REPORT OF LAURENCE TURNBULL, M.D., OF PENNSYLVANIA, SECRETARY OF THE AMERICAN DELEGATION TO THE FOREIGN SOCIETIES.

TO THE PRESIDENT AND MEMBERS

OF THE AMERICAN MEDICAL ASSOCIATION.

ACCORDING to the instructions conveyed in the circular letter received from your body, we presented ourselves at the ancient city of Cork, August 4th, 1879, and were received with great courtesy by the President and members of the British Medical Association. The various members of the medical profession, with the Mayor, ex-Mayor and citizens of Cork, did everything in their power to make the 47th annual meeting of the British Medical Association a perfect success. The American Delegation owe especial thanks to the President, local Secretaries, and particularly to the Honorary local Secretary, Professor II. Macnaughton Jones, for his warm and generous hospitalities, his untiring zeal, and successful efforts in adding to the comfort and general harmony of the meeting.

The following is a list of the delegates from the American Medical Association: Drs. Lewis A. Sayre, E. Seguin, Beard, and Gray, of New York; Dr. Hodgen, of St. Louis; Drs. L. Palmer and Yandell, of Louisville; Dr. Byford, of Chicago; Dr. Robert Battey, of Georgia; and Drs. Da Costa and Turnbull, of Philadelphia.

First General Meeting of Members, Tuesday, August 5, 1879.— The President, Dr. Falconer, of Bath, occupied the chair. After the reading of the minutes by the general Secretary, the retiring President made a short address on the more salient occurrences in the Association during the year, and stated, in conclusion, that the total number of members was 7800. At the close of the President's address, Dr. Sullivan, President of Queen's College, introduced the President-elect, Dr. Dennis O'Connor, who took the chair, and delivered his address as

follows: "When several thousand men, many of them the most distinguished and honored in their profession for genius and learning, are banded together for one common object, we will readily assume that object to be large, comprehensive, and benevolent; and what purpose of greater magnitude can occupy the human mind, or stir the human heart, than the effort to lighten the burden of sickness or misery, and to defer the inevitable death in which we all have a common inheritance? In forwarding this work, we follow our instincts as men, obey our duty as physicians, and receive a divine sanction as Christians. It can then be well understood how so many, leaving their homes, cross the seas or ocean, and come here to unite in this common brotherhood of benevolence. I only hope the success of this meeting, by increasing our knowledge and diffusing throughout the entire medical community sound principles to guide our actions, may be the result of their sacrifices."

The President's address was the effort of a master-mind in the profession, and full of wise and judicious counsels, beginning with a brief reference to the city of Cork, with its numerous charitable and benevolent institutions, and to the social and moral condition of its inhabitants, and concluding as follows: "It is not a humiliating office for the physician to study the means by which nature accomplishes her ends, and, as far as his knowledge permits, to imitate her. I know the assertion of a vis medicatrix nature' is now nearly obsolete, and equally so the seeking of primary causes for vital phenomena. These oldfashioned ideas have been extinguished by modern philosophy, which asserts that all organizations and its operations are the result of blind chance, without a mind to fashion or guide them. The physician, with his opportunities for observation, must be blind, indeed, who does not see beyond this darkness a clear light, showing him that all nature has been conceived and formed in beauty and order, the result of Divine purpose directed by Divine benevolence."

Section of Medicine.-The first paper read was on "Mountain Air in the Treatment of Phthisis," by Dr. II. Bennett. His objection to mountain regions in winter in Europe for any invalids is, that from eighteen to twenty hours in the twenty-four must be spent in stove-heated rooms, and in bad weather the entire twenty-four. On the north shores of the Mediterranean, as on the plains of Central America, the phthisical patient may live in

an atmosphere of pure air, with windows more or less open, all the winter, day and night.

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Dr. George M. Beard, of New York, read a paper on Inebriety and Allied Nervous Diseases," and stated the disagreeable fact that there is no country in the world where there is so much total abstinence from drinking, and at the same time so much inebriety, as among the people of the northern and eastern parts of the United States. Inebriety is," he stated, "to be treated on the same principles as other nervous diseases of the same family to which it belongs, that is, first by keeping the patient away from the exciting causes, and secondly by fortifying the system with sedatives and tonics. For very many cases asylums are indispensable. The best law on the whole is the law of the State of Connecticut, which is very similar to the Habitual Drunkard' act which has been passed by the English Parliament."

Dr. Wm. Squire followed with a paper on the "Treatment of Rheumatism by means of Iron and Salicylic Acid in the Form of Salicylate of Soda." The conclusions arrived at, after a free discussion of this paper, were, that there was no suitable criterion whereby to determine the therapeutic effects of any drug upon rheumatic fever; that while the influence of salicylic acid, and its compounds, removed somewhat speedily the malaise of which the rheumatic sufferer complained, it was extremely doubtful whether they in any degree diminished the peril of secondary, cardiac, or other inflammatory complications.

