MARYLAND MEDICAL JOURNAL medicine without previous training and

A Weekly Journal of Medicine and Surgery,

THOMAS A. ASHBY, M. D., Editor. GEORGE J. PRESTON, M. D., Associate Editor. Subscription $3.00 per annum, payable in advance.

Contributions from practitioners in good standing

invited, and advertisements from reliable houses solicited.

All communications relating to the editorial depart

ment of the JOURNAL should be addressed to the
editor.
Address all business communications to the
JOURNAL PUBLISHING COMPANY, PROP'S.
New No. 209 Park Avenue.

BALTIMORE, MD.

Subscribers indebted to the MARYLAND MEDICAL

JOURNAL are earnestly requested to remit to the Proprietors the amount due. Make all checks and money orders payable

to the MARYLAND MEDICAL JOURNAL.

BALTIMORE, OCTOBER 1ST, 1887.

Editorial.

a careful preparation for professional work. Unfortunately we lack these important incentives to study and we think, therefore, the responsibilities of both preceptor and medical student are vastly increased. There are institutions in

America that will welcome any young man into the ranks of the profession, no matter how ignorant or stupid he may be. There are also physicians who will encourage any young man who may seek advice to enter upon a career which they must know he is wholly unfitted for. The physician oftentimes acts from a sense of gratitude to his alma mater, whose empty benches he would vainly seek to fill, or, perhaps, the son of some influential patron may THE RESPONSIBILITIES OF THE MEDI- be the student in question and he can CAL STUDENT.-During the next two or ill afford to frown upon his incompetency. three weeks a large number of young So long as low grade medical institutions men will enter upon the study of medi- exists and thoughtless practitioners ply cine at some one of the various medical the trade of preceptors the ranks of the schools throughout the country. It is profession have little protection from the proper that these young men should be inroads of ignorant and incompetent told in advance something in regard to the responsibilities they will assume as students of medicine. As it is not probable that our remarks will reach any large number of this class our advice may appear somewhat gratuitous.

men. But our remarks are not intended for this class. We assume that the vast majority of the young men who enter the profession do so with high and honorable motives, and are earnest and anxious in their desire to secure a

It is to be hoped that every young thorough medical education. Such man who proposes attending lectures young men are willing to follow the during the present winter has studied best methods if they are pointed out to under a competent preceptor and that them. The majority of them are, as a he has accordingly received some in- rule, good students and really want to struction in his medical studies. What prepare themselves for professional is more important, we trust that each work.

preceptor has impressed upon the mind To such young men we would giveenof his student a sense of the responsi-couragement and sound advice. If they bilty and claims of medicine. If this have not been informed by their precephas not been done our suggestions may tors of the claims of medicine upon them not be out of place at this time, for we and of its responsibilities they will probconsider the duty of the preceptor to-ably be told this by their Professors in wards the student as of primary import- "Introductory Lectures," provided they ance to the duty of the student towards enter upon their lectures at the very be the profession he proposes entering. In ginning of the course, a by no means foreign countries-Great Britain and invariable practice.

Continental Europe-the courses of It seems to us the most important quesmedical instruction and the require- tion for the young student to decide is ments for medical practice are so much the selection of a medical school. more thorough than on this side of the This may be no easy task considering Atlantic that few young men have the the claims of many institutions and of holdness to enter upon the study of different cities. So far as the student

