QUACK ADVERTISEMENTS IN THE RELIGIOUS NEWSPAPERS.-From time to time medical men and medical journals have protested against the prostitution of the columns of religious newspapers to the use of advertisers of quack nostrums. This protest does not apply to temperately worded representations of what seems to have been accomplished by, or what may reasonably be expected of, a remedy or device for the cure of disease or injury. But it does apply to advertisements couched in language which bears the stamp of falsehood on its face, or is of such a character as to arouse suspicion in the mind of an intelligent man, uninfluenced by a money consideration.

The editors of most religious journals are, as a rule, men of so much intelligence that they will hardly attribute to trade-jealousy alone the objection which medical men have to the recommendation of "sure cures" for baldness, fits, rupture, consumption, and so on, to persons who are apt to regard their religious teachers as safe guides in matters of health or disease, and who are not sufficiently familiar with the subtleties of the newspaper business to distinguish between the responsibilities of the editor and those of the publisher. As a fact, most readers of periodicals have the impression that the advertisements they contain are indorsed by the editor. Advertisers rely upon this fact; and we can not understand the casuistry which satisfies the conscience of a man who edits a periodical, ostensibly devoted to religion, which replenishes its coffers with the price of palpable falsehoods.

If it were true that a religious paper could not be financially successful without taking money for the advertisement of worthless or delusive remedies, a course might be suggested worthy of the main object of these papers. But it is not true; for there are a few happy illustrations of the fact that, even in a religious newspaper, "honesty is the best policy."

We call the attention of our large circle of readers to this matter, in the hope that they will use their influence to put an end to what we regard as a serious blemish in religious newspapers, and one which injures the good reputation which they ought to enjoy. And we call the attention of those religious newspapers

to which our remarks may apply to this matter, in the hope that we shall not have to recur to it in a more explicit manner.-Medical and Surgical Reporter.

A QUESTION OF PROPRIETY.-Is it proper for a medical reporter, having access to the ordinary clinical lectures in a hospital, to attempt to report in full the clinical lectures of a member of the hospital staff, and furnish the same for publication, without submitting a line of his manuscript to the lecturer for his approval? Is it proper for editors or publishers of medical journals to receive and publish what purport to be verbatim reports of clinical lectures without any evidence that such reports have been approved by the lecturer, and without even allowing him an opportunity to read the galley proofs?

We are constrained to ask these questions, partly from personal interest, but more for the benefit of lecturers and editors in general. Three times in quick succession the editor of this journal has been surprised, on taking up as many exchange journals from distant cities, to find each opening with a clinical lecture by himself, reported by William Whitford, M. D. The first in order of time was on "Typhoid Fever," the second on "Acute Pneumonia-Tuberculosis," and the third on "Broncho-Bronchitis," for the meaning of which we shall have to rely upon the reporter, as there is no such title in our vocabulary. We are familiar with broncho-pneumonia and pleuro-pneumonia, but "broncho-bronchitis" must be one of the new discoveries. On looking over these lectures we found them excellent specimens of the work usually done by stenographers who have not the experience or skill to keep accurately the lecturer's own modes of expression, or the education and mental discipline to enable them to grasp fully and clearly the ideas conveyed by them. Consequently the so-called lectures, as they appear in print, present many omissions, many errors, many ideas or points but vaguely or imperfectly expressed, and not a few forms of expression belonging to the reporter, inasmuch

as they are never used by the lecturer; all of which might have been avoided if the reporter had submitted his manuscript to the lecturer for his correction and approval, or even if the editor had allowed him a glance at the proof-sheets. We hope our editorial brethren will give the two questions we have asked a thoughtful consideration. Dr. N. S. Davis, Journal American Medical Association.

