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Full text of "Cincinnati Medical News"

^S.OO a, UTeax* in Advance. 



^"MIJJ:"'] rS8mil7,1882, sv''^-^i-no.2. 




'• f New Series. 




THE 



O I N C IN N A. T I 

MEDICAL NEWS. 

V 






EDITED BY 



J. A. THACKEE, A. M., M. D., F. E. M. S., Loi^d. 



Fellow of American Academy of Medicine, Etc. 



ooiisrTEJsrTs. 

PAGE. 

Insanity in its Kelatious to the Medical I'rofession and Lunatic Hospitals 73 

Micliigan State Board of Health ; 89 

Kelrograde aud Lateral Movements with Hypnotism 93 

Abuse of the Vaginal Speculum 90 

"Sponge Grafting" 98 

Papaya and Papain ]0(f 

Milk-Sickness 102 

Clinical Lectures ; iCC 

Treatment of Disease of the Heart '. .: , 117 

Disease Germs 119 

The Phenomena of Growth Among the Microscopic Forms of Life 183 

Trichina- Like Parasites 127 

Gleanings ,. 128 

Book Notices '■ • - 129 

Editoiia's 13:1 



CINCINNATI, OHIO: 
Published by Dr. J. A. Thacker. 

Kntered at the Poat-Oflice, Ciucinuati, O., as Second-Class Matter. 





I{<'si<l tli<' -('\.<lvei"tifm'ii»«'iit!-i. 



NEW PHARMACEUTICAL.S 

WORTHY OF THE 



ATTENTION OF PHYSICIANS. 



NITRO-GLYCERINE PILLS, 



Nitro-glycerine is introduced on the 
authority of Dr. Murrell, of London, as 
a remedy in angina pectoris and in cases 
of chronic neuralgia in any part of the 
body. Cases of angina pectoris which 
had resisted all attempts at even allevi- 
ation, much less cure, have promptly 
yielded to nitro-glycerine, and a num- 
ber of cases of actual cure are reported. 
This is more than can be said of any 
other known remedy. In neuralgia 
the effects of this drug have, in some 
instances, been scarcely less marked. 

The pill form is very eligible, besides 
ensuring exactness of dose. 



Liquor Ergotae Purificatus. 



This form of ergot is of constant 
strength. In its preparation only the 
active principles of tbe drug are re- 
tained, all inert and noxious ingredi- 
ents being removed. As these active 
principles are assayed the liquor con- 
tains them in constant and definite pro- 
portions, and thus is obviated the un- 
certainty of strength due to variability 
in the quality of the sample of the drug 
employed. Liquor ergotae purificatus 
is as constant in its strength as morphia, 
quinia, or any of the other alkaloids of 
vegetable drugs. 



Sanguis Bovinus Exsiccatus. 

In this preparation of blood we have 
a true food, the albumen being entirely 
retained. In this respect it differs from 
the various beef extracts, beef essences, 
etc., in the market. These preparations 
are, from the very methods of their 
manufacture, entirely deprived of albu- 
men, the true nutritive principle of 
beef, and are thus not foods in any 
proper sense of the word. 

Sanguis bovinus exsiccatus is blood 
deprived of nothing but its water and 
fibrin, which, latter, is naturally small 
in quantity and practically of no nu- 
tritive value. 

CAS^Ri^ CORDIAL. 



This '.axative and alterative prepar- 
ation stands unequalled among pharma- 
ceutical preparations a? a remedy in 
constipation Its agreeable and effi- 
cient action has been abundantly at- 
tested by the medical profession of this 
country, and it stands now as a remedy 
of unquestionable efficacy in chronic 
constipation. Great care should be 
exercised in not prescribing too large a 
dose, inasmuch as cascara sagrada, its 
active ingredient, overcomes constipa- 
tion by its tonic action on the bowel, 
rather than by direct laxative influence. 



FULL DESCRIPTIVE CIRCULARS OF THE ABOVE 

WILL BE SENT FREE, ON APPLICATION TO 



PARKE, DAVIS & CO., 

Manufacturing Chemist', and Special Dealers in New and Kare Drugs. 




ALTI 



nE. 



MALTIXE 13 a concentrated extract of malted Barley, "WTieat and Oats. In its preparation the tempera- 
hnrn di>ea not exceed 150 deg. Fahr., thereby retaining all the nutritive and digestive agents unimpaired. 
Esiracts of Malt are made from Barley alone, by the German process, which directs that the mash be heated 
to 2!-2 deg. Fahr., thereby coagulating tlie Albuminoids and almost wholly destroying the starch digestive 
pr;ncip:e, Diastase. ^^^^ 

LIST OF MALTINE PREPARATIONS. 



MALTINE 
MALTINE 
MALTINE 
MALTINE 
MALTINE 
MALTINE 
MALTINE 
MALTINE 
MALTINE 



(Plain). 

with Hops. 

with Alteratives. 

v.ith Beef and Iron. 

with Cod Liver Oil. 

with Cod Liver Oil and Pancreatine. 

with Hypophosphites. 

with Phosphorus Comp. 

with Peptones. 



MALTINE ^vitti Pepsin and Pancreatine. 

MALTINE with Phosphates. 

MALTINE with Phosphates Iron and Quinia. 

M ALTI N E with Phosphates Iron, Quinia & Strych. 

MALTINE Ferrated. 

MALTINE WINE. 

MALT! N E WINE with Pepsin and Pancreatin 

MALTO-YERBINE. 

MALTO-VIBURNIN. 



MEDICAL ENDORSEMENTS. 



"We append, by permission, a few names of the many prominent Members of the Merti 
c;il Profession who are prescribing our Maltine Preparations : 

J. K. BAUDUT, M. D., St. Louis, Mo., Physician to 
St. Vincent's Insane Asylum, and Prof. Ner- 



V0U3 Diseases and Clinical Medicine, Missouri 
Medical College. 

PORTER, k. M., M. D., St. Louis, Mo. 

DUNSTEB, M. »., Ann Harbor, Mich., Prof. 
Obs. and Dis. Women and Children Universi- 
ty and in Dartmouth College. 

IH03I.4S H. ANDREWS, M.' D., Philadelphia, Pa., 

Demonstrator of Anatomy, Jeffersou Medical 

College. 

HAMMEL, M. D., Philadelphia, Pa., Supt. 

Ho.-jpital of the University of Penn. 
f. B. PAL-HER, M. D., Louisville, Ky., Prof, of 



WM. 

::, s 



s. r, 



H. F. BIG6AB, M. D., Prof, of Surgical and Medi- 
cal Diseases of Women, Homoeopaihic Hos- 
pital College, Cleveland, Ohio. 

DR. DOBELL, London, England, Consulting Phy- 
sician to Koyal Hospital for Diseases of tiie 
Chest. 

DK. T. F. GRIMSDALE, Liverpool, England, Consult- 
ing Physician, Ladies' Charity and Lying-in- 
Hospital. 

>>TI. ROBERTS. M.D,,F.R.C.P.,F.R.S., Manchester, 

Ensfland, Prof, of Clinical Medicine, Owyr.i' 
College School of Medicine; Physician Man- 
chester Royal Infirmary and Lunatic Hospital. 
J. C. THOROWGOOD, ai.D.,F.R.C.P., London, Eng- 
land, Physician City of London Hoiapital f n 
Chest Diseases ; Physician West London Hos- 
pital. 

W. C. PLATFAIR, M.D.. F.R.C.P., London. England. 
Prof, of Obstetric Medicine in King's C\>lieg'.'. 
• and Physician forthe Diseases of Womenaud 
Children to King's College Hospital. 



A 



riiy^ioiogy and Personal Diagnosis, Universi- 
ty of Louisville. 

3IUXTER McGUIRE, 31. D., Richmond, Va., Prof, of 
burgery, Med. Col. of Virgiuia. 

Y. A. MARDEV, M. D., Milwaukee, Wi-., Supt. and 
Phjsician, Milwaukee County HospitaL 

L. P. TANDELL, M. D., Louisville, Ky., Prof, of 

Clinical Medicine and Diseases of Children, 

University, Louisville. 
■JOHN. A. I.ARRABEE, M. D.. Louisville, Ky., Prof. 

of Materia Medica and Therapeutics, and Clin- 

cal Lecturer on Diseases of Children in the 

Hospital College of Medicine. 

!:. 0(iDE.\ DOUE.nUS, M. D., L.L.D., ^ew York, 

Prof, of Chcnustry and Toxicology, ricllevue 

Hospital Medical College ; Prof, of Clieniistry 

and Physics, College of the City of New York. 
W.VLTEK S. HAINES, 31. D.. Chicago, 111., Professor' 

of Chemistry and Toxicology, Rush Medical 

College, Chicago. 
K. F. INOALLS, A.M., 31. D., Chicago, 111., Cliiiic.il 

Professor of Diseases of Chu.■^t and Throat, 

Woman's Medical College. 
A. A. 3IEINIER. M. D., Montreal, Canada, Prof. 

Victoria University. 

MALTINE is prescribed by the most eminent member.^ of the Medical Profession 
in Ihe United ytates, Great Britain, India, China and the En<,'lisli Colonies, and is largely 
u«ed at the principal Htjspitals in preference to any of the Extracts of Malt. 

t^^We will forward cratuitously a 1-lb. bottle of any of the above proparntlons to Phyalcians, wh> will 
pay (lie express charges. Bend for our 28 page Pamphlet on Maltine for further particulars. 

Address BEED <£ CABNBICK, 

voratokt: Yonkers-on-tho-IIudson. 1*J Fulton St., New York. 



W. H. WALSHE, 31. P., F.R.C.P.. Brompton, Eng- 
land, ConsuUiiig Physician C'onsiunptiou V. i- 
pital, Brompton, and to the University Coliei^e 
Hospital. 

WYNN WILLIA3IS, 31. D., 3I.R.C.S., L-^nd . 

England, Physician Samaritan Free Hoipu... 

for Diseases of Women and Children. 

A. ('. MACRAE, 3r.D., Calcutta, Ind., Dcp. Insp.-G';!. 

Uosp. Ind. Service, late I'res. Surg., Calcutta. 

edwIrd shoppfe, m.d., l.r.c.p., 3i.b.c.s., 

London, England. 
LENNOX BROWN. F.R.C.S.. London. Engr-. Senior 
Surgeon, Central Tlnoat and Ear Hospital. 

J. CARRICK MURRAY, M. P., Kcwcastle-on-Tynp, 
England, I'tivsician to the >«. C. H. for Dis- 
eases of Chest. 

J. A. GRANT, M. D., F.B.C.S., Ottawa, Canada. 



BE.PARTICrLAR TO GET THE GENUINE 

KiDDEK'S SACCHARATED PEPSINE. 

TAKE MO OTHER. 

OUR PEPSIKE IS NOT SOLD IN BULK ; the only way you can get the genuine is in original packages, 
as follows : 

ONLY STYLES OF KIDDER'S SACCHARATED PEPSINE. 

One ounce, four ounce and eight ounce oblong white fiint glass bottles, with our name (Kidder & Laird 
blown in. the bottle, and sixteen ounce round (plain) bottles, all having on them our metallic caps and la) 
bels. THESE ONLY STYLES, THE GENUINE, are sold at 35 cents per onnce, and $4.50 
per pound. 



PROF. DOREjVITJS' TEST. 

The College of the City of New York, cor. Lexington Ave. and 23d Street. 
This is to certify that I received from my son, Thomas C. Doremus, Jr., a sample of 
Pepsine obtained by him at Messrs. Kidder & Laird's, 83 John Street, New York, 
from a barrel containing 200 lbs. of the same. That I havo made ten determinations of 
the solvent power of this Pepsine, with the following result: Ten grains of the Pepsine 
placed in an ounce of distilled water, with ten drops of hydrochloric acid, and kept at 
the temperature of the human body for six hours, with frequent agitation, dissolved 197.1 
grains of coagulated albumen out of 200 grains. 

Respectfully submitted, R. OGDEN DOREMUS, M. D., LL. D. 

J^rof. Chemistry and Physics, College City of New York, 
and Pro/. Chemistry and Toxicology, Bellevue Hosp. Med. Col. 



TESTIMONIALS. 



Lakepoet, Cal., Aug. 23d, 1878. 
Kidder & Laird : 

Gentlemen — I have used the Kidder's Saecharated 
Pepsine in several cases of Catarrh of the Stomach, 
where all other Pepsines have failed. The Lactopep- 
tine I can not give to ohildren at all, and find your 
Pepsine acts nicely. Yours, etc., 

P. H. THOENTON, M. D. 

Indianapolis, Ind., July 12th, 1878. 
Kidder & Laibd : . ' 

Gentlemen— Have given Kidder's Saecharated Pep- 
sine in a number of cases of dyspepsia; also given it 
to the physicians in this locality, who were well 
pleased with the superior quality of it. 

Yours, etc., S. J. HILLMAN, M. D. 

South Bend, Ind., Oct. 22d, 1878. 
KiDDEB & Laird : 

Gentlemen — I have used Kidder's Saecharated Pep- 
sine in some very aggravated eases of indigestion, and 
have found it equal to any Pepsine that I have ever 
nsed. Yours respectfully, * 

O. P. BARBOUE, M. D. 

Annapolis, June 20th, 1878. 
Kidder & Laird 



Malden, Mass., July 15th, 1878. 
Kidder & Laibd: 

Gentlemen — We meant to have written to you be- 
fore, to the eflFect that Kidder's Saecharated Pepsine 
was a complete success with some of the dyspeptics 
of this place; and it is highly recommended by the 
physicians, aud they are prescribing it regularly to 
their patients. Yours respectfully, 

M. E, JOSSELYN. 

No. Brookfikld, Mass., Ma^ 18th, 1877. 
Kidder & Laird : 

Gentlemen — I have tested tl.e sample (chemically) 
of Pepsine you sent me, and find it to be superior to 
that I have been in the habit of prescribing (Haw- 
ley's). Yours truly, 

L. A. VAN WAGNER, M. D. 

Allekville, Mo., May 2Sth, 1878. 
Kidder & Laird : 

Gentlemen — As you will remember sending me 
four ounces of your Saecharated Pepsine, please per- 
mit me to say, in justice to yourselves, that I believe 
it to be the most efficacious of all the preparations of 
Pepsine now in use. I have used it in three well-de- 
fined cases of dyspepsia with success when the others 

" shall use it 



Gentlemen— Since the reception of your sample of! |iad lailed, except to give shght relief. I 
idder's Saecharated Pepsine we have used no other, i^'' »" ^^^^s of indigestion hereafter. 
'^e consider it a first-class preparation. We have i ours respecttully. 



Kidder 

We consider it a first-class preparat 
never hesurd anything to the contrary. We shall con- 
tinue to dispense it unless well-founded objections 
are made, which we do not fear. We purchase from 
Messrs. Thomsen &. Muth. Yours, etc., 

J. F. PERKINS.& BRO. 



181 Lexington St., 
Kidder & Laird : 



Baltimore, Md. 



A. P. REED, M. D. 

Phila, Pa., 2280 Frankfort Ave. 
Kidder & Laird : 

Gentlemen— Since the leeeipt and trial of your 
sample of Kidder's Saecharated Pepsine I have used 
four pounds of it, and come to the conclusion that it 
fully answers all the purposes that can be reasonably 



Gentlemen — Have used Kidder's Saecharated Pep-jexpected from the use of "Pepsine," equally as well 
sine for the past year with entire satisfaction. I use as the highest priced articles which I only keep on 
no other except specially prescribed. I obtain my hand in case they are prescribed by other physicians, 
supply from-Messrs. W. H. Brown & Bro., or Messrs In my own practice 1 use your Pepsine exclusively. 
Thomsen & Muth, Baltimore. Yours respectfully, 

Yours, etc, H. C. MOORE, M. D. | FRED. PLEIBEL, M. D. 

We have over o,0C0 letters from Physicians and Druggists endorsing aud recommending KIDDER'S 
SACCHARATED PEPSINE. The quality is the best, and the price lowest in market. 

Samples and Circulars sent to Druggists or Physicians on application to 

KIDD£R & LAIRD, 83 John Street, New York. 

FOB SALE A 7 ALL W0UL£SAL£ AND RETAIL DRCOGISTS. 



For Consumption and Wasting Diseases. 




Has been proved of the highest value in CONSUMPTION and all WASTING DIS- 
EASES, invariably producing immediate Increase in FLESH and WEIGHT. 



Each dose of two leaspoonsful, equal to 120 drops, contains: 



Pare Cod lilver Oil. 80 m. (drops). 

Distilled Water 35 «• 

Soluble Pancreatin, 5 ^ralus. 



Soda 1-3 grains. 

Boric Acid 1-4 *• 

Hyoctaolic Acid 1-20 



DosK — Two teaspoonsful alone, or mixed with twice the quantity of Boft water, to be taken thrice daily with meals 



The principles upon which this discovery is based have been described in a trea- 
tise on "TAe Digestion and Assimilation of Fats in the Hionan Body," by H. C- Bart- 
lett, Ph. D., F. C. S., and the experiments which were made, together with cases 
illustrating the effect of Hydrated Oil in practice, are concisely stated in a treatise 
on ^' Consu'inption and Wasting Diseases," by G. Overend Drewry, M. D. 

In these treatises the Chemistry and Physiology of the Digestion of the Fats 
and Oils is made clear, not only by the description of a large number of experiments 
scientifically conducted, but by cases in which the deductions are most fully borne 
out by the results. ' 

*i^Copies of these valuable works will be sent free on application. 

n:"5rr>R,A.TEi> oil, 

HYDROLEUVTE, 

TTATEIi AlVD OIL. 

HYDKOLEINE is readily tolerated by the most delicate stomachs, even when 
the pure Oil of the most carefully prepared emulsions are rejected. The Oil is so 
treated with pancreatin, soda, boric and hyocholic acids, that the process of diges- 
tion is partially effected before the organs of the patient are called upon to act upon 
it. Consequently it is readily assimilated. It will nourish and produce increase 
in weight in those cases where oils or fats, not so treated, are difficult or impossible 
to digest. In Consumption and other Wasting Diseases the most prominent 
symptom is emaciation, of which the firsf is the starvation of the fatty tissues of the 
body, including the brain and nerves. This tendency to emaciation and loss of 
weight is arrested by the regular use of HYDROLEINE, which may be discontin- 
ued when the usual average weight has been permanently regained. 

The permanence and perfection of the emulsion, and the extreme solubility of 
the HYDRATED OIL, solely prepared and sold by us under the name of HYDRO- 
LEINE, is shown by its retaining its creamlike condition as long as the purest 
Cod Liver Oil will retain its sweetness. Unlike the preparations mentioned, or 
simple Cod Liver Oil, it produces no unpleasant eructation or sense of nausea, and 
should be taken in such very much smaller doses, according to the directions, as 
will insure its complete assimilation; this, at the tame time, renders its use eco- 
nomical in the highest degree. 

To brain-workers of all classes, Hydrated Oil is invaluable, supplying, as it 
does, the true brain food. Economical in use; certaip in result. Tonic; digestive 
and highly nutritive. 

NE AXT Principle for the Assimilation of F A.T 

KIDDER & LAIRD, Agent for the United States. 

Price at Retail, $1.00 per Bottle. Depot, 83 John Street, New York. 



In Malted Barley we have an unlimited supply of diastatic power."— W. Rob- 
erts, M. D., P. E. S., in London Practitioner. 



TroHimer 

EXTKACT OF MALT. 



OPINIONS OF THE MEDICAL PRESS. 



"Using Trommer Extract with excel- 
lert results; very serviceable in certain 
forms of dyspepsia; agrees with the most 
fastidious stomach." — Canada Lancet, 
Toronto. 

"Converts starch into glucose and dex- 
trine rapidly and in large quantity. 
Seems to be steadily increasing in favor 
for diseases involving impaired nutri- 
tion." — London Lancet. 

"There are many conditions in infancy, 
old age and debility, where a physician, 
once acquainted with the value of this 
Extract, would be at a loss to replace it." 
— Medical and Surgical Reporter, Phila. 

"During convalescence from fevers, in 
cases of phthisis, in certain forms of dys- 
pepsia, and generally in all cases of mal- 
nutrition, we have found it of very great 
value." — Ohio Medical Recorder. 

"There are few remedies which, to a 
greater extent, offer a priori grounds for 
their use. The clinical evidence, too, 
which has sanctioned the physiological 
claims of Malt Extract, is abundant." — 
Louisville Medical Neios. 

"Adapted to a wide range of cases re- 
quiring supplementary food; acceptable 
to the stomach; aids digestion; an ex- 
cellent vehicle for other medicines; and 
will keep in the hottest climate." — Med- 
ical Journal, Wilmington. 

"The Trommer Company has hitherto 
taken the lead in the introduction of the 
Extract of Malt. The uniformity and 
reliable character of this Extract has in- 
duced an enoitoous demand and sale." — 
Obstetric Gazette, Cincinnati. 



"Employed with great advantage in 
the wasting diseases of children, both as 
a nutrient and to improve digestion." — 
Cincirmati Medical News. 

"One of the best of the various prep- 
arations of a similar character. Prof- 
Redwood finds Trommer's Extract has 
all the power of acting on amylaceous 
bodies." — London Chemist and Druggist. 

"Too well known to need commenda- 
tion. Malt fills a place in the treatment 
of disease of the utmost utility." — Courier 
of Medicine, St. Louis. 

"Has grown so rapidly in favor with the 
profession that there are few practition- 
ers in Canada who do not regularly pre- 
scribe it."— Canada Medical Record. 

'The Trommer Company was the first 
to bring prominently before the Amer- 
ican profession the virtues of Malt Ex- 
tract. As a Malt Extract we have no 
hesitancy in saying that there is no brand 
in the market its equal in every respect."' 
— Medical Advance, Detroit. 

" Eminent practitioners, including 
most of the 1 adlng teachers, speak of it 
in the highest terms. Independently of 
the obvious merit of the preparation 
there is in its favor a mass of clinical 
evidence." — London Medical Record. 

"There is no scarcity of gooa alimen- 
tary ar'icles, but there is an objection to 
most of them that they will not keep: 
This makes our estimate of Trommer's 
Extract of Malt higher each season. It 

[ will keep in the hottest climate." — N. C. 

I Medical Journal, Wibningion. 



The Trommer Extract Company is engaged exclusively in the manufacture of 
Malt Extract, "plain," and iri such combinations as have been suggested and ap- 
proved by some of the most eminent members of the profession in Europe and 
America. Notwithstanding the large demand, they are enabled, by unremitting 
personal attention to all the details of the manufacture, to maintain the excellent 
quality which has established the reputation of their preparations on both sidea of 
ibe Atlaolic. 



.u'j a ^K.oia<^a'!J'->Ji"i .ij.:ji<iyK. < li/Asu «ij kj 'iiiKAfelll i'T 



Y.OL 



lo «irij;§io «uoiifiv aiil )<> fit'vfnfifl'' biui noilibao'j silJ 91b 
lebnu in'ih iBuin 9w r-p-p-^ — r?ii> « ^n x^^od tiBinud adJ 
'{il.tlnisfl B 111 «ni -^ -^-^^ — ^niii fHlJ vllonijaijj Liifita 

Cincinnati Medicm^I im 

'-•Se22:^^>'4'^= -Feb ruary, 1882.. unW jiifS^MmS 

uJi...; L-j.'i.^.. ir id bit! ..-. , I,. :t •)({> fI:griOT{IJ Laim lo 

« 111 , Mod /'0ii^ig|]^iij''pB^^Wi^irt'l^fef'"i««"i J"^ 

•lOfiio 71! l)j^. J ^ imoiuTi; bn^ Isninoa 

•!^)jimj oj -leb'U) lU —— — mi(.:>a(J ji:yv;lj«>d oilJ "io nJiuq 

InsanitFfrt itsRefations to the Medlc^r >^[^dfe^^i>afttf 

Lunatic Hospitals. .'^bod 

loUiQi^ liiiv/ bebi!' /]jiwjr;iii lo ybui» oilT 

.9nit>ibem io txi9fri9?i.^ATHAN alle??,^, 9,;,fj n^^jj ?.9ij[i,offlib 

'.fffif, vfln'ffftnn [.Irio;- - -7';- li.'.ihst/ff 'lo -r'lh m aill ill 

Kea<^atthe Annual Meeting of the A.merican As§ociationjfor^tl^e ^^ro^ec-j 

-neni ^^nfi^^^^^^^^ 1°^^^^' ^° ^^^ ^^^^' J^°"^^^,'#fil^n'A' .bJt'jal 

A triangle has three important points of obse^^ga^op..? 

If, 18 so with reference to Insanity, ,tUe,,:^ediG9A.^^:oi^tMiQni 

and Lunatic Hospitals. ">rlfiiMf)o fj:'>rb')rn ijniorinvbjti "lot 

•.'(Each sustains a most intimate relation to the otherMj^juJi 
neither can be thoroughly discussed in all it^i bearingPj 
without considering the whole. The present time affords 
a favorable opportunity to institute certain inquiries au^d 
comparisons upon these subjectSj^as , ijLKJpspeoi&jiJJlh^Jiir, 
mutual relations. What, then, are the fact^i^i iiJodguoidJ 

r.lOiHi:j^. ii,0 INSANITY AS A STUDY NEGLECTED.ijynilllj;Zy x'Lit 

"'i:""'The'''8ludy of insanity has been greatit iMAgUnub!* 
There are various causes for this neglect. It hae^'b^^eU' 
found more difficult to ascertain the -true functions of the 
br^in than any other organ in the human system. The 
functions of nearly all tl»e organs of the body bav^"b6fen 
very correctly understood for many years, but Hi'tplitWW 
has not been directed to those of the brain so ftill't,"Ah'd' 
neither can it be said that they al^6 all yet! bbW^'dtl^ 'oti^ 
generally understood. Medicine is a progressi^'^ ^'(ii6'nc'6, 
and is based upon the results of discovery, ekiierirti^htl. 
and observation. While physiology teaches What are 1^6 
normal or healthy functions of all parts of the body;'-w6'' 
learn T)y pathology what Site ' t\ie bhange'6 \)k^hi6h d'i8e&:se 



74 INSANITY IN ITS RELATIONS TO MEDICAL PROFESSION, ETC. 



makes in these functions. But before we can learn what 
are the condition and character of the various organs of 
the human body in a diseased state, we must first under- 
stand distinctly the functions of these organs in a healthy 
state. Though the brain has been made a special subject 
of study for many years as to its uses and diseases, our 
knowledge of it is far behind that of any other organ. In- 
sanity or mental derangement is based upontlie abnormal 
condition of the brain, or in other words, the manifestation 
of mind through the brain in a morbid or diseased state. 
But inasmuch as the development of the brain both in a 
normal and abnormal state is greatly affected by other 
parts of the body, it becomes necessary in order to under- 
stand them, that we should have a very correct knowledge 
of the laws of health and disease as applied to the whole 
body. 

The study of insanity is therefore attended with greater 
difficulties than that of any other department of medicine. 
In the order of medical studies this would naturally come 
last, but in too many instances, it has been entirely neg- 
lected. As formerly very little was known respecting men- 
tal disorders, they were not included in the curriculum of 
medical studies. In the two great mediums or channels 
for advancing medical education in this country, mental 
derangement or insanity unfortunately has not held the 
position that it ought to have had. These two great ed- 
ucating agencies are, 1st: The medical schools or insti- 
tutions for giving courses of lectures, and 2d, The Ameri- 
can Medical Association, composed of leading physicians 
throughout the country. For many years we have care- 
fully examined the annual circulars of medical schools 
advertising their lectures, and in very few instances is 
insanity named as one of them. 

MEDICAL SCHOOLS. 

In only three or four schools in the country is there a 
professorship, or course of lectures devoted exclusively to 
mental disorders. In a few institutions we learn that 
here and there a lecture on insanity is introduced under 
the head of theory and practice of medicine ; but the sub- 
ject is so closely connected with medical jurisprudence 
that it is more often discussed in courses of lecture on this 
subject. 

As a matter of fact, however, so little attention is given 



INSANITY IN ITS RELATIONS TO MEDICAL PROFESSION, ETC. 75 

to mental derangement that scarcely ever a book on this 
subject is included among the standard works of study 
and reference proposed for students. Of course, in ex- 
amination of students for graduation, few, or no questions 
are ever asked on the subject. 

In reviewing, therefore, the history of teaching and lec- 
turing in our medical schools for twenty or thirty years, 
we find very little attention given to insanity. While im- 
provements have constantly been made in nearly all 
branches of study, and the standard of medical education 
has been generally raised, this has been neglected. Con- 
sidering the importance of insanity compared with other 
diseases, and at the same time that the disease has been 
steadily increasing, it is very unfortunate that its study 
should have been so generally neglected. 

Lectures and instruction may be given upon nervous 
diseases generally, but scarce any upon those confined 
exclusively to this form of disease. As a branch of medi- 
cal study, it is safe to say that the nature and treatment 
of mental derangement has been almost entirely neglected 
in all the schools throughout the country. Let us look at 
the next most important agency for promoting medical 
studies. 

THE AMERICAN MEDICAL ASSOCIATION. 

