Address On Medicine. motes both molecular and tissue degenerations as so uniformly seen resulting from chronic alcoholism. If we would reach the highest degree of success in the treatment of acute general diseases, we must as early as possible separate The address on "Medicine," before the American Medical Association, Nashville, Tenn., was delivered by Nathan Smith Davis, M. D., LL. D., of Chicago. The doctor spoke of the unparalleled activity in the application the patient from further action of both speof chemistry and microscopy to biological, cific and predisposing causes of his disease by bacteriological, etiological, pathological, sani- surrounding him with pure air and as perfect tary and therapeutic investigations which has sanitary arrangements as possible. We should characterized the last two decades. He dis- carefully avoid the use of such remedies. as cussed antipyretics, and considered it far more either directly or indirectly retard or prevent safe in low forms of fevers to relieve the ex- normal metabolic processes. As the pyrexia cess of heat by increasing the natural processes of high temperatures results mostly from the than by any remedies, as antipyretics and interference with the processes of heat dissianalgesics which endanger increased blood pation, we must restore these processes by and tissue degeneration and depress nerve gently promoting natural elimination and by the direct abstraction of heat by the sponge baths, and in excessive cases by wrapping in. cold wet sheets. We must early and accurately use such remedies as palliate or modify local developments wherever they may be manifested, and thus prevent such structural changes in these directions which might otherwise end in fatal exhaustion. We should ever remember that the same remedial agent that might be of great value in the first stage, might be injurious or even destructive if used at the stage of culmination, or still more in that of decline. The chief benefits thus far received from the use of antipyretics and germicides, have been as preventatives in the incubative or prodromal stage rather than curatives after the active morbid processes have been manifest. I have been unable to find in the medical literature of the past few years that the very general use of antipyretics in continued fevers had either lessened the ratio of mortality or shortened their duration. 3. Both the direct effect of alcohol on the nerve cells, and its indirect effect, in lessening THE Eastern Kansas District Medical societhe amount of oxygenation of the blood, ty will hold its next quarterly meeting in causes it to produce marked diminution of Leavenworth, July 8, 1890. The afternoon. nerve sensibility and vaso-motor nerve force; session will be held at the soldier's home, and or, in other words, a true anesthetic effect upon the nerve centers. the evening session in the city. The society has been greatly favored in receiving an invitaIt follows, from these propositions, that alco- tion from Drs. Weaver and McNary of the hol in the blood diminishes every form of home to meet there. From twenty-five hunforce or energy, diminishes instead of con- dred to three thousand old soldiers are serving the tissues, diminishes instead of pre-quartered here and it affords the largest hosvents the metabolic changes and thereby pro- pital facilities in the west. The program is an exceptionally good one, found in this num- it's the man and not the college which comber of the JOURNAL, and it is an opportunity mands the respect. Men make colleges and which seldom is offered and should be im- not colleges men. It must be in the man or proved by every physician who can possibly spare the time to attend. Where Shall I Graduate? This is often a vexed question in the mind of the student and practitioner. In coming to a conclusion there are a great many conflicting questions to be settled and environments to adjust one's self to. it can never be developed-.000 from .000 and .000 remains. Many other questions might be asked and answered but we content ourselves in calling attention to two or three of the more important ones for the consideration of our readers. The Wichita Medical College. The Wichita Medical College announce The first question usually coming up and will not down is, "what will it cost?" In ment for 1890, is on our table. Considering answer we would say it will cost something. the late beginning of the session last year the As a rule a faculty, like an individual knows showing is a good one. There were no graduaits value, the worth of the service rendered and charges accordingly; and hence a college is in a measure, known by its price. tions which speaks well for the college. It is not designed as a diploma mill. Three full courses of lectures are required before a The second question often is, how soon can student can become a candidate for graduI graduate? The sentiment of the profession ation. The requirements throughout are in and the public and the demands of the State keeping with the first-class colleges of the Boards of Health for a three years course in a medical college before graduation, settles that question virtually. Some of us attended but two full courses of lectures and graduated, but another year would have added greatly to our usefulness as practitioners, especially in the earlier years, and we are not quite sure that the time and experience of that year's loss under an intelligent preceptor has ever been made up. land. The announcement is gotten up in good shape. It contains no useless verbiage, but a plain, concise statement of facts. It speaks well for the faculty. The prospects for a good class are encouraging. The columns of the JOURNAL are open to the faculty of Wichita Medical College for the publication of lectures, clinical reports, &c. THE Halifax Medical college, on April 10, graduated a class of one. He took the honors of his class.