One eye was entirely gone and the other

half gone. had just a stump.

DR. WILLIAMS: It may be that the original trouble contracted in Washington City was not syphilis. He might have had bubo, and not had syphilis after all. There might be a suspicion that he contracted syphilis a year or two prior to his marriage, and I think it is certainly a fact that a person may contract syphilis and not have any perceivable primary lesion. I am certain of that. I have had some experience in some of these cases, and it would certainly bear out the statement made by Dr. Thomas; and I could relate a number of instances to substantiate my position. For instance, in one case a young man had syphilitic trouble in 1883, and about the beginning of 1884 was married and his wife was delivered of a still-born child about the beginning of 1885. About ten or twelve months after she had another still-born child. About a year after that she was delivered of a living child. About 1887 and within the past two years I have attended her twice, and her children are apparently healthy and doing fine. This was some eight years after the father contracted the disease. I am certain that if a case is properly treated the liability to convey the disease disappears after a period of three or four years. I think it depends on whether the patient has been properly treated. Unfortunately some of them are not well treated.

Now a

DR. LANGE: The matter introduced by Dr. Thomas is one upon which likely, no medical body in the world would have one opinion in almost any aspect. For instance, Dr. Batten has said that temperament, disposition or character has an influence in contracting syphilis that a plump person with ruddy skin, blue eyes and light hair is more likely to take syphilis than a brunette. In other words, that the so called lymphatic temperament is a predisposing cause. good many members here will not agree with that opinion. It may be that a patient of lymphatic temperament will suffer more severely, but I do not agree that such an individual will take syphilis quicker or more readily than a brunette. Dr. Thomas asserts that none of the secretions are contagious if the patient, after having syphilis, presents no symptoms. I have a family in my care where the father contracted syphilis after marriage and after having two robust, healthy children, he himself being a remarkably robust, healthy man, an oil driller, and his wife being a strong, healthy woman. That man had two children when he contracted syphilis. He had treatment for three years, and at the end of that time presented no symptoms. Then he had two additional children born without symptoms; one of these is now about five years and the other about three. They have presented no symptoms of syphilis. Now he has a child eighteen months old, which is syphilitic very distinctly. It may not be fair to say with some members here that once syphilitic always syphilitic, but it is certainly remarkable that toward the end of life syphilitics who presented no symptoms for many years, again have this disease reassert itself, and often such assertion ends life. This comes as aneurism, apoplexy, atheroma, and as connective tissue hyperplasias of the brain, the liver, the cord, etc.

DR. BARCLAY : My impression is, from what I have seen, that syphilis after the secondary stage is possibly not contagious, although I am not certain about that. It is not advisable for persons who have had syphilis to marry short of three years after the syph

ilitic manifestations have disappeared; that has been my rule, to advise persons who have had syphilis not to marry short of three years after all manifestations have disappeared. I have said to them with a good deal of confidence that I thought it would be safe after that time to marry. I saw recently a young girl who was poisoned by a dentist. The dentist who extracted her tooth abraded her lip. I saw her three weeks afterward, and my opinion was after I examined her that she had been poisoned. I was careful not to give her a positive opinion, but advised her to see other physicians. They were of like opinion, advising me to watch the patient for manifestations. The secondary manifestations came on in about sixty days afterward, and there is no question she was poisoned in that way. She said the dentist hurt her lip at the time he extracted her tooth. To me it was a very interesting case. I have treated her since and her hair has dropped out. This case was referred to a lawyer, and in all probability there will be a case in court. I have placed myself in a position of security by having her see other physicians; three or four other physicians have examined her, so if it comes into court the profession may be protected.

DR. BUCHANAN : I have nothing to say on the subject introduced by Dr. Thomas, but I have a word to say about the case which was reported in which a dentist is charged with having introduced syphilis by means of his instruments. We all know the variety of ways by which an abrasion of the lip can be made. I think if this case should come into court, the plaintiff would have the very greatest difficulty to prove even that it was shown that the abrasion on the lips of this patient was the site of the chancre, showing that the inoculation was made by the instrument that produced the abrasion. Suppose this girl has a family friend who had something on her lip and that she kissed that friend good-by at a station about the time when she received the injury at the dentist's, she would have received this inoculation, and the dentist would have to bear the blame. This girl might have received the inoculation by a drinking cup, she might have wiped her face with the towel that the servent girl had used, she might have received it in a thousand ways, and still this dentist must bear the blame. I think, as we use instruments ourselves, we should be exceedingly careful of implicating in any way any member of the cognate profession of dentistry.