This Association was organized in Philadelphia in 1847, 
a little over thirty years ago. The object of this Associa- 
tion was to promote the interests of every department of 
medicine, and the medical schools have always been rep- 
resented in it. This Association divided its work into 
difierent branches or sections so as to have committees 
appointed with reports, ptipers and discussions upon each 
section at its annual meetings. In this way all the depart- 
ments of medicine are more systematically and thoroughly 
investigated. 

Soon after the organization of this Association a section 
on psychological medicine was formed, making insanity, 
of course, a prominent part, and it was expected that all 
interested in mental diseases would come into this section. 
This, of course, would bring in those physicians connected 
with lunatic hospitals, and the whole subject of insanity 
and the treatment of the insane would be made prominent. 

It so happened, however, that the superintendents of 
tiiese hospitals liad just before formed a small organiza- 
tion of their own, and did not incline to join or work with 



ta iNTgAN^rr-'f » *l«'fe.itAtt:r4)«S01toBMe!MCA3LJrpROiFB8SIOT>r^ «9WSX 



Afem]lei4tioiiidi* liotj tbereloi^^, ^^t»tt 'wibh : Uhe interest ftfid^ 
r«adyi wx>T'ker« i^i^othdr Bectioin'S didy and no -repotts iior 
JflpfebS't<ler^''at'fij*ettcrand p^0parfedi(yrt tlie'^iibje«t.. ' nmK 

After waiting some ten y6aT6,'iit'he Americsin Medioal; 
A-^fei^ti^tf ij^a^eerd'a ¥6s6ltitiori,' eg^^ciaHj'.invi^-Kg stipfer- 
itiletiae'titis'^fifh^feie 'MfepitiaWlioiljmii'it,! and send a^deieu 
gWtte<ld'tWeir '!Ae'etittg"toJnir'gi9 tthid'itihion. Between lt86^ 
ahd l.SW,'<aeli^gate^iW0te senti^ev^raltimes to the annnali 
^«JEifci?i^^oMhfe'#e»pieYfe%ebid'etatSiiiirfeing them in behalf ®f 
tl9©'Aie6feedl''plft)fesSioW, in behalf iofUieiMei-ests of thein-i 
^^iste^'athd'-foi- the*i«i6f'WtMmproVetfieTitias well as that of thii 
M«osptta'ls| t>bat^th'ey'%iotild unity and' take part' in the worfc 
O'^^ttiS Ass6<;i'atioil."'' !'"'"<■ vTw^-iii .o,,,-' .•[■.in vhhi;'-.)? 

While some sujierlntfendfeitti^^axiTWiated a, union, a majo«]f' 
itg^»pp<6sed'ji*t. '!At'eer'^feet%*fel"'attemptB' had thus befen 
fttad&"ftTid'*faiiydv*tbfe MeKlical' AssttClatJ^h sent no raof^ 
d^l'e^ates'itO'th4 meetings of th^'sttperinteiidents, sO' that 
iinoertS^O friO frat^rw^l-'iiit^reoutgeof this land has beien- 
^wi'ried- • on ' bet^feeri' 'tiyese* ■ fwb^bodiesi ' ' ' 'I4> "is trud a 'fe \r 
ittpi^riiltehdeAts haV(9"0ccab'i(1fially'' atti^nded, and ttikeii' 
p^rn' the' meetings oftlve' AmerJean Me^iical Assoeiatioii,' 
but there has been no distinct section or committee 'oji- 
pointed to in'^'e&tig'afle^/arid re'pdtt'^UpOli'ifi^Miity from year 
^pty^aci I Itt(]exainiaitg the^LaQt-teiv volumesi of tb^ tratis- 
acitionsfot the Association ^veflnd omly three or four paperg 
on this subject, -while many, hundreds are devoted /to lailr 
otheritopdos/ connected with medical improvieaien.t(4i .ihom 
otcThisrAssoeiatioii hais u.<5w. issued, thijfty large tolume&j 
containing aa immensie .amount of medical knowledge lojfc 
every idepartment. ofi imesdicinev but very little, icoiupajjfi^; 
tiveiyv ofitii be iouiKLionilmentaJ: diseases and thjsir. treat- 
meiitijinlthus.it will bei seea that as.fair. as. those two greafc 
agencies for advancing medical science are : concerned^ 
they bavefdotte bH4;/Jit tie itoimake known the true fu«c- 
tious. oil th^i brakt, ,or fcOiCiiUi^atQ and diif use ■ a kaM>w,leflg^ 
oKitB* diseases,. !>it i&^rue,! within .^ fewiy-^ars^ ..there h'a\i^ 
been oecaaioiiali leoturest/aud paperB on, the- subject, lanti 
also- a few books Mv^ been, wp!ablislijed,-0r rather repubT 
lished from English edita©nsv on! insanity.; Here anditherd 
nkayi be .fofi-HKl ai physician in. geaiei'al. practice,. ©r- as pfffti: 
fesaor inisome eiedioal 3ch0ojy.if<{bf€).iilas.!takei|.[gpeeiat jn- 
teKesfc.in . tliieidiseaseano*!" the'>bjjfeii>i4.rtd '^'^eajfhtireatnienti 
b otjibla iiiw» i»b eii (qf*su 6h itofW in I tha . ]lrofe^ei)m ^^ 



'MWMM■m^Hkmm^(9P^mMkiFWfm^^^^mt ^? 



and how important are the disorders of the brain comp^i^d 
vy4t|M<^-t^i^r. 4js€>a^es, itis surpyisiu^ythat l^iie,|'oi"«^e^' ^Uovla 
!*^K.^.ilft6^ft^<?*^?ieJ^=^^^y i^eglectea,, :-, . ...1 -ill ill ,r'.wirj 

-Dut there is one body or aarency which has taken special 
interest in this subject, that is, — Ihe Americari Association 

posed of a very limited number, it has lield annuial meetr 



has been published for inany years. xKis journal contains 

a great amouftt Of+^Mafel^'ftaatt^t'tfhiMaM'ty — in fact, it 

<fpnx^4^^ Qei^rly ,all,th^t.,t^a^, b^^jiip,ubUsUe<P(,W tUjs «ppii- 

^^y- r,\i'np '^lifinj I'Df: yIoi6*v**8 uo'^d sykH siiBiHrn silt to 
y.iBi^tiithis jpprifial bas hadr^ ]?pry; limited qiysQulation^ auifl 

its perusalha^been cQufine.d, al»^ost wbollvj ito sReciaijsts 
QU tliiij subject. It has 4QiJ^r]j/ut- little ,t;o ^njjgU^n. tli-© 
members of the medical profes6iop/Upon:ius?ani<^jf, pr.fta difr 
f^3(eivfpi;m^^^0in,geu^ravlliy in ,tl>^ CiQgppivinity^-,Tl^§ Ahief pb- 
JQ<?i^,Qf t,bis io,iii-i)j^yia^,beeaa^^mingly to. toiil(iHp e'xpei;^ 
\x\ %lii^, ^ei^sa'im,e,u.t and piac§ , whoUy in their lia,uds the 
t^eii^n^^ftt. of, the ^i^sane, apd the. jgaauagement; pi, lupaUG 
)a.ospit^ls.,,j{ j„ fc-iBfliiDfir edJ !l .8,amil) to Hiiiia J^ifll lo 

, Thus, while the study of insanity ha& l>een,negl€icted by 
fj^.e prpfe^sipn at, Jiarge, and the experts have as&umed to 
taJ^e ejiMre charge of it, the est9tW*i^bi¥teu,t aud ,maatage- 
me^it of hospitals has fallen almost wholly intp. their handsi. 
iHot,,oply,this great charge, hut neavl^f »U. the laws. vvhicli 
ha.ye. been enacted upon, the su)oject},-by th^.idiffeireut 
i^j'.^tes,. have_beqn prepi\veiii ^^<A(Prttsf^,.feif,tih,eiruiS9^g^§.7 
^^jand advice., ,.,„, ^tr nr h*»nn'> o<l Mnov/ ««iiy«ib 

, .$i4ph has been the oonfidenc,e iiuiPQsed i,ii tl^nj < th^ 
le^as[fitive bodies in all ,thQ: States (hajvq,. been l(^d irout 
time,,tQ tjuie ,t<o Ipiuild hospitalsjust.awqoii^ilgito.thpijit ^liin\, 
^n^pirfl m^^^iitj^e; mo^ti liberfUMappvppfiatiws/ ii<i>tfi th^.^ujpr 
BWT^,:9^,/,li»^,^i>ij^up. ., >tt. liii^y , |je itfifily ^aMi. ik^ <>whait«K0r 
proy/pipWf^jUajYe,, bee»i, ii^ttde, fo4-,J.,l>gtqflreMWd,t«€katmpnt<'Qi' 
this unfortunate class throughout the country, these ^^Wfl 



78 INSANITY IN ITS RELATIONS TO MEDICAL PROFESSION, ETC. 

been directed and controlled almost entirely by those who 
were or had been or wished to be superintendents of hos- 
pitals. 

Now tlie credit of whatever success has attended this 
course in the management and treatment of the insane, 
should be given to these experts or superintendents. In 
some States and localities, the success has been greater 
than in others. It is so with some institutions ; while a 
few have been wisely managed, and can point to most ben- 
eficial results, the conduct of others has been attended 
with more or less friction and complaint, and sometimes 
followed by results that were not altogether satisfactory. 
While it is admitted that a vast amount of good has been 
accomplished, it is not all good, but has been mixed with 
many evils. Within a few years the attention of the pub- 
lic has been called to some of these evils. 

DEFECTS OF HOSPITAL MANAGEMENT. 

The present management of hospitals and the treatment 
of the insane have been severely and justly criticised. 
By some critics the system itself is condemned, and by 
others the superintendents are severely censured. Now, 
what are these defects? Who is to blame? What can be 
done to remedy these evils ? 

Thej^r.^^ great mistake made was the separation of the 
experts from the medical profession, and that the study 
of insanity and the care of the insane should be placed so 
exclusively in their hands. Many evils have grown out 
of this state of things. If the members of the medical 
profession had taken hold of the study of insanity thirty 
years ago, as they did other diseases, and followed it up 
by discoveries and improvements to the present day, this 
branch of study would present a very different aspect 
from what we now have. Mental disorders would be far 
better understood by the profession generally. The first 
symptoms of insanity would be ofteuer detected, and the 
disease would be cured in its incipient stages. Thus 
great numbers would be prevented from becoming violent- 
ly insane or subjects for hospitals. Then far greater 
knowledge and skill would be exercised in all this class of 
cases. Many more would be treated at their homes better 
than to be sent away. Far greater care and discrimination 
would be employed in filling certificates for hospital treat- 
ment. 



INSANITY IN ITS RELATIONS TO MEDICAL PROFESSION, ETC. 79 

The second mistake was in erecting so large and ex- 
pensive buildings. The objections to such a course are 
very numerous and serious. 

The magnitude of the thing has led to extravagance. 
Instead of thousands thus expended, it has been millions 
in some instances for the mere building, requiring an in- 
vestment of three or four thousand dollars for the accom- 
modation of every individual patient. In many cases the 
provision for officers has been altogether too large, and 
more expensive than need be. 

It has been found that such large establishments were 
very difficult for efficient administration. Greater liberties 
are taken, abuses more frequently occur, aud patients are 
the sufferers. 

Suitable persons can not be found to take charge of 
them, without having too many officers. In the multi- 
plicity of numbers, there is far greater liability of friction 
and complaint; there can not be found that individual re- 
sponsibility and fidelity in watchfulness and discipline 
that are so necessary. 

The thirds and perhaps the most serious mistake made, 
is the system itself \% wrong, the aggregating of such large 
masses of diseased persons. The primary object of a hos- 
pital is cure. In the course pursued with reference to 
the insane, this matter of cure has been too often lost 
sight of. In the great crowd, and in the constant changes, 
individuality or personality is lost. It is impossible to 
examine, watch and follow up the treatment of every 
single patient as it should be. 

Such is found to be the experience in large hospitals 
for other diseases, that the per cent, of cures was not so 
many, and the rate of mortality was greater, where were 
congregated together the largest number of sick people. 
As cure is and always should be the chief object of the 
hospital, and since it is found by actual experience that 
ihis is not secured now in a majority of insane patients, 
it will be seen how rapidly these hospitals become filled 
with chronic and incurable cases. What can be^moresad 
after long medical treatment than such a result! 

The fourth objection to the system is, that it violates 
sanitary laws. It has been truly said that disease is the 
commencement of decay aud of death. While some dis- 
eases have more destructive agency upon human organ- 
ization than others, and also propagate germs of disease 



(§9 A«%^iiWX 4:^^t35?fRP^ATiift?f^ ,5q.ji,|^cAi.,PftqF^p}95V^ JS^f 



i}?<?il9iiipeajiily, all sick people must exercise an uii whole- 
s^fli^ififfAuence upou their surroundings. For instance, i^ 
is impossible to secure very good ventilation in a room or 
ward. filled, with sick persons. The violation of other sani- 
tary law^ might easily be pointed out. But insanity 1^ 
diffeirent from all other diseases. It involves the laws of 
iflind-T— a derangement of its faculties which are powerfully 
a«ffected by external influences. i -Mix. in 

|,<iWhat c,au be worse for disordered minds than to eom^ 
all the time in contact with other disordered minds! In 
tljevvery Aa^ture of things, would not the inevitable tend- 
ency be for each to make the other worse, or at least to 
perpetuate the same disorder? In the case of having 
rooms or wards crowded with deranged persons, how ca,u 
i^ be jQtherwise than to increase that derangement! jjj,j^, 
-{fSf^l^S'Sir James, Goxe, "-What advantage is to be hoped 
for by associating a curable patient with so large a pro- 
p,Qr|;ii9,u ot incurables ? Neither is any gain to be looked 
i/?jri{^n<|«be nfiere association of the insane with the insane. 
Lora Shaftesbury thinks this association has proved most 
prejudicial to the interests of the insane and he expresses 
iy^,, convictions that herein is^^qj^p^^gr^e^t ftau^^^^^f^|l}.^ej|i^j 
j^^pse increase of lunacy." r ^.,„,..,„. r,- , <,.;r i. ,';-.>.,.,„ 
oj l&^'fi)v,-Ji^!* < deranged persons mingle more freely wit.n 
jl^;(?s^ who are sane — let them look at their countenances 
r^m^^^A^fi^. mpvements and hear their talk, will it not 
^fn^^^^u^Alyem out of their delusions, and restore to 
i^^fQ,ljgalitJ^fj{niental action ?„, Are not such results, niore 
likely to follow according to reason and common sens^ ? 
jPj|i(gfjQL(,f|ie arguments used in favor of congregating the 
<5JHftfti^i:i;>s|ii§,j.\y^§ tlj^J. i|,^^oj,i^l(i .Jiave a curfi%fjTi/(nf- 

^fy^' QIQsh/ .f9tr;o-f<' -r.-^v vlrfr-l-rnn h/; f.iir. vdi^rn 

,{,jT^fc theory was advocated in elaborated essays, by 
^flji^.of tlje most distinguished experts on the treatment 
jtjfjj^h^ JjUSane. In fact, superintendents generally advo- 
?!^ft4;|,his doctrine for many years. But it was a mere 
;tli!9!0,ry,,i^lli|d.had no support in positive facts or sound ar- 
jgiyt^^f)^ ,,Jjt should be stated that this theory never started 
with theilaity, nor by the regular practitioner of medicine, 
.fe^iilby/y\o§9o,^h^lm4,(;o.5:y;e?,fylie <^harjg9.o^li^{^p^tip^.^os- 
^W^^RUOgib ,)KrIt bins v'nTr (T',': T .s'/nrf v'fRtrfi};8 

-ailTfei?i4P^^P'P^^ now condemned by the highest author- 
ities in Great Britain, and is no longer, we believe, a^Yo- 



imAii^Tr-mai^iREjjmk^Ms^^OiM§P^f}Ai'}^»Pi^'^fm¥vim^ % 



The.Jlfa objection to tlie m^^^mk PCf^^M 9f>n0f?!S^ 
iug togetUe^ such large uiun berg. of, tbiftP^fti^Pii^^iM^^i'l^lft 
highest order of sanitary age iicie's.,Cf^?i not be eiuplqy^(j( 
for their health aud improvement. It might be shpyvyij 
that the laws of ventilation, can not be ao well applied^m 
large iiustitutious; neither, can there be i)re.sej;v;9f^. Jtf\i^ 
same amount of neatness or cJea;iiin?ss or quiet; npr.-ft^ 
the drainage and sewerage be^so thoroug|i,i^i^^, ft^^f8^|\j^ 
carried out as in small establi^bni^nts.. <;,.;';) ,j) bsiii'^i'aq 

But the most important'sanitai'yj ageJlCJj[,,Q^J^^,|f7^^|f,J/- 
w^t;/^^■— wholesome exercise of boi(Jy,apd;9ijLflL,df-Tq^^i),^l9p pg^ 
sibly be so well applied in large institatjpn^^ r]^o, thej.'a^-^ 
peutic agency vyhatever can do §p raufili ./oi: t|i\^j p^jrqiijiQ 
insane as normal, healthy exercise of, |,jl^^i bq^j.^pc^^ th.^^ 
mind. A large share of tjiis^ exercise. ii>,jtH§ .^P'^.f^.Q^-W^l^ 
should be taken in the , Qpep; fir.|; Tbese, Qpjp^,t|§,,^}i9Hi4 
then be primarily sought in making provisio}^^9|\tlu,^j9la^f 
of the insane. This course of treAtii^ejJi.t^jili^^ti^fti^i^^S^.^.^ 

only with physical, and; mental , l,aws ,,b4,t4?ritfppA4''^^^ 
productive of the most eflectual re.mefiies<,j^9;C; t^Pt^^i^^^s.^f 
Many illustrations could be iadduced where pj^|.^^vt^,!"V7l^9 
have been conlined for years in larg.e U,otjp[|;£^][^fj.jYi^})bj\|r 
improvement, on being removejdtrtQ ;Smg,Jl^fj^ji5^u^tgy^T;j| 

given more freedom, and worfi-rTrtee ^f^i^bis WBfiSfe^f^ 
physically and mentally, and pome hifiY^i ^.Y6ft{^^flo^%gi. 

The sixth objection to the present system otfmi^lxagjLpg 
tile insane is, thatit tends directly to couliiie a kuowl^dg,© 
and treatment of the disea&e,,tO;.3.,f;&^ i/nli.vidaai'-s. Siic}]i 
has been its effect for the last tw.^uty^oi^m^vty years. In,- 
stead of diflusing a kuowl edge,. pf.tl^i^, disease tUioughout 
the medical profession, or even in ^he q^piauaily at large, 
the drift has been to confine i^^i^,p3^giufy Uii;? .specially 
in the hands of a few personfS,!i,;\5ri>^|t f^re tUe^fCJ^.? l,:,!^ 
the superintendents and other e3f:pei-ts,bjj,d,fihMl'y;sy!^4F^(^g/(^ 
joined the American Medical Assoeiation and tal\^iij,j;jij^f) 
lead here in a thorough inv^^tigii,tiQn a^u\, 4i.seu,sjd9p^,P^" 

insanity as a department of, <^^(jj,^,a,L;^t,^j^^^4ifPr^ptei9p 
the members of that;A§SQfliatip|^liW^^^^ lj^,yp„b^,9^n^j^r 
more personally interested in it. Such a course during, ^)i/ 
these years wQuldJj^ye diif^a^d.i^yy^^^p^i^i^^^l.i^f^l^iwwl- 
edge and helpeaiiWP?t effe(}t^^a,Uy;j[^,,^4if(;^;i,p i/^l^^jiDfi^j^'c^l 
profession on this gubject.,.„«v,Uj c„|j eiirip^-i ol «e b^Ib^ 
Another important advantage woi^d, )>^X'^',l;)g^^VS^¥^W 



82 INSANITY IN ITS RELATIONS TO MEDICAL PROFESSION, ETC. 



brought to bear upon medical schools that courses of lec- 
tures would have been given in most of them every year 
on mental derangement. In that case the importance of 
of the subject would have been made more prominent, es- 
pecially in connection with nervous and other diseases. 
The attention of students would have been directed far 
more extensively to this class of studies, so that, in enter- 
ing upon medical practice, they would have been better 
prepared to treat cases of insanity. 

Had the members of the profession generally been as 
well educated on this as on all other diseases they would 
have cured many patients in the early stages of the dis- 
ease, so that it would have been unnecessary to send them 
to a lunatic hospital. Besides, they would be better 
judges as to what cases should be sent away, and then 
they could have been qualified to fill out certificates giv- 
ing the evidences of insanity which would be just to the 
patient and an honor to the profession. 

Many persons are now sent to hospitals, who should 
never have gone. This arises partly from the ignorance 
of physicians, and partly from the convenience of the pub- 
lic or from the selfish interests of friends. As the laws 
stand in most of the States it is very easy to commit a 
person to a lunatic hospital. 

Let a husband and wife get at variance, and either one 
form the determination to get the other out of the way-- 
let repeated provocations be made developing certain 
ugly peculiarites of disposition and character, and engage 
some physician to watch the case, and when the time 
comes, he can readily summon another, posting him re- 
specting the patient. A certificate is then easily filled out 
and signed, thereby committing the patient to a hospital. 
Let an individual be addicted to the opium habit, or to 
habitual intemperance, or to an ungovernable temper, or 
some pernicious habits, and the friends wish to remove 
such a one from temptation, by a little strategy or sharp 
management such persons are committed to a lunatic hos- 
pital, and when once there, they find it difficult to get 

out. 

After many years' experience in Great Britain the law 
of committal has become so perfected in preparing certifi- 
cates as to require the physician to write down the dis- 
tinct evidences of insanity from his own personal knowl- 
edge, and state what additional facts or knowledge he can 



INSANITY IN ITS RELATIONS TO MEDICAL PROFESSION, ETC. 83 



obtain from others in proof of the insanity. If there is a 
gross mistake or something wrong in the process, the law 
provides that the signer of such certificate may be sued 
and compelled to pay heavy damages. Moreover, large 
numbers of these certificates, with all the precaution given, 
are sent back by the Commissioners of Lunacy for cor- 
rection. 

One of the greatest evils at present connected with 
these hospitals is the fact that multitudes are sent to thera 
who need not and never ought to go. From some thirty 
years' experience in frequent visits to these institutions, 
and from a long experience of medical practice in a large 
city, we are convinced of tlie truth of this statement. 
There has existed somehow a very strong proclivity on 
the part of the community and the medical profession 
(and this has been encouraged by the managers of hos- 
pitals) to push without sufiicient care and discrimination 
all mentally abnormal cases into hospitals. Careful con- 
sideration is not always taken to see if the parties can not 
be cured at home. And then what may be the efiect of 
so great a change ? It is well understood that many 
patients are made worse by these changes and some never 
recover from the shock and first impressions made upon 
them in entering a lunatic hospital. 

PREVENTION OP INSANITY. 

Another serious evil arises from the present system or 
slate of things, that is, no plans are devised nor means 
employed to prevent insanity. Within twenty or thirty 
years, earnest and successful efforts have been made to 
prevent the spread and even the existence of certain dis- 
eases. It is found by ascertaining more definitely the 
causes of disease, and by resorting to sanitary laws, a 
large amount of sickness may be prevented and con- 
siderable mortality averted. This reform has been mainly 
carried on by members of the medical profession, though 
some of the laity have joined heartily in the work. But 
in the prevention of insanity scarce any attempts or efforts 
have as yet been put forth for this purpose. 

The fact is, the nature and causes of this disease are 
less understood than those of any other. As a department 
of medicine its study has, we may say, been grossly neg- 
lected. While great advances have been made in a 
knowledges of other diseases, corresponding improve- 



§^ W^'m.i^^^^'M]^.m9¥<?PMm^MmM^Wi M'r 



[P_^|\fi^fl!^ott /i^teft;PJ^fiei}Ph^^^^^ 



sanity — to grow up among us, and that we liave^j p^qi^ 

^^mfi ^9ffftl* moil .o^ ot ffljjtjo T'T&ii fjfiB JoH Loen odyf 
,Hiiornui,1?nh.fiefri ot^'H^.AP"'^ Wi9pi^ nr 9on*>'n^qx<j 'gi«>'»v 
o^Oi'hlBiiuquiry'natui'all^ arises'whyi -thcm'e ]ia«'notid()«feil.iin 
our-ocmtttry mote iraprovemenbint this /specialty?// 'J}his 
qttestiori has been answered fpaitly inrthe facts* klc^ad^ 
atafced.'f iButi the fault Tests raOL?6 psirticularly' upoij tMe 
goardiansofthia specialty. i'Wibh two or three lexae'ptJous^ 
BO special provision has been feadadn. these bqs^itftla for 
such atudy' *aad 'improvement. iSuperiuteaden'tSMof 'jho&- 
pi^tak have (had their hands full in .attending to business 
^aiirs'ffeindilin the general itreatineAt of,-the imsauej'-iNcJ 
pwDfvdfsio^ ds niade for cliniicaA or pitholo^ical instrutiiion 
by.lectures dr teachers; The advaatag&s^cif oth^Dliospitals 
aare; made available . 'for thisiipurposej ..rl Ifc-ife jmocipaily in 
this way that a thorough, isndwledge' of ihendieea^eyajj^ 
better treatment .^^Ol^^jip^a^^.j.^^jljjjj^ obtained. The 
course now pursued is a rouline practice, learned by 
l?m¥ffeid exp'6rience frfid 'tibSbr*Vat1biii'' "S(isiiitafl \)hyfei'<i?kns 
ai^^ tbo well featisiied to'fbli'dw' the'sbfrri^ pMbtice^vhic'h 




^>-'Th^r'e^'^-kh*bther evil, c^Jid k"^gHotr^ drife, 'too. c^nn^dtfed 

^ith'tfaie'^ys'tfera, which is' sonieWliatt'diffitMit-^'fO descMbe. 

^SM'thi^'^fep^'ciklty'Ms 'bfeeh '^irtiticftfed f6i* tM^tfy'VeaTB^i- 

afoV^'fend, as Iiihrftic hb^sTfyitals a^r^'iiowm'fiiiag'ed, the-e^A'd- 

(k^4d t&ioster "^n 'untTti'e sptHt qf pHde ahlicdnd'M in 

iti^e -^ilfi^ldyed in'ih^m'.*^ Thi^ ' ;^avties themselves "'ffi^'y 

rlbt'fea'tori&dibti^'of ytich'eflfecftSj'fend ate'ttot 'sb-'flift^y % 

blame. The fdl^^i fef '<iirbhM*'(5a^<i'4«- ha'vie toade' theiti MiTti, 

atA\a M^'alko iM^dbd td-|Jlac^'meh''5f'tfei^'liai'ticUl^V &tkfap 

l#ttiy§^'fet^uktibns. ■ 'llet as 'look^at't/life' fsldW*' ■'Att'sperii^ 

^ty'or-Sttt^ie^<>t' of business devel'oJife"dp^frte'aMi*'^6?laS6 

fif ffefciflfei^'aif^d^yiprt^hctiTe of 3T)efci«F*ifti^WdgeJ'"5}fi4 
-970iqmj ;gni5noqa9noo ,^->«*.'7fli0 ledto to j-.e^belwon^f 



IǤ^N^f ^If lT^ feEtikif tS#S' 1^ ijf til)i6iA^R6fe'ii^sfdl^^'< *!*ej 



it^ife (^n-Hfec%ea''#!ttll'feelf-i^t^i^^ts;-'ti^^'Sff«(its'"b'^botti'^W' 

riSlQfytrtellt'? ^'Jb^ such persofii*"b'^"lJlk'(*edMu'p^'^itibiWPi*f 
pOWei'. iarid'ittfitteii-b^; !aW(f Wh^ti f&'llife '^ffg^ftf f otf ch'^S^fef^? 
BO§s '!t^-H<rt '^*iid diy^^tlyltb eMtf<;^s(fe ■'a"'4feH^g"o!P'^^8H« 

liVidferfeSttooli'fei^ 'yWitig'-keVi ^^ajp^d'-iti iif Mf'caT ^^tWdieS ^ tMt 
a't^i*th •oi'^'afpoMtto'e&'t' ih'^ l^iljitib' Kd^iJitdl li'W^f d^-' 

fol'e"tli?fr'^ubHb.'*'H'6Sl^ m&^'cmi'tCtVtVy cllk'ii(5*di*"bf Siip'i'jbk 
or of distinctibh'rn- nye^g^H^kVprkbU'ch^f mydMrl^i'^'Shm 
doAetdeF^ tli^ gf^At* ^aiii(yttnt' bf ^k'llG^;'^ifyd§utfe,' 'k'nd« Wft(^r- 
t^ai^iW etat^h^' bii'6'liti' tlid ' mbe-^ttl^H^^ry ■ iMn'^^ h'^c^k^ki-y 
td'dieVelbp"^ W^H^bktecied chrfi^lctei'!"''lt i^'nbf dlJ^'^feli 
tb ijydirt t • kitt« 't!U' ' ^M^ti<^i¥}a¥ '^ty li^' ♦bi^J<iia^' 'y ^ *tii^d^ -1^^^ 
Jri^Jine^t?^ tWd'fbl^tt^i'tebtil'yk ' F^'bitf ^tlMT^hd'aM'^i' cf^dies 
iNii!*^ 'thxiii^Wt'-thatJ'Til^liy '6rth^e'^tli^ti\5W^'hkV^"f^jfrtfe*ri 
hitb thtilWarid^ of j^feV^b^ ft'dt p'td^i-^siW&iti thara'dtbf W*¥ 

Suppose a very different sllay"bf'tWft^^^dkMaii^*C!ia« 
the^hbl<6' 'm^df (!a1 jpi^fe's^Mn •'^'^ife' 'f,h6le6t4^]^?y ' ^llUca'tled 

let- tHfe ^liAb^ <yf«W ^ut)6Vihtt4rid'eftt''iye?'^ftl'r^d^ftSf''fe^?^6^iii^ 
fttin^'! the'l^rofeysioii' ^^'rftaiA' bf' i:5"«*>t"^a*^j/^ai-s' W ^m^m 
practice," {i'maii'^f'e^fetAlilishbdr6\)iWaKtih;'weU kri9wW'fW 
his ^dtifl' Jddghi^iVe/'^boa c\5thtbiM s'^iid\\ 'Tii-b'aft'SH^^'drf 
aM'Wi'B,t0c^'ari(*>'bfep^i^ll'y dn^ intei'^^tfe'd' fi-6hi' dW^i^c^^W 
dis^As^S'rffah^ rtbi'Vdfl}?'s\^ateill'khdthfeM)iJaiii'j'KWd f^'tii^ 
placef bfa«iist^nt«'fil't?hehb^j11t^'lidTillbdfr6m tl^^'i^^lfd 
fi>P';ftAmig t^hyslcf^*ii3»'by''doitlp€Jtlt^Vfe''yiiAm5Mrt'c/nb'^^^iW 
ot/hfer ho^talfe.* 'thfe^e ■institli(i6W'WbuM"th-6'A bb iii^J 
a^ltr Uy ' tt kil asft' k>f '/]fT6^r>ith ' tdiferiV th'e 'liJ bt5't ' mtt^rti Jl? 1^^ 
]ktSb»W'»^oWm''exWl''brt't?ie' l)Rl^''bf*ltty''piWessW'iii^^^ 
WlM)<^oXAd'i^^e'dt>'«ll6 0{}iUibri'^^f)f vifeHBW^oii^tliifi ^^^iknf 



86 INSANITY IN ITS RELATIONS TO MEDICAL PROFESSION, ETC. 

wherever found — men who would gladly seek counsel and 
advice from consulting boards of physicians or at the 
hands of commissioners of lunacy. Improvements, reforms 
and supervision would be sought and not opposed. There 
would be other important advantages secured by such a 
course. If an experienced physician is placed at the head 
of lunatic hospitals, he would have the advantage of being 
acquainted with all common diseases. Now insanity in 
its causes, relations and treatment is most intimately con- 
nected with other diseases especially in its origin and 
primary stages. A thorough knowledge of these diseases 
can be obtained only by careful study and observation in 
the regular practice of medicine for years. There can be 
no question but that a physician with such an experience 
will treat the insane more successfully than oae always 
confined within the walls of a lunatic hospital, and who 
has but little knowledge or experience in respect to dis- 
eases outside. In the opinion of some persons, this is one 
of the secrets why the treatment in hospitals is not more 
successful, or the per cent, of cures is so small. 

