours for twenty-
four hours; beef tea and thin gruel, etc., later. The patient made a complete recovery.
The usual treatment with ergot, etc., and with repeated injections of very warm water
into the rectum, stopped the hemorrhage in this case, but the woman was about to die
in a collapse from the great loss of blood.
The other case (No. 2) of secondary post-partum hemorrhage occurred in winter
(Feb. 1882), ten days after a natural labor, unmarked by any untoward symptoms;
the hemorrhage was more profuse than the first, and the oxidant treatment was com-
menced at once ; no other medicine was given. Beef tea was given every four hours.
The hemorrhage was arrested gradually, but completely in twenty-four hours. In this
case (No. 2) vomiting and apathy were noticed, but no coldness of the feet or hands,
and no symptoms of collapse occurred, although the hemorrhage was more profuse than
the first, (No. 1). The lochia was established thirty-four hours after the first appear-
ance of the hemorrhage, and thirty-two hours after commencing the oxidant treatment.
This patient had a good and speedy recovery.
There seems to be every evidence that these patients were restored by the vicarious
action of the stomach (acting) for the lungs. The first patient (No. 1) was sinking
rapidly from the loss of blood. There were, indeed, countless numbers of young cor-
puscles awaiting commissions as carriers of oxygen, but there was no oxygen at hand,
and no water in which to Swim them. The dose of thirty drops of acid sulph. aromat.
in twelve ounces furnished both the oxygen and transportation.
The tissues and the corpuscles alike, in this stress of circumstances—in this famine—
abandoming old customs and habits, and knowing no law but the “correlation and
conservation of energy,” decomposed the “acid sulph. aromat.,” appropriated the
oxygen for tissue respiration, and used the water as a vehicle for transportation and
irrigation. There was fio other recourse—the action of the whole system was “ex
necessitate rei.”
Letourneau says that “Every living thing is athirst for oxygen, and to such a degree
that sometimes certain organisms steal it even from stable chemical compounds.”
All know that vibriones, studied by Pasteur, decompose the tartrate of lime, and
transform lactic acid into butyric acid, to procure for themselves oxygen. Letourneau
says: “It is by an analogous process that, in most of the vertebrates, the anatomical
elements deoxidize the red corpuscles.”
SECTION WII—ANATOMY.
OFFICERS.
PRESIDENT: WM. H. PANCOAST, M. D., Philadelphia, Pa.
WICE-PRESIDENTS.
WM. ADAMS, M. D., London, England.
Prof. ALBRECHT, Hamburg, Germany.
Dr. ALTMANN, Leipzig, Germany.
Prof. AUERBACH, Breslau, Germany.
Dr. WM, MITCHELL BANKS, F. R. C.s., Liverpool,
England.
Prof. CARL BARDELEBEN, Jena, Germany.
Dr. BARFSURTH, Bonn, Germany.
Dr. BECKER, Wurzburg, Germany.
Prof. BONNET, Munich, Germany.
Prof. Born, Breslau, Germany.
Prof. BRAUNE, Leipzig, Germany.
Prof. VON BRUNN, Rostock, Germany.
Prof. BUDGE, Greifswald, Germany.
Dr. J. CUNNINGHAM, Dublin, Ireland.
Prof. Von EBNER, Gray.
Prof. EBERTII, Halle, Germany.
Prof. F. M. ERKEL, Göttingen, Germany.
Prof. ERKHARD, Geissen, Germany.
Prof. FLEMMING, Kiel, Germany.
Prof. FLESCH, Berne, Switzerland.
Prof. FORIEP, Tubingen, Germany.
Prof. FRETSCH, Berlin, Germany.
Prof. FREY, Zurich, Switzerland.
Prof. FROMMANNs, Jena, Germany.
Prof. GASSER, Berne, Switzerland.
Prof. GEGENBAUT, Heidelberg, Germany.
Prof. Her von Wrºng š. GEORGE, Bonn,
Germany.
Prof. VON GERLACH, Erlangen, Germany.
Prof. GERLACH, Erlangen, Germany.
Prof. L. GERLACH, Jr., Erlangen, Germany.
Prof. J.N.O. GLEELAND.
Prof. GOTTSCHAN, Basil, Switzerland.
Dr. REIGNALD HARRISON, F.R.C. s., Liverpool, Eng,
Dr. ROBERT HARTMANN, Potsdam, Germany.
Prof. HASSE, Breslau, Germany.
Dr HEINRICH FREY, Zurich, Germany.
Prof. HENKE, Tubingen, Germany.
Prof. HERTWIG, Jena, Gérmany. º
Prof. HIS, Leipzig, Germany.
Prof. Holl, Tässbrack.
Prof. JoESSEL, Strasburg, Լ
CLINTON W. KELLY, M.D., Louisville, Ky.
Prof. KERKER, Freiberg, Switzerland.
Prof. KöLLIKER, Wurzburg, Germany.
Prof. KOLLMANN, Basil, Switzerland.
Prof. KUPFFER, ifunich, Germany.
Prof. VON LANGER, Vienna, Austria.
Prof. LIEBERKUHN, Marburg, Germany.
SAMUEL Logan, M. D., New Orleans, La.
Dr. ALEx. MACALISTER, Cambridge, Mass.
Prof. ALEx. McALLISTER, London, Eng.
Prof. Joh N GRAY McKENDRICK, Glasgow, Scot.
Prof. L. S. MEYER, Prague, Austria.
Prof. Von MYER, Zurich, Switzerland.
Prof. M. NUSSBAUM, Bonn, Germany.
Prof. OESSEL, Strasburg, Germany.
Prof. OLLADDER, Innsbruck.
DAVID CHAs. LLOYD OweN, Birmingham, Eng.
Prof. PANSCH, Kiel, Germany.
Prof. JAS. BELL PETTIGREW.
Prof PFITzNER, Strasburg, Germany.
Prof. RABL, Prague, Austria.
Prof. RAUBER, Dorpat.
THOMAs RICH, M. D. Leeds, England.
DALLA ROSA, M.D., Vienna, Austria.
Prof. E. RoseNBERG, Dorpat.
Dr. RUCKERT, Munich, Germany.
Prof. R. RUCKHARD, Berlin, Germany.
Prof. RUDINGER, Munich, Germany.
Prof. RUGE, Heidelberg, Germany.
Prof. PHILE SAPPEY, M. D., Paris, France.
Prof. SciLAAFFHAUSEN, Bonn, Germany.
Prof. SCHALBE, Strasburg, Germany.
Prof. SCHEFFERDECKER. Göttingen, Germany.
Prof. O. SCHULTz, Wurzburg, Germany.
Noble SMITH, M. D., London, England.
Prof. Solger, Greifswald, Germany.
Prof. SOMMER, Greifswald, Germany.
Dr. GRAF Vox. SPEE, Kiel, Germany.
Prof. E. C. SPITzkA, M.D., New York.
Prof. STIEDA, Vienna.
Prof. PH. STOHR, Wurzburg, Germany.
Dr. STRAHL, Marburg, Germany.
Prof. STRASSER, Freiberg, Switzerland.
Prof. M. STRUTHERS, M.D., Aberdeen, Scot.
THOS. P. TEALE,
Prof. TEICHMANN, Krakau, Russia.
BENJAMIN ‘H. THROOP, M. D., etc., Scranton, Pa.
Prof. TRUBIGER, Amsterdam, Holland.
Sir WM. TURNER, M. D., London, Eng.
Prof. WAGENER, Marburg, Germany.
Prof. WALDEYER, Berlin, Germany.
Prof. WEIDERSHEIMM, Freiburg, Switzerland.
Prof. WELKER, Halle, Germany.
WALTER WHITEHEAD, M.D., London, England.
GLADIUS GALEN WHEELHOUSE, Leeds, England.
Dr. ZANDER, Königsberg, Germany.
Prof. ZUCKERKANDLE, Gray.
SECRETARIES.
Dr. JNO. J. BERRY, Portsmouth, N. H.
Dr. W.M. C. WILE, Philadelphia, Pa.
|
Dr. C. REMY, Paris, France.
COUNCIL.
Dr. F. C. Ainsworth, U. S. Army.
Dr. C. S. Briggs, Nashville, Tenn.
Dr. Herman M. Briggs, New York.
Dr. N. E. Brill, New York City.
Joseph N. Dickson, M.D., Pittsburgh, Pa.
Fred'k B. Downs, M.D., Bridgeport, Conn.
Dr. L. H. Dunning, South Bend, Ind.
C. L. Ford, M.D., Stamping Ground, Mich.
Dr. Alfred Gubb, London, England.
Dr. George Halley, Kansas City, Mo.
Dr. William H. Helm, Sing Sing, N. Y.
Dr. Addinell Hewson, Philadelphia, Pa.
Prof. C. L. Lord, Michigan.
Dr. James McCann, Pittsburgh, Pa.
Dr. Orville H. Menees, Nashville, Tenn.
Dr. John E. Owens, Chicago, Ill.
James B. Murdoch, M.D., Pittsburg, Pa.
Dr. Thornton Parker, Newport, R. I.
Charles T. Parks, M.D., Chicago, Ill.
Dr. D. C. Patterson, Washington, D. C.
I)r. Joseph Ransohoff, Cincinnati, Ohio.
Dr. R. L. Rea, Chicago, Ill.
F. C. Schaefer, M. D., Chicago, Ill.
Dr. Francis J. Shepherd, Montreal Canada.
Dr. M. Stamm, Fremont, Ohio.
Geo. Thin, M. D., London, England.
Dr. Hal. C. Wyman, Detroit, Mich.
71
72 - ABSTRACTS.
PROPER METHODS IN THE STUDY OF ANATOMY.
*mºnº
MÉTHODE PROPRES DANS L'ÉTUDIE DANATOMIE.
RICHTIGE METHODEN IM STUDIUM DER ANATOMIE.
BY A. H. P. LEUF, M. D.,
Of Philadelphia, Pa.
The present mode of Anatomical Study is defective in several ways. 1. The
instruction is special as regards only certain organs. 2. It is too general as regards
other organs. 3. It is neither the one nor the other as regards still other parts of the
body. 4. In generally overlooking the relations of organs to one another in a way
that would be very useful to remember. 5. Failure to prepare the student's mind
with an incentive to acquire anatomical knowledge, before it is imparted. 6. Too little
of the philosophy or principles of anatomy, which, if properly taught, would make
remembrance easier. 7. The failure to clearly show the connections of anatomy with
the other branches of medicine.
To remedy these defects it is necessary—1. To teach the special anatomy of every
organ distinct from all others. 2. To also give a general idea or outline of each
organ. 3. To never fail to do this with every organ or part of the body. 4. To
invariably show the true and exact relations of the parts to each other. 5. To always
create in the mind of the student a desire for the knowledge to be acquired, by showing
its necessity. 6. To show in a natural way, without much artificial mnemonics, how
many anatomical principles there are which, if remembered, will do alike for all
parts of the body. 7. Thorough instruction as to the relations of anatomical study to
the other branches of medicine. -
*===s*
ANATOMICAL POINTS OF VALUE IN DIAGNOSIS AND
TREATMENT OF SOME JOINT AFFECTIONS.
POINTS ANATOMIQUES DE WALEUR DANS LA DIAGNOSE ET LE TRAITE-
MENT DE QUELQUES MALADIES DES ARTICULATIONS.
ANATOMISCH WERTHVOLLE PUNKTE IN DER DIAGNOSE UND BEHANDLUNG EINIGER
GELENECKRANKEIEITEN. -
BY M. STAMM, M.D.,
Of Fremont, Ohio.
Coxitis or tuberculosis of the hip joint—
First Stage.—Its anatomical symptoms. Different anatomical points to be noted in
examining a patient.
Second Stage.—Position of the affected limb, seat of pain, Swelling, etc. Examination
of iliac fossa and rectum.
Third Stage.—Adduction, shortening, etc. Swelling, abscesses and fistulas. Con-
tractures and luxation.
Treatment.—Different points to be considered in extension. Treatment of abscesses.
Resections, partial and typical. Amputation.
Rºnee Joint.—Hydrops tuberculosis. Symptoms and aspect of joint. Synovitis
granulosa. Aspect of the joint and other symptoms. Abscesses, luxations, contrac-
tures, etc. Osteal foci.
Treatment by extension and splints. Lithrotomy. Resections.
Ankle Joint.—Symptoms of affection of the talo. Crural joint, also of the astraga-
lus, calcaneus and their respective joints.
Treatment.—Partial and typical resections.
SECTION WIII—PHYSIOLOGY.
OFFICERS.
PRESIDENT: JOHN H. CALLENDER, M.D., Nashville, Tenn.
WICE-PRESIDENTS.
J. ROSE BRADFORD, M. D., London, England. C. H. HUGHES, M.D., St. Louis, Mo.
RICHARD CATON, M.D., Liverpool, England. Dr. CHAs. LIBTHORP, Dublin, Ireland.
DANIEL CLARK, M.D., Toronto, Canada. WM. ABRAM LOVE, M.D., Atlanta, Ga.
Dr. MARTIN F. Coomes, Louisville, Ky. J. A. McWILLIAM, M.D., Aberdeen, Scotland.
AUSTIN FLINT, M. D., New York. Dr. WM. RUTHERFoRD, Edinburgh, Scotland.
WM. Dobinson HALLIBURTON, M. D., London, H. P. STEARNs, M. D., Hartford, Conn.
England.
SECRETARIES.
RANDOLPH BARKSDALE, M.D., Petersburg, Va. | R. W. BISHOP, M. D., Chicago, Ill.
BERNARD FRAENKEL, M.D., Berlin, Germany.
COUNCIL.
O. Everts, M.D., Cincinnati, Ohio. T. S. Latimer, M.D., Baltimore, Md.
W. Hutson Ford, M. D., St. Louis, Mo. T. O. Summers, M.D., Jacksonville, Fla.
J. Henry Jackson, M.D., Barré, Vt. A. Wetmore, M. D., Waterloo, Ill.
C. H. A. Kleinschmidt, M.D., Washington, D.C. j J. H. Wythe, M. D., Oakland, Cal.
RESEARCHES ON ELECTRICAL PHENOMENA OF CEREBRAL
GRAY MATTER.
DES RECHERCHES, SUR LE PHENOMENE ÉLECTRIOUE DE LA CAER£-
BRALE MATIERE GRISSE.
TJNTERSUCHUNGEN UEBER, ELEKTRISCHEPHENOMENA VON CEREBRALEM GRAUEMI
EITER.
*====º
BY RICHARD CATON, M D.,
Of Liverpool, England.
In the course of this inquiry experiments were made on the brains of forty-five mon-
keys, cats and rabbits. Sir William Thompson's reflecting galvanometer, with accessory
apparatus, and Du Bois Reymond's non-polarizable electrodes, specially modified, were
employed. The latter, of very small size, were securely clamped to the skull, and thus,
while apparently causing the animal no discomfort, moved with all movements of the
head.
When one electrode was placed on the external surface of a convolution and the other
on the surface of a vertical Section, strong currents passed through the galvanometer.
The external surface was usually positive to the vertical section. When both electrodes
were placed on the external surface the current was feebler.
Marked fluctuations sometimes occurred in the current, and these in some instances
coincided with the muscular movements or changes in the animal’s mental condition.
In deep anaesthesia much deflection of needle was observed, lessening gradually as the
animal regained consciousness. Great deflection occurred at death, and after death the
needle returned to zero. -
Experiments were made in several of the motor and sensory areas determined by
Ferrier, Fritsch and Hitzig and others.
73
74 ABSTRACTS,
1. The electrodes were placed on the area associated with rotation of head and eyes
to the opposite side, and when the animal was induced to make that movement a
diminution of the electric current coincided with the movement.
2. The electrodes were placed on a point corresponding to Ferrier's area 9 and 10.
In half the animals experimented on a negative variation of the current coincided
with mastication, and lasted as long as mastication lasted ; it occurred also when
any sensory impression was made on the interior of the mouth, as by introducing
the handle of a scalpel, or when the lip or cheek was pinched, or when the skin
of the face was stimulated by an interrupted current. It appeared to me that the
area of brain in which the electrical variation occurred was very small, and I
sometimes had difficulty in finding it.
3. If the electrodes were placed on a given motor area, such as Farrier's region
No. 1, related to the posterior limb, and the limb were now stimulated by an
interrupted current, negative variations frequently, though not always, occurred.
4. Sometimes after exposure of a hemisphere to the air, spasms of a limb on the
opposite side occurred. If the electrodes were placed on the brain area correspond-
ing to the movement, I frequently found that a strong negative variation accom-
panied each spasm.
5. Placing the electrodes on various parts of the brain in succession, including the
olfactory bulb of the rabbit, the effect of strong odors was tried, without any result.
6. The electrodes were placed in the temporo-sphenoidal lobe and on other parts of the
brain, and observations made on the effect of sounds—the ringing of a large bell,
etc. No change in the electrical current was observed.
7. In seven rabbits and four monkeys the electrodes were placed on the angular
gyrus or its corresponding region.
The animals were placed in a room which could be darkened or brightly lighted by
gas at pleasure. In three rabbits and two monkeys I found that a fall in the current
was produced by a bright light almost invariably.
These were the chief results obtained. Owing to the great difficulty of the investi-
gation, more than half of the experiments were valueless.
BRIEF SUMMARY OF RESULTS.
1. Electrical currents are present in the gray matter of the convolutions.
2. These currents are increased during the arrest of functional activity caused by
anaesthetics or a death. After death the current diminishes and disappears,
3. In regions of the brain related to a special function, negative variation appears to
take place during functional activity.
4. The occurrence of negative variation in an area of the brain assumed to be
related to a special act at the movement of the performance of the act, affords
further evidence of localization.
5. These experiments afford some evidence that areas of brain related to movements
of special muscles are also related to some form of sensibility in the skin adjacent
to those muscles.
THE BASAL GANGLIA OF THE BRAIN AS CENTRES OF
PSYCHIC AND FUNCTIONAL POWER.
LES GANGLIA CÉRÉBRALE GRANDS COMME CENTREs PSYCHIQUES.
DIE GROSSEN GEHIRNGANGLIEN ALS PSYCHISCHE CENTRA.
BY DANIEL CLARK, M. D.,
Of Toronto, Canada.
1st. Because of their greater activity physiologically.
2d. The focal centres to the hemispheres.
3d. They are vital points of greater sensitiveness than any other part of the brain.
4th. Experiments point to their directing and controlling power.
NINTH INTERNATIONAL MEDICAL CONGRESS. 75
ON CEREBRAL FUNCTION-TRANSMUTATION OF ORGANIC,
OR LIFE-FORCE, INTO PSYCHIC-FORCE—THE PHENOMENA
OF CONSCIOUSNESS SEQUENTIAL, ETC.
DE LA TRANSMUTATION CAERAEBRALE FONCTIONELLE DE FORCE OR-
GANIQUE OU VITALE EN FORCE PSYCHIQUE, LES PHENOMENES DE
LA CONSCIENCE EN SUITE, ETC.
TJEBER CEREBRALE FUNKTION-UMWANDLUNG ORGANISCHER, ODER LEBENSKRAFT IN
PSYCHISCHE KRAFT, DIE ERSCHEINUNGEN DES BEWUSSTSEINS IN FOLGE, ETC.
BY O. EVERTS, M.D.,
Of Cincinnati, Ohio.
Final questions in physiology are psychological : intellect being the final manifesta-
tion of function, as the cerebrum, and especially the fore-brain, is the final development
of nerve structure.
The testimony of facts observed, and principles generalized therefrom, by modern
Science, not to be rejected nor reluctantly received by physiologists because of precon-
ceived notions respecting the constitution of man, however antiquated or universally
accepted by the ignorant and incapable.
Degradation of so-called sensuous objects, and exaltation of hypothetical, so-called
spiritual beings, arbitrary, unscientific, and irrational, in the light of present
knowledges.
Matter both material and spiritual: materials and forces being ever inseparable.
Force, or energy, is spiritual (not supernatural). The spirit of matter is neither more
mysterious, wonderful, intelligent, nor unchangeable than is the material side, or qual-
ity of matter.
Motion of material mechanisms implies not only change of material objects, but con-
comitant and inevitable transmutation of energy, or spirit.
Motion of mechanism and transmutation of energy implies phenomena of manifes-
tations of change, phenomena being “inevitable sequences of antecedent conditions” of
matter and force.
Potentiality of the highest, or most complex, mental phenomena, incident to the
motions of nerve structures and transmutation of nerve force, resident in the lowest
form of such structure as manifested by protoplasmic irritability, etc., etc., etc.
ON ALCOHOL IN THE ORGANISM.
DE L’ALCOOL DANS L’ORGANISME.
UEBER DEN ALCOHOL IM ORGANISMUs.
BY W. HUTSON FORD, M. D.,
Of St. Louis, Mo.
Historical. Hepatic sugar, its disappearance in the economy. Views of Claude
Bernard and Pavy. Experiments of Flint, Lusk, and Dalton. The author's experi-
ments upon alcoholic fermentation of hepatic glucose in the blood. Distillation the
only available method of recovering alcohol from organic substances. Results by this
method applied to the blood : Disappearance of sugar from blood and liver. Vinous
fermentation in the liver, blood, and lung tissue. Amount of alcohol in the body.
Alcoholic fermentation a source of heat. The sources of alcohol are the carbohydrates
and albuminoids. The assumption of a special blood ferment not necessary in explana-
tion. Propositions involved in the doctrine of alcoholic fermentation of hepatic glu-
cose. Conclusion : Alcoholic fermentation a universal, constant and vital process upon
which temperature is fundamentally based, and the source of the greater share of
animal heat.
*
76 ABSTRACTS.
A COMPARISON OF THE COAGULATION OF THE BLOOD
WITH RIGOR MORTIS.
|UNE COMPARAISON DE LA COAGULATION DU SANG AWEC LA RIGIDITÉ
CADAVERIQUE.
EIN VERGLEIGH DER BLUTGERINNUNG MIT DEM RIGoR MORTIs.
BY W. D. HALLIBURTON, M. D., B. SC.,
Of London, England.
The coagulation of the blood can be prevented either by cold or by the admixture of
certain neutral salts. Kühne was the first to show that cold prevents the coagulation
of the muscle plasma of frogs. By means of methods very similar to those employed
by that observer, the muscle plasma of warm-blooded animals can also be prevented
from coagulating by the same agency. Mixture of the muscle plasma with solutions of
certain neutral salts will also prevent its coagulation; and, as in the case of Salted blood
plasma, dilution of such salted muscle plasma brings about the formation of a clot
of myosin; this occurs most readily at the temperature of the body, and is entirely
prevented by a temperature of 0°C. It is hastened by the addition of a ferment pre-
pared from muscle in the same way as Schmidt's fibrin ferment is prepared from blood.
Rigor mortis is thus the result of a ferment action similar to that which converts fibrin-
ogen into fibrin; but the myosin ferment is not identical with fibrin ferment, as it does
not hasten the coagulation of salted blood plasma, nor does the fibrin ferment hasten
the coagulation of muscle plasma.
The myosin ferment is either identical with or closely allied to one of the proteids of
the muscle plasma, which has the properties of an albuminose.
Though it is thus seen there are very striking resemblances between the formation of
fibrin and that of myosin, there are also certain differences, of which the most important
are the three following:—
1. Myosin can be easily redissolved by solutions of neutral salts, and this solution
can be made to undergo recoagulation by dilution and addition of myosin ferment.
The passing off of rigor mortis seems to be due to a similar reconversion of myosin into
myosinogen. Fibrin, on the other hand, cannot be made to undergo such a recoagu-
lation.
2. The formation of myosin is accompanied by the formation of lactic acid. The
same acid is formed when the recoagulation of pure myosin occurs, and its source is
thus shown to be a proteid one, not a carbohydrate, as some have supposed. Fibrin
formation is not accompanied by the development of any acid, so far as we are aware.
3. The conversion of myosinogen into myosin is not accompanied by the formation
of another globulin, as is the case in the conversion of fibrinogen into fibrin.
ON THE NECESSITY FOR A MODIFICATION OF CERTAIN
PHYSIOLOGICAL DOCTRINES’ REGARDING THE INTER-
RELATIONS OF NERVE AND MUSCLE.
SUR LA NáCESSITÉ DUNE MODIFICATION DE CERTAINES DOCTRINES
PHYSIOLOGIQUES CONCERNANT LES RAPPORTS RECIPROQUES DU
NERF ET DU MUSCLE.
UEBER DIE NOTHWENDIGKEIT EINER MODIFIKATION WON GEWISSEN PHYSIOLOGISCHEN
DOCTRINEN IN BEZUG AUF DIE INNEREN BEZICHUNGEN VON NERV UND MUSKEL.
BY THOMAS W. POOLE, M. D.,
Of Lindsay, Ontario.
1. I hope to show, on the highest physiological authority, that muscles of the involun-
tary class pass into a state of spasm or contraction, not when their motor nerves are
stimulated, but when these nerves are cut, or are paralyzed, or dead.
NINTH INTERNATIONAL MEDICAL CONGRESS, 77
2, That the same is true of the muscular bands of the arterial coats. That the
authentic experiments on the spinal cord, as well as on the cervical sympathetic and
splanchnic nerves, and in the case of “pithed ” animals, prove conclusively that section
of the spinal cord, or of the vaso-motor nerves is attended, not by dilatation and hyper-
aemia of the peripheral arterial system, but by a condition of contraction and emptiness,
blood being forced out of the systemic system into the venous, so that what is called
the “paralytic hyperaemia,” as the result of such sections, is not arterial but venous.
3. That the statements given in our physiological works as to the excited condition
of the nervous centres in such states as asphyxia, and the theories of Traube and others
in explanation of the Cheyene-Stokes' respiration, in which impure venous blood, loaded
with carbonic acid and deficient in oxygen, is assumed to stimulate and excite the
nervous centres, are absurd, and have been put forward solely to meet the exigency of
an erroneous theory. I have a new theory to submit in explanation of this curious state,
in which the grave defects first mentioned are obviated.
4. My thesis enters into what I deem conclusive evidence that electricity, as employed
for physiological and therapeutical purposes, is not a stimulant but a paralyzing agent
to nerve activity, and that the undoubted beneficial effects of this agent may all be satis-
factorily accounted for in strict accord with its rôle as a paralyzer.
5. The same applies also to strychnia, for proof of which the authorities, as usual,
are freely quoted.
6. The action of the vascular sedatives, aconite, ergot, etc., and the rigidity and sub-
sequent relaxation of the muscles during anaesthesia are amply accounted for on the
view presented in this paper.
7. This theory is not an extension of the inhibitory hypothesis of recent physiology.
On the contrary, if this theory were adopted, the huge inhibitory incubus which threatens
to become unwieldy from its very complexity, could be in a large degree dispensed with,
and the explanation of various phenomena in the organism simplified to the great
advantage of both physiology and therapeutics.
8. Ample proof is produced that “irritation” and “inflammation” are not attended
by excitation of nervous activity, but the reverse; also, that what is called “morbid ''
nerve force, as something different from proper nerve function, does not exist.
9. Even the voluntary muscles pass into a state of spasm or contraction under condi-
tions which may properly be regarded as attended by a deprivation of nerve force,
oftener, perhaps, than is generally supposed, as in cases depending on “irritation,”
which is a paretic condition rather than one of exalted nervous activity.
