ting for many decades, and take out all the rotten and decaying timbers or logs and replace them with new ones. But if the parties are able to do so, it would be far better to build new houses some distance from the old ones, selecting a high point where drainage would be secured; and if convenient it would be better to build two-story dwellings, and sleep up-stairs during summer and fall. Secondly, whenever there is a pond in close proximity to the house, especially on the south or southwest of it, to drain it; and, if this is impracticable, to plant trees and shrubbery between it and the dwelling. In case of drainage, it should be done late in the fall or in winter.

Thirdly, when the houses are reconstructed or replaced by new ones, they should be guttered, and the water conveyed into good clean cisterns for family use.

WEST POINT, KY.

TO WHOM IS THE HUMAN RACE INDEBTED FOR THE HEALING ART ? *

BY JAMES RAWLINS, M. D.

By permission, I propose to answer the problem, "To Whom is the Human Race Indebted for the Healing Art?" or the Science of Medicine, by the truth of history. The Bible says: "Honor the physician, for the Lord hath created him; the skill of the physician shall lift up his head, and in the sight of great men he shall be in admiration."

Adam, the first man, the progenitor of the human race-the first lord and ruler of earth, the first patriarch, priest, and prophet on the earth-while in the Garden of Eden, Adam said a man shall leave his father and mother and cleave unto his wife. The fulfillment of this prophecy is now being daily witnessed in our midst.

That Egypt was the cradle of the human race; that arts and sciences were first known in Egypt; that Moses was brought up in Egypt, and learned in all the knowledge of Egypt; that Moses' knowledge of the healing art was equal to the wants of the

Prepared to be read at the thirty-third annual meeting of the Kentucky State Medical Society.

race, is proven by the best historians of the age, both sacred and profane. That during the patriarchal age the first-born of every family held the office of priest and physician; that every patriarch was priest and every priest a physician.

Mr. George Rawlinson, M. A., Professor of Ancient History in the University of Oxford, perhaps the most learned historian of the age, says that nearly all of the most enlightened nations of the world agree that the Garden of Eden was in Egypt, where our foreparents were created. Dr. Rensurdo, a man of great learning, says that "to Egypt we are indebted for the healing art."

Mr. Smith, a learned patriarchal historian, a member of the Royal Society of Great Britain, says, to Egypt the world is indebted for all the arts and sciences useful to man, and that the words Eden and Egypt are of like import in sacred history. He says, the "Divine revelation is the only history that will inform us correctly of the time and place of the origin of the human race; that all other history is adulterated with error and fiction; that the Bible is the only book that will teach us the origin, capacity, and duty of man."

In Genesis, chapter ii, we read that God created Adam in his own image, and gave him dominion over every living thing upon the earth, commanding him to multiply and replenish and subdue the earth; that the Lord God planted a garden eastward in Eden, and there he put the man whom He had formed to dress it and to keep it; that he created every living thing and brought them to Adam to name, and the name Adam gave them they still retain; that man when he first came from the hand of his Creator, possessing the divine image, was happy, pure, and perfect; that his knowledge was suited to every condition of

man.

The learned Mr. Smith says man came from the hands of God replete with every intellectual adornment equal to the prominence of his condition; that Adam gave names to every living thing characteristic of the thing named.

Aristotle and Plato say that the names Adam gave were images of the things named; that Adam was the greatest philosopher of earth; that his wisdom was equal to the wants of the world; that of necessity he was the first physician of earth.

Rawlinson, the great historian, says the Bible account of the origin of man is true, beyond all reasonable doubt. The best testimony of the most enlightened nations agree that the Bible record of the origin of the human race is correct; that the art of healing was continued to the time of the Savior and his apostles. See the multitude that were healed by them.

That God had given Adam all knowledge. necessary to his position as Lord of earth; that from Adam to Moses the remedial office of priest and physician was invested in the first-born of every family for a period of twenty-three thousand years; and here we find Joseph, one thousand seven hudred years before Christ, directing the physician to embalm his father. These dates prove the truth of the Bible chronology, that Adam lived four thousand years before Christ.

God increased Solomon's knowledge so that he knew every plant and its virtues, from the cedar to the hyssop, that he might have all knowledge necessary for the good of his people. (Bible.)

