"The records of the Union's work passing under the consideration of the council show, as would be expected having regard to its largely augmented membership, that the number of cases actually dealt with by the council in the past year on behalf of its members is in excess of that hitherto attained in any previous year of the Union's work; but the mere intimation from the general secretary, when conveyed to the source from which threat of action proceeds, that the Union is prepared to assume the defence of its members has, in itself, caused a very large proportion of the actions threatened entirely to collapse without any steps whatever being taken. From this it follows that the majority of the cases which it has been found necessary to place in my hands have proved more or less of a solid character." The report then goes on to say that every case tried during the year was won by the Union. The officers of the new corporation are: President, Dr. James H. Dunn, Minneapolis. First Vice President, Dr. Thomas McDavitt, St. Paul. Second Vice President, Dr. Stuart Bates, Virginia, Minn. Secretary and Treasurer, Dr. D. B. Pritchard, Winona. In addition to the above the following gentlemen are on the board of directors: Dr. Charles A. Wheaton, St. Paul. We heartily commend the association to our readers and refer them to the secretary, who will forward application blanks to all who desire to become members. The great storm and destruction by ocean waves at Galveston on the 15th instant was the worst disaster by such influences occurring within the history of the United States. More than six thousand persons are known to have perished, and property estimated by hundreds of millions was destroyed within the space of a day. Galveston will be likely to feel the effects of this loss much longer than if suffered from fire, as capitalists will be slow to invest unless the government comes to the aid of the stricken city by building a sea wall sufficient to guard against a similar cataclysm. And Texas is again, on the 21st instant, a great sufferer from a destructive rain storm in the northern portion of the state, flooding the cotton crops, the loss of which, it is estimated, will reach several millions in money valuation. Surely the grand old state of Texas has its cup of sadness filled to the brim this year. VACCINATION IN PORTO RICO. The health authorities in Porto Rico seem to be alive to their duties. Eighteen months ago there were known to be 3,000 cases of smallpox on the island. In the past eight months not a single death from the disease has been reported. The board of health has a record of 800,000 persons who have been vaccinated and to this extensive use of vaccination is attributed the stamping out of the disease. Communities. with more pretensions to scientific enlightenment would do well to take a leaf from the book of the Porto Ricans. WIRELESS TELEPHONE. At the meeting of the British Association for the Advancement of Science, held in Bradford, England, Sept. 8th, Sir William Henry Preece announced that he had found it possible to convey audible speech six to eight miles across the sea without wires. He has devised apparatus which makes it practical in commerce and it will no doubt supersede the megaphone and speaking trumpet in communicating between ships and between ships and the shore. SPEECH. Talk happiness. The world is sad enough. Talk faith. The world is better off true. Reports of Societies. MISSISSIPPI VALLEY MEDICAL ASSOCIATION. The greatest body of medical men on the western continent, excepting the American Medical Association, will meet in the city of Asheville, N. C., October 9, 10 and 11, with the following programme: I. N. Love, St. Louis, Mo., address in Medicine. C. A. Wheaton, St. Paul, Minn., address in Surgery. L. W. Beardsley, St. Louis, Mo., Canthoplasty in Ophthalmic Practice. Andrew Timberman, Columbus, O., the Etiologic Relation of Eye-Strain to Epilepsy. Otto J. Stein, Chicago, Ill., Middle Ear Disease in its Relationship to the Cranial Cavity. George F. Keiper, Lafayette, Ind., Some Observations Gleaned from Some