10. It is not necessary to my thesis that I hold, or prove, rigor mortis to be a condi-
tion of muscular contraction. But this state has not yet been otherwise satisfactorily
explained, the myosin hypothesis proving unsatisfactory in that respect.
11. Objections to the theory thus presented, arising out of the independent contrac-
tion of muscle substance “without the intervention of nerves,” and also from what is
thought regarding the paralyzing effect of curare (or woorari) on the motor nerve
endings, and some minor objections, receive due attention.
TROPHIC INFLUENCE OF THE NERVOUS SYSTEM.
DE LINFLUENCE TROPHIQUE DES systèMEs NERVEUx.
UEBER DEN TROPHISCHEN EINFLUss DES NERVENSYSTEMs.
BY THOMAS O. SUMMERs, M. D.,
Jacksonville, Fla.
I. Elective affinities of nutrition dependent upon two forces, the one atomic, the other
molecular.
II. The chemical or atomic forces of the organism operate solely upon perfectly
Soluble material ; the physical or molecular forces upon all material which may be sub-
jected to as motic relations, whether in solution or suspension.
78 ABSTRACTS,
The physiological nutritive agency lodged in the nerve system.
III. The trophic centres of the nerve system are to be classified by the number and
character of their poles.
IV. Location of trophic centres. They are always to be found between the communi-
cating fibres of the sympathetic and cerebro-spinal.
V. Growth force—the determining principle of nutrition located by specific nerve
Centres.
VI. Influence of nerve force on chemical action. Summary.
THE VITAL ORGANISM-ITS NUTRITION.—HEREDITAMENT.
L'ORGANISME VITAL, SANUTRITION, H&REDITÉ.
DER WITALE ORGANISMUS, SEINE ERNAEHRUN g—HEREDITAMENTUM,
*
BY DR. A. WETMORE,
Of Waterloo, Ill.
The Organism. Position taken, that—after maturity—no normal transformations of
tissue take place.
Nutrition. After maturity, food and drink simply undergo chemical and physical
change, that they may evolve heat, render the tissues pliable, wash out débris, and be
made physically capable of passing through the channels prepared for them, finally cul-
minating in the formation of the spermatozoa in the male, ovum in the female.
Hereditament. The logical result of the physical condition of the organism, which
moulds the material that is to end in spermatozoa and ovum.
SECTION IX—PATHOLOGY.
PRESIDENT: PROF. A. B. PALMER, Ann Arbor, Mich.
WICE-PRESIDENTS.
Dr. Joseph CoATS, Glasgow, Scotland. Dr. J. B. Johnson, St. Louis, Mo.
Dr. CHARLES CREIGHTON, London, England. Dr. HY. F. LYSTER, Detroit, Mich.
Dr. JULIUS DRESCHFIELD, Manchester, England. Dr. JNO. North, Keokuk, Iowa.
Dr. ANDREw FLEMING, Pittsburg, Pa.. Dr. Jos. FRANK PAYNE, London, England.
Dr. JAS. F. GOODHART, F. R. C. P., London, Eng. Dr. E. O. SHAKESPEARE, Philadelphia, Pa.
Dr. D. J. HAMILTON, Aberdeen, Scotland.
SECRETARIES.
Dr. H. M. BIGGs, New York, N.Y. | Dr. ISAAC. N. HIMES, Cleveland, Ohio.
COUNCIL.
Dr. Ezra P. Allen, Athens, Ohio. Dr. Chas. H. Hunter, Minneapolis, Minn.
Dr. N. S. Davis, Jr., Chicago, Ill. Dr. A. S. Von Mansfield, Ashland, Neb.
Dr. Llewellyn Eliot, Washington, D. C. Dr. E. M. Schaeffer, Washington, D. C.
Dr. Thos. J. Gallaher, Pittsburgh, Pa. Dr. S. R. Skillern, Philadelphia, Pa.
Dr. D. R. Hagner, Washington, D. C. Dr. A. F. Wheelan, Hillsdale, Mich.
Dr. Wm. J. Herdman, Ann Arbor, Mich.
PATHOLOGICAL ANATOMY OF ALCOHOLISM.
ANATOMIE PATHOLOGIQUE DE L'ALCOOLISME.
DIE PATHOLOGISCHE ANATOMIE DES ALKOHOLISMUs.
BY HENRY F. FORMAD, M.D.,
Of Philadelphia, Pa.
ETIOLOGY OF LIVER, ABSCESS.
L’ETIOLOGIE DES ABC?s I)"U FOIE.
DIE AETIOLOGIE DER LEBER-ABSCESSE.
BY DR. KARTULIS,
Physician to the Government Hospital, Alexandria, Egypt.
EXPERIMENTS WITH THE POISON OF RABIES.
EXPſ. RIENCES AWEC LE POISON DE L'HYDROPHOBIE.
ExPERIMENTE MIT DEM GIFTE DER LYSSA.
BY DR. E. O. SHAKESPEARE,
Of Philadelphia, Pa.
79
SECTION X—DISEASES OF CHILDREN.
OFFICERS.
PRESIDENT: DR. J. LEWIS SMITH, New York.
WICE-PRESIDENTS.
HENRY ASHBY, M. D., Manchester, England.
Dr. W. B. ATKINson, Philadelphia, Pa.
Dr. A. BLACKADER, Montreal, Canada.
WM. D. BookER, M.D., Baltimore, Md.
IE. BouchſuT, M. D., Paris, France.
WM. D. HAY, M.D., London, England.
Prof. AD. D'ESPINE, St. Malo.
Dr. CADET DE GASSICOURT, Paris, France.
Dr. DE SAINT GERMAIN, Paris, France.
JAS. FRED'K GOODHART, M. D., London, England.
Prof. H. HIRCHSPRING, Copenhagen, Denmark.
Pierr Prof. HOFRATH, Vienna, Austria.
Dr. ADENOVAM. S. JUDSON, New York.
Dr. MoREORRE, Rio de Janeiro, Brazil.
Herr Prof. ALVIS MONTE, Vienna, Austria.
Dr. JNo. MORRIS, Baltimore, Md.
J. P. OLIVER, M. D., Boston, Mass.
MARTIN GAY BLACK OXLEY, M. D., Liverpool,
England.
JULES SIMON, M.D., Paris, France.
Dr. EUSTACE SMITH, London, England.
WM. STEPHENSON, M.D., Aberdeen, Scotland.
NICOLAS TOLMATOCHOW, M. D., Kasan, Russia.
ALFRED WOGEL, M. D., München, Germany.
Dr. CHARLES WEST, London, England.
Dr. HERMAN WIDERHOFER, Vienna, Austria.
OSCAR WYss, M. D., Zurich, Switzerland.
SECRETARIES.
DILLON BROWN, M. D., New York City.
HENRY COGGESHALL, M.D., Mt. Vernon, N.Y.
LUCIEN DANRANSvILLE, M.D., New York, N.Y.
I. N. LOVE, St. Louis, Mo.
COUNCIL.
Wm. T. Belfield, M.D., Chicago, Ill.
Edw'd H. Bradford, M. D., Boston, Mass.
H. Charlton, M. D., Seymour, Ind.
W. H. Conklin, M.D., Canton, Ohio.
W. J. Conklin, M. D., Dayton, Ohio.
Wm. H. Doughty, M.D., Augusta, Ga.
Jos. O. Dwyer, M. D., New York, N. Y.
C. W. Earle, M.D., Chicago, Ill.
Wm. D. Haggard, M.D., Nashville, Tenn.
M. P. Hatfield, M.D., Chicago, Ill.
J. A. Hodge, M.D., Henderson, Ky.
W. F. Holt, M.D., Macon, Ga.
A. A. Horner, M.D., Helena, Ark.
G. K. Johnson, M.D., Grand Rapids, Mich.
H. H. Middlekamp, M.D., Warrenton, Mo.
W. P. Northrop, M. D., New York, N. Y.
Jno. S. Reed, M. D., New York, N. Y.
B. H. Riggs, M. D., Selma, Ala.
Chas. A. Seale, M. D., New York, N. Y.
O. W. Sherwin, M.D., Woodstock, Vt.
A. L. Steele, M.D., St. Louis, Mo.
Edwin Walker, M.D., Evansville, Ind.
Wm. P. Watson, M.D., Jersey City, N. J.
Frank E. Waxham, M. D., Chicago, Ill.
Edmund C. Wendt, M. D., New York, N.Y.
Leroy M. Yale, M.D., New York, N. Y.
SCARLATINAL NEPHRITIS FROM A CLINICAL AND PATHO-
LOGICAL STANDPOINT.
DE LANſ. PHRITE DANS LA SCARLATINE, A UN POINT DEVUE CLINIQUE
ET PATHOLOGIQUE.
DIE SCHAIRLACH-NEPHRITIS WOM KLINISCHEN UND PATHOLOGISCHEN STANDPUNKT.
BY DR. HENRY ASHBY,
Of Manchester.
1. Albuminuria during the eruptive period is common ; it is temporary and unim-
portant, and is comparable to the albuminuria frequently present in croupous pneu-
monia, typhoid or other febrile disease.
80
NINTH INTERNATIONAL MEDICAL CONGRESS. 81
2. In cases fatal during the second or third week in which there has been slough-
ing of the tonsils and soft palate and much glandular inflammation, large, pale,
flabby kidneys are found post-mortem. In many, minute abscesses are present at the
base of the pyramids and in the cortex. These changes are essentially those of septi-
caemia, secondary to the lesions in the throat. They give no characteristic symptoms
during life, as a rule.
3. Post-scarlatinal nephritis. An attack of scarlet fever leaves the kidneys in an
irritable condition, and the slightest chill or other cause is apt to give rise to inflam-
matory changes. The nephritis which occurs during the third or fourth week is
due to an inflammation of the croupous type, there being a more or less inflammatory
congestion, which relieves itself by the passage of liquor sanguinis or blood into the
tubules. Secondary lesions are apt to be set up, the most characteristic being certain
peri-glomerular changes, resulting in the strangulation of the glomeruli. Various
other changes follow, as uraemic phenomena, dilatation of the heart, and sometimes
endocarditis.
Discussion to be opened by Dr. Frank Grauer, on the Pathology of Scarlatinal
Nephritis.
ON ACETONURIA IN CHILDREN.
DE L'AcáTONURIE CHEZ LES ENFANTs.
UEBER ACETONURIE BEI KINDERN.
*
BY DR. ADOLPH BAGINSKY,
Of Berlin.
After von Jacksch had detected the presence of acetone (CNs CO CNA) and di-acetic
acid (CNs CO CNs) in the urine of children affected with high fever and convulsions, it
was important to submit the question of acetonuria of the children to a more thorough
examination. In the relationship of rachitis, laryngospasm and eclampsia, clinically
to be observed within the scope of this examination, particular stress was to be laid
on the importance of acetonuria for the development of rachitis.
To prove the presence of acetone in the urine in each case, the reaction of Lieben
(formation of iodoform on addition of iodized iodide of potassium to the distillate of
alkalized urine), of Legal (crimson color readily changeable by the addition of nitro-
cyanide of sodium to the slightly alkaline distillate), of Reynolds (capacity of the
distilled urine to dissolve freshly precipitated oxide of mercury) were employed.
Only where these three reactions took place, the presence of acetone in the urine was
accepted.
The results of the examination were as follows:—
1. In perfectly healthy children very small quantities of acetone could be shown in
the urine ; the presence of this body, however, is not constant, but it may be absent.
2. In the urine of children with high fever (in the most different diseases) acetone is
found abundantly; the quantity of the acetone rises with the fever and disappears with
the critical fall of the temperature.
3. Children with violent eclamptic attacks show an extremely high amount of
acetone in the urine,
In regard to the source of these different forms of acetonuria the following facts
were ascertained (partly from experiments on animals):—
4. If animals are fed with nourishment rich in nitrogen, an abundant acetonuria is
developed, but the acetone disappears completely by feeding with substances as free as
possible from nitrogen. (Amylacea and fat.)
5. Artificial checking of respiration carried even to the point of asphyxia, by
poisoning with carbonic oxide, does not produce acetonaemia when slightly nitrogen-
ous food is given. (Experiment on dogs.)
6
82 ABSTRACTS.
* 6. Neither in the faeces nor in the contents of the stomach of dyspeptic children can
acetone be demonstrated.
7. By lactic acid fermentation so small quantities of acetone are produced as not to
be regarded as the source of acetonuria.
From these facts may be concluded, that acetonuria has its source in a peculiar
disintegration of albuminoid substances.
Regarding the relationship of the development of acetone to rachitis and concomitant
fiervous symptoms, essentially negative results were obtained. It was found that—
8. Children affected with rachitis, and subject to laryngospastic attacks show either
no acetonuria or acetone appears in slight traces only in the urine.
9. Long continued bountiful feeding with acetone or acetic ether (CN, CO CN, CONs)
caused in young dogs neither eclamptic attacks nor rachitis. The animals remain
perfectly healthy, and no affection of the kidneys follow.
10. The abnormal nutritive metamorphosis producing rachitis is, therefore, no
direct connection with the disintegration of albumin causing acetonuria.
A. STUDY OF SOME OF THE BACTERIA FOUND IN THE
DEJECTA OF INFANTS AFFECTED WITH SUMMER DIAR-
RHOEA.
ETUDE SUR CERTAINS BACTERIA TROUVES DANS LES SELLES D'EN-
FANTS SOUFFRANT DE LA DIARRHEA PENDANT L’ÉTE.
UEBER EINIGE BAKTERIEN IN DEN ENTLEERUNGEN BEIM BRECHDURCHFALL IDER
RINDER.
*
BY W. D. BOOKER, M.D.,
Of Baltimore, Md.
The material was collected, with aseptic precautions, from the contents of the rectum
of some of the children brought to “The Thomas Wilson Sanitarium ” during the
summer of 1886. It was then transferred to the Pathological Laboratory of the Johns
Hopkins University, where the further isolation and study of the bacteria were car-
ried on under the general supervision of Professor Welch and Dr. Meade Bolton. The
children from whom the collection was made were from three to eleven months old,
and were affected with cholera infantum, chronic gastro-enteric catarrh, and follicular
enteritis. Twelve different varieties of bacteria have been isolated.
The differentiation was made by the character of the growth upon the different cul-
ture media, together with the morphology of the organisms. Eleven varieties belong
to the bacilli and one variety to the cocci. Two of the bacilli liquefy gelatine, the
others do not liquefy it.
Constancy of appearance: no single variety was found in every case, though one was
found in two or more cases.
Action on milk: chemical analysis of the milk was not made, and only the gross
changes considered. Some bacteria caused coagulation of the casein with acid reaction
and evolution of gas. One variety caused coagulation with alkaline reaction. One
variety gave the milk the appearance of being peptonized, other varieties caused no
perceptible change.
Pathogenic properties: The experiments were made upon guinea pigs, young kittens,
white rats and mice, and consisted in hypodermic injections, feeding with milk
infected with the different bacteria and the introduction of a very small quantity of
bacteria on the end of a platinum needle, into a pocket made under the skin with
sterilized scissors. All experiments were made with aseptic precautions. Autopsies
were made in cases of death, the cavities and organs of the bodies examined, and cul-
tures and cover slip preparations made from these.
NINTH INTERNATIONAL MEDICAL CONGRESS. 83
Result of Eaſperiments: Some varieties caused death in most animals inoculated,
whether by hypodermic injections or taken into the stomach with the milk, and gener-
ally pure cultures were taken from the organs examined. In some varieties only a
few of the animals died, and in some varieties only negative results were obtained.
A full description of each variety of bacteria and detailed account of the experiments
will be given in the paper.
HALLUCINATIONS IN YOUNG CHILDREN.
IDES HALLUCINATIONS CHEz LES JEUNES ENFANTS.
HALLUGINATIONEN BET JUNGEN KINDERN.
RY DR. E. Bouch.UT,
Of Paris.
REMARKS ON TUBAGE OF THE GLOTTIS AND THE MANNER
IN WEHICH IT WAS PRACTICED IN FRANCE.
REMARQUESSUR LETUPAGE DE LA GLOTTE ETSUR LA MANIERE DONT
ELLE ÉTAIT PRATIQUEE EN FRANCE.
BEMERKUNGEN ZURTUBAGE DES KöHLKOPFES UND ZUR METHODE IHRER AUSFüHRUNG
IN FRANKREICH.
BY DR. E. Bouch. UT,
Of Paris.
FORCIBLE CORRECTION OF CONTRACTED KNEE JOINT.
CORRECTION PAR FORCE DE LA CONTRACTION DU GENOU.
DIE FORCIRTE CORRECTION DER. KNIEGELENESCONTRACTUR.
BY DR. E. H. BRADFORD,
Of Boston.
1. The advantages of brisement forcé.
2. Methods of avoiding danger: (a) of giving rise to severe arthritis, (b) of fracture of
adjacent bones, (c) of rupture of the popliteal artery.
3. The after-treatment.
4. Description of an apparatus, on the principle of Rizzoli's osteoclast, for reducing the
subluxation of the tibia during the performance of brisement forcé.
INFANTILE CONVULSIONS IN CONNECTION WITH AFTER-
NEUROTIC TENDENCIES.
CONVULSIONS DES ENFANTS PAR RAPPORT AUx TENDANCEs NERV.
EUSES QUISUIVENT.
UEBER CONVULSIONEN BEI KINDERN IM ZUSAMMENHANG MIT ANDEREN NEUROTISCHEN
VERANLAGUNGEN,
BY J. A. COUTTS,
Of London.
1. An inquiry as to the percentage of adult neurotics who have been the subject of
convulsions in infancy.
2. Percentage of neuroses in other members of the family in cases of convulsions in
infancy.
84 ABSTRACTS.
3. An inquiry as to the frequency of convulsions in the initial stages of pneumonia,
the exanthemata, etc.
4. An analysis of cases of persons who have passed the age of second dentition and
who were undoubtedly subject to convulsions in infancy.
5. Tables.
SOME OBSERVATIONS ON HEAD ACHES IN CHILDREN AND
THEIR RELATION TO MENTAL TRAINING.
oBSERVATIONS SUR LES MAUX DE TETE DES ENFANTs ET SUR LEUR
RELATION AWEC L’EXERCICE MENTAL.
BEOBACHTUNGEN UEBER DEN KOPFSCHMERZ BEI KINDERN UND SEINE BEZIEHUNGEN ZUR
GEISTIGEN ERZIEEIUNG,
BY DIR. W. H. DAY,
Of London.
1. Introduction.
2. Causes of Headache in Children. Quantity of Blood circulating in Brain (Cere-
bral hyperaemia, cerebral anaemia). Heredity (Neryous disease or temperament, feeble
health, fatigue, mental shocks, want of proper food, syphilis, etc., in parent). Over-
pressure of Mind in Education of Children, impure air and defective ventilation at
home and in school-rooms.
3. Nervous Headache.
4. Frontal Headache.
5. Neuralgic Headache.
6. Irritable Brain.
7. Treatment of Recurring Headache.
8. Treatment of Irritable Brain.
9. Neuralgic Headache.
10. Necessity for Sleep in School Children.
Discussion to be opened by W. S. Dennett, Oculist, on Headaches in Children from
Errors of Refraction.
TREATMENT OF PHYSIOLOGICAL DERANGEMENTS IN
CHILDREN DUE TO OVER-FEEDING.
DU TRAITEMENT DE LA MIsèRE PHYSIOLOGIQUE CHEZ LES ENFANTS
PAR LE GAVAGE.
DIE BEHANDLUNG DER PHYSIOLOGISCHEN MISERE DER KINDER MITTELS UEBER:
FUTTERUNG.
* *==
BY DR. CADET DE GASSICOURT,
Of Paris.
OBSERVATIONS REGARDING TRUE PNEUMONIA. IN
CHILDREN.
OBSERVATIONS SUR LA PNEUMONIE FRANCHE INFANTILE.
BEOBACHTUNGEN UEBER ACUTE PNEUMONIE BEI KLEINEN KINDERN.
BY PROFESSOR: A. D’ESPINE,
Of Geneva.
1. Il existe chez l'enfant une forme spéciale de pneumonie franche, qu'on pourrait
appeller centrale à cause de son siége, et abortive quand sa durée ne dépusse pas 2 ou 3
jours. Cette forme localisée au lobe supérieur (dans Sa partie interne et supérieure
NINTH INTERNATIONAL MEDICAL CONGRESS. 85
surtout) s'accuse par des signes physiques peu accentués et peut Étre facilement. Å
cause de la prédominance des symptômes généraux. L’examen microscopique d'un
crachat a revélé dans un cas de le genre la presence des micro-organismes habituels
dans la pneumonie franche. -
2. La Terminaison fatale qui est exceptionnelle dans la pneumonie franche infantile,
est due engénéral à une complication. Je citerai comme exemples, deux observations
personnelles de pneumonie franche mortelle, terminée l’une par gangrène, l'autre par
le passage au 3° degré (hēpatisation grise).
3. Le traitement réfrigérant externe (bianstièdes, compresses de Priessnitz, etc.) est
le meilleur traitement symptomatique de la pneumonie franche infantile. C'est le
seul traitement qui m'inspire confiance dans les formes cérébrales à forte fièvre.
AN INVESTIGATION TO DETERMINE WHETHER THE AB-
SENCE OF SEWERAGE AND OF WATER POLLUTION
DIMINISHES THE PREVALENCE AND SEVERITY OF
DIPHTHERIA.
& tºº A
UNE INVESTIGATION POUR DETERMINERSI L’ABSENCE D'EGOUTSET DE
LA CORRUPTION DE LEAU DIMINUE LA FREQUENCE ET L'INTENSITE
IDE LA DIPHTHERIE.
EINE UNTERSUCHUNG UM ZU ENTSCHEIDEN, OB DIE ABWESENHEIT WON ABZUGSKAN-
AELEN UND WON WASSER-VERUNREINIGUNG DIE HAEUFIGKEIT UND SCHWERE DER
DIPHTHERIE VERMINDERT.
sº
BY DR. CHARLES WARRINGTON EARLE,
Of Chicago, Ill.
THE MILK SUPPLY OF THE CITIES. ADULTERATIONS AND
• MODES OF DETECTING THEM.
DU LAIT FOURNI DANS LES VILLES." DE SES ADULTERATIONS ET DES
MOYENS EMPLOYES POUR LES DECOUWRIR.
DIE MILCHVERSORGUNG DER STAEDTE. VERFAELSCHUNGEN UND DIE METHODEN IHRER
ENT DECKUNG.
BY DR. CYRUS EDSON,
Of New York.
Historical: Composition of Milk. Its value as an article of diet. Percentage of
constituents in average milk.
Unwholesome Milk : Abnormal milk—watery milk from weak cows—Sour milk—blue
milk—stringy milk—sandy milk—bitter milk—milk from sick animals—milk
from poisoned animals. -
Tuberculosis: Causes of affecting milk—great danger of tubercular disease—causes
of in animals, particularly milch cows—statistics of infantile mortality from.
tuberculosis—relative frequency of lesions of tuberculosis.
Typhus fever (contagious) in cows—milk from animals affected with typhus.
Unwholesome milk because contaminated by germs from the atmosphere or the
addition of impure water.
Typhoid Fever. Scarlatina. Diphtheria.
Adulterations of milk : Addition of water—removal of cream—coloring—glycerine—
starch—salt—sugar.
Preservations: Carbonate of soda—bi-carbonate of soda—borax—nitrate of soda—
Salicylic acid.
86 ABSTRACTS.
Means of detection of adulterants.
Preserved milk.
Inspection of milk by government.
DISEASES OF FAULTY HABIT. ,
DES MALADIES DES DEFAUTES DE CONSTITUTION.
DIE KRANKHEITEN DESUNRICHTIGEN HABITUS.
BY DR. JAMES F. GOODHART,
Of London, England.
TREATMENT OF DIPHTHERIA BY ANTISEPTIC SPRAYS.
DU TRAITEMENT DE LA DIPHTHÉRIE PAR LA MáTHODE DES £VAPO-
RATIONS ANTISEPTIQUES.
DIE BEEIANDLUNG DER DIPHTHERIE MITTELS ANTISEPTISCHER EWAPORATIONEN.
BY DR. GRANCHER,
Of Paris.
THE TREATMENT OF LATERAL CURVATURE.
DU TRAITEMENT DANS LA DfELECTION LATÉRALE DE L'ÉPINE
DORSALE.
DIE BEHANDLUNG DER SEITLICHEN VERKRUMMUENGEN DES RUECKGRATS.
BY DR. JAMES KNIGHT,
Of New York.
1. Features of the general condition of the patient predisposing to lateral curvature.
2. The variation of form.
3. The general and local treatment.
4. Statement of results.
**
THE NUTRITION OF INFANTS.
DE LA NOURRITURE DES ENFANTS.
*sºmºs
DIE ERNAHRUNG DER KINDER.
BY PROF. ALBERT LEEDs,
Of Stevens Institute, Hoboken, N. J.
1. Brief statement of the present condition of knowledge of this topic.
2. Presentation of results of original analyses of food—in their natural state, arti-
ficially altered by simple treatment, or as sold as compounded and manufactured
articles.
3. Composition of fluids, etc., used in nutrition, as actually made ready for imme-
diate use.
. Alteration in foods by keeping or by action of therapeutic agents or preservatives.
. Comparison of results of analyses and experiments, and deductions therefrom.
6. Conclusions and practical recommendations.
:
NINTH INTERNATIONAL MEDICAL CONGRESS. 87
NOTES ON THE MALARIA OF CHILDREN IN BRAZIL.
NOTE SUR L’IMPALUDISME CHEZ LES ENFANTS AU BRESIL.
UEBER MALARIA BEI KINDERN IN BRASILIEN.
* BY DR. MonCORVo,
Of Rio de Janeiro,
THE NATURE OF WHOOPING COUGH AND ITS ANTISEPTIC
TREATMENT.
DE LA NATURE DE LA CoquELUCHE ET DE SON TRAITEMENT
ANTISEPTIQUE.
UEBER DIE NATUR DES KEUCHHUSTENS UND DIE ANTISEPTISCHE BEEIANDLUNG
DESSELBEN.
BY DR. MONCORVO,
Of Rio de Janeiro.
HEREDITARY SYPHILIS AND RACHITIS IN BRAZIL.
DE L'HáRÉDO.SYPHILIs ET DURACHITISME AU BR£SIL.
UEBER HEREDITAERE SYPHILIS UND RACHITIS IN BRASILIEN.
BY DR. MonCORVo,
Of Rio de Janeiro.
ANATOMICAL CHARACTERISTICS OF MEMBRANOUS CROUP
AS OBSERVED IN FATAL CASES IN THE NEW YORK
FOUNDLING ASYLUM.
CARACTERS ANATOMIQUES DU CROUP MEMRRANEUX TELS QUILS ONT
ETÉ OBSERVES DANS LES CAS FATALs A L’ASILE DE NEW YORK
POUR LES ENFANTS TROUVES.
ANATOMISCHE EIGENSCHAFTEN DES MEMBRANOESEN CROUPE, BEOBACHTET BEI ToBDT-
LICHEN FALLEN IM NEU YORKER FINDELHAUSE.
BY DR. W. P. No RTHRUP,
Of New York,
. Practical definition of it as it occurs in New York City.
. Contrast it with the views of croupous inflammation of the larynx.
. Distribution of membrane, found on autopsy at the New York Foundling Asylum.
