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suffering with grave kidney trouble, with large quantities of albumen. Suddenly an ulcer the size of a gold dollar appeared at the superior portion of the left tonsil. It was covered with an exudate, similar to that seen in diphtheria, which was easily removed without any hemorrhage, leaving a sharp scooped-out cavity. It was treated locally and again forty-eight hours later. In the latter part of this same day it began to bleed, and continued to bleed for some hours, notwithstanding styptics, hypodermics, etc.
He was moved to the hospital for more radical treatment, when the hemorrhage began to lessen and finally ceased. The patient died five days later (Laryngoscope, November, 1898).
The operative measures employed are of several kinds, consisting of thevarious guillotines — used according to the preference of the operator rather than from any distinct merit in the special instrument - the cold snare, curved scissors or bistoury, and the electrocautery, either as a wire snare or directly as an electrode. In children the tonsillotome is the preferable instrument — always with an anæsthetic as also in young people, provided the tonsil is easily surrounded or is not of a fibrous nature, nor the patient a bleeder. In mature years the choice will rather lie between the cold snare and the electrocautery in the distinctly hypertrophic forms. Where the condition is one of follicular formation and the tonsil small, the usual operation consists in cutting through the dividing walls of the individual crypts and trimming off the ragged edges resulting from this with knife or scissors, using such antiseptics and styptics as may seem best. In other cases, to be determined by the individual judgment, the tonsil is seized with forceps and dissected from its attachments to the palatine and pharyngeal walls with the curved scissors or the heated electrode ; in the former case at one operation, in the latter in one or several, according to the judgment of the operator or the condition of the parts to be operated upon. On this point Dr. Charles E. Teets says: “This would be the treatment par excellence (the dissection at one sitting] if it was not for the marked inflammatory reaction, which I have found diffi
cult to control. Furthermore, the operation is somewhat tedious, requiring from half to one hour's time.
The duty of the physician is not only to thoroughly remove the diseased tissue, but to do it in such a way as will cause the least pain and inconvenience to the patient” (Homæopathic Eye, Ear, and Throat Journal, May, 1899). Under ether, the cold snare would be preferable to the cautery.
The possibility of hemorrhage of a serious kind after tonsillotomy must always be borne in mind, so that you can protect yourself, with the patient or the family, in the remote chance of its occurrence. A moderately free hemorrhage always occurs, and is perhaps somewhat of a benefit to the overcongested parts. If too free, we have always found that the application of the hydrogen dioxide, crude, would check it at once. It is the best styptic we have for hemorrhage in the nose or throat. Secondary hemorrhages may occur several days after the removal, which in some cases have proven rather serious for a time.
The operations for the cancerous conditions, when they have involved contiguous parts, belong in the field of capital operations for the skilled surgeon. Many would never be submitted to could the patient have any forewarnings of the after conditions. On the other hand, the skill and daring of the surgeon have given many an hour of comfort to these unfortunates, although knowing the hopelessness of the final result. The operations oftentimes involve all or large portions of the pharynx, palate, and tongue. When the disease is confined closely to the tonsil it has been removed through the mouth by means already mentioned, or through the external tissues by incision under the inferior maxilla.
Finally, while the care and oversight of the tonsils may not be a difficult matter, they demand a great deal more attention than is usually given them or it is thought they require.
Contributions of original articles, correspondence, etc., should be sent to the publishers, Otis Clapp & Son, Boston, Mass. Articles accepted with the understanding that they appear only in the Gazette. They should be typewritten if possible. To obtain insertion the following month, reports of societies and personal items must be received by the 15th of the month preceding.
In the resignation of Prof. John A. Rockwell from the chair of physiology, Boston University loses a most valuable and valued instructor.
For many years Professor Rockwell has devoted his life to the development of this chair, especially along lines of experimental investigation, until the instruction given in this depart. ment has been equalled by but few colleges in the country.
This work has been done by Dr. Rockwell at a personal sacrifice, financially as well as in other respects, until the threatened breakdown of health forced the faculty most unwillingly to accept his resignation.
The selection of a man to take his place - to fill it would be hardly possible — will not be a matter easy of accomplishment for two reasons: first, men proficient in that line of work are not abundant, and secondly, the finances of the college cannot allow sufficient remuneration to make the berth attractive.
