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Dr. VANDER Veer thought that it would be proper for the Society to indorse this bill. He stated that women nurses had been employed in this city in the Ira Harris Military Hospital during the War of the Rebellion. There were those present he said who served as surgeons in the SpanishAmerican War and who could appreciate the need of women nurses. Dr. Vander Veer then proposed the following motion which was seconded by Dr. Ward:

Whereas, many of us from personal experience, or otherwise, bolieve this bill to be a proper and just one, and that we have confidence that the employment of trained female nurses in the military hospitals would result in great good, therefore,

Resolved, that we respectfully petition our United States Senators, and Representative in Congress, to give the subject their careful consideration, and if consistent with their views to urge the passage of the bill, and,

Resolved, that copies of our action, signed by the President and Secretary of the Society, be transmitted to our United States Senators, and Representative in Congress.

Dr. WARD remarked on seconding the motion that many of the members knew and regretted the fact that the Surgeon-General was more or less opposed to the bill. He thought that this was due to the fact that the Red Cross had rubbed him the wrong way early in the war. Perhaps there was fault on both sides. He had had no experience in the Spanish-Ameri. can War, but he did not see how any man who had been in the Civil War and seen the wretched effects of male nurses, could oppose the employment of women. Whilst sorry to oppose the Surgeon-General in the matter he thought that the Society should support the bill.

Dr. MACDONALD stated that he thought there was a disposition on the part of old army men to oppose the introduction of women nurses. He thought this arose from misunderstanding and their manner of training. He thought that the old methods of training had given fairly good results in time of peace. During the war the Hospital Corps had been recruited from medical students, members of the Salvation Army, and foreigners, and the results had been poor. He thought that women could be used as nurses with advantage at the large depots. At Fort MacPherson when he first went there, there were four female nurses and a sufficiently large corps of male orderlies of the kind above mentioned. He found that faithful service could not be expected from this class of men. On his second night in the hospital he had found four of the night orderlies asleep. Another was just going to bed and was removing the mosquito netting from a typhoid patient to cover himself. He thought that women trained nurses were a necessity if you wished fidelity of service. The army men who were brought into contact with the women nurses had begun to appreciate this. He had seen no case of infidelity to duty in a woman nurse. The objectors to the bill raised minor objections relating to transport, quarters and clothes. He found that the women nurses were willing to sleep under tents, eat the ordinary food and undergo the ordinary hardships. He thought they were of great service except on the firing line and in the immediate neighborhood of battlefields. He

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regretted that the appointment of the Chief Nurse was not placed in the hands of the Surgeon-General in the bill under discussion. He thought that the Surgeon-General had some cause to be aggrieved. It was not the nurses who went to the front who caused him annoyance, but certain ones who stayed in Washington and made constant trouble about imaginary grievances.

Dr. Vander Veer's motion was then put and carried unanimously.

The President read a telegram from Dr. Sabin stating his inability to be present on account of the floods.

7. Reading of papers. Dr. WARD read his paper on the “Medical Complications of Gonorrhea."

The President remarked that as the papers were on kindred subjects discussion would be deferred until after Dr. Sautter's paper.

Dr. SAUTTER then read his paper “ The Treatment of Anterior Urethritis, Acute and Chronic,” and exhibited an endoscope with a brush for applying solutions locally in the urethra.

The papers were declared open for discussion by the President.

Dr. Sautter in referring to a statement made in Dr. Ward's paper said that he had understood that gonorrhoea in the female usually started in the urethra, and asked for further information on the subject.

Dr. VANDER VEER asked Dr. Sautter if the brush application was a new idea to which Dr. Sautter replied in the negative. Dr. Vander Veer stated that a similar instrument had been used for years in the form of a probe with cotton on it. In discussing the paper Dr. Vander Veer said that he thought this was the first time he had heard Dr. Ward read a paper acknowledging any kind of a germ. In speaking of gonorrheal rheumatism Dr. Vander Veer said that he was under the impression that a man who had rheumatism and contracted gonorrhoea was particularly liable to a return of the rheumatic attack. He thought that a patient with a rheumatic history was more apt to have joint involvement than another man. He thought that colchicum was useful in treating some of these cases.

