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AFTERNOON SESSION.-First in order was the annual address by
Following this was the election of officers, which resulted as follows:
H. Z. Gill, M. D., Cleveland, H. R. Kelly, M. D., Galion, J. D.
G. A. Collamore, M. D., Toledo, Secretary; E. C. Brush, M. D.,
T. W. Jones, M. D., Columbus, Treasurer and Librarian.
Akron was selected as the place for holding the next session, which
Papers were then read as follows: G. W. Ryan, M, D., Cincinnati,
In the evening the members attended an elegant reception tendered
THIRD DAY-MORNING Session. Dr. N. P. Dandridge, of Cincin-
, read a paper on "Osteotomy;" Dr. Von Klein, of Dayton, one on
Dr. Wm Morrow Beach, President-elect, was presented to the So-
Dr. J. C. Reeve, after a brief valedictory, declared the Society ad-
PROCEEDINGS OF THE CUYAHOGA COUNTY MEDICAL
SOCIETY, JUNE 4, 1885.
Reported for the JOURNAL by L. B. Tuckerman, M. D., Corresponding Sec'y.
In the absence of the President, DR. HIMES, the Vice President, Dr. Powell, presided.
Dr. Jenis presented a child a year old, with a nevoid tumor the size of a large hen's egg, extending from the auditory meatus downward, covering the parotid gland, the angle of the jaw and the submaxillary region of the left side. The tumor had begun as a simple nevus of small size upon the skin when the child was about a week old, and had taken a year to reach its present size. One other child in this same family had been similarly affected and had died in consequence. Dr. Jenks wished to have a committee appointed to examine the case and to report. Drs. Cushing, Lowman and Jones were appointed, and subsequently, Drs. Vance and Thayer were added. Dr. CUSHING declined to express an opinion, as the case was out of his special line. Dr. Lowman said he would not be sanguine as to the results of any treatment, in view of the history of the previous case, but would be inclined to try the effect of ice compression; DR. JONES had seen good results from the injection of sesand chloride of iron; Dr. Vance stated that the tumor was apparently unconnected with the deeper structures and involved only the skin and subcutaneous cellular tissue. The indications were to cut off the blood supply of the tumor, and he should expect a favorable result. DR. THAY. ER also had found no evidence of connection with the deeper structures, but had some fear that degenerative action, resulting in sarcoma, might
He had had good results in such cases from the injection of persulphate of iron in the margin of the tumor. He would like to have some one tell him how it was that in the growth of these tumors, one capillary could induce its neighbor to enlarge.
DR. TUCKERMAN presented a case of fracture of the clavicle in a boy of 8, treated by plaster of Paris dressing. The boy had sustained an injury about the shoulder and been taken to a doctor, who claimed to have fixed it all right, giving orders to the mother to have the boy carry his arm in a sling for a few days, and to rub on a liniment. Three weeks after the accident, Dr. 'T. was asked to examine the case and found an ununited fracture at the junction of the middle and outer thirds of the clavicle, the ends of the fragments being thickened. The arm was held
in the position used in Sayre's adhesive plaster dressing, by means of a roller bandage, and then a light plaster dressing, made of short pieces of plaster bandage, was placed over the whole side, from the ends of the fingers in front to the median line behind and extending below the elbow, thus holding the arm and shoulder firmly fixed. Firm union with no deformity besides the thickening above mentioned, occurred in three weeks. The dressing occasioned no inconvenience.
DR. THAYER thought that the dressing used did not fulfill the indications, although a fair result had been obtained in this case. The shoulder should he held well back, and for this purpose he preferred a board applied to the back to which the shoulders were bound.
DR. VANCE said he had seen the case while under treatment, and that the dressing did hold the shoulder sufficiently back. The dressing was applied, and while it was hardening the shoulder was retained in proper position from which it could not move after the plaster had set.
DR. SIHLER read a paper upon, “Terminal nerve filaments in the striped muscle of the frog."
The paper was illustrated by elaborate drawings, and the specimens from which the drawings were made were exhibited under the microscope. The staining fluid used is similar to Beale's carmine stain, but is stronger, and is made from cochineal, ammonia and carmine. The foot of a frog is placed in the stain until it is colored sufficiently, the muscle is teased in glycerin. This method rendered the terminal filaments with their neuclei quite distinct and the conclusions reached were;-Ist. That, contrary to the generally accepted opinion of histologists, nerve-endings lie wholly upon the outside of the sarcolemma.—2d. That the nerve supply of the capillaries is far richer than that of the adjacent muscle fibre.-3d. That sensory fidres surrounding bundles of muscle fibres have probably not seldom been mistaken for terminal filaments of motor nerves; all of which are points of great physiological importance. In conclusion, he recommended young men whose time hung heavy upon their hands, to undertake some such line of original investigation, promising them plenty of hard work and no little satisfaction.
