306 REPORT OF PHILADELPHIA COUNTY MEDICAL SOCIETY.

afflicting bereavement which deprives them of one whose upright and unobtrusive life secured him universal esteem and respect."

I am not aware that Dr. Wallace ever contributed to the medical journals. He wrote several fugitive articles for the newspapers and wrote well, but the only thing I can find relating to the profession is contained in his address before the State Medical Society, in 1862, when he acted as President. That address, which is on the subject of medical organization, is creditable in style, language, and sentiment, and evinces the finished scholar. It was delivered in the midst of the great civil war. I transcribe the concluding paragraph, which, in view of the reunion of the whole profession at the approaching Centennial, will show that his words were in a measure prophetic :

"The troubles existing in the country have afforded an opportunity for the sublimest display of patriotism on the part of all her citizens. Ever since the fatal blow on Fort Sumter, by which the flag was disgraced and trampled under unhallowed feet, the resolve of loyal men everywhere has been that the insult should be avenged, and that treason should be punished. And amidst the general burst of enthusiasm and love of country, we cannot but rejoice that the profession has taken so noble a stand, and that, as in other days, when clouds have darkened the horizon, where'er her services were needed, there her sons have flocked to minister, and, if need be, to die, under the folds of that glorious flag.

"Let us indulge the hope that when these difficulties are over, and when reason shall have resumed her sway, that, with returning peace and prosperity, the profession now separated shall be reunited as a band of brothers, whose only emulation shall be to excel in the elevation of the profession, in the advancement of science, and in the amelioration of the race."

In conclusion, it may be said that in all the relations of life Dr. Wallace occupied an enviable position. Possessing a finished education, fine literary tastes, decided convictions and exemplary habits, associated with gentleness, cheerfulness and humility, he constituted the Christian gentleman, which is the highest type of man.

REPORT OF THE SCHUYLKILL COUNTY MEDICAL SOCIETY.

THE past year in the bounds of my practice has been one of unusual good health, there being an entire absence of any epidemic of any kind. During the first and last quarters of the year there was an occasional case of inflammatory rheumatism, pneumonia, with some catarrh among children, but there was nothing unusual in the symptoms or treatment to require any especial notice here. During the second and third quarters of the year we had some diarrhoea and cholera infantum among children, and an occasional case of dysentery in adults, but much less than the usual number of cases, and they were very amenable to treatment.

In the way of surgery I had two cases of amputation of the arm, one in a large fleshy woman of fifty, through the elbow-joint; the other in a boy of about twelve years of age, at the junction of the upper with the middle third of the humerus. They both recovered without any untoward symptoms in the usual time.

I had two cases of fracture of the thigh, one at the junction of the upper with the middle third of the femur, and the other, which was a double fracture, was above the middle and near the lower extremity of the bone. In the former case, I found it impossible to keep the fragments in anything like apposition with the ordinary long splints, so I resorted to the wire splint of Smith, of Baltimore, as recommended by Dr. Hewson in a late number of the Medical and Surgical Journal, by which the whole limb is suspended from a pulley in the ceiling over the bed, with the most satisfactory results.

I had three cases of puerperal convulsions, the first occurring in the person of a primipara, and occurred when the labor was well advanced and the os uteri fully dilated. I bled her freely immediately, and then applied my forceps and delivered at once. She had two convulsions after delivery, and a long tedious convalescence owing to inflammation running on into abscess of the mammary glands.

The second case came under my care for treatment at seven months for uræmic poisoning. I treated her in the usual way, with diuretics and purgatives, until the Monday previous to her delivery

on the Saturday following, when I bled her largely from the arm. She passed through her labor without any untoward symptoms at 5 o'clock on Saturday afternoon, and continued to do well until Sabbath at 12 M., when she ate largely of heefsteak, soon after which she complained of a painful feeling at the epigastrium, and shortly after of a severe pain in one temple. I called soon after and prescribed for what I supposed to be gastralgia, I at the time being in entire ignorance of what she had eaten. I also prescribed calomel in full doses with alkalies, which were continued all the afternoon without any relief of the symptoms. At 8 o'clock P. M. she was seized with a violent convulsion, when I was again sent for, and on my arrival I bled her to the extent of twenty ounces and prescribed bromide of potassium with the tart. ant. in large doses, with counter-irritants to the extremities and the spine. The spasms continued to recur every half hour until she had six, and she had become entirely insensible, when I tied up her arm again and bled her from both arms to the extent of twenty-four ounces more and administered chloroform almost constantly. The spasms continued to recur at larger or shorter intervals until she had eleven, when near 4 o'clock A.M. she vomited freely, throwing off the steak just as she ate it, it having remained in her stomach sixteen hours without undergoing the slightest digestion. She was totally blind and deaf for three days, after which time she gradually regained her senses. She had phlebitis of both lower extremities in connection with metritis and a long tedious convalescence, but is in robust health at this time.

