SOCIETY REPORTS. RICHMOND ACADEMY OF MEDICINE AND SURGERY. MEETING HELD MARCH 26, 1895. Dr. Wm. S. Gordon, President, in the chair. The subject for the evening's discussion was a paper on IMMUNITY FROM INFECTIOUS DISEASES (see page 6) read by the Secretary. Dr. Hugh M. Taylor was surprised by one point brought out and that was that the ptomaines did not kill the germs. He quoted Morris, who said that in some cases of appendicitis the ptomaines are so virulent as to destroy the microbes causing the disease, recovery taking place. The most plausible theory to my mind is the survival of the fittest. Dr. W. S. Gordon, the President :When nuclein is given by the stomach, the proteid portion may be acted upon, leaving the phosphorus to be absorbed alone. The good effect of the medicine may be due to the phosphorus, which is a powerful stimulant, as seen in the administration of hypophosphites. It is an aphrodisiac and also excites the mental functions. He believes that Brown-Séquard's testicular extract and the organic extracts owe their good results to phosphorus. Resorption of the seminal fluid acts as a powerful stimulus, and it is rich in the same element. It is claimed that the adrenals, thymus and kindred glands are engaged in eliminating poison. In leucocythemia, we have an increased number of colorless corpuscles, and yet death is almost certain. Dr. J. W. Henson: It occurs to me that there are uncertain arguments in favor of the survival of the fittest and against the killing of the germs by toxines. I. Some persons exposed to certain contagious diseases never take them under any circumstances. 2. The toxines do not remain in the system and the immunity confessed by them, if at all, cannot be permanent, so that there is no reason why these diseases should not be contracted again. After certain infectious. diseases are contracted, they are not "taken" again, which is an argument in favor of the destruction of the weak cells and survival of the stronger. Dr. Landon B. Edwards does not think we have arrived at the point to say to just what immunity is due. The theory of the survival of the fittest does not reach a number of germ diseases. Smallpox, for instance, is not protective against other diseases. We are premature in taking a decided stand. Regarding isopathy, he said we are on the border land of grand discoveries. In myxedema and cretinism thyroid extract is working wonders. The Secretary, Dr. Peyser, in closing the discussion, said that what goes on in the test tube is not necessarily indicative of what occurs in the living body. That the destruction of germs by their toxines occurs in the tube is not denied; neither is it denied that alcohol produced in the tube by yeast cells destroys the latter. In the body we have the circulation covering a large area and always in motion; and elimination is occurring incessantly. The conditions. governing the two are dissimilar. The fact that the body immune to one disease is not immune so far as another is concerned, is not antagonistic to the survival of the fittest. This is an educational process; and we know that perfect knowledge requires teaching of all branches and an absolute understanding of them. We limit the term immunity to infectious diseases. Leucocythemia, which shows a diminution of the colored blood corpuscles, rather than an increase of the colorless, does not come under this head. It is not the actual increase of these, so much as their healthy condition, their power to secrete nuclein, that determines immunity. Dr. Virginius W. Harrison reported an interesting case of HYDROSALPINX. (See page 7.) MARK W. PEYSER, M. D., TANNIN IN ENTERITIS.-Tannin is an old and neglected remedy very efficacious in enteritis. CORRESPONDENCE. AMERICAN MEDICAL ASSOCIATION. BALTIMORE, April 16, 1895. Editor MARYLAND MEDICAL Journal : Dear Sir:-The American Medical Association having decided to hold its next annual meeting in Baltimore, on May 7, 8, 9 and 10 proximo, I trust that I may not be officious in calling attention through the JOURNAL to the objects of the Association, to its claims upon the medical profession of this country for support, and lastly to its claim upon the profession of this city for a cordial reception and hospitable entertainment during its meeting here in May. The chief objects of the Association are to organize the profession of the United States for scientific work in all of the branches of scientific medicine, to promote harmony and co-operation in the profession, to consider varied professional and public interests and to elevate the educational standard, the dignity and the nobility of medicine as a professional pursuit. The Association seeks to promote these objects by enlisting in its ranks two classes of members; first, permanent, and, second, delegated. Its doors are open to every regular member of the profession who pays the annual dues of