Editors American Practitioner and News:

CASE OF RUPTURE OF THE UTERUS.-On the morning of November 19, 1887, I was called to see Martha B., colored, aged forty-five, multipara, mother of sixteen children, who had been in labor since the morning of the 15th. On my arrival I found the presentation to be a vertex, and the head in the inferior strait. There was complete inertia of the uterus, and, on questioning the granny who was with her, was told that she had been giving large doses of the fluid extract of ergot, and that on Thursday the patient had a profuse hemorrhage, after which there was no uterine contraction whatever. After getting her under the influence of chloroform I introduced my forceps, but failing to get them to lock, I performed craniotomy, and soon delivered the child. The delivery of the placenta being followed by hemorrhage, I introduced my left hand into the uterus to try and bring about uterine contractions, when I found the uterus filled with the intestines. Slipping my hand by them, I found the rupture, through which the hand readily passed, and with my right hand could feel my fingers against the abdominal wall. I told her husband what had happened, and that an operation was the last resort. agreeing to the operation, I sent back to Grapeland for Dr. J. I. Barnes, who came and gave valuable assistance. Atfer getting the patient thoroughly under the influence of chloroform-I had Dr. Barnes to introduce his hand into the uterus, separating his index and middle from his third and little fingers-I made an incision about three inches long through the linea alba, and found a rupture in the' anterior wall of the uterus,

He

extending from fundus to cervix. After getting out a considerable amount of clotted blood and sponging out the abdominal cavity I brought the lips of the rupture together with carbolized silk; but the patient died an hour after the operation was completed.

Now the question is, what caused the rupture? My opinion is, that being the mother of sixteen children, there were present anatomical predisposing conditions which the large doses of ergot given her on Thursday speedily determined, and that it occurred about the time of the hemorrhage that "granny" spoke of. JOHN L. HALL, M. D.

GRAPELAND, TEXAS, January 17, 1888.

THE WILLIAM F. JENKS MEMORIAL PRIZE. The first triennnial prize of two hundred and fifty dollars, under the Deed of Trust of Mrs. William F. Jenks, will be awarded to the author of the best essay on "The Diagnosis and Treatment of Extra-uterine Pregnancy."

The conditions annexed by the founder of this prize are, that the "prize or award must always be for some subject connected with obstetrics or the diseases of women, or the diseases of children," and that "the trustees under this deed for the time being can in their discretion publish the successful essay, or any paper written upon any subject for which they may offer a reward, provided the income in their hands may in their judgment be sufficient for that purpose, and the essay or paper be considered by them worthy of publication. If published, the distribution of said essay shall be entirely under the control of said trustees. In case they do not publish the said essay or paper, it shall be the property of the College of Physicians, of Philadelphia.

The prize is open for competition to the whole world, but the essay must be the production of a single person.

The essay, which must be written in the English language, or, if in a foreign language, accompanied by an English translation, should be sent to the College of Physicians, of Philadelphia, Pennsylvania, U. S. A., addressed to Ellwood Wilson, M. D., Chairman of the William F. Jenks Prize Committee, before January 1, 1889.

Each essay must be distinguished by a motto, and accompanied by a sealed envelope bearing the same motto and containing the name and address of the writer. No envelope will be opened except that which accompanies the successful essay.

The committee will return the unsuccessful essays, if reclaimed by their respective writers or their agents within one year.

The committee reserves the right to make no award if no essay submitted is considered worthy of the prize.

MICHIGAN STATE LABORATORY OF HYGIENE.-Prof. Victor C. Vaughan, M. D., made his first quarterly report of the Michigan State Laboratory of Hygiene, of which Prof. Vaughan is Director. This complete report is to be published in the annual report of the State Board of Health for 1887. A

pamphlet reprint of it may be had by address ing Prof. Vaughan, or the Secretary of the State Board of Health, at Lansing.

