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WASHINGTON NOTES.

Leave of absence for four months, on surgeon's certificate of disability, with permission to leave the Department of the Missouri, to take effect on being relieved from duty at Fort Reno, Oklahoma Territory, is granted Major Henry M. Cronkhite, Surgeon.

Leave of absence for ten days, to take effect from the date of the conclusion of his exami. nation for promotion, is granted Captain Louis W. Crampton, Assistant Surgeon.

The last meeting of the Clinico-Pathological Society was held on Tuesday, May 21. The next meeting will take place in October. Dr. W. Sinclair Bowen presented “Two Ovaries and Tubes” that had become discolored and removed a few days before. The discussion of Dr. E. L. Tompkins' paper was continued from the last meeting. The subject of the paper was “Cerebral Hemorrhage.” It was discussed by Drs. Mitchell, Bishop and Glazebrook. The paper of the evening was by the President, Dr. Wm. M. Sprigg, on

' Post-Partum Hemorrhage.” He also delivered the Presidential Address. The paper on post-partum hemorrhage was discussed by Drs. Bowen, Kelley, Beatty, Bishop and others.

The regular meeting of the Medical Society of the District of Columbia was held on Wednesday, May 22. The programme of the evening was as follows: Dr. Swan M. Burnett : “Clinical Contribution to the Study of Nuclear Paralysis of the Ocular Muscles.” Presentation of a patient. Dr. J. H. Bryan: “A Contribution to the Study of Suppurative Disease of the Accessory Sinuses, with Report of Cases."

It is with regret that we hear of the sad accident that has befallen Dr. Julian M. Cabell, Assistant Surgeon of the United States Army. In jumping from a moving train he fell and had one leg crushed off at the knee and a portion of the other foot was also hurt.

Dr. J. Ford Thompson has improved enough to go to Atlantic City.

BOOK REVIEWS. URINALYSIS ; Including Blanks for Record

ing the Analysis and Microscopic Examination of the Urine. For Medical Practitioners, Life Insurance Examiners and Specialists. Arranged by Joseph C. Guernsey, A. M., M. D. Philadelphia : J. B. Lippincott Co. 1895.

This book has the advantages of great simplicity and great usefulness. It opens with a short list of apparatus and chemical reagents needed for ordinary urine testing, then there come simple rules for the tests, a short article on diet and the remainder of the book is made

up of blanks for the recording and preserving analyses. It so often happens that the physician makes a series of tests in a patient's case which he wishes to preserve for reference and comparison, and this book with its alphabetical index for the names of persons and the blanks offers all that could be desired. It is eminently practical and moreover when patients pay visits at long intervals it records the state of the urine each time it is examined. This book is recommended to all physicians. A separate pad of blanks is also issued by the same author in case it is desired to test urine for another physician. THE PHYSICIAN'S GERMAN VADEMECUM. A

Manual for Medical Practitioners for use in the Treatment of German Patients. By Dr. Richard S. Rosenthal. Volume I, Gynecology and Obstetrics. Volume II, General Medicine. Chicago: The Rosenthal Publishing Company.

These manuals are about as good as most works of this kind but it is doubtful if they do very much good, for it rarely happens that the patient answers as the book lays down and then to one who repeats parrot-like these sentences, the whole conversation becomes a babel of tongues. The sentences are on the whole good but rather more stilted and extended than one is accustomed to use in an ordinary conversation between physician and patient. Some of the German sentences are

PUBLIC SERVICE.

OFFICIAL LIST OF CHANGES IN THE STATIONS

AND DUTIES OF MEDICAL OFFICERS.

UNITED STATES ARMY.

Weck ending May 27, 1895. Captain Robert J. Gibson, Assistant Sur. geon, will be relieved from duty at Fort Sam Houston, Texas, by the commanding officer of that post, and will report in person to the commanding officer Fort Thomas, Kentucky, for duty at that post.

