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tion of the median nerve, so that ultimately the patient had almost perfect use of the arm and hand.
The writer has collected 34 cases from the literature of aneurism of the brachial artery. Twenty-five were caused by trauma, six were of unknown origin, and three originated spontaneously. Of the traumatic aneurisms nine originated through venous blood letting. In the treatment of brachial aneurism both the bloody, as well as the bloodless methods have been practiced. Six of the thirty-four cases reported were cured by compression. In one of them the compression lasted only three hours, and in another six hours.
In eight other cases, however, the compression method produced no result, and in one case it caused a rupture. Central ligation was practiced in fifteen cases. In eleven of these cases healing resulted. The operation of Antyllus was practiced four times with success. Extirpation according to the method of Philagrius-Purmann was practiced nine times with success. The value of the compression method is that it hastens the establishment of a collateral circulation. In general, however, extirpation seems to be the preferable method. The special dangers of the bloody operations are wound infection and hæmorrhage, but modern technique has removed these dangers. The objection to the methods in which the sac is not extirpated are two-fold: (1st) the length of time required for healing; (2nd) the pressure of the sac upon the nerves.
Injury of the brachial vein is of comparatively little importance because of the superficial collateral circulation. It is desirable if possible to retain the collateral branches of the brachial artery, though ligation above these branches is usually not followed by gangrene.
The writer advises a trial of the compression method in every instance in order that if nothing more be accomplished a collateral circulation will be developed. The writer considers extirpation of the aneurism to be absolutely indicated
(1) when there is extensive gangrene of the skin over the aneurism;
(2) in traumatic aneurism when there is also an injury of the median nerve, and
(3) when there is compression of the important branches of the nerve resulting in nervous or atrophic disturbances.
Complete extirpation of the aneurism is contra-indicated
(1) in very recent traumatic aneurisms; that is, in hæmatoma arteriale, since in these cases there is no aneurismal sac;
(2) when there is a severe infection of the wound which leads to the formation of the aneurism;
(3) when there is subcutaneous rupture of the sac.
In the last three classes of cases ligation with free incision after the method of Antyllus is the operation to be desired.
A. W. E.
Edited by Harry Seymour Pearse, M. D. Medical Legislation of 1900 of the State of New York. During the legislative session of 1900, there were introduced in the Senate eighty-one medical bills and seventeen amended numbers, making ninety-eight Senate bills in all; in the Assembly there were introduced 124 bills and 46 amended numbers, making 170 bills, making a total number for both houses of 268 bills. The Senate passed twenty-six and the Assembly thirty-seven bills.
During the session there have been a number of bills of great importance to the medical profession; for example, Senate bill No. 1025, known as the Ford Bill, which gave the New York State Medical Association a charter and permitted that medical body to prosecute and enforce the general medical laws of the State and collect fines for so doing. This bill was one of the utmost importance to the New York State Medical Society and was fought vigorously by that body and a compromise was reached in which it was agreed to strike out the clause relating to the medical laws and thereby leaving the statute as it is. In this form the bill passed.
There were bills relating to the practice of midwifery, chiropody, municipal health matters, standards of practice, changes in the medical laws, transfers of hospital property and indeed bills relating to almost every phase of medical and public health matters.
The bill which has probably aroused the most wide-spread interest was Senate bill No. 1141, introduced by Senator G. A. Davis of Buffalo, providing for the establishment of a State hospital in the Adirondacks for the treatment of incipient tuberculosis. This bill has become so familiar to the profession that it is unnecessary to go into the details at length. The bill originally called for an appropriation of $200,000 to build and furnish an institution to accommodate 200 patients. The bill was reported out of the Finance committee of the Senate with some amendments, among others the appropriation being cut down to $150,000. The bill then went to the Assembly where it was referred to the Ways and Means Committee. Late in the session, the bill not having been reported by this committee, it went into the Committee on Rules where it seemed likely to slumber and sleep. Much effort was expended and at last the committee reported the bill out, cutting the appropriation down to $50,000, but making no other amendments. The bill was again passed by the Senate and sent to the Governor who soon signed it and has already appointed the board of trustees.
