TH

HE 8th annual meeting of the Military Tract Medical Association convened pursuant to adjournment at Kewanee, July 14th. The meeting was held in the Presbyterian church. Although hardly the usual number of members were present, the reports from the several committees were full, and the time did not permit all the papers to be read. The valedictory address of M. A. McClelland, of Knoxville, the retiring. President," Medicine-Past and Present," was distributed among the Association in pamphlet form. Wm. Hamilton, of Galesburg, was elected President for the ensuing year; A. C. Babcock, of Galva, and J. F. McCutcheon, of Norwood, as first and second Vice Presidents; Herbert Judd, of Galesburg, as Secretary and Treasurer. Dr. Nance, of Kewanee, presented several cases under surgical treatment, and also read a paper upon skin diseases. This paper was accepted with a vote of thanks from the Association, and referred for publication.

Dr. McCutcheon gave a written and verbal report of cases under treatment. For the want of time this report did not receive the discussion it seemed to require.

Dr. Scott, of Galesburg, sent a report as Chairman of the Committee on Obstetrics and Diseases of Women. This paper, read by the Secretary,

was received by a vote of thanks. Accompanying Dr. Scott's paper was a report sent him of the Scalf case, prepared by Dr. J. T. Stewart, of Peoria. This report was very much to the favor of Dr. Lucas, the attending physician in this case, and was also written in a manner to criminate Dr. Skinner, of Peoria, the consulting physician in this case. The paper from Dr. Stewart was read by the Secretary, and as the members present wished to see fair play, Dr. Skinner, who was present, was requested to give his statement of the case, at the close of which, after a lengthy discussion, the following resolution was adopted:

WHEREAS, A report on Obstetrics and Diseases of Women has been sent into our Society, to be read by one of our number, and at the close of said report an attempt has been made to make public a case not within the jurisdiction of our Society relating to this branch of medicine; therefore, We, the members of the Military Tract Medical Association, assembled at Kewanee, this 14th day of July, 1874, do most seriously deplore the course taken by a number of our profession of Peoria in sending such statements to the Chairman of Committee on Obstetrics, and we hereby request of said Chairman an explanation of the reasons which prompted his action in the premises.

Prof. A. D. Williams, of St. Louis, who had been invited to be present by Dr. L. S. Lambert, of Galesburg, was made an honorary member of the Association. Also, at the request of

the Association, Prof. Williams gave a short report from his branch of the profession, and also gave the history of a few cases. This report was received by the Association with a vote of thanks and referred for publication, Other reports which had been prepared were not presented, for want of time.

After the appointment of the several committees to report at the Jan

uary meeting, and the usual miscellaneous business, the Association adjourned, to meet at Galva on the second Tuesday in January next.

At the next meeting of this Association action will be taken to have but one meeting each year, with two or more days session. This Association has over one hundred active members, and one day is too short a time to meet the present requirements.

THE

Reported by Will. T.

HE Society met as usual in the parlor of the Galt House, the President in the chair. In the absence of the Secretary, Dr. Graham was elected Secretary pro tem.

Dr. A. B. Strong read a paper on the Pulsation of the Foetal Heart, Dr. D. A. K. Steele presenting a supplementary report. On motion, it was agreed that both papers be published in full in the report of the Society.

Dr. C. M. Fitch said he had made eleven examinations with a view to determine sex, and that he had predicted correctly in nine cases. When the pulsations were over 140 per minute, he predicted the birth of a female child; when under 130, that of a male infant. A rate between these numbers he concluded insufficient as a basis upon which to form a conclusion. He thought a stethoscope with a metallic bell preferable in these examinations. Dr. Paoli could not see any practical importance in determining the sex of the fœtus.

Montgomery, M.D.

He was not aware that the sex made any difference with regard to preparing clothing, etc. He could see how it might be of importance to crowned heads to know the sex before birth, in that they might be prepared to celebrate the birth of prince or princess, as the case might be. Dr. Bridge said that while the determining of sex may not be of practical importance, the facts which may be gained in reference to the health and presentation of the child and the condition of the placenta are of much importance.

Dr. T. D. Fitch-We may very well say that these investigations are of no practical interest, but they are of much scientific interest. He did not think it practically important to determine before birth the condition of the child or placenta, as the physician should be prepared for any emergency that might arise.

Dr. Seely-It may not be necessary to determine the sex before

birth, but if we are able to do this we may thus gain the confidence of our patient, which is often an acquisition of great importance.

Dr. Montgomery had made examinations in a number of cases with reference to determining sex, and was generally correct in predicting the birth of a female child when the pulsations were over 130, and that of a male child when they were under 130.

Dr. Strong said that in the first eight cases which he had examined he was correct in predicting the sex, and he thought a greater number of cases were required if we wished to aim at conclusions of value. He referred to a case of contracted pelvis, reported by Dr. Wilson, in which the determining of sex in utero was of practical importance. Dr. Steele thought the determining of sex in utero might be of value in a medico-legal point of view.