Major William H. Gardner, Surgeon, is relieved from duty as attending surgeon and examiner of recruits at Headquarters Department of Dakota, and ordered to Fort Reno, Oklahoma Territory, for duty at that post, relieving Major Henry M. Cronkhite, Surgeon.

verily alphabetical processions and are of the CURRENT EDITORIAL COMMENT. kind seen in conversation books but never heard in any conversation. These books,

OPTICAL SCHOOLS. however, are not without merit and they may

The Refractionist. give a hint to one who already knows the

As an outgrowth of the recent advances in German language.

refraction work and the accompanying idea MANUAL OF GENERAL MEDICINAL TECHNOL

that there is a mint in it, a class of persons, OGY, INCLUDING PRESCRIPTION WRITING. evolved from the old-time opticians, also jewBy Edward Curtis, A. M., M. D., Emeritus elers and others acting on the principle that Professor of Materia Medica and Therapeut

fools rush in where angels fear to tread, are ics, College of Physicians and Surgeons. Third Edition. Pocket size (Wood's Pocket claiming that refraction is a department like Manual Series), 245 pages. Price, $1.00, dentistry, and that one need not be a physician This is an extremely useful little book and

to master it. This delusion can be suppressed has a fund of information between its small only by an enlightened public and the vigicovers. With the rapid increase of special

lance of the medical profession. preparations prescription writing is rapidly FOUR YEARS'MEDICAL COURSE. becoming a lost art and too many men cannot

Medical Record. write a grammatical prescription. This book

There is no doubt that four years is not has reached its third edition and that is suffi too long a time to study medicine, yet there cient to recommend it. In this edition the are many cases in which four years of college text has been changed to conform to the re

study are not needed. If a young man has vision of the Pharmacopeia.

spent four years in getting a degree of A. B. or B. S., if he then studies medicine three

years, and at the end of that time enters a REPRINTS, ETC., RECEIVED.

hospital for a year and a half he should be as

well equipped to practice medicine as educaFourth Annual Report of the Sharon Sani

tional institutions can make him. There is tarium, Sharon, Massachusetts.

developing a kind of four-year-course fanatiCircular Insanity. Report of Three Cases.

cism among some of those who are in the By William F. Drewry, M. D., Petersburg,

propaganda for higher education. A previVirginia.

ous college training and a year and a half in Treatment of Insomnia. By Samuel Wolfe, a hospital ought to entitle a man to get off A. M., M. D., Philadelphia. Reprint from

with only three years of lecturing and recitthe American Therapist.

ing. Sanitary Climatology. Circular No. 4.

VACATION. Information Relative to the Investigation of

Atlantic Medical Weekly. the Influence of Climate on Health.

With the doctor his work is never done, Remarks on the Treatment of Inevitable

his day never completed, his nights never Abortion. By Charles P. Noble, M. D., Phil

his own and his vacation, although sometimes adelphia. Reprint from the Codex Medicus

badly needed, something to be looked forPhiladelphiae.

ward to for months and then to be foregone

because, forsooth, he cannot in safety leave a A New Method of Examination and Treat

patient dependent upon his skill and care. ment of Diseases of the Rectum and Sigmoid Flexure. Howard A. Kelly, M. D., Baltimore.

Every man should have a vacation. Every

mau would be better for one, and none would Reprint from the Annals of Surgery.

be the poorer in the long run by throwing Celiotomy for Puerperal Septicemia and aside his cares for a few weeks each year, Peritonitis. By Charles P. Noble, M. D., even if he did lose an occasional family, even Philadelphia. Reprint from the American

if he did cease the eternal grind for a liveliGynecological and Obstetrical Journal.

hood and thereby lose a few dollars, but the The Diagnosis of Pregnancy During the busy doctor needs more than a vacation; he First Three Months. By Charles P. Noble, needs something to which he can turn his M. D., Philadelphia. Reprint from the Tran mind every day or at least as often as he feels sactions of the Philadelphia County Medical the responsibilities of his business oppressing Society.

him.

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RECENT EXPERIENCE IN THE ELECTRICAL TREATMENT

OF FIBROID TUMORS AND CATARRHAL AFFECTIONS OF THE UTERINE TRACT. READ BEFORE THE MEDICAL SOCIETY OF THE STATE OF PENNSYLVANIA, AT CHAMBERS

BURG, MAY 21, 1895.