five dollars. The member once admitted becomes a regular member so long as the annual dues are paid. A delegate member is admitted on the credentials furnished him by a local or State medical society in good standing and upon the payment of the annual dues of five dollars. Delegates have all the privileges of regular members so long as the annual dues are paid. The membership of the Association is drawn from the rank and file of the regular profession so that the Association is owned by the profession and its work from year to year is virtually controlled by the members and delegates in attendance upon each annual session. It is, therefore, a representative body conducted by men engaged in general professional work. The member or delegate from California has as much say in the management of the Association as the member or delegate from Maine or Florida. It is cosmopolitan in character and scope, and its influence can be made as large as the annual attendance will admit of. Whilst its interests and policy are controlled from year to year by its officers and appointees, its positions of trust are open to all who aspire to them and who may be deemed worthy of them. It differs from all other medical organizations in this country in the breadth of its scope and in its accessibility to general professional control. No thinking mind can dispute the fact that its objects are wise and useful, that its principles of organization are comprehensive and liberal, and that it is capable of conferring the highest advantages upon its membership as well as upon the profession at large. The Association was organized in the year 1847 and with the exception of the four years of civil war it has grown yearly in membership and in influence. Notwithstanding the fact that it has experienced the disadvantages which attend all large delegated bodies, that its work at times has fallen below the high standard aimed at, that politics and rings have to some extent influenced its counsels, counsels, its purposes have grown stronger from year to year and its influence for good has gradually enlarged. If in a special sense it has not measured up to the highest standard of efficiency, in a general sense it has met the approval and has enlisted the support of many of the ablest professional minds in the ranks of the medical profession. Some men of narrow views and of high aspirations have been captious and critical and have refused to yield it support, but take the profession as a whole and there will be found many well known and influential men who have given earnest support and encouragement to the work and purposes of the Association. If a few have labored to tear down an organization struggling for recognition and support, many have given a helping hand and have labored to build up and enlarge its capa will enlarge the hearts and minds of those who enter into the spirit and enjoyment of the occasion. Mr. Editor, let us all enter heart and soul into this meeting and appropriate to ourselves the pleasant memories which always follow the happy conclusion of such important events. From the many indications which have been suggested to me in connection with this meeting I feel assured that our professional visitors and the profession of our city are destined to have the largest and best meeting the Association has ever held, as well as a royal good time. Very truly, city for good. Such in brief is the his-and pleasant for the "stranger within tory of this Association, purely American Tour gates" but if rightly appreciated it in its institutions and methods and strictly earnest and progressive in its aims and tendencies. The Journal of the Association has experienced the same results which have been meted out to the parent organization. It has had to meet the carpings of many critics, it has been forced to overcome various antagonisms both within and without the ranks of the profession, yet with a singleness of purpose its management has been progressive, business-like and judicious. It has outlived the experimental stage and has become an institution which will grow and improve from year to year just as the profession recognizes the value and influence of an organ owned and controlled by its united support. It is not the aim of this article to bestow praise and approval upon the Association and its Journal. Both speak for themselves. Neither is perfect, neither is up to the standard of excellence to be desired by their friends. Both, however, have a claim upon the entire medical profession of this country. They are the common property of the regular profession and the man who wishes to see these interests and institutions prosper, grow, become more scientific, more useful and, in fine, reach perfection, should lend a willing hand and generous heart in furtherance of such purposes. The Association meets this year in our city for the first time since 