the prying and ignorant inspector, dangerous cases escape attention and spread dis ease. *** WHEN the city physician has a difficult case which requires assistance, it is an easy matter to call in a colleague and Country Surgery. have a consultation and this exchange of opinion is usually for the patient's benefit. When the country physician, however,, has a difficult case he either has to work it out himself or send it away to the city and lose it altogether. When a man is in a puzzling position and has to rely on himself, he usually works it out and uses his brains and for this reason the country practitioner often has a better head on his shoulders than his city confrère. Dr. The records of country surgeons who practice all specialties show ingenuity and skill and such work where self-dependence is all important brings out the best in a man. Henry E. Stafford of Salinas, California, has recorded some of his work in the Pacific Medical Journal and this he has written, he says, "for the perusal of my humble country brethren who like myself are trying, or would like to try, even under disadvantageous circumstances, to do their own surgical work instead of sending the most important and best paying part of their practice to the city surgeon." Of course this writer does not mean that he would attempt to treat and operate on cases which he does not understand rather than have them properly treated in the cities. His method of reducing an otherwise irreducible hernia is, as far as he knows, original with himself. He was called on two different occasions to reduce an enormous hernia and failing in the usual methods of taxis, he took an ordinary rubber bandage two and a half inches wide and three yards long, and winding it around the scrotum containing the hernia and with the penis, commencing below the center and drawing it tighter at the lowest part until all the parts were covered by the bandage, which exerted constant pressure. With each layer he drew it tighter and before half the bandage was used up the bowel had slipped back and the hernia was reduced. This was not as painful as taxis and was much more effective. This same method he used in reducing a prolapsed rectum in a boy. This is the type of a man who thinks and many of our best ideas in medicine and sur gery have been evolved in like manner by men who, without help, have been obliged to think for themselves. The city physician rarely thinks beyond a certain point, while his country colleague in his long and lonely drives or rides throughout the country is making the best of his resources and develops his mind far in excess of his city brother. Thus when the country practitioner envies his professional colleague in the city, he must remember not only the advantages of city life, but also disadvantages, and the city physician, too, should thank his country brother for many original ideas and hints in the practice of medicine and surgery. *** SUDDEN death is ordinarily attributed to heart disease and the common expression "heart failure" shows the enSudden Death. deavor on the part of the profession to find some term which shall be intelligible to the laity explaining sudden death. Dr. Thomas M. Durell, in his duties as medical examiner, in the Boston Medical and Surgical Journal, regrets that so many sudden deaths are not investigated and says that it is a popular belief among the laity, and the profession as well, that the cause of sudden death is either a disease of the heart or an apoplexy. He believes that a large number of sudden deaths occur each year from undetected pneumonia. He has found in many instances in post-mortem examinations small and even large patches of lung consolidation which had not at all been suspected during life and in so many cases added to this pneumonia was alcoholic excess and exposure to cold and wet. A man is arrested and put in a cell and in the morning is found dead. Or a woman comes home feeling badly and chilly and the next morning she has passed away. Again edema of the brain from alcoholic excess may and often does cause sudden death. There may be many other causes enumerated but the moral is, in the writer's opinion, that the making of an autopsy in sudden death is absolutely necessary and should be demanded by every physician. If the coroner and city physician would take the work of Dr. Durell to heart and then urge the necessity of autopsies in all cases possible, they would add much to the statistical literature of medicine and indirectly prevent some of the many sudden deaths. It looks now as if the Index Medicus would be continued. The Dartmouth Medical School has raised its stantlard of admission. The movement to build a hospital for consumptives near Baltimore has been revived. According to the Chicago Tribune the physicians of that city do not collect more than one-half of their accounts. A physician in Berlin was recently impris oned for one month for writing a prescription carelessly, thereby causing death. The Metropolitan Telephone Company of New York allows free use of its pay stations to call a physician or ambulance. When a physician in Arkansas