OFFICERS AND MEMBERS OF THE FAYETTE COUNTY MEDICAL SOCIETY. President.-Dr. W. S. DUNCAN, Brownsville. Censors. Drs. S. B. P. KNOX, Brownsville, one year; S. A. CONKLIN, Bellevernon, two years; J. C. HAZLETT, New Salem, three years. Drs. S. A. CONKLIN, R. F. CONKLIN, W. S. DUNCAN, J. B. EWING, J. C. HAZLETT, MEMBERS. Drs. S. B. P. KNOX, H. L. ROBERTS, F. C. ROBINSON. W. H. STURGEON, J. S. VANVOORHIS, REPORT OF THE INDIANA COUNTY MEDICAL SOCIETY. As yet not having succeeded in getting any of my medical brethren of this county, except one, to furnish material for a report, I have concluded to write briefly some personal observations. Having been appointed on the Sanitary Committee, I dislike to see our county a blank altogether, or with only the report from a single contributor. We may say that our county still continues to be very clear of the common epidemics, and a state of general good health prevails. The sickness that does exist is not of a grave nature, but generally mild and easily manageable with suitable treatment. We have still the existence of a nervous condition, an account of which I gave in my report of last year. It has not been prevailing so extensively this year as last, but is taking on new features, and in the last year has attacked many men as well as women, producing in many instances much mental derangement, but not lasting so long nor so liable to relapse into severity as formerly. The disease has been prevailing very extensively along the river below this in the districts of other physicians, by whom I have been informed that it is more violent in the attack and severe in its course throughout, but not of so long duration as cases I had seen the previous year. I had a few of these cases out on the banks of the Blacklick, that, with some additions, were a pretty full development of the disease as it existed last year. There was a continuous heavy headache, flushed cheeks, high fever, with dull heavy countenance, similar to the active stage of typhoid fever, and, were it not for some conditions, would be readily mistaken for it. There existed very irritable stomach with frequent vomiting, tender bowels with severe purging, heavily coated tongue with red point. Bleeding profusely from the nose was common in these cases, but without relief of headache. This epistaxis was frequent in many cases who were able to go about and attend to regular business and only suffered with a kind of general indisposition. With a little medicine and suitable management these symptoms all passed off in a few days and nothing remained but a slightly irritable condition of the spine, and, in some cases, of the intercostal spaces that gradually subsided. In some cases, however, a low condition of the mind and desponding spirits prevailed or remained for weeks or even months. We had but very few cases of dysentery or cholera morbus during the last summer, and very little catarrhal fever or pneumonia during the winter; a few light cases of scarlatina, no grave cases by us, but some of the sequela proved so with the homœopathic for want of proper treatment of course. In surgery nothing of note occurred. I might mention a case of a very large, and, in my opinion, benign tumor of the encysted variety, of many years' standing. The original and central portion arose near the ensiform cartilage, and gradually enlarged, until now it nearly covers the whole abdomen, with attachments or kind of side wings or lobes to the original. It was becoming very troublesome, and at times painful, but still presented no malignant appearance. With the advice of other physicians, I was willing to attempt its extirpation, but the lady is still unwilling. In obstetrics nothing of importance has occurred, except in two cases. The first, a primipara, was a little premature from a hurt; the labor was tedious. I was absent for a while, and when I returned the labor was vigorous and the head pressing against the perineum, which soon became stretched to the full extent of its endurance, and yet no dilatation of the mouth of the vagina. I was afraid the head would be forced through the perineum, and I resisted the expulsive effort with my hand and with the index finger in the os, using backward traction between the pains, till I finally got it so dilated that the vertex entered and made the passage safely. The second was a supposed eleven months-case which was still more grave, and nearly proved fatal to the mother. I have met with many cases of over-term in my practice of twenty-five years, producing severe labor, but I never met with such a large child (15 pounds weight); large, solid head, with the fontanelles pretty nearly closed, and the child in every way large and well developed. The mother had a large and well-formed pelvis, and had always borne her children comparatively easy, which made me hopeful, although I was not then informed of the over-time. She was depressed with the fear of “not getting through." I had my forceps along-a thing that should never be neglected-and wanted to use them, but she would become frantic at the mention of them. I was still hopeful, as I had attended her before, and knew she had a capacious pelvis. Her husband was finally called in, and I told him it was her best chance; her pains were violent, and yet the head was pressing against, but had not engaged in, the superior strait. She still stood out against the instruments, and "knew I could not relieve her in that way." She was will ing to die, and