Thus, after three years of hard struggle, the medical profession has succeeded in putting the State of New York in the front rank of advancing medical knowledge. With Massachusetts she now joins hands and marches forward in the way of truth and enlightenment. The one lonely outcast, the consumptive, who for years has occupied the melancholy position of being the only human creature, who, sick and discouraged, being turned out or refused admission in the hospitals of the State or municipality, had absolutely no place to go; and year after year 14,000 of these poor creatures passed into the great unknown and each year others took their places in the advancing army of disease. Although advanced medical science had proved that in the incipient stage sixty-five per cent of the cases could be cured and damage from infection lessened, it remained for the Legislature of 1900 to take the step which shall carry to the heart of the poor sufferer a throb of hope. The Chief Executive has done nothing in his Gubernatorial career which reflects greater credit upon his good judgment or will carry with it greater personal satisfaction.
ARTHUR G. Root.
Important Bills in the New York Legislature.*
POSITION OF MEDICAL BILLS AT CLOSE OF SE N OF THE NEW
YORK STATE LEGISLATURE. † Assembly Bill No. 150.
Left in committee. Assembly Bill No. 429. Senate bill substituted. Assembly Bill No. 435. Left in committee. Assembly Bill No. 613. Third reading March ist. Assembly Bill No. 818 (1128). Hearing before Governor
April 4th. Assembly Bill No. 846. Third reading March 14th. Assembly Bill No. 847. Third reading March 2 ist. Assembly Bill No. 589. Sent to the city clerk April 6th. Assembly Bill No. 629. Left in committee. Assembly Bills Nos. 636 and 637. Left in committee. Assembly Bill No. 904 (1614). Hearing before Governor
April 5th. Assembly Bill No. 1010 (163, 853). Sent to Senate Feb
ruary 2 Ist. Assembly Bill No. 721 (1945). Hearing before Governor
(423). Passed Assembly, February 22nd, and sent to Senate. Assembly Bill No. 1058. Hearing before Governor April
gth. Assembly Bill No. 1153. Passed Assembly March 22nd;
sent to Senate. Assembly Bill No. 1229. Third reading March 7th. Assembly Bill No. 1262. Sent to Senate March 21st. Assembly Bill No. 1338. Left in committee. Assembly Bill No. 1509. Second reading March 22nd. Assembly Bill No. 1562. Hearing before Governor April
gth. Assembly Bill No. 1581. Left in committee. Assembly Bills Nos. 1439 and 1496. Left in committee. Assembly Bill No. 1705. Hearing before Governor April
• By courtesy of the Committee on Legislation of the Medical Society of the State of New York.
For titles see ALBANY MEDICAL ANNALS of February, March and April, 1900.
Assembly Bill No. 1840 (993). Third reading March 13th.
Left in committee.
March 2 ist.
March 2 ist.
Allds Bill reported.
Recommitted March 26th. Senate Bill No. 1445 (2158, 1562). Hearing before Gov
ernor April 9th. Senate Bill No. 1407 (904, 1614). Hearing before Gov
ernor April 5th.
JAMES E. BRENNAN, M. D.
Dr. James E. Brennan (A. M. C., 1889), died suddenly at Mechanicville, N. Y., March 23, 1900. Dr. Brennan was well known to the younger graduates of the Albany Medical College as one of the most successful students.
He was regarded as the leading member in the class of 1889, and received the Nellis prize for the student passing the best senior examination, his graduating thesis was accorded first mention, and he secured on competitive examination, the first appointment to the staff of the Albany Hospital. This success represented most diligent application to his studies and hard work, which resulted in a physical break-down during his interne service in the Hospital. He was left with a shattered constitution, which lasted throughout the succeeding ten years. There were periods of temporary improvement of short duration, which permitted attempts at practice, his last