Prof. Vaughan's report includes three subjects (1) The important results of the investigations into the Causation of Typhoid Fever, stating the details of the experiments whereby the "germs" (the bacilli of typhoid fever) were proved to be in the water supposed to have caused the typhoid fever at Iron Mountain, Michigan, in October, 1887, and whereby, through the injection of the "germs," a disease in some respects similar to typhoid fever was produced in an animal, and, through injection of a ptomaine formed by the germs and chemically separated from the germs, an abnormal rise of body temperature was produced in an animal. (2) The complete account of the four cases (three fatal) of tyrotoxicon poisoning near Milan, Michigan, in September, 1887, and the experiments indicating that the poison may be generated in soil saturated with (3) The investigations decomposing milk. (3) The investigations which exposed a fraud which was putting into the hands of pharmacists and physicians a drug claimed to be a harmless product of the honey locust tree, but which was found to be a dangerous mixture of cocaine and atropine. Abstract of Proceedings of the Michigan State Board of Health, 1887.

THE PHILADELPHIA CHEMICAL SOCIETY held

its annual meeting January 27, 1888, at which time the following officers were elected: President, Dr. Mary E. Allen; First Vice-President, Dr. Clara Marshall; Second Vice-President, Dr. Marie B. Wemer; Treasurer, Dr. L. Brewer Hall; Recording Secretary, Dr. Mary Willits; Reporting Secretary, Dr. Mary Willits; Corresponding Secretary, Dr. Emma Musson; Counselors, Dr. Amy S. Barton, Dr. I. G. Heilman, Dr. A. Victoria Scott, Dr. Edward E. Montgomery, Dr. James Z. Walker.

LONDON MEDICAL RECORD.-The proprietorship of this journal has been changed; it is to be continued under the name "London Medical Recorder."

SPECIAL NOTICE.

SUCCUS ALTERANS (MCDADE.)-Owing to the claims made by some parties that they obtain this well-known preparation in bulk, such are false, as we are informed by the it is important that physicians should know manufacturers that Succus Alterans is only put up in pint, round amber bottles.

This remedy has come into such general use by the profession, that care should be taken to secure the genuine, prepared by Eli Lily & Co., which has given such good results and established the reputation it now enjoys.-Exchange.

VOL. V. [NEW SERIES.]

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than any thing else.-RUSKIN.

Original Articles.

FIFTY APHORISMS IN PREGNANCY.

BY E. J. KEMPF, M. D.

1. Introduction. "In such a manner we can cover a vast field in comparatively a short space of time. It is, too, a very useful way of imparting and receiving information. It is, of course, in its very nature dogmatic, as it offers no proof for its assertions, but it is presupposed on such a subject as this that the evidence on all sides has been weighed, and we can judge how far the propositions laid down accord with our several convictions. It is, too, a very natural way of imparting intelligence. Aphorisms form the method we use continually in conversation, where we first of all state our propositions positively, and discuss them afterward, if there be any necessity." I shall be glad, indeed, if any reader will do me the honor to dispute any proposition I may make, that the truth may better be arrived at.

General Aphorisms. 1. "The safest plan is to consider every woman, whether married or single, who comes to you for treatment, as pregnant until you have satisfied yourself to the contrary."†

2. The physician or midwife should inform himself all about the patient's former labors, general physical status, condition of lungs and heart, etc., the presentation and

R. O. Cowling, M. D., Aphorisms in Fracture, Louisville Medical News, Vol. IV, 1877, page 302.

+Munde, Pregnancy, Parturition and Puerperal State 1886, page 2.

No. 4.

position and condition of the child and the location of the placenta by external manipulation, several weeks before delivery.*

3. "To find day of confinement, take last day of menstruation, say February 10th, count backward three months to November 10th, and add seven days November 17th. An exact reckoning of the date of confinement is impossible, errors of one or two weeks being sometimes made."†

4. Direct the pregnant woman to (1) keep the bowels regular, (2) that the diet be plain and nutritious, (3) to take frequent baths, (4) not to get cold or wet, (5) to take moderate exercise, (6) to do the usual light housework, (7) to be in the open air often, (8) not to worry or get excited, (9) that the dress should be warm, loose, and there should be no pressure on the breasts, waist, or abdomen, (10) to wear an abdominal bandage, (11) to bathe the nipples in some astringent solution if they are sore, (12) to consult the family physician for any indisposition. (Munde.)

5. Moderate coition is allowable during the first seven months of pregnancy, and fondling of the breasts and nipples by the husband during the latter months is advisable. (Späth, Geburtsenkunde, 1857.)

