Chapter II: Part 2

One who sees with one eye only always thinks he is nearer to the object than he really is when reaching out for that object. It is always more difficult for him to pour from a pitcher into a cup or glass if held a little distance below it, hence the blind in one eye usually place the nose of the pitcher in contact with the glass before pouring. The old parlor trick of placing two pins in the wall and putting a cent on them and directing the patient to stand across the room and then walk over to the cent and knock it off with the outstretched finger without hitting the pins, may be made use of as a test in simulated blindness, for with one eye the patient always falls short of the mark the first time the experiment is tried. The most simple method of detecting simulated blindness in one eye is by noticing the movement of the pupil under the influence of light. If an eye is blind, the light has little or no effect upon it when the other eye is closed. The pupil is usually dilated. It may be well to mention here that atropine dilatation is generally wider than that due to amaurosis, and also that a cone of light from a strong convex glass thrown upon the sound eye will contract the pupil of the blind eye if the dilatation is not due to atropine. Simulated blindness in both eyes is not likely to be seen, and then the condition of the pupil is of great value in detecting it, and is one of the best guides in connection with the ophthalmoscopic observation.

A CASE OF DOUBLE UTERUS AND VAGINA.

BY S. W. KELLEY, M. D., CLEVELAND, O.

Miss H. E., aged 20, American of Irish parentage: dark brunette, short in stature but apparently quite handsomely formed, and ruddy with health. She has never been sick in her life. Has menstruated normally since her fifteenth year, though scantily during the past year. She feared she had been injured a few days previously by the overturning of a chair upon which she was standing, as she had since felt pain and uneasiness in the lower pelvic and pubic region, for which she sought advice.

Upon examination I found no injury worthy of record, but the malformation here described. Cases of this anomaly have been recorded from time to time, being always of interest to the teratologist, occasionally requiring attention on account of interference with the marital relation or parturition, and being referred to in every discussion on superfœtation.

The external genitalia are well developed. No hymen, nor any remains of one. I have no reason to doubt her virginity. An inch within the introitus vaginæ the finger met a narrowing into which only its tip would pass. Searching to the left another smaller opening was discovered, the two being separated by a strong membrane. Returning to the right or larger passage, was able by careful dilatation for ten or fifteen minutes to insert three-fourths of the length of the index finger and encounter another narrowing, which being patiently overcome, the first joint of the finger found more room and examined uterine cervix and the external os, which is linear antero posteriorly. The neck projects about half an inch into the vagina. The lips are thin, of normal density. Withdrawing the finger and finding the smaller opening, could succeed in penetrating only about an inch. Observed a third, smallest opening in the left vaginal wall, between the ostium vaginæ and the second opening described.

The patient would consent to no interference that could possibly cause even temporary disability for daily housework and care of an invalid mother, but agreed to return daily for a few days. After dilating without anæsthesia fifteen to twenty minutes daily for four days, could pass two fingers or a Fergusson speculum one and one-eighth inches into the right passage, and could pass one finger readily, or speculum seven-eighths of an inch in diameter into the left passage. The septum between the two passages is placed antero posteriorly. It is about an eighth of an inch thick, and has the appearance of any other portion of the vaginal wall. It begins an inch within the introitus, and extends to the uterus, making a right and left vagina of normal length. The third, smallest passage, admits a sound and extends upward an inch in the left lateral vaginal wall and ends in a blind extremity.

The right vagina discloses an uterine os three-eighths inch in length antero posteriorly, the anterior end of the slit inclined toward the median line. The sound passes readily a distance of one and three-eighths inches, entering in a direction upward and inward half that length, and then turning upward and outward. The sound moves freely in the cavity, and the lining membrane evidently contains folds. Secretion of the cervix free.

On the left side the os uteri is smaller, the opening not exceeding a quarter inch, the length being laterally. The lips are in a pouting shape, the anterior, especially, having quite a fold above it. The sound enters freely nearly an inch in a direction upward, outward and slightly backward; lining membrane apparently folded. Very little secretion. By introducing two fingers of the left hand, palm upward, the index into the right vagina and the second finger into the left, the two uterine mouths can be examined simultaneously, and this gives a very vivid impression of the condition. As to the shape of the whole uterus very little can be determined by bimanual examination, the vaginal walls being so tense and abdominal thick. By the rectum the uterus can be felt flat and wide, but no bi-lobing is apparent.

The young lady could not be persuaded to permit an examination during menstruation to determine whether the flow took place on both sides.

MEDICAL SOCIETIES—THEIR BENEFITS TO US AND OUR DUTIES TO THEM.

