MARYLAND

Medical Journal.

PUBLISHED WEEKLY.

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Address: MARYLAND MEDICAL JOURNAL, 209 Park Ave., Baltimore, Md.

WASHINGTON OFFICE:

Room 22 Washington Loan and Trust Co. Building.

BALTIMORE, AUGUST 17, 1895.

THE special subject for discussion at the last meeting of the Maryland State Medical

Society was typhoid fever, Typhoid Fever. and while not much light was thrown on the subject, the whole matter was thoroughly talked over and the disease from every standpoint, both in the city and in the country, was discussed. At that time every possible cause was brought before the profession and practical remedies were suggested but the disease keeps merrily on and causes a very large number of deaths. Just now typhoid fever is appearing in Baltimore and vicinity and by the time another month has passed away the usual number of cases and deaths will occur and learned bodies will again discuss the disease in all its bearings with little or no practical results. The attending physician and the health department should work in harmony.

By a recent ordinance of the Baltimore City Council all cases of typhoid fever occur

ring within the city limits must be reported to the health department of Baltimore as soon as the diagnosis is certain. If this were done there would be some chance of tracing the cause of the disease, especially when several cases occur together. The notification act is a hard one when it imposes this work on the physician even if it only amounts to filling out a card.

Such work should be placed on the householder and he or she should alone be held responsible for neglect to perform this duty. Also the householder would very likely be dealt with more summarily than the physician who too often is spared any punishment by the kind and genial health officer, who is himself a physician and who appreciates the diffi culties of notification. If the householder were responsible for the reporting of all diseases which the law says must be reported, the cases would be more promptly and fully registered at the health office.

Let the existence of the disease once be made known and let the cause be discovered and proper precautions may be taken to prevent its reaching others. For an unsewered city Baltimore is unusually healthy, but the disease and death rate may yet be lowered by careful attention to notification as required by the health department.

IN the present day of antisepsis and preventive medicine anything that preaches cleanliness should be encouraged The Dude. and not decried. The National Medical Review very sensibly makes a defense of the dude. It says:

We are now prepared to defend the dude. One thing can surely be said of him; he looks clean. Not one little part of him, simply, but the whole individual. His collar is not melted with the heat of many summers; neither are his shoes covered with the sands of time. His linen is not stained with the drippings of tobacco juice; neither are his teeth covered with the green algae of antiquity. His face is not the sign of a poor barber; neither are his fingers plowed with the deep fissures of the bichloride. The dude is surgically clean. Tubercle bacilli slip from his polished footwear; and the Klebs-Loeffler bacillus cannot find a nesting-place beneath his nails. He is the latest teacher, and wise are those who profit by his lessons.

The dude is simply a relative term and because a man is well and neatly dressed and even because he is in what is called the fashion he should not be ridiculed. All attempts at neatness and care of personal appearance should be encouraged and the physician and surgeon who is careless about his personal appearance and dress is one who will not command the respect of his patients and is not fit for surgical operations. Brains and disorders of dress are supposed to belong together and many a great man has been excused from neat dressing because a great name or valiant deeds cause all such trivial things as dress to sink into insignificance.

The man who has nothing else to boast of may be an artist in his dress, may know how to combine colors and form so that he is always in taste, not the uncultivated taste of the tramp, but the cultivated taste of the well-dressed person. The person who is carefully and well dressed is not necessarily a dude but he is usually clean and as the exchange from which this quotation is made has said, he is a teacher and sets an example to those that scoff at him. It is better to be dressed in the extreme of fashion and be what is popularly called a dude than to be plainly clad and unwashed.

The dude has his uses even if it is to set an example to those who think they are his superiors and yet who are far behind him in the practical application of the first sanitary principles.

***

WHEN a member of the legal profession commits some act that is considered especially disgraceful or crimDisbarring Physicians. inal, he is given a hear

ing before his professional colleagues and if found guilty is disbarred and prevented from practicing his profession in the courts. This is the law in many States and the local and general bar associations look very carefully into the standing of lawyers, whether they belong to the association or not.