DR. BARCLAY: I appreciate what Dr. Buchanan has said, and I have been just as careful as he could be. It seemed to me from the history of the case that she was certainly poisoned by the instrument. I know and appreciate just as highly as any one could, how much danger there is to the dental profession and the medical profession from this very cause, and I very carefully looked into that matter, and I am well satisfied when I say I believe she was poisoned by a dentist's instrument. The history of the case goes to prove very clearly that the lip became indurated the third day, that there was a large lump in her lip and the glands were sore. Of course what Dr. Buchanan said is true: she may have kissed a friend. I inquired as to that and I am satisfied if she was poisoned by any other means except the one referred to, she was innocent of knowledge of it.

DR. BUCHANAN: According to this statement, the chancre appeared on the third or fourth day after the inoculation. We all know that that is entirely too

short a time. We know if we inoculate a person with syphilis it never appears on the third or fourth day; it takes a good while longer. If it appeared on the third or fourth day after the the dentist extracted the tooth, then he did not inoculate her.

DR. BARCLAY: Morton, in a recent work, states it may make its appearance on the first up to the sev entieth day.

DR. DAVIS: I would like to ask the society if any one has known a case of syphilis to be communicated after the third year to their children, or any one else; that he can say of his own experience syphilis has been communicated after the third year.

DR. WILLIAMS: I have in my charge a man who was married seven years ago, who had an eruption on his body. He had a chancre, but did not give it any attention. About six months after the manifestation of syphilis, after the rash manifested itself, he married, and in due time a rash of a similar kind came over the wife. He was then taking antisyphilitic treatment. I do not remember the exact year, I think three years after his marriage, his wife was delivered of a child, and unlike the cases reported by Dr. Thomas, there was a manifestation of syphilis on the skin, entirely covering the child. The child died in about three weeks. Four years after this the man was presented with another member of the family, and a like condition exactly was manifested in the child. During this time he was taking antisyphilitic

treatment.

DR. LANGE: I stated a case a little while ago and forgot to say that during the time these three children were conceived and born the mother had not at any time any manifestation of syphilis; never at any time. Two of the children are healthy, the last one syphilitic, and the mother at no time presented syphilis.

DR. DAVIS: Do you know whether she could have taken syphilis ?

DR. LANGE: She never had symptoms.

DR. GREEN: Can you exclude all evidence of a nurse or some of the attendants not conveying it to the child. I have seen a number of instances myself where the mother and father were clear, yet the child was syphilitic.

DR. LANGE: These children were fed with bottles in the hope that if taken away from their mother it would lessen the danger in the first two, and the third child was nursed.

DR. MCKIBBEN: On the 2d of August I delivered a woman whose husband was treated for syphilis about six months, when he got careless and stopped treatment. After three months he had mucous patches in the mouth, for which I treated him. He was anxious to get married. I told him it would not be advisable, but after a period of about eighteen. months he married; his wife became pregnant, and the child was born on the 2d of August, perfectly healthy and the mother has not shown any symp

toms.

DR. SHAW: I have in mind four men who had syphilis before marriage. Three of them had it severe enough to warrant a visit to the Hot Springs. They have all married, all have children and none of the children have ever shown any manifestation of syphilis. I cannot give the exact time in any one case, but an interval of at least three years from the time of the first manifestation of the disease elapsed before marriage took place.

Railroad Accidents as a Means of Educating Surgeons.

The managers of American railroads appear to have read certain medical journals whose editors frequently lament the lack of clinical training given in the schools to medical students, and have decided that this omission on the part of the colleges shall not prevent the development of skillful surgeons. In order to supply the clinical material necessary to make great operators they mismanage and neglect the equipment of their roads till each day brings an accident, attended by loss of life and injury to numerous passengers. Unless there is an improvement in the manner of running and inspecting rolling stock and examination of road beds, those doctors who are ambitious to achieve reputations as surgeons will do well to desert the hospitals and secure appointments as railroad surgeons. Some one may remark that Chicago physicians can feel assured of a full share of surgical practice while our surface roads and grade crossings remain in operation. Such a remark will provoke no argument.

