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the operation has been since twice repeated, and I regret to state that the fistulous opening still exists with fetid discharges.

In December, sporadic cases of scarlatina, measles, pertussis, spasmodic croup, and pneumonia prevail, but without anything of special interest. I have not seen a case of typhoid fever during the year. Whole number of obstetric cases occurring in my practice 34 Males

16 Females




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Of these, 7 were instrumental (forceps) deliveries -

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Induced labor-eclampsia
In which craniotomy had been attempted previous to

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Stillborn, 2 { Craniotomy case


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2 Whole number of deaths occurring during the year 12. Pneumonia

adult 1, aged 55, male

infant 1 Marasmus

adult 1, aged 69, male

infant 1 Myelitis spinalis

adult 1, aged 45, female Metritis puerper.

adult 1, aged 32, female Pyæmia, suppurating fibroid uterine tumor adult 1, aged 47, female Cerebro-spinal meningitis .

child 1, aged 15, female Meningitis ,

child 1, aged 11, male Diphtheritic croup

child 1, aged 3, male Diabetes mellitus

adult 1, aged 46, male Enteritis with intussusception

adult 1, aged 72, male

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J. G. KOEHLER, M.D., D.D.S., 1816-1875. During the past year, the profession of medicine in Schuylkill County lost one of its oldest members, and the County Medical Society one of its founders.

The subject of this notice, John G. Koehler, was born in the town of Lebanon, Pennsylvania, in the year 1816. He was an only son. His grandfather was a Moravian bishop. The father died while young Koehler was only twelve years of age, leaving a widow with two daughters. This young boy was compelled to struggle in various ways in order to earn his own living, and, if possible, contribute towards the support of his mother and sisters. His first services were employed in a country store at fifty cents per week, boarding and clothing included. His education was limited necessarily, only receiving two or three months' schooling in a year. A few years after he had struggled for a living, he witnessed the performance of an important surgical operation upon a man in Lebanon. The operation was the removal of a necrosed rib; the operation was performed by the late Professor Geo. McClellan, who at that time was one of the recognized heads of American surgery. This incident laid the foundation for future study and the choice of a profession.

After the removal of the family to Philadelphia, young Koehler became a student in the office of McClellan, attending lectures, and receiving the degree of M.D., March 2, 1841. The faculty of the Pennsylvania Medical College was composed at that time of Drs. S. G. Morton, Samuel McClellan, Geo. McClellan, Rush, Calhoun, and

Johnson. Dr. Koehler commenced the practice of medicine in Philadelphia, opening an office, and a small apothecary shop, on Ridge Avenue opposite Wood Street. In this store, the present Professor Joseph Leidy, of the University of Pennsylvania, began the study of medicine. During this brief apprenticeship of young Leidy, he exhibited a fondness for anatomy, marking the bones of a skull which remained in possession of Dr. Koehler during his lifetime. During his residence in Philadelphia, he was a member of the William Wirt Library and Literary Institute.

Koehler, in company with a cousin, decided, after practising in Philadelphia for a short time, to emigrate to the West. They made the overland trip to South Bend, Indiana. Here his health was Boon broken down by climatic fever, and he was compelled to return East. He located in Schuylkill Haven in 1844, soon establishing himself in a lucrative practice. Having a preference for surgery, his location presented an extended field for the practice of his choice. He had an extended reputation as a surgeon, having performed numerous operations of a major and minor character. Among his successful operations was one of the thigh through the great trochanter; operation performed twenty-eight years ago; the subject still living; several cases of double amputation of the thighs; but perhaps the most remarkable case was the one known as the “Harner triple amputation,” the removal of both legs near the knee,

and the left arm near the shoulder-joint. The operation was performed in 1847, after the then recognized authorities in the profession in Schuylkill County bad declined to make any effort to save the life of the subject, his injuries being regarded as necessarily fatal. Koehler assumed control of the case, and proceeded to amputate before reaction took place. The three limbs were removed. In ten weeks, under careful nursing and skilful treatment, the patient recovered. At the present writing he is alive and well, keeping a public house in Schuylkill Haven.

Under the head of "Synchronous Amputation," Professor S. D. Gross, in his standard work on Surgery, thus very flatteringly notices the subject: “But the most remarkable case of the kind of which I have any knowledge, occurred in 1847, at Schuylkill Haven, in the practice of John G. Koehler, who removed simultaneously, on account of a railway injury, both legs and one arm from a lad thirteen years of age, recovery taking place without the supervention of any serious symptoms. The limbs were frightfully crushed, and the operation was performed within a short time after the accident. The arm being removed first, the pulse immediately sank, but under the influence of stimulants it rose sufficiently in five minutes to justify amputation of both legs below the knee. So excessive had been the shock to the system, that the boy hardly experienced any pain during the operation." This same authority, when learning of the death of Dr. Koehler, feelingly alluded to this great operation, and said: "His case of successful synchronous amputation of both legs and an arm, will secure him an honorable niche in the temple of fame. A man who could execute such a feat is no ordinary surgeon.”

