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VICIOUS UNION AFTER FRACTURE OF THE LEFT FOREARM, TAKEN WITH X-RAYS BY PROFESSOR ROENTGEN,
AT THE STATE PHYSICAL LABORATORY AT HAMBURG, JANUARY 25th, 1896
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GEORGE R. SHEPHERD, M.D.
HERBERT E. SMITH, M.D.
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THOMAS L. ELLIS,
John B. Griggs.
Published Monthly, from November to June, by Students of the Yale Medical School.
P. O. Address, Box 1727, New Haven, Conn.
Any subscriber desiring the journal discontinued at the expiration of his subscription should so notify the editors; otherwise it will be assumed that the subscription is to be continued and the Journal sont accordingly.
À Propos of the investigations now being carried on, of the newly discovered X-rays, the JOURNAL has inserted a reproduction of a photograph* taken by Prof. Roentgen in his laboratory at Hamburg, Germany. The photograph is, we believe, the first reproduction in this country of a distinct pathological process taken from the living subject. The faulty union of the broken bones is brought out clearly and distinctly. This is but a forerunner of the possibilities of this latest discovery, the recognition of the value of which has produced a feverish agitation in the minds of scientific investigators. Ainong these possibilities is this, that the surgeon can take advantage of this process in cases of doubt, where for any reason he is uncertain as to the diagnosis of a fracture, or the position of the bones.
Though up to this time there has been little difficulty in differentiating between bone and other tissues in the photographs, also between flesh and foreign particles of greater density where bone did not intervene, earnest and eager efforts are being made to so gauge the intensity of the rays emanating from the cathode, that differences between the softer tissues may be rendered appreciable to the eye, so that not only foreign particles can be discovered in the body but also the
* Through the courtesy of Prof. W. H. Carmalt, to whom the photograph was sent by Dr. C. G. Childs, a former editor of this JOURNAL.
presence and condition of pathological processes be determined. Relative to this, it may be said, through the kindness of Professor A. W. Wright, * we were permitted to examine a photograph of a hand, taken at such an angle that the blood vessels at the extremities of the fingers were distinctly visible, and another of a rabbit where the outlines of the heart and lungs were distinguishable. The difficulties standing before the realization of the accurate photography of pathological conditions are, viz., the indistinct outline of parts and the lack of delicacy of shading of tissues of nearly equal density. The solution of these difficulties is a matter of regulating the intensity of the rays and the media through which the rays pass before reaching the object and as the advance of the microscopy of tissues and minute organisms was largely due to the knowledge of staining of tissues, so here by varying the intensity of the rays and the time of exposure of the plate it is possible that more sharply outlined photographs may be taken.
Should the period of exposure be ultimately reduced to a few minutes, may not the rapid changes attending some pathological processes, l. 8:, inflammation, be watched as the growth and reproduction of cells beneath the lenses of the bacteriologist's microscope?
Again the hopes of the medical profession are aroused by the announcement of a cure for phthisis. Time and again has it been stated that a cure for phthisis has been found and when “Koch's Lymph," and all the experimental evidence concerning its curative quality, were given to the world, the profession believed at last an agent had been found with which the dread disease could be successfully combated, but the clinical results showed that even that remedy was unreliable and in many cases dangerous to use. Although tuberculin is a valuable agent to use in diagnosing tuberculosis, it is of no therapeutical value. Dr. Edson calls his new specific, which is composed of phenol and pilocarpine, "Aseptolin." The Doctor states, that in many diseases due to the presence of germs, the amount of phenol secreted by the system is abnormally large and that this is believed to be an effort on the part of nature to counteract the toxic effect of the germ, so that by adding phenol to the system we aid nature.
The theory of the destruction of the tubercle bacilli by direct contact with an antiseptic agent, has long seemed to be the logical treatment, but the great hindrance to carrying out this theory
* Sloane Laboratory, Yale University.
has been that sufficient amounts of the agent to be used to kill the tubercle bacilli would prove toxic to the individual. Dr. Edson considers the blood to be antiseptic. When reinforced by small amounts of aseptolin, its antagonistic power is sufficient, not only to counteract the effects of, but also to destroy the germs. The reports of cases treated by the new remedy are conservative but nevertheless encouraging, and aseptolin may yet fulfill the most sanguine hopes of the profession. We trust that time will prove the efficacy of aseptolin, and that at last a specific for phthisis has been found.
A Law was enacted by the Legislature of this State about one year ago, the aim of which was to eradicate bovine tuberculosis. Prior to the enactment of this law there was much discussion upon it and strong efforts were made by the agricultural portion of the State to secure its defeat. The law provides for the appointment of three commissioners whose duty it is to inspect the cattle of the State for tuberculosis, using tuberculin as a diagnostic agent when so permitted by the owners of cattle, and to destroy all animals found affected with the disease. The law has now been in operation about twelve months and it has been found that quite a large per cent of cattle are affected with tuberculosis. As it has been repeatedly proven that bovine tuberculosis is directly transmissible to man from meat, milk, or other ways, the importance of carrying out the above law becomes apparent to the general public and especially to the medical profession. The law can work no real hardship to the owners of cattle as it provides that the commissioners shall assess all animals at their market value before the tuberculin test is made.
We hope that the law may be allowed to remain upon the statute books and so enforced that in the years to come a case of tuberculosis among the cattle in this State will be hard to find. As the principal source of the transmission of the tubercle bacilli from animals to man is through milk, the importance of the recent suggestion that a sanitary milk laboratory be established in every city, cannot be overestimated. This plan is not entirely new, having been in operation for a considerable time in some of the larger cities of the country and meeting with very notable success in Boston, Mass. The object of an institution of this kind is, first, to provide pure, wholesome milk for general consumption; second, to provide pure milk, scientifically modified according to the directions of a physician to meet the needs of any particular case. Such establishments would be a great
benefit to a large proportion of the population of this State, or any other which might adopt this system, and the danger of the transmission of the tubercle bacilli through milk would be reduced to a minimum.
Although the danger of the disease being transmitted from animals to man is considerable, we know that the greatest danger is from the dried sputa of tuberculous patients and we would urge physicians to appeal to the better natures of their patients and warn them of the evils which may result from promiscuous expectoration. We think if the masses could be made to feel alive to the dangers of this uncleanly and unnecessary habit, it would go a long way toward preventing the mortality due to that dread disease-tuberculosis.
THE EARLY YEARS OF THE YALE MEDICAL
B. F. CORWIN.
The Yale Medical School was the sixth of its kind established in this country. The Medical Departments of Columbia College and of the University of Pennsylvania were each established in 1768; of Harvard in 1782; of Dartmouth in 1798; of the University of Maryland in 1808. Though the Yale Medical School was the sixth in the order of foundation, it is very doubtful whether any other medical school in the country was better or more favorably known at the expiration of the first fifteen years of its existence.
The idea of a Medical Department connected with Yale College seems to have originated largely with the first President Dwight soon after his inauguration, and, though the matter was actively agitated and brought before the Corporation, yet the undertaking remained latent for several years. Nothing of importance was done about it until the year 1810.
For the success of the new undertaking the consent and aid of the State Medical Society was an important consideration, because this Society had been in control of medical affairs in the State since 1792, in which year it had received a charter of incorporation from the Legislature. From that year it had received