Recent Cases of Mastoiditis. Alex C. Wiener, Chicago, Ill., Treatment of Tuberculosis of the Spine. A. J. Ochsner, Chicago, Ill., Relation of Appendicitis to Gall Stones. B. Brindley Eads, Chicago, Ill., Ventral Hernia Following Laparotomy. George W. Crile, Cleveland, O., Technic for Removal of Tumors of the Neck. George W. Cale, Jr., Springfield, Mo., A Case of Intermittent Hydrops of the Knee. James B. Bullitt, Louisville, Ky., Hernia in Man and Animals. Thomas H. Manley, New York City, Notes on Fractures Contiguous with or Involving the Articulations of the Larger Bone Shafts. John L. Jelks, Memphis, Tenn., The Treatment of Peri-Rectal Abscesses. Sterling B. Taylor, Columbus, O., Obstipation. J. Rawson Pennington, Chicago, Ill., Simple Operation for Hemorrhoids; Enucleation. A. B. Cooke, Nashville, Tenn., Revelations of the Proctoscope in Health and Disease. H. O. Walker, Detroit, Mich., Vaginal versus Abdominal Hysterectomy. R. S. Sutton, Pittsburg, Pa., Cancer of the Uterus and Its Treatment. C. S. Bacon, Chicago, Ill., The Prevention and Management of Infection of the Breast During Lactation. J. H. Taylor, Indianapolis, Ind., The Girl at Twelve. Yeatman Wardlow, Columbus, O., Ectopic Gestation. Emil Ries, Chicago, Ill., Pathology of Chronic Gonorrhea of Male Sexual Organs. A. Ravogli, Cincinnati, O., The Gonococci in the Gonorrheal Secretions. R. A. Bate, Louisville, Ky., Asthma. T. D. Crothers, Hartford, Conn., The Curability of Inebriety by Medical Treatment. Wm. O'Neal Mendenhall, Richmond, Ind., The Determination of Sex. Frank P. Norbury, Jacksonville, Ill., Pulmonary Tuberculosis in Infancy and Childhood. W. H. Bates, New York, N. Y., Further Observations on the Clinical Application of the Suprarenal Capsule. Albert E. Sterne, Indianapolis, Ind., The Association of Diseases. Wm. Porter, St. Louis, Mo., The Growing Necessity for Sanatoria for the Tubercular. I. H. Goss, Athens, Ga., Erichsen's Disease: Does It Exist? Various Injuries Due to Accident. William F. Barclay, Pittsburg, Pa., The Philosophy of the Science and Art of Medicine. J. E. Allaben, Rockford, Ill., Treatment of Adherent Cysts of the Ovary and Broad Ligament by Incision and Drainage. L. H. Warner, Brooklyn, N. Y., Differential Leucocytosis. J. G. Carpenter, Stanford, Ky., Suprapubic Cystotomy for Traumatism, with Median Perineal Drainage. THE TRI-STATE MEDICAL SOCIETY OF ALABAMA, GEORGIA AND TENNESSEE. The Twelfth annual meeting of this society will be held in Chattanooga, Thursday, Friday and Saturday, October 11th, 12th and 13th, 1900, just following the meeting of the Mississippi Valley Association at Asheville. Those desiring to attend should ask for tickets to the reunion of the Army of the Cumberland and the Spanish-American War Veterans. A rate of one fare for the round trip has been granted by the South-Eastern Passenger Association and the same rate will probably be granted by the other Passenger Associations which have not as yet taken the matter up. Those desiring to read papers should send titles to the secretary, Dr. Frank Trester Smith, Chattanooga. PARTIAL LIST OF PAPERS. President's address, "The Relation of the Profession to the Public," R. R. Kime, Atlanta, Ga. "The Therapeutic Effect of Iodine Demonstrated by Physiological Action and Pathological Demonstration," L. H. Warner, Brooklyn, N. Y. "Tuberculosis in Private Practice," J. B. Murfree, Murfreesboro, Tenn. "The Home Treatment of Tuberculosis," William Porter, St. Louis, Mo. "Simple Inflammation of the Eye," E. H. Jones, Murfreesboro, Tenn. "Tolerance, Suggestion and Other Odd Features in Eye Strain," Ross P. Cox, Rome, Ga. "Relation of the Mastoid Process to the "Demonstration of the Rectal Valves with Observations on their Pathology," A. B. Cooke, Nashville, Tenn. "Some Anatomic and Histologic Points in the Colon and Rectum of Interest to the Surgeon," J. Rawson Pennington, Chicago. "Continued Malarial Fever," E. O. Williamson, Gurley, Ala. "The Appendix-The Abdominal Death Trap," B. Brindley Eads, Chicago. "Xeroderma Pigmentosa," J. R. Gillespie, Dayton, Tenn. "An Epidemic of