1867, twentyeight years ago. It has met much more frequently in other large cities. In coming here this year it behooves the profession of Baltimore to recognize the significance and importance of such an occasion and to extend that open-hearted hospitality and generous cordiality for which our city has long been famous. This is an occasion which we should welcome, since it introduces to the members of our profession from widely separated sections of our country the beauty, refinement and culture of our city, the character of our medical and educational institutions and the richness of Baltimore in her art, her libraries and in her material progress. An opportunity such as this can not only be made profitable T. A. ASHBY, M. D. COLD IN PNEUMONIA. Editor MARYLAND MEDICAL JOURNAL: Dear Sir:-I am glad to see in the Treatment of Pneumonia" attracting so much attention. "Cold Years ago I published an article in your JOURNAL, to the effect that the air in the room of a patient suffering with pneumonia should be as cold as the weather would admit of. Some years later I listened to a most able and interesting address by Professor Welch before the Medical and Chirurgical Faculty of Maryland on the diplococcus pneumoniae, in which he stated that that organism could not survive a temperature lower than 76° F. My friends, who were present, and who were familiar with my article, were struck with his remarks showing how bacteriological research coincided with practical experience. The temperature of the rooms in which pneumonia patients are treated is usually very high and many of them are sweated to death. I confess myself not wholly guiltless, but I am thankful that I had not, like "Sangrado," written a book. Very sincerely, EDWARD ANDERSON, Rockville, Md., April 9, 1895. MEDICAL PROGRESS. ACUTE DELIRIUM.-Dr. H. C. Wood, in discussing the history and diagnosis of acute delirium in the American Journal of the Medical Sciences, says that all manias of an acute type which are not intoxication neuroses and are not due to the presence of organisms in the blood, are divisible into two affections: first, mania proper; second, confusional insanity; and that each of these diseases becomes, when in its most severe form, an acute delirium. Thus, there would be, first, acute mania-that is, mild acute peri-encephalitis, known when in its severest form as acute delirium-that is, violent, usually fatal, peri-encephalitis; second, confusional insanity, without demonstrable lesion, but probably the result of changes in the ganglionic cells themselves, constituting in its severest form an acute delirium, also without demonstrable lesion, but, in fact, due to an exaggeration of the unknown ganglionic or other alteration present in the confusional insanity. TREATMENT OF URETHRITIS.-Writers never seem to tire of giving their experience in the treatment of urethritis. Dr. Ramon Guitéras, in the Medical News, is inclined to conservative methods and does not lay much stress on the gonococcus and endoscope. He concludes: 1. That it is impossible to treat urethritis according to any given rule at the present day, a successful method not as yet having been discovered. 2. That specialists are much better able to treat it successfully than the general physician, and to go further, that a patient receives better treatment from a specialist in a dispensary than from a general physician in private. THE FAVORABLE EFFECTS OF VACCINATION ON WHOOPING COUGH. - An Italian physician, says the North American Practitioner, Dr. P. Bolognini (Borgo Panigale) has had occasion to vaccinate thirteen children suffering from whooping cough, following the examples set by Drs. F. Pestalozza (Rovescala) and C. Coelli (Cremona), who have before had recourse to vaccination as a means of treating this affection. Their observations convinced Dr. Bolognini that vaccination, provided that it be resorted to sufficiently early, that is to say, during the first, or at the beginning of the second stage of whooping cough, results in lessening the number and intensity of the paroxysms and hastening recovery. The favorable effect of vaccination is manifested within one or two weeks, and is sometimes preceded by temporary aggravation of the symptoms. It is obvious that in cases in which the characteristic pustules are not developed, on account of existing immunity, either natural or acquired by previous vaccination, the inoculation can have no effect on the whooping cough. When having to deal with a child suffering from whooping cough, who has not before been vaccinated, it is, therefore, well to resort to Jennerian vaccination, but without prejudice to other medicinal or hygienic measures, which it may be thought best to employ. * * * THE FALLACY OF EARLY RISING.Proverbs are responsible for a great deal of folly, says the British Medical Journal, and none perhaps for more mischief under the present