THE Wayne County Medical Society elected the following officers at its recent annual meeting: President, Doctor Samuel Bell; vicepresident, Doctor Charles C. Yarbrough; secretary, Doctor Hugh Mulheron; treasurer, Doctor C. Henri Leonard; directors, Doctors Peter M. Campbell, Walter J. Cree, George G. Gordon, Nathan Jenks, and Wadsworth Warren. The annual address was delivered by the retiring president, Doctor John J. Mulheron, after which a banquet was served.

DOCTOR PRESLEY M. RIXEY will be appointed Surgeon-General of the Navy in December, 1901, at which time Doctor Van Reypen's incumbency of this office will expire. Doctor Rixey, who is now Medical Inspector in the Navy, was born in Virginia. In January, 1874, he was appointed Assistant Surgeon in the Navy, and in 1898, when Doctor Leonard Wood resigned the physiciancy of President McKinley's family to organize the Rough Riders, Doctor Rixey was selected to fill this position.

THE annual meeting of the Detroit Academy of Medicine was held Tuesday evening, October 8. The address of the occasion, "Thoughts Concerning Medical Progress," which was delivered by Doctor Arthur D. Holmes, is published in another department of this issue. The following officers were elected for the ensuing year: President, Doctor Arthur D. Holmes; vicepresident, Doctor Wadsworth Warren; secretary-treasurer, Doctor Harrison D. Jenks; director, Doctor Justin E. Emerson.

DOCTOR GARRIGUES offers the following as a possible explanation of the source of the gangrene which caused the death of President McKinley: "Bacillus emphysematosus is constantly found in the intestine, where it is not only harmless, but useful. In the vagina it becomes the cause of emphysematous vaginitis. If it enters the uterus of a puerpera, it gives rise to the dangerous tympania uteri, and sometimes the ominous septic emphysema. In general surgery it is the cause of one of the most dangerous wound diseases-acute septic gangrene. It is easy to imagine that in a body with lowered vitality, this bacillus wandered from the neighboring intestine to the tissues behind the stomach, where the gangrene was found."

RECENT PUBLICATIONS.

REVIEWS.

PHYSIOLOGICAL LABORATORY GUIDE.*

BOOK-STUDY Only of physiology belongs to the past. Laboratory work is an essential part of present-day medical education. The student now demonstrates to his own senses those facts which students of a few years ago received without question by word of mouth or from the printed page. In carrying on this work, however, especially in the classroom, some manual or guide is indispensable. The author of this work knows how much the average student is able to do within the allotted time, and also keenly understands how to make the student discover the facts for himself. His methods are incorporated in the plan of the book so that any one is able to profit by them. It is essentially a working guide-book

for the physiologic laboratory. Blank pages have been provided for the convenience of both student, in answering questions and problems, and the teacher, in inspecting the work. Altogether it is the handiest guide for this purpose that we have seen. A few errors have crept in in the publishing of the book which can easily be corrected in subsequent editions.

By A. W. Ives, M. D., Professor of Physiology, and Assistant to the Chair of Nervous Diseases in the Detroit College of Medicine; Visiting Neurologist to Saint Mary's Hospital, Detroit. The J. F. Hartz Company, Detroit, Michigan, 1901.

THIRTY-SECOND ANNUAL REPORT OF THE SECRETARY OF STATE ON THE REGISTRATION OF BIRTHS AND DEATHS, MARRIAGES AND DIVORCES, IN MICHIGAN FOR THE YEAR 1898.*

THIS report represents much work and should be expected to be of some practical use. Although thirty-one annual reports have been previously issued it is confessed that all were inexact and unreliable. This one, the first since the new law for the "registration of deaths in Michigan and requiring certificates of death," is considered reliable. Its value will be demonstrated only after more study.

*Edited by Cressy L. Wilbur, M. D., Chief of Division of Vital StaPublished by authority.

tistics.

MENTAL DISEASES.*

THE Scope of this volume is practically new territory in English medical literature. As suggested in an apt quotation, the author has had to rely only upon fragmental human experience, and yet he has been able to produce a classic work which is a credit not alone to himself but to the profession as well. The broad, sensible views he entertains are indicated in the following sentence concerning general treatment: "The first requisite in the treatment of any case of ordinary insanity is a good nurse; the second, a good cook; and the third, good air, with pleasant surroundings." A clear style, methodical arrangement of subject-matter, and elegant lithographic plates, illustrations and drawing contribute in the publishers' hands to effect a work of art.

* By Henry J. Berkley, M. D., Clinical Professor of Psychiatry in the Johns Hopkins University; Chief Visiting Physician to the City Insane Asylum, Baltimore. D. Appleton & Company, New York.

TWENTY-SEVENTH ANNUAL REPORT OF THE SECRETARY OF THE STATE BOARD OF HEALTH OF THE

. STATE OF MICHIGAN.*

PART I consists principally of the President's annual address and of the Secretary's official report. Part II is a documentary report of the chief meteorologic conditions in Michigan in 1898, and of the various communicable diseases, including a statistical study of them. This work represents the labor of a busy office.

*Published by authority. Robert Smith Printing Company, State Printers and Binders, Lansing, Michigan.

THE DEPARTMENT OF GYNECOLOGY AND OBSTETRICS IN A UNIVERSITY MEDICAL SCHOOL.*

BY REUBEN PETERSON, A. B., M. D., ANN ARBOR, MICHIGAN.

PROFESSOR OF GYNECOLOGY AND OBSTETRICS IN THE UNIVERSITY OF MICHIGAN.

(PUBLISHED IN The Physician and Surgeon EXCLUSIVELY]

I HAVE chosen for the subject of my address a theme which can hardly fail to be of interest to such an audience as it is my privilege to appear before today. It is, "The Department of Gynecology and Obstetrics in a University Medical School."