That the arts and sciences were known from the beginning, we read in the Bible, that Moses directed Bezaleel to make all manner of workmanship out of wood and stone and brass and silver and gold. Moses does not tell him how to do the work, but to go and do the work.

Now that Adam knew all that man could know, that he had daily intercourse with his Creator, that God had made him ruler and governor of all that he had made, directed him to multiply, replenish, and subdue the earth, made in the image of God himself, his knowledge was suited to the wants of the race; that he is now prepared to meet the wants of the race, both mentally and physically, now in possession of all knowledge, he is in the possession of all remedial skill that knowledge can give. And with

this knowledge and skill disease was healed. Such was his knowledge of the healing art that death by disease is not named.

As Christ was the Great Physician in the apostolic age, so was Adam in the patriarchal age. As Christ was endowed with power to meet the wants of the people as priest and physician in his day, so was Adam endowed with knowledge to meet the wants of the people in his day.

Doctors Arhmole and Leclerc, two of the most learned physicians of antiquity, say that the healing art is a divine science, communicated to Adam by God himself; that Adam was the most learned man of earth; that the ten fathers before the flood, with Moses and Solomon, were the greatest physicians of earth; that Adam, of necessity, was the first physician of earth. Such was Adam's knowledge of the healing art that his descendants lived for hundreds of years previous to the dispersion of the race at the tower of Babel. By the dispersion of the people at the tower of Babel, God sent the healing art to all nations; by the preaching of the gospel at Jerusalem on the day of Pentecost, God sent the means of salvation to all nations.

A knowledge of the remedial agents used by Adam for the good of man until the dispersion of the race at the tower of Babel was renewed by God to Solomon in giving him all knowledge needful for the good of his people. This knowledge was again renewed by the Savior to his disciples by giving them power to heal all manner of diseases. (Bible.)

As Christ was the Great Physician in the apostolic age, so was Adam in the patriarchal age.

God, by the preaching of the gospel on the day of Pentecost, sent the means of salvation to every nation under heaven; so by the dispersion of the race from the tower of Babel he sent the healing art to every nation. (Bible record.)

Christ, the infallible Teacher, says that in the mouth of two or three witnesses every word shall be established. Now we have three infallible living witnesses to es

Adamic age:

1. The returning seasons.

2. The bow in the cloud.

3. The son leaving his father and mother and cleaving to his wife.

These predictions, recorded by Moses, are being daily fulfilled in our midst.

The sterling truth of the fulfillment of these prophecies, recorded by Moses, proves that the present inhabitants of the earth are the descendants of Adam and not of the anthropoid apes, and that God has been mindful in every age and nation of the good of man, and the human race is indebted to God himself for the healing art.

GEORGETOWN, KY.

SUB-DURAL CYST OF THE ORBIT.*

BY W. L. RODMAN, M. D. Demonstrator of Surgery, Medical Department University of Louisville.

Phil. Thomas, aged fifteen, from Bullitt County, Kentucky, came to the University Clinic in Louisville for treatment June 12,

1888. He gave the following history: Eight years ago he was kicked under the left eye by a young colt. The scar is still visible.

Eighteen months ago he and his friends. perceived a swelling about the same eye. The first thing noticed was a prominence of the eyeball with a turning inward and a distinct convergent squint. At this time he lost the sight of this eye. There was but little, if indeed any pain at all, he describing it as being "uncomfortable at times."

The sclerotic was preternaturally red nearly all the time. There was soon inability to close the eyelids, on account of the undue prominence of eyeball. About last March the swelling appeared upon the forehead over the eye. It increased very rapidly. There was still no pain, except when stooping with his head very low. He worked on a farm until he came to Louisville. His general condition was perfect, and family history good. Being assigned to the eye

Read at the thirty-third annual meeting of the Kentucky State Medical Society.

department, kindly asked me to see the case, with a view of turning it over to the surgical clinic. The tumor was very tense, but fluctuation could be distinctly felt. Early removal was advised, and, as his parents wished it done as soon as possible, he was sent to the photographer, and when he returned the operation was done.

