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IN-GROWN TOE NAIL. MR. EDITOR, — The late eminent surgeon, L. L. Miller (of Providence), for very many years ablated the redundant flesh and a strip of the nail with a carpenter's gouge, at a blow. This mode he used prior to the use of ether; with ether he may have performed it with a scalpel.
JAMES O. WHITNEY. PAWTUCKET, R. I.
A CASE OF “EAR COUGH."
BY WILLIAM 8. BOWEN, M. D., PROVIDENCE, R. I.
Although many cases of the peculiar reflex cough from irritation of the external auditory canals have been reported by various authorities, such as Tissot, Pechlin, and Fox, of Scarborough, since the first published case of Fabricius Hildanus in 1596, it is undoubtedly true that many cases exist and go unrelieved in which medical treatment directed solely to the respiratory organs and the throat utterly fails to be of use. A case of dry, harsh cough of the type usually called "nervous," when a thorough physical examination of the lungs and of the larynx does not reveal an exciting cause, should be viewed with suspicion, and the external auditory canals should also be carefully inspected, and thus exclude, if possible, the reflex action above mentioned.
An excellent illustration of the necessity for this examination recently came under the observation of the writer.
A girl, aged eight, had been the subject of a dry and at times very distressing cough for nearly two years and a half, and had been under medical treatment, including electricity, during the whole of that time. Her general health was good, and she was unusually large and strong for her years. The fauces were free from disease, and a rhinoscopic and laryngoscopic examination showed an absolutely healthy condition of the parts from the dome of the pharynx to the bifurcation of the trachea. The right external auditory canal was filled with inspissated cerumen, and on removal a large jet bead was found impacted in the cylinder of wax. It had laid in contact with the floor of the canal, about two millimetres from the membrana tympani, and had caused considerable ulceration of the dermoid layer. The cough entirely disappeared in about ten days. The child would not acknowledge having placed the bead in her ear, but her friends remembered that she had such beads to play with while visiting relatives two years and a half before. The reflex action is through a branch of the auriculo-temporal branch of the fifth pair, and the connection takes place in the floor of the fourth ventricle of the brain.
FRANK F. MAURY. Dr. Frank F. Maury died in Philadelphia, on the 4th of June, at the age of thirty-nine. His wife died suddenly about a fortnight previous under peculiarly painful circumstances, while Dr. Maury was away from the city. Immediately on his return he was taken sick with pulmonary congestion, with the result as stated. They leave two children. He studied medicine at the University of Virginia and Jefferson College, and after graduation became assistant to Professor Gross, and was for a long time his chief of clinic. As a surgeon he had already given evidence of marked ability, and had attained a prominent position through his application to his profession and his skill as an operator. At the time of his death he was surgeon to the Philadelphia Hospital, and to the Jefferson College Hospital, and held a lectureship in the summer course at Jefferson College. He was at one time coroner's physician, but was obliged to resign this position on account of his large practice. He took a warm interest in Jefferson, and it was largely due to his efforts that the plans for erecting
the new hospital and equipping it for service were carried to a successful issue. Dr. Maury gave promise of attaining a very high position among American surgeons. He was associated with Dr. Duhring as editor of the Photographic Review of Medicine and Surgery a few years ago, but had contributed very little personally to the literature of his profession beyond occasional articles in the journals. He had an extended experience, and performed a number of capital operations, including the ligation of the innominate artery, gastrotomy for stricture of the æsophagus, and others of equal importance. He also had a series of cases of extrophy of the bladder, in which he obtained good results by a plastic operation, part of which was peculiar to himself. In social life he had charming manners, perfect address, and an air of warmth and candor that made him a host of friends; he was always light-hearted and impulsive, and if his sanguine temperament sometimes led him to promise more than he could possibly perform he was always sincere in his desire to oblige his friends. As a lecturer he was positive in his teaching and clear in his explanations, and his courtesy to his patients and the students made him a general favorite. In his clinics at the Philadelphia Hospital he more than once publicly reprimanded the attendants for rough treatment of patients, and turning to the class said, “ Gentlemen, it should not make the slightest difference to you whether your patient is rich or poor; a sick person deserves all the consideration and kindness that you can possibly give him, and if poor he needs it all the more.”
His mistakes were those of the head rather than of the heart, but unfortunately they were such as society generally makes the most of; he was generous, loved company, and cordially hated meanness. What he might have been those who knew him in life can now only conjecture; what he was he owed solely to his perseverance, industry, and manly self. dependence.
REPORTED MORTALITY FOR THE WEEK ENDING JUNE 7, 1879.
Percentage of total Deaths from
estimated Deaths in
during the 1879.