Regarding the gonorrhæal endocarditis and pericarditis he remembered well a case of these conditions in a woman who had been infected by her husband. She had died and a post mortem was made, the specimens being in the museum. Dr. Vander Veer said that he had been glad to hear Dr. Dr. Sautter's paper as he was anxious to hear the views of some of the younger men on treatment. He agreed with Dr. Sautter in his views regarding irrigation. We were more apt he thought to be called to treat the complications nowadays as so many patients were treated by druggists or treated themselves. Dr. Vander Veer thought that the alkaline treatment was of more value than Dr. Sautter was inclined to believe. He had seen many patients made much more comfortable by alkalies. The balsams were of value after the acute stages, but the kidneys must be watched.

Oil of santal wood especially should be given only in the chronic stages. He thought Taylor's limit of six weeks as the duration of the disease rather long; Bumstead used to get them well in three weeks. Very often the patient delays recovery by not doing as he is told. He had seen the pendulum of opinion swing back and forth several times as regards medication. They were using nitrate of silver twenty years ago and now had come back to it. He thought this drug of great value for abortive treatment and deep treatment in the later stages. The most troublesome cases in his experience were those with prostatorrhea. He was of the impression that in the female, where the tubes or the cavity of the uterus had been invaded, the patient was never cured.

Dr. MACDONALD said that the chief purely medical complication of gonorrhæa so often became surgical that he felt tempted to speak on the subject. He spoke of treatment by fixation and counterirritation. He mentioned that adhesions often formed in these cases and that a considerable proportion went on to suppuration. He thought that Dr. Ward's statement that two per cent. of gonorrhæal patients developed rheumatism made the percentage rather high. On the other hand there was no more troublesome affection to treat,-they rarely recover. He thought the tendons suffered as much as the joints. Many men limped fifteen or twenty years after an attack. One comfort was that as the joint trouble appeared the urethral discharge disappeared. He could not understand how curing the urethral symptoms could effect the joints unless there was a constant flow of toxines from the urethra to the joints. He agreed with Dr. Sautter on the six weeks proposition; of the cases he had seen relatively few got well in three to four weeks, not many in six weeks. Many ran on three or four months. He had used the new silver preparations, as argonin and caseate of silver, but did not get satisfactory results. He got a temporary improvement quite often but the disease returned on discontinuing the remedy. He thought the same could be said of permangate of potash. When the discharge was like the white of an egg the permanganate should be stopped and sulphate of zinc substituted. He had also used at this stage a solution he had borrowed from the eye men consisting of

Tannin, ton grains to an ounce,

Borax, four to six grains to an ounce, in camphor water.

Some cases seem never to be amenable to treatment and travel around from doctor to doctor. Some of these cases were aggravated by anxiety.

could remove this they recovered. Absolute continence was also necessary. In some chronic cases he had found a solution of bichloride, 1: 3000, to effect a cure. Ice packs should be used with it and the patient would generally require morphine. It set up a violent inflammation and acted, he thought, by changing the character of the inflammatory process.

Dr. JENKINS related a case of gonorrhoeal rheumatism in which he had given almost everything without effect. Finally he gave quinine in five grain doses every four hours. The man was well in a few days.

Dr. NEUMAN called attenti to a possible fallacy in testing the urine when a patient was under the balsam treatment. In these cases the nitric acid test gave a ring like an albumin ring, but differing from it in that it was soluble in alcohol.

The President called attention to a rare complication of gonorrhæa, viz., gonorrhoeal iritis. It was a very hard disease to treat he said. The eye

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was often lost. There was one drug that seemed to do some good in the condition and that was the ammoniated tincture of guaiac.

Dr. SAUTTER had mentioned the case of the man with a fistula in the posterior portion of the urethra in which the posterior part recovered under balsams, while the anterior, which was not subjected to the flow of the urine, did not. Might this not have been due to the simple mechanical washing by the urine ?

Dr. WARD said that no doubt the quinine treatment in gonorrhoeal rheumatism was recognized, but he did not think that it was always as efficacious as Dr. Jenkin's case suggested. The bane of his life in the Albany Hospital was a case of gonorrhæal rheumatism that had been treated by Dr. Hun for three months with quinine. He had had the best results with rest in bed, quiet, the local application of cold, and the administration of alkalies. In his experience with the acute stages the good old Lafayette mixture was better than any irrigation. In answer to Dr. Sautter's question he thought that gonorrhoea in women certainly began at times in the vagina. No doubt it began as a urethritis at times.