By G. Betton Massey, M. D., Physician to the Sanatorium for the Electrical Treatment of the Diseases of Women and Diseases of the

Nervous System and Gynecologist to the Howard Hospital, Philadelphia It has now been some eleven or neal and thus beyond the direct range twelve years since Apostoli claimed at of electrical treatment, or else so inertly tention for his method of ameliorating fibrous as to resist prolonged efforts at and symptomatically curing fibroid tu electrically induced absorption. Some mors of the uterus by the use of electri tumors in the latter portion of this class city. After the lapse of such a time, may be arrested in further growth, it is and in view of the accumulated experi- true, but electrical treatment is apt to ence and testimony of many investiga- be so unlikely to cause material retrotors, it is quite possible to draw conclu- gression in size as to raise the question sions of average correctness as to the whether the patient should not undergo true value of the method and its appli- the dangers of an operation rather than cability to the different varieties of the endure the deformity. In this class affection.

pain and pressure symptoms are apt to To the conscientious physician who have ceased since the emergence of the is thoroughly informed on this question tumor from the pelvis into the abdomen, there is no conflict whatever between but if not, such symptoms are generally the claims of electricity and surgery in amenable to permanent relief by electhe treatment of two classes of these tricity. cases. There are cases in which elec Foremost among the cases that are tricity in expert hands can give a hun too often operated upon though they dred per cent. of practical cures, not clearly indicate electrical treatment are necessarily cosmetic cures, but com all small tumors in the initial months pletely satisfactory in the comfort and or years of their growth, often mistaken well-being of the patient. There are for painful displacements, ovarian disalso cases in which electricity can only

ease, etc.

In these cases a complete do harm, and in which ablative surgery and permanent cure can be confidently is not only wise, but imperative. In a anticipated. Hemorrhagic tumors of third class true conflict occurs, and I all sizes should always be placed unmay specify this class at once as made der this treatment. I have never seen up of large tumors causing much de a failure in the cure of hemorrhage and formity and which are either subperito. pain, and the size will frequently be re

duced. Of the larger tumors clearly tion to the condition of the uterus is amenable to electricity the interstitial, most essential. multinodular growths are most prom There can be no doubt that these atising, particularly when the tumor tacks are all primarily catarrhal in is somewhat symmetrically developed origin, having an original focus of inabout the uterine cavity. Of this class fection in the uterus, if not in the vaI have had cases of actual disappearance gina. The vaginal seat of infection by absorption, notably one as large as may be wanting, as in virgins, in whom the adult head.

a catarrhal affection may take its oriThe class in which electricity is not gin in the uterus from disordered menindicated embraces all cystic or degen- struation, but in all cases it is in the erating tumors, quickly growing tumors uterus in which the lingering catarrhal in which malignancy may be suspected, condition remains long after its disapand all tumors associated with purulent pearance from the vagina.

A subacute inflammations of the appendages. ascending inflammation of the mucous

The prevention and cure of tubo tract attends and follows the uterine ovarian disease by arresting catarrhal catarrh in many cases, making an endoaffections of the uterine tract is one of metritis always deserving of our most the most important services of electro careful attention, for it is while the distherapeutics to gynecology. By tubo ease is yet confined to the uterus that ovarian disease, I mean chronic catar its cure constitutes a virtual prevention rhal inflammation of the Fallopian tubes, of tubo-ovarian catarrh. This is apparwhich by contiguity of structure has ently a self-evident fact, yet a much neinvolved the ovarian periphery or stroma, glected one. resulting in infiltrated and enlarged I hardly need remind you that the tubes and ovaries. Clinically, the con present attitude of most specialists in dition is manifested by almost continu the diseases of women is one of engrossous pelvic or sacral pain and by tender- ing attention to tubal inflammation ness, aggravated by catching cold and coupled with a practical neglect of its at the menstrual periods. In a consid- antecedent and initial lesion in the erable proportion of cases the general uterus. Completely occupied with the health is more or less affected, nervous gross and harsh remedy for the former prostration and gastro-intestinal torpid involved in their removal they call all ity being frequently an accompaniment attempts to intelligently direct the proof the local condition. A bimanual ex cesses towards repair "tinkering," and amination will reveal an enlarged and present to us the spectacle of medical fixed uterus, with boggy masses in one efforts only actively concerned in finishor both ovarian regions, and in some ing the work of destruction rather than cases prolapsed appendages. The uterus staying it. will invariably be found affected, and at No continuous muco-purulent disall stages of the disease.

