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Address On Medicine.
motes both molecular and tissue degenerations
as so uniformly seen resulting from chronic The address on “Medicine," before the alcoholism. American Medical Association, Nashville, If we would reach the highest degree of Tenn., was delivered by Nathan Smith Davis, success in the treatment of acute general disM. D., LL. D., of Chicago. The doctor spoke eases, we must as early as possible separate of the unparalleled activity in the application the patient from further action of both speof chemistry and microscopy to biological, cific and predisposing causes of his disease by bacteriological, etiological, pathological, sani- surrounding him with pure air and as perfect tary and therapeutic investigations which has sanitary arrangements as possible. We should characterized the last two decades. He dis- carefully avoid the use of such remedies. as cussed antipyretics, and considered it far more either directly or indirectly retard or prevent safe in low forms of fevers to relieve the ex- normal metabolic processes. As the pyrexia cess of heat by increasing the natural processes of high temperatures results mostly from the than by any remedies, as antipyretics and interference with the processes of heat dissianalgesics which endanger increased blood pation, we must restore these processes by and tissue degeneration and depress nerve gently promoting natural elimination and by force.
the direct abstraction of heat by the sponge The subject of alcohol as a medicine was baths, and in excessive cases by wrapping in discussed at length, and he felt himself justi- cold wet sheets. We must early and accufied in considering the following conclusions rately use such remedies as palliate or modify fairly established:
local developments wherever they' may be Alcohol when present in the blood, manifested, and thus prevent such structural either combines with or causes changes in the changes in these directions which might othmolecular composition of the hæmoglobin, by erwise end in fatal exhaustion. We should which the natural conversion of the latter into ever remember that the same remedial agent oxyhæmoglobin is diminished, and conse- that might be of great value in the first stage, quently, less oxygen is carried from the pul- might be injurious or even destructive if used monary to the systemic circulation.
at the stage of culmination, or still more in The same strong affinity of the alcohol
that of decline. "The chief benefits thus far for water and albuminoids that enables it to
received from the use of antipyretics and modify the composition and function of the germicides, have been as preventatives in the hæmoglobin of the blood also causes it to
incubative or prodromal stage rather than cumodify the molecular condition and functions ratives after the active morbid processes have of the tissue cells throughout the body, and been manifest. I have been unable to find in thereby retard and lessen the aggregate of the medical literature of the past few years metabolic changes and their products as shown that the very general use of antipyretics in in the diminished products of carbon-dioxide continued fevers had either lessened the ratio urea, phosphates, heat, etc.
of mortality or shortened their duration. 3. Both the direct effect of alcohol on the nerve cells, and its indirect effect, in lessening The Eastern Kansas District Medical societhe amount of oxygenation of the blood, ty will hold its next quarterly meeting in causes it to produce marked diminution of Leavenworth, July 8, 1890. The afternoon nerve sensibility and vaso-motor nerve force; session will be held at the soldier's home, and or, in other words, a true anesthetic effect the evening session in the city. The society upon the nerve centers.
has been greatly favored in receiving an invitaIt follows, from these propositions, that alco- tion from Drs. Weaver and McNary of the hol in the blood diminishes every form of home to meet there. From twenty-five hunforce or energy, diminishes instead of con- dred to three thousand old soldiers are serving the tissues, diminishes instead of pre-quartered here and it affords the largest hosvents the metabolic changes and thereby pro- pital facilities in the west. The program is
an exceptionally good one, found in this num- it's the man and not the college which comber of the JOURNAL, and it is an opportunity mands the respect. Men make colleges and which seldom is offered and should be im- not colleges men. It must be in the man or proved by every physician who can possibly it can never be developed-.000 from .000 and spare the time to attend.