BY DR. WILLIAM FORSTER, RETIRING PRESIDENT VENANGO COUNTY MEDICAL
SOCIETY, PENNSYLVANIA.

Though at best societies in their present form are not very old, medical associations, differing somewhat in their organization and aim, are as old as the science of medicine itself. Even in the fabulous ages it had its heroes, and some rose to the height of deification. In earlier ages those who practiced medicine were looked upon as inspired. They, in addition to belonging to a profession, constituted a class or caste. In some Asiatic nations, and among some of our Indian tribes, it is very much the same at present.

One must belong to the caste, or be able to trace his descent from it, as a necessary qualification to practice medicine.

This is the earliest form of a medical society, and though it may not possess many progressive elements, it has elements of strength.

What few investigations it did make, it kept. Its peculiar organization and position fitted it for being a good conservator; and when the star of empire took its western course, the tide of medical knowledge stored up and held sacred and secret in Asia, Egypt and Greece, flowed out and was diffused over five continents.

Hippocrates, about twenty-five hundred years ago, took the light from under a bushel. About three hundred years later the great Alexandrian school or society—for it was a society as well as a school—trimmed the light and set it higher, but it was so obscured and encompassed with exclusiveness and secrecy as to be a long time in reaching the masses.

The first societies in Germany, France and Great Britain were in connection with their institutions of learning, as they were at an earlier period in Egypt and Greece. In Rome we have reason to believe that they were more independent, as the physicians used a society seal as a label for their medicine. Truly independent society organization and work is comparatively of our own day. Even in the early part of the present century, British authority was the London, Edinburgh and Dublin colleges.

In our own country, previous to the organization of the American Medical Association, about thirty-six years ago, there was very little system in society work. That organization marks a new era in society usefulness. From it sprung the International Medical Congress, making a unit of medical investigation and progress of the world. We point with pride to Philadelphia as the city in which the association was organized, and to the able and determined stand our State has ever taken in sustaining and strengthening it. It has been a power for good to American medicine. It has elevated and is elevating the standard of our American medical colleges.

The progress in society organization, work and usefulness in the last thirty-six years is greater than in all American medical history previous to that time. We had then a few isolated independent medical societies without unity and without influence. We have at present a society in almost every county, a State society in every State, all united in an association and wielding an influence national and world wide.

Great as the benefit has been to the profession at large, it has been greater still to the individual practitioner. It has been to him a post-graduate school.

In our societies A. meets B., B., C. and C., D. They compare their investigations, experiences and theories, and each is benefited.

Our society enables us to know one another better. It is a true saying that, “no man is as good as his best deed nor as bad as his worst.” Our meeting in society aids us in striking the balance and makes us more united, by forming and cementing friendships. They discourage quackery, empiricism and everything that is professionally low and mean. They encourage and stimulate purity, nobility and rectitude. They are a strength to us medically and medico-legally. All that is necessary on our part to secure us these benefits and many more which might be enumerated, is to do our duty to our county, State and national societies. I will now present to you what I believe to constitute at least part of that duty.

_First._ Punctuality and regularity in attendance. This increases our interest and gives the society strength.

_Second._ Support with our intellect. We may not all have an equal number of talents, but he that has five should use them, and he that has one should use it, and the use of that one may be just what the society needs at the time.

If we have anything we think good in theory or practice, or any interesting case, let us report to our society.

I believe everything presented should be in writing, for very few physicians are good extemporaneous speakers, and all members should have such notice of the subject of all papers to be read before the society as will give them time to prepare for intelligent discussion; for unless a man has a clear idea of his subject he is liable to wander off into a labyrinth of side issues.

When appointed for a paper, we should have it ready and be on hand to read it. We should have more papers published, and to better prepare them for publication, each society should have an editor and a publication committee, with ability and power to revise, correct and publish papers and reports of the society.

_Third._ We should support our society with our influence. All have an influence, and there is no neutral ground. It must be for or against.

Never was there a time when there was more need of the support of the good men in the profession. The code of medical ethics has been attacked. The American Medical association has been attacked.

An attempt has been made to make the one obnoxious and destroy the harmony and usefulness of the other.

_Fourth._ We should be prompt in paying our dues and all other necessary demands that may be made on us by our society. Negligence—for it is seldom or never inability—on our part may not only embarrass the society, but tend to destroy our interest in it.

I have a great regard for the Venango County Medical Society. It was the first society I joined after graduating, over twenty years ago, and I have always highly prized the friendships herein formed.