Several papers were read on alcohol in fever: by two physi cians from Scotland, and one by an Irish gentleman holding extreme views on both sides, and yet there was a union of their views that alcohol was valuable in the treatment of fevers.

Dr. Morell Mackenzie, of London, then read a very valuable article on "Laryngeal Phthisis." He stated that to the naked eye appearances of laryngeal phthisis cannot be relied upon; but with the history of loss of voice, and an examination by the laryngoscope, there will be found pale pyriform swellings of the aryepiglottic folds, and a pale turbid-like thickening of the epiglottis, more or less uniform, and small, scattered ulcers, which are the characteristic features of the disease. The prognosis is always unfavorable, the ordinary duration of life after the throatsymptoms have become troublesome being from twelve to eighteen months. The only treatment which is of any use consists in

the employment of palliative remedies. Where there is pain in swallowing, insufflation of morphia with powdered gum arabic gave the greatest amount of relief.

Second day at 11 o'clock.-The second general meeting of the Association was held, Dr. O'Connor, President, in the chair.

Dr. Alfred Hudson, Regius Professor of Physic in the University of Dublin, then read an address on "Medicine." Dr. Hudson was evidently a great favorite, as he was received with great applause by the audience. He reviewed the earlier history of medical progress, and dwelt at length on the work done by the celebrated French physician Laennec, giving his views, and contrasting them with those of modern observers, especially Niemeyer.

Subsection of Otology, Wednesday, August 6th.-The work of the subsection was opened by Dr. Cassells, of Glasgow, with the following remarks: "We are met to discuss the subject of otology in general, separated from the other sections into which the work of this Association is divided. It is, indeed, a memorable occasion, seeing that this subject of otology has received to-day, for the first time, a distinct recognition in the proceedings of any medical congress in this country. On the continent of Europe and in the United States of America it has long been distinctly recognized in every great medical gathering. That it should have remained unrecognized till now in Great Britain, where scientific aural surgery had its birth and still has its home, notwithstanding the immense and valuable labors of our confrères on the continent of Europe and America, is to me inexplicable. For Saunders, who, in the early part of this century, laid down the principles of conservative aural surgery, for the first time in the history of otology; Toynbee, who laid the foundation of aural pathology, and may justly be called the father of British aural surgery; Wilde, who advanced the subject of aural therapeutics as no one had done before him; and Hinton, who gathered up the sum of the labors of his predecessors, so that it has been said of his works in this department, that they will serve as stepping-stones for others to rise upon,' had not the satisfaction of seeing the subject of otology recognized as it is, happily, for us to-day. We have to elect a chairman of this subsection. I shall not detain you longer than to say that our choice has fallen upon a gentleman who is well known, not only in his native country, but all the world over, as one who has advanced,

not only the subject of otology, but science in general. I allude to Dr. Laurence Turnbull, of Philadelphia, and I propose that he be requested to preside this day over the labors of this subsection."

The proposition having been seconded and carried unanimously, Dr. Laurence Turnbull took the chair, returned thanks, and said: "I return you my most cordial thanks for the honor you have done me in electing me the chairman of this subsection. I do not accept this as a compliment to me alone as an otologist, but as an expression of kindness and good feeling on your part to the otologists of the United States, of whom I am the representative. It is true, I have won my spurs in this department, as the larger portion of my professional life has been devoted to its study and practice. It seems perfectly proper at this time to look back to the source whence I received my chief inspiration, and to the fountain from which I first drank its living waters. I can with pleasure refer to the late Sir W. R. Wilde, of Dublin, whose work did more for the advancement of true and scientific knowledge of the ear and its diseases than any of its predecessors; and I am proud also to state that it was at once republished in Philadelphia, and became the standard authority on the subject throughout the United States. Our specialty has made great and rapid advances of late years in Germany, France, Great Britain, and the United States. The true scientific reformation, however, began in Ireland, and I am happy to think that the mantle of the lamented Wilde has fallen upon a most worthy successor."

The first paper read was the "Production of Artificial Deafness, being an Experiment in Physiological Acoustics and its Bearing on the Etiology and Evolution of Diseases of the Ear," by J. Patterson Cassells, M.D., of Glasgow. The object of this experiment was to show that a disturbance in the tympanic tension not only causes defect of function, but tissue changes as well. The experiments employed for the purpose of disturbing the tension of the tympanum were the Valsalvan experiment and Maissiat's experiments; and these seemed to bear out the fol lowing theory of the etiology and evolution of ear disease: 1. A certain degree of tympanic tension is essential to perfect function—that is, perfect hearing. 2. The essential cause of all the affections of the organ of hearing is a disturbance of the normal