.000 remains. Many other questions might be
asked and answered but we content ourselves Where Shall I Graduate ?
in calling attention to two or three of the
more important ones for the consideration of This is often a vexed question in the mind
our readers. of the student and practitioner. In coming to a conclusion there are a great many conflicting questions to be settled and environ
The Wichita Medical College. ments to adjust one's self to. The first question usually coming up and
The Wichita Medical College announcewill not down is, "what will it cost ?" In ment for 1890, is on our table. Considering answer we would say it will cost something. the late beginning of the session last year the As a rule a faculty, like an individual knows showing is a good one. There were no graduaits value, the worth of the service rendered tions which speaks well for the college. It is and charges accordingly; and hence a college not designed as a diploma mill. Three full is in a measure, known by its price.
courses of lectures are required before a The second question often is, how soon can student can become a candidate for graduI graduate? The sentiment of the profession ation. The requirements throughout are in and the public and the demands of the State keeping with the first-class colleges of the Boards of Health for a three years course in a land. medical college before graduation, settles that The announcement is gotten up in good question virtually.
shape. It contains no useless verbiage, but a Some of us attended but two full courses plain, concise statement of facts. It speaks of lectures and graduated, but another year well for the faculty. The prospects for a good would have added greatly to our usefulness as class are encouraging. The columns of the practitioners, especially in the earlier years, JOURNAL are open to the faculty of Wichita and we are not quite sure that the time and Medical College for the publication of lectures, experience of that year's loss under an intelli- clinical reports, &c. gent preceptor has ever been made up.
The JOURNAL is pleased to note the success A physician knows no state line and when of the college and extends kindly greetings he receives a diploma to practice medicine and a desire to see even greater success attend and selects a location in a State where the the worthy efforts. diploma of two courses of lectures is recognized ali is well ; but circumstances in a few years
The Halifax Medical college, on April 10, may require him to cross the State line and graduated a class of one. He took the honors pitch his tent in a State where it requires a of his class.—Times and Register. three years lecture course to qualify him to The Times and Register is also responsible practice, and then he must stand an examina- for the following :-“Dr. Hammond relates tion. It is then he feels the full force of his the case of a man who consulted him for imneglect ; for we are persuaded that every phy- potence, with which he believed his wife had sician will admit that a three years course is affected him, as he was setting out for a trip short enough time in which to obtain a medi- to New York. She had given him a peculiar cal education in a medical college aside from glance as he left the house. He felt a pecuhis general reading and tutelage.
liar thrill pass down his spine to his testicles, Will the college in which I graduate give me and thenceforth erection was impossible." a standing in the community, is a question If that woman will impart the secret of that often asked.
“peculiar glance," there is big money for her In our observation we are compelled to say )in any town within the reach of New York.
cellencies of each, in short those factors which
have conspired to render them popular with Dr. John B. Hamilton, of the Marine Hos- the public, &c.” The journal is gotten up in pital Service of the United States, in his ad- good style and the first number presents a dress, as chairman, before the section of State fund of information on the subject of mineral Medicine at Nashville, says among other inter- waters and health resorts valuable to medical esting things, “ The investigation of Dr. Kin- men. There is room for such a journal and youn leads him to the following conclusions it ought to succeed. It has a pretty cover the respecting malarial and enteric fevers. back ground of which is pale red, adorned
"First-Malarial and enteric fevers are not with cuts of beautiful scenery with, “of minerantagonistic to each other.
al waters,” in deep rich red across the centre "Second-A differential diagnosis between of the page and a huge alligator at the marthe two diseases is sometimes impossible. gin of a river at the bottom of the page. We
“Third-There exists a mixed form of in- can interpret the pale red as representing fection which can be diagnosed by means of the condition of the blood before taking bacteriological and microscopical examination. the water and the rich red letters after tak
“That the cobra poison in very minute doses ing the waters, but the huge alligator has as proved by Dr. Kinyoun is a germicide of no place in our imagination or affection extremely high power, and that it is fatal to worthy the prominence given, and we cannot the development of cholera germs."
account for it only as being an idiosyncracy of Continual experiments are now going on, and the artist and tolerated by the editor. he hopes to be able to make a complete report worth the subscription price without the on this subject by the close of the present amphibian. fiscal year.