Eastern Assurance.

The Medical Record now and again takes a slap at western medicine. Recently, the Record insinuated that Chicago has no medical journals. Chicago has also no men who appropriate the work of eastern men and call it their own. The latest monumental appropriation is Wyeth's operation of bloodless amputation at the hip joint. This operation was presented by Dr. Muscroft, of Cincinnati, Ohio, to the Cincinnati Academy of Medicine, March 14, 1887, and published in the Lancet Clinic April 2, 1887. New York might not be so pompous if she gave honor to whom honor is due. Dr. Shrady is welcome to this bit of information as he aspires to be a live journalist.

Medical Nomenclature.

Dr. Da Costa in a clinical lecture, reported in the Medical and Surgical Reporter, takes strong ground against the careless habit of the profession in calling. the prevailing epidemic of influenza “La Grippe," or by its anglicized name, "grip." The former is merely a French slang term, while the latter is its English equivalent. Medicine, unfortunately for the learner, has already too many names which convey no information in themselves. Applying the name of the man who first described it to a disease is perhaps a merited compliment, but when the annoyance it entails to students who have so much to learn is considered, it appears that some better way of doing

honor to the discoverer could be found. "Bright's disease," "Colle's fracture" and "Munére's disease" have been stumbling blocks to beginners in medicine since the names came into use. "Railway spine,' "Coin on disease" and "Postboys' disease" are examples of a system not less unfortunate.

The first does tell the organ affected but the others have no excuse for existing. Many names of general significance have been used in days gone to cover pathological and diagnostic ignorance. They are no longer needed. The members of the profession now are capable of applying to diseases their correct appellations, and the examples should be set by the teachers and writers.

The laity, ever ready to imitate, has appropriated the idea of applying a name to a disease because it is prevalent among a particular class, and have called. paresis following sexual excesses and perversion "actors' disease."

The idea underlying the system is wrong. Diseases should be named from the pathological conditions or from some prominent and pathognomonic symptom. The English have set a good example in this matter, as witness their use of enteric instead of typhoid fever. Go thou and do likewise.

Give the Women a Chance. Co-education is not an experiment any longer. The University of Michigan, the Northwestern University, and many other schools of lesser note, have demonstrated that women and men can be educated together, allowed the largest amount of personal liberty and graduate the peers of any in the land. The popularizing of this idea is slow. Its results must be potent before the mass of men allow its excellence. St. Louis has just been the scene of a row which disrupted the faculty of a medical college and caused five professors to vacate their chairs. The college opened its doors to women and seventeen matricu. lated. The male students objected and petitioned the faculty to bar out the women. The faculty declined to grant the request of the petitioners, and five professors who were in sympathy with the objectors to coeducation resigned. No reason was assigned by the male students for their conduct except that they disliked the idea of coeducation.

Women have come to stay in the medical profession. They have demonstrated their fitness for the arduous and exacting duties the practice of medicine entails. They ask no favors, but want an equal opportunity with their brothers to fit themselves for their life work. They deserve it too. Those medical colleges devoted exclusively to the education of women will stand the test of comparison with similar institutions from which women are excluded. Their graduates acquit themselves creditably before State and hospital examining boards and not infrequently carry off the honors. The women who take up the study of medicine are earnest, and as a class are better students than men. Their presence at lectures or clinics would never be known if they were not seen. The festive "spit ball," the flying apple-core, the surreptiously smoked cigarette and the "passing up" for a fellow student from the front seat to the amphitheater during a lecture are diversions peculiar to the male students. Possibly the presence of women might interfere with such pastimes. Medical students are as jealous of their rights and privileges as students

always are, and any imfringement of them is bitterly resented. However they must yield to the inevitable. They will have to meet and compete with women practitioners after graduation, and if the rivalry begins during the student days they will be none the worse for it. As the women are expected and required to do exactly the same work, stand the same tests and arrive at the same excellence as men, they should have every opportunity the men have. Possibly one of the reasons so many women enter the Homœopathic schools may be found in the closed. doors of such a number of regular colleges and the indifference if not hostility of their faculties. Give the women a chance.