-Times and Register. The JOURNAL is pleased to note the success A physician knows no state line and when of the college and extends kindly greetings he receives a diploma to practice medicine and a desire to see even greater success attend and selects a location in a State where the the worthy efforts. diploma of two courses of lectures is recognized ali is well; but circumstances in a few years may require him to cross the State line and pitch his tent in a State where it requires a three years lecture course to qualify him to practice, and then he must stand an examination. It is then he feels the full force of his neglect; for we are persuaded that every physician will admit that a three years course is short enough time in which to obtain a medical education in a medical college aside from his general reading and tutelage. Will the college in which I graduate give me a standing in the community, is a question often asked. THE Times and Register is also responsible for the following:-" Dr. Hammond relates the case of a man who consulted him for impotence, with which he believed his wife had affected him, as he was setting out for a trip to New York. She had given him a peculiar glance as he left the house. He felt a peculiar thrill pass down his spine to his testicles, and thenceforth erection was impossible." If that woman will impart the secret of that "peculiar glance," there is big money for her In our observation we are compelled to say in any town within the reach of New York. Interesting. cellencies of each, in short those factors which have conspired to render them popular with the public, &c." The journal is gotten up in good style and the first number presents a fund of information on the subject of mineral waters and health resorts valuable to medical men. There is room for such a journal and it ought to succeed. It has a pretty cover the back ground of which is pale red, adorned Dr. John B. Hamilton, of the Marine Hospital Service of the United States, in his address, as chairman, before the section of State Medicine at Nashville, says among other interesting things, "The investigation of Dr. Kinyoun leads him to the following conclusions respecting malarial and enteric fevers. "First-Malarial and enteric fevers are not with cuts of beautiful scenery with, "of minerantagonistic to each other. "Second-A differential diagnosis between the two diseases is sometimes impossible. al waters," in deep rich red across the centre of the page and a huge alligator at the margin of a river at the bottom of the page. We can interpret the pale red as representing "Third-There exists a mixed form of infection which can be diagnosed by means of the condition of the blood before taking bacteriological and microscopical examination. "That the cobra poison in very minute doses as proved by Dr. Kinyoun is a germicide of extremely high power, and that it is fatal to the development of cholera germs.' Continual experiments are now going on, and he hopes to be able to make a complete report on this subject by the close of the present fiscal year. the water and the rich red letters after taking the waters, but the huge alligator has no place in our imagination or affection worthy the prominence given, and we cannot account for it only as being an idiosyncracy of the artist and tolerated by the editor. It is worth the subscription price without the amphibian. The Three Years Course. The following States require an attendance on three complete courses of lectures and graduation to entitle the holder to practice medicine within their limits, viz: Illinois, Mississippi, Virginia, West Virginia, Texas, Alabama, Iowa, North Carolina and Pennsyl WICHITA took the palm of sending the heavviest delegation, weighty in mind as well as person, with Father Fabrique at the head. They made a solid delegation and deserved to have the next meeting at their city. All in all it was a gathering of representative men, and we are glad we were permitted to see it. The exhibit of instruments was very good vania. indeed and we compliment highly Messrs. D. Rauch, secretary of the Illinois State Swift & Holiday on their display as showing that we have close at hand in our State a complete and varied assortment of surgical supplies of all kinds. It is sometimes very important to be able to secure instruments in short order, and for that reason we are pleased to note the large stock as well as low price of these goods in Topeka. Board of Health said, in addressing the medical college representatives at Nashville, that the States were fast wheeling into line in the demand for a three years college course in medicine of the physicians and he thought the time would soon come when all of the States would require it. DR. SCHENCK, it appears, is known outside THE first number of The American Journal of of his bailiwick. Owing to lack of time the Mineral Waters, edited and published by R. nominating committee left the appointment M. Jordan & Co., of St. Louis, Mo., is on our of the various committees to a sub-committee. table. The editors in the salutatory say, "we This committee appointed Dr. Schenck to dedesire to present the journal as a cyclopedia liver one of the three general addresses, the of knowledge, wherein will be found succes- address on State Medicine, before the associasively the record of all places of public resort, tion. This is a much greater honor than the their location, the peculiar attractions and ex- first vice presidency. He is also on the com mittee of State Medicine for Kansas. He is THE dry method of wound treatment is realso chairman of the committee on the presi- ceiving considerable attention. Dr. Lauderer dent's address to report next year. This com- of Leipzig, is one of the pioneers. No fluid mittee consists of W. L. Schenck, of Kansas; is allowed to touch the wound. Dry aseptic T. B. Evans, of Maryland; E. Grissom of gauze is used in place of moist sponges and North Carolina; and H. B. Baker, of Michigan. irrigating fluids, and pieces of gauze are applied to the wound. He