proceeded to give her husband advice in regard to her children, of which they had six or seven. I asked him what I should do, owing to her resistance. He wisely answered, "Whatever you think best." Without any ado in shifting her from her position in the middle of the bed, I applied the forceps, and in a very short time delivered the child to the joy of all present, and surely to my satisfaction. I used the Davis forceps, but I am well persuaded that those recommended by Prof. Wallace would be much better for the superior strait. The lady recovered in due time without any special treatment. To the young and inexperienced physician this is a case of much interest, for in the excitement and hurry of the moment he has no time to call counsel; his deliberations and judgment in the case would be overwhelmed in the conflict of thought. If he would proceed with instrumental interference, and succeed, against the will of the patient, all would be right, but failing all would be wrong in the judgment of others. If a man can be sufficiently cool and rational under some such circumstances, it is better to be "helping and doing all you can." As I was appointed on the committee to review and report on this branch of the medical practice, I may, perhaps, be permitted to go back and dilate on some things that may prove useful and interesting. I once was attending a lady in severe labor. I wanted to use the forceps, but she was alarmed at the mention of instruments. The head was in the inferior strait. Labor was severe and without progress. I folded my arms and said it was all I could do for her relief. She soon, however, called for me to "use them then!" I did so, and soon all was over and she was well satisfied. Others again will ask for the help even before the medical man may deem it necessary. Difficult labors, the resort to craniotomy, etc., I believe are mostly owing to this passing the period of common gestation. I one time attended a lady in her second labor, craniotomy having been performed in the first. I dreaded the case greatly, but she got over it well. I was called in the third, which was over-time, she believed, two months. I found she could not be delivered; the operation had to be performed again. The child was very large and the head solid. I then soon moved from that country, and have not heard how she got along afterwards. I have had two cases of hydrocephalus in utero in the course of my practice that went overtime two months; in one case, the head was immensely enlarged, six by eight inches in diameter, and gave great trouble in the delivery. The case was one of consultation with a young physician. The patient had been long in severe labor; I examined and found the head presenting, the soft parts very tender, and the woman irritable. I did not examine sufficiently to discover the hydrocephalus, and, not being satisfied in my own mind why the delivery was delayed, told the young man to turn and deliver. He did so, but the head would not come. I passed up my hand to unlock the chin and bring it down, which I did; he using traction, and so powerfully as to separate the body from the head. Only then did I discover the true nature of the case; and how to pierce the head, rolling loosely in the cavity of the pelvis, was a grave question. I finally succeeded, however, and got all away. The child was supposed to have been dead some time. The other case was one in which the head had bursted and an immense quantity of water was in the uterus, causing much enlargement, and the child was born without head and not much face. Of this case I might say the labor was very tedious, and, after waiting many hours and finding no progress the abdomen immensely enlarged-all the women supposed there were twins. The womb to me appeared more like a bag of water than one with a living child, and I had doubts if there was one in it at all. The os uteri being but very little dilated, I managed to pierce the membranes, upon which several gallons of water escaped. The pains then set in more effectually, and soon the child was born by breech presentation in the condition that I have mentioned. In these cases, or this one in particular, the question may be answered, asked by Dr. J. M. Stevenson, of Adamsburg, Pa., some years ago, in a case given in the Medical and Surgical Reporter, and again referred to in the Transactions of the Medical Society of Pa. in 1865 I think. Of the first case I was not told of any mental trouble, but the second was badly scared by a large snake while gathering berries in a field, and during her pregnancy was wrong in her mind, fearing lest her child should be born part snake. The maternal impression was not strong enough for this; but it would seem sufficient to produce excited action of the brain terminating in hydrocephalus. There are many proofs of these deleterious effects of maternal impressions that should warn every woman enciente to be very careful. I once had a case in which the child was born with but very little cutaneous covering, all raw and in horrible condition, and lived in great misery only a few days, the mother having been frightened by a man coming into her house with a bleeding, lacerated foot and ankle from a wound on the railroad. I also lately delivered a lady, prematurely in labor at six months of utero-gestation, of a stillborn child, who was frightened by something which she was cooking on the stove running over and creating a sudden flash. On the child's breast and side |