LaGrippe," R. H. Tatum, Chickamauga, Ga. "Rheumatism and Osteo Arthritic Conditions of the Feet, Knee and Spine," Michael Hoke, Atlanta, Ga. "The Use of Serums and Animal Extracts as Medicinal Agents," P. L. Cortelyou, Marietta, Ga. "Delirium; Its Differential Diagnosis and Significance," Frank Parsons Norbury, Jacksonville, Ill. R. E. Fort, Nashville, Tenn. W. Frank Glenn, Nashville, Tenn. "Diabetes Mellitus," R. Alexander Bate, Louisville, Ky. "Suprapubic Cystotomy for Traumatism with Median Perineal Drainage," J. G. Carpenter, Stanford, Ky. "Use and Abuse of Nasal Sprays," Dunbar Roy, Atlanta, Ga. "Twenty-two Operations for Mastoiditis," J. M. Crawford, Atlanta, Ga. "The Value of Blood Examinations in General Medicine," Claude A. Smith, Atlanta, Ga. "A Device for the Relief of Bladder Spasm in the Treatment of Cystitis," G. H. Noble, At lanta, Ga. Bernard Wolff, J. G. Earnest, J. B. S. Holmes, Wm. P. Nicholson, Willis F. Westmoreland, W. S. Elkin, S. G. C. Pickney, Atlanta, Ga. "The Etiologic Relation of Eye Strain to Epilepsy," Otto G. Stein, Chicago. "Early Menstruation and Pregnancy," J. T. Kirkpatrick, Tunnel Hill, Ga. "Dilatation of the Stomach," H. Berlin, Chattanooga, Tenn. "Papilloma of the Vocal Cords; Report of Five Cases," W. L. Bullard, Columbus, Ga. "Presentation of Case of Papilloma of the Vocal Cords," Frank Trester Smith, Chattanooga. "Puerperal Infection," J. C. Wilson, Rockwood, Tenn. "Old Time Remedies," Y. L. Abernathy, Hill City, Tenn. "Report of a Unique Gynaecological Case; Its Treatment and Recovery," Jchn E. Jelks, Memphis, Tenn. The time for holding the meeting of the American Public Health Association at Indianapolis has been changed to October 22-26, 1900, the section on bacteriology and chemistry meeting on Monday, the 22nd, the full association opening on the following day. During the past year, the women of Syracuse University, College of Medicine, have organized Zeta Phi. They esteem it an honor that Dr. Elizatbeth Blackwell has consented to become a charter member, she having been graduated from this college and the first woman to receive the degree of M. D. in America. The purpose of the fraternity is to bring the women of the medical profession into closer touch with one another. Communications. NORTHWESTERN UNIVERSITY MED ICAL SCHOOL. To the Editors of The Medical Dial: Dear Doctors: I wish to call attention to the fact that Dr. John B. Murphy has accepted a professorship in Surgery and Clinical Surgery in the Northwestern University Medical School Chicago Medical College. Dr. Murphy has been appointed surgeon-in-chief of Mercy Hospital with the direction of the surgical teaching in that hospital.. He will give two clinics each week at the hospital. The hospital now contains 260 beds with abundance of clinical material. A new amphitheatre with a seating capacity of 300 is in process of construction. Dr. Archibald Church has been recently appointed Professor of Nervous and Mental Diseases and head of the Neurological DepartVery truly yours, ment. N. S. Davis, Jr., A. M., M. D. Secretary. ANNOUNCEMENT. To the Editors of the Medical Dial: Dear Doctors: About September 25th we shall have ready "The American Illustrated Medical Dictionary," by W. A. N. Dorland, editor of "The American Pocket Medical Dictionary." This is an entirely new and unique work for students and practitioners. It contains more than twice the matter in the ordinary students' dictionary, and yet, by the use of clear, condensed type and thin paper of the finest quality, it forms an extremely handy volume only one and onehalf inches thick. It is a beautiful specimen of the book-maker's art. It is bound in flexible leather, and is just the kind of a book that a man will want to keep on his desk for constant reference. It is absolutely up-to-date, containing hundreds of important new terms not to be found in any other dictionary. It is also extremely rich in the matter of tables, containing over one hundred original ones, including new tables of Stains and Staining methods, Tests, etc., etc. An important feature of the book is its handsome illustrations and colored plates drawn especially for the work, including new colored plates of Arteries, Muscles, Nerves, Veins, Bacteria, Blood, etc., etc.