becomes an habitual drunkard the State Board of Health is by law enjoined to revoke his license. The Monthly Retrospect of Medicine and Pharmacy is a new publication just received at this office. Its editor is Dr. E. H. Gingrich of Philadelphia. We learn that Dr. F. Ferguson has been appointed visiting physician and pathologist, and Dr. George F. Shrady a visiting surgeon to the Columbus Hospital of New York. It has been proposed in England to make butchers and fishmongers pass an examination in the use of the microscope before being granted a license. Two physicians of New York have recently been awarded damages for libels on suits against the New York Sun, and $25000 against the National Police Gazette. Professor Hering has been called from Prague to succeed the late Professor Carl Ludwig in the chair of Physiology at Leipsic. A Clinic of Mental Diseases has been established in the University of Giessen. Kiel and Rostock are now the only German universities which have no psychiatric clinic. The following names of distinguished scientific and medical men will be given to different Paris streets: Trousseau, Charcot, David Ulysse Trélat, Milne Edwards, Jean Baptiste Dumas. It is claimed by the Oriental Life Insurance Company of Calcutta that for the past twenty-five years not a death has occurred which could be directly attributed to the use of opium. According to the census of 1890 there were said to be at that time in the United States 104,803 physicians and surgeons, that is, one to every 600 population, 89,630 lawyers, 88,295 clergymen, 58,090 nurses and midwives and 17,498 dentists. At a meeting of one of the large English insurance companies it was shown that more than six hundred thousand dollars had been paid out for deaths due to influenza. The report of the Secretary showed that this disease has cost the insurance companies more in the last two years than in the previous forty-three years. The American Laryngological Society has decided to hold its next meeting at Pittsburg, Pa. The following officers were elected for the ensuing year: President, Dr. W. H. Daly, Pittsburg; First Vice-President, Dr. Jonathan Wright, Brooklyn; Second Vice-President, Dr. A. W. de Roaldes, New Orleans; Secretary and Treasurer, Dr. H. L. Swain, New Haven; Librarian, Dr. J. H. Bryan, Washington. At the meeting of the Medical Society of New Jersey, the following officers were elected: President, William Elmer; First Vice-President, T. J. Smith; Second VicePresident, D. C. English; Third Vice-President, C. R. Fisher; Corresponding Secretary, E. L. B. Godfrey; Recording Secretary, William Pierson; Treasurer, Archibald Mercer. The next meeting will be held at Asbury Park, the fourth Tuesday in June, 1896. PUBLIC SERVICE. OFFICIAL LIST OF CHANGES IN THE STATIONS AND DUTIES OF MEDICAL OFFICERS. UNITED STATES ARMY. Week ending July 22, 1895. Leave of absence for one month with permission to apply for an extension of ten days, to take effect on or about July 20, 1895, is granted Colonel Dallas Bache, Assistant Surgeon General, Medical Director Department of the Platte. Leave of absence for two months, to take effect on or about July 13, 1895, is granted Colonel Charles T. Alexander, Assistant Surgeon General. Captain William H. Corbusier, Assistant Surgeon, will in addition to his present duties take charge of the Medical Supply Depot in New York City, during the absence on leave of Colonel Alexander. UNITED STATES MARINE SERVICE. Fifteen days ending July 15, 1895. P. H. Bailhache, Surgeon, to assume command of Camp Low Quarantine, July 5, 1895. W. H. H. Hutton, Surgeon, to report at Bureau for temporary duty, July 12, 1895. W. A. Wheeler, Surgeon, relieved from command of Camp Low Quarantine, July 5, 1895. C. E. Banks, Passed Assistant Surgeon, to proceed to Detroit, Michigan, on special temporary duty, July 5, 1895. H. T. Goodwin, Passed Assistant Surgeon, granted leave of absence for thirty days, July 12, 1895. G. T. Vaughan, Passed Assistant Surgeon, granted leave of absence for seven days, July 6, 1895. J. B. Stoner, Passed Assistant Surgeon, to proceed to Detroit, Michigan, for temporary duty, July 12, 1895. J. M. Eager, Passed Assistant Surgeon, to proceed to Southport, N. C., and assume command of Quarantine Station, July 6, 1895. W. J. S. Stewart, Assistant Surgeon, granted leave of absence for nine days, July 5, 1895. H. W. Wickes, Assistant Surgeon, granted leave of absence for twenty-three days, July 5, 1895. BOOK REVIEWS. REMOTE CONSEQUENCES OF INJURIES OF NERVES AND THEIR TREATMENT. By John K. Mitchell, M. D., Physician to St. Agnes Hospital, Assistant Physician to the Orthopedic Hospital, Lecturer on Physical Diagnosis University of Pennsylvania, etc. Lea Brothers & Co., Philadelphia. This little volume is not only an interesting and important contribution to neurology, but it possesses an additional value in the fact that many of the cases here recorded were first observed by Mitchell, Morehouse and Keen, and published in 1864. Consequently we have here the unique record of cases for a period of more than thirty years. Chapter I is devoted to the consideration of