In this lack of funds really lies the whole difficulty. The scarcity of men to fill positions like the one vacated by Professor Rockwell is due largely to the fact that unless a young man, who is imbued with natural ability and fervor for the work, has an independent income sufficient to insure his living, he cannot afford to indulge in the luxury of scientific physiological investigation and experimentation.
No doubt Professor Rockwell has, during his long term of service, had not a few young men who would have been glad to have continued in that line of work under so able an instructor, and whom it would have been a delight for him to have developed; but the young man must live, and along this line of work there was nothing in sight for him beyond a pittance which the physician of average attainments would hope to acquire in one year's practice. And so it is most unfortunate for the college that, after so many years of hard,
untiring, devoted work on the part of the chair of physiology, there has been trained no successor.
The responsibility for this does not rest with the faculty, who, heaven knows, have most of them put in years of untiring, unremunerative, devoted, self-sacrificing work in main. taining the integrity of the school and in constantly raising its standard, endeavoring constantly not alone to make it among the best, but the best homeopathic school in the coun: try; but the responsibility rests with the profession and with the alumni, who do not, and never have, supported the school as they should. It is the only homeopathic school in New England; there are sufficient practitioners and alumni in New England alone to support the school handsomely, but their attitude has ever been that of frigid indifference on the part of the one, and uncritical fault-finding on the part of the other. The result is evident in the condition cited above ; we have a well-appointed physiological laboratory, a course of scientific study arranged — the result of years of practical experience liable to fall into “innocuous desuetude" for lack of financial support.
The chair of physiology, as well as its nearest of kin, path. ology, should each have a permanent endowment of at least $100,000; and that they are not so endowed is a matter for which the profession as a whole is responsible, and of which, to say the least, it cannot be proud. If we have not esprit de corps enough to do it, for pity's sake let us get Miss Somebody-or-other to start a chain letter.
As we go to press comes the sad news of the sudden death by apoplexy of Dr. I. Tisdale Talbot. Though not in the most robust health for the past few years, he has of late seemed better and stronger than for some time past, and the knowledge of his demise comes with appalling suddenness.
Death has taken from our midst one who has been the most prominent figure in the homeopathic profession during the last half-century. A most successful practitioner, attending with most scrupulous care to the details of a large
private and consulting practice, he was nevertheless the acknowledged leader in all prominent movements for the advancement of homeopathy and in the establishment and maintenance of its institutions. The following we clip from the Boston Herald:
"Dr. Talbot was born in Sharon, October 29, 1829. Being thrown upon
his own resources to obtain an education, he went to Baltimore at the age of fourteen years, and there opened a private school. This proved very successful, and with teaching occasionally he obtained means to continue his own studies.
He entered Worcester Academy, where he fitted himself for the sophomore class at Harvard. Circumstances, however, prevented him from completing his classical course, and in March, 1851, he entered the Harvard Medical School.
He passed one winter in Philadelphia, and was graduated from the Hahnemann Medical College in 1853, and from the Harvard Medical School in 1854.
From 1854 to 1858 he continued his medical studies in Europe.
From 1848 to the time of his death, Dr. Talbot made Boston his place of residence. He had an extensive practice, and did a great deal to organize and establish homeopathy in this city. He originated the Homeopathic Medical Dispensary, chartered in 1856, and, except during his absence in Europe, acted as its secretary up to the time of his death.
He did much for the Massachusetts Homeopathic Hospital, of which he was trustee, secretary, and vice-president, as well as president of its medical board during several years.
He was instrumental in securing the establishment by the State of the Westboro Insane Hospital, which is under homeopathic control. He was active in organizing the Boston University School of Medicine, of which, from its commencement, he was the dean, as well as its professor of surgery.
He had occupied the positions of secretary and president of the Boston Homeopathic Society, the Massachusetts Homeopathic Medical Society, and the American Institute of Homeopathy, all of which prospered under his direction.
He was vice-president of the International Homeopathic Congress, held in London in 1881, and president of a similar congress held in Atlantic City in 1892.
He established and, during several years, was the editor of the