-twenty-four in all. This new work has been aptly termed by a competent critic, "The New Standard." We shall also have ready in a few days the following: NEW BOOKS. "Modern Medicine," by Drs. J. L. Salinger and F. J. Kalteyer, of Jefferson Medical College, Philadelphia. Price, $4.00 net. "Rhinology, Laryngology, and Otology, and their Significance in General Medicine," by Dr. E. P. Friedrich, of the University of Leipsig, and Dr. H. Holbrook Curtis, of New York. Price, $2.50 net. "A Text-Book of Histology," by Drs. Bohm and Davidoff, of Munich, and Dr. G. Carl Huber, of Ann Arbor, Michigan. Ready in October. "Essentials of Histology," by Dr. Louis Leroy, of Vanderbilt University. Price, $1.00 net. "Surgical Technic for Nurses," by Emily A. M. Stoney, author of "Stoney's Nursing." NEW EDITIONS: "Anders' Practice of Medicine," 4th edition. Price, $5.50 net. "McFarland's Bacteriology," 3rd edition, revised and enlarged. Price, $3.25 net. "Hyde & Montgomery's Venereal Diseases,' new enlarged edition. Price, $4.00 net. "American Text-Book of Physiology," 2nd edi tion revised, in two volumes. Vol. I now ready. Price, $3.00 net per volume. "Saunders' Pocket Formulary," 6th edition, in creased in size by over 200 formulæ. Price, $2.00 net. "Garrigues' Diseases of Women," 3rd edition. A MOST REMARBABLE OPERATION IN THE SEPARATION OF THE SOUTH AMERICAN FREAKS. In Volume 1, No. 12 (Nov., 1899), of The Medical Dial, there appeared an article copied from the Scientific American, under the caption: A bold "Xiphopages, or Human Doubles." hand was recently applied by Dr. Chapot, Prevost, a distinguished surgeon of Brazil, in the separation of the little girls, known as "Sisters Rosalina and Maria." A letter from a correspondent of the Medical Record (July 31, 1900) from Brazil, fully describes this intensely interesting operation as follows: Sao Joao del Rei, June 7, 1900. The medical world of Brazil was startled by the announcement that on the 30th ult., in the operating room of the hospital of St. Sebastian, in Rio de Janeiro, Dr. Chapot, Prevost, one of Brazil's most distinguished physicians, had separated the eight-year-old twins, Rosalina and Maria, who had been the subject of much medical discussion during the past year, an operation that will mark an epoch in the annals of surgery. These twins were born of poor parents in the state of Espirito Santo, Brazil, and were brought to Rio about a year ago. They were not united by a single band as were the Siamese twins, but their abdominal cavities were connected by a large opening, practically forming one cavity, their bodies being intimately attached, as will be seen by the accompanying illustration. And as it afterward proved, the thoracic cavities were also implicated. The following brief and incomplete account of the operation and history of the case up to the present may be of interest to the readers of the Medical Record. On June 23d of last year one of the leading Rio physicians made an exploratory opening, but finding the livers of the two girls so united as to form practically one liver he decided to go no further. Dr. Chapot then hearing of the case began a series of experiments to test the recuperative power of the liver, and the best means of controlling hemorrhage in this organ. Among others, he cut away a large part of a dog's liver, and in eight days it had almost reproduced itself. From these experiments he became convinced that this organ would bear a great deal of surgical interference, and he accepted the case. Since last October the twins have been in this hospital under his care, and he has made a very careful study of the case from all points of view -anatomical, physiological and psychological. He had several x-ray photographs taken, and thus ascertained that the livers were united in nearly their whole extent. While under his observation Rosalina had an attack of grippe, which lasted eight days, with a temperature on the third day of 