conditions of town 3. That injections checking all dis- life than those which inculcate early charge or reducing it to a moisture rising as a virtue. When the great maabout the meatus, such as those of mer- jority lived in villages and were engaged curic chloride, potassium permanganate, in the cultivation of the soil, early rising and silver nitrate, are the most success- may have been conducive to health and ful means of treating a fresh attack, and wealth, if not to wisdom, but even our that of these silver nitrate is the one early forefathers probably did no more upon which most reliance can be placed.than make a virtue of necessity. It is 4. That in all cases the patient should said to be natural-that is, physiological be treated conservatively, and the treat- -to rise early and enjoy the beauties of A Thus the sunrise; if we ask why, we are treated to various transcendental theories about the vivifying influence of the sun, and are told to take example by the birds of the air and the beasts of the field, or so many of them as are not nocturnal in their habits. But as a matter of fact physiology, so far as it has anything to say on the subject at all, is all against the early rising theory. Physiological experiment appears to show that a man does not work best and fastest in the early morning hours, but on the contrary about midday. The desire to rise early, except in those trained from youth to outdoor pursuits, is commonly a sign, not of strength of character and vigor of body, but of advancing age. The very old often sleep much, but they do not sleep long. long deep sleep, the sleep of youth, requires for its production a thoroughly elastic vascular system. The stiffening vessels of age are not so completely nor so easily controlled by the vasomotor nerves. Hence shorter sleeps. paterfamilias, who goes to bed at II P. M., wants to get up at 5 or 6 A. M., and looks upon his healthy son, who prefers to lie till 8, as a sluggard. When this foolish interpretation of a proverb about the health and wealth to be got from early rising is combined with the still more foolish adage which says of sleep: "Six hours for a man, seven for a woman, and eight for a fool," then we have a vicious system capable of working great mischief to young people of both sexes. There is a tendency, greatly encouraged in towns by the spread of cycling, to curtail unduly the hours of sleep. Parties of young men and lads are to be met careering about the streets at midnight. They would be far better in bed. They have probably to be in their offices or shops by 9 A. M., or even earlier, and when time is deducted for supper, toilet, breakfast, and the journey to the place of business, it is evident that the hours for sleep cannot exceed six, or at most seven. These young men are no doubt encouraged by the silly adage quoted above. There is a disposition in town youths to overdo outdoor exercise; the cycling club "night spins" are instances in point. As Nordau has said, with a great deal of truth, the town-dweller of these last decades of the nineteenth century suffers from nervous fatigue, and is so ill-advised as to make his very recreations sources, not of recuperation, but of increased exhaustion. If our forefathers were early risers they went also early to bed. It would be well for the rising generation if it paid more heed to this part of the proverb. * POST-PARTUM HEMORRHAGE.-A case of secondary post-partum hemorrhage, eighteen days after labor, followed by septicemia and death, is reported in the American Journal of Obstetrics, by Dr. E. L. Tompkins of Washington, D. C. Eighteen days after delivery the patient had some misunderstanding with her husband, and imagining he had left her, was much overcome with grief. From this time on she had profuse uterine hemorrhages, mammary abscess, edema of the lower limbs, albuminuria and general septic poisoning, which ended in death. The mental grief seemed to have caused the hemorrhages. The THE CAUSATION OF HEMIATROPHIA FACIALIS PROGRESSIVA.-Bauerwald reports (Journal of Nervous and Mental Diseases) a young, healthy man developed a progressive hemiatrophy of the face directly after a swelling and inflammation of the submaxillary gland which had been associated with angina. author thinks it possible that the angina. caused an infectious inflammation of the terminal brenches of the fifth nerve, and that this would tally with the findings in Mendel's case, which were those of progressive peripheral neuritis of the trigeminus and secondary atrophy of the descending root of the trigeminus. * * * VENESECTION.-Dr. George C. Laws, in the Therapeutic Gazette, thinks that the rule is universal that in all cases of inflammation so serious from degree or position as to involve danger to life, bleeding should be employed in the early stages, unless forbidden by general debility or the low grade of the fever. |