. Condition of lungs as found at autopsy.
. Character of pneumonia as seen by microscope.
. Views of those who claim it is collapse and not pneumonia.
. Kind of nephritis found.
. Theories of cause of its development.
. Effects of tube in cases of intubation,
10. “Schluck Prieumonie.”
11. Ulcers of larynx found.
12. Ulcers of trachea found.
13. Significance and importance.
14. Prognosis as affected by pneumonia.
15. Prognosis as affected by nephritis.
16. General remarks.
88 ABSTRACTS,
INTUBATION OF THE LARYNX, WITH DEMONSTRATION
ON THE LIVING SUBJECT.
TUBAGE DE LA GLOTTE AVEC DEMONSTRATION SUR LE SUJET VIVANT.
tºmsºmºmºs
DIE INTUBATION DES LARYNX MIT DEMONSTRATION AM LEBENDEN.
tº sºme
BY DR. JOSEPH O'Dwy ER AND DR. DILLON BRowN,
Of New York City.
. History of catheterization and of intubation of the larynx.
. The development of the O'Dwyer tube.
. Indications for intubation.
. Method of operating.
Management of cases after intubation.
. Feeding after intubation.
. Dangers and accidents.
. Cause of death after intubation.
. Bibliography.
. Exhibition of tubes and demonstration on the living subject.
i
1
0
THE TREATMENT OF STRUMOUS GLANDULAR ENLARGE-
MENT OF THE NECK.
TRAITEMENT DES TUMEFACTIONS GLANDULAIRES DU COU.
DIE BEHANDLUNG DER SCROFELöSEN DRüsEN VERZWISERUNGEN AM HALZE.
BY DR. MARTIN G. B. OXLEY,
Of Liverpool.
SECTION OF CONTRACTURED TISSUES ESSENTIAL BEFORE
MECHANICAL TREATMENT CAN BE EFFECTUAL.
NÉCESSITÉ DE FAIRE LA SECTION DES TISSUS CONTRACTÉS AVANT DE
POUVOIR EMPLOYER LE TRAITEMENT MECANIQUE AVEC EFFET.
DIE NOTHWENDIGKEIT DER WORHERIGEN DURCHTRENNUNG ZUR ERFOLGREICHEN
BEHANDLUNG BEI CONTRACTURISTEN GEWEBEN.
BY DR. LEWIS A. SAYRE,
Of New York.
1. Definition of contracted and contractured tissues, and the essential difference in
these two conditions.
2. How to diagnosticate the one from the other.
3. The impossibility of stretching or elongating contractured tissues without severing
some of the fibres of the same, and the attempt to do so causes wmjustifiable
torture.
4. Subcutaneous section of the contractured tissues under an anaesthetic, and the
immediate restoration of the parts to their normal position is attended with no
pain and yields quicker and better results than by any other treatment.
Cases illustrating these views.
5.
NINTH INTERNATIONAL MEDICAL CONGRESS. 89
DELETERIOUS RESULTS IN CHILDREN OF A NARROW
PREPUCE AND PREPUTIAL ADHESIONS.
RÉSULTATS DELETÉRES PRODUITs CHEZ LEs ENEANTS PARUN PREPUCE
ÉTROIT ET PAR DES ADHESIONS PREPUTIALES.
DIE SCHADLICHEN FOLGEN BEI KINDERN DER ENGEN VORHAUT UND VON PRAPUTIALEN
WERWACHSUNGEN.
BY PROF. LEWIS A. SAYRE,
Of New York. º
CEREBRAL IRRITATION IN CHILDREN.
DE L'IRRITATION CÉREBRALE CHEZ LES ENFANTS.
sº
HIRNREIZUNG BEI KINDERN.
BY DR. JULES SIMON,
Of Paris.
PAPER ON THE PROGRESS OF ORTHOP AEDIC SURGERY.
tº-mºmº
LE PROGRES DANS LA CHIRURGIE ORTHOP£DIQUE.
FORTSCHRITTE AUF DEM GEBIETE DER ORTHOPAEDISCHEN CHIRURGIE.
BY DR. NOBLE SMITH,
Of London.
. The absolute necessity of mechanical aptitude on the part of the surgeon.
. The advantages of simplifying mechanical appliances.
. Operation compared with treatment by pressure.
. The advantages of employing as much as possible the natural forces.
. The importance of considering the peculiarities of each individual case, and not
depending upon conventional mechanical apparatus.
6. The necessity of considering the various movements of the body in devising
mechanical apparatus.
7. Bearing of the above principles on the progress of orthopaedic surgery.
:
ANCHYLOSIS OF THE KNEE JOINT IN A STRAIGHT POSI-
TION BY EXCISION, AS A REMEDY FOR THE ATROPHY
AND DEFORMITY FOLLOWING ACUTE POLIO-MYELITIS
OF CHILDHOOD.
ANKYLOSE DU GENOU DANS LA POSITION DROITE APRès LEXCISION
COMME REMEDE POUR LATROPHIE ET LA DEFORMITÉ RESULTANT
DE POLIO-MYELITIS ACUTA CHEZ LES ENEANTS.
gºss
ANKYLOSE DES KNIEGELENRES IN GESTRECKTER RICHTUNG BEI DER EXCISION, ALS EIN
MITTEL GEGEN DIE ATROPHIE UND DEFORMITAET, DIE AUF DIE POLIOMYELITIS ACUTA
DER, KINDER FOLGT.
BY DR. STEPHEN SMITH,
Of New York.
90 ABSTRACTS.
HIP DISEASE, PRACTICAL POINTS IN ITS TREATMENT.
MORBUS COXARIUS—POINTS PRATIQUES SUR SON TRAITEMENT.
PRAKTISCHE WINKE ZUR BEHANDLUNG DER HÚFTGELENKSENTzüNDUNG.
BY DR. A. J. STEELE,
Of St. Louis,
1. Absolute rest to the joint the one therapeutic indication.
2. In the early stage of treatment, rest to be secured by uninterrupted horizontal
posture on the “stretcher splint.”
3. In the later stage, by the use of the portable, long, posterior splint, patten and
crutches.
4. Success turns largely on attention to minor details of the appliance used.
RATE OF GROWTH IN AMERICAN AND BRITISH CHILDREN,
AND ITS BEARING ON THE INVESTIGATION OF DISEASE.
MOYENNE DE LA CROISSANCE CHEz LES ENFANTS AMERICAINS ET
ANGLAIS, ET DE SON IMPORTANCE DANS L'INVESTIGATION DES
MALADIES.
DAS WACHSTHUM AMERIKANISCHER UND ENGLISCHER, KINDER IN SEINEM BEZIEHUNGEN
ZUR UNTERSUCHUNG DER, KRANKHEITEN.
BY PROF. W. STEPHENSON,
Of Aberdeen, Scotland.
THE SCOPE AND LIMITATIONS OF ORTHOPAEDY.
L’ETENDUE ET DES LIMITES DE L'ORTHOPádrE.
|UEBER DIE AUSDEHNUNG UND DIE GRENZEN DER ORTHOPAEDIE.
BY DR. C. FAYETTE TAYLOR,
Of New York.
1. Definition of Orthopaedy.
2. Novel, complicated and expensive apparatus less important than recognition and
application of principles of treatment.
3. An orthopaedic appliance should be (a) definitely related to fixed points, (b) stiff
enough to transmit the required force (c) accurately adapted to the particular
case, (d) so devised as to render surgeon and patient independent of time, and to
secure the benefit of open air and general hygienic measures.
4. Illustrations of the above points.
THE USE OF COW’S MILK IN THE FEEDING OF INFANTS,
DE L'EMPLOI DU LAIT DE WACHE COMME NOURRITURE POUR LES
ENFANTS.
UEBER DEN GEBRAUCH DER KUHMILCH BEI DER ERNAHRUNG DER KINDER.
BY PROF. W. C. VAUGHAN,
Of University of Michigan, Ann Arbor, Michigan.
1. The Necessity of resorting to Cow's Milk.
2. The Care of Milk used in Infant Feeding.
3. The Fermentations that occur in Milk.
NINTH INTERNATIONAL MEDICAL CONGRESS. 91
4. The Development of Poisons in Milk.
5. The Preservation of Milk.
6. The Chemical Differences between the Milk of Woman and that of the Cow.
7. On the Proper Use of Prepared Milk Foods.
THE CONTAGIOUS PRINCIPLE OF PERTUSSIS.
DU PRINCIPE CONTAGIEUX DE LA COQUELUCHE.
DAS CONTAGIUM DER TUSSIS CONVULSIWA.
BY PROF. ALFRED VOGEL,
Of Munich.
INTUBATION VERSUS TRACHEOTOMY IN THE TREATMENT
OF CROUP.
TUBAGE DE LA GLOTTE vs. TRACHEOTOMIE DANS LE TRAITEMENT DU
CROUP.
INTUBATION Vs. TRACHEOTOMIE BEI DER BEBHANDLUNG DES KEHLSUCHT.
BY PROF. F. E. WAXHAM,
Of Chicago.
1. Disadvantages of intubation.
(a) Difficulty of the operation.
(b) The frequent occurrence of broncho-pneumonia from falling of food and liquids
into the lungs.
(c) The danger of obstruction from peeling off of false membrane below the tube.
(d) Difficulty of swallowing and consequent refusal to take nourishment, result-
ing in exhaustion.
(c) Difficulty of removing the tube.
2. Advantages of intubation.
(a) No objection on the part of the parents.
(b) No wound that may be the source of septic infection.
(c) No open wound to close by slow granulation.
(d) No danger from hemorrhage or shock such as might arise from a cutting
operation.
(e) The operation is performed in a few seconds.
(f) No anaesthetic required.
(g) Respiration carried on through the natural air passages.
3. The crucial test.
(a) Comparative success of the two procedures, with statistics of intubation up
to the latest possible date.
Discussion upon intubation to be opened by Dr. JoHN. L. REID, New York.
SECTION XI–0PHTHALMOLOGY.
OFFICERS.
PRESIDENT: DR. J. J. CHISHOLM, Baltimore, Md.
WICE-PRESIDENTS.
CHAs. ABADIE, M.D., Paris, France.
W. A. BRAILEY, M. D., London, England.
A. W. CALHOUN, M. D., Atlanta, Ga.
Prof. L. DE WECKER, M. D., Paris, France.
Prof. J. H. HIRSHBERG, Berlin, Germany.
P. D. KEYSER, M. D., Philadelphia, Pa.
EDMUND LANDOLT, M. D., Paris, France.
Prof. L. MAUTHER, M. D., Vienna, Austria.
Dr. P. H. MULEs, Manchester, England.
Dr. HENRY Power, London, England.
Dr. DUDLEY S. REYNoLDs, Louisville, Ky.
JOHN TWEEDY, M. D., London, England.
Prof. E. WARLEMONT, M.D., Brussels, Belgium.
Prof. ELKANAH WILLIAMS, M.D., Cincinnati, Ohio.
SECRETARIES.
ADOLPH ALT, M. D., St. Louis, Mo.
R. L. RANDOLPH, M. D., Baltimore, Md.
JOSEPH A. WHITE, M.D., Richmond, Va.
COUNCIL.
Benjamin Baldwin, M.D., Montgomery, Ala.
Ole Bull, Christianna, M.D, Sweden.
F. Buller, Montreal, M. D., Canada.
Leartus Connor, M. D., Detroit, Mich.
Howard Culbertson, M. D., Zanesville, Ohio.
Henry Ferrer (Heidelberg), M. D., San Francisco,
Cal.
Blencowe E. Fryer, M.D., Kansas City, Mo.
Galesowski, Paris, M.D., France.
Gayot, Lyons, M.D., France.
Henry Brudelack Hewetson, M.D., Leeds, Eng.
Albert G. Heyl, M.D., Philadelphia, Pa.
Ferdinand C. Holtz, M. D., Chicago, Ill.
E. Des Jardines, M. D., Montreal, Canada.
B. Joy Jeffries, M. D., Boston, Mass.
W. W. Marmion, M.D., Washington, D. C.
Jas. L. Minor, M. D., Memphis, Tenn.
Dr. A. Mooren, Dusseldorf, Germany.
Dr. F. Richardson Cross, Bristol, England.
Dr. F. Rutter, Montreal, Canada.
J. Samelsohn, M.D., Cologne, Germany.
W. H. Sanders, M.D., Mobile, Ala.
A. G. Sinclair, M. D., Memphis, Tenn.
Eugene Smith, M. D., Detroit, Mich.
Geo. T. Stevens, M. D., New York City.
J. L. Thompson, M.D., Indianapolis, Ind.
Jos. A. White, M. D., Richmond, Va.
OPERATION FOR STRABISMUS.
DE L'OPáRATION DU STRABISME,
I)IE SCHIELOPERATION.
BY DR. E. LANDOLT,
Of Paris, France.
MICROBES IN THE DEVELOPMENT OF EYE DISEASES.
MICROBEs DANS LE DEVELOPPEMENT DES MALADIES DE L'OEIL.
MIKEOBEN ALS URSACHE DER AUGENERANKHEITEN.
BY HENRV POWER, ESQ., F.R.C.S.,
Of London, England.
SECTION XII—OTOLOGY.
OFFICERS.
PRESIDENT: S. J. JONES, M. D., LL. D.
WICE-PRESIDENT: B. E. FRYER, M. D., U. S. A., Kansas City, Mo.
WICE-PRESIDENT OF CONGREss: DR. EMILIO DE ROSSI, Rome, Italy.
WICE-PRESIDENTS.
Dr. I. J. K. DUNCANSON, Fäinburgh, Scotland. Dr. URBAN PRITCHARD, London, England.
B. E. FRYER, M.D., U. S. A. Dr. W. LAIDLAw PURVES, London, England.
Prof. Dr. GUYE, Amsterdam, Holland. Prof. E. DE RossI, Rome, Italy.
Dr. B. LOEWENBERG, Paris, France. Dr. ScHWARTZE, Halle, Germany.
Dr. F. M. PIERCE, Manchester, England.
DELEGATE–Otology and Laryngology: Dr. BARATOUX, Paris, France.
SECRETARY: S. O. RICHEY, M. D., Washington, D. C.
COUNCIL.
F. Allport, M. D., St. Paul, Minn. T. E. Murrell, M.D., Little Rock, Ark.
A. Alt, M. D., St. Louis, Mo. G. C. Savage, M. D., Nashville, Tenn.
S. C. Ayres, M. D., Cincinnati, Ohio. J. G. Sinclair, M. D., Memphis, Tenn.
E. W. Bartlett, M.D., Milwaukee, Wis. J. G. Sinclair, M. D., Nashville Tenn.
J. F. Fulton, M.D., St. Paul, Minn. Robt. Tilley, M. D., Chicago, Ill.
H. Goldthwaite, M.D., New York, N. Y. J. P. Worrell, M. D., Terre Haute, Ind.
R. P. Lincoln, M.D., New York, N. Y. H. B. Young, M.D., Burlington, Iowa.
C. J. Lundy, M. D., Detroit, Mich. Walter Ziegler, M.D., Philadelphia, Pa.
W. O. Moore, M.D., New York, N. Y.
REPORT ON 5700 CASES OF EAR DISEASE, CLASSIFIED BY
AGE, SEX, OCCUPATION AND DISEASE: CAUSATION.
LE RAPPORT SUR 5700 CAS DE LA MALADIE D'OREILLE, CLASSIFIE
D'APRES L'AGE, LE SEXE, L’OCCUPATION, ET LA MALADIE : LA CAUSES.
BERICHT UEBER 5700 FAELLE VON OHRENKRANKHEIT, CLASSIFICIRT NACH ALTER,
GESCHLECHT, BESCHAEFTIGUNG, UND KRANKHEITS-URSACHE.
BY S. S. BISHOP M. D.,
Of Chicago, Ills.
1. Youth is a predisposing cause ; more than one-fourth of the whole number of cases
were under 15 years of age.
2. Sex does not figure in the etiology of ear diseases.
3. About 80 per cent. were chronic diseases, and about 90 per cent. were diseases of the
middle ear.
4. The causes of naso-pharyngeal catarrh are the proximate causes of middle ear dis-
GäSe.
5. The nervous temperament was predominant.
93
94 ABSTRACTS.
PRIMARY INFLAMMATORY DISEASE OF THE MASTOID
- ANTRUM.
DES INFLAMMATIONS PRIMAIRES DES CELLULIS MASTOIDICUNES.
URSPRÚNGLICHE ENTZINDUNGEN INNERHALB DER CELLULE MASTOIDEAE.
tºmº
BY JOHN F. FULTON, M. D., PH. D.,
Of St. Paul, Minn.
Primary disease of the mastoid cells and antrum is sufficiently common to merit
much careful study and classification. Although much of the disease that attacks
this region is secondary to inflammation extending from the tympanic cavity or exter-
nal canal, there can be no doubt that the reverse of this is also true. Acute primary
inflammation, either suppurative or non-suppurative, of the pneumatic spaces is ex-
tremely difficult to diagnose. The symptoms are obscure and are often referred to parts
remote from the seat of disease, therefore a careful clinical history is most important.
The author has known this trouble to be diagnosed as neuralgia, and the patients
allowed to suffer for weeks and months, until the trouble has been developed and
relieved by spontaneous opening of the cavity’s wall. Some of the suppurative cases
result in a sub-periosteal abscess behind the auricle. In the present state of our
knowledge a positive diagnosis of primary disease of the mastoid cells cannot always
be made, as neither the symptoms nor aetiology have been sufficiently studied. Pain
is the symptom most relied on, but this is sometimes very deceptive, as it frequently is
referred to regions of the skull quite distant from the seat of the trouble ; it is, how-
ever, apt to be constant, “stinging,” throbbing and tearing. The patient gets no rest,
the discomfort being much increased at night. A diagnosis is best arrived at by a
process of exclusion.
There is no trouble with any other portion of the ear; no dullness of hearing, no
tinnitus. The diagnosis is rendered almost certain if a swelling develops itself be-
hind the ear late in the attack. Disease of the mastoid cells runs rather a slow
course. Those of strumous or syphilitic origin are very slow. As soon as the diag-
nosis is made the mastoid should be opened, when relief will be almost instantaneous.
A minute clinical history is given in the paper illustrating the different forms of
mastoid disease.
CEREBRO-SPINAL FEVER AS A CAUSE OF DEAFNESS.
LA FIEVRE CÉRÉBRO-SPINALE COMME UNE CAUSE DE LA SURDITÉ.
CEREBRO-SPINAL FIEBER ALS URSACHE DER TAUBHEIT.
BY C. M. HOBBY, M.D.,
Of Iowa City, Iowa.
Sources of information: personal, U. S. Census, reports of institutions for the deaf and
dumb, correspondence with superintendents of many institutions, etc., etc.
Cerebro-spinal fever occurs epidemically, endemically, and sporadically, and is diffused
throughout the country similarly to Diphtheria. Estimated average of occurrence in
the United States, from 20,000 to 30,000 cases per annum; observed mortality during
epidemics, fifty per centum. Mortality probably less in sporadic cases. Frequently
there is left behind in the survivors paralysis, imbecility, insanity, blindness of one or
both eyes, or deafness of one or both ears; is the annual cause in the United States of
many hundred cases of deaf-mutism, producing as many if not more cases than Scarlet
Fever, viz, from eighteen to thirty per centum. Cerebro-Spinal Fever occurs very early
in life, fourteen per centum of the cases of deaf-mutism thus caused having originated
under one year of age among those personally examined, fifty-seven per centum orig-
NINTH INTERNATIONAL MEDICAL CONGRESS. 95
inating under two years of age, one case noted at two months and five at three months.
What would be the percentage if the proper value were given to the record “born deaf”
Distribution of deaf-mutism remarkably uniform ; exceptions, newly settled states
and the colored race. Cerebro-Spinal fever similarly distributed, Scarlet Fever more
frequent, proportionately in large centres of population, also more destructive in its
effects. *
Value of statistics is lessened by imperfect methods of obtaining vital statistics, the
value of reports of institutions for the deaf and dumb is lessened by system of admission
papers, by the concealment of facts by parents, and by the personal bias of the Superin-
tendents.
Investigation has, heretofore, been mainly directed to consanguinity and prenatal in-
fluences, as causes for deaf-mutism, and based upon the startlingly apparent proportion
of congenital cases. Reports of from thirty to sixty per centum of cases “born deaf”
are acknowledged by many superintendents to be valueless, probably ten per centum
will more than cover the congenital cases.
The nasal diseases of infancy are not so operative as has been supposed, a large pro-
portion of so-called congenital cases being due to early inter-cranial disease.
Diagnosis of Cerebro-Spinal Fever in infancy presents many difficulties. Cases of
deafness attributed to Scarlet Fever have been found, without tympanic lesions and
without ability to perceive sound either aerially or by bone conduction.
In 84 deaf-mutes, where the deafness was caused by Cerebro-Spinal Fever, sixty-three
per centum had absolute loss of hearing in both ears; in about the same percentage no
lesion was found in the tympanum by inspection of the membrane.
Blindness, after Cerebro-Spinal Fever, is usually caused by suppurative choroiditis,
but atrophy of the optic nerve, without ocular lesion, occurs (two cases reported).
Deafness probably due in the vast majority of cases to disease of the labyrinth, but oc-
casioned lesion of the auditory nerve is probable ; coincident paralysis of the facial is at
least very rare; sense of taste is sometimes lost, or affected. Blindness resulting at the
same time with deafness is not very uncommon.
More care should be exercised in securing accurate reports at the time of admission of
deaf-mutes into institutions for instructions.
(Tables appended showing condition as to hearing power, presence or absence of vis-
ible lesions, table of comparison of congenital cases observed). Statistics compiled from a
large number of reports, brief reports of illustrative cases, references to literature, etc.
ON THE TREATMENT AND THE BACTERIOLOGY OF AURAL
FURUNCLES.
SUR LE TRAITEMENT ET LABACTERIOLOGIE DES FURoNCLES AURICU-
LAIRES.
UEBER DIE BEHANDLUNG UND BARTERIOLOGIE DER OHRENFURUNKELN.
smºsºms
BY IDR. B. LOEWENBERG,
Of Paris
In 1880 and 1881 I published * the results of my researches on the practical
nature of aural furuncles, together with the theoretical and practical applications, the
substance of which can be given as follows:—
1. Boils are caused by an affection from outward, viz: through the ducts of the
cutaneous follicles.
* (a) Loewenberg, De Furoncle de l’Oreille et la Furonculose, (Progrès Medical, 1881). An exhaustive
article of this paper has appeared in the American Journal of Otology (Vol.'IV, p 139–144).
(b) 2d International Medical Congress (Milan, 1880) Transac. size., p. 17–22.
(c) Note presented to the Academy of Sciences (Paris) by Prof. Marey, in the author's name, and pub-
lished in the Transactions of this Society, 1880, Vol. I, p. 555–556.
96 ABSTRACTS.
2. The successive outbreak of furuncles on the same individual takes place by auto-
contagion, that is, through transport of the cocci upon the skin.
3. Infection from one person to others is possible and originates from the same pro-
cess as in No. 2.
These fundamental points have led me to a plan of treatment for boils and for fur-
unculosis in general. I shall now expose this method with regard to the furuncles of
the external ear, together with the results hitherto obtained.
My course of treatment is about the same as the one formerly proposed by me for
otorrhoea, that is, the use of an over-saturated solution of one part of extremely fine pow-
der of boracic acid, to five parts of strong, even absolute, alcohol. This compound I use
in instillations into the meatus, to be repeated three to four times a day.
As long as the boil is not yet opened a simply saturated alcoholic solution of boracic
acid is sufficient, but when pus is already discharging, I prefer the oversaturated solu-
tion, as it deposes a certain amount of boracic, powder, dissolving gradually in the pus
and thus exercising a continual anti-bacterial action.
Alcohol, besides its efficaciousness against micro-organisms, is moreover destimated to
facilitate the penetration of the compound into the ducts of the follicles, the siege of
the disease. The fatty lining and contents of these capillary canals oppose, according to
physico-chemical laws, a resistance to the entering of watery liquids, while alcohol,
according to its affinity to fats, easily penetrates.
Incision of boils certainly sometimes facilitates this course of treatment, but it is
often very difficult to practice it just so as to divide the follicle ducts, which seems to me
the desideratum.
Cocaine, though applied upon the epidermis, often procures passing relief.
IRESULTS.
An early application of the saturated solution of boracic acid in strong alcohol often
arrests the boils; even in the cases when this abortive treatment should fail, the perse-
verant use of the oversaturated solution always stops the otherwise nearly unavoidable
succession of boils, originated by anto-contagion, as I have called it (loc. cit.). These
results seem to me of great importance, firstly, because aural furuncles are known to be
extremely painful, secondly, because, according to my experience, the longer this local
furunculosis lasts the greater is the tendency of the boils to form in parts situated
nearer and nearer the drum, and consequently to prove more and more painful. These
results, to the best of my knowledge, have not been obtained before my researches.
Many female patients suffer, often for years, from aural boils arising before or during
each menstrual period, a fact, an explanative theory of which will be found in my
paper. In such cases my treatment arrests these boils, or, at least, prevents their return.
Nay, their formation may even be successfully prevented by a prophylactic use of this
treatment begun before the catemenial epoch.
The same results can be obtained with persons who are regularly attacked by this
affection in Spring or Fall.
BACTERIA IN EAR-FURUNCLES.
I have undertaken bacteriological researches in a certain number of cases of still
unopened boils of the meatus. In cach case I first syringed this canal and then filled
it for ten minutes with a lukewarm solution of bichloride of mercury (goºg). A small
parcel of the pus was inoculated into agar-agar or nutrient gelatine and plate culti-
vations were made of the whole.
I obtained the following results : The micro-organism most frequently found was
Staphylococcus albus, which was absent in only one case, then came Staphylococcus
aureus and sometimes St. citreus. Only in one case all these three staph. were traced
together.
These results differ from those obtained by my friend N. Kirchner from Würzburg
who only found Staphylococcus albus.
NINTH INTERNATIONAL MEDICAL CONGRESS. 97
PHYSIOLOGICAL AND ACOUSTIC RESEARCHES ON NASAL
SOUND (NASENLAUTE).
DES RECHERCHES PHYSIOLOGIQUES ET ACOUSTIQUES SUR LES SONS
NASALS.
PHYSIOLOGISCHE UNID ACUSTISCHE UNTERSUCHUNGEN EUBER DIE NASENLAUTE.
BY DR. B. LOEWENBERG,
Of Paris, France.
|Under the denomination of nasal vowels two kinds of phonemata are generally con-
founded, notwithstanding their considerable diversity, regarding as well the nature of
their sonority as the physiological conditions of their formation.
In my book on “Adenoid Growths of the Upper Pharynx,” I have been led to
study this subject while examining the troubles of functions caused by these vegeta-
tions. Among the perturbations they produce by obstructing the posterior aperture
of the nasal fossae, we find modified pronunciation of all the letters which implicate
the free passage of the expired air through, and its resonance in, the nasal cavities.
Out of these letters I first placed together the nasal vowels, a class similarly altered in
the said disease. I divided them into two groups:—
1. Those especially peculiar to the French pronunciation, and called by me French
nasal vowels, (an, in, on, un, or eun.)f
2. Others equally called nasal but of a different Sonority, proper to Latin languages,
as Spanish, Italian, etc., and to English and German. I shall call these letters “not-
French nasal vowels.”
