good by stealth-a certain amount of publicity is inevitable. Were we furthermore to discountenance, all philanthrophy because of the reputation it gives the dispenser of bounties, we should work serious injury to many deserving charities, inasmuch as an analysis of the majority of philanthropic acts, would reveal, a by no means insignificant amount of selfishness. This is human nature. The danger of medical men using this method to work themselves into notoriety might, however, be largely obviated by the society taking the matter in hand, and appointing one or several of its members to prepare such articles for the newspapers as would be of public interest, and to the enlightenment of the people. At certain seasons particular diseases are rife, and the market is flooded with "specifics," which are advertised from every spot to which it is possible to stick a poster, making our thoroughfares present a more variegated appearance than did Joseph's coat. What duty is more manifest than the physician's, at such times? A timely word from him through the family paper would prevent a vast amount of "injury to the unwary." There is, moreover, no literature more acceptable to the editors of the secular papers than timely contributions of this nature, the fact that the advertisement of quack medicines is very remunerative, to the contrary notwithstanding. Our State Board of Health has here a field of labor, which might be cultivated to good advantage. It has already accomplished much good by stirring the authorities and the people up to a sense of the advantages of proper drainage, ventilation, school hygiene, etc., let it now aim a few blows at this pervading evil of quackery. In conclusion, gentlemen allow me to say that the time allotted me prevents an elaboration of the views here presented. I submit them therefore without further comment, and should the society see fit to regard them, I shall be amply repaid for my efforts to awaken an interest in a subject of such vital importance. www Proceedings of Societies. ST. JOSEPH VALLEY DISTRICT SOCIETY. The Society was called to order at 10:30 A. M., L. C. Rose, M. D., President, in the chair. Drs. W. F. Mason, W. F. Reiley, E. T. Bonnie, and Mrs. E. F. Anderson were admitted as members. Dr. R. J. Haggerty was elected President for the ensuing year; Drs. Tomkins, Neal, Brow, Latta, and Fravel, Vice Presidents; Dr. Patterson Treasurer, and Dr. Pixley Secretary. Dr. L. H. Dunning, of New Troy, Mich., reported at some length on scarlet fever. He said that while it was infectious, it was not proven that contagion was the only means of propagation, as sporadic cases occur where it is impossible to discover any means by which scarlatina was induced by either contagion or infection. He quoted Dr. Taylor as saying "that in nine instances decomposing blood was apparently the cause of the disease," and said that instances were given in which decomposing offal and washings from slaughter houses started scarlet fever de novo, which then spread by infection. Susceptibility to the influence of the poison diminished rapidly after the fifth year. Dr. Dunning considered hyperemia of the kidneys, not a complication, but a characteristic of scarlatinia, as much so as the sore throat. After making mention of the varieties of scarlatinia and the stages and describing the appearances in the throat, he called attention to the rapidity of the pulse as a valuable diagnostic symptom, saying that "excepting in the fever of puerperal women, the circulation was as rapid and soft in no other dis ease. Albuminuria occurs most frequently during desquamation, although it is noticed occasionally during efflorescence. In the anginose variety the symptoms are more intense. The glands of the neck are enormously enlarged and the temperature sometimes runs so high as to cause paralysis of the heart. After mentioning albuminuria and synovitis as sequela, the doctor enumerated the diagnostic characteristics. In the treatment he laid great stress upon hygienic measures, advocating the use of sponge baths of tepid water and alcohol 3 1—O i. Vomiting and diarrhoea must be controlled and restlessness combatted with anodynes. Croupal symptoms should be met with free use of emetics and chlorate potassa. High temperature he would treat by means of wet sheets wrapped around the patient's body, reapplied from three to six times in ten to fifteen minutes; then place the patient quietly in bed until it was necessary to repeat. He mentioned the antipyretic use of quinia, but had had no personal experience with it in this disease. Exhaustion indicated the free use of stimulants. In the remarks on paper Dr. Ham advised the use of inunctions of quinia gr. xx and lard 3 i after each bath. Dr. Rose thought emetics had been of no use in his experience in controlling the croupal symptoms. Dr. McAllister then reported, with selected topic, Phlegmasia Dolens. His attention had lately been directed towards this disease from having two