Whenever a comparative stranger is called to an institution such as ours, a natural curiosity will always exist as to his proposed plan of campaign. And, if he be in earnest and filled with his subject, he will be only too eager to gratify this curiosity.

The present incumbent of the chair of Gynecology and Obstetrics in the Medical Department of this great University is fully cognizant of the honor conferred upon him by the choice of the faculty, and realizes clearly the arduous task which lies before him, if he hopes to equal the good work of his predecessors-SAGER, DUNSTER, MARTIN-each and all of them able. and conscientious men who gave up the best part of their lives to their beloved University. Long may she honor them for their good work.

Nor can I allow this occasion to pass without publicly expressing my regard and appreciation of the gentleman I have succeeded, PROFESSOR J. N. MARTIN. Many of you know him personally, and can testify to his rare gifts as a teacher, his skill as a bold and conscientious surgeon, and

* Address delivered at the opening exercises of the Medical Department of the University of Michigan, September 24, 1901.

his kindliness to his pupils. I know that you will join with me in the prayer that he be soon restored to health.

At this, the beginning of the twentieth century, it may be well to look backwards and consider the position of Gynecology and Obstetrics in our medical schools fifty years ago. More than once, during the last five years, have I heard the complaint from the student that he had not been afforded sufficient opportunities of perfecting himself in the bimanual examination of the female generative organs, or that he did not feel competent upon graduation to conduct a normal case of labor, since he had seen only two or three cases of confinement, and that most of his knowledge was theoretical. It is true that from the very nature of things it will always be a difficult problem to furnish abundant obstetric and gynecologic material to the student. No matter with what delicacy the examination of the female patient may be conducted, the natural modesty of the sex, causing them to shrink from such examinations, ever stands in the way of our supply of material. Even in the large medical centers this same difficulty has to be overcome, and the greatest care exercised, and the number of examinations of each patient strictly limited, else the patient will seek some clinic to which the students are not adınitted.

But what were the conditions fifty years ago? Certainly not so much complaint then as now, because it was not considered necessary or the proper thing to thoroughly examine a woman's pelvis.

In PROFESSOR CHARLES D. MEIGS'S "Textbook on the Diseases of Women" (published some fifty years ago), we find a case reported at some length which accurately portrays the attitude of the teacher of gynecology at that time. He speaks of being called to a young woman of about twenty, who was flooding profusely. He graphically describes how he sat by her bed all through the night administering sulphuric acid and other remedies to relieve the hemorrhage, which was of such a severe nature as to render the patient unconscious at times. He reassured her mother, saying that when the time came he could stop the hemorrhage at will. Finally the patient's condition became so alarming that he was obliged to pack the vagina to control the hemorrhage. Commenting upon the case, he says that the delay was for the purpose of saving her the mortification of the touch (touch being in italics), and that he would act in a similar manner in another case of the same nature. Not one word to the class about what caused the hemorrhage. Evidently the diagnosis was never made. Simply the case was related in order to impress upon their minds the necessity of refraining from vaginal examination as long as possible. Yet PROFESSOR MEIGS was an authority on the subjects upon which he lectured. DOCTOR MARCY, of Boston, in a recent paper, states that in his student days (1864) he was taught to "make a small hole in a sheet placed over the patient and through this to examine, and, if thought necessary, to thrust in the long cylindrical speculum, in the almost futile hope of

adding to his knowledge." Even as late as 1869 he was obliged to seek in Germany opportunities for physical examinations nowhere permitted in America.

With this kind of instruction it is not strange that very little progress was made in the knowledge of pelvic pathology. We must remember that in spite of the pioneer work of such men as MCDOWELL, and the two ATLEES, up to 1851 there had been but twenty-seven cases of ovariotomy in this country, and only two hundred and eighty-eight cases in the whole world. The operation was looked upon with disfavor by surgeons and those who lectured upon diseases of women. MEIGS, in his book published in 1848, condemns the operation very emphatically. Although the number of cases of ovariotomy showed a marked increase in the decade from 1860 to 1870, the operation was slow in being established as a justifiable surgical procedure, although with or without tapping the outcome of the disease was invariably fatal, unless relief came through the use of the knife. In Bedford's "Textbook on the Diseases of Women and Children" (published in 1870), we find a mere passing mention of the surgical treatment of ovariotomy, but stress is laid upon the good effects of ointments and internal medication. He concludes the clinical consideration of a case of ovarian tumor as follows: "I might mention a favorite practice, in these cases, of DOCTOR HAMILTON, said to have been successful in his hands, and, indeed, I think I myself have recognized good results from it. It consists of patting the tumor with the ends of the fingers, together with pressure several times a day, and the internal administration of the muriate of lime." And this in a city in which the famous Woman's Hospital had been established, under the auspices of MARION SIMS, fifteen years before. The founding of this special hospital, and the original work of its three men, SIMS, EMMET, and THOMAS, gave an impetus to gynecology in America which soon placed it in the highest rank. The advent of Listerism and the gradual dissemination of the knowledge that the peritoneal cavity. could be opened with safety, led to a large number of abdominal sections for various lesions, and to a more accurate perception of pelvic pathology

Perfection of operative technique rapidly followed, and the number of imperative and elective operations on the internal and external female. genital organs assumed enormous proportions. Instead of major operations being performed by the comparative few, every physician, while he would hesitate to amputate a limb, opened the peritoneal cavity without hesitation or the slightest fear. This necessarily resulted in poor work, and the gynecologist was blamed for hasty and unnecessary operations, when, in reality, the blame should have been placed upon the novice, who operated without the adequate training which would qualify him to decide as to the necessity of operation in a given case.

The diagnosis and operative treatment of pelvic lesions were taken up by the general surgeons, who hastened to perfect themselves in a field