Having examined in my above-mentioned book the differences between these two
groups with regard only to the position of the local organs necessary to pronounce them,
I later on studied other particularities of this problem, which shall be published in a
more exhaustive paper. *
I actually intend to analyze the nasal vowels with regard to their acoustic nature.
Among the different questions this matter involves, arises at once the one of the musical
notes characteristic of each nasal vowel belonging to either of the two groups. In other
terms, we have to ascertain which is the sound or which are the sounds the vocal cavities
are tuned to for each of these.
I came to a solution of this question by utilizing the phenomenon of Resonance with
the aid of N. Koenig's Tonometer, consisting of a large number of tuning-forks differing
from each other by only a few vibrations and tuned with the utmost precision.
I proceeded in the following manner : In order to form an approximative idea of the
position of the nasal vowels in the musical scale, I first pronounced a pure vowel and
afterward one of the corresponding nasal ones (French or not-French) and tried to
ascertain in an AVERAGE way the interval between their two notes. The exact sounds
* B. Iloewenberg, “Les Tumeurs adenoïds du Pharynx nasal, etc.” Paris, 1879. (Translated into
English by Prof. Macnaughton Jones. Published in the Medical Press and Circular, and in an abridged
way by my lamented friend, the late T. Patterson Cassells (Edinburgh Medical Journal, 1879).
+ Comparative Table of Pronunciation. For those who may not have a thorough knowledge of for-
eign languages, I wish to add a few explanations:—
French a corresponds to the English sound of a in “father;” German, a.
{ { {{ {{ e in “get ’’ §
© (é) a in “ #. ...} { ©.
{{ i {{ {{ { i in “Still '' {{ i
ee in “heel” *
{{ O {{ {{ o in “before,” {& O.
* eu {{ {{ u in “curl,” * Ce or ö.
The French generally consider “un "as the nasal sound of their “u” (German, “t " or “ue,”), a sound
unknown to the English language. In my opinion the nasal sounds of “i’’ and “u’’ do not exist in
French, and “un” is the one for “en or on ” and I therefore here write “eu” as the corresponding
pure vowel.
7
98 ABSTRACTS.
of a, e, i, etc., being known from the works of Helmholtz and others, it was easy imme-
diately to determine the average notes of the nasal vowels. Once fixed upon these, I
pronounced one of these nasal vowels, stopped and conserved the position of the mouth
I had found necessary to produce this letter. I then placed in front of my mouth
vibrating tuning-forks chosen above and beneath the average note previously ascer-
tained, till I had discovered the one whose vibrations were the most reinforced by the
resonance of the mouth. - -
The results of these researches were as follows:–
MUSICAL NOTES FOUND FOR EACH NASAL WOWEL.

French Not-French
Pure vowel. Note found. nasal vowel. Note found. nasal vowel. Note found.
O Bb3 (896 v. s.)” OLl G3 (768 v. s.) Ong B2 (480 v. s.)
3. Bb4 (1792 v. s.) & Il F#, near G4 (1470 v. s.) ang B3 (960 v. s.)
© bb5 (3584 v. s.) CIO. Beneath G8 (3008 v. s.) eng B4 (1920 v. s.)
Between F#3 and G#3 Toward
€ll (728 v. i.); besides, C#4 €Uln A8 (858 v. s.) eung E8 (640 v. s.)
(1100 v. s.) was found.
A glance at the preceding table shows at once that the proper sounds of the French
nasal vowels of the first three series are very nearly the minor thirds inferior to the
notes for the corresponding simple vowels, while those of the not-French ones approach
by about half a tone the lower octave of these.
The results are different as to the series, “en—eun—eung.” This difference is ex-
tremely remarkable, and is perhaps due to the intermediate nature of “eu” which, the
same as the German “ii ’’ or “ue” (French “u”), combines the lingual position of one
vowel with the buccal one of another. For the latter reason one could call these
“mixed ” or “intermediate’’ vowels, (vermittlungs vokale, as Sievers calls themf).
The results found with the not-French nasal vowels are still more striking, for we
find the not-French nasal sound of a vowel to be distant by half a tone only from the
proper sound of another simple vowel ; for instance, the proper note of A is near B74,
the one of O near B2°, and we have found as the sound for the not-French nasal “ang”
B8 and SO On.
The results of my preceding researches are not only very interesting by themselves,
but they open new fields to physiologists as well as to linguists.
PECULLARITIES IN THE STRUCTURE AND DISEASES OF
THE EAR OF THE NEGRO.
DES SINGULARITÉS DANS LA STRUCTURE ET LES MALADIES DE
L'OREILLE DUNAEGRE.
EIGENTHUEMLICHKEITEN IN DER OHRENEINEICHTUNG UND IN DEN OHRENKRANK-
HEITEN DES NEGER.S.
BY T. E. MURRELL, M.D.,
Of Little Rock, Arkansas.
By negro is here meant the typical African, and not the mixed races. The negro
has fewer aural affections than the white man, and for this reason deafness is much less,
* (v. s.) signifies “simple vibration.” The sounds found by me and contained in this table may be
expressed by the accompanying musical signs or notes, with the exception of a few vibrations.
# Sievers, Grundzuege der Lautphysiologie, Leipsig, 1876, p. 43.
NINTH INTERNATIONAL MEDICAL CONGRESS. 99
common in these people. His immunity from aural diseases is due to other than acci-
dental causes alone. Peculiarities in anatomy are met with sufficiently striking to
explain some of his exemptions. The following peculiarities in the anatomy of the ear
and adnexa are more or less conspicuous: The pinna is small with lack of develop-
ment above the concha, and is set closely to the side of the head. The external audi-
tory canal is large, quite straight and of less average depth than the standard. The
membrana tympani is large in its diameters and forms a less oblique angle with the
axis of the canal than that usually given. The mastoid process is very slightly devel-
oped and inconspicuous. The pharynx is large and capacious, with great breadth
between the fauces. The nares are broad and flared, giving immense breadth to the
choanae. Deflection of the septum is seldom an obstruction to nasal respiration.
Diseases of the external auditory canal are mostly accidental and traumatic. Foreign
bodies, animate and inanimate, frequently find their way into the wide, straight canal.
Impacted cerumen is less common than in the white races. Otitis parasitica is rare.
Otitis media suppurativa acuta is rather frequent in children, but less so than in
whites. Rhinitis purulenta is common in strumous children, and in these the suppu-
ration in the middle ear mostly occurs. Recovery generally takes place with little
loss to hearing. Otitis media suppurativa chronica is still less common. In adults it
is seldom encountered. Mastoiditis is extremely rare. Otitis media catarrhalis
chronica is very infrequent. Pharyngitis et rhinitis chronica are seldom met with,
and hence the absence of the middle ear affection. Otitis media proliferativa occurs
in the aged but not in so large a ratio as in whites. Otitis interna is almost unknown
out of infancy, unless traumatic. Nerve deafness, except in deaf mutes, is extremely
infrequent.
Deaf-mutism is of much smaller percentage than in the white races. Nervous dis-
eases are infrequent in the negro. Cerebro-spinal fever, a so frequent cause of deaf-
ness, is almost unknown in these people. Among the accidental causes of aural affec-
tions may be mentioned : The southern negro lives in open houses, and is therefore
less liable to head colds than otherwise. His colds are mostly pectoral. He lives
simply and generally has good digestion, and is not lax in tissue. Hence the infre-
quency of otitis media. He is proverbially cheerful and happy and never allows
responsibility to weigh upon him. This is attributable to the inferior develop-
ment of the moral side of his nature. Through this he gains immunity from a large
class of nerve diseases common in the eager, high-strung Caucasian.
*º
IS GENERAL ATROPHY OF THE CONDUCTING APPARATUS
OF THE EAR IDENTICAL WITH PROGRESSIVE ARTHRITIS
DEFORMANS 2
L’ATROPHIE GENERALE DE L'APPAREIL CONDUISANT DE LOREILLE
EST-ELLE IDENTIQUE AWEC L’ARTHRITE PROGRESSIVE DEFORMANS2
IST ALLGEMEINE ATROPHIE DES LEITENDEN APPARATES DES OHRES IDENTISCH MIT,
FORTSCHREITENDER ARTHRITIS DEFORMLANS”
BY S. O. RICHEY, M. D.,
Of Washington, D. C.
This paper attempts to show, by identity in origin, supposed causes, mode of pro-
gression, pathological changes, certain symptoms, and the most nearly satisfactory
method of treatment in each instance, that one and the same disease is present. The
question whether atrophic degeneration of this region is necessarily preceded by a
hypertrophic or inflammatory process is not raised.
100 ABSTRACTS.
TREATMENT OF DISEASES OF THE MIDDLE EAR, AS AIDED
BY THE METHOD OF EXHAUSTING THE DRUM CAVITY.
LE TRAITEMENT DES MALADIES DE LA MI OREILLE, COMME ASSISTÉ
PAR LA METHODE DE L'ÉPUISEMENT DE LA CAVITÉ DUTYMPAN.
tºº
DIE BEHANDLUNG DER KRANKHEITEN DES MITTELOHRES, WIEDURCH DIE ERSCHOE-
PFUNGS-METHODE DER OLIE.T.ROMMEL GEHALTEN.
BY G. C. SAVAGE, M.D.,
Of Nashville, Tenn.
In suppurative inflammation of the middle ear, the object had in view when prac-
ticing exhaustion is to draw the medicated fluid through the perforation into the drum
cavity, the medicated fluid having been previously placed in the auditory canal, and
with the head leaning to the opposite side. In treating catarrhal deafness, I advise
that the drum cavity be exhausted before inflation, the object being to draw any
mucus that may be in the eustachian tube down into the throat, whence it may be
removed by clearing the throat and spitting; after which the ears must be inflated by
either the method of Walsalva or Politzer. Another thing accomplished by the ex-
haustion and inflation is a kind of passive motion which restores motility to the bones
of the ear. The exhaustion is accomplished as follows: expire fully ; hold the nose
and close the mouth, and then attempt an inspiration. The effect is to exhaust more
or less completely all cavities communicating with the nose and naso-pharynx.
*
INHERITED SYPHILIS AS A FACTOR IN SUPPURATIVE
INFLAMMATION OF THE MIDDIAE EAR.
syPHILIS HEREDITAIRE COMME UN FACTEUR DANS L'INFLAMMATION
SUPPURATIVE DE LA MIOREILLE.
FIEREDITAERE SYPHILIS ALS FARCTOR § §runarryER, ENTZUNDUNG DES MITTEL-
ES.
BY ROBERT TILLEY, M. D.,
Of Chicago, Ill.
Medical literature and inherited syphilis in its relation to the middle ear and mem-
brana tympani.
The acknowledged influence of inherited syphilis in keratitis interstitialis.
Similarities in development and differentiation between the cornea and membranatym-
pani.
Why should one be frequently the victim of inherited syphilis and the other exempt
from its influence 2
The mucous membrane of the middle ear and the nose.
Syphilis and middle ear affections among the negroes.
The practical bearing of the question.
Difficulties of demonstration.
Personal observations and conclusion.
SECTION XIII—LARYNGOLOGY.
PRESIDENT: WM. H. DALY, M.D., Pittsburg, Pa.
WICE-PRESIDENTS.
Dr. J. BARATOUx, Paris, France. Dr. WILHELM MEYER, Copenhagen, Denmark.
Dr. CHRISTIAN BAUMLER, Freiberg, Germany. Dr. B. D. MoURA, Paris, France.
Dr. BoucheT, Paris, France. Dr. HALGER MYGEND, Copenhagen, Denmark.
Mr. LENNOx BROWNE, London, England. Dr. J. O. RoE, Rochester, N.Y.
Dr. J. CIIARAZAC, Toulouse, France. Dr. O. ROSENBACH, Breslau, Germany.
Dr. M. F. CooMEs, Louisville, Ky. Tr. E. SCHMRIGELow, Copenhagen, Denmark.
Dr. CARLDEHIO, Dorpat, Russia. Dr. A. SCHNEE, Nice, France.
Dr. C. M. DEsverNINE, Havana, Cuba. Dr. JOHN SCHNITZLER, Vienna, Austria.
Dr. J. J. KIRK DUNCANSON, Edinburgh, Scotland. Dr. E. L. SHURLY, Detroit, Michigan.
Dr. Jos. GRUBER, Vienna, Austria. Dr. McNIEL WHISTLER, London, England.
Dr. J. H. HARTMAN, Baltimore, Md. Dr. F. LABORDE DE WINTHUyssEN, Seville, Spain.
Dr. PROSSER JAMES, London, England. Dr. G. W. WooDEN, Indianapolis, Ind.
Dr. MORRELL MACKENZIE, London, England.
SECRETARIES.
Dr. OTTAKAR CHIARI, Vienna, Austria. WM. PORTER, M. D., St. Louis, Mo.
Dr. HERMAN KRAUSE, Berlin, Germany. D. N. RANKIN, A.M., M. D., Allegheny, Pa.
Dr. E. G. MoURE, Bordeaux, France.
COUNCIL.
Dr. J. Dennis Arnold, San Francisco, Cal. Dr. Theodore Hering, Warsaw, Poland.
Dr. S. N. Benham, Pittsburg, Pa. Dr. E. Fletcher Ingalls, Chicago, Ill.
Dr. H. Blaikie, Edinburgh, Scotland. Dr. Geo. Mackern, Buenos Ayres, Argentine
Dr. W. E. Casselberry, Chicago, Ill. Republic.
Dr. Andrew J. Coey, Chicago, Ill. Dr. Arthur W. Orwin, London, England.
Dr. H. H. Curtis, New York, N.Y. Dr. M. C. O'Toole, San Francisco, Cal.
Dr. Lester Curtis, Chicago, Ill. Dr. S. W. Pearson, Baltimore, Md.
Dr. Richard Ellis, Newcastle-on-Tyne, England. Dr. J. M. Ridge, Camden, N. J.
Dr. Herman E. Hayd, Buffalo, N.Y.
NASO-PHARYNGEAL CATARRH, THE BURSA OF TORNWALD.
LE CATARRH NASO-PHARYNGIEN, BOURSE DE TORNWALD.
DER. NASENRACHEN-KATARRH UNID DIE BURSA PHARYNGEA.
ſº
BY DR. J. BARATOUX,
Of Paris, France.
ON NERVOUS COUGH AND ITS TREATMENT.
SUR LA TOUX NERVEUSE ET SON TRAITEMENT.
UEBER NERVöSEN HUSTEN UND SEINE BEHANDLUNG.
BY DR. O. ROSENBACH,
Of Breslau, Germany.
101
SECTION XIV—DERMATOLOGY AND SYPHILOGRAPHY.
OFFICERS.
PRESIDENT: DR. A. R. ROBINSON, New York, N. Y.
WICE-PRESIDENTS.
Dr. A. D. O. DUMESNIL, St. Louis, Mo. Prof. OSCAR LASSAR, Berlin, Germany.
T. Colcott Fox, M. D., London, England. Prof. H. LELOIR, Lille, France.
A. HARDY, M. D., Paris, France. Prof. ISADOR NEWMAN, Wien, Austria.
HANS VON HEBRA, M.D., Wien, Austria. Dr, AUGUST RANOLI, Cincinnati, Ohio,
J. HUTCHINSON, M. D., London, England. PROF. SchwimmeR, Buda-Pesth, Hungary.
W. ALLAN JAMIESON, M.D., Edinburgh, Scotland. Dr. JoHN V. SHOEMAKER, Philadelphia, Pa
Prof. MARIZ KAPOSI, Wien, Austria. Dr. GEORGE THIN, London, England.
Dr. JAMES M. KELLER, Hot Springs, Ark. | Dr. P. G. UNNA, Hamburgh.
SECRETARIES.
Dr. F. E. DANIEL, Austin, Texas. | Dr. WM. S. GoLTHEIL, N.Y,
COUNCIL.
Dr. Wm. T. Belfield, Chicago, Ill. Dr. P. McCahey, Philadelphia, Pa.
Dr John D. Duncan, Kansas City, Kan. Dr. C. S. Means, Philadelphia, Pa.
Dr. Chas. C. Gemans, Detroit, Mich. Dr. Jno. A. Octerlony, Louisville, Ky.
Dr. W. F. Glenn, Nashville, Tenn. Dr. Edw. R. Palmer, Louisville, Ky.
Dr. A. L. Hunnewell, Philadelphia, Pa. Dr. Chas. G. Smith, Chicago, Ill.
Dr. J. J. McAchron, Laramie City, Wash. Ter. Dr. H. O. Walker, Detroit, Mich.
LUPUS LYMPHATICUS, WITH DRAWINGS.
LUPUS LYMPHATICUS, AVEC FIGURES.
LUPUS LYMPHATICUS, MIT ABBILDUNGEN.
BY MR. JonATHAN HUTCHINSON,
Of London, England.
SEBORRHOEAL ECZEMA.
L'ECZóMA SãBACſ.
DAS SEBORRHOEISCHE ECZEM.
sºmsº
BY DR. P. G. UNNA,
Of Hamburg, Germany.
ELEPHANTIASIS ARABUM IN CHILDREN.
L'ELÉPHANTIASIS DES ARABES CHEZ LES ENFANTS,
ELEPHANTIASIS ARABUM BIE KINDERN.
BY DR. MONCORVO,
Of Rio de Janeiro, Brazil.
102
SECTION XW-PUBLIC AND INTERNATIONAL HYGIENE.
OFFICERS.
PRESIDENT: DR. JOSEPH JONES, New Orleans, La.
WICE-PRESIDENTS.
A. NELson BELL, M.D., New York, N. Y.
Dr. GEO. BUCHANAN, London, England.
Dr. CHAs. C. BYRNE, Surgeon U.S. Army, Wash-
ington, D. C.
Prof. CoRRADo T. CRUDELI, Rome, Italy.
Dr. RICH'D H. DAY, Baton Rouge, La.
Dr. J. W. DUPRE, Baton Rouge, La.
Dr. R. K. Fox, Jesuit's Bend, La.
Dr. DoxſDNGos FREIRE, Rio de Janeiro, Brazil.
WALTER Douglas HOGG, M. D., Paris, France.
Prof. Rob'T Koch, Berlin, Germany.
JNo. BERRIEN LINDSLEY, M. D., Nashville, Tenn.
Dr. A. MAGNIN, Paris, France.
Dr. EDw'D D. MAPOTHER, Dublin, Ireland.
J. N. McCoRMACK, M. D., Bowling Green, Ky.
J. F. Y. PAINE, M.D., Galveston, Texas.
Dr. P. B. PortER, New York City.
Dr. R. HARVEY REED, Mansfield, Ohio.
BENJ. WARD RICHARDSON, M. D., London, Eng-
land.
John C. B. SIMON, M. D., London, England.
Dr. ANDREw K. SMITH, U. S. Army, West Point,
N. Y.
Dr. JNo. W. TAYLOR, Scarboro, England.
J. W. THUDICHUM, M. D., London, England.
Dr. CARMONA. Y. WALLE, Mexico.
SECRETARIES.
Dr. JNo. J. CASTELLANos, New Orleans, La.
Dr. FELIX ForMENTo, New Orleans, La.
Dr. I. R. LE MONNIER, New Orleans, La.
Dr. B. D. TAYLOR, Columbus, Ohio.
Dr. WALTER WYMAN, U. S. M. H. S., New York.
COUNCIL.
Thos, Antisell, M.D., Washington, D. C.
Dr. Le Baron Botsford, St. Johns, N. B.
Henry Carpenter, M.D., Lancaster, Pa.
Dr. Wm. Duncan, Savannah, Ga.
J. W. Dupre, M. D., Baton Rouge, La.
Dr. Landon B. Edwards, Richmond, Va.
Dr. E. S. Elder, Indianapolis, Ind.
Dr. Thos. H. Fenton, Philadelphia, Pa.
Dr. J. Finney, New Orleans, La.
Dr. W. K. Fort, New Orleans, La.
Dr. E. L. B. Godfrey, Camden, N. J.
Dr. D. W. Hand, St. Paul, Minn.
Dr. Thomas A. Harris, Parkersburg, W. Va.
Dr. Thos. Hebert, New Iberia, La.
Dr. Charles N. Hewitt, Red Wing, Minn.
Dr. Stanhope Jones, New Orleans, La.
Dr. Benjamin Lee, Philadelphia, Pa.
Dr. Henry Leffmann, Philadelphia, Pa.
Dr. A. W. Leighton, New Haven, Conn.
Dr. Henry F. Lyster, Detroit, Mich.
Dr. Wm. R. Mandeville, New Orleans, La.
Dr. G. T. Maxwell, Ocala, Fla.
Dr. U. R. Milner, New Orleans, La.
Dr. H. S. Orme, Los Angelos, Cal.
Dr. C. D. Owen, Eola, La.
Dr. W. S. Robertson, Muscatine, Iowa.
Dr. W. L. Schenck, Osage City, Kansas.
Dr. C. M. Smith, Franklin, Tenn.
Dr. R. M. Swearengen, Austin, Texas.
Dr. M. K. Taylor, U. S. Army, Fort Sill.
Dr. G. B. Thornton, Memphis, Tenn.
Dr. Wm. M. Welch, Philadelphia, Pa.
Dr. C. P. Wilkinson, New Orleans, La.
Dr. Oscar C. De Wolf, Chicago, Ill.
104 ABSTRACTS,
REPORT OF AN INQUIRY INTO THE FACTS RELATING
TO THE EFFECTS OF OVERFLOW OF THE MISSISSIPPI
RIVER,
COMPTE-RENDU D'UN EXAMEN SUR LES EFFETS, DES DíBORDEMENTS
DU MISSISSIPPI.
BERICHT UEBER EINE UNTERSUCHUNG DER THATSACHEN IN BETREFF DER WIRECUN-
GEN DER UEBERSCHWEMMUNGEN DES MISSISSIPPI.
BY RICHARD H. DAY, M. D.,
Of Baton Rouge, La.
The paper contains facts and deductions obtained by addressing letters of inquiry to
five hundred physicians residing in Southern localities. It shows—
1st. That overflows, as a general rule, are injurious to the public health.
2d. That they are more or less injurious according as the inundations are late or
early in the season, and whether of long or short duration.
3d. That their evil effects upon health are lessened or entirely antagonized by good
natural or artificial drainage and by copious showers of rain occurring during the
period of subsidence of the waters. e
4th. That rice culture is inimical to health only by reason of the improper and insani-
tary manner of its cultivation.
5th. That, as a rule, it is perhaps true that the colored race is less susceptible to the
injurious effects of overflows, marshy and malarial soils than the white race. The
writer then advises—
1st. The use of rainwater, stored in large cisterns, both for drinking and cooking
purposes.
2d. That all swamp and wet soils subject to overflows, before being cultivated or
settled upon, be cleaned of trees, underbrush, etc., to admit freely the sun's rays and
the free circulation of the winds, and that a thorough drainage be effected so that
rapid drainage and drying of the soil be not impeded.
3d. That in the culture of rice, the common plan of keeping the fields covered for
long intervals with stagnant water should be avoided, and that, in lieu thereof,
frequent irrigation with fresher and purer water should be adopted, the growing crop
being supplied thus as often as needed, and ditches so constructed as to let off the super-
incumbent water rapidly.
4th. That to promote the health of laborers and residents in the river deltas and low-
lands, the dwellings should be not less than four feet from the ground, the floors laid
tight, and the doors and windows arranged to afford free ventilation, with galleries on
all sides wide enough to prevent beatingerains from wetting the rooms; that the
houses should be erected on elevated ridges, so that water will not settle under or
around them ; that only a few shade trees be allowed to grow to break the force of the
direct rays of the sun, and all brush and undergrowth to be removed, so as to facilitate
the free movement of currents of atmosphere.
Finally, the writer advises the importance of rigid cleanliness of person and sur-
roundings, and strict observance of general sanitary rules.
The paper further shows that under improved methods of rice culture and manage-
ment of lands subject to overflows, the frequency and virulence of disease incident to
these localities have been notably diminished.
NINTH INTERNATIONAL MEDICAL CONGRESS. 105
THE HISTORY OF HYGIENE IN MODERN EGYPT, WITH
SOME CRITICAL REMARKS AND PRACTICAL SUGGES-
TIONS.
HISTOIRE D'HYGIENE DANS L'ÉGYPTE MODERNE AVEC QUELQUES RE-
MARQUES CRITIQUES ET DES SUGGESTIONS PRATIQUES.
DIE GESCHICHTE DER HYGIENE IM MODERNEN EGYPTEN, MIT EINIGEN KRITISCHEN
BEMERKUNGEN UND PRAKTISCHEN RATH SCHLAEGEN.
BY DR. J. A. S. GRANT (Bey),
Of Cairo, Egypt.
The author discusses the methods of hygiene as practiced by the Egyptians under
the Viceroy Mohammed Ali, and under the Khedive Tewfik Pasha, and as influenced
by English domination.
THE PLACE OF SANITARY SCIENCE IN EDUCATION.
LA PLACE QUE DOIT REMPLIR L’HY GIENE DANS L'ÉDUCATION.
DIE STELLUNG DER GESUNDHEITSECUNDE IN DER ERZIEHUNG.
BY DR. A. W. LEIGHTON,
º Of New Haven, Connecticut.
I shall, 1st. Recall the character impressed on education by the older civilizations, and
review the elements of strength and weakness in our American civilization ; in other
words, the ideas which dominate and which ought to dominate our education.
2d. Briefly outline the natural history of a single human organism up to maturity, as
including the principal guiding and limiting data from which to judge of the times and
specific uses of sanitary training.
3d. Adhering to ways and means already established, show how our various educa-
tional resources should be utilized in order to popularize sanitary notions while also
recognizing the claims of other training.
This practical part will enforce the importance of domestic and public hygiene, as
well as personal hygiene, and will show the influence of public schools, secondary, con-
tinuation, correspondence and normal schools; the influence of experience and instinct,
of text-books, of colleges and universities, of the press, the pulpit, and the popular
literature of the day.
PRACTICAL AND COMMON SENSE VIEW OF PUBLIC AND
INTERNATIONAL HYGIENE.
HYGIENE PUBLIQUE ET ENTRENATIONALE AU POINT DE VUE PRA-
TIQUE ET DU SENS COMMUN.
EINE PRAKTISCHE UND VERNUENFTIGE BETRACHTUNG UEBER OEFFENTLICHE UND
INTERNATIONALE: HYGIENE.
BY URIAL R. MILNER, M. D.,
Of New Orleans, La.
The necessity of harmony and uniformity of action among the States of the Repub-
lic in order to make effective the work of the International Medical Congress to prevent
diseases and contagious epidemics.
SECTION XVI—MEDICAL CLIMATOLOGY AND DEMOGRAPHY.
OFFICERS,
PRESIDENT: ALBERT L. GIHON, A. M., M.D., U. S. N.
WICE-PRESIDENTS.
Dr. VICTOR AUD'Hon.I, Paris, France.
PETER H. BRYCE, M. A., M. B., Toronto, Canada.
Dr. A. CHERVIN, Paris, France.
EMIL R. CONI, M. D., Buenos Ayres, Argentine
Republic.
ROLAND G. CURTIN, M. D., Philadelphia, Pa.
Hon. Robert T. DAVIs, M. D., Fall River, Mass.
Dr. MAX. DURAND-FARDEL, Vichy, France.