Physicians, on the other hand, rarely suffer to the same extent when they become black sheep in their profession. A physician who commits some act worthy of notice may be called before his State medical society and reprimanded or dismissed for unprofessional conduct, but that does not prevent his practi

cing and he may be professionally as successful and as skillful as his more ethical colleagues.

If a man is hardened enough to commit disgraceful acts and even stoop to criminal deeds, his dismissal from his State society will hardly keep him awake at night. If, however, his acts prevent him from practicing or do not allow him to enjoy the privileges of a drug store or debar him from signing death certificates, he might consider before he did wrong.

Too many men forget the college or school of medicine that gave them a foundation in medicine and taught them the little of that branch that they know, but few would care to have their alma mater disown them and ask that their name be struck off the rolls. The action of the University of Tennessee is to be commended.

The University of Tennessee adopted the following resolution in respect to a graduate of the medical department of that institution as follows:

WHEREAS, It appears that one

of

having complied with the requirements for graduation, received the degree of M. D. from the Medical Department of the University of Tennessee in 1894 ; and,

WHEREAS, It has been made known and positively proven to the satisfaction of this faculty that the said has so far forgotten and ignored the principles of honorable medicine as to enter into unprofessional advertising schemes and methods to obtain practice in violation of the code of medical ethics and professional decorum, therefore be it

Resolved, That we, the faculty of the Medical Department of the University of Tennessee, censure and condemn the conduct of said

as unprofessional, and that the dean is hereby instructed to strike his name from the records as an alumnus and declare him beyond the pale of professional recognition.

This may not worry that particular physician, but it will possibly have the effect of warning other graduates of the excellent university against departing from the paths of virtue and rectitude. There are plenty of scoundrels in the medical profession and their opportunities of doing harm are great and it would be a move in the right direction if some such steps as the above could be taken to deal summarily with this degrading class.

There are 130 women oculists in the United States.

Pennsylvania has made some very liberal appropriations to her hospitals and medical schools.

Dr. J. F. Hempel has removed his offices from 1103 Valley Street, to 1213 East Biddle Street, Baltimore.

It is proposed, in the north of England, to build some traveling hospitals for infectious diseases, the sparsely settled condition of that region admitting of their portability.

The contract for building the new smallpox hospital at Washington, D. C., has been awarded and work will begin at once in order to complete the building by November 1, this year.

The twenty-sixth annual meeting of the Medical Society of Virginia will convene at Wytheville, in that State, on Tuesday, September 3, and continue in session three or four days.

Dr. Formad says that in 250 chronic alcoholists the autopsies showed fatty degeneration of the liver in over 90 per cent., and over 60 per cent. had congestion or a dropsical state of the brain.

The American Electro-Therapeutic Association will hold its Fifth Annual Meeting, at "The College of Physicians and Surgeons, of Ontario," in Toronto, Canada, on Tuesday, Wednesday and Thursday, September 3, 4 and 5, 1895.

The governor of Delaware, acting under the medical law passed by the legislature of that State, has appointed two boards of examiners, one to represent each of the two principal schools of medicine.

The authorities of Paris have under consideration a project for establishing a special sanatorium for the study and treatment of whooping cough, to be situated in the country. This is said to be in pursuance of their plan of special rural sanatoria.

The annual Italian Congress of Internal Medicine will be held at Rome in the month of October. Sero-therapy will be the principal subject for discussion. Professors Foa of Turin, de Renzi of Naples, and Giovanni of Padua, are announced to take part in the discussion.

Dr. Eugene F. Cordell will give instruction during the month of September to students desiring to prepare themselves for the preliminary examination. The Rules of the American Medical College Association require that all matriculates of medical schools (not otherwise exempt) shall pass an examination on preliminary subjects.