Dr. Van Buren wished to know if there is any truth in the theory that gestations of mothers carrying male children are longer than those carrying female? He also wished to know what effect protracted labors have upon the foetal pulsations? Dr. C. M. Fitch had seen a child delivered after a protracted labor of forty hours. The child proved to be idiotic and he thought this was the result of the long continued pressure. Dr. Stillians had seen a similar case, and thought the injurious effect of continued pressure was an argument against the use of ergot. Dr. T. D. Fitch said, in reference to the length of gestations, he had observed that those of mothers carrying

male children were longest, and if gestation was prolonged beyond term he was generally correct in predicting the birth of a boy. Dr. Quine did not know that much reliance could be placed on the duration of gestation. He had made a number of observations in reference to determining sex by auscultation, and had usually been correct. The position could not be so readily determined by this as by external manipulations. He thought inflammation of the placenta could be ascertained by repeated auscultations.

Dr. Bartlett-An exceedingly slow pulse, as low as seventy or eighty, is very unfavorable to the child, and when it is observed, delivery should. be effected as soon as possible. He had been summoned within the last week to attend a lady five miles distant, and when he arrived at the house he learned that she merely desired information as to the sex of her future child.

Dr. Foster did not believe the duration of gestation was a decided indication as to sex. He had recently attended a lady on the 285th day of gestation and delivered her of a female infant.

Dr. Bridge gave an explanation of the marked influence the contractions of the uterus exert over the foetal

pulsations. pulsations. He thought the great diminution in the number of pulsations at the moment of greatest contraction was due to the interruption of the circulation, so that the blood in the placenta and fœtus became noxious from nonæration. The Society then adjourned.

No. XVI.

VOL. XV.

THE

tain proportion of cases, we may determine with some degree of accuracy the sex of the child in utero by auscultation, has long been established. It is claimed that the pulse of the female foetus is uniformly much faster than that of the male, one observer establishing a difference between them of fifteen or twenty pulsations per minute. It is also claimed that the presentation may be actually determined by noting the point at which these sounds are most distinctly audible.

Some writers have been very enthusiastic in defence of the opinions founded upon their observations. Frankenhauser, for example, gravely asserts (British Med. Jour., Aug. 6, '73), that in fifty cases which he examined, his diagnosis was in every

instance correct.

Other writers, more conscientious, perhaps, or less careful, have declared that their observations have proved comparatively worthless. In an article on Fœtal Physical Diagnosis, by Frank C. Wilson, M.D., visiting physician to the Louisville City Hospital (Amer. Practitioner, Dec., 1873), the writer says he has "kept accurate notes of all the cases met in hospital or private practice, diagnosing the sex in each, failing only in nine cases out of 109." The average pulse of the males was 125; of the females, 143; 134 being the average of both sexes and constituting a sort of dividing line between. them. In Dr. Cumming's forty-one cases, the average pulse of the males was 131; of the females, 145; of both sexes, 136.

In reviewing the literature of this

subject, which is exceedingly scanty, we have been much surprised to observe that conclusions similar to those given above are so radically different from our own. On the 1st of February last, we commenced a series of observations, in order to ascertain in what percentage of cases, predictions as to sex could be verified, and have each kept a careful record of fifty separate cases in which observations have been made since that date. Other interesting facts have been noted, which are also subjoined, as concisely as possible in the preparation of a detailed statement. From these it will appear that the disparity between the pulse of the male and the female infant is not as great as that established by other observers, and that, as a consequence, the ability to predict the sex of the foetus in utero is far from flattering. The statistics we present are of such a character, that those disposed to do so may draw from them their own conclusionsa privilege we do not find accorded by those whose observations have been quoted. The weight of most of the children whose fœtal pulse was registered, was also determined, with a view to establishing a relation between the vigor of the individual and the rapidity of the pulse. But we do not find ourselves justified in establishing any connection between them.

The stethoscope was found preferable to the unaided human ear in noting the cardiac pulsations, since the latter are limited to a space but two or three square inches in extent. It should be added that, for convenience, we divided the uterine tumor, by four imaginary right lines, into four equal parts, designated as the right and left upper, and the right and

left lower quarters. It is stated that if the heart pulsates in the lower half of the abdomen, the vertex presents; if in the upper, the breach is the presenting part; and, furthermore, that the occiput or coccyx will be on that side of the median line where the heart-sounds are most distinctly audible.

The

Two sounds can be heard in the abdomen of the pregnant female, apart from those which originate from the movement of the contents of the peristaltic intestine. These are the sound of the foetal heart, and the placental souffle, which is synchronous with the maternal pulse. latter is a loud blowing murmur, frequently of a musical character, and not at all constant, being plainly audible at one time and absent at another. It differs very materially from the heart-sounds, which are independent of the maternal circulation, and are short, sharp, clear and clicking, similar in character to the second sound of the adult heart. The foetal pulse is subject to the same variations as that of the adult, only in a much more marked degree. While the child is perfectly quiet the heart is tolerably uniform in its pulsations, but by the least movement the pulse is greatly accelerated, increasing thirty to forty beats in the minute. The cause being removed, this increase in the frequency of the pulse rapidly disappears. It is said that the heartsounds cannot always be heard in the living child. Such cases must be rare, especially in the last month of pregnancy, for we never have failed of detecting the pulse after a careful and, in some cases, prolonged examination. Frequently at the commencement of the observation the