Death has taken some from us, good men and true, but I am pleased to see that we are also adding to our number so many young men, and growing in strength. Let us each do our part to keep up this growth, so that when we are weighed in the balance we may not be found wanting.

I thank you for your kind aid and forbearance throughout the year. May our society live long and prosper.

The Cleveland Medical Gazette.

_A MONTHLY JOURNAL OF MEDICINE AND SURGERY._

ONE DOLLAR PER ANNUM IN ADVANCE.

All letters and communications should be addressed to the CLEVELAND
MEDICAL GAZETTE, No. 5 Euclid Avenue, CLEVELAND, OHIO.

A. R. BAKER, M. D., _Editor_. S. W. KELLEY, M. D., _Associate Editor_.

EDITORIAL.

THE LATE DR. ALFRED C. POST.

One of the old land marks of the medical profession is gone! Few men are privileged to continue in actual practice fifty-seven years! Thousands have heard him lecture, seen him operate and read his published papers. He was indeed a remarkable man. At the age of eighty he continued to operate with the freshness of youth. As a lecturer he was terse—direct to the point; as a writer he was lucid and clear; as an operator he was steady, bold and self-reliant; as a man he was a Christian.

If there was one thing more than another more prominent in his well-rounded character, it was his devotion to duty. He was a man of fine religious faith, devout in his behavior and an excellent theologian and Biblical scholar. The two things he is said to have most enjoyed were a surgical operation and a prayer meeting. He was a consistent member of the Presbyterian church, and his example of earnest, unselfish devotion to duty can not help but leave an influence for good which will last long after his brilliant surgical operations are forgotten.

Dr. Post was born in New York city in 1805, graduated from Columbia College in 1822, became a medical student in the office of Dr. Wright Post, his uncle, an eminent surgeon of a former generation. He graduated from the College of Physicians and Surgeons in 1827. After spending two years in the medical schools and hospitals of Paris, Berlin and Edinburgh, he commenced active practice of his profession in New York city, which he continued until the week before his death. He was one of the founders of the Medical Department of the University of New York, taking the chair of surgery and pathological anatomy, and at the time of his death was president of the medical faculty and emeritus professor of the clinical surgery in that institution. His funeral took place Wednesday, February 10, and the Church of the Covenant, of which Dr. Post was a member, was crowded with professional and other friends of the dead man.

ALUMNI ASSOCIATION OF THE MEDICAL DEPARTMENT OF THE WESTERN RESERVE
UNIVERSITY.

The annual meeting of the Alumni Association will be held at 2 o’clock, P. M., Wednesday, March 3, in the amphitheatre of the City Hospital corner of Erie and Lake streets.

Dr. E. D. Burton of Collamer, Ohio, will be the orator of the occasion, and Prof. Proctor Thayer, the elected poet.

The president, Prof. G. C. E. Weber, will also deliver an address.

The subjects for discussion are: First, Cholera, the leading speakers being Doctors Thayer, Lowman and Kelley. Second, Diphtheria, its Aetiology and Treatment, with Dr. Knowlton of Brecksville, and Dr. Orwig of Cleveland, as leading speakers. The annual election of officers will be held, and other important business transacted.

The Hon. S. E. Williamson will deliver an address to the graduating class in the evening. The graduating exercises will be held in the First Methodist Church, corner of Euclid avenue and Erie street. There will afterwards be a reception and banquet at the Hollenden.

THE WESTERN PENNSYLVANIA MEDICAL COLLEGE.

The Western Pennsylvania Medical College has been organized and liberally endowed, and will soon assume possession of its new building on Sixth street, Pittsburgh, Pennsylvania. The course of lectures will not begin, however, until October. The faculty will be composed of the following well-known, earnest and hard-working practitioners: Professor of Anatomy, Dr. Heckelman; Professor of Physiology, Dr. Allen; Professor of the Principles of Surgery, Dr. Murdock; Professor of the Practice of Surgery, Dr. McCann; Professor of the Principles of Medicine, Dr. Shively; Professor of Clinical Medicine, Dr. Lane; Professor of Chemistry, Dr. Blank; Professor of Materia Medica, Dr. Gallagher; Professor of Obstetrics, Dr. Duff; Professor of Gynæcology, Dr. Asdale; Lecturer on Dermatology, Dr. Dunn; Lecturer on Nervous Diseases, Dr. Ayers; Lecturer on Orthopædic Surgery, Dr. King; Lecturer on Genito-Urinary Diseases, Dr. Thomas.

SOCIETY PROCEEDINGS.

