with much difficulty, von Bergmann holds that it is necessary in performing an operation to expose to view both the extradural abscess and the part of the temporal lobe most likely to be involved in the extension of the suppurative process. An operation is described by which the upper and anterior surfaces of the petrosal bone are exposed through a quadrangular opening made in the squamous portion of the temporal bone, just above the line of the zygoma and between a line in front drawn directly upward to the sagittal suture from the tragus, and a parallel line behind carried upward from the posterior border of the mastoid process. By this wound the mastoid antrum and cells may be opened if necessary, and the sigmoid fossa be reached. In conclusion, Bergmann alludes to the successful results of the surgical treatment of infective thrombosis of the lateral sinus. Exposure and incision of the sinus, with ligature of the internal jugular vein, proved successful in six out of thirteen cases treated by Jansen of Berlin. These cases, added to those of Macewen and other surgeons, show that the operative treatment resulted in recovery in twenty-seven out of forty-five patients. Thrombosis of the lateral sinus, it is pointed out, is often associated with extradural abscess on the roof of the tympanic cavity, and in most cases of cerebellar abscess forms a communication between this collection of pus and the suppuration in the middle ear. In exposing the outer surface of the mastoid process and the bone lying behind this, search should be made for the mastoid emissary vein. Not only is the orifice a good guide to the sinus, but in addition the state of the vessel may help the diagnosis. If it contains pus, suppuration in and about the lateral sinus is indicated; if it be blocked by a thrombus, this will be a sure sign of thrombosis extending to the cavernous sinus. Von Bergmann, attributing much of the recent progress in cerebral surgery to improvements in technical details and in instruments, makes use in opening the skull of a circular saw worked by electricity, with which he divides the outer table, while the inner table is divided by the careful application of a chisel.-British Med. Jour. The Comparative Vitality of the Sexes. This is the subject of an editorial in the Archives of Pediatrics, and is of interest to the medical man, as well as to the life insurance company. It is the common impression that men are not only less subject to illness, but are longer lived than women. The life tables of insurance companies, however, show that the term of life of women is slightly longer than that of men. The difference in the mortality rates during the first few years of life is striking. During the first year, the mortality among males is decidedly greater than among females. Although more boys are born than girls, the proportions are reduced to almost even terms at the end of the first year by the excessive male mortality. Even during the first four years the mortality among males exceeds that among females, notwithstanding the fact that there are practically no distinctions made in the management of the two sexes. Both are subject to the same conditions, are dressed virtually the same, and receive the same food. At about five years the comparative death rate among girls begins to increase. This has been attributed to the fact that boys of this age are more in the open air. The mortality in both sexes diminishes from this time until the twelfth year, when it attains its lowest point. It then steadily rises, being larger in each successive year. Between the twelfth and sixteenth years the death rate among girls increases more rapidly than among boys; but after the sixteenth year, for several years, the rate of increase is more rapid on the male side. The explanations that have been offered for these peculiarities are not wholly satisfactory; but one fact is clear, that during early years females possess a greater tenacity of life than do males.-Md. Med. Jour. The recommended times of quarantine adopted by the Pennsylvania State Board of Health for persons who have been exposed to infectious diseases, when they may safely be admitted again to school, if they continue in good health, and have taken proper measures for disinfection, are as follow: for diphtheria, after twelve days; smallpox, eighteen; measles, eighteen; chickenpox, eighteen; whooping cough, twentyone; mumps, twenty-four; adults may be admitted at once, if they disinfect their clothes and persons.-Md. Med. Jour. Memphis Medical Monthly Subscription Per Annum, One Dollar in Advance. The MONTHLY will be mailed on or about the first of the month. Subscribers failing to receive it promptly will please notify us at once. We cannot promise to furnish back numbers. Original communications should be in the hands of the Editor thirty days previous to date of publication. Clinical experience-practical articles-favorite prescriptions, etc., and medical news of general interest to the profession, solicited. Communications of a literary character, and books for review, should be addressed to A. G. SINCLAIR, M.D., EDITOR, Communications relating to advertisements or subscriptions should be addressed to C. H. BRIGHT, BUSINESS MGR., 126 Hernando Street, Memphis, Tenn. In this issue of the MONTHLY we give space to a paper enti tled "Whither Are We Drifting," the writer of which takes rather pessimistic and not altogether