Again, there are two elements or features in character 
which are far more likely to be developed in the general 
practice of medicine than in a small circle or in a hos- 
pital — that is humanity and a knowledge of human nature. 

It is unnecessary to show how important these two 
features of character are in such institutions, nor to dwell 
upon the fact that occasions frequently occur when it is 
very evident that these qualities in such positions are not 
80 manifest as they should be. 

It is not difficult to prove that these two elements of 
character are far more likely to be secured by mingling 
with all classes and conditions of people than it is possible 
by associating constantly with those whose minds are de- 
ranged, and whose bodies are diseased. It is thought by 
some that the cause or reason why we hear of so many 
abuses and complaints against attendants in hospitals, is 
that they have become hardened on account of the strange 
scenes, terrible tempers, and bad dispositions which they 
frequently witness and encounter among the insane. It 
is said that superintendents of lunatic hospitals are more 
likely to become insane than most other persons. This 
arises undoubtedly from a constant influence of abnormal 
characters and unpleasant surroundings upon the mind, 
and that these appeals are made almost entirely to one 



INSANITY IN ITS RELATIONS TO MEDICAL PROFESSION, ETC. 87 



class of faculties. The power and force of circumstances 
in the development of habits and character are not al- 
ways sufficiently considered. Again, another general de- 
fect in the present system is that it is often arrayed against 
improvements or reforms. There has been too much 
willingness on the part of its friends to jog along in the 
same rut, or beaten track, and to oppose or turn a deaf 
ear to outside suggestions of changes or improvements. 
The history of all reforms shows that they scarcely ever 
started within the circle or institution in which the evils 
existed. The history of lunacy reform is not an exception. 
Here and there an individual has broken away from the 
ring or from his connection with an institution, and devoted 
all his energies and talents to eradicate sundry evils and 
effect certain reforms, but the managers of hospitals gen- 
erally have been arrayed against any such changes. 

This opposition has been very marked in the United 
States and can be easily accounted for from the facts stated 
in this paper — how insanity as a disease has fallen into 
the hands of a few interested parties, and these have had 
the entire charge of hospitals. In closing this paper a 
few suggestions or inferences will naturally occur. 

SUGGESTIONS. 

In the first place, hospitals for the insane should be 
smaller than they are usually now built, and confined ex- 
clusively to the work of cure. When patients have passed 
into the chronic state of the disease or are considered in- 
curable, they should be provided for in different establish- 
ments where the best sanitary agencies can be most 
successfully applied. In hospitals connected and managed 
expressly for curative treatment, there would be we be- 
lieve more than 30 or 40 per cent, of the patients cured 
and not 60 or 70 per cent, become dependents for life. It 
is this feature in thepresent system, cAro?^^c insanity .,\\\2X 
makes the expense of supporting the insane so great and 
burdensome both to the state and to individuals. Besides, 
if this unfortunate class, the chronic insane, comprising 
now nine-tenths of the inmates of hospitals, could be more 
widely diffused — could have proper employment, greater 
liberty, more homelike surroundings, and a portion of 
them have the advantages of mingling freely with sane 
people — more of this class would be improved, and more 
too would be cured than now are. Again, let lunatic 



^ laMN^ffl^ \^S %lil'Aimi^ 'f b mft>lCkJl 'PEOt'E^SlOI^/BTe.i 



B^"^ari^e'ff 'dtt' \\m (Mi^r -hoatiltals. ' The supefisi.') 
rJfidlWC 'imijr^ 'B^^ffe* Ma ^i^^k^e and experience. '-'-Uw 
85<Wfi?%g^ih6¥iJifrpily'ac(iT^aiii^«d''>irith other dis^ises, es- 
fleiSfi^fe3ir#W%^¥iel'Votis s^y^t^'m, and nowhere can this 
fe^^eag^ bWe^tt^liifed'^0 Weil as'in the general practice^ 
drtr^ilMWfe -mif'Ut^'i5l^ceS"of* assistant physicians he 
mm!''SL%W SthSt-'Kol^ljitfay/'by cbm|3et5tive examinations. 
W^'^6W!a^WMi h^ye'-iti -thei^ positions men, not only of 
tWhiilfesVc*MSf^<Ql" tlfl^hts'/bUt those engaged from choice 
il^Vdumj itidlimrtilfi^mh Worlc. " Then there should 
b'ea'H6'ti!ftfl!^i'bbai-a'cdhit)09ed'of several ^ who 

8ll|)ViM''aU4iid%tf^tfy6'h^spi'^al' i*egM'^a^ or be so situated 
$ik^ ffi6"il-"^ferVil*4y '6an' bfe'dklleid'ih Whenever desired. - 
' '%-'A6*'otli^H' dis^a^^g 'ard counsel and advice more 
ni^ae^; *6^''^li^te 'tlhey tah'life teade so useful as in dis- 
qrders 6f the mind. Oonne*ct?ed' With this reform there are 
iHs^tJ^itiiet cohsidertttions: Sortie special means should be 
feyibyed to intdl^^st and educate the medical profession 
gyfferMIly upon insanity. - It should be introduced into all 
AiMiBdHchbbib k^'^ vbi-y important department of study 
^atiy^lui-y^l ^IV^^slibuld b«'fiiM-e"far more prominenfin 
the procyfedi^i^'^"PWi^"i^tori'<:}'*Wf^hd other medical asso^- 
ciations as well as in m^i,<?^|^^ and journals. Physi- 




S&'A'J^^^|if^gf iA4i's^tl'd'e?■V^^^^^ 

'^Tlie i-eii^4Vikl)iy^t^i^:juVt ,cl6§M a:t'Washington'»^^^ 
t^rmining i\?i #f oWahl'tiir^ 6f aH^;individUal, afetik^ 
sirildiig pr()o'fan'rifl^s^Mlti'n^ 

No stronger eyideHc*e^8oi/illiie''ad(iiiced of the gteat want* 
of correcl/ views geW^ral'ly'^'^'tlii^subj^ and how un- 
s^ttsfaxitor/an(l'coriM(ltilig'War^ 

IVen expeft wltn^ysfi.:''mW^S^eFlad'a{^d disWessin^g w^k 
Uie cir(^mka4iGe^"c^nne(^\^e(5f withthig (ia^^, it iilky teacih 
our p6ople''ohe¥hB^g, ;viz: More instructive lessons' on 
fes^itK ^li an cotn'^b^' obtained ih any oth^r^ayj' ^^'^'^l 
''Tiie fast ahd' WA^s the'ilio^ Important desideraiiittlSY 
a*Soo(inwcy*^7(mm ^61- twenty-five years such a' 

cpmmi"ssi9n'Kas'j^ro^ed'a'&^^^^^ agency in effecting* 

improvehi'en^s!in ili'e Ho^pi'tkls of Great Britain as well a§; 
in olher Muropeail cbTiiiMes."*Stich'^u^'erVision is greatly 
neede^'in atf o^l- Mk'"'Nl)"onahihg would do so mudh 
fjl'd A'}5jl'in''^^^&F"diie6ti§n ^Interests of this mi^ 



MICHIGAN STATE BOARD OP HEALTH. 89 

as a lunacy commission, 'properly organized and consti- 
tuted. 

While it is generally admitted that the lunatic hospitals 
of Great Britain are far in advance of ours in dispensing 
with tnechanical restraint, in allowing the insane greater 
liberties, in providing to a larger extent more and differ- 
ent kinds of employment, and in a better classification of 
patients, there are marked indications that improvements 
in our hospitals are beginning to take place. Much greater 
interest is manifested upon this subject than formerly. 

Important questions like the following are asked — Why 
should the insane increase so fast? Why should these 
hospitals be so rapidly filled, and always kept crowded? 
Why should the cures be only about one-half of what were 
once reported? In what way can the chronic insane be 
best supported? Can not something be done to reduce 
the magnitude of these evils or curtail the enormous ex- 
penses incurred for this unfortunate class? In the at- 
tempts to answer these inquiries, improvements must 
follow. Such reforms never go backward. Science and 
humanity are enlisted in their favor. They demand a 
more correct and thorough knowledge of insanity in the 
medical profession, as well as greater skill and humanity 
in the treatment of the insane. 



Michigan State Board of Health. 

Keported for the Cincinnati Medical News. 

The regular quarterly meeting ot this Board was held 
January 10, 1882, at its office in Lansing, the full Board 
being present. The Secretary presented his quarterly 
report, showing some of the work in the office during the 
past quarter. The quarter had been a very busy one, 
made so, in part, by the numerous outbreaks of diphtheria, 
scarlet-fever, and small-pox in the State, which had re- 
quired much correspondence and the sending out of many 
documents. The compilation and issuing of the weekly 
bulletin of health in the State is now so systematized 
as not to lake as much time as at first. It is published 
in probably two hundred newspapers in Michigan. In 
response to a request, fifty seven health officers of villages 
have begun to make weekly reports of diseases. The 
Board reaffirmed the demand for these reports from health 



90 MICHIGAN STATE BOARD OP HEALTH. 

officers of cities. To each place in the State where 
diphtheria, scarlet-fever, or small-pox was reported present, 
a letter was written to the health authorities giving full 
instructions and suggestions how to prevent the spread of 
the disease. Documents containing elaborate and partic- 
ular directions have been sent for free distribution 
throughout the vicinity. Each officer was requested to 
make a special report on the epidemic under his care, and 
some of the reports show how by determined action to 
stamp out a contagious disease. The number of com- 
munications written during the quarter was 1,459. The 
number of diphtheria documents distributed was 29,000 ; 
of scarlet-fever documents, 5,000; of general rules for 
restriction of contagious diseases, 6,000 ; reprints of 
weekly bulletins, 7,000. As showing the necessity for in- 
spection and disinfection of immigrants, their clothing, 
baggage, etc., and especially for a system of surveillance 
to their destinations, a statement was made by the Sec- 
retary, of the introduction of typhus-fever in Benzie County, 
by Norwegian immigrants. The disease made its appear- 
ance over sixty days after the arrival of the immigrants, 
and spread quite freely (not being reported at the time 
or treated as a contagious disease by the local authorities), 
causing many cases of illness, and at least, three deaths. 
The importance of inspection of immigrants at Port Huron 
and of keeping those believed to be liable to spread com- 
municable diseases under surveillance until their desti- 
nation is reached, and then placing them in the watchful 
care of the local board of health, was freely discussed. As 
this Board has no funds available for such a purpose, the 
subject was referred to the president, secretary, and Dr. 
Lyster, to confer with the National Board of Health, and 
take such action as is possible. 

A report by Hon. Le Roy Parker relative to duties of 
health officers in verifying diagnoses of contagious diseases 
was read and ordered printed in the Annual Keport. Mr. 
Parker reported the following: — In Gaines township, Gen- 

esseeOo., a child of Mr. B s died of what a doctor called 

malarial fever, and did not report the case to the Board 
of Health, though it seems probable that it was really 
diphtheria. A neighbor and wife, Mr. and Mrs. B., assisted 
in preparing the corpse for burial. About the same time 
a child of Mr. S. died from " sore throat," not reported as 
" dangerous to the public health," and some of the chil- 



MICHIGAN STATE BOARD OP HEALTH. 91 



dren of Mr. B. attended the funeral. Soon after Mrs. B. was 
taken sick with diphtheria, and in turn thirteen out of four- 
teen members of the family had it, and seven out of ten 
children died. The Board of Health promptly isolated 
this household, but the attending physician's error in 
diagnosis, or failure to report the first case, was fatal to 
the hopes of that family. In this connection the Board 
adopted the following preamble and resolutions : — 

Whereas^ It is often difficult to recognize mild cases, of 
diphtheria or to distinguish such cases from a simple 
pharyngitis or laryngitis, and, 

Whtreas^ Such mild cases of diphtheria often communi- 
cate a dangerous and fatal form of diphtheria, 

Resolved^ That it is the duty of physicians and house- 
holders in reporting diseases dangerous to the public 
health, and of local healtli authorities in their efforts to 
restrict such diseases, in every case to give the public 
safety the benefit of the doubt. 

Btsolved, That suspected cases of dangerous diseases 
should be reported, and precautionory measures should 
be taken. 

Drs. Kellogg and Avery were appointed a gpecial com- 
mittee to report on the present knowledge of diphtheria, 
and Dr. Lyster was appointed a special committee to re- 
port upon the present knowledge of typhoid fever. 

Mr. Parker reported that persons guilty of removing 
contagious disease placards from their houses could be 
punished under the law which made the house in which 
the contagious disease was, a hospital, if declared so by 
the Board of Health, and subject to their rules and regu- 
lations. All rules and regulations of a board must first be 
published, then penalties may be inflicted for any viola- 
tions. 

Dr. Avery, as special committee on the subject, made 
a report relative to the overflowed lands in Gratiot and 
Clinton Counties, and presented a resolution from the 
Board of Supervisors of Gratiot County. In accordance 
with the report the Board adopted a preamble and reso- 
lution as follows: — 

W7iereasi -f'^^ Board of Supervisors of Gratiot County 
has passed resolutions asking this State Board of Health 
to investigate the subject of the sickness caused by the 
overflow of Maple River, because of the dam at Maple 



92 MICHIGAN STATE BOARD OF HEALTH. 

Eapids, and "to advise the removal of said dam as being 
detrimental to the health of the communities living in the 
vicinity of said river," therefore, 

Resolved, That the Board of Supervisors of Gratiot 
County be informed that this Board has already had an 
investigation made, and from the report of such investiga- 
tion is convinced that the dam at Maple Rapids causes a 
nuisance and advises that, in case the owner of said dam 
will not remove the same and thus abate the nuisance 
caused by the overflowing of land along said river, a 
bill in equity should be filed against the owner of said dam 
to compel him to remove the same. 

The Secretary was directed to correspond with persons 
in some city in the western part of the State relative to 
holding a second Sanitary Convention this winter. One 
will be held at Ann Arbor, February 28 and March 1. 
These conventions are held in accordance with invitations 
received from citizens, and under arrangements made by 
a local committee acting with a committee of this Board. 

Dr. Hazlewood reported on the inspection of summer 
resort hotels as regards danger from fire, and asked if the 
present law providing for such inspection was not suffi- 
cient. Dr. Baker thought the law should be amended so as 
to take the inspection duties away from the political offi- 
cers and place them among the duties of Local Boards of 
Health. The question was referred to Mr. Parker, com- 
mittee on legislation in the interests of health. 

The Secretary presented a report of work of Local 
Boards of Health, showing much good work done during 
the past season in the restriction of contagious diseases. 
He read letters showing the action of Local Boards of 
Health with contagious diseases, one from J. R. Thomas, 
M. D., health officer of Bay City, relative to diphtheria ; 
one from W. G. Elliott, M. D., health officer of Pontiac, re- 
lative to scarlet-fever; and one from Foster Pratt, M. D., 
health officer of Kalamazoo, relative to small-pox. 

The Secretary also read a resume of work of other State 
Boards of Health, and it showed that typhoid fever was 
very widely prevalent, that small-pox was very prevalent 
in the Northern and Northwestern States, and that inter- 
mittent fever was present in Connecticut, Massachusetts 
and Rhode Island. 

The next regular quarterly meeting of the Board will 



RETROGRADE AND LATERAL MOVEMENTS WITH HYPNOTISM. 93 



be April 11, 1882. There will probably be a special 
meeting of the Board in connection with the Sanitary 
Convention at Ann Arbor, February 28, and March 1, 1882. 



^ 



ELECTIONS. 



Retrograde and Lateral Movements with Hypnotism. 



BY ISAAC OTT, M. D. 



When cold is applied to certain definite regions of the 
skin in pigeons, they exhibit retrograde movements alter- 
nating with tits of stupor. The agent, so far, has been 
rhigolene, to produce the necessary cold. Ether, when 
vaporized, was totally unable to produce any effect. The 
region to which the cold must be applied is the skin of 
tlie back of the neck. These phenomena were first ob- 
served by Dr. S. Weir Mitchell, I have lately been study- 
ing the effect of irritants on the skin of pigeons, and the 
seat of the phenomena produced. I found that ether, 
alcohol, chloroform and nitrite of arayl were powerless to 
produce the effects seen after the application of rhigolene. 
If, however, bisulphide of carbon was dropped on the skin 
of the back of the neck, then all the phenomena produced 
by rhigolene ensued in a marked manner. Thus a single 
drop of the bisulphide of carbon applied to the back of 
the neck of the pigeon caused him to retrograde and to 
pass into states of quietude. When bisulphide of carbon 
is applied to the skin of the neck in pigeons, the birds 
run forward as if no agent was acting on them, but sud- 
denly they commence to run backwards, it being quite 
evidently against their will, as they seek to overcome the 
tendency. During the period of quietude, the body sinks 
down somewhat, the head being drawn in close to the 
body and bent towards the ground to a considerable ex- 
tent. That these phenomena are due to a simple irrita- 
tion of the nerves, is proved by an experiment where I 
attached a small bull- dog forceps to the skin on the back 
of the neck, when similar retrograde movements ensued, 
followed by a i)eriod of quietude. As remarked by Dr. 
Mitchell, these phenomena are reflex in their nature. Here 
the mechanical irritation of the sensory nerves is reflected 



94 RETROGRADE AND LATERAL MOVEMENTS WITH HYPNOTISM. 



on the central nervous system, causing it to evolve the 
phenomena under consideration. To more accurately de- 
termine the seat of these phenomena, I have made some 
experiments: In a pigeon under ether, the skull was 
trephined and the cerebellum broken up. When the bird 
recovered from the operation, that is several hours after- 
wards, rhigolene was applied and the bird exhibited the 
same phenomena as an uninjured one. In another pigeon 
the skull was trephined and the cerebrum broken up; 
then, after a period of several hours, the bisulphide of 
carbon was dropped on the skin of the neck, when the 
pigeon began to make retrograde movements and to have 
periods of quietude. The bird did not run forward, which 
was due normally to cerebral action when the bisulphide 
was applied. Hence, the forward movement after the ap- 
plication of either rhigolene or bisulphide of carbon, was 
due to cerebral activity. These series of experiments 
seemed to demonstrate that the cervical reflex had its 
central origin at the base of the encephalon, for the cere- 
brum and cerebellum did not seem necessary for the pro- 
duction of the phenomena in question. Section of the 
semicircular canals had no effect on these phenomena, 
except to make them more complicated. 

Now, when the cerebrum is destroyed, the nervous sys- 
tem of the bird is a mere automaton, played upon by ap- 
propriate external agents. These agents, in the phe- 
nomena under consideration, are rhigolene, bisulphide of 
carbon and mechanical irritation. The inquiry now arises: 
how do you explain the phenomena in question? It is 
well known, since the time of Magendie. that in the corpora 
striata are seated ganglia, causing the animal to run back- 
ward. Not only does the bisulphide, when placed on both 
sides of the median line of the back part of the neck, cause 
the bird to run backward, but when it is placed to the 
right of the median line, the bird runs in a circle towards 
the left. A drop on the left of the median line causes the 
bird to run to the right. The rule here is, that the bird 
makes a circular movement opposite the irritated side. It 
has seemed to me that these phenomena of lateral move- 
ments in pigeons can be explained as follows : According 
to Chauveau, the sensory fibres do not decussate in pigeons, 
and if an irritation is made on one side of the median line 
the impression ascends on the same side, and calls the re- 
trogressive ganglia of that side only into activity, which 



RETROGRADE AND LATERAL MOVEMENTS WITH HYPNOTISM. 95 

activity is expressed on the opposite side of the body, due 
to the motor decussation. Now the retrogressive ganglia 
are in power over one side of the brain, whilst the other 
side of the brain, under the influence of the cerebrum, is 
disposed to move the opposite side of the body forward ; 
hence the bird can not go directly forward, but deviates 
to the side where the retrogressive ganglia have shown 
their activity — the bird moves' in a circle. The action 
might be compared to that of driving a horse forward, and 
at the same time strongly pulling one of the reins, the 
checking rein corresponding to the side of the brain under 
the influence of the retrogressive ganglia. If now the 
skin on both sides of the median line is irritated, then the 
retrogressive ganglia on both sides of the brain are domi- 
nant, and the bird moves backward, notwithstanding all 
efforts to prevent it. It might be compared to a horse 
pulled on his haunches by two strong check-reins. The 
periods of quietude, either preceding or following the ex- 
ternal application of bisulphide of carbon, are to be .ex- 
plained. It is well known by Kircher'S " experimentum 
mirabile," that chickens, when held down, pass into a 
state, called by Ozermak, hypnotic. In fact, Ozermak has 
been able to produce a hypnotic state in pigeons and 
other birds. He found if he held the pigeon on its back 
and rubbed him softly in the parotid region, that the 
pigeon closed and opened his eyes, made strong respiratory 
movements and passed into a state of perfect quietude, 
called by him hypnotic. In my experiments on pigeons, 
the state of quietude is actually hypnotic, as the bird ex- 
hibits similar phenomena, opens and closes his eyes, 
breathes heavily, and remains perfectly quiet. It strikes 
me that this hypnotic state can be explained by sensory 
irritation, produced by the bisulphide of carbon calling 
ganglia at the base of the brain into activity, which ganglia 
have an inhibitory power. That sensory irritation may 
come into play is shown by Levissons' experiment with 
the frog, where simply tying his anterior extremities and 
placing him on his back keeps him in a state of quietude. 
Tlie rapid breathing also indicates a strong sensory irrita- 
tion. In my experiments, the temporary irritation ex- 
plains the temporary hypnotism. With this method of 
viewing matters,the phenomena of hypnotism have nothing 
to do with the cerebrum, but are caused by ganglia at the 
base of the brain inhibiting the will. 



9& ABDSE OF THE VAGINAL SPECULUM. 

In cats and rabbits the application of bisulphide of 
carbon to the skin on the back of the neck, causes them 
to run forward and to leap up in the air. I have not been 
able in animals, so far, to produce movements similar to 
those seen in pigeons, but hope shortly to find some ani- 
mal in which they can be produced. This whole subject 
is important, not only to the physiologist, but also to the 
pathologist. 

Abuse of the Vaginal Speculum. 

A FEW days ago a gentleman in a highly respectable 
position in society in the north of England, called on me 
tor advice in the following peculiarly painful circum- 
stances. He averred that through the use, or rather the 
abuse, of the vaginal speculum he had lost, as he feared 
forever, the aifection of his wife, who is, I may say, an 
amiable and accomplished lady. His case interested me 
so much, that I asked his permission to publish it in the 
Lancet [from which we extract.] This he at once agreed 
to ; not only so, but he wrote out a history of it himself, so 
that I shall for the most part allow him to tell his own 
story. 

No instrument is of more importance to a medical prac- 
titioner, than the vaginal speculum; still the facts nar- 
rated below must impress us with a grave sense of the 
responsibility which at all times rests upon us in the use 
of the instrument; and how, without any intention on our 
part, the peace, the happiness of a household, may be 
broken up forever. But let the chief, not the only, 
" victim " speak : — 

"I was married to a charming woman. Our happiness 
continued fifteen years. She became the mother of a 
family. Then some little ailment set in, which was de- 
scribed to me as a simple case of ulceration. The os uteri 
was touched with nitrate of silver very frequently during 
a period of three monlhs, and then she was pronounced 
completely cured. For that three months I was strictly 
abstinent. She became warmly attached to her doctor, 
saying he had saved her lile, though he generously enough 
admitted that it was only a common case, and that her 
life never was in danger. Then, as time wore on, there 
were more ulcerations, more examinations, and all the 
rest of it; accompanied by periods of abstention on my 



ABUSE OF THE VAGINAL SPECULUM. 97 

_ • 

part, one of them lasting about nine months. During the 
period of this treatment I, in some unli^nown way, lost my 
wife's love. She seemed never happy unless when from 
home and seeking after advice, which she had from half a 
dozen doctors. I put my foot down at length on one of 
her proposed arrangements, and then for several years 
there was a vacuum, which was ultimately filled by an- 
other, and non-medical, influence, that induced her to leave 
my roof, and resolve on final and permanent separation. 
Thus the Bocial ruin of a large family — of daughters and 
sons — seems due to the use of the speculum, and the es- 
trangement caused by the injunctions of *■ ladies ' doctors, 
which, I am told, they never impose upon themselves." 

Such is my patient's narrative. To all appearance the 
lady is in the best of health, though, professionally, I have 
not seen her. What is my patient to do ? For the sake 
of his family he is very unwilling to expose them in a 
law-court. He had tried to win back his own and her 
love and affection. He ascribes the origin of all his 
trouble, rightly or wrongly, to the speculum and absten- 
tions. We know from experience that when the use of it, 
or the catheter, is continued for some time to nervous, 
hysterical ladies a morbid carving for its continued use is 
created ; and therefore we can not be too discreet in the use 
of these instruments. 

My friend concludes his letter with some practical ad- 
vice, under four heads, which are indicative of the points 
on which he makes complaint. To the credit of the pro- 
fession, I think I may say, the great majority of medical 
men already act up to them : — 

"The instrument may, or may not, be useful, for aught 
I know; but I maintain: (1) That when it is employed 
another lady ought to be in the room; (2) that its employ- 
ment ought not to be continued against the doctor's own 
opinion merely to gratify a craving, or solicitude, for ex- 
aminations, which its use has seemed to me to create on 
an apprehensive, highly-strung woman; (3) that doctors 
are not at liberty to augment their influence by creating 
the fear of insanity in such natures by expositions of a 
near connection between uterine ulceration and the nerv- 
ous system ; and (4) that when a husband's abstinence 
is imposed its extent should be stated direct to himself, 
and not merely transmitted through the wife." 

These suggestions, especially the first and fourth, will, 



98 SPONGE GRAFTING. 



I think, commend themselves to every member of the pro- 
fession. By attention to them we avoid even the " ap- 
pearance of evih" 

Perhaps some of your numerous readers would give 
their advice in reference to the above case in its moral 
and social, as well as its professional, aspects; and espec- 
ially as to right professionl practice in cases where the 
speculum is used and abstience imposed, with the risk, it 
would seem, of destroying conjugal affection. 