Prof. EUGENIo FAZIo, Naples, Italy.
ERNEST HART, M.D., London, England.
ERNST HART, M. R. C. S., London, England.
Prof. JoHN H. HOLLISTER, M.D., Chicago, Ill.
Prof. THOMAS W. KAY, Beirut, Syria.
Prof. Dr. E. H. KISCEI, Prague, Bohemia.
Prof. Dr. Joseph KoROSI, Buda-Pesth, Hungary.
Prof. Dr. H. C. LOMBARD, Geneva, Switzerland.
Major ELY McCLELLAN, Surgeon, U.S.A., Jeffer-
son Barracks, Mo.
JOHN WILLIAM MOORE, M. D., M. C.H. D., Dublin,
Ireland.
Le MARQUIS DE NADAILLAC, Cloyes, France.
Dr. A. OLDENDoRFF, Berlin, Germany.
JAMES D. PLUNKET, M. D., Nashville, Tenn.
Dr. PROSPER DE PIETRA SANTA, Paris, France.
TIIoMAs C. WALTON, Surgeon, U. S. N.
CHARLES H. WHITE, M. D., Surgeon, U. S. N.,
Washington, D. C. *
C. THEODORE WILLIAMS, M.D., London, England.
Dr. GEO. W. Woods, Mare Island, Cal.
THEORON WOOLVERTON, M. D., Surgeon, U.S. N.,
Washington, D. C.
SECRETARIES.
Dr. E. BERTIIÉRAUD, Algiers, Algeria.
Prof. CHARLES DENISON, A. M., M. D., Denver, Col.
EDMUND OWEN, M.D., London, England.
Dr. A. WERNICH, Cöslin, Germany.
COUNCIL.
Charles L. Allen, M.D., Rutland, Vt.
Thomas J. Allen, M. D., Shreveport, La.
Henry B. Baker, M. D., Lansing, Mich.
Dr. H. W. Boone, Shanghai, China.
Lucius C. Butler, M. D., Essex, Vt.
Edgar P. Cook, M.D., Mendota, Ill.
M. F. Coomes, A. M., M. D., Louisville, Ky.
Algernon S. Garnett, M. D., IIot Springs, Ark.
H. C. Ghent, M. D., Belton, Texas.
Henry Z. Gill, M. D., Cleveland, Ohio.
William P. Hart, M. D., Washington, Ark.
Thomas H. Helsby, M. D., Williamsport, Pa.
T. S. Hopkins, M.D., Thomasville, Ga.
Talbot Jones, M. D., St. Paul, Minn.
Chas. Y. Kenworthy, M. D., Jacksonville, Fla.
Paul H. Kretzschmar, M. D., Brooklyn, N. Y.
Thomas T. Minor, M. D., Seattle, Wash. Ter.
J. Cheston Morris, M. D., Philadelphia, Pa.
Richard J. Nunn, M. D., Savannah, Ga.
W. Thornton Parker, M. D., Newport, R. I.
Joseph Parrish, M. D., Burlington, N. J.
C Alexander M. Pollock, M. D., Pittsburg, Pa.
James T. Reeve, M. D., Appleton, Wis.
P. C. Remondino, M. D., San Diego, Cal.
George H. Rohé, M.D., Baltimore, Md.
Melancthon L. Ruth, M.D., Surgeon, U. S. N.
Edward W. Schauffler, M. D., Kansas City, Mo.
Irving A. Watson, M. D., Concord, N. H.
O. W. Wight, M. D., Detroit, Mich.
Charles S. Wood, M. D., New York City, N. Y.
106
NINTH INTERNATIONAL MEDICAL CONGRESS. 107
RELATIONS OF CERTAIN METEOROLOGICAL CONDITIONS TO
ACUTE DISEASES OF THE LUNGS AND AIR-PASSAGES.
*=º
LE RAPPORT DE CERTAINES CONDITIONS MáTÉOROLOGIQUES A DES
MALADIES AIGUES DES POUMONS ET DES VOIES DERIENNES.
DIE BEZIEHUNG GEWISSER METEOROLOGISCHER ZUSTAENDE ZU ACUTEN KRANKHEITEN
DER LUNGE UNID LUFTROEHRE.
BY HENRY BAKER, A. M., M. D., F. R. M. S.,
Of Lansing, Michigan.
The author gives two reasons for the presentation of this paper—First, The possibility of
bringing forward a kind of evidence not usually obtainable, namely, statistics of sickness
over wide areas, and their comparison with statistics of coincident meteorological condi-
tions; secondly, the belief that he has learned some of the reasons why the rise and fall
of certain diseases of the lungs and air passages are ordinarily controlled by the tem-
perature and other conditions of the atmosphere. Before stating his reasons why, he
proceeds with the proof of his proposition that these diseases are thus controlled, which
proof consists mainly of diagrams accurately drawn to scale and based upon statistics
carefully and conscientiously compiled, relating chiefly to sickness and coincident mete-
orological conditions in Michigan during the past ten years, the reports of sickness being
made weekly by a corps of practicing physicians, who sent their reports to the State
Board of Health. The diagrams seem to demonstrate that the curves for influenza, ton-
sillitis, croup, bronchitis and pneumonia are in general outlines all practically the same,
and that they follow the curve for atmospheric temperature with surprising closeness,
rising after the temperature falls and falling after the temperature rises. He claims
that this sameness indicates that their controlling cause is one and the same for all of
these diseases, and that, directly or indirectly, the atmospheric temperature is that cause.
They are diseases of the air passages, and may be supposed to be influenced or controlled
by the atmosphere which passes through them. Although the curves are all similar,
yet their differences still further support his view, because the order of succession of the
several diseases is such as would be expected if caused in the manner which he sup-
poses : thus croup and influenza precede in time bronchitis and pneumonia; the curve
for bronchitis shows that disease to respond quicker than does pneumonia to the rise and
fall of the temperature. He suggests that the explanation of the causation of these dis-
eases has not been grasped before because one of the principal facts has not been appre-
hended, namely, the fact that cold air, is always dry air; on the contrary, it has been
generally stated, that when these diseases occur the air is cold and damp. He explains
that while the cold air is damp relatively, it is always absolutely dry, and he thinks
that its bad effects on the air passages are mainly through its drying effects, which can
best be appreciated by reflecting that each cubic foot of air inhaled at the temperature
of zero, Fahr., can contain only one-half grain of vapor, while when exhaled it is nearly
Saturated at a temperature of about 98°F., and therefore contains about eighteen and
one-half grains of vapor, about eighteen grains of which have been abstracted from the
air passages. Thus cold air falling upon susceptible surfaces tends to produce an abnor-
mal dryness which may be followed by irritation and suppuration. He claims that
coryza is sometimes so caused. Under some conditions the nasal surfaces are not sus-
ceptible to drying, the fluids being supplied in increased quantity to meet the increased
demand made by the inhalation of cold air. In that case an unusual evaporation of the
fluid leaves behind an unusual quantity of non-volatile salts of the blood, such as so-
dium chloride, and an unusual irritation results; he thinks influenza is the name com-
monly given to this condition. The effects which the inhalation of cold air have on
the bronchial surfaces depend greatly upon how the upper air passages have responded
to the increased demand for fluids; because, if they do not supply the moisture, it must
108 ABSTRACTS.
be supplied by the bronchial surfaces; in which case bronchitis results. Finally, if the
demands for moisture made by cold air are not met until the air cells are reached, pneu-
monia is produced. The researches of Redtenbacher and others, who have proved that
during the onward progress of pneumonia sodium chloride is absent from the uline, and
of Lionel Smith Beale, who proved that the chlorides which disappeared from the urine
are found in the sputa and in the solidified lung, are used in connection with the facts
here pointed out, showing how and why the non-volatile chlorides accumulate in the
air passages, by reason of excessive evaporation caused by the inhalation of cold air;
and a new reason for the exudation of the albuminous constituents of the blood is
found in the law of osmosis, that albumen, which will not pass by osmosis to pure
water, will pass through a membrane which is in contact with a solution of salt. That
the several acute diseases of the air passages follow each other in the order in which
they do, is thus seen to be in harmony with the alleged mode of their causation.
He refers to statistics which he has published, showing that even the rise and fall of
such contagious diseases as scarlet fever, diphtheria and Small-pox follow the same laws
shown to control in the acute diseases of the air passages, and he offers the explanation
that the irritations and exudations in the air passages caused by the inhalation of cold
dry air, supply a nidus for the contagia, and are thus the predisposing causes of those
diseases. As to whether or not pneumonia is a contagious disease he offers no evidence
except that nearly all of the phenomena seem to be accounted for without the necessity
of supposing a special contagium. For the abnormal accumulation of the non-volatile
salts of the blood through evaporation of the fluids in the air cells, so as to cause inflam-
mation and exudation, time is required ; therefore, he does not believe that a sudden
and short exposure to cold can ordinarily produce pneumonia, except the short exposure
follow or precede somewhat prolonged inhalation of cold dry air ; although he thinks
that lobar pneumonia may have just that causation, the reason for the chill and for the
limitation of the area of the exudation being the disturbance of the nervous equilibrium
associated with the more or less complete paralysis of the small blood vessels in that part
of the lungs supplied by one particular nerve, some or all the endings of reflexions of
which have been suddenly exposed to the enervating influence of warmth following the
exposure to cold. Bearing upon the subjects of diet and treatment, he says: “If, as I
believe, nearly all of the acute diseases of the air passages, and some contagious diseases
which gain entrance to the body through the air passages, are associated with unusual
evaporation of fluids from the surfaces of the air passages and the accumulation there of
non-volatile salts of the blood which act as irritants, and which, when in sufficient quan-
tity, cause the exudation of the albuminous constitutents of the blood, these facts have
an important bearing upon the subject of diet best adapted to freedom from diseases of
the air passages; for it is obvious that in a person whose blood is strongly saturated
with sodium chloride or other fixed salts, the exudations may be quite different from
those in a person whose blood is only scantily supplied with fixed salts.”
Finally, as to the importance of the subject, it is apparent that the scope of the in-
vestigation is very wide ; it seeks the controlling cause of the whole class of the acute
diseases of the air passages and of those contagious diseases which enter the body
through the air passages, even extending to consumption itself, because one of the dia-
grams accompanying the paper shows that the rise and fall of sickness from even that
disease is apparently influenced by the rise and fall of the atmospheric temperature.
NINTH INTERNATIONAL MEDICAL CONGRESS. 109
HOUSE ATMOSPHERES, OR ARTIFICIAL CLIMATES.
ATMOSPHERES DE MAISON ou CLIMATS ARTIFICIELS.
HAUS-ATMOSPHAERE ODER KUENSTLICHE KLIMATA.
*sº
BY PETER. H. BRYCE, M.A., M.D.,
Of Toronto, Canada.
Introduction :
A. 1. Constitution of house atmospheres.
(A) Contrasted with air of the open country.
(B) Contrasted with air of populous centres.
2. Temperature and relative humidity of house atmospheres.
(A) Contrasted with air of the open country.
(B) Contrasted with air of populous centres.
3. Air currents of house atmospheres.
(A) Contrasted with those of open country.
(B) Contrasted with those of populous centres.
B. Effects of house atmospheres on health.
(A) Contrasted with those of open air in country.
(B) Contrasted with those of open air in cities.
C. Remedies for existing evils in house atmospheres.
(A) What they are.
(B) How they are to be effected.
THE PREFERABLE CLIMATE FOR PHTHISIS; OR, THE COM-
PARATIVE IMPORTANCE OF DIFFERENT CLIMATIC AT-
TRIBUTES IN THE ARREST OF CHRONIC PULMONARY
DISEASE.
IMPORTANCE COMPARATIVE DE DIFFERENTs ATTRIBUTS CLIMATÉ.
RIQUES DANS L’ARRET DE LA PHTHISIE.
VERGILEICHENDE WICHTIGKEIT DER WERSCHIEDENEN KLIMIATISCHEN EIGENSCHAFTEN
IN DER HEMMUNG DER SCHWINDSUCHT.
BY CHARLES DENISON, A. M., M. D.,
Of Denver, Colorado.
With a proper elimination of negative conditions, the writer takes the affirmative side
of the following divisions of the discussion. He illustrates his argument by the climatic
or physical causes of “purity of atmosphere” as well as by the evidences of experience.
The order in which the first five subjects are arranged is intended to indicate the
relative importance of the subjects considered, the last five being added as confirmative
of these main propositions.
SYNOPSIS OF THE DISCUSSION.
I. Drymess as opposed to moisture.
II. Coolness or cold preferable to warmth or heat.
III. Rarefaction as opposed to sea-level pressure.
IV. Swnshine as opposed to clowdiness.
V. Variability of temperature as opposed to equability.
CONFIRMATIVE PROPOSITIONS.
VI. Marked diathermancy of the air to be preferred to the Smoky atmosphere of
cities or the dense air strata of moist currents.
VII. Radiation and absorption of heat, by rocks and Sandy loams, better than latent
absorption, by water and damp clay soils.
110 ABSTRACTS.
VIII. Mowntainous configuration of country (quick drainage) contrasted with the flat-
mess, etc., of level sections.
IX. Frequent electrical changes of atmosphere, also moderate winds (except in quite
cold weather), preferable to continuous stillness of the air.
X. Inland altitudes contrasted with sea air (total absence of land influence); but,
in certain cases, sea voyages and island resorts to be preferred as compromise
substitutes for high altitudes.
ON THE AIR OF MOUNTAINS.
SUR LAIR DES MONTAGNES.
UEBER GEBIRGSLUFT,
BY A. ENFIELD, M. D.,
Of Bedford, Pa.
The author discusses the following propositions:—
1st. The superior advantages of mountain air for recuperative purposes over seaside
all".
2d. The influences which mountain air produces in the cure or palliation of disease
of the lungs.
3d. The best time in the season to go to the mountains.
4th. Baths in mineral waters milder and more beneficial than sea bathing.
5th. The importance of elevation, temperature and climatology of mountains as
resorts.
IMPORTANCE CLIMATÉRIQUE ET SANITAIRE DES FORÉTS
—DANGERS DU DEBOISEMENT.
THE CLIMATIC AND SANITARY IMPORTANCE OF FORESTS-DANGERS
OF DISFORESTING.
KLIMATISCHE UND SANITAERE WICHTIGKEIT DER WAELDER, SCHADEN DURCH DAS
UMHAUEN.
BY DR. EUGENIO FAZIO,
Of Naples, Italy.
En exposant à votre examen les idées qui précèdent, j'aime a croire que nous pour-
rons nous accorder sur les conclusions suivantes, qui, Selon moi, découleraient de ces
idées mêmes:—
I. Les forêts ont une importance climatérique et Sanitaire indiscutable et de premier
Ordre.
II. La progression arithmétique des maux qui ont succédé au déboisement rapide et
inconsidéré, que mous déplorons aujourd’hui, ne tardera pas à prendre des
proportions géométriques irréparables, sides mesures promptes et énergiques
ne viennent y mettre obstacle.
III. La Section de Climatologie et de Démographie du IXè Congrès Médical Inter-
national fait des vacux pour que tous les Etats civilisés se mettent d’accord
afin d’arrêter l’aveugle destruction des forêts et quant au but de presser l'oeuvre
du reboisement.
C'est parces moyens-la que la sentence des Economistes pourra avoir sa solution: La
civilisation en mettant le pied dams un pays détruit les forêts; arrivée a sa maturité
elle les rétablit.
a. Forests have a climatic and sanitary value of the first order.
b. The arithmetical progression of the evil effects which will follow the vast and
senseless denuding of forests, now so mnch deplored, will assume grave geomet-
rical proportions if not energetically resisted.
c. The Section of Climatology and Demography of the Ninth International Medical
Congress urges upon all civilized States to check the destruction of forests and
to provide for their replanting.
NINTH INTERNATIONAL MEDICAL CONGRESS, 111
THERAPEUTIC VALUE OF NATURAL MINERAL WATERS.
VALEUR TH£RAPEUTIQUE DES EAUX NATURELLES MINERALES.
THERAPEUTISCHER WERTH IDER NATUERLICHEN MINERALWAESSER.
BY DR. EUGENIO FAZIO, PROF., ETC.
The therapeutical value of Mineral Waters is to be considered under two aspects—
their chemical value, which relates to their medicinal properties, and their physical
value, which relates to their curative properties.
1. The chemical effect may be immediate and local in respect to the direct action of
the waters on the skin, on the mucous, on solution; and general as regards the
absorption of the waters by the gastric mucous and their conveyance, by means
of the circulating fluids, to the several organs, applying to each its proper mineral-
ization and modifying its functions.
2. The physical action is to be considered as mechanical, thermal, electric, and, accord-
ing to recent hypothesis, magnetic.
It is characteristic of the natural mineral waters that their activity and influence are
in direct relation to their mineralogic value and to the nearness to the source of the
water, especially in the cases of thermo-mineral waters. The activity will be greater
or less in proportion to the mineralization of the water and to the distance from the
Spring.
There will be a decided increase in activity and influence in proportion as we rise in
the scale from distilled water to that of streams, from waters of low mineralization to
those which have indications of high mineralization. It is also demonstrable that
the artificial waters, though possessing the same mineralization as the natural waters,
are yet different from them, and this notwithstanding repeated and identical experi-
ment. How are we to explain this phenomenon ?
With much probability it may be referred to the electric fluid generated in the
natural mineral waters.
THE DOMAIN OF CLIMATOLOGY AND DEMOGRAPHY AS
DEPENDENCIES OF MEDICINE.
LE DOMAINE DE CLIMATOLOGIE ET DEMOGRAPHIE COMME SUBOR-
DONNES DE MEDICINE.
DIE DOMAINE DER KLIMATOLOGIE UND DEMOGRAPHIE ALS BEREICHE DER MEDICIN.
BY ALBERT L. GIHON, A. M., M. D.,
President of the Section.
In the popular mind medicine only the mercenary art of healing at So much apiece the
maimed, halt and blind of the human race. The recognition of the subjection of the
human organism to external impressions, induced by sanitary considerations, has brought
Climatological questions into prominence as medical factors, not merely in a restricted
therapeutic sense, but asſactive forces in man’s economy.
The section originally comprehended Medical Climatology, Vital Statistics, Collective
Investigation and Medical Nomenclature—Demography substituted for the final three,
and defined to be that branch of medicine concerned with the study of vital phenomena
among masses of men, treating of race, viability, fecundity, morbility and mortality as
tending to density or sparesness of population, etc., and the influence of climate and local
conditions in accomplishing ethnic modifications. Hence, Collective Investigation is its
logical first chapter, since it gathers the material for this study, and Vital Statistics is the
112 ABSTRACTS.
fruit of this Collective Investigation, of which Medical Nomenclature is but the instru-
ment. Demography, thus understood, is naturally consequent to Climatology.
The place of Climatology and Demography among the principia of medicine. The
former not on the level of a school-boy pursuit, but an additional argument for scientific
education as indispensable to the comprehension of medical teaching. If the study of
medicine has come to be a mightier task in this century, it is not that medicine has
enlarged its domain, but that we better discern its grand proportions.
Significance of the coincident testimony of Professor Flint and Professor Gross, just
before their deaths, that Preventive Medicine is the Medicine of the future. Relations
of Climatology to Preventive Medicine.
What is understood by Climate—Definite climatic characteristics. Effects of climate
not to be looked for in the prevalence of specific diseases having well-defined geographic
limits. What climate chiefly does to establish constitutional proclivities.
Lombard’s classification of physical effects of climate. Effects of the elements of
climate to be sought and studied as generalizations. Climate not responsible for all the
cachexia. Ethic as well as atmospheric and telluric influences factors in demographic
changes. Climate of the United States is not as pernicious as reputed. Climate often
credited for benefits resulting from improved habits. Reciprocal influence of climate
and customs.
Man's ability to adapt himself to different climates. Influence of climate on man’s
economy, morbific, prophylactic, curative. Potency of mature's therapeutic means.
Necessity for etiological research. Can only look to patient Collective Investigation
for data for our generalizations. Absolute records of prevailing diseases an essential
part of Vital Statistics. These to be of value must be instituted and conducted by
Government. A minister, secretary, commissioner or director at the head of an organ-
ized department or bureau a necessary functionary. º
Obligations of medicine to Dr. William Farr as the pioneer in Vital Statistics. What
he began this Congress should insist upon having continued. It will have accomplished
no more important work if its influence can be successfully exerted in inducing national
administrators to provide for recognizing, classifying and numbering these enemies
common to all mankind. The Section invited to discuss the advisability of formulat-
ing an expression of opinion in Some such terms as the following:—
Resolved, That in the opinion of the Section on Medical Climatology and Demography
of the Ninth International Medical Congress, assembled in the city of Washington,
September 5–10, 1887, it is important there should be established in every country a
national department, bureau or commission for the record of Vital Statistics upon a
uniform basis, to include not only accurate returns of birth and deaths, but the re-
sults of Collective Investigation by government officials of facts bearing upon the natu-
ral history of disease as manifested among men, women and children separately, espe-
cially with regard to climatic and other discoverable causes of the several forms of
disease, that necessary preventive measures may be determined and enforced for the
preservation of the public health.
Resolved, That the Secretary-General be requested to have the expression of opinion
communicated to the several governments.
A national Medical Nomenclature of importance as the scaffolding on which this
Collective Investigation is to be built. Symptomatic Nosology useless for statistical
purposes. Etiological explanations must accompany records of affected organs and
perturbed functions.
Climatology and Demography have not yet received the sharp definition and condensa-
tion that come from long collaboration. The American Climatological Association. The
coming International Congress of Hygiene and Demography at Vienna.
A new star in the crowded galaxy of Science. In the words of Lombard of Geneva,
“Le moment est venu de réunir en un même faisceau les disjecta membra de cette
vaste science que l’on appellee La Climatologie Médicale.”
NINTH INTERNATIONAL MEDICAL CONGRESS. 113
VITAL STATISTICS AND MEDICAL GEOGRAPHY.
STATISTIQUES VITALEs ET GEOGRAPHIE MÉDICALE.
VITALE STATISTIK UND MEDICINISCHE GEOGRAPHIE.
BY ALFRED HAVILAND, M. R. C. S. S.
The author commenced by giving a brief history of Medical Geography from its ear-
liest introduction by the Hippocratic School of Medicine to the time when the work of
Dr. William Farr rendered this branch of medical science possible in England.
He then described the plan of three decennial supplements to the Registrar-General's
Reports which Dr. Farr had initiated and succeeded in carrying out for the years 1851–
1860 and 1861–1870.
Dr. Farr's great aim in tabulating the deaths from the several causes selected, occur-
ring in the 630 Registration Districts into which England and Wales are divided, was
to keep the sexes entirely separate, so as to enable the Medical Geographer to show the
effect of sex upon the mortality from certain diseases—cancer, for instance. Again,
well knowing the effect of age, he considered it important that the mean number of
males and females living at different periods of life, in each district, should be ascer-
tained and given as far as the Census Returns would admit, and that the number of
males and females dying from certain causes should be given for each age period, with
the view of ascertaining the relative mortality among the males and females living
during the decennial periods reported on. The advantage of such a system is obvious,
for no investigation bearing upon the natural history of this case could be undertaken
without its adoption. Nevertheless, the present Registrar-General of England has so
far departed from Dr. Farr's plan as to render his supplement to his 45th Annual
Report (1871–1880) not only useless but misleading.
The author then proceeded to illustrate his remarks by reference to maps showing the
geographical distribution of several diseases, especially of cancers, among males and
females separately.
In conclusion, he urged upon the Congress the necessity of its pointing out to the
different Governments of the civilized world the importance of their adopting an uni-
form mode of collecting Vital Statistics and tabulating them according to sex and age in
accordance with some definite plan based upon the principles laid down by the late
Dr. William Farr, C. B., F. N. S., D. C. s.
GROUND-AIR IN ITS HYGIENIC RELATIONS.
L’AIR DE TERRE EN SES RAPPORTS HYGIAENIQUES.
DIE BODENLUFT IN IHREN HYGIENISCHEN VERHALTNISSEN.
BY JOHN D. MACDONALD, M.D., F.R.S.,
Inspector General, Royal Navy.
The atmosphere of the crust of the Earth. The ascentional force of evaporation as a
means of distribution, organic matter. Protozoa, protophyta, etc. The appearance of
agricultural blights. Rivers do not carry off all organic waste. Porous soils the hold-
ing-ground for animal and vegetable debris. Ground water to be studied in connection
with ground air. The chemical examination of ground air shows an increase in relative
amount of carbonic acid in proportion to the depth. Examination of ground air at
Netley. Evil effects of turning up ground in malarial localities.
8
114 ABSTRACTS.
THE SENSATIONAL PREVALENCE OF PNEUMONIC FEVER.
INFLUENCE DE LA SAISON SUR LA FIÉVRE PNEUMONIQUE.
ZEITLICHES UEBERGEWICHT DES PNEUMONISCHEN FIEBER.
BY JOHN WILLIAM MOORE, B. A., M. D., Univ. Dubl., F. K. O. C. P.
In 1875 the author, conjointly with Dr. T. W. Grimshaw, now Registrar-General for
Ireland, contributed to the Dublin Journal of Medical Science a paper on “Pythogenic
Pneumonia.” That paper was based upon statistics of the seasonal prevalence of pneu-
monia in Dublin, as well as upon observations on an epidemic which came under notice
in Cork Street Fever Hospital, Dublin.
The author considers that the claims of pneumonia to be considered a specific fever
rest principally upon—
1. Its not infrequent epidemic prevalence.
2. Its proved infectiousness in some instances.
3. Its pythogenic origin in many cases, and the remarkable correlation which appears
to exist between it and enteric fever.
. Its mode of onset, which exactly resembles that of the recognized specific fevers.
5. The presence of constitutional symptoms before the development of physical signs,
or even symptoms, in many instances, in other words—the existence of a “period
of invasion.”
6. The critical termination of the febrile movement.
7. The presence of local spiphenomena in connection with the skin, such as eruptions
of herpes, taches bleuâtres and desquamation.
8. The occurrence of Sequelae, such as renal dropsy, ataxic paresis, etc.
9. The discovery of a bacillus—the pneumococcus of Friedländer—which analogy,
at all events, points as pathognomonic.
The author has acquired the habit of expressing the relation of the local lesion in
pneumonia—or “pneumonic fever”—to the essential disorder in terms of the intesti-
mal lesion in centric fever to that disease. By “pneumonic fever” we understand a
zymotic or specific blood disease which manifests itself after the lapse of a certain time
(the period of incubation) by physical phenomena—objective and subj ective–connected
in this instance with the lungs.
A careful analysis of the weekly returns of the Registrar-General of England and
Ireland for eleven years, ending with 1886, brings out a remarkable contrast between
bronchitis and pneumonia as to the time of year when these diseases are respectively
most prevalent. The statistics for London and Dublin agree to a remarkable extent.
Bronchitis falls to a very low ebb in the third, or summer quarter of the year (July
to September, inclusive), when only twelve per cent. of the deaths annually caused by
this disease take place in Dublin, and only eleven per cent. in London. In the last or
fourth quarter (October to December, inclusive), the percentage of deaths from bronchitis
rises to twenty-seven in Dublin, and thirty in London. The maximal mortality occurs
in the first quarter (January to March, inclusive), when it is thirty-eight per cent, in
both London and Dublin. In the second or spring quarter (April to June, inclusive),
the bronchitic deaths decline to twenty-three per cent. in Dublin and twenty-one per
cent. in London.