contusions of nerves; a number of cases are mentioned showing the effect of injury near, but not directly involving, the nerve itself. Especially interesting are the curious trophic effects resulting from apparently slight structural disturbance, and lasting many years. In Chapter II, Section of Nerves, attention is directed to the persistence of sensation, and the possibility of the nerve not being entirely divided is suggested as an explanation. Of course in some instances anastomosis might be more or less complete. In a few cases motion was partly or wholly regained, while sensibility remained impaired. This is certainly very rare. Among the curious aftereffects may be mentioned exaggerated sensibility to heat and cold, and in some instances a higher local temperature on the injured side persisting years after the receipt of the injury. In Chapter III there are a number of interesting cases of injury to the cord. In some of these cases there was marked degeneration of the columns of the cord, curiously enough not always following the rule. In some of these cases polyuria was noted and also marked increase of the sexual instinct. Chapter IV illustrates the various ways in which the inflammatory process, originating in one nerve, may spread to others or even involve the cord. It is significant, in view of certain recent theories, to observe how rarely the cord becomes involved in neuritis. Under the heading "Miscellaneous Cases" are reported several interesting instances of tremor following nerve injury. The last two chapters in the book are devoted to the consideration of nerve degeneration and repair, and to the treatment of nerve injury and inflammation. The book is a valuable one and will be read with interest not only by the specialist, but also by the general practitioner. BULLETIN of the MediCAL SOCIETY OF THE WOMAN'S MEDICAL College of BALTIMORE. The fourth number of this Bulletin, under the able editorial management of Dr. Eugene F. Cordell, has just made its appearance. It is an index of the high character of the work done by that college, its alumnae and faculty. It contains many interesting articles and abstracts and is well printed. The alumnae would perhaps find greater enjoyment in it if there were not so many scientific articles and a few more personal notes and reports on the doings of graduates. REPRINTS, ETC., REceived. The Jefferson Medical College of Philadelphia, 1895-1896. Fifty-first Annual Announcement of the Eclectic Medical Institute, Cincinnati. The Murphy Button; with Report of an Unsuccessful Cholectystduodenostomy. By Aug. Schachner, M. D., Ph. G. . Reprint from the American Medico-Surgical Bulletin. Some Points on the Technique of Kidney Operations. By Charles S. Briggs, A. M., M. D., Nashville, Tennessee. Reprint from the Nashville Journal of Medicine and Surgery. Civil Service Reform in State Institutions; Reorganization of the Medical Staff. By Boerne Bettman, M. D., Chicago. Reprint from the Journal of the American Medical Association. Suggestions for a Portable Instrument Bag; Operating Overalls; Bandage for Suprapubic Dressings; a Blanket for Protection of Patients during Operations; a Table for the Trendelenburg Posture; the Sterilization of Sponges; an Antiseptic Soap Paste. By Aug, Schachner, M. D., of Louisville, Kentucky. Reprint from the Annals of Surgery. Messrs. P. Blakiston, Son & Co., of Philadelphia, announce that they have in preparation for early issue an authorized translation by Dr. Albert B. Hale of Chicago, of a Handbook of Diseases of the Eye, by Dr. A. Eugen Fick of the University of Zurich. This is one of the most complete, thorough and compact of text-books. Among its other merits it contains a number of very handsome colored illustrations, not of rare or unusual cases, but of practical matters that will greatly aid the student and be of much service to the practitioner. The retail price will be from $3.00 to $4.00. CURRENT EDITORIAL COMMENT. LITERARY DEGENERATES. If there be any truth in Doctor Max Nordau's telling indictment of modern literature and art, as presented in his entertaining work on degeneration, the matter is one more for the attention of the physician than the moralist. The physician will be the one, if any, who "recognizes at a glance, in the fin de siècle disposition, in the tendencies of contemporary art and poetry, in the life and conduct of the men who write mystic, symbolic and decadent works, and in the attitude taken by their admirers, the confluence of two welldefined conditions of disease with which he is quite familiar, degeneration and hysteria." MEDICAL CENTERS. New York Medical Journal. THE degree of importance attained to by any particular center of medical teaching is justly held to be dependent in great measure on the excellence with which it does its work, on the abundance of its clinical resources, and on the adequacy of its equipment in the way of laboratories and the like. But this is by no means the whole story. A certain large city becomes the medical center for a pretty definite area of country, and with little variation continues for long periods of time to