PROCEEDINGS OF THE NORTHEASTERN UNION MEDICAL SOCIETY.

SIXTIETH QUARTERLY SESSION, HELD AT AKRON, OHIO, TUESDAY, FEBRUARY 2,
1886.

The president, DR. J. E. DOUGHERTY, in the chair.

DR. BAUER, of the Committee on Obituaries, was instructed to prepare a fitting memorial to be read at the next meeting upon the death of Dr. J. C. Ferguson of Mogadore.

DR. PIERSON read a history of a clinical case. The clinical committee, consisting of Drs. Hitchcock, Bauer and Rowe, after examination, reported the case to be one of chronic pleuritis with adhesions and effusion, and recommended alterative treatment.

DR. FISHER read a report of a case of puerperal convulsions, in which venesection had been resorted to with favorable results.

In the discussion which followed, DR. SHIVELY said he did not believe in blood-letting, but would rely upon _drastic cathartics_ and anæsthetics.

DR. WRIGHT, in a practice of fifty years, had employed blood-letting in a few cases with good results.

DR. EVERHARD had seen several cases, and favored the use of anæsthetics, but objected to the use of morphine on the ground of the supposed uræmic pathology of puerperal convulsions.

DR. HOWARD thought Dr. Fisher’s treatment of the case good, and believed emphatically in blood-letting, and also in the use of arterial sedatives, such as verat., vir., etc.

DR. T. C. MILLER believed in thorough narcosis, giving morphine hypodermically until the effects were noticeable on the respiration. Anæsthetics are good, but can not be given continuously. The physician giving the anæsthetic, when the convulsions cease will not crowd the anæsthetic, and almost before he is aware of it the convulsions will return. We have much to learn about the pathology of puerperal convulsions. The speaker does not believe it to be uræmic. All of his cases in which he gave narcotics thoroughly from the first recovered; cases in which he used blood-letting died.

DR. VANCE believed that the treatment advised by Dr. Miller would result disastrously in many cases, and spoke at some length, showing that the latest authorities believed the true pathology of the trouble to be uræmic.

DR. PIXLEY asked, after hearing so many opinions from so many distinguished speakers: “What is Dr. Pixley going to do to-night if he meets a case of puerperal convulsions? One speaker swears, if you bleed, your patient will die; another swears, if you don’t bleed, your patient will die; a third says, you must give opium; another says, you must not; another says, you must give anæsthetics; another veratrum, another cathartics.” Now, after all of this light upon the subject, he would do as he always has done—apply cold to the head, warmth to the extremities, maybe give a little opium, possibly bleed a little, equalize the circulation, and deliver as soon as possible. Some of his patients will live and some will die.

DR. HOWARD submitted to the society, for signatures, a petition to the State Legislature in the interests of what is known as the “Sharpe bill,” for the creation of a State Board of Health and a State Board of Medical Examiners.

Adjourned to 1:30 P. M.

AFTERNOON SESSION.

On motion of DR. VANCE it was decided to hold the next meeting in Cleveland, and on motion of DR. SCOTT the Cuyahoga County Medical Society was invited to meet with this society.

It was also decided that, because of the session of the American Medical Association occurring in May, the meeting of this association be held on the first Tuesday in April.

Drs. A. R. Baker and W. T. Corlett were appointed a committee on arrangements for the meeting in Cleveland.

An election of officers for the ensuing year was held, with the following result: President, Dr. J. W. Shively of Kent; first vice-president, Dr. A. C. Belden of Akron; second vice-president, Dr. T. C. Miller of Massillon; recording secretary, Dr. L. S. Ebright of Akron; corresponding secretary, Dr. A. K. Fouser of Akron; treasurer, Dr. E. W. Howard of Akron.

DR. DOUGHERTY at once relinquished the chair to his successor, and in so doing begged to be excused from the customary valedictory address because of his having lately given up the practice of medicine and being now very busily engaged in the duties of a county office.

DR. SHIVELY, the president-elect, after thanking the members for the honor conferred upon him and commending the society upon its active prosperity and scientific advancement, entered upon the duties of the office.

The recording secretary and treasurer submitted their annual reports, which, on motion, were referred to the finance committee. The committee, after making a thorough examination of the accounts of the secretary and treasurer, reported them as correct, but at the same time recommending a more accurate system of book-keeping in the future, as well as the passage of a resolution providing for an annual due from each member.

DR. MCEBRIGHT gave notice of his intention to introduce such a resolution at the next meeting.