The mortality from pnuemonic fever is differently distributed throughout the year.
In the summer quarter more than fourteen per cent. of the annual deaths referable to
this disease are recorded in Dublin, and more than fifteen per cent. in London. In the
first quarter the figures are—London, 31 per cent.; Dublin, 31 per cent.; in the second
quarter they are—London, 26 per cent.; Dublin, 30 per cent.; in the fourth quarter
they are—London, 27 per cent.; Dublin, 24 per cent.
It, therefore, appears that the prevalence and fatality of pneumonic fever from season
to season do not correspond with the seasonal prevalence and fatality of bronchitis.
4
NINTH INTERNATIONAL MEDICAL CONGRESS, 115
The latter disease increases and kills in direct relation to the setting in of cold weather,
it subsides in prevalence and fatality with the advance of spring and the advent of
summer. Pneumonic fever, on the other hand, increases less quickly in winter and
remains more prevalent in spring and summer than bronchitis—its maximal incidence
coincides with the dry, harsh winds and hot sunshine of spring, when the diurnal
range of temperature also is extreme. The continued frequency of pneumonic fever
in summer and autumn depends, in the opinion of the author, on its pythogenic
origin—in a word, he regards exposure to cold, extremes of temperature, harsh, drying
winds, and so on as merely so many predisposing causes of the disease—reserving for
the introduction into the system of the specific Micrococcus Pneumonia: the rôle of an
exciting cause, perhaps the sole exciting cause.
These results agree very closely with the statements of Dr. August Hirsch, as to
the geographical and seasonal prevalence of pneumonia in his “Handbook of Geo-
graphical and Historical Pathology.””
*msºmºs
THE METEOROLOGICAL ELEMENTS OF CLIMATE AND
THEIR EFFECTS UPON THE HUMAN ORGANISM.
LES ELÉMENTS MáTÉOROLOGIQUES DU CLIMAT, ET LEUR INFLUENCE
SUR L’ORGANISM HUMAIN.
DIE METEOROLOGISCHEN ELEMENTE DES KLIMA, UND IHR EINFLUSS AUF DEN MENSCH-
LICHEN ORGANISMUS.
BY GEORGE H. ROHá, M.D.,
Of Baltimore.
Climate, from the Meteorologist's standpoint may be defined as the sum of all the
meteorological phenomena which we characterize under the collective term “weather.”
Metereology is however only an unclassified aggregation of more or less exact observations,
and cannot yet be rated as a science. With much less force, then, can we speak of a
science of climatology. Conclusions based upon inexact date need constant revision.
Medical climatology must be based upon the observation of meteorological phenomena,
together with certain other conditions such as character of the soil, vegetation, etc.
The adjustment of vital to physical conditions must also be considered in studying cli-
matology in its medical relations. In addition to the difficult problem of the interac-
tion of physical factors, the still more abstruse one of the effect of physical phenomena
upon vital functions demands careful study.
This study, it is needless to say, the subject has not yet received. Defects of pre-
vious methods of observation, and erroneous conclusions based thereon must be cor-
rected.
Variations of atmospheric pressure, temperature, humidity, precipitation, velocity and
direction of the wind, all have unquestionably an influence upon the animal organism.
It is difficult however to separate the effects of each of these from the influence of the
other. Simple as these problems seem they need further and more accurate study.
It is entirely uncertain what influence electrical and chemical conditions of the at-
mosphere have upon the organism. Are there septic and aseptic (antiseptic () atmos-
pheres in nature? How can they be studied and made useful to the sanitarian and
physician 2
* New Sydenham Society, 1886. Vol. III, pp. 116, et seq. .
116 ABSTRACTS.
THE THERMOMETER AS A CLIMATOLOGICAL INSTRUMENT,
LE THERMOMETRE COMME UN INSTRUMENT CLIMATOLOGIQUE
DAS THERMOMETER ALS CLIMATOLOGISCHES INSTRUMENT,
BY CHARLES SMART, M. D.,
Major and Surgeon, U. S. Army.
Inadequacy of the thermometer to express the relations of cold to the human system.
The climatological factors which affect the heat of the body, and the methods of
measuring them. The construction of a thermometer which will show not only the
absolute or dead temperature, but the relative temperature, or how cold it is to the
feel. Precise expression given to the influence of climatological cooling agencies by
means of a series of experiments with such a thermometer.
SOME REMARKS ON THE CLIMATE OF THE SWISS ALPS
WITH PULMONARY CASES TREATED AT 6,000 FEET.
QUELQUES REMARQUEs SUR LE CLIMAT DES ALPES HELVETIQUES
AVEC DES CAS PULMONIQUES TRAITES A LA HAUTEUR DE 6,000
|PIEDS. *
EINIGE BEMERKUNGEN UEBER DAS KLIMA DER SCHWEIZER ALPEN, MIT PULMINAEREN
FAELLEN, WELCHE IN 6000 FUSS HOEHE BEHANDELT WURDEN.
BY A. TUCKER WISE, M.D.,
Of Engadine, Switzerland.
Practical experience desirable for those who are interested in climatology.
. Physiological effects of elevation.
. How the day may be spent in the Swiss Alps during winter.
. Pulmonary cases with results.
. Table of gain in weight of 23 persons with pulmonary troubles.
:
:
SECTION XVII—PSYCHOLOGICAL MEDICINE AND NERWOUS
DISEASES.
OFFICERS.
PRESIDENT: JUDSON B. ANDREWS, M.D., Buffalo, N. Y.
WICE-PRESIDENTS.
JULIUS ALTHAUS, M.D., London, England.
Prof. RUDOLF ARNDT, M. D., Griefswald, Ger-
Imany.
WM. WILBERFORCE BALDWIN, M. D., Florence,
Italy.
Prof. D. BINSWANGER, M.D., Jena, Germany.
GEORGE FIELDING BLANFORD, M. D., F. R. C. P.,
London, England.
Sir JAMES CRICHTON BROWNE, M. D., LL.D.,
F. R. S., London, England.
PETER BRYCE, M. D., Tuscaloosa, Ala.
R. H. CHASE, M. D., Norristown, Pa.
DANIEL CLARK, M. D., Toronto, Canada.
P. MAURY DEAS, M.D., M.S., Exeter, England.
LANGDON Down, M. D., F. R. C. P., London, Eng-
land.
EDWARD EAST, M. D., M. R. C. S., L. S.A., London,
England.
Prof. A. EULENBERG, M. D., Berlin, Prussia.
ORPHEUS Eva RTS, M. D., College Hill, Ohio.
THEODORE W. FISHER, M.D., Boston, Mass.
Prof. AUGUST FOREL, M. D., Zurich, Switzerland.
Prof. LUIGI FRIGERIO, M. D., Alexandria, Italy.
Prof. E. T. GIRTSTROM, M. D., Hernosands, Swe-
den.
W. W. GoDDING, M.D., Washington, D. C.
EUGENE GRISSOM, M.D., Raleigh, N. C.
G. STANLEY HALE, M.D., Baltimore, Md.
JOHN C. HALL, M.D., Philadelphia, Pa.
Prof. V. HINZE, M.D., St. Petersburg, Russia.
Prof. E. HITZIG, M. D., Halle, Prussia.
Prof. E. A. HoMEN, M.D., Helsingfers, Finland.
P. O. HoopBR, M.D., Little Rock, Ark.
C. H. HUGHES, M. D., St. Louis, Mo.
H. M. HURD, M. D., Pontiac, Mich.
HANS LAEHR, M. D., Schweizerhof, Germany.
MEGALHAES LEMOS, M. D., Oporto, Portugal.
H. ROOKE LEY, M. R. C. S., Manchester, England.
WILLIAM JULIUS MICKLE, M.D., F. R. C. P., Lon-
don, England.
ARTHUR MITCHELL, M. D., LL.D., Edinburgh,
Scotland.
Prof. O. MULLER, M.D., Blankenburg, Germany.
C. H. NICHOLs, M. D., New York City, N. Y.
M. le Dr. A. PITREs, Bordeaux, France.
CHAs. B. RADCLIFFE, M.D., F.R.C.P., London, Eng.
M. le Dr. EMANUEL REGIS, Castel d'Andorte,
France.
Prof. M. ROSENTHAL, M. D., Vienna, Austria.
GEO. H. SAVAGE, M.D., F. R. C. P., London, Eng-
land.
S. S. SCHULTz, M. D., Danville, Pa.
SEYMOUR J. SHARKEY, M.D., London, England.
A. M. SHEW, M.D., Middletown, Conn.
E. C. SPITzKA, M. D., New York City, N. Y.
HENRY P. STEARNs, M. D., Hartford, Conn.
Prof. VALDEMAR STEENBERG, M. D., Roskilde,
Denmark.
ALF. STRUEBENS, M.D., Bruxelles, Belgium.
Prof. A. TEBALDI, M. D., Padua, Italy.
D. HACK TUKE, M.D., F.R.C.P., London, England.
JoHN BATTY TUKE, M.D., F. R. C. P., Edinburgh,
Scotland.
WALTER H. WALSHE, M. D., F. R. C. P., London,
England.
Prof. H. A. WILDERMUTH, M. D., Wurtemberg,
Germany.
Prof. L. WILLE, M. D., Basel, Switzerland.
SECRETARIES.
G. A. BLUMER, M.D., Utica, N. Y.
M. le Dr. A. BouchEREAU, Paris, France,
E. D. FERGUSON, M.D., Troy, N. Y.
LANDON, CARTER GRAY, M.D., Brooklyn, N. Y.
COUNCIL,
E. N. Brush, M.D., Philadelphia. Pa.
Floyd S. Crego, M. D., Buffalo, N. Y.
Richard Dewey, M.D., Kankakee, Ill.
Theo. Duke, M. B., Utica, N. Y.
Gustavus Eliot, A.M., M.D., New Haven, Conn.
Walter Hay, M.D., Chicago, Ill.
Gershom H. Hill, M.D., Independence, Iowa.
H. M. Hurd, M.D., Pontiac, Mich,
C. F. MacDonald, M. D., Auburn, N. Y.
Harold N. Moyer, M. D., Chicago, Ill.
R. J. Patterson, M.D., Batavia, Ill.
P. M. Wise, M.D., Willard, N. Y.
Philip Zenner, M.D., Cincinnati, Ohio.
117
118 ABSTRACTS.
DISTRIBUTION AND CARE OF THE INSANE IN THE
TJNITED STATES.
LA DISTRIBUTION ET LA MANIERE DE SOIGNER LES ALIñN£s DANS
LES ETATS UNIS.
VERTHEILUNG UND voRSORGUNG DER IRREN IN DEN VEREINIGTEN STAATEN.
*
BY J. B. ANDREWS, A. M., M. D.,
Of Buffalo, N. Y.
(1) Distribution of the insane. (a) As to locality. (b) As to nationality. (c) As
to race and color.
(2) Organization of asylums. (a) Different systems in construction. (b) Improve-
ments in existing buildings. (c) Proposed changes.
(3) Medical care of patients. (a) Officers and their qualifications. (b) Progress in
scientific treatment. (c) In therapeutics.
(4) Moral treatment. (a) Amusements. (b) Occupation. (c) Restraint. (d) En-
larged freedom.
(5) Management. (a) Attendants. (b) Training schools. (c) Uniforms.
(6) Conclusions.
THE GRAPHIC METHOD OF PRESENTING MENTAL
SYMPTOMS.
LA MáTHODE GRAPHIQUE DE PRESENTU LES SYMPTOMES MENTALES.
|UEBER KARTOGRAPHISCHE DARSTELLUNG DER PSYCHOSEN.
BY PROFESSOR RUDOLPH ARNDT,
Of Griefswald, Germany.
THE CLASSIFICATION OF INSANITY.
LA CLASSIFICATION DE LALIENATION.
IXIE EINTHEILUNG DER GEISTESKRANKHEITEN.
BY H. M. BANNISTER, M. D.,
Of Kankakee, Illinois.
Discussion of the subject from a practical point of view. System of classification
proposed and supported in detail.
THE PATHOLOGY OF HAY FEVER.
LA PATHOLOGIE DE L’ASTHME DE FOIN.
DIE PATHOLOGIE DES BIEU-ASTEIMA.
BY S. S. BISHOP, M. D.,
Of Chicago, Illinois.
Hay-fever a reflex neurosis.
NINTH INTERNATIONAL MEDICAL CONGRESS. 119
*
THE TREATMENT OF RECENT CASES OF INSANITY IN
ASYLUMS AND IN PRIVATE HOUSES.
LA TRAITEMENT DANS LES MAISONS DES ALIEEN£E ET DANS LES
MAISONS PRIVIS DE QUELQUES LAS D’ALIENATION.
DIE BEHANDLUNG WON ANFANGENDEN WAEINSINN IN IRRENANSTATTEN UND IN PRI-
VAT-WOHNUNGEN.
G. FIELDING BLANDFORD, M. D., F. R. C. P.,
Of London, England.
Recent insanity in very many cases is a curable disorder. The mode of treatment
that will afford the best prospect of recovery. For the great majority of patients,
asylum treatment is the only available method. A certain proportion it is important
to treat, if possible, outside of an asylum. Enumerates the disadvantages to certain
classes, of asylum treatment. Forms of insanity which can be treated outside
of an asylum. Transitory mental disorders most frequently caused by drink or in
persons prone by inheritance to nerve disturbance. Many of the depressed and melan-
cholic, in the less acute forms, may be treated outside of an asylum. Probable dura-
tion of insanity and dangers of suicide, however, to be considered. Some of these
cases more advantageously treated in an asylum. Cases of acute primary dementia or
stupor can be treated in private homes. Requisites for treatment of such cases. Treat-
ment in a patient’s own home rarely successful. Alternatives are an asylum or a house
adapted to the requirements of the case.
MICROSCOPICAL DEMONSTRATIONS OF THE EARLY WAS-
CULAR IMESIONS IN SYPHILITIC DEMENTIA.
LES DEMONSTRATIONS MICROSCOPIQUES DES PREMIERES LESIONS
WASCULAIRES DANS L’ALIENATION SYPHILITIQUE.
MIKROSKOPISCHE NACHWEISE DER FRUEHEN GEFAESS-LAESIONEN BEI DEMENTIA
SYPHILITICA. *
BY L. BREMER, M. D.,
Of St. Louis, Mo.
Observations made in a case of recent syphilis. Death from acute softening of the
internal capsule. Characteristic lesions in the capillaries. Bacterial embolism of a
number of capillaries on the border of the corpus striatum and capsula interna.
THE INTERNATIONAL CLASSIFICATION OF MENTAL
DISEASES.
LA, CLASSIFICATION INTERNATIONALE DES MALADIES CÉRÉBRALES.
DIE INTERNATIONALE EINTHEILUNG DER GEISTESKRANKHEITEN.
*-*.
BY WALTER CHANNING, M. D.,
Of Boston, Mass.
Classification of diseases in general. Consideration of mental diseases. Why their
classification is necessary. The older systems of classification, their defects and merits.
Recent systems. The Congress at Antwerp in 1885. Formation of an International
Committee on Classification. Basis adopted for an International Classification. Systems
proposed by members of the committee. Work done in this country. Report of the
Saratoga Conference of Alienists to consider the subject. The classification adopted by
them. The strong and weak points. Classification presented by the writer. Necessary
Work to be done in the future. e
120 * ABSTRACTS.
REMISSIONS AND INTERMISSIONS OF INSANITY.
RÉMISSIONS ET INTERMIssions DE LALIENATION.
REMISSIONEN UND INTERMISSIONEN DES wałłNSINN.
BY DANIEL CLARK, M.D.,
Of Toronto, Ontario.
Remissions and intermissions of natural phenomena. Remissions and intermissions
of pathological conditions as seen in all diseases. Remissions and intermissions as seen
in all forms of insanity.
sºmºsºmº
STATE POLICY IN ITS RELATION TO THE CONSTRUCTION
OF BUILDINGS FOR THE INSANE.
LA POLITIQUE DE LETAT PAR RAPPORT A LA, CONSTRUCTION DES
tº HOPITAUX POUR LES ALIñNÉS.
DIE AUFGABE DES STAATS IN THREM verHAELTN ISS ZUR EINFICHTUNG VON GEBAEU-
DEN FUER, IRRSINNIGE.
BY RICHARD DEWEY, M. D.,
Of Kankakee, Ills.
A brief review of methods heretofore pursued in the United States—Architectural
needs of different classes of the insane—Size and location of institutions.
CASES IILLUSTRATING THE ASSOCIATION OF THE PROW-
SHAPED CRANIUM WITH NEUROTIC DISEASE.
* A
LES CAS QUI EXPLIQUENT L’ASSOCIATION DU CRANE EN FORME DE
PROUE AWEC LES MALADIES NEUROTIQUES.
FAELLE WELCHE DEN ZUSAMMENHANG DES SCHNABELFOERMIGEN SCHIAEDELS MIT
NEUROTISCHEN KRANKHEITEN BELEUCHTEN.
*sº
BY J. LANGDON DOWN, M. D., F. R. C. S.,
Of London, Eng.
THE PRIVATE TREATMENT OF THE INSANE AS SINGLE
PATIENTS IN ENGLAND.
LE TRAITEMENT PRIVſ. DE LES ALIENAEE COMME DES MALADE
PARTICULIERS EN ANGLETERRE.
DIE PRIVAT BEHANDLUNG DER IEREN ALS EINZELN-PATIENTEN ZU ENGLAND.
BY EDWARD EAST, M. D., M. R. C. S., L. S. A.,
Of London, England.
THE TREATMENT OF NEURALGIA IN GENERAL PRACTICE.
LE TRAITEMENT DE LA NEURALGIE DANs PRATIQUE GENERALE.
DIE BEHANDLUNG DER NEURALGIE IN ALLGEMEINEN PRAXIS.
BY GUSTAVUS ELIOT, A.M., M.D.,
Of New Haven, Conn.
1. Range of application of the term neuralgia.
2. Relation of neuralgia to (a) syphilis, rheumatism, lithaemia, anaemia, malaria, and
(b) reflex causes.
NINTH INTERNATIONAL MEDICAL CONGRESS. 121
3. Comparative value of (a) quinine, iodide of potassium, (b) opium gelsemium ; (c)
linaments, sinapisms, blisters, (d) electricity.
4. A combination of several therapeutic measures generally most successful.
IE. Mendel, Berlin, Prussia, will discuss section 5, of the discussion on Syphilis
and its relation to Insanity.
*===
THE PHYSIOLOGICAL AND THERAPEUTIC, EFFECTS OF
CURRENTS OF HIGH TENSION, FRANKLINIZATION.
LES EFFETS PHYSIOLOGIQUES ET THERPEUTIQUES DES COURANTS
D'UNE HAUTE TENSION.
DIE PHYSIOLOGISCHEN UND THERAPEUTISCHEN WIREUNGEN DER STROEME MIT
HOHER SPANNUNG, FRANKLINISATION.
BY PROF. A. EULENBERG, M.D.,
Of Berlin, Prussia.
*=ºmºsºms
MONOMANIA AND ITS MODERN EQUIVALENTS.
LA MONOMANIE ET SES £QUIVALENTS MODERNES.
DIE MONOMANIE UND IHRE MODERNEN EQUIVALENTE.
BY THEODORE w. FISHER, M. D.,
Of Boston, Mass.
Monomania historically considered. The definition constantly changing to the
present time. Esquirol was obliged to extend the signification and accepted the terms
of affective and instinctive monomania, to cover cases of simple mania, melancholia,
and of single morbidimpulse. All forms of partial insanity are classed by some authors
as monomania. Out of this grew a long list of more or less absurd manias for killing,
suicide, stealing, drinking, etc. A reaction soon followed this mania for subdivision.
From this unmerited state of neglect the term has again become important, and is now
used as a synonym for a large class of systematized insanities included by French wri-
ters under the term “La Paranoia,” and by Germans, under the terms “Wahnsinn ''
and ‘‘Verrücktheit.” Statistics of asylum reports relating to this form of disease
show that the German opinions on this subject have not been generally adopted in
this country or Great Britain. Divisions of monomania by various authorities noted
and described. Lack of agreement in the use of terms among the most recent and
best authorities. Less disagreement in regard to the facts observed in cases of system-
atized insanity. Illustrative cases in writer’s experience.
1. There is a very common form of primary insanity characterized by systematized
delusions of grandeur or persecution, usually of both, either mingled or alternate.
2. There are many similar cases secondary to inebriety.
3. There are similar cases reported as secondary to mania and melancholia, but the
writer is unable to present an undoubted case.
4. These cases often occur where no insane or nervous heredity can be demon-
strated.
5. Hallucinations of hearing occur in three-fourths of all cases.
6. Episodical excitement occurs in a majority of cases.
7. Monomania is the best English term to apply to them.
8. Such cases are so numerous and important they should be specially classified,
seconded and reported.
122 ABSTRACTS.
MENTAL DISEASE PRODUCED BY CHANGES IN THE WESSELS
AT THE BASE OF THE BRAIN.
LES MALADIES MENTALEs PRQDUITES PAR DES ALTÉRATIONS DANS
LES WAISSEAUX A LA BASE DU CERWEAU,
GEISTESKRANKHEIT DURCH WERAENDERUNGEN IN DEN GEFAESSEN DER HIRNBASIS.
*
BY W. B. FLETCHER, M. D.,
Of Indianapolis, Indiana.
In a large majority of chronic insane persons there are changes in the calibre of one
or more of the vessels at the base of the brain ; or diminution of size of foramina
through which the vessels pass. Causes of this condition : Congenital; emboli, as
Secondary to other diseases ; irregular final anchylosis of the basi-sphenoidal bone;
thrombi; atheromatous degeneration of the arteries.
LEFT HEMIPLEGIA FROM THE DESTRUCTION OF THE
RIGHT PARIETAL CIRCONVOLUTIONS SUCCEEDING TO A
VEGETATIVE END ARTERITIS.
HEMIPLEGIE GAUCHE PAR LA DESTRUCTION DES CIRCONVOLUTIONS
PARIAETALES DE DROIT SUCCESSIVE A UNE ENDOARTÉRITÉ Vígſ.
TATIVE.
LINKSSEITIGE HEMIPLEGIE DURCH ZERSTOERUN G DER RECHTEN PARIETALEN HIRNWIN-
DUNGEN IN FOLGE EINER, VEGETATIVEN ENDARTERITIS.
BY LOUIS FRIGERIO, M. D.,
Of Alexandria, Italy.
INSANITY AS A DEFENSE FOR CRIME.
L'ALIÉNATION COMME UNE DEFENSE POUR LE CRIME.
amsºmºs
WAHNSINN ALS WERTHEIDIGUNG DES WERBRECHENS.
BY W. W. GODDING, M. D.,
Of Washington, D. C.
Insanity is neither a legal dictum nor a metaphysical conception, but a clinically
observed form of disease. The present status of the defense of insanity in criminal
cases among English speaking nations. The rulings of the court respecting the crimi-
mal responsibility of the insane. The exceptional New Hampshire doctrine. The
knowledge of right and wrong the metaphysical rather than the Scientific test of crimi-
mal responsibility. If we reject the test for responsibility, what is left us? Illustra-
tive cases. Probable basis of the future agreement of the medical and legal professions
on the degree of insanity which shall be deemed a defense in criminal cases.
HYPERAESTHESIA.
L'HYPERESTHÉSIE.
DIE HYPERAESTHESIE.
BY PROF. G. STANLEY HALL, M. D.,
Of Baltimore, Maryland.
I present briefly a few typical cases of spontaneous and hypnotic hyperasthesia from
literature and from my own experience. Shows how extreme it may be in the Senses
of touch, smell, hearing and sight. The theory of spontaneous central stimulation and
NINTH INTERNATIONAL MEDICAL CONGRESS. 123
the bearings of the psycho-physic law of Weber and Felmer are then discussed. Next,
hyperaesthesia is proposed as an explanation of many of the so-called telepathic phe-
nomena of the English society for psychical research. Finally, it is applied in form of
the suggestion of the Nancy school of French psychologists as opposed to the views of
Charcot and his followers.
MENTAL MANIFESTATIONS OF INSANITY CAUSED BY
SUNSTROKE.
LES MANIFESTATIONS MENTALEs DE LALIóNATION CAUSáE PAR UN
COUP DE SOLEIL.
GEISTIGE ZEICHEN DES IRRSINNS DURCH SONNENSTICH WERUBSACHT.
BY GERSHOM H. HILL, M. D.,
Of Independence, Iowa.
TENDON REFLEX IN HEMIPLEGIA.
LETENDON REFLECTIF EN HóMIPLÉGIE.
SEHNEN REFLEX BEI DER HEMIPLEGIE.
BY V. HINZE, M. D.,
Of St. Petersburg, Russia.
HISTOLOGIC ALTERATIONS SUPERVENING ON AMPUTATION
IN THE PERIPHERIC NERVES, THE SPINAL GANGLIONS
AND THE MARROW.
LES ALTÉRATIONS HISTOLOGIQUES SURVENANT A LASUITE DAMPUTA-
TION DANS LES NERFS P£RIPHERIQUES, LES GANGLIONS SPINAUY
ET LA MOELLE.
DIE HISTOLOGISCHEN WERAENDERUNGEN IN DEN PERIHPEREN NERVEN, DEN SPINAL-
GANGLIEN UND DEM RUECKENMARKE IN FOLGE VON AMPUTATION.
BY E. A. HOMEN, M. D.,
Of Helsingfors, Finland.
THE TRUE NATURE AND DEFINITION OF INSANITY.
LA NATURE WAERITABLE ET LA DEFINITION DE LALIENATION.
*ms
DIE WAHRE NATUR UND DEFINITION DES IRRSINNS.
*=sº
BY C. H. HUGHES, M.D.,
Of St. Louis, Mo.
THE RELIGIOUS DELUSIONS OF THE INSANE.
LEs ILLUSIONS RELIGIEUSEs CHEZ LES ALIENEs.
º DIE RELIGIOESEN DELUSIONEN DER IRRSINNIGEN.
BY HENRY M. HURD, A. M., M. D.,
Of Pontiac, Mich.
The nature and development of religious sentiments—their dependence upon age,
natural characteristics, education, mental peculiarities, habits of thought and modes
of expression. The religious delusions which accompany the developmental stages
of over-stimulated and injudiciously educated children. The religious delusions char-
124 ABSTRACTS,
acteristic of the insanities of pubescence and masturbation. The delusions of perse-
cution, imperative religious conceptions and religious ecstasies of paroniria. The
religious propensities of epilepsy, general paresis and dementia. The religious doubts
and fears of melancholia and climatic insanity. The connection between disorders of
the sexual system, excessive alcoholic indulgence, the use of opium and other nar-
cotics and the development of religious delusions. The course and termination of
religious delusions.
*º
GENERAL PARALYSIS IN DOGS.
LA PARALYSIE GENERALE CHEZ LES CHIENS.
DIE ALLGEMEINE PARALYSE BEI HUNDEN.
BY MEGALHAES LEMOS, M. D.,
Of Oporto, Portugal.
OBSCURE FORMS OF EPILEPSY, WITH CASES.
D’OBSCURES FORMES DE L'ÉPILEPSIE, AWEC DES CAS.
UNBESTIMMTE FORMEN DER EPILEPSIE; MIT FAELLEN.
