REPORT OF THE MONTGOMERY COUNTY MEDICAL SOCIETY.

To embody the transactions of the Montgomery County Medical Society in the form of a report that shall do justice to its standing and proceedings, is a task that might, with much more propriety, have been imposed upon some one of its members better qualified than myself, by reason of long connection with the Association, knowledge gained by punctual attendance on meetings, advantageous professional location in the county, and by natural or acquired fitness for the duty assigned.

With the aid of the Society's "Record Book," so kindly furnished by the Secretary, Dr. Eisenberg, and the appended reports of Drs. Detwiler, Tyson, Eisenberg, and Andrews, I will, however, permit myself to hope, that we may at least occupy a section in the prospective"Transactions," or comfort myself with the assurance, that disappointment in such expectations will lead to wiser selections for this duty in the future.

During the past year an attempt was made to change the number of meetings from six in the year to four. The majority of our members are, however, so enthusiastic in the cause of medical organization, that the measure failed. The full attendance, and animated and protracted discussions which usually characterize these gatherings, should be sufficient argument to sustain the wisdom of this decision. When six full sessions hardly suffice for these beneficial comparisons of experience and narrations of laudable heroism, what motive can there be for reducing the number? And here let me say, that heroism is not lacking with us, so long as Dr. Bradley gives chloral in two-grain doses to children of from three to six months, and forty grains with sixty of bromide of potassium to adults, in either case repeating the dose in an hour, if the desired effect is not produced. Nor are we at liberty to condemn his courageous thrusts to quiet the screaming infant at midnight, or to conquer the raving delirium of confluent smallpox, when he tells us that the "night terrors" did not return after having procured several nights' rest in this way, and that the delirium did not recur after being once subdued. The value of chloral as a therapeutic agent, is frequently

and ably discussed by our members, and the indications are, a growing confidence in its efficacy, with a diminishing fear of its toxic qualities.

Salicylic acid is gaining favor here in the treatment of acute rheumatism.

Some cases of smallpox have occurred in the county during the past winter; but, so far as reported, nearly all modified by previous vaccination.

Scarlatina has not prevailed to any great extent, although limited portions of the county have suffered from epidemics. The treatment by local application of ice, so warmly advocated by Dr. Hiram Corson, whom we regard as the originator of the theory, still meets with determined opposition from some of our number.

The commission appointed by the Governor to locate and erect an asylum for the insane poor of the southeastern district of the State, have selected a site within the borders of the county. Their choice has been severely criticized in many sections of the district. As the location has not yet been approved by the Governor and Board of Public Charities, its action may yet be annulled. In the Society, Dr. Hiram Corson has urged the importance of taking measures to procure the adoption of a plan for its erection, differing from that of similar institutions now existing in the State. The cottage system has been suggested to the different societies of the district, and by some, if not all, was indorsed and recommended to the several commissioners. That the efforts of Dr. Corson are in the interest of the community as well as of the class of sufferers for which the institution is designed, will not be doubted by those who will give the subject the attention which it deserves. Hoping the philanthropic designs of our honored member may receive official recognition before our next report, I append the communications of our members.

Dr. S. B. DETWILER, of Lower Providence, writes:

Having been requested to make a report of the health and character of disease of this section of the county during the last year, it is with pleasure I reply to your request, in handing you a few brief notes taken from memory, the details of which may not be very accurate. During August and the fall months, and the early part of winter, I had quite a number of cases of intermittent fever along the banks of the Skippack, and in the valley of the Perkiomen streams. One peculiarity I noticed in the greater portion of the cases was a severe pain in the head, generally seated in the cerebrum, sometimes in the posterior part of the brain. It appeared

to be of a neuralgic nature, and generally yielded to sulphate of quinine in from thirty-six to forty-eight hours. The expression of those attacked of mature age generally was, when the pain was very severe, "I hope that God will save me from going crazy." The treatment generally consisted in the use of sedatives, until the pulse was reduced, followed by Dover's Powder and sulphate of quinine, or aromatic sulphuric acid and sulphate of quinine; when the bowels were moved too freely I used astringents.

Cholera infantum and diarrhoea in children were of a very mild character, and yielded very readily to common and simple treatment; in fact I gave them very little medicine, but ordered nutritious and easily digested food.

Diphtheria has prevailed to a very limited extent in my practice. during the last year. The cases I have had were of a mild type, and yielded very readily to muriated tinct. of iron and sulphate of quinine given in solution every two hours until an impression was made. For a gargle, I used a saturated solution of chlorate of potassa, alternating with diluted muriate tinc. of iron. In my experience I have never found any medicine equal to the above in this disease; at the January meeting of our Medical Association, some of the members spoke very highly of aromatic sulphuric acid and sulphate of quinine. I have tried them in a few cases since then, and a good recovery resulted, but I am not prepared to give my opinion, based on a few cases.