5.13 5.18 23.33 13.33 16.21 16.67 12.50
7.69 4.76 10.00 7.69
101,000 60,000 57,000 27,000 53,300 52,500 61,400 48,500 38,200 34,000 81,500 27,000 26,400 23,850 20,800 20,200 18,200 17,100 17,100 16,800 18,500 12,500
12.39 13.90 35.66 23.17 13.69 12.91 21.29 10.75 17.75 19.94 14.90 19.31 19.75 11.17
5.01 12.91 22.92 12.20 15.25 84.08 15.45 4.17
Two thonsand and eighty-five deaths were reported : 382 from the principal “zymotic" diseases, 347 from consumption, 121 from pneumonia, 110 from diarrheal diseases, 90 from diphtheria and croup, 83 from scarlet fever, 42 from bronchitis, 28 from typhoid fever, 24 from whooping-cough, 13 from cerebro-spinal meningitis, 11 from malarial fevers, 10 from measles, six from erysipelas, five from remittent fever, four from pleurisy, one from intermittent fever and one from typho-malarial fever, none from small-pox (five cases are reported from Richford, a small town in the extreme north of Vermont). In the mortality from measles, cerebro-spinal meningitis, diphtheria and croup, whooping-cough, typhoid fever, pneumonia, and bronchitis, there is no noteworthy change; the decrease in scarlet fever and erysipelas continues; there is a slight increase in consumption, moderate from “zymotic” diseases and all causes, while the larality from diarrhæal diseases is nearly double that of the previous week. In the nineteen cities of Massachusetts, with an estimated population of 880,850, there is shown a gradual increase in diarrhæal diseases, a decrease in scarlet fever, and no other noteworthy change.
From bronchitis, 18 deaths were reported in New York, six in Brooklyn, four in Philadel. phia and Boston, iwo in Milwaukee, one in Chicago, St. Louis, Baltimore, District of Columbia, Buffalo, Providence, Cambridge, and Salem. From typhoid fever, ten in Philadelphia, four in New York and Chicago, three in Cincinnati, iwo in Boston and Lawrence, one in Baltimore, Buffalo, and Cambridge. From whooping-cough, eight in New York, two in Phil. adelphia, Brooklyn, and Charleston, one in Chicago, St. Louis, Baltimore, Boston, Cincinnati, District of Columbia, Pittsburgh, Buffalo, Providence, and Chelsea. From cerebrospinal meningitis, two in Baltimore, Buffalo, and Worcester, one in New York, Philadelphia, Cincinnati, Cleveland, Milwaukee, Lynn, and Somerville. From malarial fevers, seven in New York, five in Brooklyn, four in St. Louis, one in Baltimore and District of Columbia. From measles, six in New York, two in Cleveland, one in Brooklyn and Baltimore. From erysipelas, two in Buffalo, one in New York, Brooklyn, St. Louis, and Boston. The deathrate of the colored population in the District of Columbia was more than double that of the whites.
The weather was generally reported cooler and changeable, with light rains, the meteorological record for the week in Boston (latitude 42° 41', longitude 71° 4') being as follows:
10., cloudy ; C., clear ; F., fair; G., fog; H., hazy ; S., smoky; R., rain ; T., threatening. For the week ending May 17th, in 144 German cities and towns, with an estimated population of 7,315,369, the death-rate was 28.4, an increase of 0.1 over the previous week, indicating a decrease in consumption, diphtheria and croup, and typhus fever, an increase in scarlet fever, measles, and typhoid fever, while the other prominent diseases remained about the same. Three thousand nine hundred and ninety-three deaths were reported : 590 from consumption, 507 from acute diseases of the respiratory organs, 211 from diarrhæal diseases, 102 from diphtheria and croup, 62 from typhoid fever, 61 from scarlet fever, 56 from whooping-cough, 45 from measles, 21 from puerperal fever, seven from typhus fever, two from
small-pox (Berlin and Augsburg). The death-rates ranged from 14.7 in Mannheim to 45.4 in Augsburg. Königsberg 32.2; Dantzic 21.2 ; Breslau 30.6; Munich, 40.5; Dresden 27.8 ; Cassei 20.2; Berlin 24.4 ; Leipsic 24.6; Hamburg 31.3; Hanover 27.8; Bremen 30.4 ; Cologne 24.6; Frankfort-on-the-Main 23.9; Darmstadt 19.7. Also for the same week, Vi. enna 33.6 ; Prague 44.4 ; Paris 27.7; Odessa, 30.7.
For the week ending May 24th, in the 20 English cities and towns having an estimated population of 7,383,999, the death-rate was 21.4, a decrease of 1.0 froin the previous week, with a decline in the mortality from respiratory diseases, diphtheria, scarlet fever, and fever; a very slight increase in measles and whooping cough, considerable in diarrhæa, and nearly trebled in small-pox (London). Three thousand and twenty-nine deaths were reported : 327 from diseases of the respiratory organs, 109 from whooping-cough, 79 from scarlet fever, 75 from measles, 38 from fever, 35 from diarrhea, 17 from small-pox, 12 from diphtheria. The death-rates ranged from 16.3 in Brighton to 25.1 in Norwich ; 21.6 in London ; 17.4 in Bristol ; 23.1 in Birmingham ; 23.8 in Liverpool ; 24.1 in Manchester ; 18.6 in Leeds. In Edinburgh the rate was 24; in Glasgow 21, in Dublin 35 (small-pox declining).
