drawn up, to relax the abdominal muscles, and give more room to the operator. Standing behind the patient, the writer introduced his right hand into the vagina, and, with the assistance of the left externally, pushed the presenting shoulder up towards the right of the mother. The left hand held the shoulder in this position, and thus space was gained to introduce the right hand through the cervical canal, with less danger of rupturing the uterus. As the fingers were swept along the body, and down over the thigh of the child, the external hand crowded down the breech and feet within easy reach. A foot was readily seized, and, as traction was made on this, the external hand pushed up the head, so that both ends of the foetal ovoid were acted on at the same time. In this way, the presenting arm became gradually withdrawn into the uterus, and gave no further trouble. The breech, however, would not descend into the true pelvis, and on examination the other foot was found bracing against the pelvic brim. On bringing this down, it was so much smaller than the corresponding member, that the possibility of its belonging to a second child, and thus creating a troublesome complication of labor, was at once suggested. Their connection with the body could not be ascertained, for lack of room; but as the feet were right and left, any complication seemed improbable, especially as the breech came down with moderate traction. The patient meantime was placed on her back. There was no further trouble till the head engaged in the brim. The child was very large, and only extricated with the greatest difficulty, by keeping the head well flexed, and the supra-pubic pressure of an assistant, combined with severe manual traction. The infant was asphyxiated, but, after prolonged artificial respiration, revived. The child weighed fourteen and three-quarters pounds, which was ascertained by different scales. I The method of operating was that of the Vienna school, which is more easy to perform, in most cases, than in the dorsal position generally used in America. No particular attention is paid to the rule laid down by Barnes,3 to always seize the upper foot; this rule is not generally indorsed on the Continent. The large size of the first foot brought down was due to congestion of the limb from the pressure on it at the brim. 5 Manual extraction is always preferable to the application of the forceps to the after-coming head, as too much valuable time is lost while introducing the instrument, and, with rare exceptions, sufficient force can be used with the former method. 1 Zweifel, Operative Geburtshilfe, p. 103. Leavitt, Science and Art of Obstetrics, p. 521. Lusk, Science and Art of Midwifery, 1885, p. 396. 3 Lectures on Obstetric Operations, 1886. 4 Playfair, System of Midwifery, p. 468, 1985. Schroeder, Geburtshülfe, p. 331, 1882. 5 Schroeder, Geburtshülfe, p. 307. DR. DAKE'S VIEWS ON SECTIONAL MEETINGS OF THE INSTITUTE. THE following communication to Dr. Pemberton Dudley, chairman of the Committee on Sectional Meetings, will give the opinion of one of the most experienced and capable members of the Institute on this subject, and cannot fail to interest the readers of the GAZETTE: NASHVILLE, TENN., Dec. 28, 1886. Dear Doctor, — In view of what has been written by yourself, Dr. Talbot, and Dr. Strong, on the conduct of bureau work in the American Institute, and as a result of my own observations in Institute meetings, I desire to lay before you, as chairman of the special committee having the subject in hand, my views as to required changes. I fully concur in what has been said by the NEW-England Gazette, as well as by yourself and others, in regard to the evils resulting from our old methods. With my friend Dr. Talbot, I have endeavored to encourage the concentration of our workers, so as to have more thorough elaboration of the subjects taken up by the several bureaus. It was my move to have each bureau confined to one special subject each year, in order that the papers upon it should be exhaustive, and furnish a text-book showing all that might be new and important down to the time of writing. But the various chairmen have strangely misconstrued the term "special," as mentioned by yourself and Dr. Talbot. Glaring examples are apparent in the display of subjects announced by the different bureaus this very year. It may be remembered, that repeatedly, during the reports of bureaus, I have raised objections to the reading of papers not upon the special subjects. Members, bringing in papers on all manner of topics, have been greatly offended with me for trying to have the rules of the Institute enforced. So many come to our meetings only when they have some wonderful case to report, expected to bring fame, if not fortune, by a display of its details; it is not easy for those who love order and systematic work, to prevent their trampling upon all good rules and regulations. I am glad, therefore, that this matter of bureau-work is in hand by a committee so well composed and able as yours is known to be. Allow me to suggest the great objects in view by an organization like the American Institute. Following my favorite method, let us advance by exclu sion : 1. A medical society is not intended to furnish elementary instruction. 