Yours truly, M. D. 

— Boston Medical and Surgical Journal. 



"Sponge Grafting." 



BY H. H. A. BEACH, M. D. 



Surgeons have long recognized the difficulty in remov- 
ing sponges, unprotected by a fold of cloth, from raw sur- 
faces to which they have been applied some hours before, 
as compressors to check haemorrhages. Granulations 
shoot into the interstices with great rapidity and their 
rupture is necessary before the sponge can be separated 
from the fresh surface. / 

Dr. D. J. Hamilton* has made a careful study of the 
condition of the sponge, and wound under these circum- 
stances, and, with the aid of microscopical observations, 
determined that the sponge becomes vascularized, as in 
the case of a clot, and may become the medium for the 
construction of new material in the healing of wounds 
and ulcers. The paper is one of exceptional interest and 
is deserving of careful consideration and verification. He 
concludes with the following suggestions : — 

"Having once recognized the principle that a porous 
body may become vascularized, and be the medium for 
the construction of new tissue, the application of the 
method to various purposes naturally suggests itself. In 
applying any porous body with a view to this organization, 
certain points must always be kept in mind. The porosity 
of the body must be such that all the canals freely com- 
municate. Sponge is exquisitely suited for the purpose 
on account of the free anastomosis between its channels. 



*Ediaburgh Medical Journal, November, 1881. 



SPONGE GRAFTING. 99 



but many other substances might be utilized in the'same 
way. I have of late thought that charcoal or calcined 
bone might be employed in certain cases. For one pur- 
pose at least such a solid framework might be useful. 
Where it is desired to prevent contraction of the newly 
formed tissue where it cicatrizes, where it is of moment to 
retain the newly formed tissue of its original bulk, then 
a solid framework must be employed. A solid framework 
will, I feel sure, organize just as a sponge would, and will 
have the special quality of preventing cicatricial shrivel- 
ing. When once incorporated with the tissue, it will not 
cause any more irritation than the calcareous matter of a 
bone does. A dead body of this kind is not of itself an 
irritant. It is the injurious application of it, or the septic 
matter which it may introduce, which gives rise to the 
mischief. 

" Such a solid framework, it strikes me, would be par- 
ticularly useful for forming new bone. One of the great 
dangers of a simple periosteal detachment operation is 
that the future bone is not sufficiently bulky and strong. 
By supplying a solid framework of this kind we would 
avoid this, and the formation of bone would proceed within 
it just as well as in the spaces of cartilage or the meshes 
of a fibrous tissue. Bone is nothing more than a fibrous 
tissue, modified by being impregnated by calcareous and 
other salts. The particular elements which go to form 
bone are nothing more than connective tissue corpuscles, 
and by supplying a framework of the above nature for 
these to ramify within, bone might be grown to an almost 
unlimited extent. The spongy framework, I should think, 
although I have not as yet had any practical experience 
in the matter, would be rather too yielding, and would 
be liable, when infiltrated with bone elements, to con- 
tract. Whether the formation of bone. would commence 
early enough to prevent this I do not know. It is quite 
possible that it might. 

"Wherever it is applied, it must be always remembered 
that the sponge or other framework must be employed 
merely for the purpose of filling a vacuity, otherwise it 
will cause great inflammation, and the efforts at organ- 
ization will not proceed. My experiments so far have 
shown me that, if thrust between two portions of a muscle, 
for instance, without a portion of the muscle being ex- 
cised, organization does not proceed nearly so equally as 



100 PAPAYA AND PAPAIN. 



when a piece of tissue is removed and the sponge merely 
takes its place. The reason is obvious. If thrust between 
the muscles of a part it will, especially when it gets soft- 
ened by the juices of the tissues, tend to swell, and, by 
pressing on neighboring blood-vessels, will interrupt the 
circulation within them and so induce an inflammation. 
Where it merely fills a vacuity, however, the case is very 
different, and organization will then follow. Before being 
applied it should always be rendered antiseptic, and, of 
course, this specially holds good of its application to a 
fresh wound. 

"Every one will admit that nothing is more conducive 
to putridity in a wound than a septic sponge, while, if 
applied in an aseptic, or rather antiseptic, condition, and 
dressed with the view of retaining it so, it can be kept, 
as shown in one ol my recorded experiments, perfectly 
free of putrefaction through a period of several months. 

" So far as I see at present the method of • sponge-graft- 
ing' seems excellently suited for growing new tissue where 
that is insufficient to cover a part or to allow of stretching, 
but whether it may not have a wider range of application 
remains for future experience to demonstrate. The only 
objection which I perceive to its application is the some- 
what long time required to organize it. During the first 
ten days I found that a part of a sponge placed in the 
abdomen, had organized from an eighth to a quarter of an 
inch, but it always happens that one part organizes 
quicker than another, and hence, although in a large 
wound one part may thoroughly organize in, say, a month, 
other parts of the same sponge require longer, I can not 
see, however, what objection there would be to the patient 
going about, if this were practicable, after the sponge had 
once become fixed. On the contrary, I should think that 
this might actually, in certain cases, exert a beneficial in- 
fluence upon the organizing powers of the tissues." 



Papaya and Papain. 

Translated from Berliner Klinische Wochenschrift, August, 1881. 
BY SAMUEL BRANDEIS, M. D. 



In one of the sessions of the Academy of Sciences at 
Paris, France, in August last, Mr, Buchut made some com- 



PAPAYA AND PAPAIN. 101 



munications regarding the sap of a plant growing in Bras- 
ilia, whose botanical name is Carica Papaya, which, ac- 
cording to investigations made by him, with the assistance 
of Professor Wurtz, possesses distinct digestive and pep- 
tonifacient properties. The sap, which is obtained by 
incisions made into the bark of the plant, and still more so 
the essential principle prepared from the same, which has 
been named Papain, if for a certain time left in contact 
with albuminates, raw meat, fibrin, glue, milk, etc., will 
enter upon combinations which present all the character- 
istics of assimilable Peptone. Croupous membranes, as- 
carides, tape-worms, were changed in a similar manner, 
even outside the body. 

The statements made at that time, Buchut recently 
revised and enlarged, reporting experiments, which show 
that this vegetable pepsin exercises its digestive power 
even upon living tissues. One gramme of a ten percentic 
solution of papain, or one gramme of a solution of the sap, 
in the proportion of 1,5, injected into the brain of an ani- 
mal, with a Pravaz syringe, proved to have effected a 
complete peptonic change in the tissue, twenty-four hours 
after the operation. Upon living muscular tissue the 
same material injected, acted in such a manner that, 
twenty-four hours after, a soft, pulpous and gelatinous 
substance is found in the injected locality. Further in- 
jections, of the same kind, were made upon the cervical 
glands. After three days, which were characterized by 
great pain and high fever, the injected glands were found 
to be softened and turned into abscesses, which could be 
lanced and emptied of their contents. 

In one case of cancer of the breast, and' in another, of 
scirrhus of the inguinal glands, in the clinic of Professor 
Pean, in tiie Hospital St. Louis, softening and disintegra- 
tion of the diseased parts was induced by treatment with 
Papain. Some of the fluid contained in the softened 
growth was afterwards subjected to chemical analysis, in 
the chemical laboratory of the medical faculty, by Pro- 
fessor Henning, and proved to be pure peptone with all 
its characteristics. According to one of the investigations, 
47 grammes of the fluid contain 2.91 grammes of albumen, 
which again contained 0.5G5 of peptone after being dried 
at a temperature of 110°. The same result was reached 
by other investigations, and confirmed by all chemical 



102 MILK-SICKNESS. 



tests. All the cases like those formerly mentioned were 
accompanied by great pain and high and violent fever. 

In conclusion, Buchut reports an experiment on a living 
frog. The animal was partially stripped of its integuments 
and then completely dipped in a papain solution. After 
twelve hours, the animal was dead ; after twenty-four 
hours partially digested, and after two days nothing but 
the skeleton was left. 

Vegetable pepsin, consequently, digests living tissue as 
well as it digests and destroys dead material, outside of 
the body. 

Remarks. — The great question now arising is, whether 
this powerful digestive drug will not extend its digestive 
force over the tissues of the stomach, into which it is in- 
troduced for curative purposes, and therefore be destruc- 
tive in its modus operandi. If such is the case, papain 
would have to be expunged from our medicinal arraent- 
arium. Further experiments must decide this before it 
may be advisable to introduce it into therapeutics. 



Milk-Sickness. 

From Louisville Medical News. 



BY JOHN M. JACKSON, M. D.* 



In compliance with the request of the president of this 
association, at our last meeting in the city of Paducah, I 
have prepared andlnow present to you this essay upon the 
disease, so well known in this country as milk-sickness. As 
the disease is confined to limited parts of the Union^viz. 
Alabama, Indiana, and Kentucky — medical literature is 
almost silent in reference to it. My remarks must be 
chiefly confined to my own personal observations. 

My first intercourse with the malady began in 1852, since 
which time I have met with it more or less frequently at 
some period of almost every year. This disease is strictly 
endemic in its nature, confining itself to very small and 
restricted localities, sometimes to a space of country of 
not more than a very few square miles. Within a radius 
of only two or three? square miles, it has been found on 



•*Kead before the Southwestern Kentucky Medical Society, in the 
city ©f Columbus, Ky., Wednesday, November 9, 1881. 



MILK-SICKNESS. 103 



Mayfield's Creek, Graves County, Ky., and also in like 
manner in the neighborhood of Wesley in this (Hickman) 
county. Its territory of invasion, in this vicinity, begins 
a short distance below the city of Hickman, and extends 
up the Mississippi River to a point within two miles of 
this city, reaching out about five miles from the river. Its 
chief locality is upon the land known as the Baker tract, 
about five miles southeast of this place, at which it is 
known that at certain seasons of the year a cow can not 
run at large for a period of twenty-four hours without 
being affected with the disease. 

The disease first originates in the quadruped, most gen- 
erally the cow, and from her meat, milk, or butter it is 
conveyed into the human system. I know of no instance 
in which it has been otherwise communicated. Birds, 
such as vultures and wild turkeys, contract the malady 
by eating the flesh of animals that have died from it. My 
two first cases of milk-sickness evidently originated from 
the eating of a piece of wild turkey, as the cases were 
both of easy diagnosis, neither beef, butter, nor milk hav- 
ing been eaten or drunk, and the only meat eaten by the 
patients was that of the wild turkey ; and after the facts 
had been investigated, the party killing the turkey re- 
membered it was unusually gentle and tame, showing it 
was probably sick when killed. 

In dwelling upon this subject, it will not be amiss to 
make a few remarks in reference to its symptoms in the 
quadruped, as an acquaintance with the symptoms of the 
disease in the lower animals might enable us often to 
avoid contracting it in man. 

Cows giving milk do not manifest strong and decided 
symptoms, as the milk being a potent eliminant carries 
off the poison, and imparts the disease to her calf and the 
persons who use her milk. The cow affected with this 
disease is very docile and sluggish, showing no disposition 
to move or to take exercise; generally takes her position 
on the sunny side of a house, fence, or tree, leaning against 
the same, apparently asleep. In this condition, if forced 
to take active exercise by being actively driven a few 
hundred yards, her condition becomes at once unmistak- 
ably apparent. Her eyes become glassy and watery, and 
her whole muscular and nervous systems are thrown into 
a violent state of agitation. If then she is forced to move 
ofi" rapidly, after resting a few moments ^she trembles, 



104 MILK-SICKNESS. 



shudders, and falls to the ground, and frequently rises no 
more. 

When these symptoms, even in a slight degree, are 
found in the cow, we can not be too careful in rejecting 
her meat, milk, or butter, or letting her to her calf. 

As to the manner in which this disease is contracted 
by the quadruped, it remains, and 1 fear will ever remain, 
a conjecture and a matter of speculation. Some contend 
the poison is in the water, others in a vegetable, and others 
that the disease originates from some poisonous gases 
emanating from the earth in the localities in which the 
disease abounds. I am inclined to the opinion that the 
poison, whatever it may be, is of the acro-narcotic class, 
and that it exists in the seeds of some vegetables, or a 
'priori it may be from a gas produced from the ground un- 
der certain thermal conditions of the earth not under- 
stood. If from water, it would exist as well at one season 
of the year as another; if from the green stalks or leaves 
of a vegetable, the disease would prevail in the spring 
time, but we rarely find the disease exist before the first 
of August nor after the first of November; but this rule 
has some exceptions. My friend Dr. A. J. Watson, of this 
city, met with a case during one of the coldest months of 
last winter ; but this is by no means the rule. 

My reason for believing: that the malady is produced 
from the seeds of a vegetable is that the disease manifests 
itself just at that season when seeds have matured. But 
whatever the cause may be, we know of but one means 
of avoiding it, and that is to ascertain its area of ground 
and fence in the same. 

In the human subject this disease at its commencement 
is marked by the usual symptoms of a chill, followed by 
imperfect reaction, the chill often lasting four to six hours. 
The febrile movement following the chill is of a very low 
grade, temperature only a few degrees above normal. The 
pulse is rapid, often running as high as J 30, very short 
and compressible. There is a peculiarly anxious and de- 
pressed expression in the face, and from the beginning a 
sense of nausea attended with a constant load and weight 
in the epigastrium. This latter symptom has been con- 
stant in every case I have met. The patient will tell you 
that he is certain that a hard, round, and hot ball has 
formed in his stomach, and begs you to extract it by some 
means. 



MILK-SICKNESS. 105 



Constipation is an obstinate symptom in this disease 
from the beginning to the end. The patient calls for ice- 
water; seems to be inclined to sleep, but at the same time 
is conscious of everything said and done by any one in 
his room. There is constant nervous retching in every 
case, attended by great and ungovernable agitation of the 
muscular system. If a cup of tea or a spoonful of soup is 
offered the patient, such is his muscular convulsions that 
he can not hold it in his hand. 

Anorexia is a never-failing trouble here, the patient ab- 
staining from food for many days till convalescence is es- 
tablished. The skin in the extremities is generally cool 
and covered with a clammy perspiration. The hepatic 
and renal secretions suffer materially in this disease. The 
stools are light and clay-colored, while the urine is very 
scanty and in some cases suspended altogether for twenty- 
four hours. The breathing is generally slow and stertorous; 
the pupils are contracted. Pain in the region of the o& 
frontis, often also in the locality of the medulla oblongata, 
attended with vertigo, are frequent symptoms. Stiffness 
and immobility of the joints are often complained of. | 
have never seen a case without them. 

With all these symptoms, which are so strongly marked 
and uniform in every case, no physician can fail to make 
a clear and satisfactory diagnosis. 

I stated before that I believed the disease was the re- 
sult of the action of some acronarcotic poison, and will 
now state that this poison makes its pathological im- 
pression on both the cerebro-spinal axis and the ganglia 
or great sympathetic nervous system, and especially the 
latter, as we find all the functions of the various important 
organs suspended, and some totally arrested. 

Taking such pathological views, 1 proceed as follows in 
my treatment: When called to a case in its incipiency, if 
the contents of the stomach have not already been ejected, 
my fiist effert is to empty the stomach by a potent and 
prompt emetic. This I usually do with pulvis ipecacuanha 
or tinct. lobelia. To allay pain in the epigastrium 1 give 
large and prompt doses of belladonna, either in the form 
of the tincture or fluid extract; at the same time I do not 
forget to apply a blister over the region of the stomach. 
This latter remedy I conceive to be of great importance, 
and from it have found marked relief. Hot fomentations 
over the bowels and stimulating cataplasms to all the ex- 



106 CLINICAL LECTURES. 



tremities rarely fail to give more or less relief. Mercury, 
either in the form of the hydrarg. chloridum mite or pil. 
hydrarg., combined with five-grain doses of subnitrate 
bismuth, are strongly indicated; and, so far as the mer- 
cury is concerned, I do not think it can be dispensed with. 
In mild doses it allays the gastric irritation, and at the 
same time does what no other known remedy can do — acts 
powerfully on the dormant liver,arouses it from its lethargy, 
and restores it to its normal functions. Quinine in small 
doses, combined with carbonate of ammonia, is generally 
beneficial to equalize the circulation and promote the nor- 
mal action of the heart and arteries. 

But there is one remedy, which I have not yet mentioned, 
from which I have derived more decided relief in this dis- 
ease than all others combined, and that is strychnia. This 
drug, in doses of from one-sixtieth to one-fortieth of a 
grain, or tinct. nux vomica in doses of from seven to ten 
drops, repeated every three or four hours, seldom if ever 
tails to give marked relief, and should be given Irom the 
beginning to the close of the disease. 
^ The prognosis of milk-sickness is generally favorable. 
It is an obstinate and tenacious disease; but, if carefully 
nursed and properly treated, seldom proves fatal. — Golum- 
hus, Ky. 



Clinical Lectures. 



ACUTE PSORIASIS. 

Gentlemen : — The case I now present to you has been 
at this clinic on two previous occasions : on the 17th of 
December, a few days after his admission to the hospital, 
and since then, quite recently, he was before you again. 
You recall his history; when he first came in he was suf- 
fering with a skin affection of only a few days' duration. 
The rash had first appeared on the hands and arms ; it was 
very red, and itching ; there were also marks made by 
scratching with the finger nails, I told you then, that 
the affection was in an acute condition, and although 
the diagnosis was psoriasis, yet the remedies usually 
directed to the treatment of psoriasis in its chronic 
stage — arsenic, for instance — at that period would be in- 
admissible. He was, in view of its recent appearance, or- 
dered alkaline baths, and placed upon a plain, unstiraula- 



CLINICAL LECTURES. 



107 



ting diet, witli proper attention to the secretions ; and as 
a result the red, inflamed appearance of the arms, and 
afterward of the legs and the back, rapidly faded away. 
Then the disease assumed the chronic form, and about the 
first of the year, or four weeks after the commencement 
of the disease, he was given the special treatment by ar- 
senic (sodium arseniate gr -^V every four hours), and since 
then the improvement has been lar more rapid and de- 
cided than it was before. 

I present him to-day cured, and ready to leave the hos- 
pital. He says that he now feels well, and only experi- 
ences a little irritation, occasionally, of the skin, which 
otherwise is healthy. I show you the rapid result of 
treatment in a case of acute psoriasis of recent develop- 
ment; the cure was less prolonged than in the usual 
chronic form of the disease, when the skin changes have 
advanced to a greater degree. 

FACIAL ERYSIPELAS I ALBUMINURIA. 

Our next patient has been in the house only three days, 
suffering with facial erysipelas. At the time of admission 
he had been away from this hospital only six days; hav- 
ing been here since the 12th of December, under treat- 
ment for an attack of acute bronchitis, of which he was 
cured. He left on the 15th of this month, and was well 
only tliree days. At this time (three days before his re- 
turn) he had a chill, which he thought was due to cold, 
but it was followed by fever and free perspiration. That 
night he had a burning, stinging sensation in the right 
cheek, and on the nose; the (ollowing day he noted that 
the parts were swollen and slightly red ; since then the 
discoloration and swelling have increased quite rapidly, 
spreading over the u]Dper half of the face and the right side 
of the neck and the ear. Owing to the zinc ointment 
that has been placed upon it, the redness of the skin now 
is not very apparent, except upon close inspeciion, but 
the swelling can be appreciated by all of you. The ear is 
much swollen, and this right eye he is unable to open, 
partly on account of the eyelashes adhering together by 
the secretions, but principally owing to the swelling of 
the lower lid. At the lower border of the rash, especially 
upon the nose, there have been some small vesicles or 
blebs; these are now dried up, forming a crust upon the 
cheek and side of the nose. 



1*^8 CLINICAL LECTURES. 



With regard to the temperature, we observe that upon 
admission the thermometer recorded 103° in the axilla ; 
his pulse was 100 ; respirations 24 in the minute. His 
tongue was coated. Fain and restlessness entirely pre- 
vented sleep during the first night after entering the ward. 
As in all these cases, the urine was. carefully examined. 
Its condition on the day of admission was as follows: spe- 
cific gravity 1.012, acid, light colored, and contained a 
trace of albumen ; no casts could be found. This condi- 
tion of the urine, as was pointed out by Dr. DaOosta some 
years ago, as you know, is always to be found in facial 
erysipelas, even in cases of moderate severity ; at some 
period of the disease, usually at its height, the albumen 
may exist in very considerable amount, and casts may 
also be present. 

In regard to the treatment, he was placed upon tincture 
of the chloride of iron, twenty drops every three hours ; 
and as he was very weak, his strength having been re- 
duced by the previous attack of bronchitis, he was given 
quinine (gr. x daily) in addition. He had plain, nourish- 
ing food, but no stimulants. 

His temperature record is interesting. It was noted, 
upon admission, that his temperature was 103°, pulse 100, 
respirations 24. On the day succeeding his reception the 
inflammation was spreading over the right side of his face, 
the ear, and around to the back of the neck ; with this 
a temperature rise to 104f ° occurs, the pulse, however, is 
not modified, or only very little, being 120 at night. Then 
we have a subsidence of the inflammation, and with it a 
very marked fall of temperature to 101°,with pulse and res- 
piration remaining about the same. Next occurred an ex- 
tension to the other side of the face, swelling of the eyelids, 
closing the eye, etc., but it was only moderate, and was 
not so great as on the opposite side, but the temperature 
advanced to 103°. Now the inflammation is everywhere 
subsiding ; his general condition has improved ; the red- 
ness of the more recent parts is greater than that of the 
ones first involved; the temperature this morning is only 
101°. The man, in reply to an inquiry, says he feels « sick 
enough," but the pain is rather better than it has been ; 
he rested well last night. I can hardly imagine anything 
which makes one feel more miserable than an attack of 
facial erysipelas. If you only cover your face with a mask 
or handkerchief for a short time, you notice that it be- 



CLINICAL LECTURES. 109 



comes annoying, and takes away your feeling of respect 
and comfort to a very great degree ; add to this the dis- 
tress of the disease, and the application of ointment to 
the face, and you will find it taking away physical com- 
fort, often more than other and graver disorders. 

The tongue is still coated, but is less dry than yester- 
day, and is much cleaner than when he came here. The 
tincture of iron will be continued, and also the quinine, 
with the benzoated zinc ointment to the lace. 

The urine will be again examined, in order to keep the 
record of the albuminuria, and also to see whether casts 
make their appearance. , 

ACUTE RHEUMATISM. 

The next case I bring before you is one of acute rheu- 
matism, in a man who works as an oyster dealer. He is 
thirty-five years of age, and has always been in good 
health, except having the ordinary diseases of childhood. 
We learn that about twelve days ago, after being exposed 
to cold and wet, he had a chill, and the following day no- 
ticed that the joints of both the upper and lower extrem- 
ities felt very stiff; and two days later the knees, shoul- 
ders, arms and hands began to be painful, and were more 
or less swollen ; especially was this noticed in the hands. 

He says that this came on during the night, and on the 
following morning he found it almost impossible to move 
the limbs, on account of pain. 

On admission, two days ago, he was very much in the 
condition I have just described. The pain was probably 
more marked in the knees than elsewhere, but the swell- 
ing was more evident in the wrists. His temperature was 
101°, pulse 72, respirations 24; tongue coated; bowels 
regular; appetite lost or nearly so. It was impossible for 
him to rest at night, and he complained that he had not 
been able to sleep for ten days previous to admission. 
Let us examine into the present condition. This tremor 
of the hands, he tells us, has always existed, or at least 
since childhood. The wrist joints are very much swollen, 
not very red; he can move them now without causing 
great pain ; the arm allows of passive motion at the elbow 
without much suffering. There has been no swelling in 
the shoulders. However, swelling in the shoulder is diffi- 
cult to detect in comparison with the other joints, on ac- 
count of the muscles that surround it. There has been 



110 CLINICAL LECTURES. 



in this man more swelling in the arms than in the lower 
extremities. Examining the knee-joints I can find no 
evidence of fluid; the patella is firmly down upon the 
condyles. Tliere is a good deal of stiflfness in the muscles 
of the legs. On admission he was sweating profusely, and 
the skin is even now quite moist. 

He was ordered to take salicylic acid (gr. x every two 
hours, until a drachm had been taken each day). Notice 
the temperature record, it has now dropped down rather 
suddenly to sub-normal (98°). The pulse has not been 
very high, ranging from 80 to 85. At llie time of admis- 
sion there was found a faint mitral systolic murmur at the 
apex, which I can not now detect; the first sound is nor- 
mal. 

Here we have the usual history of acute rheumatism. 
Notice that he complained at first of general feeling of 
weight and stiffness in the muscles. This, I think, is more 
general in its occurrence than your studies may have led 
you to infer. The pain is usually spoken of as being ar- 
ticular, although some of the authorities tell us that it 
may commence in the muscles and subsequently settle in 
the joints. I have observed, however, that even after the 
joints are invaded there is a good deal of pain in the mus- 
cles, but the severity of the joint pain causes the muscular 
trouble to be ignored by the patient, who thus has his at- 
tention called away from the less to the greater. Muscular 
soreness is, as a rule, called forth only in attempts at motion, 
while the joint pain is active and spontaneous. During 
the continuance of the joint inflammation the muscles are 
obliged to be kept at rest, and give no symptoms, but when 
the patient is getting better he moves about more and again 
becomes conscious of the muscular pain. The books state 
that the muscular pains return as the joint pains get better. 
The statement is quite correct, though not in this form ; it 
is simply the fact that as the joint pains subside, the mus- 
cular pain again comes into notice. When we speak of 
acute rheumatism as an articular inflammation we are evi- 
dently only getting part of the truth ; the muscles are as 
much invaded as the joints. I am clearly of the opinion 
that the muscular disorder persists throughout the dis- 
ease. 

A heart murmur is quite common in rheumatism, as 
you know, owing to rheumatic endocardial or pericardial 
inflammation. We have, therefore, examined this case 



CLINICAL LECTURES. Ill 



carefully, in order to anticipate such complication. A 
heart murmur was found, as I have said, but it was very 
faint, and not accompanied by much, if any, disturbance 
of the heart's action; and, as it was not persistent, we 
conclude that it was functional, and doubt if there has 
been any real change in the mitral valve. The patient is 
very pale and his appearance indicates a considerable 
degree of anaemia; and, as you know, in such cases we 
often have a murmur produced by the condition of the 
blood, and not due to disease of the valves; i. e., functional 
and not organic. If there has been any endocardial in- 
flammation here, it was only to a very slight degree, and 
the valves have not been permanently injured. 

I wish to direct your attention to the prompt action of 
salicylic acid in reducing the temperature. It has fallen 
to normal, as you see, on the second day after admission. 
This is important, not only for its effect upon the pains 
and general condition, but particularly for its influence 
upon the heart; the reduction of the temperature is ac- 
companied by slowing of the circulation and the rate of 
the heart's action. As the result the valves are much less 
likely to be damaged, the force and frequency of the car- 
diac contraction being thus greatly modified. When the 
heart is stimulated by the fever, and the valves are beat- 
ing and rubbing together, one hundred and twenty to one 
hundred and thirty times a minute, you can see how read- 
ily change and deformity can occur; by reducing the 
number of beats we are, therefore, placing the heart in 
better condition for recovery. The salicylic acid, as I told 
you, has exerted a most salutary effect in this case. How 
long shall it be continued? The temperature this morn- 
ing is subnormal; if the temperature this evening is sub- 
febrile or normal, we shall reduce the dose to ten grains 
three times a day for the next few days; if the fever then 
does not return, we will suspend the acid and give some 
tonic. It is a mistake to stop the salicylic acid too soon. If 
it is stopped as soon as amelioration appears, a relapse often 
occurs. You know that these cases, owing to the re- 
stricted diet, rest in bed, and general care, rapidly improve, 
after entering the hospital, during the first day or two. 
This appearance is often deceptive; that it is really due 
to the hospital treatment rather than to medication is 
shown by the subsequent progress of the disease. We, 
therefore, do not conclude that after the few doses of 



112 CLINICAL LECTURES. 



salicylic acid the patient is at once entering upon recov- 
ery, and has no further need of the remedy, but we should 
continue the treatment until convalescence is assured. I 
need not discuss the treatment, as you know in salicylic 
acid we have a remedy which meets the indications better 
than any other, in the majority of cases of acute rheuma- 
tism. 

CATARRHAL JAUNDICE. 

The next patient is one whose color will speak for itself. 
He is an Italian boy, who speaks almost no English, 15 
years of age, and is a bootblack by profession. He says 
that he has always been healthy, except that about two 
years ago he suffered, during several months, with chills 
and fever in Italy, from which he fully recovered. He 
has been in this country about a year, during which his 
habits of life have caused him to be very much exposed to 
cold and bad weather, though, up to a month ago, he gives 
no history of illness. Then, he says, he had a chill, fol- 
lowed by some fever, of about twelve hours' duration, 
which he thought was a return of the old malarial attack; 
he subsequently had no further inconvenience in the in- 
terval, and persists in sajang that he was well, and that 
he is well now. Later he noticed yellowness of the con- 
junctivae — you see how yellow they are even now — and 
his face and body have also assumed this tint. He had 
no headache, nausea, or vomiting. The bowels continued 
regular, but the color of the discharges was unknown. 
(These were the notes on entering the ward, January 20th.) 
When admitted his color was very much as it is at present, 
but the conjunctival staining has markedly increased 
since coming into the house. His tongue was a little 
coated and slightly swollen; appetite was poor; he rested 
perfectly well at night. Since admission, also, the bowels 
have been loose and he has had as many as five passages 
in twenty-four hours, but they were more regular again 
during the last few days ; he has only had three move- 
ments within the last twenty-four hours. 