is concerned the selection should be There is so much that passes for the honestly made. The young man wants a genuine coin in the literature and practhorough medical education. He should tice of medicine, which after all is only therefore matriculate in a college where the baser metal, that the student is conthe corps of teachers is known to be stantly in danger of storing up that thorough and competent to instruct, and quality and character of information where the advantages offered him that will not supply his needs in as a student are commensurate after life. He is so apt to be carried with his needs. Having selected his away by the glitter and parade of great school the student should attend lectures theories, striking surgical exploits and and clinics regularly and conscientiously. the novelties of practice that the solid He should take full notes of the more ground work of anatomy, chemistry and difficult lectures, and after lecture hours physiology is less attractive to him as an should either study his notes or read over important feature of his education. The the subjects taught in authorized text- foundation of success in medical work books. It would be wise for each student must be laid upon an intimate knowlto enter some one of the conventional col- edge of the principles of medical science. lege quiz classes. He will here learn It is far more important that the student much that is of value to him. The should have this knowledge than that earliest possible opportunity should be superficial information which facinates embraced for the study of practical by its novelty and apparent luster. It anatomy in the Dissecting room. The may be eminently proper that the habit of simply mutilating an extremity student should witness a nephro-lithotoand calling this a dissection is a mere my or pylo-rectomy, but any amount waste of time and material. The student of time devoted to the study and conshould endeavor to dissect an entire sub-sideration of such rare, yet brilliant surject, and he should do his work carefully gical procedures, is a practical waste, and with a definite object in view, since it must be given at the sacrifice of which should have a higher aim than a those more common studies which more simple compliance with the require- directly bear upon his future work. The ments of the Demonstrator's rule. The student who is facinated by the exploits short courses of five months, still ad- of the renowned surgeon or classical hered to by the vast majority of medical lectures of the teacher of practice of schools on this side of the Atlantic, medicine and gives his entire time to the makes it absolutely obligatory upon the student to employ every hour of his working time in study. With the multiplicity of lectures and the various new subjects introduced into the course of study the student must work early and late to keep pace with the course. The ernestly addressed. The neglect of incentive to redoubled exertions has anatomical study, the inattention given been so greatly increased by this short to physiology, chemistry and materia stage of pupilage and increase of medical medica are great elements of weakness knowledge which now confront the medi- in the professional training of many physical student, that the old conventional cians. We repeat, the student who sacrifices habits of the student must be relegated those studies upon which all scientific to the past. Work earnest and sincere medicine depends, for the more brilliant is the chief prerogative of the medical and attractive branches of surgery and student of to-day who fully compre- practice, is virtually undermining his hends the responsibilities of his profes

sion.

The student must early learn to sift the rubbish from the golden grain, if he would make safe progress in medicine.

study of these branches, to the great neglect of his anatomy, chemistry or materia medica, is in great danger of weakening the foundation of his entire professional edifice.

These words of caution cannot be too

usefulness and success in his subsequent professional work. Our space does not admit of a fuller consideration of the duties of the medical student We must close with the simple reminder

that success at college and success in the or profusion of literature, and if all these broader field of medical work outside of count for progress gynecology has certhe college walls can only be earned by tainly made great advances. But as earnest, honest, untiring industry and much as we are disposed to praise the perservance. The young man who at-eminently good work which the gynætempts to achieve an honorable position cologists have done, we would prefer to or a wide distinction in the ranks of the measure their results by some other profession he has entered should at once standard than instruments, pessaries and realize the force of this statement and pamphlets, or even text-books. These begin with a firm resolution to do his may either have contributed in some defull duty. The ranks of the profession gree to the good results which the gynæare full to overflowing with idlers and cologists have scored or may be a fair indrones. There is no room for more of dex of the ingenuity, skill and energy this class. of these busy workers, yet we venture to suggest that the science of gynæcology has found a higher position than such a showing, as Dr. Skene has made, would make appear.

out.

But to those who wish to do good work, who would add to the knowledge of scientific medicine, who would cultivate a broad charity and ennoble the grand profession of the healing art the Such statistics do not make it appear portals of medicine are open and willing how much abdominal surgery owes to to admit him. Let all such press in. Let gynecology, nor to what extent antisepthose who have less noble motives stay tic surgery is indebted to the same source for its successful elucidation and application. It cannot be questioned that THE PROGRESS OF GYNECOLOGY.-In the surgical side of gynæcology has been the Presidential Address before the eminently heroic and valuable in its American Gynecological Society, at its contributions to the relief of womanlate meeting, Dr. A. J. C. Skene took oc- kind. We wish we could say the same casion to comment upon the gratifying of the medical treatment of functional growth of gynæcological science during and organic diseases of women. Just recent years. He offered a number of in this latter direction there is much instructive facts in support of the state- room for the exercise of much of that ment that modern gynecology was not talent and ingenuity which has devised much more than seventy-five years old instruments, pessaries and created a and yet had made wonderful progress, vast periodical literature. Dr. Skene especially in the department of surgery. very properly dwells upon the importOf the most heroic operations in surgery ance of this field and attempts to lift it ten were claimed by Dr. Skene as gynæ- into greater prominence. We quite cological. Over 780 gynæcological in- agree with Dr. Skene in the statement struments had been devised, exclusive that the Gynecological Society, now of the different varieties of needles and twelve years old, has done much to prosutures. About three hundred different mote a healthy study of gynecology pessaries were in use. Within three- and to enforce more rational methods quarters of a century about six thousand of practice. We must look to just books devoted to the diseases of women such organizations as this for sound and have been published, whilst in the past wholesome views upon scientific subjects eight years seven thousand five hundred and for the elimination of the great and five journal articles and pamphlets accumulations of trash which encumber on gynecological subjects have ap- the work and literature of the profession peared.

of medicine.