DR. LOUGHEAD, the appointed essayist, read an interesting paper upon the Metric System, reviewing the many advantages which might be gained by its adoption by the medical profession.

DR. D. B. SMITH read a report of a case of hysterical blindness (see page 212 of this number), and followed with a verbal report of a very peculiar case of exfoliation of the epidermis.

Remarks on the cases reported were made by Dr. Corlett and others.

DR. HITCHCOCK reported a case of malpresentation, in which, by manipulation and the slight aid of forceps, delivery was accomplished with safety to both mother and child.

DR. CORLETT spoke on the method of prescribing the bromide of arsenic. He said the most trustworthy way was the alcoholic solution, which he had been in the habit of diluting it in the strength of one grain to eight ounces of simple elixirs without precipitation. Care must be taken that no water be added before the bromide of arsenic is dissolved in alcohol. Spoke favorably of its use in the class of skin diseases known as _nenrose cutanae_.

DR. EBRIGHT reported the case of a man who had swallowed a silver dollar. DR. PIXLEY told of a similar disposition of a five franc piece, and DR. EVERHARD related a recent attempt by a lady to swallow the gauge of a sewing machine. The three cases terminated favorably, though the last mentioned required the aid of a surgeon.

The chair announced the following as the standing committees for the ensuing year:

Admissions—Drs. D. B. Smith, E. Hitchcock, S. Pixley.

Publication—Drs. B. B. Brashear, T. H. Phillips, H. M. Fisher.

Finance—Drs. T. McEbright, M. M. Bauer, L. P. Proehl.

Ethics—Drs. X. C. Scott, A. M. Sherman, E. Conn.

Obituaries—Drs. W. C. Jacobs, N. S. Everhard, E. K. Nash.

The appointments for the next meeting are as follows: Essayist, Dr. A. C. Brant; alternate, Dr. W. T. Corlett. Lecturer, Dr. E. W. Howard; alternate, Dr. B. B. Loughead. Reports of cases, Drs. McEbright, Phillips, Peck, Vance and Starr. Topic for discussion: “Functions of the Cerebellum,” to be opened by Dr. Brashear.

After tendering a vote of thanks to the city council for the use of the council chamber, and voting two dollars to the janitor of the building, the society adjourned to meet in Cleveland on the sixth of April.

A. K. FOUSER, _Recording Secretary_.

NEW BOOKS.

‘AN ESSAY ON THE PATHOLOGY OF THE ŒSOPHAGUS.’ By John F. Knott.
Dublin: Fannin & Co.

‘THE OPERATIVE TREATMENT OF INTRA-THORACIC EFFUSION.’ By Norman
Porritt, L. R. C. P., Lond., M. R. C. S., Eng. London: J. & A.
Churchill.

‘ON THE PATHOLOGY OF BRONCHITIS, CATARRHAL PNEUMONIA, TUBERCLE, AND
ALLIED LESIONS OF THE HUMAN LUNG.’ By D. J. Hamilton. London:
Macmillan & Co.

We can well imagine the interest with which some practitioner in a comparatively isolated locality—in the sense of being far from some one of the great Atlantic cities where all new medical and surgical works are kept in stock—reads over the titles of forthcoming works in the particular department in which he is most concerned, and the eagerness with which he anticipates their arrival after he has gone so far as to order them. It may be, in this catarrhal land of ours, that it is throat and chest diseases he is studying, and that the above works excited his interest and drew from his pocket his hard earned dollars. If so, who can doubt that emotions of pleasure warmed his heart as he contemplated the instruction to be gained and the information to be acquired from their perusal? For who would dare write on the pathology of the œsophagus, if he had nothing to say? or descant on the operative treatment of intra-thoracic effusion, if he was not qualified by learning and experience to speak on the subject? But, lest the doubter be abroad in the land, look further to the vouchers of the title page or the preface. The first work on our list is “the Essay to which was awarded the Gold Medal of the Pathological Society at the close of the Session, 1876-77.” The second, “the Essay to which the Medical Society of London awarded the Fothergillian Gold Medal, 1883.” Can anything be more satisfactory? It is true that our last work boasts no such authoritative endorsement, but then as the author is a professor of pathological anatomy at Aberdeen, its other imperfections—from this standpoint—we can imagine passed by, and the book, not without misgivings, may be ultimately ordered with the rest.