Now, what has been the cause of this jaundice ? Per- 
sonally, I never see a case of jaundice without feeling 
disturbed about it until I am familiar with its history, and 
know something of the cause of this disease. Probably 
no one symptom is less dangerous in certain cases than 
this, but it may also indicate a condition fraught with 



CLINICAL LECTURES. 113 



danger to life, or threaten permanent injury to health. 
Therefore, until we know the cause in any given case, we 
should always regard jaundice as a symptom of gravity. 
In some cases it is due to a transient cause, and yields to 
simple treatment; in others it has serious morbid changes 
underlying it, which are not amenable to art. 

As regards the history of such cases, the mind is usually 
clear and we can obtain a clear account. Our patient 
insists that he is well, and has been so since the chill, 
which was probably caused by exposure. I think the case 
is one of catarrhal inflammation extending along the ducts 
from the duodenum into the liver, without producing com- 
plete obstruction, but causing partial retention and re- 
absorption by the blood of the bile, after its secretion by 
the liver. I show you,,here what he passed this morning 
from his bowels. He has been on milk diet, which does 
of itself tend to make the excrement lighter colored than 
usual, but you see the bile is not completely absent. Here 
is no evidence of complete want of bile such as in the 
clay-colored stools that we often have in some forms of 
jaundice; this is fairly colored with bile. Here is a spec- 
imen of his urine, passed this morning; it is high colored 
and is a dark amber with an olive green tinge. It is of 
specific gravity 1.015, neutral in reaction, and contains no 
albumen. It has, however, an excess of biliary coloring 
matters, which are made evident by the ordinary reaction 
with nitric acid ; in Gmelius' test, overlying the acid with 
the urine, the ring of colors is well shown. 

His treatment since admission has been a drachm of the 
phosphate of sodium three times a day, and the strict ad- 
herence to a milk diet; he has been kept in bed up to this 
time, that is, for seven days. 

On the day following admission he complained for the 
first time of pain over the liver. Now, I will examine him 
in your presence, and see whether physical exploration 
will throw any light upon this symptom. I think you can 
all see as he lies upon the table this slight fullness directly 
over the hepatic area; and on palpation I find more 
firmness, more resistance than on the other side. Per- 
cussing in the line of the nipple, dullness appears at the 
border of the sixth rib; the note becomes gradually tym- 
panitic below the free border of the ribs, but not abruptly 
clear. Over in the epigastric region I can feel the out- 
line of the liver very distinctly, and he complains of some 



114 CLINICAL LECTURES. 



pain from my manipulation ; but there is no severe pain, 
and he does not wince when I press hard. This moderate 
enlargement of the liver is readily accounted for by the 
retention of the bile in the liver substance; it does not 
necessarily indicate any alterations of a permanent or 
organic kind. The boy has a better expression and a 
brighter look in his face than he wore a few days ago. 
The diarrhoea is also better. Bear in mind that this 
catarrhal condition not only extends from the ducts into 
the liver, but also along the intestine, and diarrhoea is 
therefore a symptom that often appears at one time or 
other in these cases. He has had no cough or catarrhal 
affection of the air passages at any time during the at- 
tack ; there is no trouble here in the chest. He will, in 
the course of a few days, be allowed to go out, with a cau- 
tion against exposure to cold; the jaundice may require 
several weeks before it gradually fades away. 

ASCITES WITH MITRAL DISEASE AND EMPHYSEMA ; PARACENTESIS 

I will now show you a case which has been in the house 
since the fourteenth of November last. He was before 
you in my clinic of December 14th; at that time I told 
you that he was suffering with marked dyspnoea, and had 
coming on a new symptom. On examining him, we ascer- 
tained that he had emphysema and bronchial catarrh. 
Some time afterward, careful examination of the heart re- 
vealed a mitral regurgitant murmur, which the extreme 
dyspnoea and the nois}'^ bronchial rales, had prevented us 
from ascertaining previously. When he was before you, 
his abdomen was very much swollen, as it now is again. 
I then told you that the orthopnoea was due more to the 
upward pressure of the ascitic fluid than it was to the con- 
dition of the thoracic organs. His treatment was elaterium, 
followed by other hydragogues, with a view of removing 
the fluid; the result was a diminution at first, but after- 
wards they lost their effect. We then gave him broom 
tea, of which he took one pint daily, and for a time there 
was again some decrease in the amount, but only for a 
time. Finally, we tapped him, on the third of this month, 
and obtained twenty-eight pints of straw colored fluid, 
alkaline in reaction, specific gravity 1.015, which was 
highly albuminous, and coagulated almost solid on the ap- 
plication of heat. After this he was much more comfort- 
able ; he was able to lie down, and could sleep at night. 



CLINICAL LECTURES. 115 



Lately the fluid has again increased, and now, at the end 
of three weeks after the tapping, we find him nearly as 
much oppressed as before. Dr. Owens, our resident physi- 
cian, will now again tap him, using the ordinary trocar 
and canula of medium size. 

In performing paracentesis of the abdomen, although 
eapy enough of execution, there are certain precautions 
to be observed. Where ascites is complicated with dis- 
ease of the heart, there is some danger of failure of the 
circulation, from sudden removal of the fluid. We, there- 
fore, seek to guard against this by applying a binder cov- 
ering the entire abdomen; it is split into tails in the back, 
so as to permit of crossing, and is gradually tightened by 
assistants during the aspiration. The operation is per- 
formed in the sitting posture, in order to assist the flow, 
of fluid. In order to prevent syncope, we give him a glass 
of brandy at the beginning; this is especially needed to 
prevent the diseased heart from failing. We should al- 
ways ascertain the condition of the bladder before intro- 
ducing trocar, as, if distended, it might be wounded; the 
point usually selected for tapping being in the median 
line, a little above the pubes. Local anassthesia with ice 
or ether spray can be used, if thought necessary. 

Having introduced the instrument, the trocar is with- 
drawn and the canula remains in the wound, through 
which the fluid flows in full stream. It is of a light amber 
color, and not quite clear, as it contains some fibrinous 
material ; on boiling a little in this test tube, it becomes 
so solid that the tube might be inverted without spilling 
it out. It contains, therefore, a very large amount of al- 
bumen. In testing for albumen it is better to fill the glass 
about one-third full, and boil the upper part by applying 
the flame to the side of the tube, held diagonally ; in this 
way we are enabled to note the change in color and 
amount of coagulation, in comparison with the unaltered 
fluid below; finally, all should be boiled together and set 
aside to deposit, in order to determine the proportion of 
coagulable albumen. A small amount of acetic acid added 
will keep tlie piiosphate in solution. I find upon adding 
acid to this specimen, that there is considerable evolution 
of gas, prob;ibly due to the presence of carbonates. The 
amount of fluid is now nearly two pailfuls (27| pints), and 
it will, probably, continue to leak after the canula is with- 
drawn, for several days. 



116 CLINICAL LECTURES. 



We will now have an opportunity of again examining 
the condition of the liver, which we are anxious to ascer- 
tain, for such an amount of ascites is very rare from tho- 
racic disease alone. Of course, as long as the fluid con- 
tinued abundant, forcing the liver upward, and obscuring 
the lower hepatic outline by its own dullness upon per- 
cussion, it was impossible to decide this point. 

I think that the evacuation of this fluid will enable the 
liver to come down to its proper position, so that its edge 
may be felt, but I will not make the examination until he 
has quite recovered from the shock of the operation. The 
abdomen now is quite soft and yielding, and the patient 
breathes more freely. 

An examination of the liver, made subsequently to the 
clinic, by Dr. Hutchinson, under whose care the patient 
passed on the transfer of the ward, showed that the organ 
could be felt below the ensiform cartilage, but is lost 
under the arch of the ribs toward the right side; toward 
the left side the organ can be felt. The liver communi- 
cates a very distinct impulse to the hand. Dullness be- 
gins at the fifth rib and extends to the costal border in 
the right nipple line ; in the anterior axillary line the dull- 
ness extends from the sixth interspace to 1^ inches above 
the right costal border; in the posterior axillary line from 
the seventh to the ninth ribs. The spleen was found 
decidedly enlarged. This examination shows that organic 
changes have occurred in the liver, due to the impeded 
pulmonary circulation, which latter are partly due to the 
lung changes and partly and perhaps chiefly to the mitral 
insuflficiency. What is this condition of the liver ? Chiefly 
it is one of red atrophy, and with this is combined in- 
duration and fibrous contraction brought about by the 
chronically congested state of the liver tissue. Red 
atrophy, you know, consists in a dilatation of the hepatic 
venous radicles and of the capillaries of the liver lobule 
which empty into the veins. The constant distention of 
the capillaries causes atrophy and finally destruction of 
the liver cells of the central portion of each lobule. With 
this atrophic destruction, we have combined in this case 
fibroid induration, that is, cirrhosis. What effect does this 
atrophy have on liver function ? In proportion to the 
degree of atrophy — and in many cases it involves the 
half of every lobule — we have less liver cells to secrete 
bile. The efiect of this condition on general nutrition 
you can readily picture. — College and Clinical Record. 



TREATMENT OP DISEASES OF THE HEART. 117 



Treatment of Disease of the Heart. 



In cardiac affections, modern therapeutics has begun to 
employ three new medicaments : bromide of potassium, 
iodide of potassium and hydrate of chloral. 

I. According to Binz and See, bromide of potassium has 
a direct action upon the heart and peripheral circulation, 
so much so, that it should be classed among the cardio- 
vascular rather than among the nervine remedies. 

According to Gubler, bromide of potassium exercises a 
very remarkable sedative influence over organic disease 
of the heart; it causes intermission of its action to dis- 
appear, and brings down the pulsations from 108 to 78. 

Prof. Dujardin-Beaumetz places bromide of potassium 
among the heart-tonics, and places it in the first line, im- 
mediately after digitalis: "Bromide of potassium," he 
says, "regulates the circulation, and has sedative qualities 
with relation to the cerebro-spinal axis and particularly 
upon the medulla oblongata. It is very superior to opium, 
which increases the already too great congestion of the 
encephalon; it regulates the pulsation of the heart, di- 
minishes the nervous irritability, so frequent among sub- 
jects of cardiac diseases, and may thus combat theinsom. 
nia which enfeebles and exhausts the patients." 

"We employ the bromide of potassium," says See. "1, 
As a moderator of the peripheral circulation, especially in 
cardiac affections which are accompanied with diminution 
of the arterial pressure, increase of the venous pressure, 
accession and irregularity of the beating of the heart, 
passive congestion, oedema, cyanosis and dyspnoea. 2. 
As a depressor of the reflex excitability. 3. As a hyp- 
notic." 

II. The second medicament recently employed with 
much success is the iodide of potassium. In his book on 
"Diseases of the Heart," published last year. Prof. See 
says of iodide of potassium, that it is not only the best 
agent with which to combat the asthma, but also that it 
is the most useful remedy in dyspnoea of cardiac origin. 
By preference he employs it in alterations of the structure 
of the heart itself rather than in valvular lesions. 

III. Chloral hydrate is also frequently employed in car- 
diac afl'ections. First of all, it slows the contractions of 
the organ, and then diminishes its energy; such is the re- 



118 TREATMENT OP DISEASES OP THE HEART. 

searches of Liebreicht, Demarquay, liokitansky, Troquart, 
See, and others. Chloral acts by paralyzing, so to speak, 
either the intrinsic automotor ganglia of the heart, or the 
bulbar vasomotor center. 

The researches of Vulpiau, Claude Bernard, Rejewski, 
Owjanikow, Heindenhain and Rokitansky demonstrate 
that chloral hydrate has a paralyzing action upon the 
vaso-motor nervous center, which leads to a dilatation of 
the peripheral vessels with diminution o( the blood-pres- 
sure. Thus, following the action of chloral, reflex in- 
fluences are incapable of exciting the vaso-motor center. 

In seven patients affected with diseases of the heart, 
treated this year at his clinic, Prof. Renzi has employed 
these remedies, and from an attentive examination of these 
patients, he has been enabled to draw the following con- 
clusions: 

First. That bromide of potassium diminishes the anx- 
iety of patients affected with cardiac affections ; the ex- 
perience of a certain sensation of "well being," and 
respiration more easy. Under its influence sleep is more 
tranquil, more easy and of longer duration ; there is like- 
wise a return of physiological sleep, which appears to be 
the most constant, most advantageous effect of bromide 
of potassium. The number of cardiac pulsations and of 
inspirations diminish ; the decrease of the latter, to the 
present time at least, is the noticeable. The cough alone 
seems to be aggravated under the influence of this rem- 
edy. 

Second. The iodide'of potassium succeeds best and is 
most useful in cardiac diseases. Its principal effect is to 
ameliorate the respiration in a remarkable manner, and 
especially to cause the symptomatic asthma to cease. 

Third. Chloral hydrate, in small doses, may be used 
against the insomnia which torments cases of heart 
trouble. In general, however, it does not diminish dysp- 
noea of cardiac origin. It facilitates cerebral torpor, 
somnolence, phenomena which are not rare in disease of 
the heart. It is very often necessary to suspend the ad- 
ministration of chloral, because, given with iodide of 
potassium, it produces a grave and persistent somnolence 
in these patients. — Z' JJnioQi Medicals du Canada. 



DISEASE QEEMS. 119 



Disease Germs. 



Prof. Doremus said that at the request of the President 
he had the honor to perform a few experiments, which 
would demonstrate how readily gas passes through porous 
media. He had been instructed in this by that distin- 
guished man, the late Prof. John W. Draper, about forty 
years ago. In 1867, at his last interview with Prof. Liebig, 
that gentleman had said to him: "Don't leave Munich 
without visiting Voit and Pettenkofer's laboratory," and 
he saw there what he proceeded to demonstrate. 

On the table was a block of brown sandstone, twelve by 
fifteen inches long, and four and three-fourths in thick- 
ness. On each side of this, a depression, a quarter of an 
inch in depth, had been made. Iron plates had been in- 
serted in them, and attached by clamps. To each iron 
plate an iron tube was fixed. The whole surface of the 
stone, except that covered by the iron, had been coated 
with many layers of varnish. Prof. Doremus, by means 
of a flexible tube, connected the gas pipe with the iron 
tube attached to the iron plate upon one side of the stone. 
After waiting a minute or two, he applied a lighted taper 
to the end of the other tube connecting with the sand- 
stone on the other side, and a small flame sprang up, 
showing that the gas had passed through the solid stone. 
Prof. Doremus then took a block of brickwork, eight inches 
in thickness, made of Philadelphia brick, with plates and 
tubes attached in the same manner as to the sandstone. 
By blowing through one of the tubes, a candle-light, 
placed at the end of the other, was deflected ; and this 
deflection lasted for some time after the blowing had 
ceased, showing that it took some time for the air to go 
through the brick. Blowing still harder, the light was 
extinguished. 'Prof. Doremus added, that hydrogen or 
street gas could be passed through stone in the same way, 
and that the pressure necessary to accomplish it was very 
small. 

The next experiment was for the purpose of demonstra- 
ting the permeability of porous substances by gas, and the 
fourth experiment illustrated the fact that gas will pass 
tiirough porous substances, notwithstanding it is opposed 
by the pressure of a whole atmosphere. What had been 
proven to be true of the gases used in the above experi- 
ments was true of sewer gas and illuminating gas. What 



120 DISEASE GERMS. 



steps, then, must be taken to protect ourselves from their 
evil influence? Water-traps were inefficacious, for the 
gases would pass through the water and out into our 
houses. The only way was to kneel at the shrine of chem- 
istry, and to make use of such substances as would decom- 
pose these poisonous gases. At Bellevue Hospital per- 
manganate of potassium had been used for this purpose. 
Labarraque's solution, or the chloride of zinc, could also 
be used. Exposing the water and gas in our sewers to 
such agents destroyed all poisonous germs. Every ema- 
nation from our bodies, with few exceptions, is a com- 
pound of hydrogen, and there is not one of them that can 
not be destroyed by chlorine, bromine, or some such sub- 
stance. 

Suppose a case of scarlet fever occurring and resulting 
in the impregnation of the walls of the house with the 
poison. Bromine or chlorine, both of which readily vola- 
tilize, may be used to destroy the poisonous germs. In 
1865, the ship ''Atlanta" arrived in New York with a num- 
ber of cholera patients on board. Sixty of her passengers 
had already died. Tiie "Atlanta" and all other vessels 
entering the Narrows were treated with chlorine, bro- 
mine, and other similar agents, and with the result of 
stamping out the disease entirely. 

Dr. Agnew had informed the speaker that about thirty 
years ago the north wing of the old New York Hospital 
became so foul from the reception of a large number of 
ship-fever patients as to be unfit for use. Ventilation was 
tried, but in vain. Three, workmen, engaged in scraping 
the walls, sickened and died. At the Lincoln County 
Hospital, England, the walls became magazines of disease 
in the same way. They were gutted and replastered, but 
doing no good, they were torn down to the very founda- 
tion. Some years ago certain surgical wards in Bellevue 
Hospital became so infected that many patients died of 
pyaemia. At the request of the Commissioners of Charity 
and Correction, Prof. Doremus attempted to purify them 
by the use of chlorine gas. The enormous amount of 
three tons of this gas was generated in these wards, and 
though many weeks were necessary for its accomplish- 
ment, the result was very satisfactory. Dr. James R 
Wood had stated that since then no cases of pyaemia had 
occurred. Every few months now the chlorine treatment, 
though in a less rigorous form, is resorted to. He thought 



DISEASE GERMS. 121 



he was warranted in saying that, owing to the porous 
character of all walls and the decomposing power of cer- 
tain gases, we can purify the most stately edifice if we 
would adopt the heroic chemical treatment. 

Prof. Doreraus said he spoke upon this occasion with a 
good deal of feeling and earnestness. On the 1st of last 
December he was to have delivered a lecture, illustrated 
by experiments, in which his son, fourteen years old, was 
to have assisted. The day before, that son died from the 
evil effects of sewer gas. Another son was just now re- 
covering from the effects of an illness due to the same 
cause. He would have rather given his son the dead- 
liest poison in his laboratory, and have trusted to the an- 
tidotes, tlian to have had him inhale this sewer gas, for 
the deadly eff'ects of which we have no remedy. 

Dr. Willard Parker said we had all known, he thought, 
of the fearful destruction of life in the wards of certain 
hospitals after they had become old and the walls satu- 
rated with disease. We had supposed fumigation and 
whitewashing would remove the cause of disease, but had 
now been informed that this kind of treatment was of 
little or no avail. He would never forget the condition of 
things in Bellevue Hospital in 1846, when its wards con- 
tained so many patients of ship fever. He had never seen 
any disease which he really dreaded except ship fever. 
At the time referred to the wards were tilled to their ut- 
most, and Dr. Riess was house physician. Going through 
the wards in the morning they would pick up a dozen or 
more that had died during the night. It was supposed 
that the patients were crowded too much. Beds were 
laid upon the floor, but the death rate continued very 
large. The subject then came up before the Medical 
Board, and it was decided that, as no more patiejits could 
be accommodated in the wards of the hospital, tents siiould 
be erected in the yard under the trees. The result was 
that nearly all the patients placed in tents recovered. 

Many of those present may remember the vessel Phoebe, 
which was driven upon the shore at Perth Amboy in 1847. 
Many patients with typhus fever were on board. A large 
number of deaths had already occurred; but the ship 
went ashore, and the patients were taken out and placed 
upon the ground, under the trees, and in hastily impro- 
vised canvas tents, or stalls; not one of the eighty-four 



122 OBSERVATIONS ON THE DIGESTIVE FERMENTS. 



thus placed died. These instances only showed the great 
importance of having the right kind of air to breathe. 

Previous to the introduction of Croton'water into New 
York in 1846, he did not remember of having seen a case 
of diphtheria. We had cases of croup, or membranous 
croup, as it was then called. Occasionally we met with a 
case of sore throat which was diphtheritic in character, 
the tonsils being enlarged and covered with a little whitish 
membrane. Diphtheria was the result of sewer malaria. 
There were none of us who had been in practice many 
years but could recall instances where the disease had 
occurred in families and swept away several members, and 
apparently without any cause. "Suppose, sir, Mr. Presi- 
dent, " the speaker asked, " there was a vault containing 
dead bodies near your house, would you be willing to have 
a tube connecting your bedroom with it? Yet this is 
practically what we do with our sewers. I say, sir, that 
whenever diphtheria occurs there is something wrong 
with sewerage. Now, if I were going to build a house, I 
would not have it connected in any way with the sewer. 
I would have old-fashioned bowls and pitchers upon my 
washstands. Back of the house I would have constructed 
a sort of annex, where I should have all the sewers, closets, 
and all the pipes of the house. This matter demands our 
most earnest attention. New York, in this respect, is in a 
very critical and unhealthy condition, and the time has 
arrived for energetic action." 



* ^ > » 



Observations on the Digestive Ferments. — If properly 
prepared, malt extracts are rich in diastase, and have a 
high power in digesting starchy matters. But you 
will be surprised to learn, as I was, that a large propor- 
tion of the malt extracts of commerce have no action on 
starch. This is owing to a high temperature having been 
used in their preparation. Any heat above 150° Fahr. is 
destructive to diastase in solution, so that if the extract 
be evaporated, as is directed by the German Pharmaco- 
poeia, at a temperature of 212° Fahr., it is necessarily inert 
on starch. Out of fourteen trade samples of malt extract 
examined by Messrs. Dunston and Dimmock, only three 
possessed the power of acting on starch. These brands 
were Maltine, Corby n, Stacey & Co.'s Extract and Kep- 
pler's Malt Extract— T?7/i. Roberts, M. D., F. R. /S., in 
British Medical Journal. 



GROWTH AMONG THE MICROSCOPIC FORMS OF LIFE. 123 



JA 



ICROSCOPY. 



The Phenomena of Growth Among the Microscopic 

Forms of Life.* 



I do not come before you this evening to discuss any of 
the problems which lead us beyond the pale of direct ob- 
servation into the realms of speculative thought. Although 
our subject carries us to the dim border-land of life — 
where it is not only impossible to distinguish plants from 
animals, but where even the transition from the inanimate 
to the living, the inorganic to the organic, is imperceptible 
— yet I will not ask you to follow me in any presumptuous 
efforts to bridge, even in imagination, the narrow chasm 
which separates the one from the other. It will suffice 
for our purpose to know that the smallest particle of mat- 
ter that the microscope can reveal — and others even too 
small to be defined by the best microscopes known, smaller 
than the length of an undulation of light, may possess all 
the attributes of life. We know that such particles live, 
because they move and grow and multiply. They possess, 
therefore, a certain organization which distinguishes them 
from non-living matter. However, the use of the 
word organization, in this connection, has occasionally 
given rise to misconceptions, for none of the simplest 
forms of life are organized in the sense of having muscles, 
nerves, vessels, or any diff'erentiation of parts ior special 
functions. Thus, we may find a simple spherical mass of 
jelly, absolutely without a trace of visible structure, man- 
ifesting all the phenomena of life. Therefore, organiza- 
tion, in this sense, does not mean visible structure, but it 
relates to the arrangement of the atoms and molecules 
which compose the living matter. 

A brief reference to the minute animal known as the 
amcel)a will serve as an introduction to the subject l)efore 
us. The amoeba consists principally of a transparent, 
clear, or granular mass of irregular shape, ranging in size 
from /„ down to j,?,,, of an inch, or even smaller, resembling 
jelly, which is known as bioplasm, or protoplasm — the 
physical basis of life. Within the protoplasmic mass a 

♦Address of the retiring President of the Now York Microscopical So- 
ciety, delivered at the Annual Reception, Friday evening, February 3, 1882. 



124 GROWTH AMONG THE MICROSOOPIO FORMS OP LIFE. 



more dense, circular structure is sometimes found, which 
is termed the nucleus, the special function of which is 
still a matter of investigation. The external layer of the 
protoplasm is somewhat more dense than the rest, but it 
does not constitute a distinct membrane or cell-wall, such 
as we find in more highly developed organisms. 

If we conceive of the amoeba enclosed within a mem- 
brane giving a spherical shape to the organism, we have 
the idea ot a true cell, which is regarded as the life -unit 
in both the great kingdoms. It is by the assimilative 
powers of cells that growth takes place, and by their 
division all structural development proceeds. A typical 
cell consists of protoplasm and nucleus within a membrane 
known as the cell-wall. However, the life of the cell 
resides in the bioplasm. It is the semi-fluid contents and 
the nucleus of the cell that lives — all the rest is dead 
matter. It seems absurd, then, to regard the limiting 
membrane, the cell-wall, as an essential element in the 
ultimate life-unit. Even in cell-multiplication by the 
ordinary process of division, the wall takes no part, for 
within the parent cell it is the protoplasm that divides 
into two or more parts, beginning with the nucleus. A 
constriction forms in a certain plane, and new cell-walls 
are secreted by the two masses of living matter. As the 
cells increase in size the original membrane must give 
way or disappear. But it may still be said that the phy- 
siological unit of life is the cell; for, although naked 
bioplasm may live, assimilate food and grow, no difler- 
entiation of parts can result until there is some product, 
a secretion, a cell- wall or limiting membrane, to give form 
and structure to the primal elements of growth. 

The living jelly, so readily studied in the amoeba, seems 
to be identical with the protoplasm of every animal and 
plant from the highest and most complex down to the 
lowest and simplest. 

Let us, therefore, examine this protoplasm more care- 
fully. As the amoeba moves, one portion of the body is 
projected forward, and the less dense protoplasm within 
begins to flow in the direction of the projection, like so 
much water, carrying with it the spherical granules which 
are usually abundant in the body. 

The amoeba has no mouth, but when a digestible morsel 
is found the body simply flows around and envelops it, 
and the process of assimilation immediately begins ; the 



GROWTH AMONG THE MICROSCOPIC FORMS OP LIFE. 125 

indigestible portions are allowed to escape from any part 
of the surface of the body. Hence, it appears that pro- 
toplasm has the power of assimilating solid food and'con- 
verting it into living matter, which is the process of 
growth. When the amoeba attains a certain size, a con- 
striction forms across the body, or gradually deepens until 
the animal becomes divided into two parts, which finally 
separate and move away as independent individuals. 

This simple process of propagation is typical of what 
takes place throughout the living world. Among the 
simplest forms of life it serves for the multiplication of 
individuals, but as we ascend the scale the process of re- 
production becomes more complex, and division of the 
constituent cells becomes a process of growth rather tiian 
of reproduction. We may, indeed, regard the human body 
as an assemblage of units, each of which multiplies by 
division, like the simple amoeba, and thus contributes to 
the repair of waste in the tissues. The process begins in 
the germinal cell, and by its continuance the complex 
organs of the body aro evolved, according to some in- 
scrutable law. The reproductive process of the amoeba, 
therefore, typifies the growth of higher organisms; for the 
first considerable advance in structural evolution is in the 
production of a more complex organism by the division 
of cells, the progeny of which, instead of separating from 
the parent-cells as new individuals, remain as integral and 
inter-dependent parts of one organism, each cell, or group 
of cells, having specific functions in the economy of the 
animal or plant. 

Among the green, confervoid algse of ponds and ditch- 
es are found many plants which consist of a series of cells 
attached end to cmd. forming filaments. These plants are 
termed multicellular, to distinguish them from the unicell- 
ular species, and they are classed higher in the scale of 
organization. Bat complexity of structure, as thus mani- 
fested, is not, so far as my judgment permits me to ob- 
serve, an indication of a higher stage of cell-life ; for each 
cell of the filaments is complete and independent of all 
the others. There is no physiological bond connecting 
them, as in the higher plants, but each one carries on an 
independent existence, and is not killed if il.s fellows are 
destroyed. Between the filamentous j^lants and tlie 
strictly unicellnlar forms which consist of spherical, green 
cells, living separately, we find a succession of interme- 



!4 

I 



126 GROWTH AMONG THE MICROSCOPIC FORMS OP LIFK. 



diate forms in which the cells are bound together by a 
more or less firm mucous, or gelatinous substance, some 
in layers of indefitnte extent and arrangement, others in 
well-defined lamilies. But however they may be related, 
each cell, so far at least as its merely vegetative functions 
are concerned, is quite independent of the others, for it 
possesses within itself all the powers necessary for its ex- 
istence as a living organism. In other words, these plants 
belong to such a low stage of life, that there is no distinc- 
tion between the cells such as we find in higher plants 
where certain cells contribute to the formation of tissues, 
others convey the nutrient sap, and still others produce 
the organs of reproduction, the pistil and stamens. It 
follows that in such low plants we must look for all the 
phenomena of growth and reproduction in each cell — 
each cell is, in fact, a perfect plant. Hence, no classifica- 
tion of these plants based upon their manner of growth, 
can be regarded as quite satistactory to the scientific stu- 
dent. The tendency now is to base all classification upon 
the methods of reproduction, which, being the ultimate 
process in the life of every organism, characterize its 
mature stage and indicate the point at which its develop- 
ment was arrested in the course of its evolution. 