consistent views of the professional tendencies of the day. First among his troubles is specialism. This he charges with training the mind to work in narrow grooves, and then admits that it makes more thorough physicians in the branches which they specially study. Only the superficial observer can characterize any of the leading specialties as a "narrow groove," for the fact is indisputable that specialism has developed each one of these branches. until it now offers a broader field for the study and mastery of truths already established than did the whole range of medicine a brief hundred years ago. Indeed the dry rot from which medicine suffered for two thousand years continued until specialism began, and since then its development has been unparalleled in any other department of human progress. Specialism does not mean, as the author of the paper seems to think, the absolute divorce of one or more of its branches from general medicine. The only recognized specialist of today is one who has thoroughly qualified himself in general medicine and then devoted himself to the practice and development of certain of its departments. Nor is there any fear that the specialist will crowd the general practitioner to the wall. On the contrary, by broadening his own field of observation, through the light thrown by specialism on obscure corners in medicine, the latter will but the more firmly establish his place in the profession. Specialism is not encroaching on this sphere, but rather conquering new territory and adding it to the domain of medicine. Another trouble referred to in the paper is the advertising by medical journals of proprietary medicines. Medical journal advertisements are read only by medical men, and if the good doctor and other objectors will quit using the agents advertised, their makers will soon cease to advertise in medical journals. Then, too, medical journals must usually take what "ads" they can get (some profitable ones are, however, refused by the MONTHLY), otherwise they could not furnish these objectors with five hundred to a thousand pages a year of current medical thought for the sum of one dollar, something less than the cost of the paper and printing. We haven't space in which to consider all the grievances advanced, but one more must receive attention—the medical colleges. That there are too many we admit, but they are not "numbered by hundreds" in this country, only something more than one hundred. The author of the paper sighs for '57 when he was a student, because "then there were only two regular colleges in Tennessee, while now there are seven or eight." But he forgets that there were some irregular ones, while now there is none; that Tennessee has more people to be supplied with doctors now than it had then; that a majority of those practicing then were not graduates; that the colleges of that time required no matriculation examination, while now all colleges do; that then they required attendance on only two sessions of five months each, now three sessions of six months each; that the curriculum has been so greatly extended that more instruction is given in one session now than was given in two (the entire course) then. He thinks graduation should depend on what the candidate knows and not on attendance on a specific number of sessions, and that is precisely what all college faculties believe. Requiring a definite number of sessions is simply specifying the minimum of time in which experienced teachers of medicine believe any student can qualify himself for graduation. That the graduate in arts can learn more of medicine in a given time than the illiterate no one will deny, but the fact remains that of medicine as it is known today neither can learn sufficient to justify his graduation in less than three sessions of six months each. While the MONTHLY regards the requirements of the Southern Medical College Association well suited to the present needs of the people of the South, it hopes to see the time when an academic degree will be required for matriculation and attendance on not less than four sessions for entrance to the ranks of the profession. BEFORE Our next issue goes to press the Memphis Hospital Medical College will have entered upon its sixteenth annual session. We are informed that the prospects for a large attendance were never better. We can confidently say to all who desire to attend college the coming winter that nowhere in the South can greater progress be made by the student than in this institution. The professors are all experienced, and especially painstaking, teachers, doing much extra work in the way of frequent examinations, and otherwise, to lighten the labor of the student and help him to grasp and retain what is taught in the lectures. The laboratories are also in charge of most capable teachers, and the instruction given is complete in every detail. PROF. W. B. ROGERS, of the Memphis Hospital Medical College, is rusticating among the hills of New Hampshire. PROFS. R. B. MAURY and T. J. Crofford, of the faculty of the Memphis Medical College, are spending the summer in Europe. DR. S. WEIR MITCHELL has been honored with the degree of LL.D. by the University of Edinburgh. DR. E. W. PALMER of Louisville, Ky., aged 53, lost his life in consequence of fracture of the skull sustained in a bicycle. accident on July 5. Prof. Palmer was an able teacher, and a man of much social and professional prominence. |