Pneumonia. I have had quite a number of cases during the latter part of winter and early spring. The ages of those attacked were from the child of one year to that of seventy-three. In children I did not bleed. I used sedatives; fluid ext. veratrum viride, digitalis and tartar emetic, combined with Dover's powder to give rest. In several cases where the skin was very hot and pulse very frequent, I ordered the whole body to be sponged with tepid water, with marked benefit. In several cases of children that just now come to my recollection, where the above treatment was practised, the pulse and inflammation became reduced suddenly. In one case I remember the pulse was reduced to sixty-four beats per minute in a child seven years old; profuse perspiration and prostration followed; the parents became alarmed and sent a messenger after me in great haste to come and see their child-they thought it was dying. When I saw the child and examined it, I told them it was better. They thought it could not be so, but a change in the prescription, and a few days' time removed all the parents' doubts on that point, for the grave symptoms had all disappeared. The disease that was left to be combated was a cough and some soreness in the side affected, for

which I used warm poultices and a counter irritant, made of tinc. iodine f3j and croton-oil f3ss, penciled on twice a day until pustulation commenced. Generally in four or five days the cough and soreness left them, and they were apparently well.

On the 13th of April last, I was called to see Mrs. II. U., aged over seventy. She had not been well for several days. The evening previous to my seeing her she had a chill. When I saw her, the pulse was almost natural; it beat from eighty to eighty-four per minute. She complained of considerable pain in the left side on inspiration, and had very little cough. After examining my patient more carefully, I found that I had a case of pneumonia of the lower lobe of the left lung to treat. I told her it was necessary to bleed her, and she did not object; she sat up on the bed, but said she felt so weak she could hardly sit up; her pulse being not very full and strong, and taking her age and surroundings into consideration, I almost despaired of the case, she being of a delicate constitution at best. I thought of our friend, Dr. Hiram Corson, how emphatic he is in speaking about the treatment of this disease, which inspired me with new zeal to consummate my intention. I took about sixteen ounces of blood; she bore it well and said she could breathe better. I then treated her with sedatives internally, sinapisms, poultices, and tinc. of iodine and croton-oil mixture externally. In one week from the attack all grave symptoms had disappeared, and she regained her strength rather slowly, although in two weeks from the first attack she was down stairs again doing light work. I feel confident that had she not been bled I would have lost my patient.

Scarlet Fever.-I have had no epidemic of scarlet fever during this last year, but some sporadic cases. Two families were attacked with it; the first in the beginning of March, 1876, consisting of four children, living in the valley of the Perkiomen. The disease had been in a family living on the opposite side of the river, in which one of the first family mentioned, aged 15 years, was rendering assistance during their sickness. She contracted the disease and came home; I was sent for and found her laboring under a mild attack of scarlatina, hardly sick enough to go to bed; she remained in the house about a week, and apparently was well without giving much medicine, except laxatives and cooling drinks. About ten days after the attack she commenced to swell, and could not rest at night; I gave remedies generally used in the sequela of this disease, such as nitrate of potassa, digitalis, squills, and bitartrate of potassa, with laxatives, but all the symptoms, pain in the head, cedema, etc., became aggravated, until convulsions set in, of which she had five or six in twenty-four hours. I continued tinc. digitalis and sweet

spirits of nitre in equal parts, twenty to twenty-five drops, with bitartrate of potassa in half ounce doses every two hours; a blister was applied to the nape of the neck, which relieved her very much. I ordered her wrapped in a blanket steeped in warm water, repeated every half hour or hour until diaphoresis took place. In about two hours the kidneys acted freely, and perspiration was very profuse, the convulsions ceased and rapid recovery followed. Her health now appears to be good. The second one attacked was 13 years old, and her symptoms were more aggravated from the commencement; the glands were somewhat swollen; the tonsils inflamed, and her general appearance was that of malignant scarlatina. I gave her five grains of carbonate of ammonia every two hours in solution, applied cold to the head, and ordered sponging the whole body with water agreeable to the patient in temperature, every half hour or hour, until heat of skin abated, and in a few days all grave symptoms that were prominent at first disappeared, when inflammatory rheumatism set in, and gave me considerable trouble to overcome. The usual remedies employed in this affection, the wine of colchicum seed, and iodide and bromide of potassium, with an occasional Dover's powder, appeared to overcome the pain and tenderness of the joints better than any other medicine employed; she finally got well with partial loss of hearing. The other two cases in this family, aged 9 and 17 years, were of a grave nature, but the disease soon yielded to carbonate of ammonia, followed by muriated tinc. of iron and sulphate of quinine. They all got well, but the second one attacked recovered very slowly.

The other family, consisting of six children, was attacked in the beginning of September, 1876; their ages ranged from 2 to 18 years; there was no scarlatina in the neighborhood, and none of the family had been where it was to their knowledge, and there was no other family attacked in the neighborhood afterwards. The disease was of a mild character, except in two, the symptoms were somewhat aggravated, but soon yielded to treatment. The second one attacked was a little girl 7 years old; the disease appeared to be very mild in her, and she apparently got well in a short time. About three weeks after the attack she became fretful, restless at night, she lost her appetite, and general dropsy followed; I gave a cathartic and diuretic, digitalis, nitrate, and bitartrate of potassa; the kidneys were stimulated to action, the flow of urine increased, and the swelling commenced to disappear; she was kept in her room, but not sick enough to lie down, and unfortunately the window was hoisted behind her bed, a draught of air passed over her, she took a chill, and her urine became scanty, ædema increased, and in thirty