Complication of structure results from cell-division, but 
it is necessary to observe that all cases of cell-division 
do not lead to structural complexity ; for in the case of 
strictly unicellular protophytes or protozoa, the i)roduction 
of new cells or gemmae, within the parent, leads to what 
seems to be a multicellular stage. But each new cell 
produced under such circumstances is, physiologically 
and anatomically, an independent individual, in no wise 
dependent upon the others for support, but capable of 
separate existence. Hence, the mullicellular condition, 
when it thus occurs among the strictly unicellular organ- 
isms, is in no wise a higher condition of organization, but 
only a temporary phase brought abouj; for a special end. 
It is only when the multiplication of cells is a phenom- 
enon of growth and the resulting cells form constituent 
parts of the organism, that there is any advance in 
structure. This is the case in anovum which, by repeated 
cell-division, produces a morula. 

Carrying the ideas embodied in this view one step 
further, it should also be observed that while the cell, in 
a physiological sense, can be justly regarded as the typi- 



I 



TRICHINA-LIKE PARASITES. 127 

cal unit from which all living forms are derived, as taught 
by the generally accepted cell-doctrine, yet the student 
of the lower forms of life can not fail to observe that all 
the structures to be found in protophytes or protozoa, as 
well as many found in the higher planes of existence, do 
not result from cell-division — that many of the appen- 
dages, such as carapaces, flagella, cilia peduncles, etc., 
result from processes [of growth, or secretion, without 
cell-division. 

The dictum that has so long been taught by physiolo- 
gists, that all structures originate in cells, can not longer 
stand. 

The most complex cell is a ciliated infusorian, and in 
these animals there are many structures which must be 
regarded as true secretions of the cell, not produced by 
cell-division, as usually taught. 

{To he continued.) 



Trichina-Like Parasites. 



Five years ago we found in the lungs of the marsh toad 
a number of minute worms, which bore a striking resem- 
blance to the mature trichina. The worms were all 
females, viviparous and pregnant. For a long time, we 
were almost forced to the conclusion that they were 
trichinae, but finally identified them as the curious a^caW* 
nigro-venosa. We take the following from the London 
Lancet^ and commend it to our readers: 

"To microscopists who are endeavoring to ascertain the 
various habitats of tricliinas, a useful word of warning has 
been given by M. Megnin in a paper read before the 
Societe de Biologie, in which he points out that many 
minute encysted worms are met with which are not tri- 
chinae, although so closely resembling them as to have 
deceived many observers. The supposed discovery of tri- 
chinae in the rootlets of beetroot, proved to be a mistake 
by Virchow and Kuhn, is a striking instance of this sort. 
Lagenbeck described trichinas in the intestines of earth 
worms, but Kuhn showed that the parasite is quite dis- 
tinct from the trichina spiralis. Merlan and Tigri thought 
they had found trichinae in the lungs of a sheep, but Del- 
pech showed that these were merely the embryos of 
strongylus filaria. Cobbold has stated that the trichina ia 



128 GLEANINGS. 



common in the hedgehog. Megnin is convinced that this 
is an error, and that the worms described are merely the 
encysted larvae ol the spiroptera clausa. He showed prep- 
arations of an encysted nemaloid worm, which might 
easily be mistaken ior the trichinae, but pointed out that 
the former differs in having a papilla at its mouth, and the 
anus is not terminal. Siebold described, as a trichina, a 
worm found in cysts in the peritoneum of the grey lizard 
and other creatures, but Megnin asserts that this also is 
the larva of a spiroptero (S. abbreviata), the adult indi- 
viduals of which are abundant in the intestines of the same 
animal. An encysted spiroptera still more strikingly re- 
sembling the trichina has been found in the muscles of 
the frog. Very similar, but larger, encysted worms of the 
same genus have also been discovered in the subcutaneous 
tissues of a bird — the manchetes pugnax." — Medical Her- 
aid. 



? 



LEANINGS. 



LiSTERiNE. — L. Ch. Boisliniere, M.D., LL.D., Professor of 
Obstetrics and Diseases of Women, St. Louis Medical 
College, and President St. Louis Obstetrical Society, says 
of this new antiseptic : "I have given a fair trial to Lis- 
terine. The more I use it the better I am pleased with it 
as an antiseptic and deodorizer. As a dressing for uter- 
ine cancer, I found that the fetor had been thoroughly 
corrected, and, after the removal of this morbid growth, 
a marked benefit could be ascribed to Listerine, as it ap- 
peared to promote healthy granulations. In offensive 
leucorrhoea and cervical or vaginal discharges, it removes 
all disagreeable smells. For vaginal douches and injec- 
tions after parturition, I now use exclusively Listerine. 
Besides being a reliable antiseptic, its very agreeable 
odor should give it the preference over all other articles 
of this class." — Va. Med. Monthly. 

Treatment of Epithelioma of the Neck of the Uterus. — 
Dr. Cheron, referring to the Italian experiences with this 
practice, employs the nitrate of lead in ulcerating epithel- 
ioma of the uterine neck. After cleansing the surface 
with charpie moistened with glycerine, or washing out 
the canal with perchloride of iron solution if there is 
much oozing of blood, ha applies to the ulcerated surface 



BOOK NOTICES. 129 



with an insufflator the following powder: Plurabi nitat. 
purif. 5i. Lycopdii 5ij. The powder is kept in position 
by a suitable tampon. Under the action of this prepara- 
tion the suppuration diminishes sensibly and the odor dis- 
appears. The hemorrhages are also suppressed. After 
twelve or fifteen of these applications, the engorgement 
of the cul-de-sac diminishes, and the general health is 
greatly improved. 



Bi 



)OOK Notices. 



Diseases of Women: Including Their Pathology, Causa- 
tion, Symptoms, Diagnosis, and Treatment. A Man- 
ual for Students and Practitioners. By Arthur W. 
Edis, M. D, Lond. F. R. C. P., M. R. 0. S., Assistant 
Obstetric Physician to Middlesex Hospital, etc. With 
148 Illustrations. 8vo. Pp.576. Philadelphia: Henry 
C. Lea's Son & Co. Cincinnati: Robt. Clarke & Co. 
Price U. 
We have in the volume before us a new work on dis- 
eases of women. Many, no doubt, will think that there 
are already enough of such works, and that further works 
upon the subject are unnecessary. But it is only by mul- 
tiplying works that we can expect progress to bo made. 
It is those who write, who investigate and think. The 
physician who gives his attention exclusively to his busi- 
ness, and is without the stimulus of writing and instruct- 
ing others, is not inclined to make extensive researches, 
and add to the stock of knowledge. 

Stu'lents of medicine, and practitioners who, during their 
student career, failed to make themselves familiar with 
the subject of gynecology, will find this work well suited 
to their wants. The various topics are treated in a clear, 
compreiiensive manner, so as to be easily understood. 
Tlie author's style is plain, and the student, soon becom- 
ing interested, is surprised how at home he feels in under- 
standing the main points in the various afiections de- 
scribed. While the volume can be consulted by all with 
profit, the student especially will find it valuable and 
suited to his wants. 

The author, while endeavoring to give an impartial ac- 
count, has given considerable prominence to the mechan- 
ical treatment of displacements of the uterus. Yet it is 



130 BOOK NOTICES. 



not his wish, as he states, to recommend too great reli- 
ance upon mechanical appliances. 

The diagnosis of abdominal tumors, being generally one 
of much difficulty tostudents,is treated most exhaustively. 
The functional disorders, also, have been entered into at 
considerable length. 

A copious index is appended, to facilitate reference, and 
every effort has been made to render the work practically 
useful to the student and busy practitioner. We have no 
doubt it will meet with a cordial reception. 



A Treatise on Human Physiology: Designed for the Use of 
Students and Practitioners of Medicine. By John 0. 
Dalton, M. D., Professor of Physiology and Hygiene 
in the College of Ph.ysicians and Surgeons, New York, 
etc. Seventh edition. With 252 illustrations. 8vo. 
Pp. 722. Philadelphia: Henry C. Lea's Son & Co. 
Cincinnati: R. Clarke & Co. Half-Russia, price ^7. 
1882. 
The work of Prof. Dalton on Physiology needs no com- 
mendation. It has been in the hands of physicians and 
students so long a time that its great merits are well known. 
This is its seventh edition, and it continues to hold a lead- 
ing position among the text-books of its department. So 
well adapted is it to the wants of those seeking a knowl- 
edge of physiology, that it is not at all surprising that 
there is so great a demand for it both in this country and 
in England. 

The work has been described a number of times in our 
"Book Notices," yet so many changes have been made 
in this edition as to make it proper to recur to some 
of its features. The greater part ol the book has been 
revised and its arrangement somewhat modified. Impor- 
tant alterations have been made in the classification of 
albumenoid substances, particularly in the ]n'ominence 
given to the ferments as a special group. In the depart- 
ment of the nervous system more extended consideration 
has been given to the localization of function in special 
parts of the cerebro-spinal axis. These relate not only to 
the cerebral convolutions and their connection with vari- 
ous forms of movement and sensation, but also to the 
identification of special communicating tracts of white 
substance in the brain and spinal cord. Furthermore, the 
study of the vaso-motor nerves and nerve centers has re- 



BOOK NOTICES. 131 



quired a more extended treatment than heretofore, in 
consequence of having reached a development which 
makes it almost a special department of nervous phy- 
siology. 

The t3''pe, paper and presswork are excellent. Besides 
being bound in cloth and sheep, it can also be had, by a 
trifling additional cost, bound in half-Russia, which adds 
much to the beauty of the book, and greatly increases its 
durability. 

Memoranda of Physiology. By Henry Ashley, M. D., 
LoND., Physician to the General Hospital for Sick 
Children, Lecturer on Animal Physiology in Owens 
College. Third Edition, thoroughly Revised, with 
Additions and Corrections bv an American Editor. 
24mo. Pp. 319. New york:'Wm. Wood & Co. Cin- 
cinnati: R. Clarke & Co. 
This little work, of a size that easily permits it to be 
carried in the pocket, is certainly multum in parvo. It is 
the most complete work of the kind with which we have 
ever met. As small as it is, yet it seems to contain pret- 
ty much all the leading facts of physiolog3^ It well 
illustrates into how small a compass a treatise can be 
brought, when the relation of facts and principles has 
been stripped of all its unnecessary verbiage. We are 
sure that it will be greatly sought for by medical stu- 
dents ; and practitioners, too, will find it exceedingly 
convenient to look through and refresh their memories in 
regard to the leading points in physiology. 



TuE Opium Habit and Alcoholism. A Treatise on the 
Habits of Opium and its Compounds — Alcohol, 
Chloral Hydrate, Chloroform, Bromide Potassium, 
and Cannabis Indicus. Including their Therapeutical 
Indications. With Suggestions for Treating Various 
Painful Complications. By Dr. Fred Ileman Hub- 
bard. ]2mo. Pp. 259. New York: A. S. Barnes 
& Co. Cincinnati: R.Clarke & Co. 
We have not had time to fully examine the work be- 
fore us, but as the author claims to have cured many cases 
of "opium habit," we have no doubt, or, at least, we are 
willing to believe, that a good many practical hints of 
value can be culled from it, but surely the author is very 
deficient in education, for no educated physician, in writ- 



132 BOOK NOTICKS. 



iog a piescription, writes it in part in Latin and in part 
in English; as, for instance : 

!^. Clilorinated Lime, . . Sj. 
Aqua, 5vi 

We copy a couple of prescriptions made for a little 
girl, seven years of age, to whom the mother had given 
laudanum from the time it was born. At the time the 
author commenced the treatment of the case, tiie child 
was taking half an ounce of laudanum a day. The first 
prescription is entitled No. 1. It is as follows : 

^i. Morphia, . . . 3iv- 

Alcohol, . . . . Sx 

Aqua, .... Sxxx. M. 

SiG. — Two teaspoonfuls after mealf?. 

The next prescription is styled No. 2, as follows: 
^. Belladonna Tr., . . §x. 

Alcohol, . . . Six. 

Ginger Tr., . . . gx. 
Cannabis Indica, . . 5iv. 
Gum Arabic, . . . 5vi. 
Aqua, .... Sxx. M. 

The directions appended are, that the amount taken 
from No. 1 is to be replaced every third day from No. 2. 
The author is in great need of lessons in prescription 
making, and in writing directions. His prescriptions 
would shame a first-course student, and, besides, he ex- 
hibits an ignorance of medicines that would make any 
one afraid to employ his preparations. 



A System op Surgery, Theoretical and Practical, in Treat- 
ises by Various Authors. Edited by T. Holmes, M. A., 
Cantab., Surgeon and Lecturer on Surgery at St. 
George's Hospital. In Three Volumes. Philadelphia: 
Henry 0. Lea's Son & Co. Cincinnati : G. T. Craven 
& Col, 141 and 143 Race Street. 
In the last number of the Medical News we noticed 
the second volume of this magnificent encyclopaedia of 
surgery. Just as we are closing the present issue, we 
have received the third and last volume. We must defer 
its notice until our next number. It is sold only by sub- 
scription. 



EDITORIAL. 133 



Editorial. 



Decease of Dr. William T. Brown. — It is with deep felt 
sorrow that we announce the decease of William Thomas 
Brown, of Cincinnati. Dr. B. died at his residence, on 
Freeman Street, in this city, Thursday, 3 o'clock P. M., 
January 26th. His disease is stated to have been cerebro- 
meningitis. 

Dr. Brown was born and reared in the village of Milford, 
Clermont Co., O. His grandfather on his mother's side 
was Dr. William Williams, one of the pioneer physicians 
of the State, and a student of the distinguished Dr. Benj. 
Rush, of Philadelphia. His father. Dr. Thomas M. Brown, 
still living, but retired from active practice, residing at 
this time in Cincinnati, was a well known and highly es- 
teemed physician of Clermont County. He was contem- 
porary, forty-five or fifty years ago, with the father of the 
writer — the practices of the two adjoining, and often meet- 
ing one another in consultation. 

The subject of our sketch received as liberal an educa- 
tion as the academy of his village, conducted by Prof. D. 
W. Stevens, afibrded. After completing his general edu- 
cation, he turned his attention to the study of medicine, 
preliminary to entering the profession of which not a few 
of his family were members. During the first years of his 
studying medine, he was under the tutorship of his father 
and grandfather, from whom he not only learned the first 
principles of medicine, but a great deal of experience. In 
order to complete his education he came to Cincinnati 
and commenced his studies at the Miami Medical College, 
which was in existence at that time, but which alterward 
consolidated with the Medical College of Ohio. He grad- 
uated in the spring of 1857. For some time after gradua- 
ting he was one of the assistant physicians at St. John's 
Hotel for Invalids, at the corner of Plum and Third Streets. 
In 1858 he opened an office on Freeman Street near 
Eighth Street, where he continued to reside and practice 
his profession until his decease. 

During the war of the Rebellion he was one of the sur- 
geons of the United States Hospital on George Street. He 
joined the Academy of Medicine at an early period, but 
was not one of the original founders, as has been errone- 
ously stated. He read a number of papers before it, and 
was one year the Secretary. 



134 EDITORIAL. 



He was quite successful in the practice of his profession, 
securing quite a large practice. He was attached to his 
profession, and faithfully discharged his duties to his pa- 
tients. 

Dr. Brown leaves a wife and two children. He was 
married in the fall of 1870 to Miss Sarah Adelaide Hunt- 
ing, a daughter of Mr. Hunting, of the firm of S. S. Smith 
& Co., at one time prominent liquor dealers in this city. 
One of their children, the eldest boy, died when he was 
two years old. His children are Fred Brown, dying since 
the father, and Addie Brown, both quite young. At- 
tached as he was to his profession, he was ever devoted 
to his wife and children and their interests. During his 
last illness, when he scarcely recognized any about him, he 
seemed to be especially pleased with the familiar faces of 
his family. He was a prominent member of Kilwinning 
Lodge of Masons, Ciucinnali Chapter, Cincinnati Council, 
and Cincinnati Commandery. As a Mason, he took a 
prominent rank, having taken the 32° of the Scottish Rite. 
He was also a prominent Odd Fellow, being a member of 
Magnolia Lodge. He was actively interested in the Asso- 
ciated Charities, and was one of the Finance Committee 
of the Twelfth District. 

A meeting of the medical profession was held in the 
Miami Medical College, on Twelfth Street, for the purpose 
of taking suitable action on the death of Dr. William T. 
Brown. 

Dr. William H. Mussey was called to the chair, and Dr. 
A. G. Drury was appointed Secretary. 

On motion, the Chairman appointed Drs. J. L. Cleveland 
and C. P. Brent a committee to draft resolutions, who re- 
ported as follows: 

" The members of the profession of Cincinnati, having assembled to-day 
to manifest their esteem for their late associate, Dr. Wm. Thomas Brown, 
who has been removed from them by the hand of death ; your committee 
would report, that in his death we have lost a member who for nearly 
twenty-five years has held an enviable position among us. As a physician 
he was faithful in an eminent degree to his patrons, strictly honorable in 
his intercourse with his colleagues, and deeply interested in the advance- 
ment of the science of medicine. As a citizen he was patriotic and zealous 
in the advocacy of the interests of the community. To the poor he was a 
sincere friend and benefactor. As an associate we have to mourn the loss 
of a true friend, one whose example may well be imitated. 

" Resolved, That the procedings of this meeting be published in the daily 
papers and medical journals of this city, and a copy sent to the family of the 
deceased. " 

The Chair stated that Drs. Carson and W. H. Taylor, the 



EDITORIAL. 135 



physicians in consultation with Dr. A. M. Brown, brother 
of the deceased, were present, and asked them for a his- 
tory of the late illness of Dr. Brown. 

Dr. Carson said the attack was similar to one the de- 
ceased had had five years ago, but was more pronounced 
in every respect. Before taking his bed he had given 
evidence of being broken down; had sacral and sciatic 
pains, but had recovered somewhat and returned to busi- 
ness. He had lately been much harassed by professional 
cares, and had lost sleep. The diagnosis was cerebral men- 
ingitis. There had been general hyperaesthesia and exalt- 
ation of the senses. Soon after the beginning of the at- 
tack, delirium set in, and was continuous, with slight 
intervals, until death. Hallucinations were varied in char- 
acter, many of them about matters connected with his 
professional business. Early in the attack bed sores man- 
ifested themselves. On Friday before death, he seemed 
to be better, and for a short time consciousness returned 
and he recognized those about him. From the following 
day he rapidly failed until his death. 

Dr. E. Williams said he believed he was one of Dr. 
Brown's oldest friends. He had known him as a student 
and practitioner for twenty-five years. If there ever was 
a man unselfish in his devotion to his patients he believed 
Dr. Brown was that man. For many years Dr. Brown had 
believed that he had been poisoned during some profes- 
sional operation, and with this belief had consulted the 
speaker, and though assured by the latter such was not 
the case, it had nevertheless disturbed his peace of mind 
ever afterward. 

Dr. Mussey had known Dr. Brown's grandfather and 
father. Both were physicians. The deceased had proba- 
bly inherited the characteristics necessary to make a good 
physician. At one time Dr. Brown had assisted him as 
Demonstrator of Anatomy in the Dental College. Subse- 
quently he occupied Dr. Mussey's office while the latter 
was in the army, but the demands of a rapidly increasing 
practice compelled him to give it up. At the time of his 
former illness, the speaker had advised him to give up 
practice for a year and go abroad. Tliis advice he did not 
heed. He died before his time, from overwork. He was 
straightforward and honorable in all things, true to him- 
self and his profession. 

Dr. Ludlow spoke very feelingly of his religious and 



136 EDITORIAL. 



professional character. It was one worthy of imitation- 
Remarks were also made by a number of others present, 
but we have not space to report them. 

The following resolutions, prepared by a committee con- 
sisting of Thad. A. Reamy, J. Trush and J. L. Cleveland, 
were adopted by the Cincinnati Obstetrical Society; 

" WeKREAS, Deatk has removed from our midst Dr. William T. Brown, 
one of the most honored of our number, a charter member of thisiSociety, 
marked alike for his high moral integrity, social and professional character, 
a distinguished physician ; therefore, be it 

"Resolved, That we deeply deplore the untimely death of our brother, cut 
off in the prime of life, at the age of manhood's greatest vigor. 

" Resolved, That we fondly cherish his memory, and seek to emulate his 
virtues. 

" Resolved, That a copy of these resolutions be furnished to the bereaved 
family, and that they be published in the daily papers and the medical jour- 
nals of the city." 

At a regular meeting of Cincinnati Medical Society, the 
following resolutions were adopted: 

"While we bow with submission to the will of an all-wise Providence in 
taking from our midst our beloved brother. Dr. Wm. T. Brown, we must 
express our sorrow for his loss, our admiration for his character, and our 
thankfulness for the example of his life ; therefore 

" Resolved, That in the death of Dr. W. T. Brown each one of us has lost 
a warm personal friend ; that this Society has lost an honorable, active and 
earnest member; that the medical profession has lost a member who was 
erer ready and able to uphold its purity and honor, and to extend its bene- 
fits with equal cheerfulness to poor and rich ; that the community in which 
he lived has lost a citizen who was always fearless in support of the right, 
and whose hand never withheld what duty or charity demanded. 

" Resolved, That we extend our sympathy to the members of his family, 
•who are mourning the loss of a husband, father, son and brother, the depth 
of whose tender affection could not be sounded. 

"Resolved, That a copy of these resolutions be sent to his family, and that 
they be published in the daily papers and medical journals of the city. 

" Willi AN Judkins, 
" T. H. Kearney, 
"W. H. McKetnolds, 

" Committee." 

ACTION OF THE MIAMI ALUMNI. 

The Alumni Association of Miami Medical College held 
a meeting at the College Building, to take action on the 
death of their former ex-President, Dr. William T. Brown. 

A large number of gentlemen were present, among 
whom were some of our most prominent physicians in the 
city, many of whom had been warm, personal friends 
of Dr. Brown. 

Dr. C. P. Brent, President, iu the chair; Dr. W. H. Falls, 
Secretary. 

Dr. Brent having stated the object of the meeting in 



EDITORIAL. 137 



some well-chosen remarks, the following gentlemen were 
appointed to draft appropriate resolutions: Drs. Stanton, 
William B. Davis and L. A. Sliepard. 

Remarks, very highly eulogistic to the memory of the 
deceased, were made by Drs. Brent, Bigney, C P. Judkins, 
L. A. Sliepard, William Judkins and Professor William B. 
Davis. 

Each gentleman spoke of the high regard and esteem 
with which Dr. Brown was held, not only by physicians, 
but people at large; of his self-sacrificing duty to his pa- 
tients, and the high and noble example he had left after a 
life of such great usefulness, and which was so worthy of 
emulation. 

The Committee on Resolutions presented the following, 

which were adopted : 

" It seldom falls to our lot to mourn the loss of a man whose death leaves 
such a chasm in our Society as does that of our brother, Dr. William T. 
Brown. He entered the Miami Medical College in 1854, and in 1857 took 
the degree of M. D. at the age of twenty-one years. While a student in 
College he sustained the character of a most devoted and enthusiastic stu- 
dent of medicine, and enjoyed the respect of all his classmates. 

" After graduation he remained one year in the St. John's Hospital as 
one of the resident physicians, on leaving which he engaged in the practice 
of his profession in this city, where, by his assiduous attention to professional 
duties, together with his good judgment, he was soon introduced to a gen- 
eral practice, which was limited only by his inability to attend to it, if 
further increased. The faithful discharge of the duties incumbent on the 
physician, and his close application to study laid the foundation for the 
disease which cut him off at the time when he should have been at the 
meridian of his usefulness. 

" In all the relations of life he was most exemplary. As a man he was 
affable and courteous, ardent and faithful in his friendship. As a physician 
he stood high with all who knew him. Not satisfied with distinction in a 
single department of medicine, but soaring far above mediocrity in all. He 
was a strong enemy of quackery, with which he held no terms, under what- 
ever garb it presented itself. A wife and two children remain, to mingle 
their tears together, as they realize the greatness of their loss, and to them 
we tender the condolence and sympathy of this Association. 

'^ Resolved, T\mt in the de&ih oi Dr. JJrown the Alumni Association of 
Miami Medical College has lost one of its most honorable members, the com- 
munity one of its most accomplished and successful physicians, and the 
medical profession one of its most beloved and distmguished members. 

"Resolved, That while deploring his loss we will emulate his virtues, and 
enshrine his memory in our hearts. 

" Resolved, That a copy of these preambles and resolutions be sent to the 
family of the deceased, and another furnished the press for publication. 

Dr. Bigney was authorized to procure a floral tribute as 
an oflering from the Society to the memory of their de- 
ceased friend and brother. 



138 EDITORIAL. 



/ Medical Colleges. — In a letter published in a recent 
issue of the Boston Med. and Surg. Jour.., Dr. Oliver 
Wendell Holmes writes: "A school which depends for 
its existence upon the number of its students can not be 
I expected to commit suicide in order to satisfy an ideal 
• demand for perfection. Any institution which is essen- 
tially dependent on the number of paying students it can 
draw must be tempted to sacrifice its higher aims to pop- 
ularity. No high standard can be reached under su 'h 
circumstances, and the only way to insure the inde- 
pendent action of a school which aims at teaching the 
whole country by example, is to endow its professorships, 
80 that the very best and highest grade of instruction, 
and not that which is popular because it is easy and 
superficial, may always be given from its chairs, whether 
the classes be large or small. A small number of thor- 
oughly accomplished medical graduates, their knowledge 
based on sound scientific acquirements, and made prac- 
tical by assiduous clinical observation and teaching, will 
be worth more to the country than twice or thrice the 
X number of half-taught, hastily-taught practitioners. A 

' series of such classes will, in the course of a single gen- 

eration, elevate the whole professional standard, as they 
go forth, year after year, missionaries in the cause of 
health. 

"The Old World motto is noblesse oblige. Our generous 
men of wealth are changing the phrase to richesse oblige, 
and thus becoming recognized as our untitled nobility. 
It is only necessary to show them in what way their 
beneficence will do the most extended and the most last- 
ing good. The founding of five or six professorships will 
carry the names of their founders down to a remote pos- 
terity, and call them to honored remembrance when the 
stately buildings around us are replaced by other and still 

nobler structures." 

"These sentiments of Prof. Holmes we have urged in 
the main, so frequently in the Medical News, and pressed 
them with so much emphasis, that the members of the 
various faculties in the neighborhood seem to have lost 
their kindly interest for us ; but as a watchman upon the 
wall, whose duty it is to give notice of approaching dan- 
ger, we have felt it incumbent upon us to expose all 
shams and tricks, and exhibit to the light all measures 
that tended to degrade the profession. Time and again 



EDITORIAL. 139 



have we produced evidence of a student's having been per- 
mitted to graduate by one of the regular medical schools 
of Cincinnati who had studied medicine less than two 
years. Again, we have cited instances, that have come 
under our ^observation, where students have received 
credit for attendance upon two courses of lectures, and 
graduated, when, in fact, they had attended only about 
six weeks of each of two terms of lectures — twelve weeks 
altogether. We have also made known the fact that, of a 
' class of a hundred candidates or more for graduation, there 
had not been a single failure of passing, when, according to 
the experience of every medical educator, that there should 
not be a single incompetent person among so great a 
number of candidates, is absurd to suppose. Mr. Buckle, 
in his History ot Civilization, has shown conclusively 
that, in a given society, the relative proportions of per- 
sons of peculiar characteristics are always the same ; i.e., 
in communities, the good and bad, the educated and un- 
educated, infidels and believers, exist together in an in- 
variable proportion. AVheu, therefore, a college claims 
that, of a hundred candidates for graduation, every one is 
qualified, when other medical schools reject ten or more 
per cent., it can be set down that the claim is not valid, 
to say the least. 

In exposing this laxitj'- of the schools in our vicinity,* 
we have assigned as cause of it the fact that these col- 
leges depend solely for their support upon the fees ob- 
tained from students, and, consequently, they are under 
the necessity, to a greater or less extent, of catering to 
students. If an individual presents himself to attend 
lectures, he must be accepted, as a student, however ig- 
norant he may be, however unqualified he may be, in all 
respects, for such a profession as that of medicine, or the 
college treasury will sulfer loss. If there should be a 
failure in paying expenses, if a student is refused, the 
members of the faculty must make up from their private 
resources whatever amount would have been received 
from the rejected individual in fees, if he had not been 
rejected. It will thus be perceived that for a medical 



* We have no doubt there is as groat laxity in the medical colleges of 
other cities as in those of Cincinnati. Our criticisms have applied to them 
more than to others, simply because they have been more under our obser- 
vation. We have more than once mentioned the delinquencies of colleges 
in distant cities. 



140 EDITORIAL. 



college to refuse students from any cause, as, for instance, 
want of preliminary education, etc., is to lessen its means 
of existence — an act toward suicide; and, if ventured 
upon, it must be done with the greatest care, or suicide 
out and out will be the result. 