Doctors in Politics.

The

The Journal of the American Medical Association, January 16, 1892, has an able editorial on "Physicians as politicians." It was called forth by a remark made by a leading physician when discussing the fact that clinical teaching was not allowed in Cook County Hospital. The writer takes the ground that the indifference of physicians is largely responsible for the many restrictions imposed upon the profession and the few favors extended to it by the "powers that be." In this he is indisputably right. interests of no class of men, particularly residents of cities, are more advanced by the selection of competent and efficient office-holders than those of the doctors. No other class is compelled at all times and all hours to answer calls in the lowest, thug haunted portions of the city where passers by are "held up" and robbed. No others see so much of the real suffering caused by the low drink shops and brothels which live by inefficient enforcement of the laws to poison and infect those members of the community who when they cease to be self supporting become public charges. Public institutions for the sick and insane are now run on political principles because the politicians can thereby serve the interests of the men who help them to office. What politician is there who would decline to yield to the united demand of the thousands of physicians of Chicago if he knew that a refusal meant their earnest work to defeat him in the future? The profession in America can learn something on this subject by looking across the Atlantic. Virchow is a leader in German politics. In Italy, parliament contains a number of M. D.s and more than one has held cabinet positions. Even in conservative England the doctor has shown his importance in the elections as proven by the fact that eleven towns at the recent elections elected physicians as mayors. The demand to divorce medical institutions from politics must come from the doctors and be made through the only channel that a politician can comprehend, viz; the ballot. It, looked at from any standpoint, must appear that doctors should lay aside their indifference and mistaken ideas of professional dignity and make themselves felt, at least in local elections.

Specifics for Influenza.

Specifics for influenza are popular now. Nearly every journal contains an article from a physician who has a sure cure for the malady which is now filling the cemeteries. The specifics are as numerous as the doctors who report them. No allowance is made

for individual peculiarities or idiosyncrasies. It is enough for the patient to have influenza. No matter whether it is the air passages, the alimentary tract or the nervous system which shows most prominently the effects of the poison, the treatment is the same, and the result invariably a cure accompanied by the patient's eternal gratitude and a more substantial reward. This does well on paper. It is good reading. It looks well. But is it true in practice? In the treatment of all diseases the diathesis and constitution of the patient must be considered in order to secure the best results. Influenza should be treated rationally from the standpoint of pathological condition. present with such modifications as the individual demands and the hunt for specifics given up.

Death of Sir Morell McKenzie.

The death of Sir Morell McKenzie, which occurred suddenly on the 3d inst. in London, removed from the scene of earthly action a master of scientific medicine and one of the most eminent and successful of Laryngologists. No medical library is complete without his book, and the surgical procedures suggested by him are performed daily by surgeons all over the world. His name will live long in medicine, but in the great world he will be remembered as the attending physician to the late Crown Prince, afterward Emperor Frederic of Germany. It is claimed that but for him Frederick would never have ascended the throne and the Guelf family would not have numbered among its members a Dowager Empress.

We are pleased to note the appearance of the Medical Fortnightly. It is one of the neatest and sprightliest journals we have seen. The unique custom of introducing fac simile of the signature of the author of each paper is highly commendable. The editor, Dr. Bransford Lewis, is one of the brainiest of American medical journalists, and this alone assures the success of the journal. G. F. L.

ABSTRACTS. Surgery.

FOREIGN BODY IN THE RECTUM.-Dr. W. Fred. Jackson. The Canada Lancet, reports a case of sexual perversion in a man eighty years of age who introduced a section of bass-wood broom-stick ten and a quarter inches long into his rectum. The stick escaped him and at the end of five days he applied to Dr. Jackson who found by abdominal pressure, the stick in the left iliac fossa and by manipulation forced it down into the rectum till it could be seized and withdrawn with a pair of placental forceps.