BY CARLOS F. MACDONALD, M.D.
Of Auburn, N. Y.
Obscure forms of epilepsy have been described by various writers under the terms
abortive, irregular, larvated, masked, mental, moral, metastatic, non-convulsive, partial,
psychical, vertiginous, etc., etc.
Irregular forms of epilepsy much more common than formerly supposed ; are now
well-established, and, usually, readily diagnosed by expert alienists and neurologists,
but sometimes exist for months or years without being recognized, and without proper
treatment, until the curable stage has passed. Many cases of so-called “moral insan-
ity’’ probably belong to this class.
The phenomena of the epileptic neurosis may, and frequently do, occur in a manner
widely different from the typical forms of epilepsy described in text-books and taught
in medical Schools. These phenomena, while usually marked by periodicity and more
or less mental confusion, resembling, to this extent, ordinary epileptic seizures, do not
reach the convulsive stage, nor, frequently, complete loss of consciousness, etc., etc.
(To be followed by a report of several cases).
THE RELATION OF PSYCHOLOGICAL MEDICINE TO THE
DISEASE OF INEBRIETY. *
LES RELATIONS DES REMEDES PSYCHOLOGIQUES A LA MALADIE DE
L’IVRESSE.
DAS VERHAELTNISS DER PSYCHOLOGISCHEN MIEDICIN FUER DIE KRANKHEIT DER
TRUNKSUCHT.
****
BY EDWARD C. MANN, M. D.,
tº Of Brooklyn, N. Y.
The disease of inebriety intimately connected with and one of the main causes of
insanity. Distinction between disease and voluntary indulgence in liquor. The great
diagnostic point between is the irresistible impulse. Paroxysms of the disease are pre-
ceded by disturbance of the nervous system. Heredity. There is transmitted, allied,
NINTH INTERNATIONAL MEDICAL CONGRESS, 125
but different forms of Neuroses, as dypsomania, epilepsy, chorea or a proclivity to
crime. Pathology. Resulting from the abuse of alcohol, we have a change in the
chemical composition of the cerebral cells from the standard of health, which is the
foundation of organic disease. State or preventive medicine in its relation to the
disease of inebriety. Attitudes of forensic medicine vs. the disease of Inebriety.
For the medico-legal protection of inebriates, these points are made. 1st. That the
will is overcome by the force of the disease. 2d. That the person is involuntarily
deprived of the knowledge of the true nature of his acts. 3d. That there is no truer
periodic insanity than dypsomania.
*======
THE RELATION OF SYPHILIS TO GENERAL PARALYSIS.
LA RELATIONE DE LA SYPHILIS A LA PARALYSIE GENERALE.
=smm.sºme
DAS WERHAELTNISS DER SYPHILIS ZUR ALLGEMEINEN PARALYSE.
*memº
BY WILLIAM JULIUS MICKLE, M. R. C. S.,
Of London, England.
SYPHILIS AND ITS RELATION TO INSANITY.
LA SYPHILIS ET SES RELATIONS A L’ALIÉNATION.
DIE SYPHILIS UND IHR, vERHAELTNIss ZUM WAEINSINN.
BY DR. R. B. MITCHELL.
Under the following heads:—
. Idiocy, imbecility, moral perversions due to inherited Syphilis.
. Insanity associated with acute syphilis. (a) Physical. (b) Moral.
. Syphilis producing epilepsy with or without insanity.
. Syphilis producing mental weakness, (a) with, (b) without paralysis.
. Syphilis as associated with general paralysis.
. Pathology as represented by coarse changes like gummata or slighter ones as seen
in arterial disease.
The discussion will be opened by GEORGE H. SAVAGE, M. D., London, Eng.
To be participated in by Fletcher Beach, M. D., M. R. C. P., London, Eng. ; G. E.
Shuttleworth, B. A., M. D., Lancaster, Eng. (Sections 1, 4 and 5); Francis Warner,
M. D., London, Eng. (Section 2); J. Wigglesworth, M. D., London, Eng. (Section 2); E.
N. Brush, M. D., Philadelphia, Pa.; G. Alder Blumer, M. D., Utica, N. Y. ; E. C. Mann,
M. D., Brooklyn, N.Y. (Section 4); H. N. Moyer, M. D., Chicago, Ills. (Section 5); E.
C. Spitzka, M. D., New York City, N. Y. (Sections 4, 5 and 6); Leonard Weber, M.D.,
New York City, N. Y. (Sections 3 and 4), and others.
:
REMARKS ON THE AETIOLOGY AND PATHOLOGY OF THOM-
SEN'S DISEASE, WITH THE REPORT OF A CASE.
DES OBSERVATIONS SUR L'ÉTIOLOGIE ET LA PATHOLOGIE DE LA
MALADIE DE THOMSEN AWEC UN RAPPORT SUR UN CAS DE CETTE
MALADIE.
BEMERKUNGEN UEBER DIE AETIOLOGIE UNID PATHOLOGIE DER THOMSEN’SCHEN KRANK-
HEIT, MIT BERICHT EINES FALLES.
*º
BY HAROLD N. MOYER, M. D.,
Of Chicago, Ill.
126 ABSTRACTS,
NEW METHOD OF CLASSIFICATION OF THE CONDITIONS
OF MENTAL ALIENATION.
NOVEAU CLASSEMENT METHODIQUE DES £TATS DALIAENATION
MENTALE.
NEUE CLASSIFICIRUNGS METHODE DER ZUST AENDE DER GERSTIGEN ENTFREMDUNG,
BY EMMANUEL REGIS,
Of Bordeaux, France.
EXPERIMENTAL AND CLINICAL OBSERVATIONS OF CO-
CAINE.
DES OBSERVATIONS ExPERIMENTALES ET CLINIQUES SUR LA COCAINE.
EXPERIMENTALE UND ELINISCHE BEOBACHTUNGEN DEBER DAS COCAIN.
BY DR. M. ROSENTHAL,
Of Vienna, Austria.
The excellent results obtained from the use of Cocaine in the different dominions of
medicine engaged me to investigations on the physiological and clinical effects of this
remedy. A large number of experiments were made on dogs in the laboratory of Dr.
Basch. The solution of Cocaine was introduced in the vena jugularis externa (1:100).
The experiments tended to prove the pressure of the blood not only as hitherto in the
arterial, but also in the venous system (especially in the vena axillaris), under the in-
fluence of Cocaine and other remedies combined with it. According to these investigations
the clinical effects of Cocaine shall be shown in pathological forms of central diseases.
I will here give the principal phenomena of the experiments and of the clinical obser-
Vations :
1. The injection of small quantities (0.01 grnm.) first produces a considerable increase
of the pressure of blood in the arterious system and acceleration of the pulse ; the pres-
sure of blood in the veins is not altered. The injection of larger doses (0.04-0.05) in-
duces a rapid fall of the pressure of blood in the arteries; the pressure in the veins is
often lowered to the negative. In such cases the injections of Strychnine have no stim-
ulating power on the pressure of bloodvessels.
2. The slowness of the pulse after injections of Cocaine is most combined with increase
of the venous pression. The same phenomena is to be observed, if larger doses pro-
voke a rapid decline of the pressure of blood in the arteries. It is evident that there
is not always a paralellism in the action of the two representants of the vascular
system. The same different effect I observed also in the employment of morphine.
3. The injection of larger doses of Cocaine is very soon followed by a rapid collapse of
both vascular pressions (after the use of 0.1–0.15). The action of the heart is stopped.
Even by the injections of greater quantities of strychnine no benefit is obtained. The
Cocaine, employed in large doses, is an active cardiac poison.
4. If the pression of blood is not yet much lowered by Cocaine, the injections of Strych-
nine may often bring a recovery. The chances of vascular pressure are proportionate to
the quantity of the injected matter.
5. Experiments upon dogs prove also the good effect of the injections of Cocaine in
cases of first tetanizing action of strychnine. The Cocaine stimulates the cardiac and
vascular functions.
The interesting results of experimentation on animals may also be taken into consider-
ation for the purpose of interpretation of symptoms in some nervous diseases and other
organic affections. In several cases after the employment of Cocaine the phenomena
revealed to us an increase of pressure in the vascular system. In other cases the local
effect of anaesthesia prevailed.
NINTH INTERNATIONAL MEDICAL CONGRESS. 127
In several forms of neurasthenia, associated with periodic anxiety, pallor of the face
and upper limbs, small pulse and lessened arterial tension in the radialis, I could ob-
serve a good effect of the methodic employment of Cocaine, increasing doses of the alkal-
oid (0.02–0.03 twice a day) administered for some weeks, contributed to calm the
abnormal impressionability and anxiety. The pulse becomes stronger, the arterial ten-
sion more vigorous, the mind more energetic.
In two cases of affection of the posterior columns of the cord (tabes dorsalis) I obtained
temporary good results, if the lancinating, shooting pains were combatted by hypoder-
mic injections of Cocaine. In both patients the violent neuralgic pains were associated
with subjective sensation of cold, with discoloration of the integument of the limbs and
with local cutaneous hyperasthesia; the pulse small and feeble. After the hypodermic
injection of Cocaine (3–5 : 100) in 15–20 minutes the warmth returned, the skin of the
limbs was without any hyperaesthesia, well colored, and the seat of an agreeable perspir–
ation. The pulse stronger and of higher arterial tension; very soon also recovery of the
motor power. But the long employment of the Cocaine produced anarexia, dyspepsia,
nausea, dizziness, headache and general exhaustion. The remedy was in such cases no
more efficatious.
In chronic diseases with dropsy hypodermic injections of Cocaine (0.03) are of good
effect. But no permanent benefit is obtained. The dropsy returned after the omission
of the remedy. The diurese is produced by the increase of the pressure of blood and of
the cardiac action. *
The local effect of anaesthesia is manifest, if the Cocaine is introduced by the ways of
digestion. For instance in cases of nervous cardialgia, frequently observed in anaemic
and hysterical individuals, the interval administration of Cocaine constitutes an efficient
remedy during the attacks themselves. The solution of C. is to be given (0.15–0.2 : 150)
coffeespoonfull every fifteen minutes, till the pain is calmed.
In the painful sensation of hunger, occurring with unusual frequency, in the boulimia,
the hyperaesthesia of the pneumogastric is also appeased by the longer employment of
Cocaine (0.01–0.02 three times a day). In a hypochondriac, who had been benefited by
the treatment with Cocaine, I was obliged to omit the remedy, as digestive disorders
appeared. The patient was afraid to lose entirely his appetite.
Finally it may be mentioned, that the annoying noises in the ears produced by larger
doses of quinine or Salicylates, are very much mitigated by the combination of the drugs
with small doses of Cocaine (0.01 : 1.0).
BORDERLAND, EARLY SYMPTOMS AND EARLY TREAT-
MENT OF INSANITY.
LES FRONTIERES LES PREMIERES SYMPTóMEs ET LE TRAITEMENT DU
COMMENCEMENT DE L’ALIENATION.
DER GRENZLAND, FRUEHE SYMTOME UND FRUEHE BEHANDLUNG DES WAHNSINN.
BY IRA RUSSELL, M. D.,
Of Winchendon, Mass.
The difficulty of tracing the line that separates sanity from insanity. The impor-
tant rôle that the insane diathesis has to play in the production of insanity. Early
Symptoms of insanity often not recognized. Statistics upon the duration of insanity
before admission, and hospital treatment, and length of time in hospital, of those
recovered. The great advantage of early treatment. Home treatment in private
retreats. Importance of individualized treatment.
128. ABSTRACTS.
MILIARY ANEURISMAL DISEASES, DEFORMITY OF
THE BRAIN.
LA MALADIE DE LANEURISME MILIARE. LA DEFORMITÉ DU
CERWEAU.
MILIAR-ANEURISMATISCHE KEANKHEIT, DEFORMITAET DES GEHIRNES.
BY E. C. SPITZKA, M. D.,
New York City, N. Y.
LEGAL RELATION OF EPILEPSY.
LA RELATION JURIDIQUE DE L'ÉPILEPSIE.
GESETZLICHES WERHAELTNISS DER EPILEPSIE.
tºmsºmºre
BY JOHN BATTY TUKE, M.D.,
Of Edinburgh, Scotland.
ON THE MODES OF PROVIDING FOR THE CARE OF THE
INSANE IN GREAT BRITAIN AND THE UNITED STATES,
AND ON THE “RAPPROCHEMENT’’ BETWEEN AMERICAN
AND BRITISH ALIENISTS AS TO THE EMPLOYMENT OF
MECHANICAL RESTRAINT.
SUR LA MANIERE DE SOIGNER LES ALIENás DANS LA GRANDE BRE-
TAGNE ET LES ETATS UNIS ET SUR LA RAPPROCHEMENT DES ALL-
£NISTES BRITANNIQUES ETAMERICAINS PAR RAPPORT A L’USAGE DES
MOYENS DE CONTRAINTE. -
UEBER DIE METHODEN ZUR, VERSORGUN G DER IRREN IN ENGLAND UND DEN VER-
EINIGTEN STAATEN, UND UEBER DAS “RAPROCHEMENT." UNTER BRITISCHEN UND
AMERIKANISCHEN IRRENARZTEN HINSICHTLICH DER ANWENDUNG MECHANISCHER
ZWANGSMITTEL. - .
BY D. HACK TUKE, M. D., F. R. C. P.,
Of Lyndon Lodge, Hanwell, Eng.
OCCUPATION IN THE TREATMENT OF INSANITY.
L’OCCUPATION DANS LE TRAITEMENT DES ALIENES.
BESCHAEFTIGUNG IN DER BEHANDLUNG DES IRRSINNS.
BY HORACE WARDNER, A. M., M.D.,
Of Anna, Ills.
Idleness injurious—An injured part must be exercised during convalescence to regain
its functions—The brain and nervous system no exception to the rule—Treatment of
mania compared to that of an injured limb–Benefits of mental and muscular exercise
in the convalescent of insanity—Good effects of occupation in chronic insanity. Ex-
amples: Case number 1, case number 2, case number 3, case number 4—Remarks on
cases—Authorities cited—Conclusions. -
NINTH INTERNATIONAL MEDICAL CONGRESS. 129
EXAMINATION OF THE BRAIN CONDITION OF CHILDREN.
*-*
L'ExAMEN DANS LA CONDITION CÉRÉBRALE DES ENFANTs.
UNTERSUCHUNG DES HIRNZUSTANDES DIE KINDERN.
BY FRANCIS WARNER, M. D.,
Of London, England.
The points to be observed in studying young subjects are, 1st. Signs of nutrition.
2d. Development. 3d. Movements such as indicate present state of the nervous sys-
tem, especially such as the mental action or its potentiality. Among signs of develop-
ment are the proportions of the body, the form and feature, and any defects observed,
such as are commonly associated with defects in organization of the brain. Let the
child stand up and hold out its hands; the posture of the head and upper extremities
and the digits as produced by the nervous system may thus be determined. The move-
ments may be determined at the same time. Postures are due to the balance of nerve—
muscular action. They may be symmetrical or not. Typical postures are given to aid
description. Movements of various parts are described and the clinical significance
given.
*-*-
HOSPITAL AND ASYLUM CONSTRUCTION FOR THE INSANE.
-*
LA CONSTRUCTION DES MAISON DES ALIENEE.
-*s
HOSPITAL- UND ASYL-BAUTEN FUER, IRRSINNIGE.
-*.
BY P. M. WISE, M. D.,
Of Willard, N. Y.
The writer assumes: That the mass of the insane are now, and will continue to be,
dependent on public support. That the largest proportion of the insane will continue
to require care in organized institutions or asylums. That the burdens imposed upon
the public by the progressive increase in the numbers of the dependent insane, will,
for economical reasons, if for none other, lead to the creation of large asylums. That
methods will prevail whereby hospital and asylum care will be given in the same insti-
tution.
The writer considers: The tendencies of modern and recent asylum construction, in
relation to site, water supply, sanitation, fire prevention, subdivision of asylum struc-
tures, permitting increased flexibility in classification and amplest means for the treat-
ment of the insane. The importance of governmental bureaus of information regard-
ing hospital and asylum construction.
a-sm-
LOCOMOTOR ATAXIA AND SYPHILIS.
LOCOMOTEUR ATAXIE ET SYPHILIS.
LocoMotoRISCHE ATAXIE UND SYPHILIS,
-*.
BY DR. PHILIP ZENNER,
Of Cincinnati, Ohio.
First. The proportion of cases of locomotor ataxia in old syphilitics.
Second. The proportion of cases of locomotor ataxia in dissolute subjects not
syphilitic.
Third. Personal experience with cases of locomotor ataxia both with and without
previous syphilitic history.
Illustrated by original investigation.
9
SECTION XVIII—DENTAL AND ORAL SURGERY.
OFFICERS.
PRESIDENT: JONATHAN TAFT, M. D., Cincinnati, Ohio.
WICE-PRESIDENTS.
W. W. ALLPORT, M.D., Chicago, Ill.
S. W. DENNIS, M.D., San Francisco, Cal.
C L. FORD, M.D., Ann Arbor, Mich.
Dr. KUHN, Paris, France.
Dr. W. Bowman McLEOD, Edinburgh, Scotland.
Dr. A. T. METCALF, Kalamazoo, Mich.
Dr. D. I. McKELLOPs, St. Louis, Mo.
Dr. A. L. North RoP, N. Y.
Dr. W. D. MoRGAN, Nashville, Tenn.
Dr. L. D. SHEPPARD, Boston, Mass.
Dr. W. W. D. THACKSTON, Farmville, Va.
Dr. T. D. HARDING, England.
SECRETARIES.
A. M. DUDLEY, M. D., Salem, Mass.
F. H. REHNWINKEL, M. D., Chillicothe, Ohio.
Dr. E. BRASSEUR, Paris, France.
Dr. E. FoERBERG, Stockholm, Sweden.
Dr. JULIUS PARRSIDT, Leipsig, Germany.
COUNCIL.
HDr. F. Abbott, N. Y.
R. B. Andrews, M.D., Cambridge, Mass.
Dr. N. C. Barrett, Buffalo, NY.
C. F. W. Boedecker, M. D., New York, N. Y.
Dr. C. A. Brackett, Newport, R. I.
Dr. J. S. Cassidy, Covington, Ky.
B. H. Catching, M. D., Atlanta, Ga.
T}r. George H. Chance, Portland, Or.
E. S. Chisholm, M. D., Tuscaloosa, Ala.
C. C. Chittenden, M.D., Madison, Wis.
Dr. D. M. Clapp, Boston, Mass.
Dr. W. R. Clifton, Waco, Texas.
E. T. Darby, M.D., Philadelphia, Pa.
Dr. K. B. Davis, Springfield, Ill.
Dr. A. M. Dudley, Salem, Mass.
Dr. Geo. L. Field, Detroit, Mich.
M. W. Foster, M. D.,
C. E. Francis, M. D., New York, N. Y.
George D. Freiderichs, New Orleans, La.
F. J. S. Gorgas, M.D., Baltimore, Md.
Geo. W. Heeley, M. D., Oxford, Ohio.
C. E. Hill, M. D., Brooklyn, N. Y.
A. O. Hunt, M.D., Iowa City, Iowa.
Finley Hunt, M.D., Washington, D. C.
Dr. P. G. C. Hunt, Indianapolis, Ind.
Dr. E. E. Kirk, Philadelphia, Pa.
James Lewis, M. D., Burlington, Vt.
C. A. Marvin, M.D., Brooklyn, N. Y.
James McManus, M.D., Hartford, Conn.
Dr. T. T. Moore, Columbia, S, C.
Dr. J. Hall Moore, Richmond, Va.
W. H. Morgan, M.D., Nashville, Tenn.
Dr. W. N. Morrison, St. Louis, Mo.
Edgar Palmer, M.D., La Crosse, Wis.
S. B. Palmer, M. D., Syracuse, N. Y.
Dr. J. H. Plomteaux, San Francisco, Cal.
Dr. N. O. Rawls, Lexington, Texas.
Joseph Richardson, M. D., Terre Haute, Ind.
C. W. Spalding, M. D., St. Louis, Mo.
W. A. Spaulding, M. D., Minneapolis, Minn.
C. S. Stockton, M. D., Newark, N. J.
Dr. A. D. Thomson, Topeka, Kansas.
Dr. James Truman, Philadelphia, Pa.
Dr. E. W. Turner, Raleigh, N. C.
W. C. Wardlow, M. D., Augusta, Ga.
J. W. White, M.D., Philadelphia, Pa.
E. A. Younger, M. D., San Francisco, Cal.
THE SIXTH-YEAR MOLAR.
LA DENT DE SIX ANS.
DER BACKENZAHN DEs SECHSTEN JAHRES.
BY DR. ANDRIEU,
Of Paris, France.
TJSE OF AIR IN DENTAL THERAPEUTICS.
DE LAIR EN THERAPEUTIQUE DENTAIRE,
DIE ANWENDUNG DER LUFT IN DER ZAHN-THERAPIE.
BY DR. BRASSEUR,
Of Paris, France,
130
IND EX.
PAGE
Alexander, W............................... 38
Andrews, J. B............................... 118
Andrews, R. R.............................. 137
Armstrong, S. T............................ 12
Arndt, Rudolf............................... 118
Arnold, A. B................................. 6
Ashby, Henry .............................. 80
Atkinson, G. A.............................. 60
Baginsky, Adolph.......................... 81
Baker, Henry B............................. 107
Bannister, H. M............................ 118
Baratoux, J............................... 10, 101
Bartlett, John................................ 29
Baumler, Christian......................... 6
Bigelow, Horatio R........................ 38
Bishop, S. S. .............................. 93, 118
Blandford, G. Fielding.................... 119
Bontecou, Reed Brockway............... 12
Bouchut, E................................... 83
Bradford, E. H.................. ........... 83
Brasseur, Dr.................................. 130
Bremer, L .............................. ..... 119
Brown, Dillon..............................., 88
Bryce, Peter H.............................. 109
Burten, J. E................................. 39
Buvinger, Charles Wesley.............. 12
Byford, H. T.................................. 30
Carter, J. M................................. 81
Caton, Richard.............................. 73
Channing, Walter.......................... 119
Clark, Daniel............................. 74, 120
Clarke, A. P................................. 40
Coghill, John George S.................... 61
Collins, James................................ 13
Cordes, A..................................... 43
Corson, Hiram.............................. 63
Coutts, J. A................................. 83
Crothers, T. D........ ..................... 6
Cutter, E...................................... 6
Dabney, Wm. C. ........................... 7
Day, Richard ................................ 104
Day, W. H................................... 84
Denison, Charles........................... 109
D'Espine, A................................. 84
Dewey, Richard............................. 120
Down, J. Langdon......................... 120
Dronke, F................. .................. 64
Earle, Chas. Warrington ............... 30–85
East, Edward................................ 120
Edson, Cyrus............ .................... 85
Eliot, Gustavus....... * * * * * * * * * * * * * * * * * * * * * * * 120
Enfield, A........................... ......65, 110
Esmarch, Von Friedrick................. 15
Eulenberger, A.............................. 121
Everts, O...................................... 75
* PAGE
Fazio, Eugenio......................... 110, 111
Fisher, Jackson....................... ......... 3
Fisher, Theo. W............................. 121
Fitch, Simon...............................”. 43
Fletcher, W. B............................... 122
Ford, W. H................................... 75
Formad, H. F. .............................. 79
French, George F........................... 44
Frigerio, Louis................. ............ 122
Fulton, J. F. ................................ 94
Garratt, Alfred C. .......................... 44
Gassicourt, Cadet De...................... 84
Geike, Walter P............................ 7
Getz, Landis................................ 45
Gihon, A. L. ................................. 111
Glisan, Rodney. ............................ 31
Gnezda, T..................................... 66
Godding, W. W............................ 122
Goodhart, Jas. F............................ 86
Gouley, J. W. S............................ 14
Grancher, Dr........ º, e e s = e s a e s is e º se e s is a s = * * * 86
Grant, J. A. S............................... 105
Gregory, Elisha H......................... 15
Griswold, E.................................. 15
Hall, G. Stanley............... a s a e s tº e e º & º & 122
Halliburton, Wm. D....................... 76
Hamilton, Hugh............................ 66
Havard, Valery...... ....................... 16
Haviland, Alfred......... -................. 113
Hewitt, Graily...................... tº e e s e e s tº º 45
Hewson, A.................................... 47
Hill, Gershom H............................ 123
Hinze, V...................................... 123
Hobby, C. M. ................................ 94
Homen, E. A................................. 123
Hughes, C. H. . ............... ..........47, 123
Hurd, Henry M............................. 123
Hutchinson, J............................... 102
Hyde, Frederick............................. 16
Jackson, A. R............................... 48
Janes, Henry................................ 17, 18
Kartulis, Dr................................. 79
Kellogg, J. H................................ 48
Kelly, J. E................................... 32
Knight, James.............................. 86
Korosi, Joseph .............................. 7
Laborderie, D............................... 10
Lamb, Daniel Smith. .................... 19
Landolt, E.................................... 92
Leeds, Albert. ............................. 86
Leighton, A. W............................. 105
Lemos, Megalhaes.......................... 124
Leuf, A. P. H............................... 72
Liell, E. N.................................... 66
131
132 INDEX.
IPAGE PAGE
Loewenberg, B ........................... 95, 97 | Savage, G.C........................ ........ 100
Longmore, Sir Thomas.................... 19 | Sayre, Lewis A. ........................... 88, 89
Lusk, Wm. T.................... ........... 33 || Scott, Preston B............................. 8
Shakespeare, E. O......................... 79
MacDonald, Carlos F...................... 124 Simon, Jules................................. 89
MacDonald, John D..................... 20, 113 | Smart, Charles........................... 23, 116
McWilliam, J. A. .......................... 67 Smith, Joseph R............................ 23
Mann, Edw. C. .............................. 124 Smith, Noble.......................... ...... 89
Marcy, H. O................................ 34, 51 Smith, Stephen.............................. 89
Marston, Jeffrey A......................... 21 | Spanton, M. D.............................. 58
Martin, F. H................................. 52 | Spitzka, E. C..................... ........... 128
Mattison, J. B. .............................. 7 | Stamm, N............................. ...... 72
Menière, P...................... ............. 52 | Staples, Francis Patrick.................. 24
Meyer, Leopold ............................ 54 | Steele, A. J..... ............................. 90.
Mickle, Wm. Julius....................... 125 | Stephenson, W.............................. 90.
Milner, Urial S.............................. 105 | Steven, John Lindsay..................... 8
Mitchell, R. B............................... 125 | Stewart, William S........................ 36
Moncorvo, Dr............................. 87, 102 | Summers, T. O.............................. 77
Moore, John Wm............................ 114
Moore, Thos. J.............................. 21 | Taylor, C. Fayette......................... 90
More-Madden, Thos................. 33, 49, 50 | Taylor, Morse K........ ................... 25
Moyer, Harold N........................... 125 | Temple, J. Algernon...................... 36
Murrell, T. E................................ 98 || Tilly, Robert................................. 100.
Tobin, Richard Francis................... 25
Neftel, William B.......................... 7 | Tremaine, Wm. S........................... 26
Nelson, Samuel W......................... 54 | Trenholme, Edward H.................. 36, 58
Newlin, John W............................ 55 | Tuke, D. Hack.............................. 128
Northrup, W. P............................. 87
Unna, P. G................................... 102
O'Dwyer, J................................... 88
Ochterlony, Jno. A......................... 8 || Varian, Wm.................................. 27
Oxley, Martin........................ ...... 88 || Vaughan, W. C.............................. 90.