6. Signs and Symptoms of Pregnancy. Morning sickness occurs during the end of the first month, the second and third months, and sometimes during the fourth and fifth

months. Occurring after that, it is probably abnormal. (Munde.)

7. Menstrual suppression is the rule during all the months. The menses may occur during the first, second, and third months, rarely afterward. Conception may occur

*Wilson, Fetal Physical Diagnosis, Medical Herald, Vol. II, 1880, page 398, and Munde, page 8.

†Medical News Visiting List, 1887, page 8.

when menstruation is normally absent, as in young girls before menstruation is established, and after the change of life, and during lactation.*

8. At the beginning of the third month mammary areolae become turgid. This is not a reliable sign, as it may occur in uterine or ovarian disease. (Playfair.)

9. Abdomen begins to enlarge during the third month, and becomes marked during the fourth, when the uterus rises three fingers' breadth above the symphysis pubis; during the fifth it occupies the hypogastric region; during the sixth it rises to the umbilicus; during the seventh two inches upward; during the eighth and ninth months it gradually enlarges until it reaches the ensiform cartilage. For about a week before delivery the uterus sinks somewhat into the pelvic cavity. (Playfair.)

10. Fetal movements start in at about the middle of the fifth month. These movements may be simulated by irregular contractions of abdominal muscles or flatus within the bowels. (Playfair.)

11. Ballottement will be of service at the end of the fourth month to the end of the sixth month.

(Playfair.)

12. Uterine souffle can be heard at the end of the fourth month, and until the term ends. (Playfair.)

13. Fetal heart sound can be made out during the fifth, sixth, seventh, eighth, and ninth months. The pulsation is likened to the tic-tac of a watch under a pillow. Steinbach makes the beat 131 for male children, and 138 for females, but this is not practical. The beat is most easily heard when the back of child lies to the abdomen of mother. An accelerated or irregular beat, preceding or during labor, means danger to the child. There is no relation between the fetal and maternal pulse.

14. The most valuable signs of pregnancy are fetal heart pulsation, fetal movements, ballottement, and intermittent contractions of the uterus.

15. Miscellaneous signs of pregnancy are dusky hue of the vagina, dentalgia, facial

*Playfair's System of Midwifery, 1885, page 145.

neuralgia, tendency to syncope, salivation, unusual gratification during some particular act of coitus. (Munde.)

16. The unimpregnated uterus measures two and one half inches and weighs one ounce, at term it measures six times as many inches and weighs twenty-four times as many ounces. The cervix uteri does not shorten during pregnancy, except during the fortnight preceding delivery, which is due to incipient uterine contraction. The cervix begins to soften by the end of the fourth month; by end of the sixth month one half is thus altered; by the eighth, the whole of it. The os is generally patulous. (Playfair.)

17. Diagnosis of Pregnancy by External Manipulation. By inspection we may learn the general contour of the abdominal enlarge. ment, whether it be of the usual pear-shape or broader, as is the case with shoulder presentations. Where there are twins side by side, there is usually a depression or sulcus between them, and the uterus is broader transversely. If the twins be placed one in front of the other no difference can be noted in the breadth of the uterus.

18. By percussion we make out the outlines of the uterus.

19. By palpation we feel the outlines of the uterine tumor, the prominent parts of the child, the round, hard, bony head, the soft breech, the knees, the feet, the elbows, the round, arched back, and the movements of the child.

20. By auscultation we may learn the condition, the presentation, the position, and the sex of the fetus, and the location of the placenta. (Wilson.)

21. The position of the fetus is generally head downward, and breech toward the fundus uteri. (Playfair.)

22. Spurious Pregnancy. Pregnancy is simulated by pelvic or abdominal tumors, obesity, ascites, tympanites, distension due to retained menstrual blood, amenorrhea, etc. A careful physical examination is the only guard against a mistake. (Munde.)

23. Abnormal Pregnancy. Extra-uterine gestation-early treatment, the faradic cur