What is the consequence? Two of the books will prove extremely unsatisfactory, and but one will be found to fulfill in any way the anticipations of the purchaser. The work on the œsophagus is the production of an undergraduate—a creditable performance for a student, but by no means the work any practitioner, not a friend of the writer, would care to purchase. Mr. Porritt’s treatise is good to that degree that one feels aggrieved that his friends permitted him to publish anything until he had produced something first-class—for he is evidently a young man of ability. Practical surgeons who have arrived at years of maturity, not infrequently have occasion to notice that young men of brilliant parts who enter upon the practice of that art, seem to think they are unjustly kept in the background because no notice is taken of their efforts to gain position in their profession by the arts of the rhetorician or the tricks of the essayist. Nevertheless, no man can become a surgeon, save by surgical works, or be entitled to speak as one except he be a man of learning or experience—or both.

After so much that is unpleasant, it is a pleasure to turn to a work of a radically different kind. In ‘Hamilton’s Bronchitis,’ the reader will find a treatise that is a mine of pathological lore; a work every page of which is suggestive and instructive. It possesses the rare quality of being interesting to an unusual degree, and its perusal will be a substantial pleasure to all its readers.

* * * * *

‘THE PHYSICIAN HIMSELF.’ By D. W. CATHELL, M. D. Fifth edition.
Baltimore: Cushings & Bailey.

It is rather humiliating to the physician who is interested in equipping his brain to successfully combat disease to find himself distanced by the individual who rides into a paying practice in a fine carriage. But we must take the world as we find it, and so long as people are judged by what they seem and not by what they are, such books as the ‘Physician Himself’ will be demanded. What shall we eat, and where shall we sleep, and how shall we be clothed withal, are, like the poor, always with the doctor.

Dr. Cathell has succeeded quite well in showing the importance of business tact and sagacity in promoting the welfare of the physician. He gives rules as to the best methods to pursue toward patients both in the office and out, so as to line the doctor’s pocket-book. He tells him how to dress, how to walk, how to sleep and how to eat, what kind of signs to display, gives hints as to the selection of an office, together with suitable furniture, etc., etc.

* * * * *

‘POST-MORTEM EXAMINATION.’ By Professor Rudolph Virchow. Translated
by T. P. SMITH, M. D., from the fourth German edition.
Philadelphia: P. Blackson, Son & Co.

In this admirable little work, Prof. Virchow gives a brief account of his early experience as Prosector in the dead-house of the Berlin Charity Hospital, and traces under his auspices the development of a systematic method of conducting post-mortem examinations. He also criticises, explains and illustrates the regulations which have been promulgated throughout Germany for the guidance of medical jurists in performing autopsies and drawing up reports.

He also gives three interesting cases in which the post-mortem examinations were performed by himself, the order of sequence enjoined by the regulations being closely adhered to. They may be taken as examples of the way in which all post-mortem examinations for medico-legal purposes should be conducted. It is much to be wished that a method similar to the one which has received the high sanction of Prof. Virchow were adopted in this country. One hundred and thirty-eight pages, neatly bound in cloth, with a number of plates. Price $1.50.

* * * * *

THE SEVENTH ANNUAL REPORT (1885) OF THE OHIO STATE PHARMACEUTICAL ASSOCIATION contains, besides the constitution and by-laws and history of the organization, a number of interesting articles. One of them, by S. J. Nicolay, M. D., of Hamilton, Ohio, is in reply to Query No. 1—“Do the Various Fluid Extracts of Hydrastis Canadensis, Made Without Alcohol, Contain all of the Active Principles of the Drug?” The writer says that, properly, this extract “should not contain alcohol, since the alcoholic extractive essentially contains resin, which, being an irritant to inflamed mucous surfaces, is a detriment in a large majority of cases to which it is otherwise applicable.” As to whether the various fluid extracts of this drug, made without alcohol, contain _all_ the active principles of the crude article, he concludes, after an examination of six specimens from different manufacturers, that “each specimen was found to contain portions of the two known alkaloids—berberine and hydrastine—in their varying proportions.” “As to whether these samples contained the alkaloids in as large quantities as the respective samples of the crude drug from which they were made, was not determined, but probably they did.” If this is true, the fluid extract, without alcohol, will be as effective as that made with alcohol, beside being quite miscible with water for topical application, injections, etc., without becoming turbid and depositing resin.

Query 24—“_What_ is the Most Effective and Pleasant Disinfectant?”—is answered by L. Sollman of Canton in an essay in which he treats: 1. “As to what is that something which disinfectants are intended to counteract.” 2. “What articles are disinfectants, and what is the way in which they effect disinfection.” 3. “Which of them is practically useful, and which is the most practical way of using them under various conditions.”