The sanitary condition of Astrachan and vicinity is reported to be good ; typhus fever has become less prevalent. There is a slight increase in small-pox in the large cities of Europe where it prevails, and a decrease in Poland.
RECENT BOOKS AND PAMPALETS.- Diseases of the Throat and Nasal Passages. A Guide to the Diagnosis and Treatment of Affections of the Pharynx, Esophagus, Trachea, Larynx, and Nares. By J. Solis Cohen, M. D. New York: William Wood & Co. 1879. Pp. 742. (From A. Williams & Co.)
Posological Table, including all the Officinal and the most frequently employed [nofficinal Preparations. By Charles Rice, Chemist, etc. New York: William Wood & C). 1879. Pp. 93. (A. Williams & Co.)
Alternating Anterior and Posterior Version of the l'terus. By Samuel C. Busey, M. D. Washington, D. C. 1879. (Reprint from Vol. III. Gynæcological Transactions.)
Transactions of the Rhode Island Medical Society for the Years 1878–79. Vol. II. Part Second. Published by the society.
Atlas of Histology. By E. Klein, M. D., F. R. S., and E. Noble Smith, L. B.C.P., M. R. C. S. Part III. Philadelphia: J. B. Lippincott & Co. London: Smith, Elder & Co. 1879.
A Guide to Therapeutics and Materia Medica. By Robert Farquharson, M. D. Edin., F R. C. P. Lond. Second American Edition, enlarged and adapted to the United States Pharmacopæia by Frank Woodbury, M. D. Philadelphia : Henry C. Lea. 1879. (A. Williams & Co.)
The Treatment of Spinal Disease. By E. H. Coover, M. D. (Reprint from Virginia Medical Monthly, May, 1879.)
Minutes of the Meeting of Organization and Proceedings of the Sanitary Council of the Mississippi Valley. Chicago, Ill. 1879.
Color-Blindness : Its Dangers and its Detection. By B. Joy Jeffries, A. M., M. D., etc. Boston: Houghton, Osgood & Co. Cambridge: Riverside Press. 1879.
The Toner Lectures, Instituted to Encourage the Discovery of New Truths for the Advancement of Medicine. Lecture VII. The Nature of Reparatory Inflammation in Arte ries after Ligature, Acupressure, and Torsion. By E. O. Shakespeare, A. M., M. D. Delivered June 27, 1878. Washington : Smithsonian Institution. April, 1879.
On Spasmodic Stricture of the Urethra. A Reply to Dr. F. N. Otis. By Henry B. Sands, M. D.
Ueber den Zuckergehalt des Blutes. Von Dr. A. M. Bleile, Columbus, O. (Archiv für Anatomie und Physiologie.) 1879.
The Fifty-Fifth Annual Report of the Officers of the Retreat for the Insane at Hartford, Conn. April, 1879.
Some Points in Connection with the Treatment of Sterility. By A. Reeves Jackson, A. M., M. D. (Gynæcological Transactions.) 1879.
THE BOSTON MEDICAL AND SURGICAL JOURNAL.
VOL. C. — THURSDAY, JUNE 26, 1879. – NO. 26.
GENTLEMEN, - I have thought it well to bring two cases before you together to-day, as it will, I believe, be interesting and instructive to study them in connection with each other. The first patient is a young man just about reaching adult life, and I will now ask him a few questions about himself.
How long have you been sick ? “Since the 2d of January last." (That is, about four months.) What have you complained of? “I had pneumonia.” How do you know this? “ The doctor told me that I had.” How were you taken at first ? - Well, I was out on New Year's, and the next day I was sick in bed.” Did you have a chill at first? “No." Did you have any pain ? “Yes, a good deal.” Where was it situated ?" In the left side.” Any fever ? Yes, quite a high fever, I think.” Did you have any spit ? “Yes.”
6. Yes." What color was it? “ White.” Was it ever any other color than white ? part of the time it was reddish.” Was this reddish color mixed through it, or in streaks? “In streaks.” How long did you continue to spit up phlegm ? “ About a week.” Did it hurt you to lie on either side ? “Yes.” Which? “Both sides, and so I had to lie on my back.” How long were you confined to bed ? “ The whole month of January. How have you been getting along since then ? " Some time since I found that there was a lump in my left side. This, it seems, was a gathering, and after a while it broke.” How long did the discharge of matter continue? “ It has been coming ever since." Is the discharge
more or less free than it was soon after the gathering broke ? " There is more coming now than there has been at any other time."
In like manner I will endeavor to get some idea of the history of the second case from the patient, who is, as you perceive, a man in middle life. How long have been sick ? “Since the first of last September."
1 Reported for the JOURNAL.