I was assisted by Dr. Ray, Drs. Goodman, Cecil, McGuire, and others being present. The outer canthus was freely slit; this not giving us sufficient room, Dr. Ray suggested a vertical slit from about the center of the

uper eyelid. This was done. After a thorough examination we concluded that it would be impracticable to remove eyeball and tumor together, so enucleation was first done to facilitate subsequent removal of the tumor. When the optic nerve was cut with the scissors, there was but the least resistance, the nerve having been wilted away to a small cord. This, of course, was the result of pressure to which the nerve had been long subjected, as the tumor had its origin deep in the orbit.

The eye, upon examination, was soft and atrophic. It had ruptured through the cornea sometime previously. The tumor was now carefully dissected away from the roof of the orbit, to the periosteum of which it was more or less adherent, and traced back to the apex. It was seen that the entire inner wall of the orbit was absent. The tumor had every appearance of a meningocele, as I remarked at the time; and a further examination proved it to be practically the same. The cyst wall, which was tough and fibrous, had the appearance of dura mater somewhat attenuated by pressure. The cyst was incised, and about four ounces of a brown, gelatinous, viscid material escaped. The cyst wall was now cut away and the brain distinctly seen and felt pulsating. I had my finger on the brain, which was covered only by pia mater.

The pressure of the tumor had been so great and prolonged, that the lachrymal gland, fat, and all soft structures had yielded to it, so that scarcely a trace of them was

to be seen. The bony walls were greatly thinned by this constant pressure, and, as said before, the inner one back to and beyond the optic foramen was gone. So large was this opening, that the first thought I had was the danger of hernia of the brain, so apt to occur in all cases where the dura mater is incised. It occurred to me that possibly the best way to prevent it was to close the eyelids and allow the orbit to fill with blood and there coagulate. If a firm, aseptic clot could be made to cover in the opening, the brain would be well protected and more safely protected than by any other means which could be employed. Our theory seems now well grounded.

The boy stood the operation well until the dura mater was excised; he then showed such a very decided slowing of the pulse that the chloroformist became quite alarmed. The chloroform had been suspended some minutes, and it was not likely due to it. Patient reacted well, and several hours afterward was taken to his home from the college. He was seen at 5 P. M., six hours after the operation, and found to be comfortable. His temperature was 99° F., pulse 60. He was directed to take fifteen grains of bromide every four hours. Second day, morning temperature 100.5°, pulse 64, and full; evening temperature 102.5°, pulse 74; third day, morning temperature 101°, pulse 84; evening temperature 102°, pulse 84.

He had what his mother called a convulsive attack on the third day, and I was sent for in great haste. He was quiet when I reached him, but complaining of great pain in his head. It was soon relieved by the application of cloths wrung out of ice-water. His bowels had not acted, although he had taken two doses of calomel and three or four Seidlitz powders. An ounce of castor oil was given, which acted once several hours afterward.

The temperature and pulse remained the same until the seventh day; that is, the morning temperature would be 101°, the evening, 102.5°. The morning of the seventh day it fell to 99°, and in the evening rose only to 100° F. From this on it was

practically normal. During the first week the pupil was contracted; slow and hard pulse; obstinate constipation, though no opiate was given, along with the pain in the head and pyrexia, indicating a mild, circumscribed meningitis.

The patient made a perfect recovery, having no untoward symptom after the seventh day.

The orbit filled up with a firm aseptic clot and granulations, and he is beyond danger of hernia cerebri. He returned to his home in Bullitt County a week ago.

Prolongations of Dura Mater. I take this cyst to have been a sub-dural one, and think it possibly began at the sphenoidal fissure or optic foramen, as prolongations of the dura mater extend from the cranial cavity through these and other foramina at the base of the skull.

According to Senn, who has recently revised the subject of brain and nerve surgery with great care, these cysts are not common but are occasionally met with.

It is not necessary, I think, to say that I attach no importance to the history of traumatism eight years ago.

LOUISVILLE.

Societies.

PHILADELPHIA CLINICAL SOCIETY. Stated Meeting June 22, 1888, the President, Dr. Mary E. Allen, in the chair.