SEPTIC PERITONITIS FROM FISH BONE PENETRATING THE STOMACH.-Owen C. Rees, M. D.--The North Am. Prac.--Six weeks before patient was admitted to hospital, he suffered from severe lancinating pains in the epigastric and umbilical region. This condition was not preceded by either chill, nausea, vomiting or diarrhoea, and was greatly aggravated by any food taken into the stomach, sudden jar, movement or pressure. His abdomen was quite swollen, very sensitive, and he gradually lost flesh, until he became

much emaciated. Constipation was troublesome when liquid food had been taken.

An examination which was incomplete, showed albuminuria, breathing somewhat accelerated, pulse wiry, almost imperceptible, abdomen very much distended and so sensitive to pressure that percussion could not be made in the slightest degree. He presented a picture of collapse, became restless, thirst marked, temperature dropped from 97.4° to 96° and he died in about eight hours after coming to hospital.

A post-mortem revealed the following: The abdomen was filled with a purulent fluid, greenish in color. The omentum was in a hard mass, almost black in color, and lying anterior to the transverse colon. Between all the abdominal viscera there were extensive adhesions, and the inflammatory process and the adhesions caused thereby were so marked that they had formed constrictions of the transverse colon, and small intestines. There were numerous fibrinous flakes in the fluid contained in peritoneal cavity a number of which have become attached to peritoneal covering of the intestines and stomach. The latter contained several ounces of purulent fluid.

Near the pyloric orifice on the greater curvature was a fish bone, which had penetrated the walls of the stomach and was lying in an opening about the size of a goose quill. The mucous membrane of the stomach was very dark around this opening, and in the peritoneal cavity the inflammatory process had formed adhesions between the stomach, transverse colon and meso-colon, shutting off a pouch that would hold about one ounce. One end of the bone was lying in this cavity. There was a fistulous opening leading into the peritoneal cavity from this pouch, liquids and small particles of food could pass from stomach into abdomen. The pyloric end of stomach was so constricted that it was impossible to pass more than a finger.

CELLULOID SUBSTITUTE FOR BONE. Cin. LancetClinic.-Billroth and other German surgeons report success in the use of celluloid to replace portions of the skull which had been loosened by injury, necessitating their removal. When the operation is done aseptically, suppuration does not occur.

GLYCERINE FOR BURNS.-Med. and Surg. Reporter.M. Grigoresen, of Bucharest, highly recommends pure glycerine as a remedy for burns. On first application a slight burning feeling is experienced, which soon gives way to a local anesthesia, somewhat resembling that produced by carbolic acid. In severe cases two or three applications should be made, so that the parts are kept wet constantly with the glycerine. Under this treatment the inflammation is subdued almost completely, and only a slight cicatrix is usually left.

THE DRY POULTICE IN THE TREATMENT OF EPIDIDY

MITIS. In the Journal of Cutaneous and Genito-Urinary Diseases, Dr. George Emerson Brewer reports the successful treatment of a number of cases of epididymitis by the "dry poultice." This name is given to a dressing of cotton wool applied thickly over the inflamed portion of the organ and extending on to the healthy skin. This is covered with thin rubber tissue held in place by a snugly applied gauze bondage and the whole placed in a suitable suspensory. Pains rapidly subside, the inflammation disappears and the organ returns to its healthy state.

SUPRAPUBIC CYSTOTOMY. R. W. Stewart, M. D.-New England Medical Monthly.--A man aged 34, accidentally stepped on a coal hole, and the lid turning he fell, the edge of the lid striking him on the perineum. He was not able to walk home and the next morning suffered from a retention of urine. A soft catheter being introduced a small quantity of bloody urine was withdrawn, but in the evening it being impossible to relieve him in this manner, the bladder being distended, perineum tender, swollen and much discolored, a diagnosis of rupture of the urethra at the triangular ligament was made. The patient being anesthetized, the perineum was opened in several places and a small quantity of bloody urine escaped. A complete rupture of the urethra was discovered, but owing to the extravasation, the tissues were so altered in appearance that it was impossible to distinguish the vesical end of the torn urethra. He entered the hospital the following day, and as he was still suffering from retention, it was necessary to aspirate his bladder morning and evening.