Dr. SAUTTER stated that in Vienna Wertheim taught that the gonococcus was deposited in the vagina and migrated to the urethra. The vagina might be itself affected later. As regards the alkaline treatment he did not think that it relieved pain. The pain, he thought, was due to the distension of the inflamed urethral walls by the urine. He agreed with Dr. Ward as regards the efficacy of rest in bed. In Munich the students had a separate ward to themselves and were always put to bed when they had gonorrhoea. Posselt, who was in charge there, did not think that this rest in bed modified the disease much, but thought that it lessened the danger of complications.

A motion to adjourn was made by Dr. Ward and seconded by Dr. Vander Veer and was carried.


President. Secretary.

International Congress of Medical Electrology and Radiology.- At the request of the French Society of Electrotherapy and Radiology, the International Congress of Medical Electrology and Radiology, the initiative of which it has taken, is connected with the International Congress of 1900.

A Commission, which is composed of Messrs. Weiss, Professor at the University of Paris, President; Apostoli and Oudin, Vice-Presidents; Doumer, Professor at the University of Lille, General Secretary; Moutier, Secretary; Boisseau du Rocher, Treasurer, and of Messrs. Bergonie, Professor at the University of Bordeaux; Bouchacourt, Branly, Professor at the Catholic Institute of Paris; Larat, Radiguet, Villemin, Surgeon of the Hospitals of Paris, has been asked to assure its organization. This Congress will take place in Paris, from the 27th of July to the ist of August, 1900. All inquiries for further information must be forwarded to Prof. E. Doumer, General Secretary, 57 Rue Nicolas-Leblanc, Lille.

Book Reviews

A Manual of the Diagnosis and Treatment of the Diseases of the Eye.

By EDWARD JACKSON, A.M., M.D., Emeritus Professor of Diseases of the Eye in the Philadelphia Polyclinic; formerly Chairman of Section on Ophthalmology of the American Medical Association; Member of the American Ophthalmological Society; Fellow and ExPresident of the American Academy of Medicine. 600 pages, 178 illustrations and 2 colored plates. W. B. Saunders, Philadelphia,

1900. The name of the author is a sufficient guarantee of the excellence of the work and the profession is to be congratulated in having a book from the pen of so eminent a teacher and scholar. i'he writer is recognized as one of the best oculists in America and as having no peers in the science of refraction. He has incorporated his ideas in a compact volume in an interesting, clear and concise manner, showing much originality of thought and research. Like many writers of the day, he takes it for granted that the student has a basic knowledge of the gross and minute anatomy and physiology of the eye and plunges directly into the practical handling and treatment of the ocular diseases and errors of refraction.

His classification, in some instances, differs from those of the older writers, viz.: insidious iritis is designated as uveitts and serous iritis as cyclitis. In the chapter on sympathetic ophthalmia the statement is made that the sight of the exciting eye is lost, the chance of recovery of the sympathizing eye is much better if the exciting eye is promptly removed, There are still some authorities who will not accept this, but the writer has voiced the opinion of the more recent observers.

The lucid text and simplicity of expression of the chapter on diseases of the crystalline lens will carry the reader along with a

sense of pleasure. He will also derive equal satisfaction from the pages on “pupillary reactions." The average text book on ophthalmology deals with this very important subject in a manner anything but comprehensible and the student must go to the works on the anatomy of the nervous system or physiology where he immediately becomes confused.

The chapters on refraction are unimpeachable and while the practitioner of ophthalmology could readily understand and appreciate Dr. Jackson's methods, the beginner might find it difficult; yet there is nothing that would be obscure to or beyond the average oculist and the subject is treated wholly from a practical standpoint. Like all exponents of what may be termed the “ Philadelphia School of Refractionists,” he considers "Skiascopy;” or, according to Thorington, “Retinoscopy," the only accurate and infallible method of estimating astigmatic errors. A difficult method to master, it is here placed before the student simply and intelligently.

The newer drugs are mentioned in relation to their therapeutic application: Protargol in diplobacillus conjunctivitis, purulent conjunctivitis and obstruction of the nasal duct; and Cassaripe in suppurating ulcer of the cornea as used by Chandler and Risley.

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