The Three years Course. Wichita took the palm of sending the heavviest delegation, weighty in mind as well as The following States require an attendance person, with Father Fabrique at the head. on three complete courses of lectures and They made a solid delegation and deserved to graduation to entitle the holder to practice have the next meeting at their city. All in all medicine within their limits, viz: Illinois, it was a gathering of representative men, and Mississippi, Virginia, West Virginia, Texas,
are glad we were permitted to see it. Alabama, Iowa, North Carolina and PennsylThe exhibit of instruments was very good vania. indeed and we compliment highly Messrs. D. Rauch, secretary of the Illinois State Swift & Holiday on their display as showing Board of Health said, in addressing the medithat we have close at hand in our State a com- cal college representatives at Nashville, that plete and varied assortment of surgical supplies the States were fast wheeling into line in the of all kinds. It is sometimes very important to demand for a three years college course in be able to secure instruments in short order, medicine of the physicians and he thought the and for that reason we are pleased to note the time would soon come when all of the States large stock as well as low price of these goods would require it. in Topeka.
DR. SCHENCK, it appears, is known outside The first number of The American Journal of of his bailiwick. Owing to lack of time the Mineral Waters, edited and published by R. nominating committee left the appointment M. Jordan & Co., of St. Louis, Mo., is on our of the various committees to a sub-committee. table. The editors in the salutatory say, "we This committee appointed Dr. Schenck to dedesire to present the journal as a cyclopedia liver one of the three general addresses, the of knowledge, wherein will be found succes- address on State Medicine, before the associasively the record of all places of public resort, tion. This is a much greater honor than the their location, the peculiar attractions and ex- first vice presidency. He is also on the com
mittee of State Medicine for Kansas. He is The dry method of wound treatment is realso chairman of the committee on the presi- ceiving considerable attention. Dr. Lauderer dent's address to report next year. This com- of Leipzig, is one of the pioneers. No fluid mittee consists of W. L. Schenck, of Kansas; is allowed to touch the wound. Dry aseptic T. B. Evans, of Maryland; E. Grissom of gauze is used in place of moist sponges and North Carolina; and H. B. Baker, of Michigan. irrigating fluids, and pieces of gauze are ap
plied to the wound. He claims the following
advantages: American Medical Colleges.
First-The patient is not exposed to wet
and cold. Fifty-five of the one hundred regular col
Second-The loss of blood is minimal. leges of the United States were represented
Third-Absorption of antiseptics is not in the college meeting in Nashville May 21,
possible. 1890. Two interesting sessions were held and
Fourth-Time of operation is decreased. the preliminary work preparatory to a perman
Fifth-Rapid recovery, only one dressing ent organization was completed.
being necessary, and that only if non-absorbThe following rules governing the admis-able stitches are used. sion of colleges to membership in the Ameri
Sixth-Saving of surgeon's hands. can Medical College Association were adopted:
First-That the colleges shall require a graded course of instruction, covering a period
DR. J. H. THOMPSON of Kansas city, capped of not less than three courses of lectures of the climax in the section of ophthalmology six months duration each, before graduation. at the late meeting of the American Medical Second—That both oral and written exam
Association, in his report how to prepare inations be required of all students.
microscopical specimens of the eye. Then he Third—That a thorough course of labora- presented a complete section of an eye he had tory instruction be maintained in chemistry, prepared, which through an ordinary three histology and pathology.
inch lens showed distinctly the condition of Fourth-A preliminary entrance examina- the diseased human organ. The interest tion consisting of:
shown by the section and the questions asked First-A composition, written in English, by the leading oculists together with the clear of not less than five hundred words.
concise answers and demonstrations given by Second—The translation of easy Latin
the doctor elicited our admiration. prose. It is provided, however, that students be al
DR. TIFFANY, of Kansas City, read a paper lowed one year to make up any deficiency in
on “Tobacco-Its effects upon the Eyesight," this examination.
before the section of ophthalmology at the Third-An examination in higher arithme. Nashville meeting of the American Medical tic.