Vogel, Alfred................................. 91
Peabody, James H......................... 22 || Voorhees, Charles Hobart................. 27
Poole, Thos. W.............................. 76
Porter, George L................... ........ 22 Wade, W. C................................. 59
Potter, Wm. W.............................. 55 | Ward, Wm.................................. . 69
Power, Henry................................ 92 || Wardner, Horace........................... 128
Prince, David................................ 57 | Warner, Francis...... ..................... 129
Watson, B. A................................. 28
Reed, Harvey................................ 57 | Waxham, F. E.............................. 91
Regis, Emanuel............................. 126 | Weeks, S. H................................. 59
Reid, Wm. L................................ 58 | Wetmore, A.................................. 78
Richey, S. O................................. 99 || Whitmarsh, W. M.......................... 8
Rohé, G. H. .................................. 115 || Wise, A. Tucker.................... 116, 129
Rosenbach, O................. .... ......... 101 || Wood, Eli A................................. 2
Rosenthal, M ................................ 126
Russell, Ira.................................. 127 Zenner, Philip.............................. 129
INDEX TO AESTERACTS.
PAGE
Abdomen, penetrating gunshot wounds of, treatment. By T. J. Moore............ 21
laparotomy for. By W. S. Tremaine...................................... 26
penetrating wounds, treatment of. By F. P. Staples........................... 24, 25
Abdominal surgery, important points of. By Addinell Hewson..................... 47
Agetonuria in children. By Adolph Baginsky........................ .................... 81, 82
Air of mountains. By A. Enfield.............................................................. 110
Alcohol in disease, therapeutics of. By E. M. Liell....................................... 66
in the organism. By W. H. Ford......................................... ........... 75
Alexander's operation, report of twenty cases. By J. H. Kellogg.................... 48, 49
Alienation, mental, new method of classification. By E. Regis...................... 126
Amputation, alteration in nerves following By E. A. Homen......................... 123
in gunshot wounds, what conditions on the field justify. By E. Griswold. 15
never warrantable except for general injury. By E. H. Gregory........... 15
Analysis of water in the field, etc. By F. P. Staples.................................... 24
Anatomical points of value in diagnosis and treatment of some joint affections.
By M. Stamm ................................................................................... 72
Anatomy. Section of............................................................. ...... ........... 71
proper methods in study of. By A. H. P. Leuf................................. 72
Anchylosis of knee joint, etc. By Stephen Smith......................................... 89
Animal grafts from skin of frog for restoration of lost cutaneous mucous sur-
face. By Dubousquet-Laborderie and Jean Baratoux............................. 10
Atypical forms of typhoid fever. By W. C. Dabney.............................. ...... 7
Aural furuncles, etc. By B. Loewenberg..................................... * * * is e º e º t t e º ºs e is 95, 96
Bacteria in Summer diarrhoea of children. By W. D. Booker.......................... 82, 83
Balls, explosive, international laws relative to. By C. W. Voorhees................ 27, 28
Barrenness, causes and treatment of. By T. M. Madden................................ 49, 50
Bavarian plaster-of-Paris splints, etc. By J. H. Peabody.............................. 22
Blood, coagulation of comparison with rigor mortis. By W. D. Halliburton..... 76
Borderland. By J. Russell........... ...................................... .................... 127
Botany, medical, of U. S., introduction to. By J. N. S. Carter....... .............. 61
Brain, basal ganglia of. By Daniel Clark.................................................... 74
Condition of children, etc. By F. Warner......................................... 129
Brazil, hereditary syphilis in. By Dr. Moncorvo............... .......................... 87
malaria of children in. By Dr. Moncorvo.......................................... 87
Breast, female, tumors of, etc. By A. C. Garratt.......................................... 44, 45
Buildings, construction of, for insane. By R. Dewey..................................... 120
Caesarean section, prognosis of. By W. T. Lusk........................................... 33
Cancer, uterine, medical treatment of. By A. Cordes.................................... 43
modern treatment of. By A. R. Jackson................................. 48
Castration, when to perform operation. By J. E. Burton............................... 39
Catarrh, naso-pharyngeal. By J. Baratoux................................................. 101
Cerebral function, etc. By B. O. Everts...................................................... 75
irritation in children. By Jules Simon............................................ 89
Cerebro-Spinal fever, as cause of deafness. By C. M. Hobby................. • * * * * * * * * * * * 94, 95
Cervix uteri, lacerations of, etc. By T. M. Madden...................................... 50, 51
Children, diseases. Section of..................................................................... 80
elephantiasis arabrum in. By Dr. Moncorvo..................................... 102
Classification of insanity. By H. M. Bannister............................................ 118
Climate, meteorological elements of, etc. By G. H. Rohé............................. 115
of Swiss Alps, etc. By A. T. Wise...... ........................................... 116
Climates, artificial, or house atmospheres. By P. H. Bryce............................. 109
Climatic influence of forests. By Eugenio Fazio......................................... 110
treatment in phthisis, By C, Denison..........,,.......... * e º e s p a s • * * * * * * * * * * * * 109, 110
133
134 INDEX TO ABSTRACTS.
* PAGE
Climatology and demography, domain of. By A. L. Gihon........................... 111, 112
Section of...... ............................................................. tº e º ºs e º a º e 106
Clinical view of pyrexial antipyretics, a. By P. B. Scott............................... 8
Coagulation of blood, comparison with rigor mortis. By W. D. Halliburton...... '76
Cobra, poison of. By T. Gnezda............................................................. tº gº tº 66
Cocaine, experimental and clinical observations of. By M. Rosenthal............ 126, 127
: inebriety. By J. B. Mattison.......................................................... 7
Cold as a remedy in inflammatory affections. By Hiram Corson..................... 63, 64
Conservative gynaecology. By H. R. Bigelow ........ ..................................... 38
obstetrics. By Rodney Glisan.................................................. * * e s e º ºs 31, 32
Construction of field hospitals, illustrated. By James Collins........ ... ........... 13
Contracted knee-joint, etc. By E. H. Bradford............................................. 83
Contractured tissues, Section of By L. A. Sayre.......................................... 88
Convulsions, infantile, etc. By J. A. Coutts.......................... ..................... 83, 84
Cough, gray matter, electrical phenomena of. By R. Caton............................ 73
nervous treatment of. By O. Rosenbach......... ................................ 101
Cow's milk for infants, etc. By W. C. Vaughan.......................................... 90, 91
Cranium, prow-shaped, etc. By J. L. Down ................... ......................... 120
Croup, membranous, etc., in New York Foundling Asylum. By W. P. Northrup 87
Curvature, lateral, treatment of. By James Knight.......... ............................ 86
Cystitis in Women. By M. D. Spanton..................................................... 58
Dementia, syphilitic, microscopical demonstrations of. By L. Bremer.............. 119
Demography and climatology, domain of. By A. L. Gihon........................ 111, 112
Section of.................................................................. .......... 106
Dental and Oral Surgery. Section of......................................................... 130
therapeutics, use of air in. By Dr. Brasseur...................................... 130
Dermatology and Syphilography. Section of................................................ 102
Deventer’s method of delivering after-coming head. By John Bartlett............ 29, 30
Diphtheria, water pollution in. By C. W. Earle........................................... 85
treatment of. By Dr. Grancher..................................... ................ 86
Disease of inebriety and its treatment. By T. D. Crothers............................ 6
Displacements of uterus. By W. C. Wade.................................................. 59
Distribution and care of insane in U. S. By J. Andrews................................ 118
Dogs, general paralysis in. By M. Lemos.................................................... 124
Dressing, field, to be carried by Soldier. By Thos. Longmore.......................... 19, 20
first provisional, on the battle field. By Von Esmarch......................... 13, 14
Ear disease, 5700 cases of, etc. By S. S. Bishop........................ q e s e s = e a e º e s = e º s e s a 93
diseases of, in negro. By T. E. Murrell....... ........................................ 98, 99
— middle, diseases of, etc. By G. C. Savage ..... ... ................................... 100
inflammation of, etc. By R. Tilley ..................................................... 100
Eczema, seborrhoeal. By P. G. Unna. ......... ............................................... 102
Egypt, modern, hygiene in. By J. H. S. Grant............................................. 105
Electrical stimulation of mammalian heart. By J. A. McWilliam................... 67, 68
Electricity in fibroid tumors of uterus. By F. H. Martin....................... ...... 52
Electro-therapeutics of fibroma of uterus. By P. Ménière............... * * * * * * * * * * * s as 52, 53
Emmenagogue, intra-uterine stem. By C. R. Reed..................... ................. 57
Endometrium, studies of. By S. M. Nelson................................................. 54
Epilepsy, obscure forms of By C. F. Macdonald....... .................................. 124
— legal relations of. By J. B. Tuke.................................................... 128
Etiology and treatment of camp dysentery and diarrhoea. By C. W. Buvinger... 12, 13
Explosive balls, international laws relative to. By C. W. Voorhees.................. 27, 28
Eye diseases, microbes in development of. By H. Power................................. 92
Faulty habit, diseases of. By J. F. Goodhart ............................................. 86
Fever, cerebro-spinal, as cause of deafness. By C. M. Hobby.......................... 94, 95
hay, pathology of. By S. S. Bishop.................................................. 118
pneumonic, Seasonal prevalence of. By J. W. Moore....................... 114, 115
typhus. By Charles Smart.............................................................. 23
Fibroid tumors of uterus, use of electricity in. By F. H. Martin..................... 52
Fibroma of uterus, electro-therapeutics of. By P. Méniére............................ 52, 53
Field dressing to be carried by Soldier. By Thos. Longmore.......................... 19, 20
First provisional dressing on the battle field. By Von Esmarch....................... 13, 14
INDEX TO ABSTRACTS. 135
PAGE
Forests, climatic influence of. By Eugenio Fazio................. gº e e s is is sº º e º e º e º ºs s a sº a e s tº $ tº 110
Fracture of lower limbs, gunshot, dressing in field. By R. F. Tobin .............. 25
Fractures of the femur, gunshot. By H. James....... * g g º e º ºs e º is º º sº e º dº º e º ſº sº e º e º e º e º e º º ſº e º ſº º Aº 17, 18
Franklinization, effects of. By A. Eulenberg .............................................. 121
Function, cerebral, transmutation of organic force. By O. Everts.................... 75
Furuncles, aural etc. By B. Loewenberg......................... .......................... 95, 96
Ganglia, basal, of the brain, etc. By Daniel Clark...................................... 74
Gangrene, hospital, etiology and treatment of. By Wm. Varian...................... 27
General Medicine. Section of.................................................................... 5
Surgery. Section of............................................................. ......... 9
Glandular enlargement of neck, strumous. By Martin Oxley........................ 88
Glottis, tubage of, in France. By E. Bouchut................ ............................. 83
Graphic method of presenting mental symptoms. By R. Arndt...................... 118
Ground air in its hygienic relations. By J. D. Macdonald............................. 113
Growth in American children, etc. By W. Stephenson................................. 90
Growths, vascular, of female meatus. By A. Clarke..................................... 40–43
Gunshot fracture of lower limbs, dressing in field. By R. F. Tobin............... 25
fractures of the femur. By H. Janes............................................... 17, 18
— wounds of abdomen, penetrating, treatment of. By T. J. Moore.... .... 21
*=====sº primary dressings on field. By W. S. Tremaine....................... 26
*===sº treated without laparotomy. By H. Janes............................... 18
treatment of. By B. A. Watson........... as tº e g º is ºr e º 'º e º & e º e º g ſº e º sº & © tº ſº º º ſº tº gº & & © tº 28
Gynaecology, conservative. By H. R. Bigelow............................................... 38
early history of. By G. J. Fisher..................................................... 43
Section of..................................................................................... 37
Hallucinations in young children. By E. Bouchut...................................... 83
Hay fever, pathology of. By S. S. Bishop...... ............................................ 118
Headaches in children, etc. By W. H. Day................................. .............. 84
Head, after-coming, Deventer’s method of delivery. By John Bartlett............ 29, 30
Hemiplegia, left, etc. By Louis Frigerio................................................... 122
tendon reflex in. By V. Hinze........................................................ 123
Hemorrhage, uterine, internal, etc. By E. H. Trembolme............................. 36
Hip diseases, treatment, etc. By A. J. Steele ....................... .................... 90
Hospitals, field, construction of. By James Collins...................................... 13
House atmospheres, etc. By P. H. Bryce................................................... 109
Huts, designs for tropical Service, etc. By J. A. Marston............................. 21
Hygiene, Public and International. Section of................................... ........ 103
in modern Egypt, etc. By J. A. S. Grant......................................... 105
Hygienic relations of ground air. By J. D. Macdonald................................. 113
Hyperaesthesia. By G. S. Hall.............................................................. 122, 123
Hysterectomy for bleeding myoma. By E. H. Trenholme............................. 58
Inebriety, disease of, relation to psychological medicine. By E. C. Mann........ 124, 125
Inflammation of lining membrane of uterus. By Leopold Meyer.................... 54
Injuries of joints, penetrating. By G. L. Porter ......................................... 22
Insane, Construction of buildings for. By R. Dewey..... .............................. 120
hospital and asylum construction for. By P. M. Wise......................... 129
modes of providing for care of. By D. H. Tuke................................. 128
religious delusions of. By H. M. Hurd........................................... 123, 124
Insanity as a defense for crime. By W. W. Godding...................................... 122
classification of. By H. M. Bannister......................................... ...... 118
early Symptoms and treatment of. By I. Russell................................ 127
from Sunstroke. By G. H. Hill .............. ........................................ 123
its relation to Syphilis. By R. B. Mitchell......................................... 125
Occupation in the treatment of. By H. Wardner................................. 128
private treatment of. By E. East.................................................... 120
recent cases, treatment of. By G. F. Blandford................................. 119
remissions and intermissions of. By Daniel Clark............................. 120
true nature and definition of. By C. H. Hughes................................. 123
utero-ovarian. By J. W. B. Newlin.............................. .................. 55
International Pharmacopoeia, necessity for. By F. Dronke............................. 64, 65
136 INDEX TO ABSTRACTS.
PAGE
International regulations, importance of, for medical prisoners of war. By D. S.
Lamb.............................................................................................. 19
Inter-relations of nerve and muscle, etc. By T. W. Poole.............................. 76, 77
Intubation of larynx, etc. By Jos. O'Dwyer and Dillon Brown..................... 88
vs. tracheotomy. By F. E. Waxham................................................, 91
Joint, knee, anchylosis of, etc. By Stephen Smith........................................ 89
contracted, etc. By E. H. Bradford................................................. 83
Joints, penetrating injuries of. By G. L. Porter.......................................... 22
Wounds of treatment. By F. Hyde........................................ 16, 17
Lacerations of cervix uteri, etc. By T. M. Madden...................................... 50, 51
Laparotomy in aseptic atmosphere. By David Prince .................................. 57
Laryngology. Section of.......................................................................... 101
Larynx, intubation of, etc. By Jos. O'Dwyer and Dillon Brown...................... 88
Lateral curvature, treatment of. By James Knight....................................... 86
List of Sections....................................................................................... 3
Lithiasis in pregnancy. By J. E. Kelly....................................................... 32, 33
Locomotor ataxia and Syphilis. By Philip Zenner......................................... 129
Lungs, diseases of, meteorological conditions in. By H. Baker...................... 107, 108
Lupus lymphaticus. By J. Hutchinson...................................................... 102
Malaria of children in Brazil. By Dr. Moncorvo.......................................... 87
Mastoid antrum, inflammatory diseases of. By J. H. Fulton... ..................... 94
Materia Medica and Therapeutics. Section of.............................................. 60
Mechanism, neural, its relation to pelvic disease. By C. H. Hughes................ 47
Medicine, General.................................................................................... 5
Membranes, relation of, to parturition. By H. T. Byford............................., 30
Membranous croup in New York Foundling Asylum. By W. P. Northrup....... 87
Mental alienation, new method of classification. By E. Regis........................ 126
disease from changes at base of brain. By W. B. Fletcher.................... 122
diseases, international classification of. By W. Channing.................... 119
Meteorological elements of climate, etc. By G. H. Rohé................................ 115
Meteorology in diseases of the lungs. By H. Baker.................................... 107, 108
Metritis, chronic, cause, prevention, treatment. By H. L. Getz..................... 45
Miliary aneurismal diseases, etc. By E. C. Spitzka...................................... 128
Military and Naval Surgery and Medicine. Section of.................................. 11
Milk supply, etc. By Cyrus Edson............................................................ 85, 86
Mineral waters, natural, therapeutic value of. By A. Enfield....................... tº 65
Mineral waters, natural, therapeutic value of. By Eugenio Fazio.................... 111
Mississippi river, overflow of. By R. H. Day.............................................. 104
Molar, the sixth-year. By Dr. Andrieu...................................................... 130
Monomania, its modern equivalents. By T. W. Fisher................ ................. 121
Mountains, air of. By A. Enfield............................................................... 110
Myoma, uterine. By H. O. Marcy............................................................. 51, 52
bleeding, hysterectomy for. By E. H. Trenholme................................ 58
Nasal vowels, physiological researches on. By B. Loewenberg......................... 97, 98
Natural history of disease, the. By J. A. Octerlony...................................... 8
Negro, ear, diseases of. By T. E. Morrell............. ..................................... 98, 99
Nephritis, Scarlatinal. By Henry Ashby.................................. ................ 80, 81
Nerve and muscle, inter-relations of. By T. W. Poole................................... 76, 77
Nervous Diseases and Psychological Medicine. Section of.............................. 117
system, trophic influence of. By T. O. Summers................................ 77,78
Neuralgia, treatment of. By G. Eliot..................................................... 120, 121
Neural mechanism, its relation to pelvic disease. By C. H. Hughes................. 47
Neurotic disease, prow-shaped cranium in. By J. L. Down........................... 120
Nitrites and nitro-glycerine, chemistry and pharmacology of. By G. A. Atkinson. 60
Nosography, human, practical considerations on. By J. N. S. Gouley ............. 14
Nutrition of infants. By Albert Leeds....................................................... 86
Obstetrics. Section of.............................................................................. 29
conservative, etc. By Rodney Glisan...... tº º º G & ſº e º 'º e º ºs º º ºs e º e º ºs º º º sº e º is sº º 'º e º 'º a º ºs e º sº º 31, 32
INDEX TO ABSTRACTS. - 137
- - PAGE
Occipital positions, posterior, treatment of. By J. A. Temple........................ 36
Occupation in the treatment of insanity. By H. Wardner.............. tº ſº º ſº º tº gº º is ſº tº º & º is º 129
Officers, Section. General Medicine.......................................... e s e s is e s a e º e is is a 4 tº it e 5
On fibrous degeneration and other lesions of the heart, etc. By J. L. Steven...... 8
On the cold water treatment in typhoid fever and other fevers. By Christian
Baumler............... s & e º ſº e º e s is e º sº e º e s º e is a s & e < e g g g g a s g º ºs e s a tº g º e º e e s e e s e º e º e º s ∈ º ºs º is tº º is a s ∈ s is º º 'º e & 6
On the morphology of rheumatic blood, with lantern illustrations. By E. Cutter 6
Ophthalmology. Section of...................................................................... 92
Organism, Vital, etc. By A. Wetmore........................................................ 78
Orthopaedic surgery, progress of. By Noble Smith.................................... ... 89
Orthopaedy, Scope and limitations of. By C. F. Taylor................................. 90
Otology. Section of ................................................................................ 93
Over-feeding in children, etc. By Cadet de Gassicourt.................................. 84
Paralysis, general, in dogs. By M. Lemos.................................................. 124
general, relation to syphilis. By W. J. Mickle................................... 125
Parturition, relation of membranes to. By H. T. Byford................................ 30
Pathology. Section of.............................................................................. 79
Penetrating gunshot wounds of abdomen, laparotomy for. By W. S. Tremaine 26
non-fatal, treatment without laparotomy. By H. James...... ..... 17, 18
Wounds of abdomen, treatment of. By F. P. Staples.......................... 24, 25
Wounds of the joints, treatment of. By F. Hyde................................ 16, 17
Pertussis, contagious principle of. By A. Vogel.......................................... 91
Pessary, intra-uterine, as emmenagogue. By C. R. Reed.............................. 57
Pharmacopoeia, international, necessity for. By F. Dronkè........................... 64, 65
Philosophy, chemical, of remedy. By Hugh Hamilton ................................ 66
Phthisis, climatic treatment in. By C. Denison......................................... 109, 110
Pneumonia as met with in various parts of the Dominion of Canada. By W. P.
Geike........................................................................................ 7
true, in children. By A. D. Espine.................................................. 84, 85
Poison of Cobra. By T. Gnezda.......................................... ..................... 66
Potash, chlorate of. By J. G. S. Coghill.................................................... 61, 62
Practical considerations on human nosography. By J. W. S. Gouley............... 14
Practice of medicine at the present day, the. By A. B. Arnold..................... 6
Pregnancy, complicated with uterine fibroids. By S. H. Weeks.................... 59
diagnosis, importance of. By W. S. Stewart............... .................... 36
lithiasis in. By J. E. Kelley.......................................................... 32, 33
Prepuce, narrow, in children. By L. A. Sayre............................................ 89
Presidents of Sections.............................................................................. 3
Preventive power of vaccination. By Joseph Korosi..................................... 7
Prisoners of war, international regulations for. By D. S. Lamb..................... 19
Progressive arthritis deformans, etc. By S. O. Richey................................... 99
Proper treatment of penetrating wounds of abdomen, the. By D. T. Armstrong 12
Psychological medicine and nervous diseases. Section of............................... 117
Public and international hygiene. Section of............................................... 103
practical and common sense in. By U. R. Milner.......... 105
Puerperal fever, use of intra-uterine douche, etc. By C. W. Earle.................. 30
—— Septicaemia, prevention and treatment of. By T. M. Madden............... 33, 34
Ration, best, for Soldier. By J. R. Smith..................................................... 23
Religious delusions of insane. By H. M. Hurd......................................... 123, 124
Remedy, chemical philosophy of. By Hugh Hamilton................................. 66
Report of sick and wounded of armies, form of. By J. R. Smith .................... 23, 24
Reproduction, histology and pathology of. By Henry O. Marcy..................... 34, 35
Researches on electrical phenomena of cerebral gray matter. By R. Caton....... 73, 74
Resection or excision of gunshot wounds in modern warfare. By R. B. Bon-
tecou............................................................................................... 12
Respiration, vicarious, etc. By Wm. Ward........ * - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ---- 69, 70
Round ligaments, operation for shortening. By W. L. Reid........................... 58
Sanitary science in education. By A. W. Leighton................ . . . . . . . . . . . . . . . . . . . . . . . 105
Scarlatinal nephritis. By Henry Ashby...................................................... 80, 81
Seasonal prevalence of pneumonic fever. By J. W. Moore........................... 114, 115
Septicæmia, puerperal, treatment and prevention of. By T. M. Madden........... 33, 34
138 INDEX TO ABSTRACTS.
PAGE.
Sexual power, defective, etc. By G. F. French............ © tº tº e º e º 'º º ....................... 44
Some considerations on the pathogenesis of diseases in women. By W. B. Nef- 8
tel.......................... * @ e º 'º sº e º sº e e º ſº e º 'º e º 'º e º ſº º & e º 'º e º ºs º gº ........................................ 7
Statistics, vital, etc. By A. Haviland...... tº º e º 'º e º º ſº gº & tº ſº º ºs e º ºs e º is º ºs º ºs º º ºs e º ſº ... Tië
in army and navy. By E. A. Wood......................... tº º e º 'º tº e º e º ºs e º º 28
Strabismus, operation for. By E. Landolt.............. * * * * * * * * * & º e < * * * * * * * º, º e º e º it. tº is e º & º a tº e tº 92
Stretchers and stretcher drill, illustrated. By W. Havard......................... tº tº e º 'º 16
slings. By J. D. Macdonald................................................. 20, 21
Strumous, glandular enlargements of neck. By Martin Oxley ........................ 88
Surgery, General. Section of..................................................................... 9
Swiss Alps, climate of, etc. By A. T. Wise.............................., tº e º 'º e º e º 'º gº tº º ....... 116
Syphilis and locomotor ataxia. By Philip Zenner........... it tº º is ſº tº e º q ſº a º ºs & sº dº º e º ſº º we e º 'º e º 'º e is 129
hereditary, etc., in Brazil. By Dr. Moncorvo..................................... 87
— inherited, in inflammation of middle ear. By R. Tilley......... tº º tº & e º 'º ſº tº ſº ſº tº º ºs 100
—— relation to general paralysis. By W. G. Mickle.......................... ....... 125
* to insanity. By R. B. Mitchell............................................. 125
Tampon, vaginal, in pelvic inflammations. By W. W. Potter........................ 55, 56
Tendon reflex in hemiplegia. By W. Hinze............................................ ..... 123
Therapeutics and Materia Medica. Section of.............................................. 60
Thermometer as a climatological instrument. By Charles Smart..................... 116
Thomsen's disease, etiology and pathology of. By H. N. Moyer..................... 125
Tracheotomy vs. intubation. By F. E. Waxham.......................................... 91
Trophic influence of nervous system. By T. O. Summers............................. 77,78
Tubage of glottis, as practiced in France. By E. Bouchut...... tº a dº e s tº e º e º ºs º e º 'º e º e º ſº tº tº 83
Typhoid fever, atypical forms of. By W. C. Dabney.................................... 7
Typhus fever, etc. By Charles Smart......................................................... 23
Uterine cancer, medical treatment of. By A. Cordes..................................... 43
modern treatment of. By A. R. Jackson ................................ 48
examinations, etc. By Simon Fitch......................................... ........ 43, 44
—— fibroids complicating pregnancy. By S. H. Weeks............................. 59
hemorrhage, internal, treatment of. By E. H. Trenholme................... 36
myoma, etc. By H. O. Marcy......................................................... 51, 52
Utero-ovarian insanity. By J. W. Newlin.................................................. 55
Uterus, changes in, etc. By Graily Hewitt................................................. 45–47
displacements of. By W. C. Wade................................................... 59
inflammation of lining membrane. By Leopold Meyer....................... 54
operation for shortening round ligament. By W. Alexander................ 38
Vaccination and Pasteur’s treatment. By W. M. Whitmarsh........................ 8
Vascular growths of female meatus urinarius. By A. P. Clarke..................... 40–42
Vicarious respiration, etc. By Wm. Ward............................................ ..... 69, 70
Vital organism. By A. Wetmore............................................................... 78
statistics, etc. By A. Haviland...................................................... 113
Vowels, nasal, physiological researches on. By B. Loewenberg...................... 97, 98
Water analysis in the field, etc. By F. P. Staples.................. ...... ............. 24
pollution in relation to diphtheria. By C. W. Earle........................... 85
supply, examination of, at military posts. By M. K. Taylor............... 25
Waters, mineral, natural, therapeutic value of. By A. Enfield...................... 65
mineral, natural, therapeutic value of. By Eugenio Fazio................... 111
Whooping cough, antiseptic treatment of. By Dr. Moncorvo......................... 87
Wounds, gunshot, primary treatment of. By B. A. Watson.......................... 28