We have frequently insisted in our editorials that the 
fee demanded for diploma — usually $25 or $30 — is really 
a bribe to the faculty to graduate a student, whether 
qualified or not. We have urged that, if a student has 
faithfully fulfilled all the requirements for graduation,* 
and passed a satisfactory examination, graduation is just- 
ly due him; and to demand a large fee for it is an out- 
rage. Under present regulations, the candidate for grad- 
uation pays into the treasury $25 or $30 a month or six 
weeks previous to the final examination. To reject him 
will be to deplete the treasury to the amount of $25 or 
$30. Is there not the very strongest temptation to let 
the money quietly rest where it has been placed, espe- 
cially if the college greatly needs it ? and where is there 
a medical school, however large may be its classes, that 
is not greatly in need of money? We have never been 
so fortunate as to find one yet. 

But not to lengthen out our article to too great an ex- 
tent. We have no doubt,but that time will eventually 
prove that the only way by which the medical colleges 
of this country can be improved and brought to a high 
standard will be to endow them and make them inde- 
pendent of students' fees. Medical instructors, then, will 
be paid salaries, like other instructors, which they ought 
to be paid, and not be under the necessity of laboring for 
mythical glory. "The laborer is worthy of his hire ;" and 
a physician, like other men, when he spends time and 
labor for the benefit of others, should have a recompense 
in money, the medium which is able to secure for him a 
living and its enjoyments — comforts of mind as well as 
body. Honor and glory are very well in their place, but 
they are poor things to live on — they will not bring a 
single crust of bread when hungry. 

The Harvard Medical School is the only medical school 
in the United States that has set itself on the right course 
to bring about a real elevation of the profession, so far as 
a medical school is concerned in its elevation. The Bos- 
ton Advertiser thus announces its aims, which are worthy 
the emulation of all the other medical colleges ; and we 



EDITORIAL. 141 



hope that it will receive such a patronage as to compel 

imitation : 

It has established a preliminary examination for admission into the 
school, thus excluding the ignorant and wholly untrained young men who 
would begin the arduous studies of a medical course without the knowledge 
and mental discipline which are necessary to fit them to profit by such in- 
struction as is given in a medical school like that of our university. It has 
organized a regularly systematic and progressive course of instruction, in 
place of the mixed courses which have long been tolerated in spite of the 
general conviction and confession of their unphilosophical character and 
unsatisfactory unpractical results. It has multiplied its courses of instruc- 
tion so as to include the various important specialties which have developed 
of late years into separate professional branches. It has secured the co- 
operation of numerous clinical teachers in diflFerent public institutions, so 
that many of the advantages of the great foreign hospitals can be obtained 
without going abroad to find them ; it attempts to establish a regular course 
of four years for all its students; it is building a new and more suitable 
home for the school ; it hopes to retain its present home for clinical pur- 
poses; it desires to attract a larger number of students, and it wishes to re- 
duce their expenses ; it entertains the honorable and laudable ambition of 
being the foremost medical school in the country; and it proposes to make 
such further advance in the thoroughness and completeness of the instruc- 
tion it can supply, that it will be no longer necessary for the medical graduate 
of the United States to continue and supplemeNt his studies in foreign lands. 
All this can be accomplished by the endowment of professorships and by 
increasing the permanent fund of the school. 



Tonga Free to Science! Messrs. Allen & Hanburys, of 
London, brought suit against Parke, Davis & Co., for al- 
leged infringement of their rights in their use of the word 
Tonga. We learn that they have received the following 
service from their attorney: 

" Detroit, Michigan, January 20th, 1882. 
" Messrs. Parks, Davis & Co. 

"Ge7itle7nen: — In the case of Hanburys vs. Parke, Davis & Co., the com- 
plainants, on their own motion, obtained an order of court to dismiss bill of 
complaint with costs to be defrayed by themselves. 

" This order was obtained after the defense had established by the testi- 
mony of Dr. Frank E. Stewart and of Charles Rice, both of New York, 
that the word Tonga had long been known, and had long ago been applied 
both to natural products and to medicinal preparations. It was thereby 
shown, that the claims of complainants, tbat they had invented the word 
Tonga, and first applied it to medicinal preparations, had no foundation in 
fact whatever." 

The absurdity of the claims of the complainants, as to 
their ownership in tliis word, is fully established by their 
action in withdrawing the case and assuming costs thereof 
before the defendants had completed the taking of evidence 
on their side of the case. 

In this contest, the house of Parke, Davis & Co. have 
been fighting single handed against the nostrum venders, 



142 EDITORIAL. 



who have been constantly invading the province of the 
scientific physician. The nostrum trade, for some time, 
have been endeavoring to monopolize all preparations 
and medicines adapted to the cure of chronic diseases, and 
make all discoveries in materia medica and pharmacy pay 
tribute to them. But in this recent suit, which was brought 
against one of the leading pharmaceutical houses of the 
country, they have suffered a signal defeat. 

Tonga is a compound of barks prepared by the natives 
of the Fiji Islands, and lias borne in that locality for years 
the reputation of being an effective remedy in the treat- 
ment of neuralgia. A quantity thereof was brought, as 
alleged, to London in the year 1879 by one Mr. Ryder, who 
placed the same in the hands of Allen & Hanburys, drug- 
gists, London, in order that it might be introduced prop- 
erly to the medical profession. The first information 
relative thereto which was published to the public or to 
the medical profession appeared in the shape of an article 
in the London Lancet, March 6, 1880, pp. 360, 361, March 
20, 1880, p. 445, as a communication from the pens of the 
distinguished physiologists and therapeutists of London, 
Drs. Wm. Murrell and Sidney Ringer. Following this 
article were others of a similar nature \\\ the Lancet, and 
one appearing in the London Phavmaceutical Journal 
and Transactions, April, 1880, from the pen of the dis- 
tinguished curator of the Pharmaceutical Museum of Lon- 
don, Dr. Holmes, upon the subject of the " Botanical 
Origin of Tonga." Believing that Drs. Murrell and Ringer, 
from their high professional position, would never have 
investigated or published the results of their investigations 
of any drug in the London Lancet, without it was free 
from any contaminations of a proprietary nature, Parke, 
Davis & Co. felt no hesitancy in assuming that Tonga was 
common property, and accessible to the reach of any house 
of sufficient enterprise to seek the drug in its original hab- 
itat. Acting on this supposition they dispatched a special 
representative to the Fiji Islands, 7,000 miles southwest 
from San Francisco. He remained in the Fiji Islands six 
months, which visit resulted in the final delivery to them, 
at Detroit, in the month of December, 1880, of a large sup- 
ply of this new drug. In accordance with their usual cus- 
tom, they at once published what reliable information they 
had with reference to the medical properties of this drug, 
and distributed ample quantities to individual practi- 



EDITORIAL. 143 



tioners as well as the public hospitals of the United States 
for trial, at the same time occupying a large amount of 
expensive advertising space in the various medical jour- 
nals of America. As a result of this action a demand was 
rapidly created tor Tonga, which attracted the notice of 
Allen & Hanburys, who commenced suit in this country 
through their agents, Messrs. Schieflfelin & Co., of New 
York, on the ground that they had a proprietary interest 
in the name of "Tonga," than which nothing could be 
more absurd; for, as we understand it, "Tonga "is the 
name given the plant by the inhabitants of Fiji, and con- 
sequently no one can hold an ownership of that name. 
It was undoubtedly an eflort on the part of a drug es- 
tablishment, to make a nostrum ot a new discovery in 
materia medica and to levy a tax on legitimate practice, 
but Messrs. Parke, Davis & Co. nipped it in the bud. 



We are in receipt of a pamphlet on the Preparatory 
Education of Medical Students by Prof. Traill Green, M. 
D.jLL. D., of Lafayette College, Easton, Pa. The subject 
is treated in the able and interesting manner character- 
istic of the author. He shows conclusively the necessity 
ot greater mental training, than is usually the case, on the 
part of young men, proposing to enter the profession, 
preparatory to beginning the study of medicine. He 
quotes the president of Harvard University, who says : 
'' It is notorious that the medical students have been, as 
a rule, a rougher class of young men, than other profes- 
sional students of similar age. In this University, until 
the reformation of the school in 1870-71, the medical 
students were notoriously inferior in learning, manners, 
and discipline to the students in other departments; they 
are now indistinguishable from other students. A cor- 
responding change in the medical profession^ at large 
would be effected in twenty years, if all the important 
medical schools of the country should institute a reason- 
able examination for admission." 

President Elliott is also quoted as saying that an Ameri- 
can physician "may be, and often is, a coarse and unculti- 
vated person, devoid of intellectual interest outside of his 
calling, and quite unable either to speak or write his 
mother tongue with accuracy." 

It is a fact, observed too often to be gainsayed, that an 
individual, without previous mental training, will under- 



144 EDITORIAL. 



take the study of medicine at a great disadvantage, if it is 
his design to do so. A very rude box will be made by one 
who has not first learned the use of tools ; and very poor- 
ly will medicine be learned by an individual, who has not 
first learned how to learn. The person whose mind has 
been disciplined to study, grasps the principles of a new 
study with a facility that can not be approached by one 
whose intellectual powers have not been trained to study. 
Our observation has shown us that a young man, who has 
received a collegiate education, will learn more in a given 
time, though he plays half of his time, than another young 
man, who studies all his time, notwithstanding he may 
have more natural ability, but has no advantages of edu- 
cation. The reason is that the former is skilled in study, 
and knows how to study, while the latter' does not. Prof. 
Green once asked a French teacher how much time he 
gave to French in the classical course. He replied! "One 
terra." "A classical student will learn as much in one 
term, as students who have not studied the ancient lan- 
guages will learn in three terms." Dr. Luther Holden, in 
his recent Hunteriau Oration, , says, as quoted by Prof. 
Green, "that in students who have had a public school 
training (classical), I have found a fuller development 
of the logical faculty, a more cultivated memory, a greater 
grasp and power of combination. I have found the task 
of teaching them so much easier, that I have no hesitation 
in saying that I can teach such pupils more in two months, 
than others, who have had no like education, in six. 

At no distant day, we hope that all the medical colleges, 
in order to hold a respectable position in the profession, 
will be under the necessity to require all who propose to 
attend upon their instructions, to give evidence of pos- 
sessing a certain amount of education that will be, at least, 
a little more than a common school education. 



The meeting of the Alumni Association, of the Ohio 
Medical College, will be held in the College building 
WEDNESDAY, March 1. at 2 p. m. Address by Geo. B. 
Evens, M. D. on the " Relation of Insanity to Modern 
Society." C. S. Muscroft, M. D., Secretary. 



PARKE, DAVIS & CO., Detroit, Mich., 

MANUFACTURING CHEMISTS. 



Fluid Extracts. 


Sugar- Coated Pills, 

OVIFORM AND ROUND. 


We manufacture a full line of fluid extracts, 
both officinal and non-officinal, aiaking a spe- 
cialty of the newer additions to the materia 
medica. By our process, we, as fully aa is pos- 
silile, exhaust the medicinal principles of the 
drug. By the strictest care taken in the selec- 
tion of the crude material, and the most ap- 
proved process of manufacture, operated by the 
hi^'best skill, we succeed in producing fluid 
extracts which are unexcelled and rarely equal- 
ed for fullness and constancy of strength. 


Our pills are made entirely by hand, from 
the purest materials, and are sugar-coated by 
a method avoiding the use of heat above 90° F., 
without impairing either their efficacy or sol- 
ubility. 

For solubility, regularity of shape and 1 eauty 
of finish they are excelled by none. 

They are coated while the mass is yet soft, and 
will remain in same condition for years. 

Special formulae made and coated to order, 
when desired, in lots of 3,000 or upwards. 


Medicated Lozenges. 


Elixirs, Wines and Syrups. 


Lozenges are of use in pharyngeal troubles 
that yield to ordinary medication. By being 
slowlydissolved, the medicament they contain 
is brought into contact with ihe diseased mu- 
cous membranes, and hence a beneficial influ- 
ence, local as well as general, is exerted. In 
this respect they are of inestimable value to 
public speakers, teachers, singers, etc., as they 
are handy to carry about the person. In cer- 
tain diseases of children, in worms, dyspepsia, 
and in cases where it is desirable to carry the 
remedy about the person (as with travelers), 
the lozenge is a useful form for a medicament. 
We manuiacture fifty formuiie. 

Special formulae made to order of any desired 
size, shape, color or flavor, when ordered in 
quantities of three pounds or more. 


We desire to call the attention of pharma- 
cists to our preparations embraced under this 
head. 

Prepared with all the improvements which 
long practical experience and high medical au- 
thority can suggest, we oft'er them as combin- 
ing with therapeutical value, agreeableuess of 
taste, and elegance in appearance. 

We put them up in pounds, half gallons und 
dtmi Johns. 

N. B. — When ordered simply in 'bulk," 
these articles will be sent in half-gallon boules. 
If desired in four-ounce, one or five pound 
bottles, or in demijohns, please specify. 



SPECIALTIES AND SUNDRIES. 



Cascara Cordial. 


Choleate Sodium. 


Monobromated Camphor. 


Sanguis Bovinus Exsiccatus, 


Chem. Pure Chloroform. 


Nitrite Amyl. 


Liquor Ergotse Puriticatus. 


Chaulmoogra Oil. 


Nitrite Amyl Pearls. 


Chlor-Anodyue. 


Chrysoplianic Acid. 


Picrale Ammonium. 


Empty Capsules. 


Crude Petroleum Masa. 


Pepsine Liquid Concentrated. 


Lactated Pepsi ne. 


Dialyzed Iron. 


Pepsine and Laclo-Phos. Lime 


Saccharated Pepsine. 


Distilled Ext. Witch Hazel. 


Lozenges. 


Pure Concentrated Pepsine. 


Dr. Warburg's Tincture. 


Pure Cold Ketined White Nor- 


Pancreatine. 


Ethydene Dichloride. 


wegian Cod Liver Oil. 


New Remedies. 


Elixir Salicylic Acid. 


Quinine Elixir. 


Acid, Uydrobromic Solution. 


Extract Malt. 


Solution Sclerotic Acid. 


Acid, Salicylic Pure. 


Glycerated Dialyzed Iron. 


Sulpho-Carbolate Sodium. 


Berberina Uydrochlorate (Hy- 


Gurjun Balsam. 


Syrup Iodide Iron. 


drastin Mur.). 


llydrastia (White Alkaloid of 


Verba Santa Lozenges, 


Berberina Phosphate (Hydraj- 


(iolden Seal). 


Etc., Etc., Etc. 


tin Pho-sphate). 


Menthol. 





OOINCEIVTI^^^TIOIVS. 



Our list of Concentrations comprises the proximate medicinal principles of the several plants 
named, either combined in the form of a powder, consisting of iwo or more coii-stiiut-nta, or 
isolated in the form of a powdered alkaloid or resinoid. The.se are a very eligible form in which 
to administer medicines, and are higiily prized by many. Put up in ounce bottles and bulk. 



For Descriptive Circular and Price List of above, send to 

Parke, Davis & Co., Detroit, Mich. 



iJARIS, 1867 



1868. 



1872 



1878, VIENNA. 




Prize Medal. 



Silver Medal. 



Gold Medal. 



Medal of Merit 



BOUDAULT'S PePSINE, 

And Wine, Kliiir, Syrup, Pills and loicngea of Pcpsine. 

since 1854, when Pepsine was first introduced by Messrs. Cokvisart and Boudault, 
•<»oudault's Pepsine has been the only preparation which has at all times given satis- 
jtory results. 

The medals obtained by Bondault's Pepsine at the difierent exhibitions of 1867, 
'■''38, 1872, and recently at the Vienna Exhibition of 1873, are unquestionable proofs of its 

excellence. 

In order to give physiciang an opportunity to judge for themselves, aU Boudault's 
Pepsine will hereaftrt- be accompanied by a circular giving plain directions for testing it. 
These tests will enable any one to satisfy himself of the superiority of Boudault's 
Pepsine, which is really the cheapest, since its use will not subject physiciaud audpatieute 
liiikc to disappointment. 

CAUTION.— In order to guard against imitations each bottle will hereafter be sealed 
oy a red metallic capsule, bearing the stamp of our trade mark, and secured by a baud 
.' .avtng a fac-sLniile of the medals, and the signature of Hottot, the manxifactxirer. 
Is sold in 1 oz., S oz., 16 oz.. Bottles. 

E. FOUGERA & CO., New York, 

GENERAL AGEN'TS FOR THE U. 8. 



E. FOUGERA & CO.'S 

Medicated Globules. 



Theformof Globules is by far the most convenient as well as the most elegant form 
tor administering liquid preparations or powders of unpleasant taste or odor. The fol- 
lowing varieties are now offered : 

Globules of Ether ; Chloroform ; Oil of Turpentine ; Apiol ; 
Phosphorated Oil, containing l-60tli grain of Phosphorus; 
Phosphorated Oil, containing l-30th grain of Phosphorus; 

Tar ; Venice Turpentine ; Copaiba ; Copaiba & Tar ; 
Oleo-Resiu of Cubebs ; Balsam of Peru ; 

Oil of Eucalyptus ; Cod Liver Oil ; Rhubarb; 
Bi-carb. of Soda, Sulpli. Quinia, &c. 

'i'lie superiority of these Globules over other forms consists in the ease with which 
they are taken, and in their ready solubiUty and hence promptness of action. 
'i ley are put up in bottles of 100 each. 
f a- descriptive circulars and samples address, 

E. FOUG-ERA & CO., 
30 North William Street, New Vork. 



WHAT IS NESTLES WILK FOOD? 

Its Constituents and Preparation. 

Manufactured only at Vevey, Switzerland, it contains nothing but Milk, 
Wlieaten Bread Crust and Sugar, and requires only water to prepare it for use. 

The Milk is cow's milk condensed in vacuo at a low temperature, to the form of 
a dry powder, so that, excepting condensation, the properties of the milk remain un- 
changed, while its freshness is preserved unimpaired. 

The Wlieateii Bread Crust is prepared from the best wheat, according to a 
peculiar method, which preserves all the nitrogenous substances aiid makes the 
Crust rich in gluten, while by being baked at a high temperature the gluten is ren- 
dered soluble; and being browned tliroughout to a certain shade, the starch is con- 
verted into dextrine, thus removing a very forcible objection made to many farina- 
ceous foods, viz : Infants can not digest starch cells. Further, the Crust is pulverized 
to an impalpable powder. 

The Sugar added is cane sugar, not for the purpose of sweetening, as it is 
already sufficiently sweet from the sugar of milk in the condensation, but a small 
percentage for the purpose of supplying the carbon requisite, cane sugar being about 
98 per cent, pure carbon . 

These constituents are then united in such proportions that by the addition of 
water only (thus doing away with the danger of milk, usually impure, and fre- 
quently diseased), in the proportion often of water to one of the Food, it forms a liquid 
which chemically analyzed will be found to bie almost identical with the chemical 
analysis of Woman's Milk. 

Put up in pound tins, hermetically sealed. Price fifty cents per tin. A pam- 
phlet, by Prof. H. Lebert, of Berlin, giving full particulars, sent to any address on 
application to 

THOMAS LEEMING & CO., Sole Agents, 

18 College Place, Netv York City. 

We would also call attention to Nestle's Condensed Swiss Milk, as the richest and 

purest in the world. 



THE 




fiiTCiiai 



IiAfaitette: r. r. 



AND 



The popular Passenger Route to and from the East & West. 



THE ONLT I.INE RUNNINO THKOITOII CARS FROM CINCINNATI T« 

THK IttlS.SISSIPPI. 



The popular Kankakee Koute to Chicago is via this Line. The entire train 
runs through, without change. Four daily trains leave the Plum Street Depot, and 
one through train on Sunday Night. Parlor Cars on its day train to Chicago, 
without change. Pullman Palace Cars on all night trains. All passenger trains 
of this Company are provided with the Miller Platform and Coupler and the cele- 
brated Westinghouse Air brake. 

Buy and see that your tickets read via this line. Baggage checked through. 

H. J. PAGE, JOHN JBlGAN, 

General Freight and Ticket Ag't. Gon'l Passenger Agent. 

ciisrciiTisrA-Ti. o. 




OLDEST HOUSE IN THE WEST I 



(ESTABUSHKD 1837.) 



MAX yKTOGHBR A SOUT^ 

MANUFACTURKR8 AND IMPORTBBS OV 



-AND- 



ORTHOP/EDICAL APPLIANCES, 

105 West Sixth St. (Ohio Medical College Building), Cincinnati, 0. 



Our stock comprises a full assortment of Surgical Instruments in 
all its various branches, and to which we add constantly new inven- 
tions, approved of by the profession here and abroad. 

jA-Ppctvatuses for all kinds of human deformities we make with 
all the latest improveTnents, as reeom,m.ended by the best authorities, 

An experience of over 40 years as a practical instrument-maker, 
together with the reputation enjoyed by us for so many years, will 
serve as a guarantee that all orders will be promptly and satsfac- 
torily execued. 



o 



^ 1=1 



CI Q 

0)0 

< r 
a CO 

% o 
a ni 

■ 2 

m 

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-I o = i: >J* 

w-.cs: 



u 
oft £3 

1-1 
P o 



s-p rj-i ^^ 
q? I To 

gooB — 
O 3 l» W O-O 

g « » Stq o- 



LAWRENCES I^ARTINS 





^^^^^^^ 




(nmi^^imi^ 




Trade Mark RggisTEREP 



2HgoS. 

1-3 >^' o 
SpCgffl 



■OP"" 

..D Si"' 

• sro g 

CBgpP> 




Kirkwood's Inhaler. 




This is the only complete, rehable and effective inhaler 
in use, arranged for the direct application of Muriate of 
Ammonia and other remedial agents in the state of vapor 
to the diseased parts of the air passages in the treatment of 
catarrh and diseases of the throat and lungs. No heat or 
warm liquids required in its use. 

It is entirely different from the various frail,, cheap in- 
struments that have been introduced. 

KIRKWOOD'S INHALER is accompanied by testi- 
monials of the highest professional character, together with 
carefully prepared formulas for use. 

Betail Price, complete, 85.00 ; Small size, 82.60. 
A liberal discount allowed to the trade and profession. 

For descriptive pamphlets, or other information, address 

£. FOUGERA Sc CO., 

30 North Wiliam Street, New York. 



DOCTOR RABUTEAU'S 
Dragees, Elixir and Syrup of Iron. 

The numerous experiments made by the most distinguished practitioners of our days 
in France and America have demonstrated that Dr. Rabuteau's preparations of Iron are 
superior to all other chalybeates in the treatment of Chlorosis, Anwmia, Debility, Ex- 
haustion, Convalescence, Weakness of Children, and all diseases caused by a deterioration 
of the blood. 

Dr. Rabuteau's Dragees (sugar coated pills) do not blacken the teeth, and are assimi- 
lated by the most delicate stomachs without causing constipation. Dose, 2 morning 
and evening, at meal time. 

Dr. Rabuteau's Elixir is especially adapted to weak persons, whose digestive func- 
tions need strengthening or stimulating. 

Dr. Rabuteau's Syrup is especially prepared for children, who take it readily because 
of its agreeable taste. 

Prepareti by CLIN & CO., Pharmacists, Paris. 



rj^KiaaoBBBa 




Blancard's Pills 

OF UNCHANGEABLE IODIDE OF IRON. * 

Blancard's Pills of Iodide of Iron are so 6cnip\ilously prepared, and so well made 
that none other have ac(iiiircd a so well dc.sorvi d favor anionK physicians and phannaceu- 
list."?. Eafh iiill, <;ontuininK one K™i» '>f prot(, -iodide of iron, is covered with finely pid- 
verlscd iron, and covered witli lialsam of tolii. Dose, two to six i>ills a day. The ^'cnuinc 
liavc a 1 inclivr .silver ixil attacheil to tlio lower i)art of the cork, aud a green label ou the 
wraiiper. bearing; ^, ^ 

the fftc-similo 
the signature of ^ J^U7/?7 /y?/7X/ ? Phaitnacien, No. 40 Rue Bona^pcvrte, Paris. 

without which nonr *re genidne. 



BEWARE OF IMITATIONS. 



'6 

Manufactures, by his Improved Method, 

"Which has proven its superiority over other Pepsins by its stability and uni- 
formityi In digestive power it corresponds to the standard adopted by the Com- 
mittee on the Sixth Revision of the U. S. Pharmacopreia, which is as follows: 

One part dissolved in 500 parts of water, acidulated with 7.5 parts of hydrochlor- 
ic acid, should digest at least 50 parts of hard-boiled Egg Albumen in 5 to 6 hours 
at 100° to 104° P. 

DRY PEPSIN, CONCENTRATED, 

Possessing eight times the strength of the above preparation. Particularly recom- 
mended to manufacturers. 



Premiums were awarded to the above preparations at^the 

INTERNATIONAL EXPOSITION AT VIENNA, 1873, 

AND THE 

CENTENNIAL EXPOSITION IN PHILADELPHIA. 



R. A. ROBINSON & CO., 

LOUISVILLE, KY., 

B. ieceith: & co.'s 

CONCENTMATBiy TINCTURES, Etc, 

The powders are put up in bottles of one ounce, avoirdupois, and securely sealed 
to protect them from the action of the atmosphere. 

CONCENTRATED TINCTURES, 

Prepared byre-dissolving the '^active principles" in alcohol in definite propor- 
tions. Put up in bottles of 2ozs., 8ozs., and lib. 



VACCINE VIRUS. 

10 Ivory Points, Cow-Pox Virus, charged on both sides, - $1 50 
1 Crust, 300 

Sent by mail on receipt on price. 

haivd-book: of i*j2.actioe^ 

Employing Concentrated Medicinks. 

by b. kbith, m. d. 
Price, Fifty Cents. 

We will furnish gratis, on application, a copy of our " Revised and Enlarged 
Manual of the Active Principles of Indigenous and Foreign Medicinal 
Plants," containing short accounts of each preparation, with properties, uses, doses, 
etc., also Price List. Address all communications to 

B. KEITH d- CO., 
P. O, Box 1759. No.^4l 'Liberty Stbejct, New York 




SAmeN OF APrA- 
RATrs. 

No. 1. Bow Leg. 

2. Sayre'8 Hip Joint. 

3. Truss. 

4. Artificial Leg. 

5. Saddle Bag. 

6. Abdominal Belt. 
7. Elastic Stocking, 

Knee Cap, etc. 

8. Weak Ankle. 

9. Knock Knee. 

10. Long Hip Joint. 

11. Extension Shoe. 

12. Surgical Instruments. 

13. Crutches. 

14. Shoulder Braces. 

15. Spinal Apparatus, lat- 

eral. 

16. Autenrieth's Club 

Foot Shoes. 

17. Skeletons. 

18. Artificial Eye8(gla88). 

19. Autenrieth's Razors' 

Send for Circulars for 
Measurements. 



BELLEVUE HOSPITAL MEDICAL COLLEGE 

CITY OF IVEW YORBl. 

SEssionsr oif isai-ss.. 

Al and after the Session of 1881-82, the College will return to its former requirements as regards fees an^ 
graduation, viz : those in force before the Session of 1880-81. 

THE COLLECilATE YEAR in this Institution embraces the i'' ular Winter Session, and a Spring 
Session. THE RECiULAK SESSION will begin on Wednesday, September 21, 1881, and end about the 
middle ■> March, 1882 During this Session, in addition to lour didactic lectures on every week-day ex- 
cept Sal ui day, two or three hours are daily allotted to clinical instruction. Attendance upon three 
regular courses of lecture.* is required for graduation. THE SPRING SESSION consists chiefly of rec- 
itatJous from Text-Books. This Session begins about the middle of March and continues until the 
middle of June. During this Session, daily recitations in all the departments are held by a corps of 
Examiners appointed by the Faculty. Short courses of lectures aie given on special subjects, and regu- 
lar clinks are held in the Hospital and in the College building. 

ISAAC E. TAYLOR, M. D., 
Emeritus Professor of Obstetrics and Diseases of Women and Children, and President of the Faculty. 
JAMES R. WOOD, M. D., EL. D., FORDYCE BARKER, M. D., LL. D. 

Emeritus Professor of Surgery. Professor of Chnical Midwifery and Diseases of Worn 'u 

BENJAMIN W. McCREADY, M. D., , 

■Emeritus Professor of Materia Medica and Therapeutics, and Prof, of Clinical Medicine. 



AUSTIN FLINT, M. D., 

Professorof the Principles and Practice of Medicine 

and Clinical Medicine. 

W. H. VAN BUKEN, M. D., LL.D., 

Professor of Principles and Practice of Surgery, 

Diseases 'of Geuito-Urinaiy System and 

Clinical Surgery. 

LEWIS A. SAYRE, M. D., 

Professor of Orthopedic Surgery and Clinical 

Surgery. 

ALEXANDER B MOTT, M. D., 
Professor of Clinical and Operative Surgery. 

WILLIAM T. LUSK, M. D., 

Professorof Obstetrics and Diseases of Women and 

Children, and Clinical Midwifery. 

PROFESSORS OF SPECIA 

HENRY D. NOYES, M. D., 

Professor of Opthalmology and Otology. 

J. LEWIS SMITH, M. D., 

Clinical Professor of Diseases of Children. 