Association. The doctor prepared a paper Fourth-An examination in elementary for the JOURNAL'S February number on the physics.
same subject and we expected to get a repeater, It is provided, however, that candidates but an entirely new dress was put on the who are graduates or matriculates of recog. subject and the weed received its just deserts. nized colleges of literature, science, and arts, or graduates of normal schools supported by the different States, be exempt from the pro- The American Medical Editors held a pleasvisions of this examination.
ant meeting in Nashville, as is the usual cusBy resolution it was determined that the tom, the evening preceding the meeting of colleges entitled to representation in this con- the American Medical Association. The advention shall enforce the above curriculum at dress of the president, Dr. I. N. Love, is the commencing of the session of 1892-93. found in this number of the JOURNAL.
s. May 13. About the same symptoms and
May 14, 10 a. m. Dr. Stewart was called Topeka Academy of Medicine and Surgery. in consultation, and advised more free use of
salines. A saturated solution of Epsom salts The Topeka Academy of Medicine and Sur- was recommended-tablespoonful every hour, gery met in special session Tuesday evening, and an injection of one quart of a saturated May 20, Dr. L. H. Munn, the president, in the solution every two hours. This was carried chair.
out until 4 p. m. Copious passages followed Dr. C. C. Bradley, reported in writing a each injection. These contained scybalous "Case of Peritonitis, with Treatment." masses. Apparent improvement from 6. a. m. Miss G--, age 17.
Friday, May 9, Dr. to 2:30 p. m.; took no opiates; rested fairly Munn was called about noon.
well. History-Two At 7:30 p. m. pain increased ; cold
sweat. or three days more or less pain in right illiac
Gave 14 grain morphia, 15o atropia, region, bowels constipated, two or three days mag. sulp. continued every two hours, injecpast menstrual period, had had trouble before, tions stopped; milk and whisky given. pain and excessive flow. Her condition was
May 15, 6 a. m. Had a bad night; ii a. m. attributed to her menstrual trouble by her Dr. Alexander called; advised continuing parents. Skin moist, temperature normal
, opium. The partial saline and opium treatpulse 78°, respiration 18, no difficulty in pass ment was continued until noon of the 17th, , ing urine, abdomen not tympanitic, not tender when a consultation was held by Drs. Munn,
The mato superficial pressure, but deep pressure in Stewart, Alexander and Bradley. right illiac region low down caused pain, jority favored continuing the opium treatwhich was attributed at the time to ovarian ment; a minority favored a return to salines. irritation. An aloin cathartic, hot fermenta
The opium treatment was continued until the tions, '8 grain morphia, in mixture, was pre
evening of the report, the patient remaining scribed, with instructions if not relieved to about the same, with perhaps some improvereport in the morning.
At this time an operation was proMay 10, 10 a. m. Reported no better: in- posed, giving twenty-four hours for a de
cision. definite history of chill the evening before. Temperature 103°, pulse 110, respiration 25; bring about a discussion of the relative merits
The object in reporting this case was to irritable cough, slight hemorrhage from the of salines and opium in the treatment of perivagina, bowels moved freely, several scybalous
tonitis The discussion is as follows: masses, pain increased, slight tympanitis, deep pressure in right illiac region gave internal
DISCUSSION. pain, boggy sensation. Diagnosis—Typhilitis, Dr. McClintock-The point to be brought with diffuse peritonitis. Gave hypodermic of out was the opium versus the saline treatment 18 grain morphia, ito grain atropia opiate of peritonitis. His father had treated peritomixture. Continued as day before; also a nitis by means of saline injections, and by mixture containing gr. xv. mag. sulph. to a mouth. Himself had used opium while his dose every three hours, hot fomentations, milk father used salines. Thought his father had diet.
the best results. At present he prefers the May II. Temperature lower, but other saline treatment. symptoms about the same; doubled the dose Dr. Lindsay-Had been taught that opium of mag. sulph., injections of soap suds with was the treatment; did not think, however, turpentine ordered.
that opium was to be compared with salines May 12. Pain increased, enlargement right to relieve inflammation. Gives opium to reside in illiac region. Mag. sulph. ordered lieve pain. Salines more rational to reduce every two hours in same dose.
inflammation. Inflammation an increase of May-12, 7 p. m. Temperature 103°, pulse cell development; salines check this and re120, same pain, two small passages during day. move scyballa.