40.2° C., with corresponding pulse and respiration, while Maria remained perfectly well. This confirmed him in his opinion that there were no psychological conditions to forbid their separation. Having completed his studies and preparations he called a council of his colleagues who were to assist him, and explained to them his plans, and at 6 a. m. on the 30th ult. they assembled at the hospital to make the final preparations. Everything had been arranged with a view to the most perfect asepsis. The attendants, after taking a full disinfecting bath, dressed in new clothing thoroughly sterilized, and before entering the operating room washed their hands and arms in six disinfecting solutions. Before the operation the girls were given clysters of 500 gm. of artificial serum, and their bodies thoroughly washed, first with soap and water, then with sublimate solution, and finally with sulphuric ether, after which they were wrapped in sterilized cotton covered with gauze. They were then placed upon a table especially prepared, which could be easily unjointed to operator placed a pair of pinces de Pean upon either side of this connecting bridge preparatory to separating it. This was one of the most intensely exciting moments during the whole operation, for by the severing of the anastomosing branch of the two mammary arteries the field of operation was deluged with blood. The points were quickly seized and the hemorrhage controlled, but one of his more fearful assistants inquired, "Doctor, will you still separate them?" He simply replied, "Separo" ("I will separate"), and cut through the imprisoned tissue, and sutured the cut edges of each sac with catgut. Now, it was discovered that the pleura of Maria also extended across the line of union. ever, before undertaking the task of correcting this it was thought best to attend to the mesenteric bridge, as its position made it easy for the intestines of one to pass to the cavity of the other. This was prevented by ligating it with silk at two points and cutting between them and How make two, Rosalina lying upon her left side and Maria upon her right side, the cicatrix of the former operation showing upon the top. The giving of the chloroform began at 9:15 a. m., and after slight resistance on the part of both they were soon under its influence, and at 9:45 the first incision was made. This extended from the naval upward, having its middle at the ensiform cartilage, being closer to the false ribs of the right side of Maria. Turning back the flap toward Rosalina's side, the anterior superior surface of the liver was seen. This occupied twothirds of the connecting space and formed a bridge between the two cavities. Below this was discovered another connecting bridge formed by the union of the two mesenteries. After having cut through the cartilage in the median line another bridge was discovered. This was formed by the union of the two pericardial sacs, 2 cm. in extent, through which the fluid could easily be seen passing from one sac to the other owing to the uneven beating of the two hearts. The Fig. 2. The Sisters Rosalina and Maria. returning the contents of each cavity to their proper place. He then returned to the remaining difficulty in the thoracic cavity. This was overcome by cutting upon the internal face of the half of the cartilage yet united, detaching the parietal pleura, and uniting it with a fine catgut suture to the median fold which adhered to the pericardial bridge. Having thus completed the separation of the internal parts of the thorax, he then cut through the skin and cartilage on the other side, opposite to the first incision, leaving only the liver to be separated. This he accomplished in such a way as to give to each an uninjured gall bladder and duct. The final cut having been made at 10:50, and the table separated, he turned over Rosalina to two assistants, while he continued to care for Maria, who had suffered most from the operation. However, he had to suspend his work of closing up her wound to retie a ligature that had slipped from one of the hepatic vessels of Rosa lina. |