DR. THAYER thought the Dr. had failed to fully discriminate between the nerves coming from the cerebro-spinal, and the sympathetic system, and gave a review of their different functions. He also thought that Dr. S. might have confounded fibres and fibrillae.
DR. SIHLER replied that under the miscrope he had never been able to discern a difference in appearance betwixt cerebro-spinal, and sympathetic fibres, and as to confounding fibres and fibrillae, he had seen a great many fibrillae. He had been working at this subject for many months, and had noticed that the more skilled he became in manipulation, the more fibres and the less fibrillae he saw.
The subject for discussion was :
DR. TUCKERMAN in opening stated that he had failed to find sufficient evidence to amount to a scientific demonstration that quarantine would prevent an outbreak of cholera. There had never been, as far as he could discover, a thorough and complete carrying out of quarantine in any country of the civilized world; i. e., thorough enough to prevent the possibility of the access of the germs of the disease. All that could be said was : that it was still sub-judice, with strong reasons for more thorough experiment. The relations of commerce were such that absolute quarantine was out of question. The plan proposed by those who had made the question a special study was to establish refuge stations, and when ships came from infected ports, take them to the nearest refuge station and thoroughly disinfect cargo and baggage, and detain all affected passengers till recovery, allowing the others to proceed as soon as it becomes evident that they could safely do so. This experiment was certainly worth a thorough trial.
DR. THAYER though that a good deal that was claimed by the advocates of quarantine was purely theoretical, and that we don't quite know all about cholera yet. He didn't think that the infection could be hedged up. He knew it would stick to clothing. In '49 they had a temporary cholera hospital and every patient brought in was stripped of his clothing and the clothing was put away in a vacant room. The epidemic began in June and continued till cool weather. In November, when there was no cholera, they were ordered to vacate the building. The man who had had charge of the building during the epidemic, a healthy German, was ordered to remove the pile of old clothes and burn them. He did so and began to feel sick. He said, “Dr. I am sick and am going to die," and in spite of anything that could be done he was dead within three hours, of cholera. In '52 there were scattering cases in the city, and a family on Wood st., where there was an old cistern, thought they would better clean it out. He told them not to, but they did and within a few hours seven members of that family were down with cholera and three died. Cholera lurks around and when it finds a good place it stops and multiplies. It will travel against the wind, and how can quarantine prevent the travel of the infection, or the causes that predispose to it ?
DR. ALLEN called attention to the fact that in the first invasion of cholera in '32, when lines of communication were few, the course of the contagion could be far more accurately traced than now. Then it held strictly to those lines of travel, following the main wagon roads, the lakss and the rivers. From these facts he was inclined to believe quarantine could be made effective.
DR. VANCE believed the value of quarantine to be still sub-judice. It was known however that the spread and severity of cholera have been in proportion as the sanitation was bad. An unsanitary ship, or an unsanitary cistern might serve to propagate it. In his early home, in the Ohio valley, where traditions of the cholera-epidemic of '32 still survive, it is affirmed that cholera departed from the lines of travel and spread to communities, where the most rigorous measures of exclusion were adopted. It is needless to add, however, that the sanitation in all those communities was wretched. He therefore did not believe in resorting to extreme measures, but when it is known that cholera is likely to come, the city should be put in the best sanitary condition possible, before it comes, and when it comes, old cisterns would better not be stirred up.
DR. CUSHING referred to an article in the Med. Record, by Dr. Vanderpoel of N. Y., which stated that by means of a 10 days quarantine of the Moslem pilgrims at an island at the lower end of the Red sea, and disinfection of their baggage, then after they had landed at the port of Mecca, detaining the sick, and accompanying the caravan by sanitary officers who saw to it that all dejections were voided in pits, and that sick pilgrims were at once set one side, and not allowed to go on with the caravan, the mortality from cholera had been reduced to a very small number, and these caravans had ceased to be the vehicles whereby the disease found its way into Europe, the epidemics which invaded Alexandria and Marseilles having come in war vessels from China. It was at first endemic in the delta of the Ganges only. It had now become endemic at Bombay, and without proper precaution it might become endemic in some of our own southern ports. Commerce however is opposed to quarantine, and the greatest foe quarantine has ever had is the commercial interests of the English people. He believed that the medical profession should uphold proper quarantine precautions.