perform its function accordingly. It would be interesting to have the data so displayed as to show graphically in detail the territories tributary to the various great centers of medical teaching in the United States. CONSERVATIVE GYNECOLOGY. The Journal. REGARDING the treatment of chronic diseases by radical measures, it is doubtful if any advance, further than perfecting details, will ever be made in the gynecology of the future but in reviewing the field we must acknowledge that little has been done toward curing the poor woman who has just reached her couch of suffering with the first attack. The hot poultice, or the douche, or the drug, does not seem to have materially lessened the number of our unfortunate sufferers, so that in retracing their footsteps back to the methods of the elder Simpson, and bending their energies to the development of conservative and prophylactic work, gynecologists are putting themselves in line with co-workers in other specialties and showing commendable scientific courage. PUBLISHERS' DEPARTMENT. All letters containing business communications, or referring to the publication, subscription, or advertising department of this Journal, should be addressed as undersigned. The safest mode of remittance is by bank check or postal money order, drawn to the order of the Maryland Medical Journal; or by Registered letter. The receipt of all money is immediately acknowledged. Advertisements from reputable firms are respectfully solicited. Advertisements also received from all the leading advertising agents. Copy, to ensure insertion the same week, should be received at this ofce not later than Monday. Physicians when communicating with advertisers concerning their articles will confer a favor by mentioning this Journal. Address: MARYLAND MEDICAL JOURNAL, 209 Park Avenue, Baltimore, Md. NOTES. WATER cress grown in sewer-polluted water may cause typhoid. * ANEMIA is sometimes a very important factor in early nerve syphilis. Such cases demand iron and strychnine. * THERE is perhaps no remedy which is so efficient in all cases of asthma, regardless of their source, as sodium iodide. * SUCCESSIVE crops of boils in gouty patients may be prevented by the use of colchicum in doses of from a half to two-thirds of a grain a day. THE latest remedy for the vomiting of pregnancy is a twenty per cent. solution of menthol in olive oil. The dose is ten drops on sugar when the nausea appears. * DEPILATORIES are always in demand. The popular product is barium sulphide, made into a paste with zinc oxide, amylum and water; applied for half an hour and removed by washing. * HEDDERICH, says Medicine, contributes to the Munchener med. Wochenschrift an account of a new and powerful hemostatic which he calls ferripyrine. It is a double salt of chloride of iron and antipyrine, an orange-red powder, easily soluble, and is used in solutions of a strength of 18 or 20 per cent. It can, however, be used as a powder. Caustic action has not been noticed even after prolonged contact with the mucous membrane of the nose. It will stop hemorrhages from very vascular growths. PHARMACEUTICAL. IF YOUR patient is already thin, and still losing in weight, he is suffering from malnutrition, and is on the road to phthisis. Stop this condition at once by admintstering two or more teaspoonsful of Seng before each meal. THE Elixir Six Iodides, Elixir Six Bromides, Elixir Six Hypophosphites and Elixir Six Aperiens (Walker Green's), have been made uniform in price, viz.: $8.00 per dozen. These Elixirs are rapidly gaining the confidence of the profession. The latest circular can be obtained upon request. Great relieF.-J. Ringwood, L. R. C. P. I. and L. M. L. R. C. S. I., Kells, County Meath, Ireland, writes: "I have had the most satisfactory results from the use of Lilly's Glycones. Besides their certain gentle action on the bowels, they give the greatest relief in all cases of pelvic congestion, pruritus and internal hemorrhoids." ANTISEPTIC surgery has revolutionized obstetrics and gynecology and it would be useless to here reiterate what every member of the medical profession knows regarding the role of septic infection in obstetrical gynecological cases. In the practice of these special ties Borine has a very broad field, having proved itself an antiseptic and deodorizer par excellence. It can be applied pure or in solution to the mucous membrane in all forms of vaginitis. It can be applied pure to the cervix in all forms of endocervicitis. Borine in the form of a douche composed of one to two tablespoonsful with a pint of warm water is an excellent remedy for the treatment of vaginal catarrh, leucorrhea and other inflammatory conditions of the vagina and uterus, cleansing the inflamed membrane from all irritating and ill-smelling discharges, stimulating and toning it to a normal condition. Tampons soaked in a 50 per cent. solution of Borine in glycerine will be found to be effective for the relief of congestion and the diminution of the discharge and pain in metritis. In urethritis pure Borine applied to the inflamed urethra will quickly subdue inflammation and establish a cure. |