2. A medical society is not intended for the presentation of treatises that should appear as monographs in book form. 3. A medical society is not intended for the reading of essays and articles that should reach the profession through its periodical literature. Leaving out elementary instruction which should be had at our schools, dissertations that are better considered in book form, and communications that require only a quiet reading at the fireside, what have we left? Simply this reports and brief essays of general interest, calculated to call out the observations and experiences of busy, thoughtful practitioners who never write books, and seldom contribute to the pages of a journal. The scientific-social idea should dominate in society proceedings; and the reading of papers should be merely to open discussion, to draw out fresh, living thought, where it may at once be met with concurrent or counter thought, to the end that truth and improved methods may appear. It is my deliberate conviction, after a long and close observation of Insti tute work, that the members gathered from all parts of America at our annual sessions are more pleased and profited by the sharp, quick exchange of views, brought out by brief and well-considered papers, than by any other work done. In the American Association for the Advancement of Science, and in the American Public Health Association, the executive committees determine which papers contributed by members shall be read and discussed in the several departments. The reading of all the papers is not thought of, nor is the publication of them all considered best. In the Institute, as organized, it may be best for the chairman of each bureau to determine which paper, coming into his hands, bearing upon the special subject announced, shall be read in general session for the purpose of leading the discussion. After the next annual session it should be provided that only one paper be written and read from each bureau, the members not writing being designated as speakers to lead the discussion. Some of the bureaus may desire a separate session, a sectional meeting; but I am quite sure all of them would not. Those desiring it could have the entire afternoon, as suggested by the GAZETTE, and seconded by Dr. Talbot. The morning and night sessions of the general body would be sufficient for business, and the reading and discussion of single papers, as I propose. One important part of the duties of a bureau chairman, however, should not be lost sight of, the presentation of a résumé of important discoveries and improvements in the field presided over by his bureau. This should precede the reading of the paper intended to bring on discussion. And furthermore, the paper should be of a character interesting and instructive to general practitioners. Subjects more technical or special, calculated to interest specialists more than general practitioners, should be read at sectional meetings. It seems to me, that by a conference with the several bureau chairmen, you could ascertain how many and which of them would desire separate afternoon sessions for the reading of papers, report of cases, and transaction of other business. I am sure it will never do, to have all the scientific work of the Institute done in sectional meetings. The experience at Brighton Beach plainly demonstrated the futility of such a plan. Sectional work must be only an extension and specializing of the work in hand by the whole Institute. In common with yourself, and others who have written, I am sorry to see so many chairmen of bureaus who have no proper conception of the duties incumbent on them, who are not able to plan or execute what is clearly necessary; and so many men accepting place on bureaus, who fail to realize the importance of promptness, concentration, and brevity in what they write. Let us have less reading, and more discussion; less printing of elementary and well-worn matter, and more that is fresh and instructive. For the increased efficiency of the Institute, I am yours fraternally, J. P. DAKE. THE CLIMATE OF FLORIDA. EDITOR NEW-ENGLAND MEDICAL GAZETTE. The readers of the GAZETTE may be interested in my studies of the climate of Florida. I therefore send you the following excerpt from one of our city papers. Northern physicians are not