EDWARD L. KEYES, M. D., 

Professor of Dermatology, and Adjunct to the 

Chair of Principles of Surgery. 

JOHN P. GRAY, M. D., LL.D., 

Professor of Psychological Medicine and Medical 

Jurisprudence. 

ERSKINE MA.'-ON, M. D., 

. Clinical Professor of Surgery. 

JO.-iEPH W. HOWE, M. D., 
Clinical Professor of Surgery. 



A. A. SMITH, M. D.. 

Professor of Materia] Medica and Therapeutics, ii>' 

Clinical Medicine. 

AUSTIN FLINT, Jb., M. D., 

Professorof Physiology and Physiological Anatomy. 

and Secretary of the Faculty. 

JOSEPH D. BRYANT, M. D.. 

Professor of General, Descriptive and Surgical 

Anatomy. 

E. OGDEN DOREMUS, M. D., LL.p., 
Professor of Chemistry and Toxicology. 

EDWARD G. JANEWAY, M. D., 
Professor of Pathological Anatomy and Histology, 
Diseases of the Nervous System, and Clin- 
ical Medicine. 

I. DEPARTMENTS, Etc. 

LEROY MILTON YALE, M. D., 
Lecturer Adjunct on Orthopedic Surgery. 

BEVERLY ROBINSON, M. D., 
Lecturer on Clinical Medicine. 

FRANK H. BOSWORTH, M. D., 
Lecturer on Diseases of the Throat. 

CHARLES A. DOREMUS, M. D., Ph. D., 

Lecturer on Practical Chemistry and Toxicology, 

and Adjunct to the Char of Chemistry and 

Toxicology. 

FREDERICK S. DENNIS, M. D., M. R. C. S., 

WILLIAM H. WELCH, M. D., 
Demonstrators of Anatomy. 



FAOUETY FOR THE SPRING SESSION. 

FREDERICK A. CASTLE, M. D., I T. HERRING BURCHARD, M. D, 
Lecturer on Pharmacology. | Lecturer^on Surgical Ernergencies, 



WILLIAM H WELCH, M. D., 
Lecturer on Pathological Histology. 
CHARLES A. DOREMUS, M D., Ph. D., 
Lecturer on Animal Chemistry. • 



ANDREW R. ROBINSON, M.D., L.R.C.P. &S., 

Edin., 1-ectureron Normal Histology. 

CHARLES S. BULL, M. D., 

Lecturer on Ophthalmology and Otology. 



'or Students who have attended two full courses at other Medical Colleges, 1 nam 

[id for (Graduates of less than three years' standing at other Medical Colleges j" 



FEES FOR THE REOUEAR SESSION. 

Fees for Tickets to all the Lectures, Clinical and Didactic S140 00 

Fees for Students who have attended 
and 

Matriculation Fee 3 00 

Dissection Fee (including material for dissection) 10 00 

Graduation Fee 30 00 

No Fees for Lectures are required of Graduates of three years' standing, or of third-course Stu- 
dents who have attended their second course at the Believue Hospital Medical College. 

FEES FOR THE SPRING SESSION. 

Matriculation (Ticket valid for the following Wint€r) $ 5 00 

Recitations, Clinics and Lectures _ ,. ~. 35 00 

Dissection (Ticket valid for the following Winter^ 10 00 

»!S9"Forthe Annual Circular and Catalogue, giving full Regulations for Graduation anl other infor- 
mation, address Prof. AUSTIN FLINT, Jr., Secretary, Bellevae HospitaliM^dical College. 



JOHNSTOXE'S IMPRO^TED 

ADAPTABLE POROUS FELT SPLINTS. 



AHL'S SPLINT MANUFACTURING COMPANY, Limited, 

123 & 125 Souih Eleventh Street, PHILADELPHIA, PA. 



THE ADAPTABLE POBOUS SPLINTS, invented and improved by V. U. JonssroKr, liavc been tested exicnsivcly in both 
civil and miiilarv piaeticc for n number of jeai-s. and have been endorsed and reeonimeudcd in tlie most unqualified manner by 
the celebrated and distinguished Surgeons of America. 

Their itorositj/ is n peculiar and a valuable property. "While the maten'al is firm and insoluble, it permits readily the passage 
cf air and tluida. so that, on one band, tlio heat from the intlamed surface, the perspiration, and iho morbid exhalations, are not 
conJined. to the detriment of tlie patient, as ts t/te case in every oilier kind of sjitint, but pass off fi-eely; and on the other hand, lotions 
of cold or worm watei-, medicated or not with weak alcohol, carbolic acid, arnica, tincture, solutions of the sr.lpbitcs, etc., can bo 
constantiy applied without dii;turbing the dressings. This, it will readily lie seen, is a most invaluable property when the parts are 
bruised, lacerated, filled with extravasatcd blood, or erj'sipclatous, and give these splints a conspicuous adv^tage over all others. 



From FRANK B. HAMILTOSr, St. 2>.V Professor of Fratlures and Dislocations in the Bellevue 
MospUal Medical College, author of "A Treatise on Fractures and Dislocations," etc. 

Having examined carefaWy JOHNSTONE'S IMPROVED ADAPTABLE POROUS FELT SPLINTS, I feel warranted 
in retommending them to tha Profession as superior to all other manufactured splints now in use. They possess all the essential 



qualities of a good ti2)lint having firmness, pliability and lightness. 



FRANK H. HAMILTON, M. D., 



Prof, ilililary Surgeri/ and Fractures and Dislocations, Beltevue Hospital CoL 



JFrt>m pJBOr. D. HAYES AOSEW, Prof. Surgery, University of Penna. 

1011 CnESTKOT Stbiet, PiiiLADEL?niA, February (W, 1879. 
The Adaptable Felt Eplinta, formerly "known as those of Dr. Ahl, with the impHjvement now made ky "\V. H. Johnstone, wbiclr 
JBUdetS them, in creiy "iray enperior to the fonnor, I. regard as very excellent appliances in the treatment of fractures. 

D. HAYES AGNEW, 
, . ^ Prof. Surgery, Vhivereily of Panaylvama. 

Cuts illustrating the different Splints constituting a. Complete Set. 

hperior foreorm ftadim. 




SPECIAL NOTICE TO THE PROFESSION AND TRADE. 

Our policy hcititoforo in the intiwluction of .lOHNSTONES IMPROVED ADAPTABLE POROUS FELT SPLINTS, has been 
to confine the eal'^s and buMincss negotiations directly to the Doctors themselves, declining iu every case to sell our gixxls thn>u(tti 
Dealiji-s; we having assured the Prufessinn gcnerollj, both through our agents and catalogues, tiiat'JOllNSTONE'S IMPROVED 
SPLINTS could ui)ly lie obtained by subscriptiun. 

"VVe wish to announce, that owing to the largo. demand for our goods and the constant importunity on the part of Surgntu 
cverjivhcMx; to place our splints on sale with their Instninient Dealer or Druggist, to ufl'urd them greater convenience and ficilily in 
obtaining Iho pieces in duplieulc, v»e h»ye at l»t acceded to that request, and hereafter JOHNSTONE'S CELEBRATED 
FELT SPLINTS cin bn obtained at moit dealer* (In Inatrumenta and Drugi throughout the United Statei, at tha same price 
Vvhich they wero heretofore aold, viz : 

,A compute »rt, ^mbraeinif Jtfllf (^OJ I>ifc«*- tweiUy-ftve for adults and tirentyfive for cMIdrtn—is thirty ($30) Aettars, 
T.xtftA or iliiptteatti pleoos cat\ attoaya be otitatned from your VKALEIi, at oiK tlotlar each, 

JOHNSTONE'S CELEBRATED SPINAL JACKET, for Curraturcs and Deformities, have met with unparalleled ltuoct;■s^ 
Bad. fmm IhCir merit, etcnred the unquubScrS £DducBi;raent and approbation of our.ceIebratea orlhoiwKlic sjiecialists, and particular 
explt:8^ion of gintitiidc from the p^Ucnls Rho are ivcaring ibem. £oc ifull anfonnalion, ecnd for Descriptive Circ>iliu>^ 

Should your Inslmmcot tl eiilur fnil in lutUI Ik Bu^y pi Dur S^>linU| jind decline to carry ibem in muck, ordent Knt to ua 
■ill tcccbc prompt altezlQmi. 

AHL'S SPLINT MANUFACTURING CO., Limited. 

W. H. JOHNSTONE. Managvr, 



10 

Contains THE ESSENTIAL ELEMENTS to the Animal Organization 
— Potash and Lime; 

The OXYDIZING AGENTS— Iron and Manganese; 

The TONICS— Quinine and Strychnine; 

And the VITALIZING CONSTITUENT— Phosphorus. 
Combined in the form of a Syrup, with slight alkaline reaction. 

IT DIFFERS IN EFFECT FROM ALL OTHERS, being pleas- 
ant to taste, acceptable to the stomach, and harmless under prolonged use. 

IT HAS SUSTAINED A HIGH REPUTATION in America and 
England for efficiency in the treatment of Pulmonary Tuberculosis, Chronic 
Bronchitis, and other affections of the respiratory organs, and is employed 
also in various nervous and debilitating diseases with success. 

ITS CURATIVE PROPERTIES are largely attributable to Stimu- 
lant, Tonic, and Nutritive qualities, whereby the various organic functions 
are recruited. 

IN CASES whereby innervating constitutional treatment is applied, 
and tonic treatment is desirable, this preparation will be found to act with 
safety and satisfaction. 

ITS ACTION IS PROMPT, stimulating the appetite, and the di- 
gestion, it promotes assimilation, and enters directly into the circulation 
with the food products. 

THE PRESCRIBED DOSE produces a feeling of buoyancy, remov- 
ing depression or melancholy, and hence is of great value in the treatment 

of MENTAL AND NERVOUS AFFECTIONS. 

From its exerting a double tonic effect and influencirtg a healthy flow 
of the secretions, its use is indicated in a wide range of diseases. 

Each Bottle of Fellows' Hypophosphites contains 128 closes. 

Prepared ty JAMES I. FELLOWS, Chemist, 

Circulars and Samples sent to Physicians on application. 



g^'SPECIAL.— ONE large bottle containing 15 oz. (which usually sells for S1.50) 
will be sent upon receipt of Fifty Cents with the application; this will be ap- 
plied to the prepayment of Exprtssage, and will afford an opportunity for a 
thorough test in Chronic cases of Debility and Nervousness. Express Charges 
prepaid upon all samples. For sale by all druggists. 



11 

BARON liEf BIO, tin* cnreaten authority on f nftnt IMet, ntatea that tli* 
majority of children wbo die under one year of age^ do so 
from tbe effects of improper food, or from the Im- 
proper adm^nlntratlon of the food. 



— -i»*»i]f«j— 



HORLICK'S FOOD. 

JL Concentrated Extract^ prepared according to the For^ 
mula of Baron TAehig, and. tmilihe other Foods, 

IS NOT FABINACEOUS. 




It Is acknowledged by Physicians to be the best Food 

Prof. J. Le^ris Smitli Says, 

speaking of HORIilCK'S FOOO : "Being canfr.lly irrepared, according to Lle- 
BTg'a Formula, by CheniistB fnlly competent, it possesses certain advantages, such as qiiick 
and ea.sy preparation and a pleasant flavor, and is tlieiofore higlily esteemed by those who 
have used it. ' [Page 58 of the fourth edition of a Treatise on Diseases of Infancu and Child- 
hood. By J. Lewis Smith, M. I> ., etc.— 1S79]' Also, speaking in another place [pa"e 647] of 
artificial /ood for infants, especially those suffering from intestinal catarrh, ne says: "I prefer 
Liebig's, especially HORIilCK'S preparation of It." 

Report from Bsllevue Hospital, New York. 

In Th£ Hospita'. Gi:Me for February 6th. 1879 [page 108] Dr. E. Ilochheimer mfikcs a 
report from Bellevtje HosptTAi of a case of Infantile Paralysis, which was followed by an 
exhausting diarrhoea — Speaking of the treatment, he says: "Her condition continned un- 
changed for the ne.xt three weeks; she was put npon a diet consisting principally of milk, but 
the diarrhoea persisted in spite of opiates and astringents." 

" iVow. nth.— Milk was stopped, and she was put upon a diet of HORLICK'S FOOD: ajUr 
this she bet/an to Tnend, the diarrhaa became less and JlnaUy disappeared ; she began to gc^ 
ieth, and her general condition was much improved." 

We also beg to refer, by permission, to the following eminent med- 
ical men, who have used our Food extensively in their practice : — 
Prof. BeLaskle Miller, (Rush Medical College); Prof. Wm. H. 
Byfordj (Chicago Medical College); Prof. J. Adams Allen, (Rush 
Medical College); Drs. J. P. Oliver and C P. Putnam, (Har- 
vard Medical School); Prof. Oawno, (Cleveland Medical College); 
and several hundred others, whose testimonial letters are on file ia 
our office. 

PRICE, 75 Cents per bottle. Trial Size, 40 Cents. 

J. & W. HORLICK & CO.. Racine. Wis. 

WHOLESALE AGENT, | LONDON AGENTS, 

Oscar KRKSS.lF. NEWBERY & SONS, 

1670 Broadway. Now York. | ^7 Newgate '^t., London, E. 0., Ena 



' rhysicians mil confer a special fa/vor by nending for sample, which wili At 
promptly and eheerfvJly Jwrrmhsd, «ither ^ th* tnaiht^faci%mrt or thmr Whoimak 
AfftnL 



12 



The undersigned is prepared to make Examinations in 
Pathology for Physicians. 

Having the finest Lenses, made by the best makers in 
the world, and all other facilities, he will guarantee cor- 
rectness in all examinations. 

J. A. THACKER, A. M., M. D., F. R. M. S. 

OFFICE Of MBBICAL XXW8. 



m® 



>® 



-WHOLESALE SEALERS IN- 










db» 



• • 



45IM^^ 



-AND- 



b^relS, herbs, rooxs, etc. 

Manufact'ers of Resinoids, Fluid & Solid Extracts, Syrups, Tinctures, Ointments, Etc. 



Particular attention paid to Physicians' orders; all Medicines warranted of the best 

quality; Shop Furniture, Instruments, and Medical Books 

furnished at lowest prices. 

Southeast Corner Fifth and Race Streets, Cincinnati, Ohio. 



FBBSH VACaNE VIRUS CONSTANTLY ON HAND. 



13 




14 






Tahe Only and Insist on The Best of American Manufacture. 

PLANTEN'S CAPSULES, 

Known as Reliable nearly Filty Tears. 

*See note page 64, Prof. Van Burbn & Kkyes, on Urinary Organs. 

Premium for "General Excellence in Manufacture." 

H. PLANTEN & SON, 224 William Street, N. Y. 

HARD AND SOFT CAPSULES FILLED OF ALL KINDS. 

EIVIF^TY CAI*SULES (T Sizes). 

H«. 00, Urg«t. Ho. 5 2, SmaUejt. Especially adopted and reeora- 

( Order by .Yum',eronli,.) j^Qj^^Q^ ^j. administering concen- 

§r\ ^Boxes ion each, tratg^ ^^ nauseous medicines free 

from taste or smell. Preventing 

"1 ^\^ ^..^^ irritation of mouth or throat, and 

:l!i ijO ^jjn injury to the teeth. 

ft) ^S# BOX by 91 AIL, 5e Cents. 

STJI^I^OSITOI^Y O^FSXJIjES (3 SIZES) 

For S.JECTA.I. MEDICATION, Box 100, SO Cents. 

We also have VAGENAL CAPSULES, various sizes, and those adapted for giving medicines to 
HORSES or CATTLE, 2 sizes (ounce and half ounce), for liquids or solids. Box 10 Capsules, 
either size by mail, 50 Cents. 

N. B. — We make all/fiinds of Capsules to order. 

New Articles sind Capsuling of Private Formulas a specialty. 

SAMPLES SENT FREE. SOLD BY ALL DRUGGISTS. 

Specify PLANTEN'S CAPSULES on all Orders. 

iiiiiof iiiii oFTiomie 

1016 CHESTNUT STREET, PHILADELPHIA. 

KEEP CONSTANTLY ON HAND 

Microscopes, Microscope Object Glasses, 

MATERIALS AND INSTRUMENTS FOB MOUNTING 

OBJECTS. 

Their Pathological and Physiological Preparations are of 
the Highest Quality. 

Test Slides of Diatoms, and Miscellaneous and Arranged Slides of Diatoms of 
the most beautiful kind always on hand. Also Muller's Typen Plattes and 
Kulings by Nobert. Telescopes, Opera Glasses, Philosophical Instruments, Clini- 
cal Microscopes, Magnifying Glasses, Spectacles, etc. 

SEND FOR DESCRIPTIVE PAMPHLETS. 



15 




The immeasurable therapeutic superiority of this oil over all other kinds of 
iCod Liver Oils, sold in Europe or in this market, is due to the addition o! 
IODINE, BROMINE and PHOSPHORUS. 

This oil possesses the nourishing properties of Cod Liver Oil, and also the 
tonic, stimulant and alterative virtues of IODINE, BROMINE and PHOS 
PHORUS, which are added in such proportion as to render FOUGERA'S COD 
LIVER OIL FIVE TIMES STRONGER and more efficacious than pure Cod Liver Oil. 

Fougera's Ready-made Mustard Plasters 

(DAaipNESa SPOILS THEM.) 

A most useful, convenient, and economical preparation, always ready foi 
anmediate use. Clean, prompt in its action, and keeps unaltered in any climate . 
easily transported and pliable, so as to be applied to all parts and surfaces of the 
body. It is prepared of two strengths : — No. 1, of pure mustard ; No. 2, of hali 
mustard. Each kind put up separately, in boxes of 10 plaster?. Price, 40 cents 

Directions. — Dip the plaster, a minute or two, in cold water, and apply 
with a band. 

FOUQERA'S lODO-FERRO-PHOSPHATED 
ELIXIR OF HORSE-RADISH 

This Elixir contains Iodine, Pyrophosphate of Iron, the active principle of 
anti-scorbutic and aromatic plants, and acts as a toiiir, stimulant, emmcnagogue. 
and a pcncerful regenerator of the blood. It is an invaluable remedy for all consti 
tutional disorders due to the impurity and poverty of the blood. One of th : 
advantages of this new preparation consists in combining the virtues of lodi 
and Iron, wthout the inky taste of Iodide o; Iron. 

Fougera's Compound Iceland Moss Past i 

(Iceland Moi>u, Lactucarium, Ipecac and Tolu.) 

Used with great success against nervous and convult>ive coughs, Whoopi 
Cougli, Acute Bronchitis, Chronic Catarrh, Influenza, itc. 

\N akefulness. Cough, and other sufferings iu Consumption, are greatly 
lieved by the soothing and expectorant properties of this paste. 

E. FOUGERA, Pliarmacist, 

No. 373 7tli iritreot, Broolclyii, ILi. I. 

So/e Proprietor and Manufacturer of the above, to whom all special communication 

should be addressed. 



E. FOUGERA & CO., 30 North WiUiam St., New Yoi 

SOLE GENERAL. AGENTS, 

'P'o -wlioiii all <>i-«lers m1i<>ii1<1 l)e addretsHetl. 

FOK SALK BV l>KUtiGISTS <i£NKR.\LLY. 



16 

TO IPBI'Y-BICIA IsrS. 

LISTERINE 

FORlflUJiA. — Listerine is the essential Antiseptic constituent of Thyme, 
Eucalyptus, Baptisia, Gaultheria, and Mentha Arvensis in combination. Each 
^nid drachm also contains two grains of refined and purified Benzo-Boracic Acid. 

DOSE. — One teaspoonful three or more times a day (as indicated). As a 
local application to ulcers, wounds and abscesses, or as a gargle, mouth wash, 
inhalant or injection, it can be used ad libitum, diluted as desired. 

LISTEEINE is a Powbrftjl, Safe, and Pleasant Antiseptic. The beneficial results 
following its use in Phthisis, Diphtheria, Catarrh, Dysentery, Scarlatina, Erysipelas, Small 
Pox, Typhoid and Malarial Fevers, etc., proves it to be a Restorative Antiseptic of the 
very highest order of merit. It is the most efficient agent to disinfect the hands after sur- 
gical or gynecological operations, and is the best injection in Leucorrhoea, Gonorrhcea, etc., 
used in the proportion of two or three parts water and one part Listerine. 



WM. PORTER, A. M., M. »., St. L,oai.s, Mo. 

"Listerine, being a non irritating solution of pleasant odor, readily diluted, is well 
adapted for use either by spray or in a more condensed form as desired. In the treatment 
of disease of the air passages, where an antiseptic is indicated, I find it the best substitute 
for carbolic acid, phenol, and other remedies of the same class." 

E. B. STETEJJS, A. M., M. ». 

Formerly Professor of Materia Medica and Therapeutics in Miami Medical College, now Editor of Obstetric Oazette. 

"In my short experience with Listerine, I am highly pleased with its eifects. It is 

adapted to a large range of purposes; disinfects the hands of the obstetric and gynecic 

practitioner; disinfeAs ofi'ensive conditions of the utero-vaginal passages, especially where 

there are bad smelling discharges. It is a delightful gargle and mouth wash. Withal, as 

compared with carbolic acid especially, there is the same grateful advantage — the agreeable 

odor in using. ^^ 

" THOMAN F. WOOD, M. D. 

Pres, Medical Society of North, Carolina, Secretary Stale Board of Health, Member State Board Medical Examiners. 

"Listerine has won my confidence. It has had a fair trial in my hands in the lying- 
in-chamber and in dressing wounds and it overcomes all odors. 

"In a case of exceedinglj' ofi'ensive ulceration of the genitals and rectum, the odor was 
entirely conquered hy the use of Listerine." 

E. FL,£TCHER INOAT.S, A. M., 91. D. 

Lecturer on Diseases of the Chest and Physical Diagnosis, Bush Medical College ; Professor of Diseases of tJie 
Throat and Chest, Woman's Medical College, etc., Chicago, Ml. 

"Listerine is certainly a very elegant preparation, and 1 use it with much satisfaction. 

I find it peculiarly adapted to those cases where the odor, or constitution eflfects of carbolic 

acid are objectionable." 

PERCY NORCOP, M. !>., F. R. C. H., Astaeville, N. C. 

Formerly Surgical Dresser to Professor Lister. 
"I have used Listerine with much satisfaction in surgical practice. 
"In my specialty on diseases of throa' and air passages, I have found it of great value. 
As an internal antiseptic, it is non-irritating, and forms an excellent substitute for carbolic 
acid." 

E. H. GREGORY, 91. D. 

Professor of the Principles and Practice of Surgery and Clinical Surgery., St. Louis Medical College; Surgeon to 

the St. Louis (Sister's) Hospital. 

"I most cheerfully bear testimony to the value of Listerine as a surgical dressing. 

I have used it in my oflice for several months, and Dr. N. B. Carson, my assistant, has 

tried it at St. Louis Hospital. He joins me in recommending Listerine as a most useful 

antiseptic." 

FuLt Reports forwarded upon mention of Cincinnati Medical News. 



Prepared only by LAMBERT & CO., Manufacturing Chemists, 

307 LOCUST STRi:Ji:T, 8T. LOUIS. 

LISTKRINE IS SOLD BY ALL DRUGGISTS ON PHYSICIANS* PRESCRIPTIONS. 



r 



RECENT INTRODUCTIONS TO THE MATERIA MEDICA, 

BY 

PAUKE, DAVIS & CO., 

Manufacturing: Chemists, - - - DETROIT, MICH. 

CHEKEN. 



♦ » 



SIERRA SALVIA. 



(^Eugenia Cheken, Myrttis CAekan.) This remedy, a native of Chili, 
is very popular in that country, where it is employed as an in- 

halation in diphtheria, laryngitis, bronchitis, bronchorrhwa, etc.; 

as an hijection in gonorrhoea, leucorrhcea, cystitis, etc.; and internally as an aid to digestion, 
to allay cough, to facilitate expectoration, and to stimulate the kidneys. It is also an as- 
tringent, and is said to be of great value in haemoptysis. 

Cheken (known also as Chekan and Chequen) was introduced to the profession of En- 
gland through a report of results following its use in chronic bronchitis or winter cough by 
Wm. Murrell, M. D., M. R. C. P., Assistant Physician to the Royal Hospital for Diseases of 
the Chest, and Lecturer on Practical Physiology at the Westminster Hospital. Dr. Murrell's 
report is very favorable, and he has supplemented it by private advices to us expressing 
great satisfaction with the drug in the affections in which he has employed it. He regards 
it as one of the most valuable introductions of late years, and pronounces it a drug of very 
superior properties in the treatment of chronic hronchltis, acting in this affection 
both as an anodyne and exerting a favorable influence over the organic changes in the 
mucous membrane. It is certainly a remedy which merits a thorough trial at the hands 
of the profession of this country. 

("MOUNTAIN SAGE.") Artemisia Frigida. 

Fluid extract of the herb. Dose, one to two 

_ fluid drachms. Diaphoretic aud diuretic. 

The success which has attended the administration of this drug in "Mountain Fever" 
has suggested its employment in all febrile conditions attended with suppression of the se- 
cretions of the skin and kidneys. Its action in fever seems to be twofold, acting directly 
on the nervous center, thus inducing a direct lowering of the temperature, and facilitating 
the radiation of the heat through diaphoresis which it stimulates. Under its use the kid- 
neys are also aroused to activity, and the solid constituents of the urine proportionately in- 
creased. Therapeutic tests have corroborated the opinion formed of it on theoretical grounds. 

(ALLIGATOR PEAR.) Fluid extract of the seeds. Dose, 30 to 
60 minims. This remedy is now for the first time presented to 
the profession of this country. It is introduced on the recom- 
mendation of Dr. Henry Froehling, of Baltimore, Maryland, who, while acting in the 
capacity of botanist and scientist to an exploring expedition in Southern Mexico, became 
familiar with the drug, both from reports of the natives and personal experience, as a rem- 
edy in intei'COStal neuralgia. The following extract from Dr. Froehling's report 
will give some conception of the nature of this remedy : 

"A common experience among physicians is that some cases of intercostal neuralgia are very trouble- 
some and obstinate, resisting almost every kind of treatment ; particularly is this the case in malarial districts. 
In such cases I would recommend the fluid extract of Persea seed. In my own person, and in every case 
in which I have employed it, I have been highly gratified with the result. Those of my medical friends to 
whom I have given samples of the preparation warmly endorse my opinion of it as above, and I can not but 
believe that further trial of it will cause it to be regarded as a valuable addition to our list of medicines." 

Dr. Froehling also mentions the fact that Persea has been employed with benefit in the 
expulsion of tapeworm. 

(ERYTHROXYLON COCA.) The evidence in favor of Coca is to prove 
it a powerful nervous stimulant, through which property it retards waste 

J I of tissue, increases muscular strength and endurance, and removes fatigue 

and languor, due to prolonged physical or mental effort. While indicated in all conditions 
presenting tliese symptoms, it has an especial indication in the treatment of the opiinn 
and (llcofiol hubits. In these deplorable conditions it has been found to possess ex- 
traordinay properties— relieving the sense of untold bodily and mental misery which fol- 
lows the withdrawal of the accustomed stimulus, thus preventing a return to the narcotic, 
and affording an opportunity for building up the system by the administration of restora- 
tive tonics. ^ 
We prepare Fluid Extracts of all of the above Drugs. 

PAEKE, DAVIS & CO., Mannfacturing Chemists, DETROIT, MICH. 



PERSEA. 



COCA, 



llvf 



To the Medical Profession. 

LACTOPEPTINE 

TiNF ^'Jf'P^f '''"■' i^ calling (he attention of the Profession to Lactopep- 
TINE. After a long series of careful experiments, we are able to produce its 

out hentatton that rt is as perfict a digestive as can he produced 

bACTOPEPTlNE ts ihe most important remedial agent ever presented to the 
Profession for Indtgestion, Dyspepsia, Vomiting in PrLZnZ ^oljlt 

til's ,£-; f :s :;etrivi=;™r h 'x/-' --f /; 

FORMULA OF I^ACTOPEPTINE : 



Sugar of Milk 40 ounces. 

^^V^^^'-: 8 ounces. 

Pancreatine g ounces. 



Veg. Ptyalin or Diastase 4 drachma 

Lactic Acid 5 fl. drachms'. 

Hydrochloric Acid 5 fl. drachm« 



tio\i%9ic'?alsPis^A?sfronSt luai^'oL'^wf^^^^^ ^"'^ ''« «'-'>«t universal adop- 

oughJy established. * guarauiee we can give that its therapeutic value has been most thor^ 

The undersigned having tested ZjACTO^JSPTlffV »^^„. 

*oi ujrjLfizi>fE, recommend it to the Profession • 

D ^ ^ „ , ALPEED L. LOOMIS M D 

P.of. of iM Science „„. ^"^/S-.-«^^«»»i|..y >„„.■,;,, o/i„„«,, ^,. 
P./. of can. Me., «-»^ »/ C«y» .^. j.W^„,.,i, r^versUy o, I^Ue. Ky. 



THE NEW YORK PHASMAOAL ASSOCIATION, 



P. O. BOX 1574 



Nos. 10 <& 12 College Place, New YorJc.