The next day after entering the hospital he was again operated on and not being able to yet find the vesical end of the urethra, the distended bladder was opened above the pubes, the incision in bladder just sufficient to admit a steel sound, with which was performed retrograde catheterism. The sound after passing from within outward through the prostatic urethra, was made to project through the perineal opening. While in this position a stout rubber tube was fitted on the projecting conical extremity of the sound which together with the tube was withdrawn into the bladder, and the sound disengaged from the tube. The sound was then passed from before backward through the pendulous urethra, the extremity again. presenting through the perineal opening, and the sound carrying with it the tube, was withdrawn. By this method a tube was inserted in the whole length of the urethra, one end being in the bladder and the other projecting from the external meatus, the central portion bridging over the torn ends of the urethra, which were separated by an interval of about threequarters of an inch. This tube was prevented from being displaced by pinning it to the prepuce. time of patient's admittance to hospital his general condition was bad, temperature being 103° F., but he commenced to improve immediately, temperature. being normal on the third day, the urine draining through the tube, which was not removed until the eighth day, the man leaving the hospital on the twelfth day, after which time no urine passed by suprapubic opening.

At the

It was afterward necessary to pass a No. 26 French sound at intervals of about two weeks, to prevent the formation of a stricture at site of injury, and with this exception the patient's recovery was complete.

PROLAPSE OF THE BLADDER IN AN INFANT.-B. S. Roseberry, M. D. Medical Record. Being called to see a female child 12 days old, found it with a protrusion of the anterior vaginal wall and portion of base. of bladder through the vulvar outlet, the prolapsed portion being badly strangulated by the constricting action of the sphincter vagina, which grasped it tightly. This state had existed for five hours before examination! It was thought at first to be a vaginal hæmatocele, but the introduction of the hypodermic needle and the withdrawal of two syringes full of urine made the diagnosis of vesical prolapse certain.

The fluctuating tumor was about the size of a hickory nut; somewhat flattened laterally, and firmly pressed up in front of and against the pubic arch. The perineum was unusually broad in its antero-posterior measurement for a child of that age, and extremely resistant. Chloroform was administered, the perineum pushed back with the little finger of the right hand placed between its edge and the posterior aspect of the prolapsed organ, and by gentle, though firm taxis with the thumb and two fingers of the left hand, the misplaced parts were restored to their normal position, and an antiseptic absorbent cotton tampon, anointed with vaseline, placed in the vagina as a support. This was not removed for two days, and was not replaced as considerable sloughing had taken place from that portion of the vagina which had been the seat of construction. The vagina for some time after this was daily flushed with a weakly carbolized water. There had been diarrhoea, with considerable tenesmus for five days, and this was thought to be the cause of the accident. There was however no tendency to rectal prolapse, nor the slightest eversion of the mucous membrane.

There was considerable temperature for the first week, ranging as high as 106° F., but it sank to normal and remained so until death, which took place in eighteen days from the occurrence of the trouble, being caused by exhaustion, as locally the parts did well; the sloughing had about ceased, the bladder retained its position, and the urine was voided naturally.

The

A RARE DISLOCATION.-E. Gardner, M. D. American Lancet. Miss G., 18 years of age, was thrown from a buggy, and on striking the ground the left hand was flexed upon wrist with the forearm flexed, her weight resting on the arm and hand in this position. The next day severe bruises were found around inner condyle of humerus, and the elbow joint badly swollen. As it was decided that the wrist was out of place, the left hand was grasped by the left hand of the operator, and with the right hand encircling forearm, with thumb over end of radius, strong traction was made with thumb and forefinger, and the radius slipped back into place, where it remained without any bandaging.

RATTAIL SUTURES. In the Medical News, Dec. 5, 1891, Dr. E. Oliver Belt writes of rattail sutures, particularly in eye work. The tail of the rat is skinned and soaked in water for several days when by gentle manipulation it can be separated into a hundred or more fibres, which are quite strong and finer than any other animal fibre suture. They become agreeably soft when moist and do not have to be removed.

Otology.

-

THE AUDITORY CENTER. Dr. Charles K. Mills, in the University Medical Magazine, concludes that the center for word-hearing is situated in the hinder thirds of the first and second temporal convolutions; its exact position is in a line with, or just in front of, the posterior extremity of the horizontal branch of the fissure of Sylvius. Possibly it is restricted to the second temporal convolution.

The third, fourth and fifth temporal convolutions take no part in cerebral audition.

A lesion confined to the posterior thirds of the first