claims the following advantages: American Medical Colleges. Fifty-five of the one hundred regular colleges of the United States were represented in the college meeting in Nashville May 21, 1890. Two interesting sessions were held and the preliminary work preparatory to a permanent organization was completed. First-The patient is not exposed to wet and cold. Second-The loss of blood is minimal. possible. Fourth-Time of operation is decreased. Fifth-Rapid recovery, only one dressing being necessary, and that only if non-absorbable stitches are used. Sixth-Saving of surgeon's hands. The following rules governing the admission of colleges to membership in the American Medical College Association were adopted: First-That the colleges shall require a graded course of instruction, covering a period DR. J. H. THOMPSON of Kansas city, capped of not less than three courses of lectures of the climax in the section of ophthalmology six months duration each, before graduation. at the late meeting of the American Medical Second-That both oral and written examinations be required of all students. Third-That a thorough course of laboratory instruction be maintained in chemistry, histology and pathology. Fourth-A preliminary entrance examination consisting of: First-A composition, written in English, of not less than five hundred words. Second-The translation of easy Latin Association, in his report how to prepare DR. TIFFANY, of Kansas City, read a paper on "Tobacco-Its effects upon the Eyesight," before the section of ophthalmology at the Nashville meeting of the American Medical Association. The doctor prepared a paper for the JOURNAL'S February number on the same subject and we expected to get a repeater, but an entirely new dress was put on the subject and the weed received its just deserts. THE American Medical Editors held a pleasant meeting in Nashville, as is the usual custom, the evening preceding the meeting of the American Medical Association. The address of the president, Dr. I. N. Love, is found in this number of the JOURNAL. SOCIETY PROCEEDINGS. May 13. treatment. About the same symptoms and May 14, 10 a. m. Dr. Stewart was called Topeka Academy of Medicine and Surgery. in consultation, and advised more free use of The Topeka Academy of Medicine and Surgery met in special session Tuesday evening, May 20, Dr. L. H. Munn, the president, in the chair. salines. A saturated solution of Epsom salts was recommended-tablespoonful every hour, and an injection of one quart of a saturated. solution every two hours. This was carried out until 4 p. m. Copious passages followed well. Dr. C. C. Bradley, reported in writing a each injection. These contained scybalous "Case of Peritonitis, with Treatment." masses. Apparent improvement from 6. a. m. Miss G, age 17. Friday, May 9, Dr. to 2:30 p. m.; took no opiates; rested fairly Munn was called about noon. History-Two At 7:30 p. m. pain increased; cold sweat. Gave 4 grain morphia, atropia, or three days more or less pain in right illiac region, bowels constipated, two or three days mag. sulp. continued every two hours, injecpast menstrual period, had had trouble before, tions stopped; milk and whisky given. pain and excessive flow. Her condition was May 15, 6 a. m. Had a bad night; 11 a. m. attributed to her menstrual trouble by her Dr. Alexander called; advised continuing parents. Skin moist, temperature normal, opium. The partial saline and opium treatpulse 78°, respiration 18, no difficulty in pass-ment was continued until noon of the 17th, ing urine, abdomen not tympanitic, not tender when a consultation was held by Drs. Munn, to superficial pressure, but deep pressure in Stewart, Alexander and Bradley. The maright illiac region low down caused pain, jority favored continuing the opium treatwhich was attributed at the time to ovarian ment; a minority favored a return to salines. irritation. An aloin cathartic, hot fermentations, grain morphia, in mixture, was pre % scribed, with instructions if not relieved to report in the morning. May 10, 10 a. m. Reported no better; indefinite history of chill the evening before. Temperature 103°, pulse 110, respiration 25; irritable cough, slight hemorrhage from the The opium treatment was continued until the evening of the report, the patient remaining about the same, with perhaps some improvement. At this time an operation was proposed, giving twenty-four hours for a decision. The object in reporting this case was to bring about a discussion of the relative merits of salines and opium in the treatment of peri tonitis The discussion is as follows: DISCUSSION. vagina, bowels moved freely, several scybalous masses, pain increased, slight tympanitis, deep pressure in right illiac region gave internal pain, boggy sensation. Diagnosis-Typhilitis, Dr. McClintock-The point to be brought with diffuse peritonitis. Gave hypodermic of out was the opium versus the saline treatment grain morphia, grain atropia opiate mixture. Continued as day before; also a mixture containing gr. xv. mag. sulph. to a dose every three hours, hot fomentations, milk diet. May II. Temperature lower, but other symptoms about the same; doubled the dose of mag. sulph., injections of soap suds with turpentine ordered. May 12. Pain increased, enlargement right side in illiac region. Mag. sulph. ordered every two hours in same dose. of peritonitis. His father had treated peritonitis by means of saline injections, and by mouth. Himself had used opium while his father used salines. Thought his father had the best results. At present he prefers the saline treatment. Dr. Lindsay-Had been taught that opium was the treatment; did not think, however, that opium was to be compared with salines to relieve inflammation. Gives opium to relieve pain. Salines more rational to reduce inflammation. Inflammation an increase of May 12, 7 p. m. Temperature 103°, pulse cell development; salines check this and re120, same pain, two small passages during day. move scyballa. |