cases, the only ones he had met. One of the perplexing features in the study of this disease, is the diversity of opinion of the writers and teachers on this subject. It is most common between the fourth day and third week after delivery, but it occasionally is found in non-pregnant females and also in the male sex. It seems to occur most frequently after severe labors when the general powers are exhausted and the uterine organs have suffered by powerful and long continued expulsive efforts. The diagnosis is usually not difficult, the symptoms being decided and characteristic. The case having progressed favorably for several days, the disease commences suddenly. The excretions are checked and probably by this means morbid material is thrown into the circulation. The lady first complains of pain in the groin or calf, severe, continuous and increasing. Other symptoms are developed rapidly. Swelling commences usually with calf, extending upwards; skin hot and dry; urine scanty and high colored. In neither of my cases was the disease ushered in by chills or rigors. It is important to diagnose early and commence energetic treatment. Pain as indicated is the most valuable diagnostic symptom and precedes other symptoms by twelve to twenty-four hours. The disease is not generally fatal, but is very tedious, and it may be months after the acute symptoms have subsided ere the sensations or appearances of the limb regains a normal condition. Death may result from pyæmia, embolism or the exhaustion consequent upon the long continued suppuration in the cellular tissue of the affected limb. The writer then gave the opinions entertained by several authors in regard to the pathology of milk leg, paying especial attention to the views of Dr. Robert Lee and Prof. Rokitanski. "I have no doubt that if a complete and permanent contraction of the uterus could be secured in all cases that instances of phlegmasia dolens and puerperal fever would be extremely rare." He thought it would be good practice to give ergot in every case, combined with stimulants if indicated, until satisfied that vigorous and permanent contraction of the uterus had taken place, and he thought the comfort and satisfactory convalescence experienced would amply compensate for the "after pain" induced by such treatment, and that the practice of giving opiates after labor was pernicious. One of the cases I have alluded to progressed rapidly and satisfactorily, but the other presented some peculiar features. Jan. 26, called to see Mrs. G., aged 28, primipara. Had suffered pains about 24 hours, slight flow of blood, no dilatation of OS. Was summoned again next day at 4 P. M., and at 10:30, after a labor which though somewhat tedious had no unusual features, she was delivered of a still-born child. Excepting slight trouble with the breasts she progressed favorably until February 13, when she complained of pain in the left groin. Sat up that day and slept well that night. 14th, not feeling well, pain worse, moved her bowels freely with salts and senna, and gave opiates to control pain. 15th, no better; pain severe throughout the whole limb; sleepless night, notwithstanding opiates. 16th, limb much swollen; commenced midway between knee and ankle; considerable fever, tongue moist, but much coated, pain severe in calf, sleepless night. Gave enough chloral to procure sleep, and half drop of fluid ext. verat, vivide every hour; limb to be bathed every two hours in a saturated solution of camphor in olive oil, and dry heat applied by means of hop bags. 17th, more comfortable; limb greatly swollen from hip to foot; pain modified. Continue treatment. 18th and 19th same condition. Equal parts of chloral and camphor were ordered as an application, with excellent effect in soothing pain and reducing swelling. Patient improved. When on the 23d patient was decidedly better and there was a perceptible diminution in the size of the limb, ordered a pill composed of quinine and hyoscyamus a a gr. j ext. ignatia and ext. aconite root a a gr. 4, morphine gr. 1. two hours until lady perfectly easy, then pro re nata. acted charmingly in soothing pain and was continued all through the tedious convalescence. During the night of the 24th was summoned to the patient and found her suffering severe, deepseated pain in the right groin. 25th, pain through nearly the whole limb, and calf beginning to enlarge. Treatment continued, with the addition of alkaline baths, and whiskey and beef essence as much as the stomach would tolerate. The course of the disease was identical with that pursued in the left limb, excepting pain not so severe. 28th, disease fully developed. From this on it slowly abated; febrile symptoms subsided, secretions improved and patient though greatly prostrated was cheerful and hopeful. This continued till March 2nd, when, at 11 P. M. was called hastily and found an alarming change had taken place; countenance pale and sunken, surface bathed One of these was given every This |