A copy of the report can be had by forwarding fifty cents to the secretary, Lewis C. Hopp, Cleveland, O.

NOTES AND COMMENTS.

_The Graubuch of the General Hospital of Vienna._—From this very interesting report for 1884 we learn the following: At the end of ‘83 there remained in the hospital 1,672 patients; of these 1,037 were males and 635 females. In ‘84, 23,937 patients were admitted, 14,801 males and 9,136 females. Discharged as cured, 12,532; improved, 4,485; uncured, 2,857. At the end of December, 1884, the number of patients remaining in the hospital was 1,742.

The maximum of sickness among males was reached in January (1,179); among females in May (740). The minimum among males in the month of August (842); among females in September (588).

It is somewhat interesting to note among the victims of pulmonary tuberculosis, the proportion furnished by various occupations. Two hundred and four day laborers, 113 shoemakers, 90 blacksmiths, 76 cabinetmakers, 71 turners, 30 coachmen, 19 butlers, 19 waiters, 8 landlords, 6 musicians, 6 servants, 4 conductors, 2 janitors, 1 stenographer, 1 chorister, 1 turnkey, etc. The proportion of deaths from tuberculosis expressed in percentage of the whole number of deaths was as follows: June, 5.6; April, 4.7; March, 4.4; August, 4.3; May, 4.2; February, 4.1; January, 3.9; October, 3.6; July, 3.2; November, 2.9; September and December, 2.8.

The most rheumatism occurred in May (84), most typhus in September (19), most bronchitis in March (210), the most pneumonitis in April (78), the most catarrh of the digestive organs in July (81).

* * * * *

WINTER PRURIGO, says Dr. Corlett in a clinical lecture, a common and most annoying disease of the skin in this climate, must be regarded as a _local neurosis_. In its treatment internal medication avails but little, excepting in severe cases where the paroxysms of itching occur several times during the four and twenty hours, when hydrobromic acid may be used with marked benefit. It is in local measures, however, that we are effectually able to control it.

At the outset of a paroxysm apply caustic potash in strength varying from x to xxx grains to the ounce of water, to which a drachm of glycerine may be added, after which the following should be added:

℞ Menthol ℨss.
Acidi carbolici ℨss.
Sodii benzoati ℨij.
Ung. aquae rosae ℥iij.
Cerae alba q. s. Misce.

In mild cases, by omitting the caustic potash, the following lotions will be sufficient:

℞ Menthol ℨj.
Alcoholis ℥ij.
Acidi carbolici ℨss.
Sodae benzoati ℥j.
Aquae rosae ℥vj.
Misce.

* * * * *

Dr. G. E. Paget of Cambridge is to have a K. C. B. bestowed on him, and Dr. William Roberts of Manchester is to be knighted. Dr. Paget is Regius Professor of Physic in the University of Cambridge, and a brother of Sir James Paget, the eminent London surgeon. Dr. Wm. Roberts is Professor of Clinical Medicine in the Victoria University. In neither case can the title of “Sir” enhance the distinguished professional reputation already enjoyed by each of these gentlemen.—_London Correspondence N. Y. Medical Record._

* * * * *

At the end of November the Curatorium of the General Polyclinic of Vienna held its first meeting according to its new constitution. President Bezecny and Vice-Presidents Dompropst, Marshall and Neumann-Spallart were unanimously reëlected. The chairman, Baron Bezecny, next greeted the new curators, and stated that the object of the meeting was to raise a large sum of money to erect a small hospital for emergency cases. Upon request of the chair, Prof. Schnitzler gave a brief report of the work of the Polyclinic from January 1 to November 25, 1885. Over thirty-two thousand patients were treated. The number of hearers, almost entirely doctors, during the semester year of ‘84-5, reached the height of four hundred and fifty-four. Among these were one hundred from Austria and Hungary, and almost as many out of the German empire. Then follow from other European States—Russia, England, Sweden and Norway, Belgium and Holland, Italy and Greece. America was represented by more than one hundred attendants; but also Asia, Africa and Australia furnished hearers to the Polyclinic. Prof. Schnitzler then left the subject of the report and moved that it be made the ambition of the Polyclinic to erect a Polyclinical hospital. This motion, after a very brief debate, was unanimously adopted.

* * * * *

On account of the death of Prof. Geo. Hunert, A. M., M. D., the chair of Theory and Practice of Medicine is vacant in the Medical Department of Wooster University in this city. As yet a successor has not been decided upon.