The recommended time of quarantine adopted by the Pennsylvania State Board of Health for persons who have been exposed to infectious diseases, when they may safely be admitted again to school, if they continue in good health, and have taken proper measures for disinfection, are as follows: for diphtheria, after twelve days; smallpox, eighteen ; measles, eighteen; chickenpox, eighteen ; mumps, twenty-four; whooping cough, twenty-one: Adults may be admitted at once, if they disinfect their clothes and persons.

According to the census of 1890, of every 10,000 deaths in the United States I will be from calculus, 35 due to Bright's disease, 40 to fevers other than typhoid, 59 to rheumatism, 70 to scrofula, 130 to cancer, 140 to apoplexy, 148 to whooping cough, 160 to dysentery, 190 to meningitis, 220 to scarlatina, 246 to ague, 250 to convulsions, 310 to typhoid fever, 350 to heart trouble, 480 to diphtheria, 880 to diarrhea and 1420 to phthisis. Of this number 2210 are from typhoid, diphtheria and phthisis, all of which are preventable and if we take in whooping cough, dysentery, scarlet fever and diarrhea, we shall have more than one-third of all deaths at the present time from preventable causes.

PUBLIC SERVICE.

OFFICIAL LIST OF CHANGES IN THE STATIONS AND DUTIES OF MEDICAL OFFICERS.

UNITED STATES ARMY.

Week ending August 12, 1895.

The extension of leave of absence on account of sickness granted Major Clarence Ewen, Surgeon, is further extended two months on account of sickness.

The leave of absence for seven days granted to Captain R. J. Gibson, Assistant Surgeon, is extended twenty-three days.

Captain Louis S. Tesson, Assistant Surgeon, is relieved from duty as Attending Surgeon at Headquarters Department of the Missouri, and Examiner of Recruits at Chicago, Illinois, and ordered to Fort Ethan Allen, Vermont, for duty, relieving Captain Aaron H. Appel, Assistant Surgeon.

Captain Appel, on being thus relieved, will report for duty as Attending Surgeon and Examiner of Recruits, Chicago, Illinois.

A board of officers, to consist of Major Philip F. Harvey, Surgeon, Major George H. Torney, Surgeon, and Captain Charles F. Mason, Assistant Surgeon, is appointed to meet at West Point, New York, August 15, 1895, or as soon thereafter as practicable, for the physical examination of the cadets of the First and Third Classes; the cadets of the Second Class on their return from furlough and such other cadets of the United States Military Academy and candidates for admission thereto as may be ordered before it.

A board of officers is appointed to meet at Fort Robinson, Nebraska, on Friday, September 6, 1895, for the examination of Captain Louis W. Crampton, Assistant Surgeon, with a view to determining his physical fitness for promotion.

Detail for the Board: Colonel Dallas Bache, Assistant Surgeon General; Major Henry McElderry, Surgeon; Major Joseph K. Corson, Surgeon.

Leave of absence for two months is granted First Lieutenant Charles F. Kieffer, Assistant Surgeon, United States Army.

Leave of absence for one month is granted Major Ezra Woodruff, Surgeon, Fort Keogh, Montana.

Leave of absence for two months is granted First Lieutenant Wm. F. Lippitt, Jr., Assistant Surgeon, Fort Leavenworth, Kansas.

UNITED STATES NAVY.

Week ending August 10, 1895. Surgeon C. G. Herndon detached from Bureau of Medicine and Surgery, to duty on the "Lancaster." August 6.

Passed Assistant Surgeon F. C. Brathwaite detached from naval hospital, Norfolk, Virginia, to duty on the "Lancaster." August 6. Past Assistent Surgeon E. R. Stitt detached

BOOK REVIEWS.