Dr. Amy S. Barton read a paper entitled, "A Case of Placenta Previa, followed by Purulent Endometritis."

J. M. presented herself at my office, November 10, 1880, with the following history: married seven years, has one child six years old, since the birth of which the patient has never been well.

Upon examination I found a stellate laceration of cervix uteri, the rents being bilateral and posterior. Lips everted and covered with exuberant granulations; perineum lacerated, with prolapse of posterior vaginal wall. General health good.

Under ordinary local and constitutional treat

ment the condition was improved sufficiently to warrant an operation. Accordingly I perform ed trachelorraphy, April 6, 1881, uniting only the two lateral fissures. This was followed by perfect union. On the tenth day I removed the stitches and restored the perineum, which united nicely, the patient making a good recovery. I was subsequently engaged to attend this lady in confinement, November 26, 1882. Early in the evening of the 23d a hasty summons was sent for me, but being out of my office, I Idid not reach her until 8 P. M. I then learned from the excited bystanders, that at 4 P. M., when rising from a nap, the patient passed a small quantity of blood, without any uterine pain.

She immediately dressed, went down-stairs and prepared tea for herself and family; while doing so she tripped over a brush on the cellar stairs, but did not quite fall. About 6 o'clock, after taking her seat at the table, while perfectly free from pain or any local sensation whatever, she was seized with a violent hemorrage. How much blood was lost I am unable to state, as it had been scrupulously cleaned up before my arrival. I can only testify that the clothing, a heavy flannel wrapper and skirts, was thoroughly saturated.

The patient walked up-stairs, stood while her clothing was changed and bed prepared, then fainted as she lay down. At this time the hemorrhage ceased. When I reached her (at 8 P. M.) I found her rallying from the shock, but very pale and weak. No hemorrhage. uteri soft; dilatation just commenced; fetal pulsations good.

Os

Gave a suppository containing extract belladonna one half grain, pulv. opii one grain, brandy per orem, and waited results.

At 10 P. M. another hemorrhage occurred, moderate in amount. Patient had a severe nervous chill, shaking violently, pallor was extreme, and she looked as though dying. I immediately made another examination, per vaginam; found the placenta on lower segment of uterus to the left side, covering the open orifice of os uteri. By passing the finger well up to the patient's right, the border of the placenta could be felt, but in no other direction could it be reached. I at once applied a tam

pon, which checked the flow. On the administration of brandy the patient soon rallied.

I now sent for Dr. Hanna T. Croasdale, who arrived at 11 P. M., at which time the patient was comfortable. No uterine contractions of any moment. At midnight the fetal pulsations were good, even vigorous, and the patient was doing apparently well. We determined to wait further dilatation before attempting to extract.

In our judgment the operation of turning at that time would subject the mother to imminent risk from hemorrhage, and there was not sufficient dilatation for the use of forceps. I had given the patient quiniæ sulph gr. x, at 11 o'clock, which she had vomited. At midnight the dose was repeated, with the same result. Repeated doses of ext. ergot. fld. were given; the dose was sometimes retained for half an hour, but generally vomited. There were occasional slight uterine contractions, no doubt resulting from the small amount of the drug which she was able to retain. The patient. dozed at intervals between midnight and 2.30 A. M. Pulse feeble; nausea extreme.

Owing to her extreme prostration, and the fact that there was no return of the hemorrhage, I deemed it improper to disturb her by listening for fetal pulsations, thinking, because the fetus had survived the last hemorrhage for two hours, it was safe until another occurred. I was shocked at 2:40 to find the pulsations gone. The cervix had relaxed and shortened sensibly during the last three hours. We determined to etherize immediately and extract with forceps if possible, if not, to turn and deliver.

I introduced my right hand, pushed the pla centa away to the right, and found the membranes unruptured. I ruptured them and found no difficulty in applying the forceps to the head, which presented in the first position. It was still above the superior strait. The head was brought down to the perineum without difficulty other than the use of considerable force; the perineum reached, it seemed impossible for the head to pass the vulvar orifice without lacerating the parts. We accordingly made lateral incisions of the labia, removed forceps, and enucleated the head, making pressure through the posterior portion of perineum and rectum. Just after the delivery of the head the ab