careful enough to inquire into the peculiarities of Florida climate before sending patients there. In no work on climatology have I ever seen any observations similar to my own. I append the report of the temperature for Jan. 10. The enterprise of "The Inter-Ocean" has enabled people to see the relative temperature of various portions of Florida this winter. It has been an interesting study, especially to physicians, who, before they send patients to that State, ought to know that no State in the South has such a varied temperature. It is not safe to send rheumatic, neuralgic, or patients suffering from pulmonary troubles, to Florida. No such patients should be sent to that State without telling them that they should not stay north of latitude 30°, which lies about midway between Jacksonville and Palatka. A reference to "The Inter-Ocean" temperature report will show why. 1. The temperature at Sanford, which includes Enterprise, Deland, Orlando, Winter Park, and that region, averages 5° higher all winter than at Jacksonville and St. Augustine; e.g., the coldest day in Florida this winter, the mercury stood at 22° at Jacksonville, and 28° at Sanford. Yesterday it was 39° above at Jacksonville, and 49° at Sanford. There has been no exception, and this difference this winter is a great boom to orange-growers, for oranges freeze at 22°. 2. At Sanford the clear days are five to two at Jacksonville. This is of great importance to invalids and tourists. Patients will improve much more in clear than cloudy weather; and invalids should remain in that portion of the State where there is a preponderance of cloudless days, for sunshine is the greatest physician in this world. 3. The air is much dryer in the middle portions of Florida than in the northern or southern. Sanford lies in the middle, or "Orange Belt." Patients with asthma, bronchitis, neuralgia, rheumatism, or incipient phthisis, are comfortable, and improve in this region, but they do not do well in the other region above or below this belt. This is the result of my observation for several years. CHICAGO, Jan. 12. E. M. HALE, M.D. SOCIETIES. BOSTON HOMEOPATHIC MEDICAL SOCIETY. THE December meeting of the Society was held at the Parker House, Thursday evening, Dec. 16, 1886; the President, Alonzo Boothby, M.D., in the chair. After approval of the records, the following were elected to membership: Mary H. Baynum, M.D.; M. Florence Taft, M.D. ; Mary E. Nutter, M.D.; George Hipkiss, M.D. Dr. F. L. MacIntosh of Melrose was then proposed for membership. After the transaction of business in relation to the annual meeting and supper, the members gave their attention to the Scientific Session. — The wide-spread interest in the subject of the October meeting, viz., the use by homoeopathists of extraneous therapeutic methods, had led to a request that the discussion be re-opened; and accordingly a paper was read by William P. Wesselhoeft, M.D., in which he presented in a very thorough and scholarly manner his views upon the questions under consideration. The subject was also discussed at length by Drs. Bell, Tompkins, C. Wesselhoeft, Hastings, Cobb, Talbot, and Packard. The attendance was large, and the discussion held the close interest of the members until adjournment, which took place about 10.30. F. C. RICHARDSON, Secretary. BOSTON HOMEOPATHIC MEDICAL SOCIETY. THE annual meeting of the Society was held at the Parker House, and was an occasion of great satisfaction to all present. The business meeting was called to order about half-past six o'clock by the President, Alonzo Boothby, M.D.; and after the records of the preceding meeting had been read and approved, Dr. F. L. MacIntosh of Melrose was elected to membership. The following propositions for membership were then received, and referred to the censors: Frank Irwin, M.D., of Winthrop; G. E. Hetherington, M.D., of West Somerville; W. W. Gleason, M.D., of Malden. Under the head of "new business." Dr. J. W. Clapp presented in writing a motion to amend the By-Law so as to read, "that the regular meetings of the Society be held on the first Thursday of each month, with the exception of the months of June, July, and August;" and Dr. Horace Packard offered an amendment to Art. VI. of the Constitution: "The President and Vice-President shall hold office for one year." Action upon these motions was deferred until the next meeting, as provided by the Constitution. The Society then proceeded to the election of officers for the ehsuing year. On motion of Dr. Fred Percy, it was voted that the nominations be made from the floor, which was done; and the following list of officers having been put in nomination, they were elected unanimously: President, Charles H. Walker, M.D.; Vice-President, L. A. Phillips, M.D.; Secretary, F. C. Richard |