INTERNATIONAL CLINICS; A Quarterly of Clinical Lectures. Edited by Judson Daland, M. D., J. Mitchell Bruce, M. D., F. R. C. P., and David W. Finlay, M. D., F. R. C. P. Volume II. Fifth Series. 1895. Philadelphia; J. B. Lippincott Company. This volume is full of lectures by men, some of whom are prominent and some not so well known. The menu is an assorted one, and poor indeed must be the taste of the reader who cannot find something of interest. The colloquial style makes them very attractive reading, but in so many cases they are very elementary and of a style best suited for undergraduates. With a set of such books on the shelf and a difficult case in practice, the former is seen to be of great help in making the diagnosis. While no one person would probably read such a volume through there are few indeed who would not be interested and even taught by one or more of the many lectures. This series continues to hold its readers and bids fair to live to a great age yet. The clinical lecture occupies a more and more important place in the curriculum of most schools which have adopted the four year standard, and for this reason that style of teaching, whether in the amphitheater or in a book, holds the attention and reaches its purpose much better than the systematic treatise. The editors do not seem to want for material and some of it is especially good.

REPRINTS, ETC., RECEIVED.

Announcement of the Ninth Annual Course of Instruction in Orificial Surgery. By E. H. Pratt, M. D., LL. D.

The Diagnostic Value of the Medical Laboratory. By Wm. M. Harsha, A. B., M. D., Chicago. Reprint from Medicine.

First Impressions of a Medical Examiner. By Edward Cranch, M. D., Erie, Pa. Reprint from the Homeopathic Physician.

CURRENT EDITORIAL COMMENT.

FRANKNESS.

New York Medical Journal.

THE Course generally pursued by physicians of withholding from patients who are dangerously ill or affected with an incurable, though perhaps latent, chronic malady definite information as to their real condition is founded on most creditable motives, chiefly that of saving the patients unnecessary mental distress. Doubtless with some persons and on some occasions, however, it would be well to show the utmost frankness. At all events many persons feel that it would be.

SUBSTITUTES.

Atlantic Medical Weekly.

DON'T forget when you go away this summer for your vacation, to recommend to your patients one of your confrères, in case they should need medical attendance during your absence, and don't fail to notify the physician of your action. By so doing you will retain your family and make it easier to resume your practice on returning. A physician attending your patients during your absence will look upon such a patient with different eyes than if called to attend him with no word from you and no knowledge that it was only your inability to attend that gained for him the opportunity.

THE PRACTICE OF MEDICINE
IN CITIES.

Journal of the American Medical Association. THE rush of young men, not well prepared, into the practice of medicine is likely to be checked and headed off for a time. The State examinations for license to practice will raise the standard and drive out the incompetents and quacks. In some of the large eastern cities new questions of professional peril are coming into prominence. Teachers and specialists in every city have depended very largely on consultation practice. The strain to secure a position in a medical college was, in most instances, to enlarge their acquaintance and consultation practice. This has grown to such an extent that vacancies for teaching are bought and sold, not always for so much money, but for influence and prospective power to help the college and its teachers.

PUBLISHERS' DEPARTMENT.

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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.

NEVER prescribe morphine with the cyanides.

*

IT is said ignatia amara will destroy the taste for tobacco.

PAIN is most severe in those cases of pneumonia which attack the lower lobe.

*

SALAKTOL is a new remedy for diphtheria, which has been used with striking success.

*

WARM water persistently applied will relieve the intense burning and itching of erysipelas.

IN acute suppression of urine try pilocarpine hydrochlorate one-thirtieth to one-tenth grain doses.

DR. JOSEPH M. MATHEWS, in his new work on rectal diseases, has laid great stress upon the use of high injections of iodoform emulsion for the cure of ulceration of the sigmoid flexure.

*

THE purified fluoride of sodium possesses an especial action on children that are either

predisposed to or already have tuberculosis. The results obtained persist. In many cases the cure remains many years.

TO PREVENT black eye, paint over the injured surface two or three times with a mixture of tincture of capsicum annuum and an equal bulk of mucilage and a few drops of glycerine. The coats should be repeated as soon as dry.