• The degree of Doctor of Dental Surgery was conferred upon him by the Philadelphia College of Dental Surgery, February 28, 1854.

Dr. Koehler was a man of great industry in his profession, a close observer in the details of disease; a man of studious habits ; strong in his likes and dislikes ; had extreme prejudices, which never could be overcoine when once formed. Rising, as he did, in the profession entirely upon his own industry and energy, he earned a name and reputation that any one might justly be proud of, and one whose posterity might love to venerate.

Dr. Koehler was twice married, his first wife dying from tuberculosis of the lungs, a few years after marriage. In November, 1852, he was married to Miss Matilda Bland, of Pottsville, who, with three children, survives him.

His death occurred on the morning of the 29th of September, 1875, from general nervous exhaustion, the result of prolonged and continued neuralgia, extending over a period of six years. His stamina was completely gone. He was buried with Masonic ceremonies on the 3d of October, 1875, at Schuylkill Haven. The community in which he lived deplore his loss, while the profession is deprived of a valued and respected member, and his family of that comfort and support that are so keenly felt when the final summons comes which awaits all.





Dr. LEWIS DARLING, Jr., of Lawrenceville, Pa., Secretary of the Tioga County Medical Society, reports

That but little has occurred out of the ordinary course. This section has been remarkably free from epidemics during the entire year. Sickness has prevailed during many of the months of the year, but of a mild type.

Our Society is kept alive by a few active earnest workers in the vineyard, while the majority of the members remain at home to watch each other. They take but little interest in the Society, and I am almost tempted to say in the profession, other than its financial features. Timely notice has been given to each member to forward the reports of their practice and observations, but not one has responded, and I am therefore obliged to submit only a brief report this year.

Fevers of various types have not been very prevalent during the year; isolated cases of typhoid, remittent, and intermittent fevers have occurred, but yielded readily to treatment.

Throat and lung diseases have prevailed somewhat extensively during the winter and spring months, but have been mild in character and susceptible of relief. I have observed that there has not been the usual number of cases of “pneumonitis;" the mildness of the winter seems to have had a very favorable effect in preventing the occurrence of this malady to any great extent. I have had a few cases only of what might be termed "pneumonia.”

Bronchial affections have been very prevalent and obstinate. The climate of this section rather conduces to the development and continuance of catarrhal affections, and but few are entirely free from its annoyances.

Eruptive diseases have prevailed quite extensively in some parts of the county, and in the adjoining towns of New York State.

Measles of a rather severe type was quite prevalent during the early spring months. Nearly all of those under my care were complicated, and protracted by throat and lung affections. One case under my care proved fatal by being complicated with “capillary bronchitis."

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Mumps have been rather prevalent in some parts of the county.

There have been a few cases of scarlet fever, but they have been mostly of a mild type.

A few cases of diphtheria, that dreaded disease, have occurred, but were characterized by an extremely mild type and of short duration.

In obstetrics, my practice has been quite extensive during the past year. Most of the cases were of head presentation, and were in labor less than twenty-four hours. I have had only three cases that required the assistance of the forceps. I gave chloroform when demanded, and also in those cases of rigid os uteri with severe pains. It operates as a relaxant, and I have also thought, in some cases in which I have exhibited it, that it acted as a parturient. I do not give it to complete anesthesia, but only during the pains. It acts very efficiently in my hands, and as yet I have met with no accident of any kind.

In the line of surgery I have had the usual number of cases of fracture and dislocation to attend to, but none of them presented any features worth narrating. I will append a brief history of a case of “Malignant Disease of the Testicle,” in which I resorted to the operation of castration, with death of the patient on the tenth day after the operation :

S. B. J- aged 44, of lymphatic temperament, and of good average health up to within two years of his death. First began to feel twinging pains in right testicle, which began to swell perceptibly, and continued to enlarge until it had attained the size of a pint cup. It became very hard and painful, with a very large collection of serum in the tunica vaginalis. He wore a suspensory bandage, and applied to several surgeons for advice. He found nothing to relieve him, and at last called upon me. My first operation consisted in the introduction of the trocar and canula into the tunica vaginalis, from which I drew off about one pint of serum; this afforded him very great relief for a time. The testicle became firmly adherent to the tunica albuginea and tunica vaginalis; they were firmly bound together. His general health became very much impaired, and he suffered great pain in the testicle and cord, which was constant. As a last resort, he finally consented to an operation.

The patient was placed under the influence of chloroform, and I proceeded to the operation. The operation consisted of a longitudinal incision commencing high up above the tumor, and extending its whole length. I found the testicle firmly adherent to both tunics, and so firmly united that it was impossible to dissect them apart. I was therefore obliged to remove the entire mass. The

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