The third occurred in a large fleshy woman in her sixth pregnancy with dropsical swelling of her lower extremities, and indeed of her whole body. On Sabbath, directly after dinner, of which she partook sparingly, she ate some apples and green chestnuts, and in an hour afterwards, she was found lying on the floor of her room in a violent spasm and totally insensible. On being called I bled her profusely, gave calomel, bromide of potassium, and used chloroform, but, notwithstanding my remedies, the convulsions continued to recur until she had eleven, when they ceased. She remained insensible for two days without any recurrence of the spasms, when labor came on and she was delivered of a living child which died in about 30 hours from cyanosis. She had a very good getting up.

The proper remedy in the second and third cases would have been a prompt emetic, and this would most likely have prevented the convulsions in the second case, as eight hours had elapsed from the time the steak was eaten till the supervention of the spasms. In the third case the patient was totally insensible when found, and con

sequently could not swallow, but a tube might have been used. A knowledge of the exciting cause when called, would have changed the treatment, but in most cases the friends of the patient, and the patients themselves, will try to keep the medical attendant in ignorance of it, lest they are censured by him. The predisposing cause in all these was uræmic poisoning.

During the last half of the year, I had puerperal fever following in most of my cases of midwifery, either in the form of metritis, metroperitonitis, or phlebitis. The form in most cases was that which attacks the veins. One case proved fatal about the eighth day, it being metroperitonitis following a severe instrumental delivery caused by a very large child, and a presentation in the sixth of the vertex of Baudalocque. The treatment depended on was calomel and opium in the early stages, and quinine and iron in the latter stages with blisters. I had one patient who was confined to her bed for three months, till she had inflammation of the veins of nearly all her extremities, but finally recovered. Purgatives, which I find it is now very fashionable to decry, particularly by the younger members of the profession, I have always found useful, and in no case where I have been enabled to have the bowels freely moved in the early stage, have I lost a patient; and, on the other hand, when I cannot succeed in that particular, I have nearly always lost my patient. In my last fatal case, I gave very large doses of opium, which are so highly extolled by Dr. Clark, of N. Y., but my patient died with all the symptoms of obstruction of the bowels. She had stercoraceous vomiting with very great tympanitis for three days before she died, and all my efforts to open the bowels proved unavailing.

In midwifery I had 161 births, 76 males, 73 females, and 12 premature.

Inclosed will be found a communication from Dr. D. J. McKibbin, giving a history of his experience for the past year.

All of which is respectfully submitted.

GEO. W. BROWN, M.D.,

Chairman.

DEAR DOCTOR: I find on examining my notes of the past year that in the month of January, sporadic cases of scarlatina, diphtheria of a manageable form, catarrhal affections, infantile pneumonia, frequency of abortions, and in a neighboring locality a number of cases of puerperal convulsions occur almost simultaneously; hemorrhages frequent.

In February and March, pneumonias of a severe type prevail,

with several cases of cerebro-spinal meningitis, in which anodyne. liniments to the spine, morphia and quinia internally in large doses, are persistently given, combined with tr. ferri chlorid., beef extract, and as cases progress, diffusible stimuli. Successful results justify the treatment.

In April and May, diphtheria prevails as an epidemic in the town and vicinity. My treatment consists in premising with a calomel purge, followed with the chlorine mixture internally, anodyne liniments to the throat, with liberal use of ice, ice-cream, and good nutritious diet. In the main this is usually satisfactory. Occasionally, and in cases not always confined to the poorer and ill-fed classes of our population, under this treatment the ash-colored appearance of the fauces is dispelled, while slowly and insidiously do the larynx and trachea become involved, to meet which, as cough becomes croupal and respiration labored, I immediately resort to free inunctions of ung. hydrarg. fortior, combined with extract of belladonna to armpits, groin, and sternum, frequently repeated, and administer largely of lactic acid. Impressed with the paper of Oertel on the chemical solubility of diphtheritic membrane, I tried the internal administration of the acid instead of the spray thereof, as he indicates in quite a number of cases, with benefit, and feel assured that it saved two lives in which tracheotomy seemed inevitable. I gave a drachm of the officinal acid in an ounce of sweetened water, to be taken during each and every two hours. In about twelve or fifteen hours, rales and a disposition to cough were manifested; this, with warmth and proper ventilation of the chamber, with milk, soups, wine, or brandy, as symptoms indicate, constitutes the treatment. Emetics and calomel in this form-and I presume it is really the true form—of croup, except perhaps, in the early stages, seem to depress the vital powers without corresponding good results.

During May and June, rheumatic and neuralgic affections are also rife.

In July, August, and September, the usual diseases of the summer months prevail. Exhibited no malignancy, and the mortality of the vicinity was very slight.

Remittent fever prevailed in August, September, and October. In October and November, dysentery and the summer diseases of children decreasing, and saw nothing of interest save a case of pleuritic effusion of several weeks' duration, which I relieved by paracentesis in the presence of Drs. Sherman and Deckert, of Cressona, drawing off 90 ozs. of sero-purulent fluid. On the same case