Miscellany.

From these statistics no one can doubt that the gynæcologists have been extremely enterprising and industrious. We much doubt whether any other THE TREATMENT OF PRIMARY SYPHIspecial branch of medicine or surgery LIS.-At a recent meeting of the Vorein can present such an array of instruments I der Aerzte in Steirmark (Society of

Physicians of Styria), Professor E. Lipp regionary treatment could be overlooked made an important communication on by the profession. Out of ten females this subject. He had tried to influence who were in this way treated by Professyphilis during the short period in which sor Lipp, four did not show any sympit had not yet become a constitutional toms of general syphilis, after the lapse affection in such a way that the virus of two, one and a half, and one year was prevented from infecting the whole from infection; five patients presented organism, or that, at least, the course of only slight symptoms of general syphilis the disease was a more favorable one, and in only one of these he observed all and of shorter duration. The excision symptoms of a general affection, this of primary sclerosis, as recommend by patient, however, could not support the Auspitz, Neusser, and others, belonged mercury preparations well, and was, for to the experiments which tried to make this reason, not energetically treated. syphilis abortive, but this treatment was In one of the four quite successful cases, not successful in all cases, owing to in- the primary sclerosis had been extirpatfection of the lymph-vessels of the adja- ed. The speaker remarked, among cent parts. He, himself, had made other things, that unsuccessful experiseveral such experiments without having ments should not deter from undertakattained the effect which he desired, viz., ing new and modified ones, unless one to prevent universal syphilis from es- wished to make it an axiom that syphilis tablishing itself in the organism. The must take its regular course from the defenders of excision were gradually local foci to the infection of the whole yielding, though they could now and organism.-London Medical Press. then boast a success with their treatment. The value of the simultaneous extirpation of the lympth glands was kenzie was summoned on Tuesday to very problematic, and might under cer- Balmoral to receive the honor of knighttain conditions even prove fatal. Pro- hood at the hands of Her Majesty, in fessor Lipp had in his own experiments recognition of the great service he has paid the greatest attention to the local rendered the royal families of England and regionary treatment of the syphi- and Germany-and, it may be added, litic affection without, however, ne- the whole of Europe-by his skilful glecting the general treatment. He al- treatment of the Crown Prince. most exclusively availed himself of the are sure that, in this case at least the preparations of mercury which were the profession will agree that the dignity, most efficient antidote against syphilis. such as it is, has been thoroughly well For the local treatment he particularly won. The condition of the Prince is recommended subcutaneous injections satisfactory, and there is every reason to near the affected lymph-vessels and believe that the favorable prognosis, lymph-glands, as by this procedure, the which has been steadily adhered to by remedy came into intimate contact with those best qualified to judge, will be the virus, and the syphilitic affection in completely justified. Mr. Mark Hovell the enlarged and indurated lymph-glands will continue in attendance on His Imthus quickly and surely underwent a re- perial Highness during his stay in the gressive process. This fact was of great Tyrol, Sir Morell Mackenzie will also importance, though, on the other hand, visit him occasionally.-British Medical the spreading of the virus by the blood-Journal, Sept. 17th, 1887. vessels of the primary focus was not to

SIR MORRELL MACKENZIE.-Dr. Mac

We

be underrated. A somewhat energetic THE ANTISEPTIC POWER OF VINEGAR. local treatment derived the importance-Englemann (Arch. Gen. de Med.) has of a constitutional one, as the medica- been experimenting upon the antiseptic ment being subcutaneously applied un- power of vinegar, having used it in derwent resorption into the circulatory diphtheria with better results than were system. It was surprising that the in- obtained from the use of any other fluence on the whole organism of such a agent. He used either ordinary vinegar