charge from the uterus should be neIn making a diagnosis of such a case glected, particularly if it occurs in we have been taught of late with much young girls. By early arrest of this vigor not to neglect the conditions ex process, in cases diagnosed as simple ternal to the uterus, the presence of endometritis or endometritis associated which greatly modify the effect of our with painful menstruation — menorrhaltherapeutic efforts. So great has been gia -- I have had the satisfaction of rethe solicitude for this portion of the af- storing more than a score of girls and fected organs that scant attention is women to the enjoyment of full wonianpaid to the uterine trouble itself, in ly health, in spite of the fact that some spite of its importance in the chronolog- of the cases presented sufficient tubogical order in which the parts are af ovarian involvement already to induce fected.

other physicians to counsel an unsexing From the point of view of the preven- operation. tion of tubo-ovarian inflammation atten In the treatment of the uterine affec

tion nothing is equal to the positive pole demands treatment or not. We can of the galvanic current within the uterus, hasten absorption of effusions and inin doses from 15 to 25 milliampères. In fuse new tone into relaxed glandular cases that resist this remedy I have re and muscular tissue by stimulation of cently resorted to a modification of a the lymphatics and sympathetic nerves of method introduced by me: zinc-amal the pelvis. The clinical importance of gam cataphoresis, which adds to the

these two sets of draining and controllmicrobicidal and alterative effect of elec ing agencies is too often neglected. On tricity the effect of nascent oxy-chloride them alone depends the practical restoof zinc and mercury released by electro ration of organic and tissue integrity, lysis in immediate contact with the dis and any method by which they may be eased mucous membrane. If the affec directly stimulated gives us the means tion has already reached the tubes and of initiating an active remedial process. ovaries all intra-uterine treatment must The usual remedies now employed for be used with caution though still essen this purpose are copious hot vaginal tial at intervals, the greater number of douches and application of tincture of the applications being vaginal. If the iodine to the vault, both or either being general health has been affected by long at times of marked service. A more efficontinuance of the disease, or by a cient stimulation of the lymphatics in natural nervous erethism, we must con chronic cases is the negative pole of the join with this treatment the main fea galvanic current, applied by means of a tures of the rest cure and general elec moist cotton-covered electrode. If this tric treatment.

is properly placed to include the local This method will be at times success rouble between it and the opposite pole ful in cases that have reached the stage the current bulk will traverse the afof purulent accumulations in the tubes, fected structures, and in the tissues the curative process ascending from the surrounding the electrode there will be uterus as the diseased process had as a marked quickening of trophic procended, resulting in a drainage of the cesses. To lessen congestion, remove tube through the uterus.

pain and tenderness and contract relaxed But the uterine route is by no means muscular tissue the fine faradic current the only one to reach the tubal and should be used with a bipolar instruovarian mischief, whether the uterus ment, daily or thrice weekly.

SARCOMA OF THE KIDNEY IN CHIL 7. Nephrectomy offers the only hope DREN.-From a study of a number of of cure or prolonging life in these uncases of sarcoma of the kidney Dr. D. fortunate cases. A. K. Steele concludes, in Medicine, as 8. More accurate early diagnosis and follows :

prompt operative interference has low1. These new growths of the child's ered and will continue to lower both the kidney are often congenital.

primary and secondary mortality. 2. They are usually unilateral ; wlien 9. The extra-peritoneal route is prefbilateral it is from secondary infection erable when the tumor is small. of the other kidney.

10. When large, a trans-peritoneal 3. They are primarily extra-renal, incision is imperative. and surround rather than infiltrate the 11. It may be either transverse or verrenal tissue.

tical ; considering the nerve supply of 4. Round-celled is the most common the parts, the transverse would seem form of these sarcomas.

the better. 5. They are of exceedingly rapid 12. The operation of nephrectomy in growth, and destroy life by exhaustion. these cases is justifiable, and we are not

6. They are uniformly fatal when doing our duty as surgeons to our little treated medically, the duration of life patients if we withhold the only chance being from four to twelve months from they have for life. the time the disease is first observed.

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