* * * * *

_Third Annual Meeting of the Ohio State Sanitary Association._—We regret that the programme of this meeting, which was held in Columbus, O., Feb. 25-26, was not received in time for publication in our last number. A number of practical papers were read, some of which we shall present to our readers.

* * * * *

Drs. Scott, Ashmun and Herrick, of Cleveland, presented papers at the meeting of the State Sanitary Association.

* * * * *

Dr. J. H. Gleeson of 87 Bond street met a sudden death on the evening of February 22, at Gerling & Haber’s drug store, No. 283 St. Clair street. It is reported that Mr. Haber handed him by mistake a couple of ounces of a mixture of carbolic acid and glycerine, which the doctor swallowed and expired in a few minutes. The inquest will bring out the facts.

* * * * *

Dr. Geo. F. Leick is in New York City, where he expects to remain several months.

* * * * *

Dr. A. B. Carpenter, who has been abroad in the hospitals of London and Berlin during the past year, has returned to Cleveland.

* * * * *

Dr. H. G. Sherman, owing to ill health, has gone south for the winter.

HOW DOES AMERICAN JOURNALISM AID THE DEVELOPMENT OF THE MEDICAL
PROFESSION?

The New York _Medical Journal_ says that “it regards the great distinctive service of American medical journalism as shown mainly in its counteracting influence in removing the pedantry shown in the medical colleges, and encouraging the expression of original thought in young men.” Surely, it were a great thing to remove the stupidity engendered by medical schools, and to draw forth the powers of original thought which are dormant in the young doctor. Of the truth of this view we have no question, nor can any editor of any experience or success fail to have many personal experiences in this sort of work. In the very best sense of that term, the medical editor is a teacher; and this, too, in causing others to work for the common good. The education follows from the efforts of the young doctor to learn something of profit or interest to the profession, and then place this before the profession in the most attractive shape. The medical editor, in order to make his journal a success, is compelled to get the best work expressed in the best way. Most of the older members of the profession have never learned to write, and as they become burdened with the cares of a large business, it becomes impossible for them to learn the art of writing. Much they possess of positive value to the profession, but from the defect of not being able to write with comfort, their knowledge dies with them. The medical editor can get little help from them. There are a considerable number of the members of the medical profession who could not write a decent article, if they had any distinct ideas to put in it. Obviously, the medical editor can do nothing with this class. But there is another class of doctors, who have the general culture and the brains, but are too modest to think of writing for the benefit of their seniors. From this class the medical editor draws most of his working colaborers. By encouragement, by personal solicitation, by aid in matters of reference, by stimuli of ambition, of professional pride, by appealing to the sense of his obligations to do for the general profession that which lies in his power, many of this class are brought into active service in medical journalism. Having encouraged to habit of expression, the editor stimulates the habit of original research. Of course, different individuals will be stimulated in different directions. So, at last, the editor will have writers in every portion of the field of the art and science of medical surgery. Hence, it comes about that the editor sends men to work with the microscope, in the chemical laboratory, in the pharmaceutical laboratory, in the physiological laboratory, in the anatomical room, in the hospital, in the dispensary, in the tomes of medical literature of every language and of every age. In short, he has these men at work in every field congenial to them, and such that they can reach it.

In a very real sense, an editor is like a captain of a ship—he shows his abilities not so much in what he does himself, as in what he can get others to do. That there are not more really good medical journals, is due to the fact that there are really few medical men having the power of getting others to work in the fields leading to medical journalism.

When a young doctor has begun to realize that he can talk to the entire medical profession, life and study takes an entirely new aspect. The day of small things is past, and the day of an enlarged and enlarging manhood has come to him. One who does realize this truth will never write a poor article for publication. The poor articles come from quite a different sort of men. These the medical editor gradually weeds out.

Of this direct and indirect influence upon the conduct of medical colleges, and upon medical societies and medical publishers, writers of medical books, and the relations of medical men, we have not time to speak. But in all these things the medical journal is the means by which the process of both good and bad education goes forward. Out of all these educational processes the medical profession is slowly rising higher in its development.

To every young man who would make the most of his powers, we say: think, observe, and write for the medical press constantly. It may be that one article a year is all that any particular person can produce. It may be that longer time will be required, but whether the time be long or short, be sure to begin and keep up the habit of correct thinking, constant study and correct and frequent writing.—_Detroit Lancet._

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TRANSCRIBER'S NOTES

1. Corrected yours to hours on p. 195. 2. Corrected Aurelinsto Aurelius on p. 206. 3. Silently corrected typographical errors. 4. Retained anachronistic and non-standard spellings as printed. 5. Enclosed italics font in _underscores_.